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The burden and trend of diseases and their risk factors in Australia, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Public Health 2023; 8:e585-e599. [PMID: 37516475 PMCID: PMC10400798 DOI: 10.1016/s2468-2667(23)00123-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 05/28/2023] [Accepted: 06/05/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND A comprehensive understanding of temporal trends in the disease burden in Australia is lacking, and these trends are required to inform health service planning and improve population health. We explored the burden and trends of diseases and their risk factors in Australia from 1990 to 2019 through a comprehensive analysis of the Global Burden of Disease Study (GBD) 2019. METHODS In this systematic analysis for GBD 2019, we estimated all-cause mortality using the standardised GBD methodology. Data sources included primarily vital registration systems with additional data from sample registrations, censuses, surveys, surveillance, registries, and verbal autopsies. A composite measure of health loss caused by fatal and non-fatal disease burden (disability-adjusted life-years [DALYs]) was calculated as the sum of years of life lost (YLLs) and years of life lived with disability (YLDs). Comparisons between Australia and 14 other high-income countries were made. FINDINGS Life expectancy at birth in Australia improved from 77·0 years (95% uncertainty interval [UI] 76·9-77·1) in 1990 to 82·9 years (82·7-83·1) in 2019. Between 1990 and 2019, the age-standardised death rate decreased from 637·7 deaths (95% UI 634·1-641·3) to 389·2 deaths (381·4-397·6) per 100 000 population. In 2019, non-communicable diseases remained the major cause of mortality in Australia, accounting for 90·9% (95% UI 90·4-91·9) of total deaths, followed by injuries (5·7%, 5·3-6·1) and communicable, maternal, neonatal, and nutritional diseases (3·3%, 2·9-3·7). Ischaemic heart disease, self-harm, tracheal, bronchus, and lung cancer, stroke, and colorectal cancer were the leading causes of YLLs. The leading causes of YLDs were low back pain, depressive disorders, other musculoskeletal diseases, falls, and anxiety disorders. The leading risk factors for DALYs were high BMI, smoking, high blood pressure, high fasting plasma glucose, and drug use. Between 1990 and 2019, all-cause DALYs decreased by 24·6% (95% UI 21·5-28·1). Relative to similar countries, Australia's ranking improved for age-standardised death rates and life expectancy at birth but not for YLDs and YLLs between 1990 and 2019. INTERPRETATION An important challenge for Australia is to address the health needs of people with non-communicable diseases. The health systems must be prepared to address the increasing demands of non-communicable diseases and ageing. FUNDING Bill & Melinda Gates Foundation.
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Saleem HT, West NS, Likindikoki S. Prevalence and predictors of depressive and anxiety symptoms in a sample of women who use drugs in Tanzania: the key role of drug use stigma. BMC Psychiatry 2023; 23:517. [PMID: 37464339 DOI: 10.1186/s12888-023-05008-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 07/07/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Globally, women who use drugs face multiple health vulnerabilities, including poor mental health. Little is known about the mental health burden among women who use drugs in sub-Saharan Africa. This cross-sectional study examined the prevalence and predictors of depressive and anxiety symptoms among a sample of women who use drugs in Dar es Salaam, Tanzania. METHODS We administered a cross-sectional survey to a non-random sample of 200 women who use drugs in Dar es Salaam between November 2018 and March 2019. We used descriptive statistics to characterize the study sample and fitted separate logistic regression models to assess depressive and anxiety symptoms and their predictors. RESULTS The percentages of women reporting depressive and anxiety symptoms were 67.5% and 43.7%, respectively. Internalized drug use stigma (AOR = 1.34, 95% CI: 1.03-1.75) and prior attempts to stop heroin use (AOR = 2.99, 95% CI: 1.28-7.00) were associated with depressive symptoms. Enacted drug use stigma from health workers (AOR = 2.02, 95% CI: 1.34-3.04) and anticipated drug use stigma from family (AOR = 1.49, 95% CI: 1.02-2.16) were associated with anxiety symptoms. CONCLUSIONS Depressive and anxiety symptoms were high among our study sample, with higher reports of symptoms of depression than anxiety. Drug use stigma was a key factor that contributed to elevated symptoms of depression and anxiety.
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Affiliation(s)
- Haneefa T Saleem
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Nora S West
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Samuel Likindikoki
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Warburton TM, Rush LD, Cullen EGR, Wiener JH, McManus BTK, Heath L, Evans D. The Impact of Homelessness, Substance Use, and Mental Illness on Surgical Inpatient Outcomes in Australia. Asia Pac J Public Health 2023; 35:335-341. [PMID: 37198924 DOI: 10.1177/10105395231175563] [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] [Indexed: 05/19/2023]
Abstract
This study investigated inpatient surgical outcomes for people experiencing homelessness (PEH) in Australia. Retrospective administrative health data of emergency surgical admissions from a single center over five years, 2015 to 2020, was included. Independent associations between factors and outcomes were analyzed with binary logistic and log-linear regression. Of 11 229 admissions, 2% were experiencing homelessness. People experiencing homelessness were on average younger (49 vs 56 years), more likely to be males than females (77% vs 61%), suffer mental illness (10% vs 2%), and substance use disorders (54% vs 10%). People experiencing homelessness were not more likely to suffer surgical complications. However, male sex, older age, mental illness, and substance use were risk factors for poor surgical outcomes. Homelessness predicted greater odds of discharge against medical advice (4.3 times) and longer length of stay (1.25 times). These results highlighted the need for health interventions simultaneously addressing physical, mental health, and substance use issues in the care of PEH.
