This study reports the 12-month prevalence of major depressive episode and its risk factors in a representative nationwide sample.
A random sample of non-institutionalized Finnish individuals aged 15-75 years (N = 5993) was interviewed in 1996. Major depressive episode during the last 12 months was assessed using the Short Form of the University of Michigan version of the Composite International Diagnostic Interview (the UM-CIDI Short Form).
The population prevalence of major depressive episode was 9.3% [95% CI 8.5,10.0], and the age-adjusted prevalences for females and males were 10.9% [95% CI 9.7,12.0] and 7.2 [95% CI 6.2,8.2], respectively. In logistic regression analyses the factors associated with major depressive episode after adjustment for age were urban residency, smoking, alcohol intoxication and chronic medical conditions. In addition, being single and obese were found to be risk factors for males.
The female to male risk ratio for major depressive episode was smaller than in many previous studies. The sex-specific risk factor associations warrant further investigation into sex differences in depression.
Accuracy of hospital discharge register data was studied by comparing 954 randomly selected abstracts to the respective medical records. The average percentages of agreement were: date of birth 98, date of admission 96, date of discharge 94, area of residence 93, principal diagnosis 91, disposition on discharge 89, marital status 84, third diagnosis 83, second diagnosis 76, social group 74, occupation 60, and source of admission 49. Accuracy of items was not related to alcohol etiology. An analysis of variance indicated that the number of items in agreement varied by both diagnosis and type of hospital.
Acute appendicitis has previously been found to be associated with social class. In an attempt to confirm this, 125 patients with histologically verified acute appendicitis were compared with 1802 control children, randomly selected from the schools of the City of Helsinki. Social class determination was based on father's occupation in families with two parents, and on mother's occupation in single provider families. No association with social class was found. The proportion of single provider families was around 25% among both cases and controls. Appendicitis patients are one potential source of control groups in epidemiological studies.
Risk factors for infectious eczematoid dermatitis (IED) were analyzed in a study of males aged 19-50 years. The subjects were 43 IED patients and 226 controls with other skin diseases from the dermatological outpatient clinics of three University Hospitals in Finland. The patients' lifestyles were assessed by a self-administered questionnaire pertaining to two specified periods: the period 12 months before the onset of the skin disease and the period 12 months before the examination date. Recalled mean alcohol intake before the onset of the skin disease was 39.2 g/day for the IED patients and 17.1 g/day for the controls (p = 0.04). The average number of cigarettes smoked daily was 17.7 for the IED patients and 10.4 for the control patients (p = 0.001). The IED patients significantly reduced their alcohol intake after the onset of the skin disease. In logistic regression analysis, IED associated with alcohol intake and smoking but not with coffee consumption, life events, age, marital status, or social group. The odds ratio for IED at an alcohol intake of 50 g/day as against no intake, was 1.7 (95% confidence interval 1.03-2.7), and the odds ratio at a tobacco consumption rate of 20 cigarettes/day as against no use of tobacco, was 2.1 (1.2-3.7). We conclude that alcohol intake and smoking appear to be risk factors for infectious eczematoid dermatitis among males.
Ethnic differences in alcohol intake among male reindeer herders were studied, since historical evidence suggests that Lapps drink more than Finns and since the considerable freedom of the herding occupation may imply a high risk for alcohol problems. In 1988, 2001 men answered a mail questionnaire including questions on alcohol intake over the past 12 months. The mean alcohol intake was 22.3 g/day among the Lapps and 13.2g/day among the Finns (P less than 0.001). The percentage of heavy drinkers (20 g or more daily) was 33.9 among the Lapps and 19.1 among the Finns. The mean frequency of getting drunk was 35 occasions/year among both Lapps and Finns. An analysis of variance showed that alcohol intake was significantly related to age, marital status, region and being of Lappish origin, but not to being a full-time reindeer herder. A significant interaction between region and marital status was also detected. The Lappish reindeer herders drink more than their Finnish counterparts. The ethnic difference is not, however, very large when compared with the stereotypic view of the drunken Lapp.
This cross-sectional analysis examined associations between alcohol intake and subjective health in a random sample (n = 6,040) drawn from the general population aged 25-64 years in Finland in 1992. Self-reported health was good for 3,375 persons and average or poor (suboptimal) for 2,665 persons. Crude odds ratios suggested a U-shaped pattern between alcohol intake and suboptimal health. The pattern took more of a J-shape after data were controlled for sex, age, education, marital status, lack of close friends, being on a disability pension, smoking, being an ex-drinker, and having decreased one's alcohol intake during the past 12 months because of health problems. An interaction was found between alcohol and smoking. The pattern of alcohol odds ratios showed a J-shaped association among never smokers, and a similar pattern was suggested among ex-smokers and current smokers. Among never smokers, the lowest risk was found at the alcohol consumption level of 100-199 g/week (odds ratio (OR) = 0.58, 95% confidence interval (CI) 0.38-0.89). The highest risk was found among persons who regularly smoked > or = 20 cigarettes per day and drank > or = 300 g/week (OR = 4.44, 95% CI 2.36-8.36). The risk for ex-drinkers did not differ from that for lifelong abstainers (OR = 0.89, 95% CI 0.62-1.28), but persons who had decreased their alcohol intake during the past 12 months because of health problems had a higher risk (OR = 1.21, 95% CI 1.05-1.39). The authors conclude that moderate alcohol intake is related to a self-perception of good health.
