Mental distress among young adults in Great Britain: long-term trends and early changes during the COVID-19 pandemic.

PURPOSE: In Great Britain, few studies documented mental health trends in young adults in the years preceding 2020, the mental health dimensions affected, and how these compare with changes observed during the COVID-19 pandemic. METHODS: Long-term trends in mental health among 16-34 year old men and women between 1991 and 2018, and changes between 2018-19 and July-September 2020 were examined using all waves from the British Household Panel Study (1991-2008), the UK Household Longitudinal Study (2009-20), and the first five UKHLS COVID-19 waves administered in April, May, June, July, and September 2020. Findings are based on the GHQ-12 continuous score (0-36), clinically significant cases (4 + /12) and severe cases (7 + /12) for mental distress, and item endorsements. RESULTS: Between 1991 and 2018, the prevalence of cases (4 + /12) increased from 14-22% to 19-32% across groups. Increases were largest in women aged 16-24. In April 2020, the risk of caseness (4 + /12) increased across groups by 55% to 80% compared to the 2018-19 baseline. This increase, however, rapidly diminished over time: in July-September 2020, there was only a higher risk of caseness (4 + /12) in men aged 25-34 (prevalence ratio = 1.29, 95% CI 1.01-1.65) compared to the 2018-19 baseline. CONCLUSION: Whereas distress surged in April 2020, its return to pre-pandemic levels by September 2020 highlights the nuanced impact that the pandemic may have over time. Given the magnitude of the decline in mental health over the past decade, attention must be given to young adults once the pandemic ends.

Transition milestones and life satisfaction at ages 25/26 among cohorts born in 1970 and 1989-90.

The transition to adulthood has become more prolonged, complex, and risk-laden over the past two decades. These changes may contribute to the decline in wellbeing observed among young adults. We test the role of reaching different transition milestones on life satisfaction by ages 25-26 among men and women born 20 years apart in 1970 and 1989-90, using data from the 1970 British Cohort (men n = 3764, women n = 4568) and Next Steps (men n = 3246, women n = 4281) studies. We regressed life satisfaction on education, housing tenure, cohabitation with parents, economic activity, relationship status, and parenthood, and tested the role of changes in the prevalence and association of milestones in explaining cohort differences in life satisfaction using decomposition analyses. Home ownership, full-time employment, cohabitation with a partner, and marriage were robust predictors of life satisfaction in both cohorts. Comparing cohorts, the association of milestones with life satisfaction was stable among men but differed among women: in the later-born cohort, women no longer benefitted from higher education and further suffered from not being in full-time employment. The findings shed new light on the relationships between young adult transitions and life satisfaction during the third decade of life. These support the argument that decreases in wellbeing may be driven by changes in the prevalence and meaning of these milestones over time, particularly among women.

Has the distribution of smoking across young adult transition milestones changed over the past 20 years? Evidence from the 1970 British Cohort Study (1996) and Next Steps (2015-16).

INTRODUCTION: Transitions into work and family life during young adulthood exacerbate differences in the progression of smoking over the life-course. Few have considered how changes in smoking and the transition to adulthood in the past two decades have influenced these relationships over time. METHODS: We compared the distribution of smoking at ages 25-26 across transition milestones among 3764 men and 4568 women in the 1970 British Cohort study (1996) and 3426 men and 4281 women in the Next Steps study (2015-16). We regressed occasional and daily smoking status on educational attainment, economic activity, living arrangements, relationship status, and parenthood, adjusting for family background, socio-demographics, and smoking history. RESULTS: There were few differences in associations between the 1996 and 2015-16 samples. Young men and women were less likely to smoke if they had higher education, were homeowners, and cohabited with a partner. Women were less likely to smoke occasionally if they were full-time students, and men were less likely to smoke daily if they were employed full-time and not living with children. However, comparing associations in 2015-16 to 1996: 1) in men, higher education had a weaker negative association and living with a partner had a stronger negative association with daily smoking; 2) in women, independently renting had a weaker positive association with daily smoking. CONCLUSIONS: Despite considerable changes in smoking and the transition to adulthood over the past two decades, the distribution of smoking at ages 25-26 across transition milestones has been relatively stable during this time period in Great Britain.

Sequelae of prospective versus retrospective reports of adverse childhood experiences.