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Affiliation(s)
- Thomas Mostyn Warburton
- Department of Surgery, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia
- Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
| | - Levon Delaney Rush
- Faculty of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
| | - Emma Grace Ruthven Cullen
- Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
- Department of Anaesthetics, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia
| | - Jonathan Harry Wiener
- Department of Surgery, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia
- Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
| | - Bryan Thomas Kelvin McManus
- Department of Surgery, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia
- Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
| | - Lucienne Heath
- Department of Surgery, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia
- Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
| | - David Evans
- Department of Surgery, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia
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Le LKD, Faller J, Chatterton ML, Perez JK, Chiotelis O, Tran HNQ, Sultana M, Hall N, Lee YY, Chapman C, Newton N, Slade T, Sunderland M, Teesson M, Mihalopoulos C. Interventions to prevent alcohol use: systematic review of economic evaluations. BJPsych Open 2023; 9:e117. [PMID: 37365798 DOI: 10.1192/bjo.2023.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Alcohol use is a leading risk factor for death and disability worldwide. AIMS We conducted a systematic review on the cost-effectiveness evidence for interventions to prevent alcohol use across the lifespan. METHOD Electronic databases (EMBASE, Medline, PsycINFO, CINAHL and EconLit) were searched for full economic evaluations and return-on-investment studies of alcohol prevention interventions published up to May 2021. The methods and results of included studies were evaluated with narrative synthesis, and study quality was assessed by the Drummond ten-point checklist. RESULTS A total of 69 studies met the inclusion criteria for a full economic evaluation or return-on-investment study. Most studies targeted adults or a combination of age groups, seven studies comprised children/adolescents and one involved older adults. Half of the studies found that alcohol prevention interventions are cost-saving (i.e. more effective and less costly than the comparator). This was especially true for universal prevention interventions designed to restrict exposure to alcohol through taxation or advertising bans; and selective/indicated prevention interventions, which involve screening with or without brief intervention for at-risk adults. School-based interventions combined with parent/carer interventions were cost-effective in preventing alcohol use among those aged under 18 years. No interventions were cost-effective for preventing alcohol use in older adults. CONCLUSIONS Alcohol prevention interventions show promising evidence of cost-effectiveness. Further economic analyses are needed to facilitate policy-making in low- and middle-income countries, and among child, adolescent and older adult populations.
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Affiliation(s)
- Long Khanh-Dao Le
- PhD, Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Jan Faller
- MHE, Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Mary Lou Chatterton
- PharmD, Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Joahna Kevin Perez
- MHE, Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Oxana Chiotelis
- MHE, Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Huong Ngoc Quynh Tran
- MHE, Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Marufa Sultana
- PhD, Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Natasha Hall
- MHE, Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Yong Yi Lee
- PhD, Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia; School of Public Health, The University of Queensland, Australia; and Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Australia
| | - Cath Chapman
- PhD, Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Nicola Newton
- PhD, Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Tim Slade
- PhD, Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Matt Sunderland
- PhD, Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Maree Teesson
- PhD, Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Cathrine Mihalopoulos
- PhD, Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
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Rabiee R, Lundin A, Agardh E, Allebeck P, Danielsson AK. Cannabis use disorder in relation to socioeconomic factors and psychiatric comorbidity: A cluster analysis of three million individuals born in 1970-2000. Scand J Public Health 2023; 51:82-89. [PMID: 36120841 PMCID: PMC9903242 DOI: 10.1177/14034948221122431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Cannabis use disorder (CUD) is one of the main reasons for seeking substance use treatment. It is thus important to monitor and increase knowledge of individuals with CUD utilizing healthcare. We aimed to examine the number of CUD diagnoses over time, compare individuals with CUD with those without and identify subgroups based on CUD diagnosis, sex, birth year, socioeconomic factors and psychiatric comorbidity. METHODS A Swedish, population-based study with 3,307,759 individuals, born in 1970-2000, with register data extending to 2016. K-mode cluster analysis was used to identify potential subgroups. RESULTS The number of individuals with a CUD diagnosis was 14,046 (0.42%). CUD diagnoses increased over time (born 1990-1994: 61 per 100,000, born 1995-2000: 107 per 100,000, by 2016). A majority of those with a CUD had another psychiatric diagnosis (80%, compared with 19% for those without CUD). Four clusters were identified. Cluster 1 comprised mainly men with low income and substance use disorders, clusters 2, 3 and 4 comprised mainly women with higher proportions of mood-related, neurotic and stress-related and behavioural disorders. CONCLUSIONS
There was an increase in CUD diagnoses in Sweden over time, especially among younger birth cohorts. Individuals with CUD were more often male, from younger birth cohorts, with lower education and income than those without CUD. Men and women with CUD exhibited differences in education, income and psychiatric comorbidity. Our results demonstrate the importance of monitoring the impact of socioeconomic factors and psychiatric comorbidity in relation to CUD.
