Author:
Lee Chien-Hung,Ko Albert Min-Shan,Yen Cheng-Fang,Chu Koung-Shing,Gao Yi-Jun,Warnakulasuriya Saman,Sunarjo ,Ibrahim Salah Osman,Zain Rosnah Binti,Patrick Walter K.,Ko Ying-Chin
Abstract
BackgroundDespite gradual understanding of the multidimensional health consequences
of betel-quid chewing, information on the effects of dependent use is
scant.AimsTo investigate the 12-month prevalence patterns of betel-quid dependence
in six Asian populations and the impact of this dependence on oral
potentially malignant disorders (OPMD).MethodA multistage random sample of 8922 participants was recruited from
Taiwan, mainland China, Indonesia, Malaysia, Sri Lanka and Nepal.
Participants were evaluated for betel-quid dependency using DSM-IV and
ICD-10 criteria and assessed clinically for oral mucosal lesions.ResultsThe 12-month prevalence of dependence was 2.8-39.2% across the six Asian
samples, and 20.9-99.6% of those who chewed betel-quid were betel-quid
dependent. Men dominated the prevalence among the east Asian samples and
women dominated the prevalence in south-east Asian samples. ‘Time spent
chewing’ and ‘craving’ were the central dependence domains endorsed by
the Chinese and southern/south-east Asian samples respectively, whereas
the Nepalese samples endorsed ‘tolerance’ and ‘withdrawal’. Dependency
was linked to age, gender, schooling years, drinking, smoking,
tobacco-added betel-quid use and environmental accessibility of
betel-quid. Compared with non-users, those with betel-quid dependency had
higher pre-neoplastic risks (adjusted odds ratios 8.0-51.3) than people
with non-dependent betel-quid use (adjusted odds ratio 4.5-5.9) in the
six Asian populations.ConclusionsBy elucidating differences in domain-level symptoms of betel-quid
dependency and individual and environmental factors, this study draws
attention to the population-level psychiatric problems of betel-quid
chewing that undermine health consequences for OPMD in six Asian
communities.
Publisher
Royal College of Psychiatrists
Subject
Psychiatry and Mental health
Cited by
53 articles.
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