Last data update: Sep 23, 2024. (Total: 47723 publications since 2009)
Records 1-6 (of 6 Records) |
Query Trace: Pratt LA [original query] |
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Excess mortality among people who report lifetime use of illegal drugs in the United States: A 20-year follow-up of a nationally representative survey
Walker ER , Pratt LA , Schoenborn CA , Druss BG . Drug Alcohol Depend 2016 171 31-38 OBJECTIVE: The purpose of this study was to determine the mortality risks, over 20 years of follow-up in a nationally representative sample, associated with illegal drug use and to describe risk factors for mortality. METHODS: We analyzed data from the 1991 National Health Interview Survey, which is a nationally representative household survey in the United States, linked to the National Death Index through 2011. This study included 20,498 adults, aged 18-44 years in 1991, with 1047 subsequent deaths. A composite variable of self-reported lifetime illegal drug use was created (hierarchical categories of heroin, cocaine, hallucinogens/inhalants, and marijuana use). RESULTS: Mortality risk was significantly elevated among individuals who reported lifetime use of heroin (HR=2.40, 95% CI: 1.65-3.48) and cocaine (HR=1.27, 95% CI: 1.04-1.55), but not for those who used hallucinogens/inhalants or marijuana, when adjusting for demographic characteristics. Baseline health risk factors (smoking, alcohol use, physical activity, and BMI) explained the greatest amount of this mortality risk. After adjusting for all baseline covariates, the association between heroin or cocaine use and mortality approached significance. In models adjusted for demographics, people who reported lifetime use of heroin or cocaine had an elevated mortality risk due to external causes (poisoning, suicide, homicide, and unintentional injury). People who had used heroin, cocaine, or hallucinogens/inhalants had an elevated mortality risk due to infectious diseases. CONCLUSIONS: Heroin and cocaine are associated with considerable excess mortality, particularly due to external causes and infectious diseases. This association can be explained mainly by health risk behaviors. |
Excess mortality due to depression and anxiety in the United States: results from a nationally representative survey
Pratt LA , Druss BG , Manderscheid RW , Walker ER . Gen Hosp Psychiatry 2015 39 39-45 OBJECTIVES: We compared the mortality of persons with and without anxiety and depression in a nationally representative survey and examined the role of socioeconomic factors, chronic diseases and health behaviors in explaining excess mortality. METHODS: The 1999 National Health Interview Survey was linked with mortality data through 2011. We calculated the hazard ratio (HR) for mortality by presence or absence of anxiety/depression and evaluated potential mediators. We calculated the population attributable risk of mortality for anxiety/depression. RESULTS: Persons with anxiety/depression died 7.9years earlier than other persons. At a population level, 3.5% of deaths were attributable to anxiety/depression. Adjusting for demographic factors, anxiety/depression was associated with an elevated risk of mortality [HR=1.61, 95% confidence interval (CI)=1.40, 1.84]. Chronic diseases and health behaviors explained much of the elevated risk. Adjusting for demographic factors, people with past-year contact with a mental health professional did not demonstrate excess mortality associated with anxiety/depression while those without contact did. CONCLUSIONS: Anxiety/depression presents a mortality burden at both individual and population levels. Our findings are consistent with targeting health behaviors and physical illnesses as strategies for reducing this excess mortality among people with anxiety/depression. |
Implications of two-stage depression screening for identifying persons with thoughts of self-harm
Pratt LA , Brody DJ . Gen Hosp Psychiatry 2014 36 (1) 119-23 OBJECTIVE: Persons with thoughts of self-harm may need evaluation for suicide risk. We examine the prevalence of thoughts of self-harm and whether persons with thoughts of self-harm are identified when two-stage depression screening is used. METHODS: Data are from the 2005-2010 National Health and Nutrition Examination Surveys. Persons responding positively to question nine of the Patient Health Questionnaire-9 (PHQ-9) are identified as having thoughts of self-harm. We compare two depression cutoff scores for the Patient Health Questionnaire-2 (PHQ-2) to see what percentage of persons with thoughts of self-harm would be identified as needing further screening with the PHQ-9. RESULTS: The prevalence of thoughts of self-harm was 3.5%. Persons 12-17years old, poor and reporting fair or poor health were more likely to report thoughts of self-harm. A cutoff score of three on the PHQ-2 identified 49% of persons with thoughts of self-harm for further screening with the PHQ-9. A cut point of two increased the proportion of persons with thoughts of self-harm continuing for further screening to 76%. CONCLUSIONS: Using a lower cutoff score, two, the PHQ-2 captures more persons with thoughts of self-harm. One quarter of persons with self-harm thoughts may not be identified for further screening when two-stage screening is used. |
Characteristics of adults with serious mental illness in the United States household population in 2007
