The prevalence of comorbid alcohol, other drug, and mental disorders in the US total community and institutional population was determined from 20 291 persons interviewed in the National Institute of Mental Health Epidemiologic Catchment Area Program. Estimated US population lifetime prevalence rates were 22.5% for any non—substance abuse mental disorder, 13.5% for alcohol dependence-abuse, and 6.1% for other drug dependence-abuse. Among those with a mental disorder, the odds ratio of having some addictive disorder was 2.7, with a lifetime prevalence of about 29% (including an overlapping 22% with an alcohol and 15% with another drug disorder). For those with either an alcohol or other drug disorder, the odds of having the other addictive disorder were seven times greater than in the rest of the population. Among those with an alcohol disorder, 37% had a comorbid mental disorder. The highest mental-addictive disorder comorbidity rate was found for those with drug (other than alcohol) disorders, among whom more than half (53%) were found to have a mental disorder with an odds ratio of 4.5. Individuals treated in specialty mental health and addictive disorder clinical settings have significantly higher odds of having comorbid disorders. Among the institutional settings, comorbidity of addictive and severe mental disorders was highest in the prison population, most notably with antisocial personality, schizophrenia, and bipolar disorders. (JAMA. 1990;264:2511-2518)

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=JAMA&articleId=383975&pdfFileName=jama_264_19_026.pdf

Comorbidity of Mental Disorders With Alcohol and Other Drug Abuse. Results From the Epidemiologic Catchment Area (ECA) Study

Mental health is fundamental to health, according to Mental Health: A Report of the Surgeon General, the first Surgeon General’s report ever to focus exclusively on mental health. That report of two years ago urged Americans to view mental health as paramount to personal well-being, family relationships, and successful contributions to society. It documented the disabling nature of mental illnesses, showcased the strong science base behind effective treatments, and recommended that people seek help for mental health problems or disorders. The first mental health report also acknowledged that all Americans do not share equally in the hope for recovery from mental illnesses. This is especially true of members of racial and ethnic minority groups. That awareness galvanized me to ask for a supplemental report on the nature and extent of disparities in mental health care for racial and ethnic minorities and on promising directions for the elimination of these disparities. This Supplement documents that the science base on racial and ethnic minority mental health is inadequate; the best available research, however, indicates that these groups have less access to and avail-ability of care, and tend to receive poorer quality mental health services. These disparities leave minority communities with a greater disability burden from unmet mental health needs. A hallmark of this Supplement is its emphasis on the role that cultural factors play in mental health. The cultures from which people hail affect all aspects of mental health and illness, including the types of stresses they confront, whether they seek help, what types of help they seek, what symptoms and concerns they bring to clinical attention, and what types of coping styles and social supports they possess. Likewise, the cultures of clinicians and service systems influence the nature of mental health services.

Mental Health: Culture, Race, and Ethnicity—A Supplement to Mental Health: A Report of the Surgeon General

Background Understanding the prevalence of schizophrenia has important implications for both health service planning and risk factor epidemiology. The aims of this review are to systematically identify and collate studies describing the prevalence of schizophrenia, to summarize the findings of these studies, and to explore selected factors that may influence prevalence estimates. Methods and Findings Studies with original data related to the prevalence of schizophrenia (published 1965–2002) were identified via searching electronic databases, reviewing citations, and writing to authors. These studies were divided into ‘‘core’’ studies, ‘‘migrant’’ studies, and studies based on ‘‘other special groups.’’ Between- and within-study filters were applied in order to identify discrete prevalence estimates. Cumulative plots of prevalence estimates were made and the distributions described when the underlying estimates were sorted according to prevalence type (point, period, lifetime, and lifetime morbid risk). Based on combined prevalence estimates, the influence of selected key variables was examined (sex, urbanicity, migrant status, country economic index, and study quality). A total of 1,721 prevalence estimates from 188 studies were identified. These estimates were drawn from 46 countries, and were based on an estimated 154,140 potentially overlapping prevalent cases. We identified 132 core studies, 15 migrant studies, and 41 studies based on other special groups. The median values per 1,000 persons (10%–90% quantiles) for the distributions for point, period, lifetime, and lifetime morbid risk were 4.6 (1.9–10.0), 3.3 (1.3– 8.2), 4.0 (1.6–12.1), and 7.2 (3.1–27.1), respectively. Based on combined prevalence estimates, we found no significant difference (a) between males and females, or (b) between urban, rural, and mixed sites. The prevalence of schizophrenia in migrants was higher compared to nativeborn individuals: the migrant-to-native-born ratio median (10%–90% quantile) was 1.8 (0.9–6.4). When sites were grouped by economic status, prevalence estimates from ‘‘least developed’’ countries were significantly lower than those from both ‘‘emerging’’ and ‘‘developed’’ sites (p = 0.04). Studies that scored higher on a quality score had significantly higher prevalence estimates ( p= 0.02).

https://espace.library.uq.edu.au/view/UQ:75868/UQ_PV_75868.pdf

A systematic review of the prevalence of schizophrenia.

