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Leung J, Mekonen T, Wang X, Arunogiri S, Degenhardt L, McKetin R. Methamphetamine exposure and depression-A systematic review and meta-analysis. Drug Alcohol Rev 2023; 42:1438-1449. [PMID: 37126460 DOI: 10.1111/dar.13670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 02/14/2023] [Accepted: 03/30/2023] [Indexed: 05/02/2023]
Abstract
ISSUES Methamphetamine use is a public health concern that has been associated with comorbid mental health problems. We aim to better understand the relationship between methamphetamine use and depression by: (i) systematically reviewing and meta-analysing the risks of depression by methamphetamine use; and (ii) investigating the risk of unmeasured confounding. APPROACH A systematic review and meta-analysis were conducted following PRISMA guidelines. EMBASE, PsycINFO and PubMed were searched to identify human studies reporting on the association between methamphetamine or amphetamine use and depressive outcomes. The data were summarised narratively and meta-analysed, stratified by cross-sectional and longitudinal estimates. Unmeasured confounding was assessed by E-values analyses. KEY FINDINGS From the 6606 studies that came up from the search, 14 eligible studies were included in the narrative review and had data for meta-analysis. A significant association was found between any use of methamphetamine and any depression outcomes in cross-sectional (odds ratio [OR] = 1.66 [95% confidence interval [CI] 1.34, 2.05]) and longitudinal estimates (OR = 1.18 [95% CI 1.08, 1.28]). People with a methamphetamine use disorder had significantly higher odds of depression than those without (OR = 2.80 [95% CI 1.40, 5.90]). The E-values ranged from 1.28 to 6.30 for cross-sectional studies and from 2.37 to 3.21 for longitudinal studies. CONCLUSION Based on limited data, people who used methamphetamine have higher odds of depression than people who do not. There were mostly a low to moderate risk of unmeasured confounding in the longitudinal study results. Future longitudinal studies conducted using causal framework methods are warranted.
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Affiliation(s)
- Janni Leung
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
- School of Psychology, The University of Queensland, Brisbane, Australia
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Tesfa Mekonen
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
- School of Psychology, The University of Queensland, Brisbane, Australia
- Psychiatry Department, Bahir Dar University, Bahir Dar, Ethiopia
| | - XiaoXuan Wang
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
- School of Psychology, The University of Queensland, Brisbane, Australia
| | | | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Rebecca McKetin
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
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Vernaglia TVC, Cruz MS, Peres S. O acesso ao tratamento de usuárias de crack sob a perspectiva dos profissionais de saúde. SAÚDE EM DEBATE 2020. [DOI: 10.1590/0103-11042020e316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO O consumo de crack é um problema de saúde pública no Brasil. Nesse grupo, as mulheres se encontram em situação de maior vulnerabilidade, em especial, por acessarem menos os serviços de saúde. Por esse motivo, o objetivo deste estudo foi analisar os sentidos do acesso ao tratamento de mulheres usuárias de crack na perspectiva dos profissionais de saúde de um Centro de Atenção Psicossocial – Álcool e Outras Drogas (Caps AD). Trata-se de uma pesquisa de campo, qualitativa, por meio da observação participante (54 visitas) e de 13 entrevistas semiestruturadas com profissionais, realizada durante oito meses de imersão em um Caps AD do Rio de Janeiro. Um software de gerenciamento de dados – o NVivo – foi utilizado para a análise temática. Trabalho aprovado pelo Comitê de Ética e Pesquisa. Para os profissionais, as mulheres vão buscar ajuda porque possuem laços familiares rompidos, precisam de ajuda social devido ao seu contexto de vulnerabilidade e procuram um tratamento direcionado ao seu corpo em falência. Conclui-se como de fundamental importância que o Caps AD ofereça um trabalho desburocratizado e que amplie suas ações no território.