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Affiliation(s)
- Rynaz Rabiee
- Department of Global Public Health, Karolinska Institutet, Sweden,Rynaz Rabiee, Karolinska Institutet, Department of Global Public Health (GPH), Stockholm, SE-171 77, Sweden. E-mail:
| | - Andreas Lundin
- Department of Global Public Health, Karolinska Institutet, Sweden,Centre for Epidemiology and Community Medicine, Sweden
| | - Emilie Agardh
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Peter Allebeck
- Department of Global Public Health, Karolinska Institutet, Sweden
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Problematic Use of Cannabis in Cotonou: Profile of Some Subjects Received in the Laboratory between 2016 and 2021. JOURNAL OF ADDICTION 2022; 2022:9702766. [PMID: 36339643 PMCID: PMC9635955 DOI: 10.1155/2022/9702766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/07/2022] [Accepted: 10/13/2022] [Indexed: 11/17/2022]
Abstract
Aims The frequent use of cannabis by certain social strata often induces behavioral changes whose severity deserves to be evaluated. This study aims to describe the profile of some subjects in a situation of cannabis dependence received at the National Laboratory of Narcotics and Toxicology over the period from January 2016 to December 2021. Methodology. The approach of direct interviews with the respondents using a semistructured questionnaire made it possible to collect their sociodemographic characteristics, their experiences, and their reference trajectories. Results A total of 48 patients, all single, with an average age of 18.13 ± 0.48 years, the majority of whom were male (77.08%) and of Beninese nationality (85.42%), were enrolled. They were pupils (58.34%), students (27.08%), and workers (14.58%). With a prevalence of consumption of 89.58%, the first experimentation of cannabis was done by imitation (83.3%), among friends (81.2%), and in schools (64.58%). The reasons for use include the search for thrills (29.20%) and the improvement of sexual energy performance (27.1%). Subjects between 64.58 and 79.17% reported having received complaints about their behavior after regular consumption of at least 3 joints of cannabis. Conclusion The knowledge of the typical profile of subjects in a situation of dependence ensures early detection of problematic uses of cannabis and offers the opportunity to intervene a little earlier in front of this phenomenon.
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Sinha A, Kohli A, Ghosh A, Basu D. Efficacy of screening and brief intervention for hazardous alcohol use in patients with mood disorders: A randomized clinical trial from a psychiatric out-patient clinic in India. Asian J Psychiatr 2022; 73:103138. [PMID: 35533601 DOI: 10.1016/j.ajp.2022.103138] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 08/09/2021] [Accepted: 04/20/2022] [Indexed: 11/24/2022]
Abstract
AIM To determine the efficacy of individual-based, face-to-face screening and brief intervention (SBI) for hazardous alcohol use among treatment-seeking outpatients with mood disorders. METHODS It was a parallel-group, single-blind, randomized controlled trial of 84 participants who met the selection criteria for hazardous alcohol use, defined by alcohol use disorder identification test (AUDIT) score 8-19. Participants were randomly allocated to either SBI or general advice group. Both groups had received a standard care for mood disorders. The outcome was assessed after 3 months. The primary outcome was a change in the mean AUDIT score and the secondary outcomes were a change in frequency of heavy episodic drinking and stages of motivation. RESULTS Majority (60%) had major depressive episodes. There was no significant difference in baseline demography and clinical variables between the groups. Both intention to treat and per-protocol analyses showed a small but significant effect of SBI on mean AUDIT score. Age, baseline AUDIT, and motivation did not moderate the effect. SBI was associated with a significant decrease in the frequency of heavy drinking and improvement in stages of motivation. CONCLUSION SBI among patients with mood disorders had a small but significant effect on alcohol use.
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Affiliation(s)
- Ankit Sinha
- Department of Psychiatry, All India Institute of Medical Sceinces, Bhubhneswar, India.
| | - Adarsh Kohli
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
| | - Abhishek Ghosh
- Drug De-addiction & Treatment Centre, Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
| | - Debasish Basu
- Drug De-addiction & Treatment Centre, Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
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Wang M, Chen Y, Li H, Zhang X, Xu Y, Ding ZH, Ma Z, Sun Y. Association Between Psychiatric Symptoms and Craving in Drug Withdrawal. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00783-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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Franz DJ, Cioffi CC. Client Characteristics Associated with Desire for Additional Services at Syringe Exchange Programs. JOURNAL OF SUBSTANCE USE 2022; 27:604-610. [PMID: 36644655 PMCID: PMC9838586 DOI: 10.1080/14659891.2021.1967486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objectives The objective of this study was to explore the relationship between client characteristics and desired services offered at syringe exchange program (SEP) sites among women who inject drugs (WWID). We investigated whether a desire for additional services varied as a function of these client characteristics. Methods A sample of 69 women who were syringe exchange clients participated in a survey about adding services to syringe exchange programs. Three Poisson regression analyses were run to examine if client age, education, housing status, polysubstance use, and previous pregnancies were associated with overall desire for services, desire for health-related services, and desire basic needs services. Results Participant characteristics of polysubstance use (IRR 1.62, 95% CI 1.34-1.96; p < .01) and greater number of previous pregnancies (IRR 1.14, 95% CI 1.08-1.22; p < .05), were predictive of a greater number of desired services. Engagement in polysubstance use was predictive of a greater number of desired basic need services (IRR 1.45, 95% CI 1.23-1.70; p < .05). Conclusions WWID desired services at SEP sites can inform policymakers to formulate policies to better promote utilization of health-related and basic need services among WWID and, in turn, facilitate improved outcomes for WWID.
