Adverse adult consequences of different alcohol use patterns in adolescence: An integrative analysis of data to age 30 years from four Australasian cohorts

BACKGROUND AND AIMS: Studies have linked adolescent alcohol use with adverse consequences in adulthood; yet it is unclear how strong the associations are and to what extent they may be due to confounding. Our aim was to estimate the strength of association between different patterns of adolescent drinking and longer-term psychosocial harms taking into account individual, family, and peer factors. DESIGN: Participant-level data were integrated from four long running longitudinal studies: Australian Temperament Project; Christchurch Health and Development Study; Mater Hospital and University of Queensland Study of Pregnancy; Victorian Adolescent Health Cohort Study. SETTING: Australia and New Zealand. PARTICIPANTS: Participants were assessed on multiple occasions between ages 13 and 30 years (from 1991-2012). Number of participants varied (up to N=9453) by analysis. MEASUREMENTS: Three patterns of alcohol use (frequent, heavy episodic, and problem drinking) were assessed prior to age 17. Thirty outcomes were assessed to age 30 spanning substance use and related problems, antisocial behavior, sexual risk-taking, accidents, socioeconomic functioning, mental health, and partner relationships. FINDINGS: After covariate adjustment, weekly drinking prior to age 17 was associated with a two to three-fold increase in the odds of binge drinking (OR: 2.14; 95%CI: 1.57-2.90), drink driving (OR: 2.78; 95%CI: 1.84-4.19), alcohol-related problems (OR: 3.04; 95%CI: 1.90-4.84), and alcohol dependence (OR: 3.30; 95%CI: 1.69-6.47) in adulthood. Frequency of drinking accounted for a greater proportion of the rate of most adverse outcomes than the other measures of alcohol use. Associations between frequent, heavy episodic, and problem drinking in adolescence and most non-alcohol outcomes were largely explained by shared risk factors for adolescent alcohol use and poor psychosocial functioning. CONCLUSIONS: Frequency of adolescent drinking predicts substance use problems in adulthood as much as, and possibly more than, heavy episodic and problem drinking independent of individual, family and peer predictors of those outcomes

The Anorexia Nervosa Genetics Initiative (ANGI): Overview and methods

Background: Genetic factors contribute to anorexia nervosa (AN); and the first genome-wide significant locus has been identified. We describe methods and procedures for the Anorexia Nervosa Genetics Initiative (ANGI), an international collaboration designed to rapidly recruit 13,000 individuals with AN and ancestrally matched controls. We present sample characteristics and the utility of an online eating disorder diagnostic questionnaire suitable for large-scale genetic and population research. Methods: ANGI recruited from the United States (US), Australia/New Zealand (ANZ), Sweden (SE), and Denmark (DK). Recruitment was via national registers (SE, DK); treatment centers (US, ANZ, SE, DK); and social and traditional media (US, ANZ, SE). All cases had a lifetime AN diagnosis based on DSM-IV or ICD-10 criteria (excluding amenorrhea). Recruited controls had no lifetime history of disordered eating behaviors. To assess the positive and negative predictive validity of the online eating disorder questionnaire (ED100K-v1), 109 women also completed the Structured Clinical Interview for DSM-IV (SCID), Module H. Results: Blood samples and clinical information were collected from 13,363 individuals with lifetime AN and from controls. Online diagnostic phenotyping was effective and efficient; the validity of the questionnaire was acceptable. Conclusions: Our multi-pronged recruitment approach was highly effective for rapid recruitment and can be used as a model for efforts by other groups. High online presence of individuals with AN rendered the Internet/social media a remarkably effective recruitment tool in some countries. ANGI has substantially augmented Psychiatric Genomics Consortium AN sample collection. ANGI is a registered clinical trial: clinicaltrials.govNCT01916538; https://clinicaltrials.gov/ct2/show/NCT01916538?cond=Anorexia+Nervosa&draw=1&rank=3

Cannabis use and suicidal ideation

Globally, suicide has emerged as the second leading cause of death among youth aged 10–24 years old. In order to better understand the causes of this phenomenon, we investigate the relationship between suicidal ideation and cannabis use. Our empirical analysis is based on a 30-year longitudinal study of a birth cohort. We find that intensive cannabis use – at least several times per week – leads to a higher transition rate into suicidal ideation for males. We find no evidence that suicidal ideation leads to cannabis use for either males or females

The utilisation of preschool health and education services

The distribution of the utilisation of health and education services during the period from birth to 5 years was studied in a birth cohort of New Zealand children. Overall patterns of service utilisation showed the presence of considerable inequities with children in the lowest 8% of the distribution receiving seven or fewer of the available services in contrast to the children in the top 8% of the distribution who received in excess of 15 services. Patterns of service utilisation showed a clear tendency to vary with the child's social and familial characteristics with children from socially disadvantaged home backgrounds, unplanned and later born children, children from economically depressed home environments and children in families facing various forms of stress and adversity showing a clear tendency to receive less care than other children. Path modelling of the results suggested that the child's family social background and family composition made the largest direct contributions to variations in rates of service utilisation with family economic situation and levels of adversity having smaller but nonetheless statistically significant effects. It is concluded that the findings provide a clear case study of the way in which well intentioned social policies may emphasise rather than eliminate inequities in the care received by children.

Neonatal cranial ultrasonography as predictor of 2 year outcome of very low birthweight infants

Abstract Real time ultrasound scans using an ATL 300C sector scanner with 5–7.5 MHz transducer were performed on days 1, 4, 7 and thereafter as clinically necessary on 153 consecutively discharged very low birthweight (VLBW) infants. One hundred and forty-six long-term survivors were assessed fully at 2 years. The prevalence of cerebroventricular haemorrhage (CVH) in these survivors was 34.2% (grade 1—21.2%; grade 2—4.8%; grade 3—3.4%; grade 4—4.8%), ventricular dilatation 19.9% (including 4.1% with ventriculoperitoneal shunt), and ischaemia 9%. Impairments at 2 years were classified as nil, mild, moderate, severe or multiply severe, based on the criteria of Kitchen et al. Overall, 120 infants (82.2%) were unimpaired and 6.2% had mild, 3.4% had moderate, 4.1% had severe and 4.1% had multiply severe impairment. The major factors associated with impairment were gestational age < 28 weeks, birthweight < 1000 g, vaginal delivery, respiratory distress syndrome, mechanical ventilation, pulmonary air leaks and CVH. When these factors were reanalysed in a logistic regression model for odds ratios, only CVH (P < 0.005) and birth by spontaneous vaginal delivery (P < 0.05) were significant. The prevalence of impairment was 11.4% with no CVH, 6.5% grade 1, 71% grade 2, 20.0% grade 3 and 100.0% grade 4 CVH. The sensitivity of CVH of grade 2 or greater as a screening test was 64.7% for impairment, 78.6% for cerebral palsy and 70% for severe intellectual handicap. The mean general quotient (GQ) (Griffiths) at 2 years for infants with CVH was 89.1, and 97.5 for those without CVH (P < 0.001). Although infants with ventricular dilatation had an average GQ that was 13.1 units less than those with normal ventricles, the difference was only significant in those with a CVH of grade 2–4. The study shows the sonographic diagnosis of CVH and ventricular dilatation, but not ischaemia, to be a useful adjunct in predicting impairment and intellectual performance in VLBW infants but does not replace the need for multidisciplinary follow-up