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Affiliation(s)
| | | | - Simone Peres
- Universidade Federal do Rio de Janeiro (UFRJ), Brasil
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McKetin R, Leung J, Stockings E, Huo Y, Foulds J, Lappin JM, Cumming C, Arunogiri S, Young JT, Sara G, Farrell M, Degenhardt L. Mental health outcomes associated with of the use of amphetamines: A systematic review and meta-analysis. EClinicalMedicine 2019; 16:81-97. [PMID: 31832623 PMCID: PMC6890973 DOI: 10.1016/j.eclinm.2019.09.014] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/20/2019] [Accepted: 09/20/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The use of amphetamines is a global public health concern. We summarise global data on use of amphetamines and mental health outcomes. METHODS A systematic review and meta-analysis (CRD 42017081893). We searched Medline, EMBASE, PsycInfo for methamphetamine or amphetamine combined with psychosis, violence, suicidality, depression or anxiety. Included studies were human empirical cross-sectional surveys, case-control studies, cohort studies and randomised controlled trials that assessed the association between methamphetamine and one of the mental health outcomes. Random effects meta-analysis was used to pool results for any use of amphetamines and amphetamine use disorders. FINDINGS 149 studies were eligible and 59 were included in meta-analyses. There was significant heterogeneity in effects. Evidence came mostly from cross-sectional studies. Any use of amphetamines was associated with higher odds of psychosis (odds ratio [OR] = 2.0, 95%CI 1.3-3.3), violence (OR = 2.2, 95%CI 1.2-4.1; adjusted OR [AOR] = 1.4, 95%CI 0.8-2.4), suicidality OR = 4.4, 95%CI 2.4-8.2; AOR = 1.7, 95%CI 1.0-2.9) and depression (OR = 1.6, 95%CI 1.1-2.2; AOR = 1.3, 95%CI 1.2-1.4). Having an amphetamine use disorder was associated with higher odds of psychosis (OR = 3.0, 95%CI 1.9-4.8; AOR = 2.4, 95%CI 1.6-3.5), violence (OR = 6.2, 95%CI 3.1-12.3), and suicidality (OR = 2.3, 95%CI 1.8-2.9; AOR = 1.5, 95%CI 1.3-1.8). INTERPRETATION Methamphetamine use is an important risk factor for poor mental health. High quality population-level studies are needed to more accurately quantify this risk. Clinical responses to methamphetamine use need to address mental health harms.
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Affiliation(s)
- Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Corresponding author.
| | - Janni Leung
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Faculty of Health and Behavioural Sciences, The University of Queensland, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Yan Huo
- Faculty of Health and Behavioural Sciences, The University of Queensland, Australia
| | - James Foulds
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Julia M. Lappin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- School of Psychiatry, University of NSW, Sydney, Australia
| | - Craig Cumming
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Shalini Arunogiri
- Turning Point, Eastern Health, Richmond, VIC, Australia
- Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Jesse T. Young
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Grant Sara
- Northern Clinical School, Sydney Medical School, University of Sydney, Australia
- InforMH, System Information and Analytics Branch, NSW Ministry of Health, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Health outcomes associated with crack-cocaine use: Systematic review and meta-analyses. Drug Alcohol Depend 2017; 180:401-416. [PMID: 28982092 DOI: 10.1016/j.drugalcdep.2017.08.036] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/29/2017] [Accepted: 08/29/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Crack-cocaine use is prevalent largely in socio-economically marginalized populations in the Americas. Its use has been associated with diverse health outcomes, yet no recent or systematic reviews of these exist. METHODS A systematic review of health outcomes associated with crack-cocaine use was performed, using MEDLINE, Scopus, Web of Science, CINAHL, PsycINFO, and LILACS up to October 2016. Search terms included crack-cocaine and health outcome-related keywords, targeting peer-reviewed studies on quantified health outcomes associated with crack-cocaine use. Random effects meta-analyses produced pooled odds ratios. Levels of evidence for major results were assessed using the GRADE approach. A review protocol was registered with PROSPERO (CRD42016035486). RESULTS Of 4700 articles returned, 302 met eligibility criteria, reporting on health outcomes for 14 of 22 ICD-10 chapters. Conclusive evidence and meta-analyses showed positive associations between crack-cocaine use and blood/sexually transmitted diseases (HIV and hepatitis C virus, others); moderate evidence and meta-analyses supported associations with neonatal health, and violence. There were mixed associations for mental and other health outcomes, yet insufficient evidence to perform meta-analyses for many categories (e.g., mortality). Most underlying research was of limited or poor quality, with crack-cocaine commonly assessed as a secondary covariate. CONCLUSIONS Crack-cocaine use was associated with a range of health outcomes, although it was unclear if there was direct causal impact, interactions between risk factors, or external drivers of both crack-cocaine use and outcomes. Rigorous epidemiological studies are needed to systematically assess health outcomes of crack-cocaine use and underlying pathways, also to inform evidence-based interventions.
