Psychopathology and attrition in the Baltimore ECA 15-Year Follow-up 1981–1996

Westat, RA, Rockville, Maryland 20850-3129, USA.
Social Psychiatry and Psychiatric Epidemiology (Impact Factor: 2.58). 03/1999; 34(2):91-8. DOI: 10.1007/s001270050117
Source: PubMed

ABSTRACT Predictors of non-response were investigated in a 15-year follow-up (1981-1996) of 3,481 individuals in a probability sample from the household population of East Baltimore. Demographics (age, sex, race, education, marital status, and unemployment), household factors (living arrangements, household income, household size, and number of children), cultural variables (ancestral ethnicity and foreign language), social variables (social support and networks, committing felony, carrying a weapon, using an alias, and wandering), health factors (physical illness, health insurance, medical assistance, Medicare, receiving disability benefits, social security, and welfare), interviewer's observation, and psychopathologic variables (mental disorders, suicide behavior, comorbidity, and drug use) were collected at baseline in 1981 and in 1982, then linked to follow-up data between 1993 and 1996. A tracing process involving mail, phone, criss-cross directories, motor vehicle administration records, a commercial credit bureau, the state criminal justice system, hospital records, the US National Death Index, and field tracing were used to locate the original sample. A total of 3,066 respondents of the original sample (88.1%) were traced. Non-response was categorized into Sample Mortality (that part of the original sample that died during follow-up), Sample Loss (that part of the original sample that survived but could not be found) and Refusal (that part of the original sample that survived and was found but refused to participate). Stratified analysis and adjusted multiple logistic regression modeling found sample mortality and sample loss were strongly influenced by individual and household variables and by psychopathology. Sample mortality was influenced by specific mental disorders or conditions as mania, drug abuse/dependency, antisocial personality, cognitive impairment, alcohol abuse/dependency, phobia, drug use (except PCP), and comorbidity. Household factors protective against mortality include higher household income, not living as extended members in a married couple family, and living with children in the household. Persons who were unemployed, widowed or single, without high school education, male, and 65 years of age or older were more likely to die. Sample loss was influenced by cognitive impairment, antisocial personality, and cocaine use. Household factors linked to sample loss include living in female-headed families, or non-family households, and living alone. Young nonwhite, divorced/separated, without high school education, and unemployed were also harder to find. Refusal was associated with being white, with incomplete elementary education, living as a spouse in traditional married couple families, or as a child in female-headed families. Psychopathology did not influence refusal.

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    • "Over time, the sample has been affected by aging and loss to follow-up. Comparison between participant and nonparticipant subjects has revealed only minor demographic differences other than age, but those with antisocial personality disorder were more frequently lost to follow-up (Samuels et al., 2002;Badawi et al., 1999). Thus, the negative findings relating to antisocial personality disorder may be due to reduced power. "
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    ABSTRACT: The serotonin transporter (SERT) polymorphism (5HTTLPR) has been reported to be associated with several psychiatric conditions. Specific personality disorders could be intermediate factors in the known relationship between 5HTTLPR and psychiatric disorders. This is the first study to test the association between this polymorphism and dimensions of all DSM-IV personality disorders in a community sample. 374 white participants were assessed by clinical psychologists using the International Personality Disorder Examination (IPDE). Associations between dimensions of each DSM-IV personality disorder and the long (l) and short (s) alleles of the 5HTTLPR were evaluated using non-parametric tests and regression models. The s allele of the 5HTTLPR polymorphism was significantly associated with higher avoidant personality trait scores in the whole sample. Males with the s allele had a significantly lower likelihood of higher obsessive-compulsive personality disorder (OCPD) trait scores, whereas females with the s allele were likely to have higher OCPD personality trait scores. This paper provides preliminary data on the relationship between personality disorders and the 5HTTLPR polymorphism. The relationship of the s allele and avoidant PD is consistent with findings of a nonspecific relationship of this polymorphism to anxiety and depressive disorders. Concerning the unusual sexual dimorphic result with OCPD, several hypotheses are presented. These findings need further replication, including a more detailed study of additional variants in SERT.
    Journal of Psychiatric Research 03/2011; 45(9):1153-9. DOI:10.1016/j.jpsychires.2011.03.003 · 4.09 Impact Factor
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    • "Also, if both MDE and obesity were related to attrition, then bias may have been introduced because of loss of follow-up. The extent of bias is likely to be small, however, since MDE is not strongly associated with attrition from cohort studies [25] [26]. Another limitation is misclassification that may have resulted from the timing of the interviews. "
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    ABSTRACT: Cross-sectional studies have reported an association between major depressive episode (MDE) and obesity. The objective of this longitudinal analysis was to determine whether MDE increase the risk of becoming obese over a 10-year period. We used data from the Canadian National Population Health Survey (NPHS), a longitudinal study of a representative cohort of household residents in Canada. The incidence of obesity, defined as a body mass index (BMI) of > or =30, was evaluated in respondents who were 18 years or older at the time of a baseline interview in 1994. MDE was assessed using a brief diagnostic instrument. The risk of obesity was not elevated in association with MDE, either in unadjusted or covariate-adjusted analyses. The strongest predictor of obesity was a BMI in the overweight (but not obese) range. Effects were also seen for (younger) age, (female) sex, a sedentary activity pattern, low income and exposure to antidepressant medications. Unexpectedly, significant effects were seen for serotonin-reuptake-inhibiting antidepressants and venlafaxine, but neither for tricyclic antidepressants nor antipsychotic medications. MDE does not appear to increase the risk of obesity. The cross-sectional associations that have been reported, albeit inconsistently, in the literature probably represent an effect of obesity on MDE risk. Pharmacologic treatment with antidepressants may be associated with an increased risk of obesity, and strategies to offset this risk may be useful in clinical practice.
    Psychotherapy and Psychosomatics 04/2009; 78(3):182-6. DOI:10.1159/000209349 · 9.37 Impact Factor
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    • "The investigation of the role of psychopathology in these studies has largely been limited to mental state pathology . Measurement of personality pathology has been limited to factors that might be associated with trait impulsivity, such as health risk behaviors (Morrison et al., 1997), and to antisocial personality disorder (Badawi et al., 1999; Cottler et al., 1996; Eaton et al., 1992). To our knowledge, no study to date has comprehensively examined the role of personality disorder (PD) in the follow-up of participants. "
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    ABSTRACT: This study investigated whether the degree of difficulty contacting participants at follow-up in a longitudinal study of adolescent psychiatric outpatients is associated with baseline and/or follow-up Axis I and II psychopathology and sociodemographic variables. At baseline, 101 participants 15 to 18 years old were assessed using standardized diagnostic instruments, and 97 were reinterviewed, face-to-face, at 2-year follow-up. A hierarchical tracking strategy and meticulous follow-up contact log were used. More than one quarter of the sample required multiple tracking efforts to be located and interviewed. The presence and number of Axis I and II disorders at 2-year follow-up was significantly associated with follow-up contact difficulty. Baseline psychopathology and sociodemographic variables were not associated with follow-up contact difficulty. The findings indicate that longitudinal studies of adolescent outpatients that compare dropouts with completers utilizing baseline characteristics are likely to underestimate the extent of psychopathology at follow-up.
    Journal of Nervous & Mental Disease 01/2007; 194(12):958-61. DOI:10.1097/01.nmd.0000243761.52104.91 · 1.81 Impact Factor
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