Study objective-Relative risks are frequently assumed to be stable across populations but this may not apply in psychiatric epidemiology where sociocultural context may modify them. Such ecological eVect modification will give curved associations between aggregated risk factor and outcome. This was examined in connection with the ecological association between suicide rates and an aggregate index of religiosity. Design-Ecological study of associations between suicide rates and an index of religiosity, adjusted for socioeconomic variation. The eVect of stratification of the study sample according to levels of religiosity, was examined.
Setting-26 European and American countries.Subjects-Interview data from 37 688 peope aggregated by country. Outcome measures-Age and sex specific (1986-1990) suicide rates. Main result-Adjusted for socioeconomic variation, negative associations of male suicide rates with religiosity were apparent in the 13 least religious countries only (test for interaction F (1, 25)=5.6; p=0.026). Associations between religiosity and female suicide rates did not vary across countries. Conclusion-The bent ecological association was apparent only after adjustment for socioeconomic variation suggesting that, rather than confounding, ecological modification of individual level links between religion and male (but not female) suicide risk is the responsible mechanism. This concurs with micro-level findings suggesting that suicide acceptance depends not only on personal but also on contextual levels of religious belief, and that men are more sensitive to this phenomenon than women. In psychiatric epidemiology, relative risks vary with the exposure's prevalence. This has important implications for research and prevention. (J Epidemiol Community Health 1999;53:204-210)
SynopsisA study was conducted using data from the Health and Lifestyle Survey, a population based community survey of England, Wales and Scotland in which psychiatric morbidity was assessed using the General Health Questionnaire. An association was found between urban residence and the prevalence of psychiatric morbidity (odds ratio 1·54, 95% CI 1·32–1·80) which persisted after adjustment for various confounding factors (odds ratio 1·34, 95% CI 1·13–1·58). The discussion mentions the need for further study into the psychologically harmful elements of urban life.
The study used the methodology of randomly allocating case vignettes to a sample of British consultant psychiatrists to assess the influence of a past diagnosis of alcohol dependence on present treatment attitudes. The case vignettes either did or did not include the previous diagnosis of alcohol dependence and the sex of the 'case' was also randomized. Psychiatrists receiving the vignette with the diagnosis of alcohol dependence were more likely to rate the patient as difficult, annoying, less in need of admission, uncomplaint, having a poor prognosis and more likely to be discharged from follow-up. There was minimal sex difference. Psychiatrist with a special interest in addictions regarded people with a past diagnosis of alcohol dependence as less difficult to manage than their non-specialist colleagues. The implications for education and treatment are discussed.
A collaborative study compared methods for measuring glycosylated haemoglobin in seven laboratories in the United Kingdom. No satisfactory standard for general use was found. Satisfactory internal quality control systems were in use for each assay which allowed the maintenance of a normal range in each participating laboratory. No satisfactory quality control system suitable for general use could be identified. Costs and convenience of the assays are reported. The technical problems with each type of assay and precautions for their use were identified, such as the need for standardization in incubation times, the practicability of automation of colorimetric assays, and the precision of pH needed for buffers in column separation methods. The relevance of the technical problems to interpretation of measurements is also considered. It is concluded that laboratories measuring glycosylated haemoglobin should maintain a normal range, use 'in-house' quality controls to monitor assay performance and keep clinical colleagues informed of the findings and of any changes in methodology that might affect the interpretation of results.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.