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Liu ZW, Yu Y, Hu M, Liu HM, Zhou L, Xiao SY. PHQ-9 and PHQ-2 for Screening Depression in Chinese Rural Elderly. PLoS One 2016; 11:e0151042. [PMID: 26978264 PMCID: PMC4792401 DOI: 10.1371/journal.pone.0151042] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 02/23/2016] [Indexed: 11/30/2022] Open
Abstract
Objectives This study aimed to explore cut-off scores of the 9-item Patient Health Questionnaire (PHQ-9) and 2-item Patient Health Questionnaire (PHQ-2) for depression screening in Chinese rural elderly. Methods A cross-sectional study was conducted on 839 residents aged 60 years and above in rural areas of Liuyang County. PHQ-9 was adopted to evaluate depression. The Structured Clinical Interview for DSM Disorders (SCID-I) was adopted to diagnose major depressive disorder (MDD) as a golden standard. Sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio, Youden’s index and the receiver operating characteristic (ROC) curve were analyzed on PHQ-9 and PHQ-2. Results The Cronbach's alphas of PHQ-9 and PHQ-2 were 0.82 and 0.76, respectively. The score of 8 of the PHQ-9 showed the highest Youden’s index of 0.85, with a sensitivity of 0.97 and specificity of 0.89 respectively, and the area under the ROC curve (AUC) was 0.97 (95% CI: 0.96–0.98). The score of 3 of PHQ-2 showed the highest Youden’s index of 0.79, with both sensitivity and specificity were 0.90 and the AUC was 0.94 (95% CI: 0.90–0.97). Conclusions Both PHQ-9 and PHQ-2 are valid screening instruments for depression in the rural elderly in China, with recommended cut-off scores of 8 and 3 respectively.
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Affiliation(s)
- Zi-wei Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Mi Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Hui-ming Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Liang Zhou
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Shui-yuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- * E-mail:
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Socio-ecological factors associated with depression, suicidal ideation and suicidal attempt among female injection drug users who are sex workers in China. Drug Alcohol Depend 2014; 144:102-10. [PMID: 25236890 PMCID: PMC5581303 DOI: 10.1016/j.drugalcdep.2014.08.011] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 08/17/2014] [Accepted: 08/17/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Female injection drug users who are also sex workers (FSW-IDUs) occupy a pivotal population in HIV transmission, whereas their mental health problems are largely overlooked. We aimed to investigate prevalence and associated socio-ecological factors of depression, suicidal ideation and suicidal attempts among FSW-IDUs in China. METHODS Using snowball sampling methods, 200 FSW-IDUs were recruited from communities in Liuzhou, China. Anonymous face-to-face interviews were administered by trained doctors. RESULTS Thirty-nine percent of participants had severe or extremely severe depression, 44.7% had suicidal ideation in the last six months and 26.8% had suicidal attempts in the last six months. After adjusting for background variables, self-stigma was significantly associated with severe or extremely severe depression (OR=1.18, 95% CI: 1.07-1.31). Self-stigma (OR=1.08, 95% CI: 1.01-1.15), depression (OR=1.11, 95% CI: 1.05-1.18), having completely broken up with family (OR=2.60, 95% CI: 1.35-5.02) and having been abused by clients or gatekeepers (OR=2.15, 95% CI: 1.32-3.50) were associated with suicidal ideation in the last six months, while self-stigma (OR=1.03, 95% CI: 1.10-1.16), depression (OR=1.12, 95% CI: 1.04-1.20) and being abused by clients or gatekeepers (OR=2.15, 95% CI: 1.09-4.24) were associated with suicidal attempt in the last six months. In mediation analyses, the associations between self-stigma and the two suicidal outcomes were fully mediated by depression. CONCLUSIONS There are unmet mental health needs of FSW-IDUs. Screening of mental health problems should be integrated into current HIV-related services. Psychological intervention efforts should include components such as self-stigma, family support and abuse.
