Summary Multiple sclerosis (MS) is a progressive disease of the CNS that is characterised by widespread lesions in the brain and spinal cord. MS results in motor, cognitive, and neuropsychiatric symptoms, all of which can occur independently of one another. The common cognitive symptoms include deficits in complex attention, efficiency of information processing, executive functioning, processing speed, and long-term memory. These deficits detrimentally affect many aspects of daily life, such as the ability to run a household, participate fully in society, and maintain employment—factors that can all affect the overall quality of life of the patient. The increased use of neuroimaging techniques in patients with MS has advanced our understanding of structural and functional changes in the brain that are characteristic of this disease, although much remains to be learned. Moreover, examination of efforts to treat the cognitive deficits in MS is still in the early stages.

https://www.thelancet.com/pdfs/journals/laneur/PIIS1474-4422(08)70259-X.pdf

Cognitive impairment in multiple sclerosis

Aims As part of a larger study to estimate the global burden of disease attributable to alcohol:

• to quantify the relationships between average volume of alcohol consumption, patterns of drinking and disease and injury outcomes, and
• to combine exposure and risk estimates to determine regional and global alcohol-attributable fractions (AAFs) for major disease and injury categories.


Design, methods, setting  Systematic literature reviews were used to select diseases related to alcohol consumption. Meta-analyses of the relationship between alcohol consumption and disease and multi-level analyses of aggregate data to fill alcohol–disease relationships not currently covered by individual-level data were used to determine the risk relationships between alcohol and disease. AAFs were estimated as a function of prevalence of exposure and relative risk, or from combining the aggregate multi-level analyses with prevalence data.

Findings  Average volume of alcohol consumption was found to increase risk for the following major chronic diseases: mouth and oropharyngeal cancer; oesophageal cancer; liver cancer; breast cancer; unipolar major depression; epilepsy; alcohol use disorders; hypertensive disease; hemorrhagic stroke; and cirrhosis of the liver. Coronary heart disease (CHD), unintentional and intentional injuries were found to depend on patterns of drinking in addition to average volume of alcohol consumption. Most effects of alcohol on disease were detrimental, but for certain patterns of drinking, a beneficial influence on CHD, stroke and diabetes mellitus was observed.

Conclusions  Alcohol is related to many major disease outcomes, mainly in a detrimental fashion. While average volume of consumption was related to all disease and injury categories under consideration, pattern of drinking was found to be an additional influencing factor for CHD and injury. The influence of patterns of drinking may be underestimated because pattern measures have not been included in many epidemiologic studies. Generalizability of the results is limited by methodological problems of the underlying studies used in the present analyses. Future studies need to address these methodological issues in order to obtain more accurate risk estimates.

The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease: an overview.

Aims To examine the literature on the associations between alcohol use disorders (AUD) and major depression (MD), and to evaluate the evidence for the existence of a causal relationship between the disorders.

Methods  PsycInfo; PubMed; Embase; Scopus; ISI Web of Science database searches for studies pertaining to AUD and MD from the 1980 to the present. Random-effects models were used to derive estimates of the pooled adjusted odds ratios (AOR) for the links between AUD and MD among studies reporting an AOR.

Results  The analysis revealed that the presence of either disorder doubled the risks of the second disorder, with pooled AORs ranging from 2.00 to 2.09. Epidemiological data suggest that the linkages between the disorders cannot be accounted for fully by common factors that influence both AUD and MD, and that the disorders appear to be linked in a causal manner. Further evidence suggests that the most plausible causal association between AUD and MD is one in which AUD increases the risk of MD, rather than vice versa. Potential mechanisms underlying these causal linkages include neurophysiological and metabolic changes resulting from exposure to alcohol. The need for further research examining mechanisms of linkage, gender differences in associations between AUD and MD and classification issues was identified.

Conclusions  The current state of the literature suggests a causal linkage between alcohol use disorders and major depression, such that increasing involvement with alcohol increases risk of depression. Further research is needed in order to clarify the nature of this causal link, in order to develop effective intervention and treatment approaches.

Alcohol and depression

The aim of the study is to test the assumption that laissez-faire leadership behavior is not a type of zero-leadership, but a type of destructive leadership behavior that shows systematic relationships with workplace stressors, bullying at work, and psychological distress. A survey of 2,273 Norwegian employees was conducted and analyzed. Laissez-faire leadership was positively correlated with role conflict, role ambiguity, and conflicts with coworkers. Path modeling showed that these stressors mediated the effects of laissez-faire leadership on bullying at work and that the effects of laissez-faire leadership on distress were mediated through the workplace stressors, especially through exposure to bullying. The results support the assumption that laissez-faire leadership behavior is a destructive leadership behavior.