Retrospective assessment of adverse childhood experiences is widely used in research, although there are concerns about its validity. In particular, recall bias is assumed to produce significant artifacts. Data from a longitudinal cohort (the British National Child Development Study; N=7710) and the retrospective Mainz Adverse Childhood Experiences Study (N=1062, Germany) were compared on 10 adverse childhood experiences and psychological adjustment at age 42 yr. Between the two methods, no significant differences in risk effects were detected. Results held for bivariate analyses on all 10 childhood adversities and a multivariate model; the latter comprises the childhood adversities which show significant long-term sequelae (not always with natural parent, chronically ill parent, financial hardship, and being firstborn) and three covariates. In conclusion, the present data did not show any bias in the retrospective assessment.

A severity scoring tool to assess the neurological features of neuronopathic Gaucher disease.

Type III Gaucher disease is one of the three recognized subtypes of Gaucher disease, an inherited deficiency of lysosomal glucocerebrosidase. Phenotypically there is a wide spectrum of visceral and neurological manifestations. Enzyme replacement is effective in managing the visceral disease; however, the neurological manifestations remain a more challenging obstacle. There is an unfulfilled need to reliably monitor neurological disease and its response to treatment. A severity scoring tool was developed through neurological domain identification, item generation and tool formation. Domain identification was established based on a retrospective single centre study (n = 15) and a systematic review of publications. Forty-seven patients with neuronopathic Gaucher disease were then assessed using the tool to establish the clinical and statistical reliability of each domain. Judgement quantification of the tool was established through a process of content validity involving five European experts. Content validity is considered to be most effective when undertaken systematically. Concurrent validity and feasibility of the tool was also highlighted. This process allowed a revised and validated version of the tool to be developed.

Childhood mental ability in relation to cause-specific accidents in adulthood: the 1970 British Cohort Study.

BACKGROUND: Few data link childhood mental ability (IQ) with risk of accidents, and most published studies have methodological limitations. AIM: To examine the relationship between scores from a battery of mental ability tests taken in childhood, and self-reported accidents between the ages of 16 and 30 years. METHODS: In the British Cohort study, a sample of 8172 cohort members born in Great Britain in 1970 had complete data for IQ score assessed at 10 years of age and accident data self-reported at age 30 years. RESULTS: The relationship between childhood IQ score and later risk of accident was complex, differing according to sex and the type of accident under consideration. Women with higher childhood IQ were more likely than those with lower scores to report having had an accident(s) while at work, in a vehicle, engaging in sports, and in unspecified circumstances. Adjustment for markers of socioeconomic position weakened or eliminated some of these relations, but higher childhood IQ remained associated with increased risk of sporting and unspecified accidents. Men with higher childhood IQ scores were less likely than those with lower scores to report accidents at work, but more likely to report accidents at home, playing sports or in unspecified circumstances. After adjustment for socioeconomic circumstances, higher childhood IQ in men remained associated with an increased risk of accidents at home or in unspecified circumstances. DISCUSSION: The relationship between childhood mental ability and accidents in adulthood is complex. As in other studies, socioeconomic position has an inconsistent relationship with non-fatal accident type.

Osteoporosis, metabolic aberrations, and increased risk for vertebral fractures after partial gastrectomy.

A case-control study compared 129 men with earlier partial gastrectomy (operation during the period 1952-1961) with 216 men from a community-based population study. All were born 1910-1915 and the mean age was 72 years. Men with a previous partial gastrectomy had vertebral fractures in 19% compared with 4% (P < 0.01) in the control population. Bone mineral density (BMD) in the right calcaneus measured with dual energy photon absorptiometry was 20% lower in men with a Billroth II operation (P < 0.001) and 8% lower with a Billroth I operation (ns). In comparison with the controls, the men subjected to partial gastrectomy had higher serum concentrations of osteocalcin and alkaline phosphatase activity, a lower serum concentration of 25-hydroxyvitamin D (25OHD) and a lower body mass index (BMI). There were no difference in serum concentrations of free calcium, intact parathyroid hormone (PTH), or free thyroxine. The smoking prevalence was significantly higher in men with partial gastrectomy than in controls. Smokers had significantly lower serum concentrations of intact PTH and 25OHD than nonsmokers and also lower BMD and BMI. The relationships between intact PTH on one hand, and ionized calcium (inverse relationship) and osteocalcin (direct relationship) on the other were preserved in smokers, however. Gastroscopy was performed in 78 men with multiple biopsies in the gastric remnant and also in the small intestine. All but two subjects had chronic gastritis. Examination of sternal bone marrow smears showed that 40% of the Billroth-operated men lacked bone marrow reticular iron.(ABSTRACT TRUNCATED AT 250 WORDS)

Peptic ulcer disease in older age groups in Gothenburg in 1985: the association with smoking.

