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Durpoix A, Rolling J, Coutelle R, Lalanne L. Psychotherapies in opioid use disorder: toward a step-care model. J Neural Transm (Vienna) 2024; 131:437-452. [PMID: 37987829 PMCID: PMC11055728 DOI: 10.1007/s00702-023-02720-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/01/2023] [Indexed: 11/22/2023]
Abstract
Opioid use disorder (OUD) is characterized by a lack of control in opioid use, resulting in psychological distress and deficits in interpersonal and social functioning. OUD is often associated with psychiatric comorbidities that increase the severity of the disorder. The consequences of OUD are dramatic in terms of increased morbi-mortality. Specific medications and psychotherapies are essential tools not only in the treatment of OUD but also in the prevention of suicide and overdoses. In our review, we assess the different types of psychotherapies (counseling, motivational interviewing, contingency management, cognitive-behavioral therapy, and dialectical-behavior therapy) that are delivered to opioid users, either associated or un-associated with OUD medications and/or medications for psychiatric disabilities. We describe the application of these therapies first to adult opioid users and then to adolescents. This work led us to propose a stepped-care model of psychotherapies for OUD which provided information to assist clinicians in decision-making regarding the selection of psychotherapeutic strategies according to patients' OUD severity.
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Affiliation(s)
- Amaury Durpoix
- Addictology Department, Strasbourg University Hospital, 1, place de l'Hôpital, 67091, Strasbourg, France
- Strasbourg University, Faculty of Medicine, Strasbourg, France
| | - Julie Rolling
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, Strasbourg, France
- Regional Center for Psychotrauma Great East, Strasbourg, France
- Centre National de la Recherche Scientifique Unité Propre de Recherche 3212 (CNRS UPR 3212), Institute for Cellular and Integrative Neurosciences (INCI), Strasbourg, France
| | - Romain Coutelle
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, Strasbourg, France
- INSERM U1114, Cognitive Neuropsychology, and Pathophysiology of Schizophrenia, Strasbourg, France
| | - Laurence Lalanne
- Addictology Department, Strasbourg University Hospital, 1, place de l'Hôpital, 67091, Strasbourg, France.
- INSERM U1114, Cognitive Neuropsychology, and Pathophysiology of Schizophrenia, Strasbourg, France.
- Strasbourg University, Faculty of Medicine, Strasbourg, France.
- Fédération de Médecine translationnelle de Strasbourg, Strasbourg, France.
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2
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Kuerbis A. Expanding and adapting prevention and treatment options for older adults who engage in harmful use of substances. Addiction 2024. [PMID: 38590265 DOI: 10.1111/add.16499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/12/2024] [Indexed: 04/10/2024]
Affiliation(s)
- Alexis Kuerbis
- Silberman School of Social Work, Hunter College at CUNY, New York, New York, USA
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3
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Wright J, Chalmers KJ, Rossetto A, Reavley NJ, Kelly CM, Jorm AF. Redevelopment of mental health first aid guidelines for substance use problems: a Delphi study. BMC Psychol 2024; 12:70. [PMID: 38351023 PMCID: PMC10865545 DOI: 10.1186/s40359-024-01561-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Substance use problems have a major impact on the physical and mental health of individuals, families and communities. Early intervention may have a positive effect on recovery and treatment outcomes for those with substance use problems, reducing related risk and harm. Separate mental health first aid guidelines on how a member of the public could assist someone experiencing or developing alcohol use and drug use problems in high income Western countries were developed using Delphi expert consensus in 2009 and 2011, respectively. This study aimed to synthesise and update these two original guidelines to reflect current evidence and best practice. METHODS The Delphi expert consensus method was used to determine the inclusion of statements in the redeveloped guidelines. A questionnaire was developed using previously endorsed helping statements from the original guidelines on alcohol and drug use problems, as well as relevant content identified in systematic searches of academic and grey literature. Three panels of experts (people with lived experience, support people and professionals) rated statements over three consecutive online survey rounds to determine the importance of their inclusion in the guidelines. Statements endorsed by at least 80% of each panel were included. RESULTS 103 panellists completed all three survey rounds. They rated 469 statements and endorsed 300 of these for inclusion in the redeveloped guidelines. CONCLUSIONS This study has developed a broader and more comprehensive set of guidelines for how to support a person experiencing or developing a substance use problem. The redeveloped guidelines provide more detail on knowledge about and recognition of substance use problems, approaching and assisting people who want to change or are not ready to change, harm reduction, community-based supports and professional help, but have less on physical first aid actions. Mental Health First Aid International will use these guidelines in future updates of their training courses.
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Affiliation(s)
- Judith Wright
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health , The University of Melbourne, 3010, Parkville, VIC, Australia.
| | - Kathryn J Chalmers
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health , The University of Melbourne, 3010, Parkville, VIC, Australia
- Mental Health First Aid Australia, Level 18, 150 Lonsdale Street, 3000, Melbourne, VIC, Australia
| | - Alyssia Rossetto
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health , The University of Melbourne, 3010, Parkville, VIC, Australia
| | - Nicola J Reavley
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health , The University of Melbourne, 3010, Parkville, VIC, Australia
| | - Claire M Kelly
- Mental Health First Aid Australia, Level 18, 150 Lonsdale Street, 3000, Melbourne, VIC, Australia
| | - Anthony F Jorm
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health , The University of Melbourne, 3010, Parkville, VIC, Australia
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Norman T, Power J, Clifton B, Murray J, Bourne A. People living with HIV who inject or have injected non-prescription drugs: Evidence of substantial differences in health inequalities and experiences of clinical care. Drug Alcohol Rev 2023; 42:1517-1528. [PMID: 37171154 DOI: 10.1111/dar.13681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 04/25/2023] [Accepted: 04/27/2023] [Indexed: 05/13/2023]
Abstract
INTRODUCTION This study investigates differences in health and well-being associated with current, past or no injecting drug use (IDU) among people living with HIV (PLHIV) in Australia, identifying key health care considerations between injecting experiences. METHODS Data were extracted from the HIV Futures 9 study; a survey of PLHIV conducted in 2018-2019. Chi-square and analysis of variance analyses compared clinical and treatment characteristics, major physical and mental comorbidities, sexually transmitted infection diagnoses, and quality of life for those who reported current (last 12 months), past (12+ months ago) or no IDU. RESULTS Current IDU (n = 106) was associated with higher rates of sexually transmitted infection testing and diagnoses, higher frequency of self-reported antiretroviral therapy non-adherence due to drug use and greater social quality of life than past (n = 126) or no IDU (n = 508; total N = 740). Past and current IDUs were associated with more mental illness diagnoses and self-reported concern about drug use. Past IDU was associated with more physical comorbidities, lower satisfaction with clinical care and greater difficulty in affording health care than current or no IDU. DISCUSSION AND CONCLUSIONS Past and current IDUs are associated with unique health concerns. However, past IDU appears to be related to greater dissatisfaction in navigating health care than individuals with current IDU experience. Higher social connection and the types of services being accessed by individuals who currently inject may play a role in shaping service satisfaction. Peer-based interventions to help support individuals in accessing services that are affirming of their needs is an ongoing priority.
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Affiliation(s)
- Thomas Norman
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - Jennifer Power
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - Brent Clifton
- National Association of People with HIV Australia, Sydney, Australia
| | - Joel Murray
- National Association of People with HIV Australia, Sydney, Australia
| | - Adam Bourne
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
- Kirby Institute, UNSW Sydney, Sydney, Australia
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Bollinger A, Stäuble CK, Jeiziner C, Wiss FM, Hersberger KE, Lampert ML, Meyer zu Schwabedissen HE, Allemann SS. Genotyping of Patients with Adverse Drug Reaction or Therapy Failure: Database Analysis of a Pharmacogenetics Case Series Study. Pharmgenomics Pers Med 2023; 16:693-706. [PMID: 37426898 PMCID: PMC10327911 DOI: 10.2147/pgpm.s415259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/19/2023] [Indexed: 07/11/2023] Open
Abstract
Purpose Pharmacogenetics (PGx) is an emerging aspect of personalized medicine with the potential to increase efficacy and safety of pharmacotherapy. However, PGx testing is still not routinely integrated into clinical practice. We conducted an observational case series study where PGx information from a commercially available panel test covering 30 genes was integrated into medication reviews. The aim of the study was to identify the drugs that are most frequently object of drug-gene-interactions (DGI) in the study population. Patients and Methods In out-patient and in-patient settings, we recruited 142 patients experiencing adverse drug reaction (ADR) and/or therapy failure (TF). Collected anonymized data from the individual patient was harmonized and transferred to a structured database. Results The majority of the patients had a main diagnosis of a mental or behavioral disorder (ICD-10: F, 61%), of musculoskeletal system and connective tissue diseases (ICD-10: M, 21%), and of the circulatory system (ICD-10: I, 11%). The number of prescribed medicines reached a median of 7 per person, resulting in a majority of patients with polypharmacy (≥5 prescribed medicines, 65%). In total, 559 suspected DGI were identified in 142 patients. After genetic testing, an association with at least one genetic variation was confirmed for 324 suspected DGI (58%) caused by 64 different drugs and 21 different genes in 141 patients. After 6 months, PGx-based medication adjustments were recorded for 62% of the study population, whereby differences were identified in subgroups. Conclusion The data analysis from this study provides valuable insights for the main focus of further research in the context of PGx. The results indicate that most of the selected patients in our sample represent suitable target groups for PGx panel testing in clinical practice, notably those taking drugs for mental or behavioral disorder, circulatory diseases, immunological diseases, pain-related diseases, and patients experiencing polypharmacy.