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Treatment-seeking behaviour among people with opioid use disorder in the high-income countries: A systematic review and meta-analysis. PLoS One 2021; 16:e0258620. [PMID: 34653220 PMCID: PMC8519451 DOI: 10.1371/journal.pone.0258620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 09/01/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives To determine treatment seeking behaviour in those with opioid use disorder (OUD) in the high-income countries. Methods Five databases were searched in November 2019 for quantitative studies that reported OUD treatment seeking behaviour. Data analysis involved determining an overall pooled proportion estimate of treatment seeking behaviour for the two base groups, lifetime treatment and past 12-month or less treatment using the IVhet effect model. Subgroup analysis included heroin OUD, prescription OUD and general OUD. The sensitivity analysis included removal of outliers, separating adults and adolescents and the metaXL sensitivity analysis (studies are excluded if outside the pooled proportion confidence interval of the base case). Systematic review Prospero database registration number [CRD42020159531]. Results There were 13 quantitative studies included in the systematic review, with all studies being from the United States of America (USA). IVhet models showed that 40% (95% CI: 23%, 58%) and 21% (95% CI: 16%, 26%) sought treatment in their lifetime and past 12 months respectively. Sub-group analysis found that lifetime treatment seeking for prescription OUD, 29% (95% CI: 27%, 31%), was less than for heroin plus combined OUD, 54% (95% CI: 26%, 82%). Most of the pooled results had high heterogeneity statistics except for results of lifetime treatment seeking for prescription OUD and past 12-month treatment seeking for prescription OUD. Conclusion All included studies in this meta-analysis were from the USA and indicate modest levels of treatment seeking for those with OUD. In particular, this review found that in the USA one in five people with OUD sought OUD treatment in the previous 12 months and two in five people with OUD sought OUD treatment in their lifetime. Further research is urgently required to explore the barriers and facilitators that can improve this low treatment seeking in those with OUD.
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Abstract
AIMS Limited information exists about the prevalence of psychiatric illness for Indigenous Australians. This study examines the prevalence of diagnosed psychiatric disorders in Indigenous Australians and compares this to non-Indigenous Australians. The aims were to: (1) determine prevalence rates for psychiatric diagnoses for Indigenous Australians admitted to hospital; and (2) examine whether the profile of psychiatric diagnoses for Indigenous Australians was different compared with non-Indigenous Australians. METHODS A birth cohort design was adopted, with the population consisting of 45 141 individuals born in the Australian State of Queensland in 1990 (6.3% Indigenous). Linked administrative data from Queensland Health hospital admissions were used to identify psychiatric diagnoses from age 4/5 to 23/24 years. Crude lifetime prevalence rates of psychiatric diagnoses for Indigenous and non-Indigenous individuals were derived from the hospital admissions data. The cumulative incidence of psychiatric diagnoses was modelled separately for Indigenous and non-Indigenous individuals. Logistic regression was used to model differences between Indigenous and non-Indigenous psychiatric presentations while controlling for sociodemographic characteristics. RESULTS There were 2783 (6.2%) individuals in the cohort with a diagnosed psychiatric disorder from a hospital admission. The prevalence of any psychiatric diagnosis at age 23/24 years was 17.2% (491) for Indigenous Australians compared with 5.4% (2292) for non-Indigenous Australians. Indigenous individuals were diagnosed earlier, with overrepresentation in psychiatric illness becoming more pronounced with age. Indigenous individuals were overrepresented in almost all categories of psychiatric disorder and this was most pronounced for substance use disorders (SUDs) (12.2 v. 2.6% of Indigenous and non-Indigenous individuals, respectively). Differences between Indigenous and non-Indigenous Australians in the likelihood of psychiatric disorders were not statistically significant after controlling for sociodemographic characteristics, except for SUDs. CONCLUSIONS There is significant inequality in psychiatric morbidity between Indigenous and non-Indigenous Australians across most forms of psychiatric illness that is evident from an early age and becomes more pronounced with age. SUDs are particularly prevalent, highlighting the importance of appropriate interventions to prevent and address these problems. Inequalities in mental health may be driven by socioeconomic disadvantage experienced by Indigenous individuals.
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Abstract
Cannabis use disorder (CUD) is an underappreciated risk of using cannabis that affects ~10% of the 193 million cannabis users worldwide. The individual and public health burdens are less than those of other forms of drug use, but CUD accounts for a substantial proportion of persons seeking treatment for drug use disorders owing to the high global prevalence of cannabis use. Cognitive behavioural therapy, motivational enhancement therapy and contingency management can substantially reduce cannabis use and cannabis-related problems, but enduring abstinence is not a common outcome. No pharmacotherapies have been approved for cannabis use or CUD, although a number of drug classes (such as cannabinoid agonists) have shown promise and require more rigorous evaluation. Treatment of cannabis use and CUD is often complicated by comorbid mental health and other substance use disorders. The legalization of non-medical cannabis use in some high-income countries may increase the prevalence of CUD by making more potent cannabis products more readily available at a lower price. States that legalize medical and non-medical cannabis use should inform users about the risks of CUD and provide information on how to obtain assistance if they develop cannabis-related mental and/or physical health problems.
