Epidemiology and Public policy Part 2 Flashcards
(13 cards)
Transition from nicotine use to dependence is associated with being young and female. When compared with whites, which ethnic group/race is less likely to transition from nicotine use to dependence?
Hispanics
Transition from nicotine use to dependence was associated with being young and female. When compared with whites, Hispanics were less likely to transition from use to dependence, whereas Native Americans, Alaskan Natives, and Native Hawaiians and other Pacific Islanders were more likely to transition to dependence.
What affect has the addition of the black box warning by the U.S. Food and Drug Administration on the potential increased risk of suicidal ideation from SSRIs had?
utilization of antidepressants in the pediatric and adolescent populations has fallen
With the addition of the black box warning and the subsequent publicity, utilization of antidepressants in the pediatric and adolescent populations has fallen, with a coincident increase in suicide-related behaviors (Nemeroff et al. 2007). In summary, despite claims to the contrary, the evidence suggests that antidepressant medications exert a protective effect on suicide risk.
Which ethnic group has been shown to have a higher lifetime prevalence of any psychiatric disorder than that of the U.S. population?
American Indian
In American Indian tribes, the lifetime prevalence of any psychiatric disorder (50%–54% in men, 41%–46% in women) has been found to exceed that of the U.S. population (44% in men, 38% in women) (Beals et al. 2005). Past-year prevalence of any psychiatric disorder is lower among African Americans (15%), Asian Americans (9%), and Hispanics (16%) than among non-Hispanic whites (21%) (Alegria et al. 2010).
Which ethnic group/race has the highest lifetime prevalence of major depression among individuals ages 65 to 74 years?
Cubans
The lifetime prevalence of major depression among individuals ages 65–74 years was highest among Cubans (14.7%), Chinese (14.1%), Puerto Ricans (14.0%), and whites (12.8%) compared with Mexican Americans (10.1%), Vietnamese (8.7%), African Americans (5.6%), Black Caribbeans (5.3%), and Filipinos (
Which mental health condition has the highest prevalence among older nursing home residents in the U.S.?
depression
The prevalence of mental health conditions in older nursing home residents to be high: depression 49.6%, anxiety disorders 16.1%, bipolar disorder 2.8%, and schizophrenia 3.6% (Eden et al. 2012).
Which of the following is associated with an increased likelihood of having an anxiety disorder?
low education
Female sex, younger age, single or divorced marital status, low socioeconomic status, poor social supports, and low education are associated with an increased likelihood of anxiety disorders. Whites are more likely to have anxiety disorders than ethnic minorities. Stressful life events and childhood maltreatment are also strong risk factors for anxiety disorders.
Which of the following statements about cannabis is associated with an increased likelihood of transitioning from use to dependence?
body mass index Hispanic comorbid mental disorder earlier onset (before age 14 years) female gender
comorbid mental disorder
Transition from cannabis use to dependence was associated with being young, male, and Alaskan Native or Native American compared with white. Earlier onset (before age 14 years) was associated with less chance of transitioning from cannabis use to dependence, whereas comorbid mental disorders increased the likelihood of transitioning to dependence. The transition from use to dependence occurred faster for cannabis than for alcohol or nicotine.
Which of the following statements about the black box warning by the U.S. Food and Drug Administration regarding the potential increased risk of suicidal ideation from SSRI use is false?
suicidal behavior has been shown to be a consequence of antidepressant use
misclassification of suicidal events may have led to an overestimation of true risk
within the study population from which the original warning was issued, there were no completed suicides
the highest number of suicide attempts occur in the month before treatment
treatment of depression, specifically the use of SSRIs, has a protective effect on emergent suicidal behavior
A relationship between antidepressant use and suicidal behaviors has been reported in the media and psychiatric literature. The impetus for this focus was the addition of a black box warning by the U.S. Food and Drug Administration (FDA) on the potential increased risk of suicidal ideation in children, adolescents, and young adults treated with SSRIs. Of note, within the study population from which the original warning was issued, there were no completed suicides. This warning stirred a debate on the risk versus the potential beneficial effects of treatment with this class of medications. Subsequent analysis of the FDA database using a standardized algorithm for assessing suicidal events, termed the Columbia Classification Algorithm of Suicide Assessment (C-CASA), suggests that misclassification of suicidal events may have led to an overestimation of true risk (Posner et al. 2007). Observational studies have shown that treatment, specifically the use of SSRIs, has a protective effect on emergent suicidal behavior (Gibbons et al. 2005, 2007; G. E. Simon and Savarino 2007). Additional research has shown the highest number of suicide attempts in the month before treatment, suggesting that suicidal behavior is often a precipitant for seeking treatment rather than a consequence of antidepressant use (G. E. Simon and Savarino 2007).