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Affiliation(s)
- Anna Bollinger
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Céline K Stäuble
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
- Institute of Hospital Pharmacy, Solothurner Spitäler AG, Olten, Switzerland
| | - Chiara Jeiziner
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Florine M Wiss
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
- Institute of Hospital Pharmacy, Solothurner Spitäler AG, Olten, Switzerland
| | - Kurt E Hersberger
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Markus L Lampert
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
- Institute of Hospital Pharmacy, Solothurner Spitäler AG, Olten, Switzerland
| | | | - Samuel S Allemann
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
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6
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Favril L. Drug use before and during imprisonment: Drivers of continuation. Int J Drug Policy 2023; 115:104027. [PMID: 37060886 DOI: 10.1016/j.drugpo.2023.104027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Many people who enter prison have recently used drugs in the community, a substantial portion of whom will continue to do so while incarcerated. To date, little is known about what factors may contribute to the continuation of drug use during imprisonment. METHODS Self-reported data were collected from a random sample of 1326 adults (123 women) incarcerated across 15 prisons in Belgium. Multivariate regression was used to investigate associations between in-prison drug use and sociodemographic background, criminological profile, drug-related history, and mental health among participants who reported pre-prison drug use. RESULTS Of all 1326 participants, 719 (54%) used drugs in the 12 months prior to their incarceration and 462 (35%) did so while in prison. There was a strong association between drug use before and during imprisonment (OR = 6.77, 95% CI 5.16-8.89). Of those who recently used drugs in the community, half (52%) continued to do so while incarcerated. Factors independently associated with continuation (versus cessation) were young age, treatment history, polydrug use, and poor mental health. In a secondary analysis, initiation of drug use while in prison was further related to incarceration history and low education. CONCLUSION Persistence of drug use following prison entry is common. People who continue to use drugs inside prison can be differentiated from those who discontinue in terms of drug-related history and mental health. Routine screening for drug use and psychiatric morbidity on admission to prison would allow for identifying unmet needs and initiating appropriate treatment.
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Affiliation(s)
- Louis Favril
- Faculty of Law and Criminology, Ghent University, Belgium.
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7
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Borges G, Orozco R, Hernández-Becerril Z, Ortega BE, Flores J, Benitez-King G, Flores-Alcantar G, Escamilla-Nuñez A, Scherer JN. Alcohol, drugs, and road traffic injuries in an emergency department in Mexico City. Injury 2023; 54:481-9. [PMID: 36588032 DOI: 10.1016/j.injury.2022.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 12/15/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
There have been no studies reporting on the use of biological specimens in Mexico to analyze the prevalence of alcohol and drug use among Emergency Department (ED) patients with a road traffic injury (RTI). We report here on a sample of 304 adult patients, admitted to the ED of a public hospital in Mexico City from January to April 2022, after being involved in an RTI. Patients gave informed consent for a breath test measuring breath alcohol concentration (BAC) and a saliva screening test for six classes of drugs (amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, and methamphetamine). We found that at least one in every four patients (27.6%) had traces of alcohol or drugs in their body upon arrival in the ED. The breath test found a positive BAC in 16.1% of the sample; the most common substances detected in saliva were amphetamines or methamphetamine (8.6%), followed by cocaine (7.0%) and cannabis (6.9%). Only a few variables differentiated those with positive BAC from those with negative BAC (male, arriving on a weekend day or night, and arriving by ambulance), and even fewer variables differentiated those testing positives for drugs than those testing negative (less than 13 years of education and drivers of cars, bicycles, or other vehicles). While alcohol continues to be the single most used substance, our findings indicate that stimulants are of great concern. Since those testing positives for alcohol or drugs are so similar in their demographic pattern to those testing negative, the introduction of biological testing as a routine practice in the ED is highly recommended. Routine testing makes it possible to provide the patient with the best treatment and is also the best way to assess substance use.
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Rakovski C, Ballester PL, Montezano BB, Dias de Mattos Souza L, Jansen K, Azevedo da Silva R, Mondin TC, Pedrotti Moreira F, De Boni RB, Frey BN, Kapczinski F, de Azevedo Cardoso T. Predictors of illicit substance abuse/dependence during young adulthood: A machine learning approach. J Psychiatr Res 2023; 157:168-173. [PMID: 36470198 DOI: 10.1016/j.jpsychires.2022.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 10/19/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
Prior studies have found an especially high prevalence of illicit substance use among adolescents and young adults in Brazil. The current study aimed to employ machine learning techniques to identify predictors of illicit substance abuse/dependence among a large community sample of young adults followed for 5 years. This prospective, population-based cohort study included a sample of young adults between the ages of 18-24 years from Pelotas, Brazil at baseline (T1). The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was used to assess illicit substance abuse/dependence. A clinical interview was conducted to collect data on sociodemographic characteristics and psychopathology. Elastic net was used to generate a regularized linear model for the machine learning component of this study, which followed standard machine learning protocols. A total of 1560 young adults were assessed at T1, while 1244 were reassessed at the 5-year follow-up period (T2). The strongest predictors of illicit substance abuse/dependence at baseline (AUC of 0.83) were alcohol abuse/dependence, tobacco abuse/dependence, being in a current major depressive episode, history of a lifetime manic episode, current suicide risk, and male sex. The strongest predictors for illicit substance abuse/dependence at the 5-year follow-up (AUC: 0.79) were tobacco abuse/dependence at T1, history of a lifetime manic episode at T1, male sex, alcohol abuse/dependence at T1, and current suicide risk at T1. Our findings indicate that machine learning techniques hold the potential to predict illicit substance abuse/dependence among young adults using sociodemographic/clinical characteristics, with relatively high accuracy.