The prevalences of peptic ulcer and smoking were assessed by a questionnaire sent to 6726 residents of Gothenburg selected at random from the birth cohorts 1945, -35, -25, -15, and -05. The point prevalence of peptic ulcer was in all age groups significantly higher among smokers than among non-smokers. The incidence of peptic ulcer in 1985 was deduced from records of ulcers detected at gastroscopy and/or radiography and/or emergency surgery (n = 1402). Smoking habits and previous episodes of peptic ulcer disease were evaluated. The estimated risk of getting peptic ulcer was significantly higher among smokers in all age groups and of both sexes than among non-smokers. Among non-smokers the risk of getting peptic ulcer was significantly higher in men than in women, whereas the risk among smokers showed no sex difference. In people aged 35-84 years, 25.4% (n = 101) of ulcers diagnosed for the first time and 42.0% (n = 246) of relapsing ulcers were estimated to be caused by smoking. The number of smoking years, however, could not be shown to influence the risk of peptic ulcer.

Surgery in patients aged 80 years and over. A retrospective comparative study from 1981 and 1987.

This is a retrospective study from a general surgical unit to evaluate the profile of surgery in patients aged greater than or equal to 80 years in the years 1981 and 1987. The proportion of admissions of such patients rose from 9.6% in 1981 to 15.7% in 1987. There was a twofold increase in emergency admissions and an increase of 30-40% in early (within 24 hours) interventions among the emergency cases of this age group. The postoperative mortality was concentrated to the emergency cases. In more than half of the admittances as well as of the postoperative fatalities the main diagnosis was a benign disease. The surgical procedure was considered to be curative or beneficial in 72% of the patients. To improve the efficiency of surgical therapy in this age group higher priority should be given to elective operations in order to avoid emergency interventions.

Incidence of peptic ulcer disease in Gothenburg, 1985.

OBJECTIVE: To determine the incidence and age distribution of peptic ulcer disease in adults in Gothenburg. DESIGN: Retrospective study of patients with symptoms over one year. SETTING: All gastroenterology and x ray departments. PATIENTS: Any patient found to have an active ulcer crater during 1985. MAIN OUTCOME MEASURES: Sex, age, past history of gastrointestinal ulcers, and smoking habit. RESULTS: In 1985, 1402 peptic ulcers were diagnosed in 1137 adults. Over half (403; 54%) of the ulcers in men and 393 (60%) ulcers in women were in patients aged over 60. All types of ulcer showed increasing incidence with age. The sex ratio of patients aged 40-50 with peptic ulcers was 1:1. Nearly half (109; 48%) of ulcers diagnosed for the first time in men and 129 (57%) of such ulcers in women were in patients aged over 60. Elderly men and women were also more likely to develop haemorrhage. CONCLUSIONS: In Gothenburg there is a surprisingly high incidence of peptic ulcer disease, which increases considerably with age, possibly explained by the availability of modern diagnostic techniques as 1121 (80%) ulcers had been diagnosed by gastroscopy. Compared with earlier studies there was no difference in the incidence between men and women aged 40-50.

Rupture of renal arterial aneurysm in pregnancy. Case report.

The case is described of a patient at term of her second pregnancy with spontaneous rupture of a renal arterial aneurysm, successfully delivered by caesarean section with primary repair of the renal artery. Sixteen cases have previously been reported, but only one was dealt with in a similar way. The literature is reviewed and the aetiology of pregnancy-related arterial aneurysm is discussed.

Lower-extremity ischemia in aortic dissection. Report of three cases.

Reports are presented of three hypertensive men with aortic dissection and signs of peripheral (leg) ischemia. The dissection was of type III b in two cases and type I in one case. Hypotensive medication was given in all cases, but in two of them peripheral vascular surgery became necessary to re-establish the circulation, while in the third case the hypotensive treatment sufficed for improvement of the leg circulation. Collaboration between thoracic and vascular surgeons can be of value in cases of aortic dissection with peripheral ischemia.

Hemodynamic findings before and after resection of abdominal aortic aneurysm.