Which statement about suicide mortality in the U.S. is true?
the incidence of suicide deaths among middle-aged adults has been decreasing
suicide mortality has long been lower among men than among women
the rise in suicide rates among those approaching late life may be due in part to a rising incidence of opioid overdose associated with increased availability
the rise in suicide rates among those approaching late life is due in part to more available suicide screening test
the rise in suicide rates among those approaching late life may be due in part to a rising incidence of opioid overdose associated with increased availability
Suicide mortality has long been lower among women than among men. In 2010, the suicide rate was 3.9 per 100,000 women ages 15–24 years versus 4.2 per 100,000 women ages 65 years and older (National Center for Health Statistics 2012). There has been an increase in suicide deaths among middle-aged adults in the United States between 1999 and 2010 (Centers for Disease Control and Prevention 2013). The rise in suicide rates among those approaching late life may be due in part to the economic downtown during the period from 1999 to 2010, to a cohort effect (in that baby boomers had higher suicide rates during adolescence and may represent a cohort at greater risk), and to a rising incidence of opioid overdose associated with increased availability (Centers for Disease Control and Prevention 2013).
Which statement is least accurate regarding opioid use disorder in the United States over the past 10 years?
heroin dependence is a persistent and in many cases lifelong condition
prescription opioid disorders were nearly three times as likely as heroin abuse and dependence
periodic remissions from opioid abuse or dependence are common
the majority of these disorders were related to the dependence of opioids other than heroin
heroin-dependent individuals are more likely than individuals dependent on cocaine or methamphetamine to reduce or cease use in the 10 years following initiation of use
heroin-dependent individuals are more likely than individuals dependent on cocaine or methamphetamine to reduce or cease use in the 10 years following initiation of use
Data from NESARC indicate that 0.4% and 1.4% of the U.S. population were diagnosed in 2001–2002 with a 12-month and lifetime opioid use disorder, respectively (Compton et al. 2007). The majority of these disorders were related to the abuse and dependence of opioids other than heroin. Similar findings were reported in the 2002 National Survey on Drug Use and Health, in which prescription opioid disorders were almost three times as likely as heroin abuse and dependence. Estimated prevalence of opioid dependence in other countries ranges from 0.11% to 0.82% (Degenhardt and Hall 2012). Heroin dependence is a persistent and in many cases lifelong condition. Longitudinal research has shown that heroin-dependent individuals are less likely than individuals dependent on cocaine or methamphetamine to reduce or cease use in the 10 years following initiation of use; however, periodic remissions from opioid abuse or dependence are common (Darke et al. 2007).
Which statement is most accurate regarding the epidemiology of cocaine use in the North America and Europe?
cocaine use has declined in North America, and stabilized in Europe
Cocaine is used by an estimated 13–19.5 million people worldwide (0.3%–0.5% of the population), with the highest rates of use in North America, western and central Europe, South America, and Oceania (Degenhardt and Hall 2012). North America has seen a marked decline in cocaine use, mainly due to a decline in the United States, from 3.0% in 2006 to 2.2% in 2010. However, there has not been a similar decline in Europe, where cocaine use has stabilized.
Which type of school-based substance use prevention program has been shown to be effective in deterring early stage drug use?
therapy sessions with counselors skill-based programs wellness programs physical education group-based programs diet and health education
skill-based programs
According to a Cochrane review (Faggiano et al. 2005) of 32 school-based substance use prevention programs, skill-based programs (e.g., decision making, peer pressure resistance) appear to be effective in deterring early stage drug use.
What is the most common disorder of adolescence?
migraines antisocial personality disorder alcohol intoxication intermittent explosive disorder nicotine use disorder avoidant personality disorder cannabis use disorder histrionic personality disorder major depression
Alcohol intoxication (18-30% report intoxication within the past month)