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Affiliation(s)
- Coral Rakovski
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Pedro L Ballester
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Bruno Braga Montezano
- Health and Behavior Department, Catholic University of Pelotas, Pelotas, RS, Brazil; Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Porto Alegre, RS, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | | | - Karen Jansen
- Health and Behavior Department, Catholic University of Pelotas, Pelotas, RS, Brazil
| | | | - Thaise Campos Mondin
- Department of Student Affairs, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Raquel Brandini De Boni
- Instituto de Comunicação e Informação Cientifica e Tecnológica em Saúde, Oswaldo Cruz Foundation, RJ, Brazil
| | - Benicio N Frey
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Flavio Kapczinski
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Porto Alegre, RS, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil
| | - Taiane de Azevedo Cardoso
- Health and Behavior Department, Catholic University of Pelotas, Pelotas, RS, Brazil; Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
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Degenhardt L, Bharat C, Glantz MD, Bromet EJ, Alonso J, Bruffaerts R, Bunting B, de Girolamo G, de Jonge P, Florescu S, Gureje O, Haro JM, Harris MG, Hinkov H, Karam EG, Karam G, Kovess-Masfety V, Lee S, Makanjuola V, Medina-Mora ME, Navarro-Mateu F, Piazza M, Posada-Villa J, Scott KM, Stein DJ, Tachimori H, Tintle N, Torres Y, Viana MC, Kessler RC, Al-Hamzawi A, Al-Kaisy MS, Alonso J, Altwaijri Y, Helena Andrade L, Atwoli L, Benjet C, Borges G, Bromet EJ, Bruffaerts R, Bunting B, Caldas-de-Almeida JM, Cardoso G, Chatterji S, Cia AH, Degenhardt L, Demyttenaere K, Florescu S, Girolamo GD, Gureje O, Haro JM, Harris MG, Hinkov H, Hu CY, de Jonge P, Karam AN, Karam EG, Kawakami N, Kessler RC, Kiejna A, Kovess-Masfety V, Lee S, Lepine JP, McGrath J, Medina-Mora ME, Mneimneh Z, Moskalewicz J, Navarro-Mateu F, Piazza M, Posada-Villa J, Scott KM, Slade T, Stagnaro JC, Stein DJ, ten Have M, Torres Y, Viana MC, Vigo DV, Whiteford H, Williams DR, Wojtyniak B. The associations between traumatic experiences and subsequent onset of a substance use disorder: Findings from the World Health Organization World Mental Health surveys. Drug Alcohol Depend 2022; 240:109574. [PMID: 36150948 DOI: 10.1016/j.drugalcdep.2022.109574] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 01/06/2023]
Abstract
AIM Exposure to traumatic events (TEs) is associated with substance use disorders (SUDs). However, most studies focus on a single TE, and are limited to single countries, rather than across countries with variation in economic, social and cultural characteristics. We used cross-national data to examine associations of diverse TEs with SUD onset, and variation in associations over time. METHODS Data come from World Mental Health surveys across 22 countries. Adults (n = 65,165) retrospectively reported exposure to 29 TEs in six categories: "exposure to organised violence"; "participation in organised violence"; "interpersonal violence"; "sexual-relationship violence"; "other life-threatening events"; and those involving loved ones ("network traumas"). Discrete-time survival analyses were used to examine associations with subsequent first SUD onset. RESULTS Most (71.0%) reported experiencing at least one TE, with network traumas (38.8%) most common and exposure to organised violence (9.5%) least. One in five (20.3%) had been exposed to sexual-relationship violence and 26.6% to interpersonal violence. Among the TE exposed, lifetime SUD prevalence was 14.5% compared to 5.1% with no trauma exposure. Most TE categories (except organised violence) were associated with increased odds of SUD. Increased odds of SUD were also found following interpersonal violence exposure across all age ranges (ORs from 1.56 to 1.78), and sexual-relationship violence exposure during adulthood (ORs from 1.33 to 1.44), with associations persisting even after >11 years. CONCLUSION Sexual and interpersonal violence have the most consistent associations with progression to SUD; increased risk remains for many years post-exposure. These need to be considered when working with people exposed to such traumas.
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Affiliation(s)
- Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
| | - Chrianna Bharat
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Meyer D Glantz
- Department of Epidemiology, Services, and Prevention Research (DESPR), National Institute on Drug Abuse (NIDA), National Institute of Health (NIH), Bethesda, MD, USA
| | - Evelyn J Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain; Pompeu Fabra University (UPF), Barcelona, Spain
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - Brendan Bunting
- School of Psychology, Ulster University, Londonderry, United Kingdom
| | | | - Peter de Jonge
- Department of Developmental Psychology, University of Groningen, Groningen, the Netherlands; Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, Groningen, the Netherlands
| | - Silvia Florescu
- National School of Public Health, Management and Development, Bucharest, Romania
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - Meredith G Harris
- School of Public Health, The University of Queensland, Herston, Queensland, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia
| | - Hristo Hinkov
- National Center of Public Health and Analyses, Sofia, Bulgaria
| | - Elie G Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon; Balamand University, Faculty of Medicine, Beirut, Lebanon
| | - Georges Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon; Balamand University, Faculty of Medicine, Beirut, Lebanon
| | - Viviane Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057, Paris Descartes University, Paris, France
| | - Sing Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | - Victor Makanjuola
- Department of Psychiatry, College of Medicine, University of Ibadan; University College Hospital, Ibadan, Nigeria
| | | | - Fernando Navarro-Mateu
- Unidad de Docencia, Investigacion y Formación en Salud Mental, Servicio Murciano de Salud, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca, Spain; Centro de Investigación Biomédica en ERed en Epidemíologia y Salud Pública, Murcia, Spain
| | - Marina Piazza
- Instituto Nacional de Salud, Universidad Cayetano Heredia, Lima, Peru
| | - José Posada-Villa
- Colegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia
| | - Kate M Scott
- Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Dan J Stein
- Dept of Psychiatry & Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, Republic of South Africa
| | - Hisateru Tachimori
- National Institute of Mental Health, National Center for Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Nathan Tintle
- Department of Mathematics, Statistics and Computer Science, Dordt College, Sioux Center, IA, USA
| | - Yolanda Torres
- Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia
| | - Maria Carmen Viana
- Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitoria, Brazil
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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Kay ES, Creasy S, Batey DS, Coulter R, Egan JE, Fisk S, Friedman MR, Kinsky S, Krier S, Noble V, Turan B, Turan JM, Yu L, Hawk M. Impact of harm reduction care in HIV clinical settings on stigma and health outcomes for people with HIV who use drugs: study protocol for a mixed-methods, multisite, observational study. BMJ Open 2022; 12:e067219. [PMID: 36113946 PMCID: PMC9486355 DOI: 10.1136/bmjopen-2022-067219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Our previous pilot work suggests relational harm reduction strengthens relationships between people with HIV (PWH) who use drugs and their healthcare providers and improves HIV health outcomes. However, there is limited research examining ways that structural (eg, strategies like syringe service programmes) and/or relational (patient-provider relationship) harm reduction approaches in HIV clinical settings can mitigate experiences of stigma, affect patient-provider relationships and improve outcomes for PWH who use drugs. Our mixed methods, multisite, observational study aims to fill this knowledge gap and develop an intervention to operationalise harm reduction care for PWH who use drugs in HIV clinical settings. METHODS AND ANALYSIS Aim 1 will explore the relationship between healthcare providers' stigmatising attitudes towards working with PWH who use drugs and providers' acceptance and practice of structural and relational harm reduction through surveys (n=125) and interviews (n=20) with providers. Aim 2 will explore the interplay between patient-perceived harm reduction, intersectional stigma and clinical outcomes related to HIV, hepatitis C (if applicable) and substance use-related outcomes through surveys (n=500) and focus groups (k=6, total n=36) with PWH who use drugs. We will also psychometrically evaluate a 25-item scale we previously developed to assess relational harm reduction, the Patient Assessment of Provider Harm Reduction Scale. Aim 3 will use human-centred design approaches to develop and pretest an intervention to operationalise harm reduction care for PWH who use drugs in HIV clinical settings. ETHICS AND DISSEMINATION This study was approved via expedited review by the University of Pittsburgh Institutional Review Board (STUDY21090002). Study findings will be presented in peer-reviewed journals and public health conferences as well as shared with patient participants, community advisory boards and harm reduction organisations. TRIAL REGISTRATION NUMBER NCT05404750.
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Affiliation(s)
- Emma Sophia Kay
- Magic City Research Institute, Birmingham AIDS Outreach, Birmingham, Alabama, USA
| | - Stephanie Creasy
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - D Scott Batey
- Department of Social Work, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Robert Coulter
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - James E Egan
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Stuart Fisk
- Center for Inclusion Health, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
| | - Mackey Reuel Friedman
- Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Sarah Krier
- Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Victor Noble
- Center for Inclusion Health, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
| | - Bulent Turan
- Department of Psychology, Koc Universitesi, Istanbul, Turkey
| | - Janet M Turan
- Department of Health Care Organization and Policy, School of Public Health, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Lan Yu
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mary Hawk
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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11
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Allen K, Melendez-Torres GJ, Ford T, Bonell C, Finning K, Fredlund M, Gainsbury A, Berry V. Family focused interventions that address parental domestic violence and abuse, mental ill-health, and substance misuse in combination: A systematic review. PLoS One 2022; 17:e0270894. [PMID: 35905105 PMCID: PMC9337671 DOI: 10.1371/journal.pone.0270894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 06/18/2022] [Indexed: 11/19/2022] Open
Abstract
Parental domestic violence and abuse (DVA), mental ill-health (MH), and substance misuse (SU) are three public health issues that tend to cluster within families, risking negative impacts for both parents and children. Despite this, service provision for these issues has been historically siloed, increasing the barriers families face to accessing support. Our review aimed to identify family focused interventions that have combined impacts on parental DVA, MH, and/or SU. We searched 10 databases (MEDLINE, PsycINFO, Embase, CINAHL, Education Research Information Centre, Sociological Abstracts, Applied Social Sciences Index & Abstracts, ProQuest Dissertations and Theses Global, Web of Science Core Collection, and Cochrane Central Register of Controlled Trials) from inception to July 2021 for randomised controlled trials examining the effectiveness of family focused, psychosocial, preventive interventions targeting parents/carers at risk of, or experiencing, DVA, MH, and/or SU. Studies were included if they measured impacts on two or more of these issues. The Cochrane Risk of Bias Tool 2 was used to quality appraise studies, which were synthesised narratively, grouped in relation to the combination of DVA, MH, and/or SU outcomes measured. Harvest plots were used to illustrate the findings. Thirty-seven unique studies were identified for inclusion. Of these, none had a combined positive impact on all three outcomes and only one study demonstrated a combined positive impact on two outcomes. We also found studies that had combined adverse, mixed, or singular impacts. Most studies were based in the U.S., targeted mothers, and were rated as 'some concerns' or 'high risk' of bias. The results highlight the distinct lack of evidence for, and no 'best bet', family focused interventions targeting these often-clustered risks. This may, in part, be due to the ways interventions are currently conceptualised or designed to influence the relationships between DVA, MH, and/or SU. Trial registration: PROSPERO registration: CRD42020210350.