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Greiner AL, Albutt K, Rouhani SA, Scott J, Dombrowski K, VanRooyen MJ, Bartels SA. Respondent-driven sampling to assess outcomes of sexual violence: a methodological assessment. Am J Epidemiol 2014; 180:536-44. [PMID: 25073471 DOI: 10.1093/aje/kwu149] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Sexual violence is pervasive in eastern Democratic Republic of Congo (DRC). Survivors of sexual violence encounter numerous challenges, and women with a sexual violence-related pregnancy (SVRP) face even more complex sequelae. Because of the stigma associated with SVRP, there is no conventional sampling frame and, therefore, a paucity of research on SVRP outcomes. Respondent-driven sampling (RDS), used to study this "hidden" population, uses a peer recruitment sampling system that maintains strict participant privacy and controls and tracks recruitment. If RDS assumptions are met and the sample attains equilibrium, sample weights to correct for biases associated with traditional chain referral sampling can be calculated. Questionnaires were administered to female participants who were raising a child from a SVRP and/or who terminated a SVRP. A total of 852 participants were recruited from October 9, 2012, to November 7, 2012. There was rapid recruitment, and there were long referral chains. The majority of the variables reached equilibrium; thus, trends established in the sample population reflected the target population's trends. To our knowledge, this is the first study to use RDS to study outcomes of sexual violence. RDS was successfully applied to this population and context and should be considered as a sampling methodology in future sexual violence research.
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Herbeck DM, Brecht ML, Lovinger K, Raihan A, Christou D, Sheaff P. Poly-Drug and Marijuana Use Among Adults Who Primarily Used Methamphetamine. J Psychoactive Drugs 2013; 45:132-40. [DOI: 10.1080/02791072.2013.785824] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Campagne DM. [Organic and comorbid causes of depression: a first step]. Semergen 2012; 38:301-11. [PMID: 23544777 DOI: 10.1016/j.semerg.2011.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 12/20/2011] [Accepted: 12/26/2011] [Indexed: 12/01/2022]
Abstract
The primary objective of this review is to obtain a clinical orientation as to evidence-supported common «other» causes of depressive symptomatology, which predominantly are: medical issues; life events; vitamin, mineral and diet-related deficiencies; and hormones. A secondary goal was to reflect those more frequent "other" causes in a checklist for clinical use, comprising also the preferred treatment (medical/dietary, antidepressants, or psychological) resulting from the available evidence. Medline, Cochrane and main related databases were searched from 4(th) October 2010 to 27(th) April 2011, no language limits, with keywords: depression; organic; comorbid; medication; life events; hormones; vitamin; mineral; diet; disease; as well as further searches into each upcoming possibly related issue. Total studies contemplated: 3.211; total studies reviewed: 301, with criteria of relevancy; date of study or review; size and type; journal status. Data were abstracted based upon probable clinical relevancy and use. The main results obtained were evidence-supported indications as to these other causes of depressive symptomatology, that warrant early screening, attention and treatment, possibly before antidepressant or psychological therapy is started. PRELIMINARY CONCLUSION: There appears to be a clinical rationale for early checking of a number of evidence-based causes of depressive symptoms for which first-line testing is readily available. In several cases clinical treatment may be simple, and improvements in depressive symptoms rapidly obtainable. Using a pre-treatment protocol, both patients and health systems could benefit from biological and comorbid causes of depressive symptoms being established early. An enhanced response to low-cost corrective measures can decrease the risk of suicide.
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Affiliation(s)
- D M Campagne
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, Universidad Nacional de Educación a Distancia, Madrid, España.
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Drug withdrawal-induced depression: Serotonergic and plasticity changes in animal models. Neurosci Biobehav Rev 2012; 36:696-726. [DOI: 10.1016/j.neubiorev.2011.10.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Revised: 10/06/2011] [Accepted: 10/15/2011] [Indexed: 12/17/2022]
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