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Subramaniam S, Yee A, Bin Amer Nordin AS, Bin Khalib AQ. Prevalence of Severe Mental Illness Dual Diagnosis Among Inpatients in a Psychiatric Hospital in Malaysia. J Dual Diagn 2021; 17:4-12. [PMID: 33308058 DOI: 10.1080/15504263.2020.1854410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The aim of this study was to determine the prevalence of alcohol or non-alcohol substance use dual diagnosis among inpatients with severe mental illness in a psychiatric institution in Malaysia. In addition, this study aimed to determine adverse outcomes between dual diagnosis versus single diagnosis. Methods: This was a cross-sectional study conducted in the inpatient ward using the Mini-International Neuropsychiatric Interview (MINI) to establish the diagnosis of severe mental illness and to screen for alcohol or non-alcohol substance use disorder comorbidity. Outcomes and severity of different domains among severe mental illness patients were assessed using the Addiction Severity Index (ASI). Results: Out of 152 patients who participated in this study, 51.3% (n = 78) had comorbid alcohol use disorder, and 29.6% (n = 45) had non-alcohol substance use disorder. Males with Kadazan ethnicity with severe mental illness and alcohol use disorder had a higher risk of having comorbid non-alcohol substance use disorder. Similarly, male Kadazan patients with severe mental illness and non-alcohol substance use disorder had a higher risk of having a comorbid alcohol use disorder. Dual diagnosis patients with alcohol and non-alcohol substance use disorder had higher rates of hospitalizations (p < .001 and p = .001). Family and social relationships were affected among the alcohol use disorder group as shown by the higher composite score for family status (FCOMP; p < .001). This group also showed more severe psychiatric status, as the composite score for psychiatric status (PCOMP) was high (p = .004). Suicidality was higher among patients with alcohol use disorder and severe mental illness (p < .001). Conclusions: The prevalence of severe mental illness dual diagnosis was high in this study with poorer outcomes, higher rates of admissions, and risk of suicidality. This highlights the importance of provisions for a more holistic treatment approach among patients with dual diagnosis.
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Affiliation(s)
- Sughashini Subramaniam
- Department of Psychological Medicine, Faculty of Medicine, University Malaya Centre of Addiction Sciences (UMCAS), Kuala Lumpur, Malaysia
| | - Anne Yee
- Department of Psychological Medicine, Faculty of Medicine, University Malaya Centre of Addiction Sciences (UMCAS), Kuala Lumpur, Malaysia
| | - Amer Siddiq Bin Amer Nordin
- Department of Psychological Medicine, Faculty of Medicine, University Malaya Centre of Addiction Sciences (UMCAS), Kuala Lumpur, Malaysia
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Jiao C, Leng A, Nicholas S, Maitland E, Wang J, Zhao Q, Xu L, Gong C. Multimorbidity and Mental Health: The Role of Gender among Disease-Causing Poverty, Rural, Aged Households in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238855. [PMID: 33260787 PMCID: PMC7734588 DOI: 10.3390/ijerph17238855] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/20/2020] [Accepted: 11/20/2020] [Indexed: 12/15/2022]
Abstract
(1) Background: The association between multimorbidity and mental health is well established. However, the role of gender in different populations remains unclear. Currently, China is facing an increased prevalence of multimorbidity, especially in its disease-causing poverty population. The present study explores the gender-based differences in the relationship between multimorbidity and mental health using data from the rural, disease-causing poverty, older-age population in Shandong province, China, as a case study. (2) Methods: The data were obtained from the survey on the health and welfare of disease-causing poverty households in rural Shandong province. We identified 936 rural participants who were over 60 years old from disease-causing poverty households. The mental health status was measured using the Kessler Psychological Distress Scale (K10) instrument. Using a multivariable linear regression model, including the interaction of gender and multimorbidity, gender differences in the association between multimorbidity and mental health were explored. (3) Results: Multimorbidity was a serious health problem in rural, disease-causing poverty, older-age households, with the prevalence of multimorbidity estimated as 40% for women and 35.4% for men. There was a strong association between multimorbidity and mental health, which was moderated by gender. Women had higher K10 scores than men, and the mean K10 score was highest in women with three or more chronic diseases. Compared with men, women with multimorbidity had a higher risk of mental health problems. (4) Conclusions: The prevalence of multimorbidity in older-age rural disease-causing poverty subpopulations is a severe public health problem in China. The association between multimorbidity and mental health differed by gender, where multimorbid women suffered an increased mental health risk compared with men. Gender differences should be addressed when delivering effective physical and mental healthcare support to disease-causing poverty, older-age, rural households.
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Affiliation(s)
- Chen Jiao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (C.J.); (Q.Z.)
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Anli Leng
- School of Political Science and Public Administration, Institute of Governance, Shandong University, 72 Binhai Rd, Qingdao 266237, Shandong, China;
| | - Stephen Nicholas
- Australian National Institute of Management and Commerce, 1 Central Avenue, Australian Technology Park, Sydney, NSW 2015, Australia;
- Guangdong Institute for International Strategies, Guangdong University of Foreign Studies, 2 Baiyun North Avenue, Guangzhou 510420, Guangdong, China
- School of Economics and School of Management, Tianjin Normal University, No. 339 Binshui West Avenue, Tianjin 300387, China
- Newcastle Business School, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Elizabeth Maitland
- School of Management, University of Liverpool, Chatham Building, Chatham Street, Liverpool L697ZH, UK;
| | - Jian Wang
- Dong Fureng Institute of Economics and Social Development, Wuhan University, No. 54 Dongsi Lishi Hutong, Dongcheng District, Beijing 100010, China;
- Center for Health Economics and Management, Economics and Management School, Wuhan University, Luojia Hill, Wuhan 430072, China
| | - Qinfeng Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (C.J.); (Q.Z.)