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Affiliation(s)
- Kate Allen
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | | | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Chris Bonell
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Katie Finning
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Mary Fredlund
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | | | - Vashti Berry
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
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12
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Borges G, Orozco R, Becerril Z, Ortega BE, Flores J. Injury, alcohol, and drug use in an emergency department in Mexico City. Journal of Substance Use 2022. [DOI: 10.1080/14659891.2022.2098844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Guilherme Borges
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramon de la Fuente Muñiz, Mexico City, Mexico
| | - Ricardo Orozco
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramon de la Fuente Muñiz, Mexico City, Mexico
| | - Zaide Becerril
- Nursing Department, Hospital General Regional No. 2 “Guillermo Fajardo Ortiz,” Mexican Institute of Social Security, Mexico City, Mexico
- Doctorate Program in Medical, Odontology and Health Sciences of the National Autonomous University of Mexico, Mexico City, Mexico
| | - Brenda E. Ortega
- Doctorate Program in Psychology of the National Autonomous University of Mexico, Mexico City, Mexico
| | - Julio Flores
- Master Program in Addictive Behaviours of the National Autonomous University of Mexico, Mexico City, Mexico
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13
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Williams R, Natkulasingam S, Tooke B, Webster E, Quirk A, Gupta V, French P, Smith J, Crawford MJ. Examining the effects of national initiatives to improve the physical health of people with psychosis in England: secondary analysis of data from the National Clinical Audit of Psychosis. BJPsych Bull 2022; 46:140-147. [PMID: 33949302 PMCID: PMC9347478 DOI: 10.1192/bjb.2021.38] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIMS AND METHODS To examine whether national initiatives have led to improvements in the physical health of people with psychosis. Secondary analysis of a national audit of services for people with psychosis. Proportions of patients in 'good health' according to seven measures, and one composite measure derived from national standards, were compared between multiple rounds of data collection. RESULTS The proportion of patients in overall 'good health' under the care of 'Early Intervention in Psychosis' teams increased from 2014-2019, particularly for measures of smoking, alcohol and substance use. There was no overall change in the proportion of patients in overall 'good health' under the care of 'Community Mental Health Teams' from 2011-2017. However, there were improvements in alcohol use, blood glucose and lipid levels. CLINICAL IMPLICATIONS There have been modest improvements in the health of people with psychosis over the last nine years. Continuing efforts are required to translate these improvements into reductions in premature mortality.
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Affiliation(s)
- Ryan Williams
- Royal College of Psychiatrists, UK.,Imperial College London, UK
| | | | | | | | | | | | - Paul French
- Royal College of Psychiatrists, UK.,University of Liverpool, UK
| | - Jo Smith
- Royal College of Psychiatrists, UK.,University of Worcester, UK
| | - Mike J Crawford
- Royal College of Psychiatrists, UK.,Imperial College London, UK
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14
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López-Toro E, Wolf CJH, González RA, van den Brink W, Schellekens A, Vélez-Pastrana MC. Network Analysis of DSM Symptoms of Substance Use Disorders and Frequently Co-Occurring Mental Disorders in Patients with Substance Use Disorder Who Seek Treatment. J Clin Med 2022; 11:jcm11102883. [PMID: 35629008 PMCID: PMC9145186 DOI: 10.3390/jcm11102883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/10/2022] [Accepted: 05/15/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Substance use disorders (SUD) often co-occur with other psychiatric conditions. Research on SUD and comorbid disorders generally flows from a categorical diagnostic or dimensional latent variable perspective, where symptoms are viewed as independent indicators of an underlying disorder. In contrast, the current study took a network analysis perspective to examine the relationships between DSM symptoms of SUD, ADHD, conduct disorder (CD), depression (MDD), and borderline personality disorder (BPD). In addition, we explored possible gender differences in the network structures of these symptoms. Method: In a sample of 722 adult treatment-seeking patients with SUD from the International ADHD in Substance Use Disorders Prevalence Study (IASP) we estimated the network structure for 41 symptoms of SUD, ADHD, CD, MDD, and BPD. We described the structure of symptom networks and their characteristics for the total sample, and we compared the symptom networks for males and females. Results: Network analyses identified seven clusters of symptoms, largely corresponding with the DSM diagnostic categories. There were some connections between clusters, mainly between some hyperactivity symptoms and CD and depressive symptoms. ADHD hyperactivity was most central in the symptom network. Invariance tests revealed no significant gender differences in the structure of symptom networks. Conclusions: The current findings support the categorical DSM classification of mental disorders in treatment-seeking patients with SUD. Future network analyses should include a broader range of symptoms and prospectively explore changes in the symptoms network of patients during treatment.
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Affiliation(s)
- Edith López-Toro
- PhD Program in Clinical Psychology, Universidad Carlos Albizu, P.O. Box 9023711, San Juan, PR 00902-3711, USA;
| | - Casper J. H. Wolf
- Department of Psychiatry, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (C.J.H.W.); (A.S.)
- Department of Cognitive Neuroscience, Donders Institute for Brain Cognition and Behaviour, Radboud University, 6525 EN Nijmegen, The Netherlands
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), 6525 HR Nijmegen, The Netherlands
| | - Rafael A. González
- National Adoption and Fostering Service & National Conduct Problems Team, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK;
- Centre for Psychiatry, Imperial College London, London W12 0NN, UK
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam University Medical Center, Location Academic Medical Center, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands;
| | - Arnt Schellekens
- Department of Psychiatry, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (C.J.H.W.); (A.S.)
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), 6525 HR Nijmegen, The Netherlands
| | - María C. Vélez-Pastrana
- PhD Program in Clinical Psychology, Universidad Carlos Albizu, P.O. Box 9023711, San Juan, PR 00902-3711, USA;
- Correspondence: ; Tel.: +1-787-725-6500
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15
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Tunçez FT, Sehlikoğlu K, Bilgin UE, Tokdemir M. Evaluation of forensic autopsy cases with substance use detected in Izmir, Turkey. J Ethn Subst Abuse 2022; 22:688-700. [PMID: 35499453 DOI: 10.1080/15332640.2022.2068721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Using postmortem toxicological analyses, we aimed to determine the origin and cause of death and type of substance used in substance use-related deaths. A total of 7475 autopsies were performed between January 2015 and December 2017 in İzmir, Turkey. In our retrospective analysis, substance use was detected in 449 (6.0%) autopsies. The majority (96.4%) were male. The most frequent deaths (18.5%) occurred in the 25-29 age group. Of the 55.2% of the cases that died of unnatural causes, accident-related events (22.9%) were most frequent. Trauma/injury caused death in 37.0% of cases and substance intoxication in 24.7%. Cannabis use was detected in 34.3% of the samples, and multiple substance use in 25.4%. Accordingly, It is thought that a multidisciplinary approach can be successful in preventing substance use and related problems.