The destructiveness of laissez-faire leadership behavior.

Chronic pain and depression are two of the most common health problems that health professionals encounter, yet only a handful of epidemiological studies have investigated the relationship between these conditions in the general population. In the present study we examined the prevalence and correlates of major depression in persons with chronic back pain using data from the first cycle of Canadian Community Health Survey in a sample of 118,533 household residents. The prevalence of chronic back pain was estimated at 9% of persons 12 years and older. Rates of major depression, determined by the short-form of the Composite International Diagnostic Interview, were estimated at 5.9% for pain-free individuals and 19.8% for persons with chronic back pain. The rate of major depression increased in a linear fashion with greater pain severity. In logistic regression models, back pain emerged as the strongest predictor of major depression after adjusting for possible confounding factors such as demographics and medical co-morbidity. The combination of chronic back pain and major depression was associated with greater disability than either condition alone, although pain severity was found to be the strongest overall predictor of disability.

Chronic back pain and major depression in the general Canadian population.

Data from the Canadian National Population Health Survey (1994-1995) were used to evaluate the associations between work stress and major depression (N = 7,344). Major depression was evaluated using the World Health Organization's Composite International Diagnostic Interview- Short Form. Work stress was measured by a 12-item scale in 6 dimensions. Significant associations between work stress and major depression were found. Gender may alter the type of work stress that is most strongly associated with major depression: psychological demands for men and physical demands for women. Some forms of work stress were more strongly associated with major depression in smokers than in nonsmokers.

Perceived work stress and major depression in the Canadian employed population, 20-49 years old.

Objective:To compare the Quality of Life (QOL) of multiple sclerosis (MS) patients with and without lifetime major depression.Method:Data on 136 MS subjects sampled from the University of Calgary M...

Major depression and quality of life in individuals with multiple sclerosis.

The objective of this study was to investigate the effect of persistent alcohol consumption on the risks of major and minor depression. A retrospective cohort study design was used. The data was derived from a large scale longitudinal national health study (Canadian National Population Health Survey). Depression status was evaluated by using the Composite International Diagnostic Interview—Short Form (CIDI-SF) for major depression. Subjects who did not have major depression at baseline were classified into groups according to the persistence of alcohol consumption during the follow-up period. The incidence of major depression in each group was calculated in men and in women separately and were stratified by age. The same procedures were repeated for minor depression. Women who reported having 5+ drinks on one occasion at least once a month were at an elevated risk of major depression. The same pattern was not observed among men in this analysis. However, no difference was found between the groups in terms of the incidence of minor depression. Frequent heavy alcohol use may be a causal factor for major depression among women. Reducing the frequency and quantities of alcohol consumption may offer an opportunity for prevention of major depression among women. Depression and Anxiety 15:42–45, 2002. © 2002 Wiley-Liss, Inc.

Prospective study of frequent heavy alcohol use and the risk of major depression in the Canadian general population.

Objective:To investigate whether alcohol consumption predicts major depressive disorder episodes (MDEs) in the general population.Method:The respondents without depression (n = 12 290) in the longitudinal cohort of the Canadian National Population Health Survey (NPHS) were classified into cohorts based on any drinking, frequency of drinking, maximum number of drinks on a maximal drinking occasion, and average daily alcohol consumption, based on data collected in the 1994–1995 survey. Major depression frequency 2 years later, in 1996–1997, was evaluated and compared across drinking categories.Results:The respondents who reported any drinking, drinking daily, having more than 5 drinks on a maximal drinking occasion, and having more than 1 drink daily on average, did not have an elevated risk of major depression. A trend in the data suggested that women who reported having more than 5 drinks on a maximal drinking occasion might be at a higher risk of major depression. No evidence of confounding or effect mod...

https://journals.sagepub.com/doi/pdf/10.1177/070674370104600708

Alcohol consumption and major depression: findings from a follow-up study.

Objective:To evaluate the impact of major depression on alcohol use in the Canadian general population.Method:This study was based on a 2-year follow-up of the Canadian National Population Health S...

https://journals.sagepub.com/doi/pdf/10.1177/070674370104600507

JianLi Wang

Papers

Perceived work stress and major depression in the Canadian employed population, 20-49 years old.

Major depression and quality of life in individuals with multiple sclerosis.

Prospective study of frequent heavy alcohol use and the risk of major depression in the Canadian general population.

Alcohol consumption and major depression: findings from a follow-up study.

A prospective study of sex-specific effects of major depression on alcohol consumption.