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Lizheng Xu
- The George Institute for Global Health, Sydney, NSW 2052, Australia;
- UNSW Medicine, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Chaofan Gong
- Center for Digital Health, School of Medicine, Stanford University, Palo Alto, CA 94305, USA
- Correspondence:
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15
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Saadati H, Tavakoli Ghouchani H, Asghari D, Gholizadeh N, Rahimi J, Valizadeh R. Comparison of the quality of life and general health in opium and non-opium users referred to the addiction treatment centers. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1838635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Hassan Saadati
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Tavakoli Ghouchani
- Addiction and Behavioral Sciences Research Center Health North Khorasan University of Medical Sciences, Bojnurd, Department of Health Education and Promotion, School of Health North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Dordane Asghari
- Measurement And Measurement Field (Psychometric Field), Addiction And Behavioral Sciences Research Center (Researcher), Bojnurd, Iran
| | - Nazanin Gholizadeh
- General Psychology, Addiction and Behavioral Sciences Research Center(Researcher), Bojnurd, Iran
| | - Jamileh Rahimi
- Department of Epidemiology and Biostatistics, School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Rohollah Valizadeh
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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16
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Virtanen S, Kuja-Halkola R, Mataix-Cols D, Jayaram-Lindström N, D'Onofrio BM, Larsson H, Rück C, Suvisaari J, Lichtenstein P, Latvala A. Comorbidity of substance misuse with anxiety-related and depressive disorders: a genetically informative population study of 3 million individuals in Sweden. Psychol Med 2020; 50:1706-1715. [PMID: 31328718 DOI: 10.1017/s0033291719001788] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Causes of the comorbidity of substance misuse with anxiety-related and depressive disorders (anxiety/depression) remain poorly known. We estimated associations of substance misuse and anxiety/depression in the general population and tested them while accounting for genetic and shared environmental factors. METHODS We studied individuals born in Sweden 1968-1997 (n = 2 996 398) with follow-up in nationwide register data for 1997-2013. To account for familial effects, stratified analyses were conducted within siblings and twin pairs. Substance misuse was defined as ICD-10 alcohol or drug use disorder or an alcohol/drug-related criminal conviction. Three dimensions of ICD-10 anxiety and depressive disorders and a substance misuse dimension were identified through exploratory factor analysis. RESULTS Substance misuse was associated with a 4.5-fold (95% CI 4.50-4.58) elevated risk of lifetime generalized anxiety/depression, 4.7-fold (95% CI 4.63-4.82) elevated risk of panic disorder and agora/social phobia, and 2.9-fold elevated risk of phobias/OCD (95% CI 2.82-3.02) as compared to those without substance misuse. The associations were attenuated in within-family analyses but we found elevated risks in monozygotic twin pairs discordant for substance misuse as well as significant non-shared environmental correlations. The association between anxiety/depression and substance misuse was mainly driven by generalized anxiety/depression, whereas other anxiety/depression dimensions had minor or no independent associations with substance misuse. CONCLUSIONS Substance misuse and anxiety/depression are associated at the population level, and these associations are partially explained by familial liabilities. Our findings indicate a common genetic etiology but are also compatible with a potential partially causal relationship between substance misuse and anxiety/depression.
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Affiliation(s)
- Suvi Virtanen
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Psychiatry Research, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Nitya Jayaram-Lindström
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Psychiatry Research, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Brian M D'Onofrio
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Christian Rück
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Psychiatry Research, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Jaana Suvisaari
- National Institute for Health and Welfare, Helsinki, Finland
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Antti Latvala
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Ferguson N, Savic M, McCann TV, Emond K, Sandral E, Smith K, Roberts L, Bosley E, Lubman DI. "I was worried if I don't have a broken leg they might not take it seriously": Experiences of men accessing ambulance services for mental health and/or alcohol and other drug problems. Health Expect 2019; 22:565-574. [PMID: 30945425 PMCID: PMC6543159 DOI: 10.1111/hex.12886] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 03/13/2019] [Accepted: 03/13/2019] [Indexed: 11/29/2022] Open
Abstract
Background A large proportion of ambulance callouts are for men with mental health and/or alcohol and other drug (AOD) problems, but little is known about their experiences of care. This study aimed to describe men's experiences of ambulance care for mental health and/or AOD problems, and factors that influence their care. Methods Interviews were undertaken with 30 men who used an ambulance service for mental health and/or AOD problems in Australia. Interviews were analysed using the Framework approach to thematic analysis. Results Three interconnected themes were abstracted from the data: (a) professionalism and compassion, (b) communication and (c) handover to emergency department staff. Positive experiences often involved paramedics communicating effectively and conveying compassion throughout the episode of care. Conversely, negative experiences often involved a perceived lack of professionalism, and poor communication, especially at handover to emergency department staff. Conclusion Increased training and organizational measures may be needed to enhance paramedics' communication when providing care to men with mental health and/or AOD problems.