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16
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Kontu M, Kantojärvi L, Hakko H, Riala K, Riipinen P. Misuse of prescribed psychotropic medication and drug crime offending: A follow-up case-control study of former adolescent psychiatric inpatients. Crim Behav Ment Health 2022; 32:124-137. [PMID: 35735190 PMCID: PMC9327718 DOI: 10.1002/cbm.2254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Various psychotropic prescription drugs are known to have potential for misuse. Among teenagers, non-medical use of prescription drugs may predate illicit drug use or occur concomitantly. AIMS Our aim was to examine prescriptions of psychotropic medications among drug crime offenders and non-criminal controls in a psychiatric inpatient cohort of 13-17-year-olds. Our research question was: were prescribed psychotropic and potentially addictive drugs associated with later drug crime offending. METHODS Our sample was of all 60 adolescents who had been convicted of a drug crime by young adulthood with a twice-sized control group, matched for gender, age and family-type, from a cohort of 508 adolescents consecutively admitted to a psychiatric inpatient care in Finland between April 2001 and March 2006. Adolescence-related information on substance use and psychiatric disorders was obtained by semi-structured interviews. Follow-up information on crimes and medication purchases was obtained from Finnish nationwide registers. The association of studied factors to drug crime offending was examined using stepwise binary logistic regression analysis. RESULTS 75% of drug crime offenders and 47% of non-criminal controls had used addictive psychotropic medications during the follow-up period (p < 0.001). 74% of all drug crime offenders' purchases of prescribed addictive drugs occurred within the year preceding drug crimes. Of addictive drugs, the use of clonazepam and gabapentinoids was most likely to associate with drug crime offending (AOR 7.77, p < 0.001). Conduct and substance use disorders diagnosed in adolescence (AOR 3.49, p = 0.010; AOR 2.34, p = 0.050) were predictors for drug crime offending. CONCLUSIONS Our findings suggest that, when treating young adults with conduct disorder and a history of substance use, physicians should prescribe addictive medications with caution, favouring instead non-addictive medications complemented by psychosocial interventions.
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Affiliation(s)
- Mikaela Kontu
- Department of PsychiatryResearch Unit of Clinical NeuroscienceUniversity of OuluOuluFinland
| | | | - Helinä Hakko
- Department of PsychiatryOulu University HospitalOuluFinland
| | - Kaisa Riala
- Department of PsychiatryOulu University HospitalOuluFinland
| | - Pirkko Riipinen
- Department of PsychiatryResearch Unit of Clinical NeuroscienceUniversity of OuluOuluFinland
- Department of PsychiatryOulu University HospitalOuluFinland
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17
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Jowsey-Gregoire S, Jannetto PJ, Jesse MT, Fleming J, Winder GS, Balliet W, Kuntz K, Vasquez A, Weinland S, Hussain F, Weinrieb R, Fireman M, Nickels MW, Peipert JD, Thomas C, Zimbrean PC. Substance use screening in transplant populations: Recommendations from a consensus workgroup. Transplant Rev (Orlando) 2022; 36:100694. [DOI: 10.1016/j.trre.2022.100694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/20/2022] [Indexed: 02/07/2023]
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18
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Chalhoub C, Obeid S, Hallit R, Salameh P, Hallit S. Addictive profiles of Lebanese university students in terms of smoking, alcohol, and illegal drug use. Environ Sci Pollut Res Int 2021; 28:57657-57666. [PMID: 34091844 PMCID: PMC8179089 DOI: 10.1007/s11356-021-14751-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 06/02/2021] [Indexed: 05/13/2023]
Abstract
The Lebanese economic crisis, financial crisis, and USD shortage were conducive to an increased drug addiction especially for students who feel that their future in Lebanon is not safe, as well as the psychological fragility of the Lebanese people, and the more permissive sociocultural context. Our study aimed to assess the addiction levels and profiles of university students in Lebanon, and thus to evaluate the rapid rising in dependence regarding smoking, alcohol, and illegal drug use during this crisis. This cross-sectional study was carried out between February and September 2020. A total of 467 participants (315 females, 152 males; Mage = 23.48 ± 6.03) were recruited through convenience sampling through several universities in Lebanon's governorates. Participants received the online link to the survey. Students were divided into three clusters as follows: cluster 1, which corresponds to students with moderate addictions; cluster 2, which corresponds to students with high addictions; and cluster 3, which corresponds to students with low addictions. When comparing cluster 1 to cluster 3, the results of the multinomial regression showed that older age (aOR=1.08) and having a high monthly income compared to no income (aOR=2.78) were significantly associated with higher odds of being in cluster 1 compared to cluster 3. When comparing cluster 2 to cluster 3, the results of the multinomial regression showed that female gender (aOR=0.19) was significantly associated with lower odds of being in cluster 2 compared to cluster 3, whereas having a dead (aOR=16.38) or divorced parent (aOR=6.54) and having a low (aOR=3.93) or intermediate income compared to zero income (aOR=4.71) were significantly associated with higher odds of being in cluster 2 compared to cluster 3. The results of our study revealed a considerable prevalence of addiction to alcohol, illicit drugs, and specially to smoking, among Lebanese university students. These findings emphasize the need to implement firm policies and rules in an attempt to minimize the tendency of the young population to engage in such addictions.
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Affiliation(s)
- Clarissa Chalhoub
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Sahar Obeid
- Research and Psychology Departments, Psychiatric Hospital of the Cross, Jal ed Dib, Lebanon
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Rabih Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
- Infectious Disease Department, Bellevue Medical Center, Mansourieh, Lebanon
- Infectious Disease Department, Notre-Dame des Secours University Hospital, Byblos, Lebanon
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon.
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Chen T, Tan H, Lei H, Li X, Wu Q, Xu X, Ye Y, Zhong N, Du J, Jiang H, Su H, Zhao M. Nature of glutamate alterations in substance dependence: A systematic review and meta-analysis of proton magnetic resonance spectroscopy studies. Psychiatry Res Neuroimaging 2021; 315:111329. [PMID: 34271295 DOI: 10.1016/j.pscychresns.2021.111329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 06/19/2021] [Accepted: 07/02/2021] [Indexed: 10/20/2022]
Abstract
Animal studies have reported the brain glutamatergic dysfunction in substance dependence. However, proton magnetic resonance spectroscopy (1H-MRS) studies of glutamate in substance-dependent patients published contradicting results. In order to investigate the characteristics of brain glutamatergic alterations in substance-dependent patients, we conducted systematic reviews and meta-analyses of 1H-MRS studies that have investigated the glutamate, glutamine, and Glx (glutamate + glutamine) concentration in substance-dependent patients. Multiple databases were searched until Sep 10, 2020. Twenty-nine studies comprising 982 patients and 787 controls were included. There was significantly decreased glutamate level in dorsolateral prefrontal cortex in patients compared with controls. Higher glutamate levels in medial prefrontal cortex and basal ganglia region were also demonstrated in patients compared with controls. Subgroup analyses based on the substance type and abstinence period (short vs medium-term abstinence period) were performed. The results revealed Glx and glutamate concentrations in all investigated brain regions were not different in patients with any types of substance dependence compared with controls. The abstinence period had no effect on the glutamate levels. In summary, substance dependence is associated with glutamatergic dysfunction of prefrontal cortex and basal ganglia. Present findings partially support the hypothesis that addiction is associated with abnormal brain glutamatergic neurotransmission.
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Affiliation(s)
- Tianzhen Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Haoye Tan
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Huiting Lei
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Xiaotong Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Qianying Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Xiaomin Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Yujian Ye
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Na Zhong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Jiang Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Haifeng Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Hang Su
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China.
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China; Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, China.
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20
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Cook WK, Li X, Sundquist K, Kendler KS, Sundquist J, Karriker-Jaffe KJ. Drinking cultures and socioeconomic risk factors for alcohol and drug use disorders among first- and second-generation immigrants: A longitudinal analysis of Swedish population data. Drug Alcohol Depend 2021; 226:108804. [PMID: 34216865 PMCID: PMC8355220 DOI: 10.1016/j.drugalcdep.2021.108804] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Few longitudinal studies investigate predictors of substance use incidence among immigrants. The current study describes substance use disorders in immigrants to Sweden, focusing on drinking culture in the country of origin and socioeconomic status (SES), and how these intersect with generational status to influence risk. METHODS Using pseudonymized Swedish population registry data, we track onset of alcohol use disorder and drug use disorder in a longitudinal study of 815,778 first-generation immigrants and 674,757 second-generation immigrants from 64 countries over a 6-year period. Cox regression analysis estimated risks of alcohol and drug use disorders in second-generation immigrants compared to first-generation, and moderation analyses assessed interactions of generational status with country-of-origin per capita alcohol consumption and SES. RESULTS Immigrants and second-generation immigrants originating from countries with high levels of alcohol consumption had higher risks for alcohol and drug use disorders. Immigrants with high SES had lower risks for alcohol and drug use disorders. The interaction between generational status and country-of-origin alcohol consumption was significant for drug use disorder (not for alcohol use disorder), with drug use disorder risk for second-generation immigrants being highest for those from countries with the lowest level of country-of-origin per capita alcohol consumption. The interaction between generational status and SES was significant for alcohol use disorder, with low-SES second-generation immigrants showing markedly higher risk than first-generation immigrants with comparable SES. CONCLUSIONS Among immigrants in Sweden, second-generation immigrants are at increased risk of developing alcohol and drug use disorders, particularly if they have lower SES. Policy and community attention to these high-risk subgroups in immigrant communities is warranted.