A preoperative and postoperative hemodynamic study was performed in 20 consecutive patients undergoing elective resection of abdominal aortic aneurysm. Screening for venous thrombosis and pulmonary embolism with 125I uptake test, measurements of maximal venous emptying and pulmonary perfusion scintigraphy were also done before and after the operation. Only five patients complained of intermittent claudication preoperatively, but the laboratory investigations revealed signs of peripheral arterial insufficiency in 15 cases. Maximal venous emptying from the legs was markedly decreased on the first postoperative day and remained significantly below normal on the sixth day. Signs of postoperative thromboembolism appeared in eight patients. These patients did not differ from the others in regard to the pattern of maximal venous emptying. In the three-year follow-up period, the calf blood flow and the ratio of systolic toe pressure to systemic systolic blood pressure were further decreased, despite significant rise in systemic blood pressure.

Persistent duodenal obstruction secondary to pancreatitis. Report of two cases.

Two male alcoholics with persistent duodenal obstruction due to relapsing acute pancreatitis are reported. Both patients were operated upon with gastrojejunostomy. One of the patients had a transient obstruction of the colon at the left flexure. The gut impairment has been followed roentgenologically and by gastroduodenoscopy. The literature concerning intestinal obstruction caused by pancreatitis is reviewed.

A study of the effect of antral distension on gastric acid secretion in man.

In 30 healthy subjects distension of the antrum by a 150-cm3 balloon reduced the acid and volume responses to submaximal stimulation achieved by a continuous intravenous infusion of pentagastrin. The inhibition persisted during perfusion of the stomach with alkaline buffer. The plasma somatostatin concentration did not increase during distension and no somatostatin was detected in the gastric contents. Balloon distension of the antrum during laparotomy did not affect the concentration of somatostatin and gastrin in portal blood in patients with gallbladder disease or duodenal ulcer. The results confirm that antral distension stimulates acid secretion in duodenal ulcer patients without involvement of the gastrin mechanism. Moreover, the inhibition of acid secretion by antral distension in healthy subjects is independent of luminal pH and does not appear to be mediated by somatostatin.

The effect of antral distension in healthy subjects on betazole-stimulated gastric acid secretion and the plasma concentration of immunoreactive neurotensin.

Antral distension in seven healthy subjects had the same inhibitory effect, approximately 20% inhibition, on gastric acid secretion stimulated by pentagastrin and betazole (Histalog). The plasma concentration of neurotensin in peripheral venous blood was unchanged during antral distension in healthy subjects. The plasma concentration of neurotensin in portal blood was also unchanged during antral distension in anaesthetized duodenal ulcer patients and in non-ulcer patients. The inhibition of pentagastrin-stimulated gastric acid secretion by balloon distension of the antrum was unchanged by preceding intramuscular injection of metoclopramide. The inhibitory effect of antral distension on gastric acid secretion in healthy subjects does not seem to be mediated by secretin, cholecystokinin, bulbogastrone, neurotensin, or a dopaminergic mechanism.

The effect of antral distension on the endocrine pancreas in man.

Isolated antral distension by a 150 cm3 balloon in man significantly elevated the plasma concentrations of pancreatic polypeptide and glucagon in portal venous blood. The concentrations of plasma pancreatic glucagon, plasma insulin, and plasma glucose were unchanged in peripheral venous blood during antral distension with or without a background infusion of pentagastrin. Antral distension significantly increased the plasma concentration of pancreatic polypeptide in peripheral venous blood. Antral distension also inhibited basal and pentagastrin-stimulated gastric acid secretion in healthy subjects. The release of pancreatic hormones evoked by antral distension cannot explain the concomitant inhibition of gastric acid secretion. The results support and extend the concept of a gastro-pancreatic reflex to the endocrine part of the pancreas with release of at least pancreatic polypeptide and glucagon.

The effects of beta-adrenergic receptor blockade on the inhibition of gastric acid secretion, and the release of pancreatic polypeptide by antral distension in healthy subjects.

In a randomized double-blind study of seven healthy subjects an intravenous injection of metoprolol and propranolol did not change the submaximal gastric acid response to pentagastrin. The inhibition of pentagastrin-stimulated acid secretion by balloon distension of the antrum was unchanged by a preceding intravenous injection of metoprolol or propranolol. The plasma level of pancreatic polypeptide in peripheral venous blood showed a significant rise during antral distension. This rise was unaltered by a preceding injection of metoprolol and slightly depressed by propranolol. We conclude that the inhibitory effect of antral distension on gastric acid secretion in healthy subjects is not mediated by beta 1 or beta 2-adrenergic mechanisms. The reflex release of pancreatic polypeptide by antral distension may possibly involve a weak beta 2-adrenergic component.