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Affiliation(s)
- Nyssa Ferguson
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
| | - Michael Savic
- Turning Point, Eastern Health, Melbourne, Victoria, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Terence V McCann
- Department of Nursing and Midwifery, College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia
| | - Kate Emond
- Department of Rural Nursing and Midwifery, College of Health, Science and Engineering, La Trobe University, Bendigo, Victoria, Australia
| | - Emma Sandral
- Turning Point, Eastern Health, Melbourne, Victoria, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Karen Smith
- Department of Epidemiology and Preventative Medicine, Monash University, Clayton, Victoria, Australia.,Ambulance Victoria, Melbourne, Victoria, Australia.,Department of Community Emergency Health and Paramedic Practice, Monash University, Clayton, Victoria, Australia
| | - Louise Roberts
- Department of Paramedics, Flinders University, Adelaide, South Australia, Australia
| | - Emma Bosley
- Queensland Ambulance Service, Brisbane, Queensland, Australia.,School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health, Melbourne, Victoria, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
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18
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An Examination of Comorbid Psychiatric Disorders in Disordered Gamblers Versus Other Substance-Related Disorders. J Gambl Stud 2019; 35:829-847. [PMID: 30778813 DOI: 10.1007/s10899-019-09839-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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19
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Zastrozhin MS, Grishina EA, Denisenko NP, Skryabin VY, Markov DD, Savchenko LM, Bryun EA, Sychev DA. Effects of CYP2D6 genetic polymorphisms on the efficacy and safety of fluvoxamine in patients with depressive disorder and comorbid alcohol use disorder. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2018; 11:113-119. [PMID: 29988737 PMCID: PMC6029588 DOI: 10.2147/pgpm.s160763] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Fluvoxamine therapy is used for treatment of patients with depressive disorder, but it is often ineffective, and some patients suffer from dose-dependent undesirable side effects such as vertigo, headache, indigestion, xerostomia, increased anxiety, etc. CYP2D6 is involved in the biotransformation of fluvoxamine. Meanwhile, the genes encoding these isoenzymes have a high level of polymorphism, which may affect the protein synthesis. Objective The primary objective of our study was to investigate the effects of CYP2D6 genetic polymorphisms on the efficacy and safety of fluvoxamine in patients with depressive disorder and comorbid alcohol use disorder, in order to develop the algorithms of optimization of fluvoxamine therapy for reducing the risk of dose-dependent undesirable side effects and pharmacoresistance. Methods The study involved 45 male patients (average age: 36.44±9.96 years) with depressive disorder and comorbid alcohol use disorder. A series of psychometric scales was used in the research. Genotyping of CYP2D6 (1846G>A) was performed using real-time polymerase chain reaction. Results According to results of Mann–Whitney U-test, statistically significant differences between the efficacy and safety of fluvoxamine were obtained on 9th and 16th days of therapy in patients with GG and GA genotypes (The Hamilton Rating Scale for Depression: 10.0 [10.0; 23.0] vs 25.0 [24.0; 16.0] (P<0.001) on the 9th day and 4.0 [2.0; 5.0] vs 6.0 [6.0; 7.0] on the 16th day; The UKU Side Effect Rating Scale: 6.0 [4.0; 6.0] vs 9.0 [9.0; 10.0] (P<0.001) on the 9th day and 5.0 [1.0; 9.0] vs 19.0 [18.0; 22.0] on the 16th day). Conclusion This study demonstrated the lower efficacy and safety of fluvoxamine in patients with depressive disorder and comorbid alcohol use disorders with GA genotype in CYP2D6 1846G>A polymorphic marker.
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Affiliation(s)
- Mikhail Sergeevich Zastrozhin
- Department of Addictology, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russia,.,Department of Addictology, Moscow Research and Practical Center on Addictions, Moscow, Russia,
| | - Elena Anatolievna Grishina
- Research Centre, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Research Centre, Moscow, Russia
| | - Nataliya Petrovna Denisenko
- Research Centre, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Research Centre, Moscow, Russia
| | | | - Dmitry Dmitrievich Markov
- Research Centre, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Research Centre, Moscow, Russia
| | - Ludmila Mikhailovna Savchenko
- Department of Addictology, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russia,
| | - Evgeny Alekseevich Bryun
- Department of Addictology, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russia,.,Department of Addictology, Moscow Research and Practical Center on Addictions, Moscow, Russia,
| | - Dmitry Alekseevich Sychev
- Department of Clinical Pharmacology and Therapy, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russia
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20
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Ganguly P, Soliman A, Moustafa AA. Holistic Management of Schizophrenia Symptoms Using Pharmacological and Non-pharmacological Treatment. Front Public Health 2018; 6:166. [PMID: 29930935 PMCID: PMC5999799 DOI: 10.3389/fpubh.2018.00166] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 05/17/2018] [Indexed: 12/16/2022] Open
Abstract
Individuals with schizophrenia lead a poor quality of life, due to poor medical attention, homelessness, unemployment, financial constraints, lack of education, and poor social skills. Thus, a review of factors associated with the holistic management of schizophrenia is of paramount importance. The objective of this review is to improve the quality of life of individuals with schizophrenia, by addressing the factors related to the needs of the patients and present them in a unified manner. Although medications play a role, other factors that lead to a successful holistic management of schizophrenia include addressing the following: financial management, independent community living, independent living skill, relationship, friendship, entertainment, regular exercise for weight gained due to medication administration, co-morbid health issues, and day-care programmes for independent living. This review discusses the relationship between different symptoms and problems individuals with schizophrenia face (e.g., homelessness and unemployment), and how these can be managed using pharmacological and non-pharmacological methods. Thus, the target of this review is the carers of individuals with schizophrenia, public health managers, counselors, case workers, psychiatrists, and clinical psychologists aiming to enhance the quality of life of individuals with schizophrenia.