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Affiliation(s)
- Won Kim Cook
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA.
| | - Xinjun Li
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | | | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics and Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Katherine J. Karriker-Jaffe
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA,Community Health and Implementation Research Program, RTI International, Berkeley, CA, USA
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Greene MC, Yangchen T, Lehner T, Sullivan PF, Pato CN, McIntosh A, Walters J, Gouveia LC, Msefula CL, Fumo W, Sheikh TL, Stockton MA, Wainberg ML, Weissman MM. The epidemiology of psychiatric disorders in Africa: a scoping review. Lancet Psychiatry 2021; 8:717-731. [PMID: 34115983 PMCID: PMC9113063 DOI: 10.1016/s2215-0366(21)00009-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 01/12/2023]
Abstract
This scoping review of population-based epidemiological studies was done to provide background information on the prevalences and distribution of psychiatric disorders in Africa for calls to broaden diversity in psychiatric genetic studies. We searched PubMed, EMBASE, and Web of Science to retrieve relevant literature in English, French, and Portuguese from Jan 1, 1984, to Aug 18, 2020. In 36 studies from 12 African countries, the lifetime prevalence ranged from 3·3% to 9·8% for mood disorders, from 5·7% to 15·8% for anxiety disorders, from 3·7% to 13·3% for substance use disorders, and from 1·0% to 4·4% for psychotic disorders. Although the prevalence of mood and anxiety disorders appears to be lower than that observed in research outside the continent, we identified similar distributions by gender, although not by age or urbanicity. This review reveals gaps in epidemiological research on psychiatric disorders and opportunities to leverage existing epidemiological and genetic research within Africa to advance our understanding of psychiatric disorders. Studies that are methodologically comparable but diverse in geographical context are needed to advance psychiatric epidemiology and provide a foundation for understanding environmental risk in genetic studies of diverse populations globally.
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Affiliation(s)
- M Claire Greene
- Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Tenzin Yangchen
- Division of Translational Epidemiology, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Thomas Lehner
- New York Genome Center, New York, NY, USA; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Patrick F Sullivan
- Center for Psychiatric Genomics, Department of Genetics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Carlos N Pato
- Institute for Genomic Health, SUNY Downstate, Health Science University, Brooklyn, NY, USA
| | - Andrew McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - James Walters
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Lidia C Gouveia
- Department of Mental Health, Ministry of Health-Mozambique, Maputo, Mozambique
| | - Chisomo L Msefula
- Pathology Department, College of Medicine, University of Malawi, Chichiri, Blantyre, Malawi
| | - Wilza Fumo
- Department of Mental Health, Ministry of Health-Mozambique, Maputo, Mozambique
| | - Taiwo L Sheikh
- Department of Psychiatry, College of Medical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Melissa A Stockton
- Division of Translational Epidemiology, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, New York, NY, USA
| | - Milton L Wainberg
- Division of Translational Epidemiology, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, New York, NY, USA
| | - Myrna M Weissman
- Division of Translational Epidemiology, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, New York, NY, USA.
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22
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Zrour C, Naja W, Chahoud M, Halabi A, Badaoui A, Haddad R. Parenting Styles and Psychiatric Profile of Parents of Adult Substance Use Disorder Patients: Cross-sectional Study. Int J Ment Health Addict. [DOI: 10.1007/s11469-021-00554-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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23
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Kaswa R. Primary healthcare approach to substance abuse management. S Afr Fam Pract (2004) 2021; 63:e1-e4. [PMID: 34082558 PMCID: PMC8378164 DOI: 10.4102/safp.v63i1.5307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 12/04/2022] Open
Abstract
Substance abuse is common amongst patients attending primary healthcare settings. Despite the substantial impact on one’s health, substance abuse is often underdiagnosed by primary care providers owing to a lack of training and time for screening. Self-reported screening tools are easy to administer and efficient to make a substance abuse diagnosis in primary care settings. Comorbid mental illness and intimate partner violence are common amongst patients presenting with substance abuse in primary care. An early diagnosis and a brief behavioural change counselling are effective in managing substance abuse before it develops into dependency. A brief motivational communication rather than a confrontation during substance abuse screening, counselling and treatment is important to achieve optimum patient outcomes.
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Affiliation(s)
- Ramprakash Kaswa
- Department of Family Medicine and Rural Health, Walter Sisulu University, Mthatha.
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24
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Wouldes TA, Crawford A, Stevens S, Stasiak K. Evidence for the Effectiveness and Acceptability of e-SBI or e-SBIRT in the Management of Alcohol and Illicit Substance Use in Pregnant and Post-partum Women. Front Psychiatry 2021; 12:634805. [PMID: 34025470 PMCID: PMC8131659 DOI: 10.3389/fpsyt.2021.634805] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/17/2021] [Indexed: 12/12/2022] Open
Abstract
Alcohol and illicit psychoactive drug use during pregnancy have increased worldwide, putting women and their children's health and development at risk. Multiple drug use, comorbid psychiatric disorders, sexual and physical abuse are common in women who use alcohol and drugs during pregnancy. The effects on the mother include poor reproductive and life-long health, legal, family, and social problems. Additionally, the exposed child is at increased risk of long-term physical health, mental health, and developmental problems. The stigma associated with substance use during pregnancy and some clinicians' reticence to inquire about substance use means many women are not receiving adequate prenatal, substance abuse, and mental health care. Evidence for mHealth apps to provide health care for pregnant and post-partum women reveal the usability and effectiveness of these apps to reduce gestational weight gain, improve nutrition, promote smoking cessation and manage gestational diabetes mellitus, and treat depression and anxiety. Emerging evidence suggests mHealth technology using a public health approach of electronic screening, brief intervention, or referral to treatment (e-SBIRT) for substance use or abuse can overcome the typical barriers preventing women from receiving treatment for alcohol and drug use during pregnancy. This brief intervention delivered through a mobile device may be equally effective as SBIRT delivered by a health care professional in preventing maternal drug use, minimizing the effects to the exposed child, and providing a pathway to therapeutic options for a substance use disorder. However, larger studies in more diverse settings with women who have co-morbid mental illness and a constellation of social risk factors that are frequently associated with substance use disorders are needed.
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Affiliation(s)
- Trecia A Wouldes
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Andi Crawford
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
- Te Ara Manapou, Parenting and Pregnancy Service, Hawke's Bay District Health Board, Hastings, New Zealand
| | - Suzanne Stevens
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Karolina Stasiak
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
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25
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Lenz AS, Li C. Evidence for Measurement Invariance and Psychometric Reliability for Scores on the PHQ-4 From a Rural and Predominately Hispanic Community. Measurement and Evaluation in Counseling and Development 2021. [DOI: 10.1080/07481756.2021.1906157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Chi Li
- The University of Memphis, Memphis, TN, USA
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26
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Pengpid S, Peltzer K, Ramlagan S. Prevalence and correlates of hazardous, harmful or dependent alcohol use and drug use amongst persons 15 years and older in South Africa: Results of a national survey in 2017. Afr J Prim Health Care Fam Med 2021; 13:e1-e8. [PMID: 33764134 PMCID: PMC8008028 DOI: 10.4102/phcfm.v13i1.2847] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/13/2021] [Accepted: 02/15/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Harmful alcohol and illicit drug use significantly contribute the burden of disease. AIM This study aimed to assess the prevalence and correlates of hazardous, harmful or dependent alcohol (HHDA) use and drug use amongst persons 15 years and older in South Africa. SETTING Population-based survey. METHOD In a national cross-sectional 2017 survey, 39 210 persons 15 years and older (Median = 34 years) responded to a questionnaire on substance and health variables. The prevalence of HHDA use was 10.3% and past 3-month drug use 8.6%. RESULTS In adjusted logistic regression analysis, men of middle age (25-34 year olds) with higher education, urban residence, drug use and psychological distress were positively associated and Indian or Asian and white population groups were negatively associated with HHDA. Women of middle age (25-34 year old) and mixed race, residing on rural farms and urban areas, with drug use and psychological distress were positively associated and older age (55 years and older) and Indians or Asians were negatively associated with HHDA. In adjusted logistic regression analysis, men, having Grade 8-11 education, mixed race, being unemployed, and the HHDA used were positively associated and middle and older age (25 years and older) and being a student or learner were negatively associated with past 3-month any drug use. Women, who were mixed race, Indians or Asians, with the HHDA use were positively associated and older age (45 years and older) were negatively associated with the past 3-month drug use. CONCLUSION About one in 10 participants with several sociodemographic and health indicators was identified to be associated with HHDA and any drug use.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand; and, Department of Research Administration and Development, University of Limpopo, Polokwane.