OBJECTIVE--To clarify the nature of the association between alcohol intake and psoriasis. DESIGN--Case-control study of men aged 19-50 with onset of skin disease in 1976 or later. SETTING--Outpatient clinics of the departments of dermatology of the university central hospitals in Helsinki, Oulu, and Tampere from September 1987 to April 1989. SUBJECTS--144 Patients with psoriasis and 285 unmatched controls with other skin diseases. MAIN OUTCOME MEASURES--Results of clinical examination and self administered questionnaire assessing lifestyle and alcohol intake during two specified periods--namely, 12 months before the onset of skin disease and 12 months before the date of examination. RESULTS--Recalled mean alcohol intake before the onset of skin diseases was 42.9 g/day among the patients with psoriasis and 21.0 g/day among the controls. In logistic regression analysis psoriasis was associated with alcohol intake but not with coffee consumption, smoking, age, marital state, or social group. The odds ratio for psoriasis at an alcohol intake of 100 g/day compared with no intake was 2.2 (95% confidence interval 1.3 to 3.9). The controls decreased their alcohol intake after the onset of the disease but the group with psoriasis did not. Analysis of serum enzyme values showed that gamma-glutamyltransferase activity was significantly correlated with alcohol intake (r = 0.35), the mean activity being 75.0 U/l among patients with psoriasis and 41.9 U/l among controls. CONCLUSIONS--Alcohol is a risk factor for psoriasis in young and middle aged men, and psoriasis may sustain drinking.
Alcohol intake and serum copper, selenium, magnesium, iron and zinc were investigated in 85 subjects, 48 males and 37 females. Alcohol intake was measured with a questionnaire probing alcohol intake during the preceding 30 days. Mean average daily intake among males was 119.7 g (range 0-622.3 g) and among females 32.1 g (range 0-378.5 g), and the mean consumption per drinking day among males was 208.5 g (range 0-666.7 g) and among females 63.8 g (range 0-63.8 g). Among males alcohol intake per drinking day correlated positively with serum copper (r = 0.50; P less than 0.001) and negatively with serum selenium (r = -0.49; P less than 0.001) and magnesium (r = 0.40; P less than 0.01). Likewise, among females alcohol intake per drinking day correlated positively with serum copper (r = 0.54; P less than 0.01) and negatively with serum magnesium (r = -0.36; P less than 0.05). Serum selenium concentration was negatively and significantly correlated with average daily intake (r = -0.34; P less than 0.05) but not with intake per drinking day. No significant correlations were found between alcohol intake and serum zinc or iron levels. Only two men, both abstainers, had abnormally low serum zinc level, and two other men (average daily alcohol intake less than 37 g) and two women (average daily alcohol intake less than 15 g) had abnormally high serum iron level. Alcohol intake was associated with high serum copper and low serum magnesium and selenium levels.
Mortality and morbidity from ischaemic heart disease (IHD) was studied in 5404 Finnish males aged 35-64 years who had been hospitalised for alcohol-related disease in 1972 without any admissions for IHD during that same period. By record-linkage, morbidity and mortality were followed up to the end of 1975. The mortality of patients with alcohol-related diseases was compared to 1120 patients with acute appendicitis by calculating indirectly age-standardised mortality ratios (SMR). The mortality and morbidity of 5963 patients with acute myocardial infarction or angina pectoris was also studied. The following SMRs for IHD mortality, non-fatal-IHD-hospitalisation and for mortality from all causes respectively, were found: acute myocardial infarction 11.6, 7.2 and 7.2; alcohol intoxication 6.0, 4.5 and 4.5; angina pectoris 5.2, 10.5 and 3.4; liver cirrhosis 2.2, 2.5 and 11.8; alcoholism 1.9, 1.9 and 3.6; pancreatitis 1.8, 1.2 and 4.4; alcohol psychosis 1.7, 2.5 and 4.2. IHD mortality and morbidity appeared to be more prevalent in patients hospitalised with alcohol intoxication than in patients with other alcohol-related diseases. This suggests that rapid drinking predisposes both to serious intoxication and to fatal disturbances of cardiac rhythm.
Moderate consumption of alcohol may reduce mortality from vascular diseases. The beneficial effects of alcohol may partly be mediated by its effects on lipoprotein metabolism. We studied the connection between alcohol consumption and the serum lipid profile from a well-documented national health program study.
Carbohydrate-deficient transferrin (CDT) and gamma-glutamyl-transferase (GGT) were used as biochemical markers for alcohol consumption. The laboratory analyses were carried out on 5675 subjects (3097 males and 2578 females). The subjects were divided into quartiles on the basis of CDT or GGT value. The highest CDT quartile and the lowest GGT quartile seemed to be associated with a favorable lipid profile and the lowest CDT quartile and the highest GGT quartile were associated with an unfavorable lipid profile. Serum high density lipoprotein (HDL) cholesterol values were significantly higher and triglycerides lower with increasing serum CDT concentrations for both men and women. Increasing serum GGT was associated with higher serum total cholesterol and higher triglycerides in both men and women and lower HDL cholesterol in men.
CDT and GGT seem to detect different populations of subjects in regard to lipid metabolism. These observations may lead to a better understanding of the effects of alcohol consumption on lipids as well as mechanisms behind favorable and detrimental effects of alcohol on vascular diseases.
Carbohydrate-deficient transferrin (CDT) and gamma-glutamyl-transferase (GGT) were used as biochemical markers for alcohol consumption. A total of 3097 males and 2578 females were divided into quartiles on the basis of their CDT or GGT values. The highest CDT quartiles had higher HDL and lower triglycerides, whereas the highest GGT quartiles appeared to be associated with higher total cholesterol and triglycerides in both genders and lower HDL in men. CDT and GGT seem to detect different populations of subjects in regard to lipid metabolism. These observations may have important clinical and public health implications.