Pratt LA . Psychiatr Serv 2012 63 (10) 1042-6 OBJECTIVE: This study described the epidemiology of serious mental illness in the adult household population. METHODS: Data from the 2007 National Health Interview Survey of 23,393 adult respondents were used. Serious mental illness was defined when respondents reported that a health professional had told them that they had schizophrenia, bipolar disorder, mania, or psychosis. Sociodemographic and health characteristics, health care utilization, and participation in government assistance programs among adults with and without serious mental illness were compared. RESULTS: Over 2% of adults reported having received a diagnosis of serious mental illness. Thirty-five percent of adults with serious mental illness had a history of homelessness or of having been in jail. Fewer than two-thirds of adults with serious mental illness had seen a mental health professional in the past year. CONCLUSIONS: Adults with serious mental illness were socially disadvantaged and had worse health compared with adults without serious mental illness. |
The association of depression, risky sexual behaviours and herpes simplex virus type 2 in adults in NHANES, 2005-2008
Pratt LA , Xu F , McQuillan GM , Robitz R . Sex Transm Infect 2012 88 (1) 40-4 OBJECTIVES: Depression has been linked to risky sexual behaviours in adolescents, but there is little research among adults. The goal of this analysis was to examine the associations between current depression and self-reported risky sexual behaviours in a nationally representative sample of US adults aged 20-59 years. The authors also examined the association between depression and infection with herpes simplex virus type 2 (HSV-2), a biological marker of risky sexual behaviours. METHODS: The authors used data from the 2005-2008 National Health and Nutrition Examination Surveys. Current depression was measured by the Patient Health Questionnaire-9. Antibodies to HSV-2 were tested using the enzymatic immunodot assay. The authors used logistic regression to examine the associations controlling for socio-demographic variables. RESULTS: Among 5273 adults aged 20-59 years, 7% had depression, 36% reported 10 or more lifetime sex partners, 15% had two or more past-year sex partners and 13% had first sex before 15 years of age. Persons with each of the risky sexual behaviours were more likely to have depression than those without. In stratified analyses, risky sexual behaviours were associated with depression in women but not in men. Among 3940 adults aged 20-49 years, 19% had HSV-2 infection. Persons with HSV-2 infection were more likely to have depression (OR 2.1, 95% CI 1.5 to 2.9). CONCLUSIONS: Risky sexual behaviour is related to current depression in adult women. Healthcare providers should be aware of this association and its potential implications in order to deliver better care for patients with depression or sexually transmitted infections. |
Mental illness surveillance among adults in the United States
Reeves WC , Strine TW , Pratt LA , Thompson W , Ahluwalia I , Dhingra SS , McKnight-Eily LR , Harrison L , D'Angelo DV , Williams L , Morrow B , Gould D , Safran MA . MMWR Suppl 2011 60 (3) 1-29 Mental illnesses account for a larger proportion of disability in developed countries than any other group of illnesses, including cancer and heart disease. In 2004, an estimated 25% of adults in the United States reported having a mental illness in the previous year. The economic cost of mental illness in the United States is substantial, approximately $300 billion in 2002. Population surveys and surveys of health-care use measure the occurrence of mental illness, associated risk behaviors (e.g., alcohol and drug abuse) and chronic conditions, and use of mental health-related care and clinical services. Population-based surveys and surveillance systems provide much of the evidence needed to guide effective mental health promotion, mental illness prevention, and treatment programs. This report summarizes data from selected CDC surveillance systems that measure the prevalence and impact of mental illness in the U.S. adult population. CDC surveillance systems provide several types of mental health information: estimates of the prevalence of diagnosed mental illness from self-report or recorded diagnosis, estimates of the prevalence of symptoms associated with mental illness, and estimates of the impact of mental illness on health and well-being. Data from the CDC 2005-2008 National Health and Nutrition Examination Survey indicate that 6.8% of adults had moderate to severe depression in the 2 weeks before completing the survey. State-specific data from the CDC 2006 Behavioral Risk Factor Surveillance System (BRFSS), the most recent BRFSS data available, indicate that the prevalence of moderate to severe depression was generally higher in southeastern states compared with other states. Two other CDC surveys on ambulatory care services, the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey, indicate that during 2007-2008, approximately 5% of ambulatory care visits involved patients with a diagnosis of a mental health disorder, and most of these were classified as depression, psychoses, or anxiety disorders. Future surveillance should pay particular attention to changes in the prevalence of depression both nationwide and at the state and county levels. In addition, national and state-level mental illness surveillance should measure a wider range of psychiatric conditions and should include anxiety disorders. Many mental illnesses can be managed successfully, and increasing access to and use of mental health treatment services could substantially reduce the associated morbidity. |
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