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27
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Sepulveda M, Manning EE, Gogos A, Hale M, van den Buuse M. Long-term effects of young-adult methamphetamine on dorsal raphe serotonin systems in mice: Role of brain-derived neurotrophic factor. Brain Res 2021; 1762:147428. [PMID: 33737066 DOI: 10.1016/j.brainres.2021.147428] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/15/2021] [Accepted: 03/08/2021] [Indexed: 01/21/2023]
Abstract
To assess the long-term effects of chronic adolescent methamphetamine (METH) treatment on the serotonin system in the brain, we used serotonin-1A receptor (5-HT1A) and serotonin transporter (SERT) autoradiography, and quantitative tryptophan-hydroxylase 2 (TPH2) immunohistochemistry in the raphe nuclei of mice. Because of the modulatory role of brain-derived neurotrophic factor (BDNF) on the serotonin system and the effects of METH, we included both BDNF heterozygous (HET) mice and wildtype (WT) controls. Male and female mice of both genotypes were treated with an escalating METH dose regimen from the age of 6-9 weeks. At least two weeks later, acute locomotor hyperactivity induced by a 5 mg/kg D-amphetamine challenge was significantly enhanced in METH-pretreated mice, showing long-term sensitisation. METH pretreatment caused a small, but significant decrease of 5-HT1A receptor binding in the dorsal raphe nucleus (DRN) of males independent of genotype, but there were no changes in the median raphe nucleus (MRN) or in SERT binding density. METH treatment reduced the number of TPH2 positive cells in ventral subregions of the rostral and medial DRN independent of genotype. METH treatment selectively reduced DRN cell counts in BDNF HET mice compared to wildtype mice in medial and caudal ventrolateral subregions previously associated with panic-like behaviour. The data increase our understanding of the long-term and selective effects of METH on brain serotonin systems. These findings could be relevant for some of the psychosis-like symptoms associated with long-term METH use.
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Affiliation(s)
- Mauricio Sepulveda
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Australia
| | - Elizabeth E Manning
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Australia
| | - Andrea Gogos
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Australia
| | - Matthew Hale
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Maarten van den Buuse
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia; Department of Pharmacology, University of Melbourne, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia.
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28
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Sarkar S, Tom A, Mandal P. Barriers and Facilitators to Substance Use Disorder Treatment in Low-and Middle-Income Countries: A Qualitative Review Synthesis. Subst Use Misuse 2021; 56:1062-1073. [PMID: 33849383 DOI: 10.1080/10826084.2021.1908359] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND AIMS One of the ways to address the treatment gap for substance use disorders is to understand the barriers and facilitators to treatment. This study aimed to synthesize the literature on barriers and facilitators of treatment in Low- and Middle-Income Countries (LMICs). METHODS We search Medline electronic database to identify English language peer reviewed empirical studies, both qualitative and quantitative which reported barriers and/or facilitators of treatment of substance use disorders. RESULTS Of 1389 titles, we selected 28 studies (14 were qualitative and 14 quantitative studies). The sample sizes of the qualitative studies ranged from 11 to 235. The majority of studies were from community or clinic settings. A wide range of barriers and facilitators were identified from the qualitative studies and were synthesized according to perceived susceptibility/seriousness, self-efficacy, perceived costs, perceived benefits, and cues to action. Most of the quantitative studies were community-based cross sectional-observational by design. Commonly identified barriers in these quantitative studies were perceived lack of problem or lack of need for treatment and low motivation whereas factors such as good family support and availability of effective treatment was found to facilitate substance use disorder treatment. CONCLUSION There are a wide range of barriers that hinder the substance use disorder treatment as well as certain factors that facilitate the treatment. Addressing them can help to minimize the treatment gap, which in turn can help in reducing the familial and social burden due to substance use disorders.
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Affiliation(s)
- Siddharth Sarkar
- Department of Psychiatry and National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Ashlyn Tom
- Department of Psychiatry and National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Piyali Mandal
- Department of Psychiatry and National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, New Delhi, India
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29
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Magri MC, Nunes AKDS, Dantas BP, Manchiero C, Prata TVG, Alves GM, Tengan FM. Meta-Analysis of the Prevalence of HBV Infection Among Alcohol Users Worldwide. Alcohol Alcohol 2020; 55:136-143. [PMID: 31912149 DOI: 10.1093/alcalc/agz102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 08/15/2019] [Accepted: 08/29/2019] [Indexed: 12/20/2022] Open
Abstract
AIMS To investigate the prevalence of hepatitis B virus (HBV) infection among alcohol users. METHODS A systematic search of articles in the PubMed, Web of Science and EMBASE databases was conducted. The methodological quality of each study was scored, and a meta-analysis was performed taking into account the heterogeneity expected among the studies. Publication bias was assessed using Begg's and Egger's tests. RESULTS The search identified 998 reports that yielded 18 eligible studies. The studies comprised 12,204 alcohol users, who were mostly men. The mean score on the quality evaluation was 6.9, and 11 studies were classified as having a low risk of bias. The estimated worldwide prevalence of HBV was 20.0% (95%CI: 19.0-20.0). The heterogeneity among the studies was substantial (I2 = 96.7%). In subgroup analyses, it was observed that among alcohol user dependents with no description of liver damage, alcohol users with different stages of chronic liver disease and alcohol users who all had cirrhosis, the estimated prevalence was 10.0% (95%CI: 8.0-14.0), 14.0% (95%CI: 13.0-15.0) and 32.0% (95%CI: 29.0-35.0), respectively. The meta-regression analysis showed that the study quality score had an influence on the investigated prevalence (P = 0.005). Nevertheless, the funnel plot showed asymmetry, and there was evidence of publication bias according to Egger's test (P = 0.003) but not Begg's test (P = 0.869). CONCLUSIONS The prevalence of HBV among alcohol users was high. HBV infection and alcohol consumption are factors affecting the development and worsening of liver disease; therefore, we suggest that adult alcohol users should be carefully monitored.
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Affiliation(s)
- Mariana Cavalheiro Magri
- Laboratorio de Investigacao Medica em Hepatologia por Virus (LIM-47), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Arielle Karen da Silva Nunes
- Laboratorio de Investigacao Medica em Hepatologia por Virus (LIM-47), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Bianca Peixoto Dantas
- Laboratorio de Investigacao Medica em Hepatologia por Virus (LIM-47), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Caroline Manchiero
- Laboratorio de Investigacao Medica em Hepatologia por Virus (LIM-47), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Thamiris Vaz Gago Prata
- Laboratorio de Investigacao Medica em Hepatologia por Virus (LIM-47), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Grayce Mendes Alves
- Laboratorio de Investigacao Medica em Hepatologia por Virus (LIM-47), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Fátima Mitiko Tengan
- Laboratorio de Investigacao Medica em Hepatologia por Virus (LIM-47), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.,Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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30
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Thompson TP, Horrell J, Taylor AH, Wanner A, Husk K, Wei Y, Creanor S, Kandiyali R, Neale J, Sinclair J, Nasser M, Wallace G. Physical activity and the prevention, reduction, and treatment of alcohol and other drug use across the lifespan (The PHASE review): A systematic review. Ment Health Phys Act 2020; 19:100360. [PMID: 33020704 PMCID: PMC7527800 DOI: 10.1016/j.mhpa.2020.100360] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 09/25/2020] [Accepted: 09/28/2020] [Indexed: 12/22/2022]
Abstract
The aim of this review is to systematically describe and quantify the effects of PA interventions on alcohol and other drug use outcomes, and to identify any apparent effect of PA dose and type, possible mechanisms of effect, and any other aspect of intervention delivery (e.g. key behaviour change processes), within a framework to inform the design and evaluation of future interventions. Systematic searches were designed to identify published and grey literature on the role of PA for reducing the risk of progression to alcohol and other drug use (PREVENTION), supporting individuals to reduce alcohol and other drug use for harm reduction (REDUCTION), and promote abstinence and relapse prevention during and after treatment of alcohol and other drug use (TREATMENT). Searches identified 49,518 records, with 49,342 excluded on title and abstract. We screened 176 full text articles from which we included 32 studies in 32 papers with quantitative results of relevance to this review. Meta-analysis of two studies showed a significant effect of PA on prevention of alcohol initiation (risk ratio [RR]: 0.72, 95%CI: 0.61 to 0.85). Meta-analysis of four studies showed no clear evidence for an effect of PA on alcohol consumption (Standardised Mean Difference [SMD]: 0.19, 95%, Confidence Interval -0.57 to 0.18). We were unable to quantitatively examine the effects of PA interventions on other drug use alone, or in combination with alcohol use, for prevention, reduction or treatment. Among the 19 treatment studies with an alcohol and other drug use outcome, there was a trend for promising short-term effect but with limited information about intervention fidelity and exercise dose, there was a moderate to high risk of bias. We identified no studies reporting the cost-effectiveness of interventions. More rigorous and well-designed research is needed. Our novel approach to the review provides a clearer guide to achieve this in future research questions addressed to inform policy and practice for different populations and settings.
