The American Indian and Alaska Native population is a heterogeneous population with significant social, psychological, and alcohol/other drug use risk factors. This article reviews the adult research to date that has examined the overlap between alcohol/other drug abuse and mental disorders. In the adult community and treatment seeking clinical populations, the co-occurrence of alcohol/other drug abuse and mental disorders is particularly high. Some studies among Native American populations have shown higher rates of affective disorders, post-traumatic stress disorders, organic brain disorders, and lower rates of drug abuse/dependence.
The authors present a critical review of the literature produced by Canadian researchers regarding medical co-morbidities and the resources and strategies they recommend for assessing and managing the physical health problems of people with schizophrenia. Scientific production in the field consists of 9 original research articles and 6 literature reviews, revealing a dearth of studies in this area in Canada. The studies examined show that diabetes, obesity, heart disease, and substance abuse are the most frequent co-morbidities affecting people with schizophrenia. Another finding is that most researchers are challenged methodologically to generalize results due to limitations in design or sample characteristics. The authors point to the need for more research to better understand the role of treatment, individual characteristics, lifestyle, and structural issues in the development of co-morbidities among people with schizophrenia. They also discuss the importance of addressing these topics in nursing practice and education.
In Canada, 20% to 30% of the general population currently smoke. Smoking is as common in those suffering from asthma as it is in the general population. However, most studies on the pathophysiology of asthma and its response to treatment only include nonsmokers. Available data that examine the influence of smoking on clinical, functional and inflammatory characteristics of asthma, as well as the influence of smoking on the therapeutic response to corticosteroids, were reviewed. Active smoking is associated with an increased morbidity from asthma and impairs the response to inhaled corticosteroids. These observations emphasize the need for smoking cessation in patients with asthma and for reassessment of current treatment guidelines in this population.
This meta analysis involved 41 studies published between January of 1985 and May of 2006, which examined the co-occurrence of eating disorders (ED) and alcohol use disorders (AUD) in women. Studies were reviewed and a quantitative synthesis of their results was carried out via the calculation of standardised effect sizes. Direction and strength of the relationships between AUD and specific disordered eating patterns were examined. Heterogeneity of reported results was also assessed and examined. Only 4 out of 41 studies reported negative associations between ED and AUD. The magnitude of the associations between eating-disordered patterns and AUD ranged from small to medium size and were statistically significant for any ED, bulimia nervosa (BN)/bulimic behavior, purging, binge eating disorder (BED) and eating disorders not otherwise specified (EDNOS). No association was found between anorexia nervosa (AN) and AUD. The magnitude of the association between BN and AUD was the most divergent across studies and those between each of BED and dietary restriction and AUD were the most consistent across studies. Reported associations of different patterns of disordered eating and AUD were generally weakest and most divergent when participants were recruited from clinical settings and strongest and most homogeneous when participants were recruited from student populations.
A large proportion of cancer survivors are of working age, and maintaining health is of interest both for their working and private life. However, patterns and determinants of comorbidity over time among adult cancer survivors are incompletely described. We aimed to identify distinct comorbidity trajectories and their potential determinants.
In a cohort study of Swedish men born between 1952 and 1956, men diagnosed with cancer between 2000 and 2003 (n=878) were matched with cancer-free men (n=4340) and followed over five years after their first year of survival. Comorbid diseases were identified using hospital diagnoses and included in the analysis using group-based trajectory modelling. The association of socioeconomic and developmental characteristics were assessed using multinomial logit models.
Four distinct comorbidity trajectories were identified. As many as 84% of cancer survivors remained at very low levels of comorbidity, and the distribution of trajectories was similar among the cancer survivors and the cancer-free men. Increases in comorbidity were seen among those who had comorbid disease at baseline and among those with poor summary disease scores in adolescence. Socioeconomic characteristics and physical, cognitive and psychological function were associated with types of trajectory in unadjusted models but did not retain independent relationships with them after simultaneous adjustment.
Among working-age male cancer survivors, the majority remained free or had very low levels of comorbidity. Those with poorer health in adolescence and pre-existing comorbid diseases at cancer diagnosis may, however, benefit from follow-up to prevent further increases in comorbidity.