Mental health: a report of the Surgeon General.

Background There are well over a million homeless people in Western Europe and North America, but reliable estimates of the prevalence of major mental disorders among this population are lacking. We undertook a systematic review of surveys of such disorders in homeless people. Methods and Findings We searched for surveys of the prevalence of psychotic illness, major depression, alcohol and drug dependence, and personality disorder that were based on interviews of samples of unselected homeless people. We searched bibliographic indexes, scanned reference lists, and corresponded with authors. We explored potential sources of any observed heterogeneity in the estimates by meta-regression analysis, including geographical region, sample size, and diagnostic method. Twenty-nine eligible surveys provided estimates obtained from 5,684 homeless individuals from seven countries. Substantial heterogeneity was observed in prevalence estimates for mental disorders among the studies (all Cochran’s v 2 significant at p , 0.001 and all I 2 . 85%). The most common mental disorders were alcohol dependence, which ranged from 8.1% to 58.5%, and drug dependence, which ranged from 4.5% to 54.2%. For psychotic illness, the prevalence ranged from 2.8% to 42.3%, with similar findings for major depression. The prevalence of alcohol dependence was found to have increased over recent decades.

/pdf/the-prevalence-of-mental-disorders-among-the-homeless-in-5ecyi3qlvm.pdf

The prevalence of mental disorders among the homeless in western countries: systematic review and meta-regression analysis.

• Lifetime and current prevalence of Diagnostic Interview Schedul/DSM-IIIdisorders were determined for a probability sample of homeless adults in the Skid Row area of Los Angeles. Compared with findings from a household sample, prevalence was substantially higher for every disorder assessed. Rates of major mental illnesses were the most disproportionately high. Substance abuse was more highly prevalent among older individuals and Native Americans, while schizophrenia was most highly prevalent among those subjects between 31 and 40 years of age. Rates of both substance abuse and schizophrenia were elevated among individuals who had been homeless many times or for long periods of time. it was estimated that 28% of subjects in this inner-city homeless sample were chronically mentally ill, a percentage that was consistent with results of well-designed studies employing nondiagnostic standardized measures of mental illness, but lower than results of studies relying on clinical judgment to assess the prevalence of specific disorders. There is a need for simultaneous attention to the social welfare and mental health needs of homeless mentally ill individuals.

The prevalence of specific psychiatric disorders among homeless individuals in the inner city of Los Angeles.

This article describes the subsistence-related activities of homeless adults in Los Angeles' downtown area, and examines whether homeless people with chronic disorders such as major mental illness and/or substance abuse differ from those with no chronic disorder in their subsistence adaptation. Findings indicate that homeless people use multiple resources over short periods of time. While minor differences between those with and without disorders were apparent, the general lack of differences between these two groups was most striking, suggesting the leveling quality of homelessness. Differences between individuals with various chronic disorders indicated that those with chronic substance abuse, and particularly those with both substance abuse and chronic mental illness, were most distinctive in their adaptation.

Subsistence Adaptation Among Homeless Adults in the Inner City of Los Angeles

Heterogeneity in an inner-city homeless population: A comparison between individuals surveyed in traditional skid row locations and in voucher hotel rooms.

The commercialization of dicamba-resistant soybean has resulted in increased concern for off-target movement of dicamba onto sensitive vegetation. To mitigate the off-target movement through physical drift, one might consider use of rope wicks and other wiper applicators. Although wiper-type application methods have been efficacious in pasture settings, the utility of dicamba using wiper applicators in agronomic crops is not available in scientific literature. To determine the utility of roller wipers for dicamba applications in dicamba-resistant soybean, two separate experiments were conducted in the summer of 2020 and replicated in both Keiser and Fayetteville, AR, USA.Utilizing opposing application directions and a 2:1:1 ratio of water: formulated glyphosate: formulated dicamba were the most efficacious practices for controlling Palmer amaranth. The high herbicide concentrations and wiping in opposing directions increased dicamba-resistant soybean injury when the wiper contacted the crop, but no yield loss was observed because of this injury. Broadcast applications resulted in greater Palmer amaranth mortality than roller wiper applications, and the most effective roller wiper treatments were when two sequential applications were made inside the crop canopy.Dicamba applications require adequate coverage for optimum weed control. While efforts can be made to increase roller wiper efficacy by optimizing coverage and timing of applications, broadcast applications are superior to roller wiper applicators for weed control. Roller wiper applications did not reduce soybean yield, thus wiper-type applications may be safely used in dicamba-resistant soybean, albeit the likelihood for off-target damage caused by volatilization of these treatments would need to be investigated. © 2022 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry. 

Rodger K. Farr

Papers

The prevalence of specific psychiatric disorders among homeless individuals in the inner city of Los Angeles.

Subsistence Adaptation Among Homeless Adults in the Inner City of Los Angeles

Heterogeneity in an inner-city homeless population: A comparison between individuals surveyed in traditional skid row locations and in voucher hotel rooms.

Utility of Roller Wiper Applications of Dicamba for Palmer Amaranth Control in Soybean