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Affiliation(s)
- T P Thompson
- Faculty of Health, Medicine, Dentistry & Human Sciences University of Plymouth, Plymouth Science Park Derriford, Plymouth, PL6 8BX, UK
| | - J Horrell
- Faculty of Health, Medicine, Dentistry & Human Sciences University of Plymouth, Plymouth Science Park Derriford, Plymouth, PL6 8BX, UK
| | - A H Taylor
- Faculty of Health, Medicine, Dentistry & Human Sciences University of Plymouth, Plymouth Science Park Derriford, Plymouth, PL6 8BX, UK
| | - A Wanner
- Faculty of Health, Medicine, Dentistry & Human Sciences University of Plymouth, Plymouth Science Park Derriford, Plymouth, PL6 8BX, UK
| | - K Husk
- Faculty of Health, Medicine, Dentistry & Human Sciences University of Plymouth, Plymouth Science Park Derriford, Plymouth, PL6 8BX, UK
| | - Y Wei
- University of Plymouth, Centre for Mathematical Sciences, School of Engineering, Computing and Mathematics, Drake Circus, Plymouth, PL4 8AA, UK
| | - S Creanor
- Faculty of Health, Medicine, Dentistry & Human Sciences University of Plymouth, Plymouth Science Park Derriford, Plymouth, PL6 8BX, UK
| | - R Kandiyali
- Bristol University, School of Social and Community Medicine, Oakfield Grove, Clifton, Bristol, BS8 2BN, UK
| | - J Neale
- King's College London Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, Denmark Hill, London, SE5 8BB, UK
| | - J Sinclair
- University of Southampton, Faculty of Medicine, 4-12 Terminus Terrace, Southampton, SO14 3DT, UK
| | - M Nasser
- Faculty of Health, Medicine, Dentistry & Human Sciences University of Plymouth, Plymouth Science Park Derriford, Plymouth, PL6 8BX, UK
| | - G Wallace
- Plymouth City Council, Public Dispensary, Catherine Street, Plymouth, PL1 2AA, UK
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31
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Altwaijri YA, Al-Habeeb A, Al-Subaie AS, Bilal L, Al-Desouki M, Shahab MK, Hyder S, Sampson NA, King AJ, Kessler RC. Twelve-month prevalence and severity of mental disorders in the Saudi National Mental Health Survey. Int J Methods Psychiatr Res 2020; 29:e1831. [PMID: 33245602 PMCID: PMC7507007 DOI: 10.1002/mpr.1831] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/12/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To estimate 12-month prevalence and severity of mental disorders in the Saudi National Mental Health Survey (SNMHS). METHODS The SNMHS is a face-to-face community epidemiological survey in a nationally representative household sample of citizens aged 15 to 65 in the Kingdom of Saudi Arabia (KSA) (n = 4,004). The World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) was used to estimate 12-month prevalence of common DSM-IV mental disorders. RESULTS Twelve-month prevalence of any DSM-IV/CIDI disorder is 20.2%. Most common are anxiety disorders (12.3%) followed by mood (6.8%), disruptive behavior (5.4%), eating (3.2%), and substance use (1.9%) disorders. The proportion of 12-month cases rated serious (39.0% of all cases) is high across virtually all disorders relative to the proportions found in CIDI surveys in other high-income countries. Younger people have significantly elevated odds of mood and disruptive behavior disorders and serious disorders. Women have significantly elevated odds of anxiety and mood disorders and serious disorders. Previously married people have significantly elevated odds of most disorder classes and serious disorders. CONCLUSIONS Both 12-month prevalence and severity of DSM-IV/CIDI disorders are high in Saudi Arabia compared to other high-income countries that carried out comparable surveys.
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Affiliation(s)
- Yasmin A Altwaijri
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine , King Saud University, Riyadh, Saudi Arabia.,King Salman Center for Disability Research, Riyadh, Saudi Arabia.,Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist, Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Abdulhameed Al-Habeeb
- National Center for Mental Health Promotion, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdullah S Al-Subaie
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine , King Saud University, Riyadh, Saudi Arabia.,Edrak Medical Center, Riyadh, Saudi Arabia
| | - Lisa Bilal
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine , King Saud University, Riyadh, Saudi Arabia.,King Salman Center for Disability Research, Riyadh, Saudi Arabia.,Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist, Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Majid Al-Desouki
- Psychiatry Unit, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Mona K Shahab
- King Salman Center for Disability Research, Riyadh, Saudi Arabia.,Clinical Epidemiology, Leiden University Medical Center; Faculty of Social and Behavioural Sciences, Clinical Psychology Department, Leiden University, Leiden, The Netherlands.,i-psy interculturele psychiatrie, Parnassia Groep, The Hague, The Netherlands
| | - Sanaa Hyder
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine , King Saud University, Riyadh, Saudi Arabia.,King Salman Center for Disability Research, Riyadh, Saudi Arabia.,Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist, Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrew J King
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
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32
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Altwaijri YA, Al-Subaie AS, Al-Habeeb A, Bilal L, Al-Desouki M, Aradati M, King AJ, Sampson NA, Kessler RC. Lifetime prevalence and age-of-onset distributions of mental disorders in the Saudi National Mental Health Survey. Int J Methods Psychiatr Res 2020; 29:e1836. [PMID: 33245595 PMCID: PMC7507419 DOI: 10.1002/mpr.1836] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 05/06/2020] [Accepted: 05/11/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To estimate lifetime prevalence of mental disorders in the Saudi National Mental Health Survey (SNMHS). METHODS The SNMHS is a face-to-face community epidemiological survey in a nationally representative household sample of citizens ages 15-65 in the Kingdom of Saudi Arabia (KSA) (n = 4,004). The World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) was used to estimate lifetime prevalence of common DSM-IV mental disorders. RESULTS Estimated lifetime prevalence of any DSM-IV/CIDI disorder is 34.2% and lifetime morbid risk is 38.0%. Anxiety disorders are by far the most prevalent (23.2%) followed by disruptive behavior (11.2%), mood (9.3%), eating (6.1%), and substance use (4.0%) disorders. Synthetic estimates of cohort effects suggest that prevalence of many disorders has increased in recent cohorts. Onsets typically occur in childhood for a number of anxiety and disruptive behavior disorders and in adolescence or early adulthood for most other disorders, although age-of-onset distributions for drug abuse is much later (median age of 31) than in CIDI surveys carried out in other high-income countries. CONCLUSIONS Lifetime mental disorders are highly prevalent in Saudi Arabia and typically have early ages-of-onset.
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Affiliation(s)
- Yasmin A Altwaijri
- King Salman Center for Disability Research, Riyadh, Saudi Arabia.,Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah S Al-Subaie
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Edrak Medical Center, Riyadh, Saudi Arabia
| | - Abdulhameed Al-Habeeb
- National Center for Mental Health Promotion, Ministry of Health, Riyadh, Saudi Arabia
| | - Lisa Bilal
- King Salman Center for Disability Research, Riyadh, Saudi Arabia.,Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Majid Al-Desouki
- Psychiatry Unit, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Maggie Aradati
- King Salman Center for Disability Research, Riyadh, Saudi Arabia.,Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Andrew J King
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
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Affiliation(s)
- Samson F. Agberotimi
- Lifestyle Diseases Research Entity, North-West University, Mafikeng Campus, Mafikeng, South Africa
| | | | - Choja Oduaran
- Lifestyle Diseases Research Entity, North-West University, Mafikeng Campus, Mafikeng, South Africa
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Kuerbis A. Substance Use among Older Adults: An Update on Prevalence, Etiology, Assessment, and Intervention. Gerontology 2019; 66:249-258. [DOI: 10.1159/000504363] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 10/26/2019] [Indexed: 11/19/2022] Open
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