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Affiliation(s)
- Pronab Ganguly
- School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW, Australia
| | - Abdrabo Soliman
- Department of Social Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Ahmed A Moustafa
- School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW, Australia.,Marcs Institute for Brain and Behaviour, Western Sydney University, Sydney, NSW, Australia
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21
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Pennay A, McNair R, Hughes TL, Leonard W, Brown R, Lubman DI. Improving alcohol and mental health treatment for lesbian, bisexual and queer women: Identity matters. Aust N Z J Public Health 2017; 42:35-42. [PMID: 29235690 DOI: 10.1111/1753-6405.12739] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 07/01/2017] [Accepted: 09/01/2017] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Lesbian, bisexual and queer (LBQ) women experience substantial unmet alcohol and mental health treatment needs. This paper explores the way in which sexual identity shapes experience, and needs, in relation to alcohol and mental health treatment, and presents key messages for improving treatment. METHODS Twenty-five in-depth interviews were undertaken with same-sex attracted Australian women, aged 19-71. Interview transcripts were analysed thematically. RESULTS Key messages offered by participants focused on language, disclosure and practitioner training. Variation in sexual identity did not alter treatment expectations or needs; however, we noted an important difference with respect to identity salience, with high LBQ identity salience linked with preference for disclosure and acknowledgement of sexual identity in treatment interactions, and low identity salience linked with a preference not to disclose and for sexual identity not to require acknowledgement in treatment. CONCLUSIONS Treatment providers may find it useful to gather information about the centrality of sexual identity to LBQ women as a means of overcoming treatment barriers related to heteronormative conventions and discrimination, language and disclosure. Implications for public health: Treatment providers should adopt more inclusive language, seek information about identity salience and the importance of sexual identity to the current treatment, and regularly pursue LBQ-related professional development upskilling.
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Affiliation(s)
- Amy Pennay
- Centre for Alcohol Policy Research, La Trobe University, Victoria
| | - Ruth McNair
- Department of General Practice, University of Melbourne, Victoria
| | - Tonda L Hughes
- School of Nursing and Department of Psychiatry, Columbia University, New York City, NY, US
| | | | - Rhonda Brown
- School of Nursing and Midwifery, Deakin University, Victoria
| | - Dan I Lubman
- Turning Point, Eastern Health, Victoria.,Eastern Health Clinical School, Monash University, Victoria
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22
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Nahas MA, Melo APS, Cournos F, Mckinnon K, Wainberg M, Guimarães MDC. Recent illicit drug use among psychiatric patients in Brazil: a national representative study. Rev Saude Publica 2017; 51:74. [PMID: 28832753 PMCID: PMC5559216 DOI: 10.11606/s1518-8787.2017051006543] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 08/11/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To estimate factors associated to illicit drug use among patients with mental illness in Brazil according to gender. METHODS A cross-sectional representative sample of psychiatric patients (2,475 individuals) was randomly selected from 11 hospitals and 15 public mental health outpatient clinics. Data on self-reported illicit drug use and sociodemographic, clinical and behavioral characteristics were obtained from face-to-face interviews. Logistic regression was used to estimate associations with recent illicit drug use. RESULTS The prevalence of any recent illicit drug use was 11.4%. Men had higher prevalence than women for all substances (17.5% and 5.6%, respectively). Lower education, history of physical violence, and history of homelessness were associated with drug use among men only; not professing a religion was associated with drug use in women only. For both men and women, younger age, current hospitalization, alcohol and tobacco use, history of incarceration, younger age at sexual debut, and more than one sexual partner were statistically associated with illicit drug use. CONCLUSIONS Recent illicit drug use among psychiatric patients is higher than among the general Brazilian population and it is associated with multiple factors including markers of psychiatric severity. Our data indicate the need for the development of gender-based drug-use interventions among psychiatric patients in Brazil. Integration of substance use treatment strategies with mental health treatment should be a priority.
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Affiliation(s)
- Miriam Almeida Nahas
- Programa de Pós-Graduação em Saúde Pública. Faculdade de Medicina. Universidade Federal de Minas Gerais. Belo Horizonte MG, Brasil
| | - Ana Paula Souto Melo
- Faculdade de Medicina. Universidade Federal de São João del-Rei. Divinópolis, MG, Brasil
| | - Francine Cournos
- Mailman School of Public Health. Columbia University. New York, USA
| | - Karen Mckinnon
- New York State Psychiatric Institute. Columbia University. New York, USA
| | - Milton Wainberg
- New York State Psychiatric Institute. Columbia University. New York, USA
| | - Mark Drew Crosland Guimarães
- Departamento de Medicina Preventiva e Social. Faculdade de Medicina. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brasil
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23
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McCrabb S, Baker AL, Attia J, Balogh ZJ, Lott N, Palazzi K, Naylor J, Harris IA, Doran C, George J, Wolfenden L, Skelton E, Bonevski B. Who is More Likely to Use the Internet for Health Behavior Change? A Cross-Sectional Survey of Internet Use Among Smokers and Nonsmokers Who Are Orthopedic Trauma Patients. JMIR Ment Health 2017; 4:e18. [PMID: 28559228 PMCID: PMC5470009 DOI: 10.2196/mental.7435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/12/2017] [Accepted: 04/21/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND eHealth presents opportunities to provide population groups with accessible health interventions, although knowledge about Internet access, peoples' interest in using the Internet for health, and users' characteristics are required prior to eHealth program development. OBJECTIVE This study surveyed hospital patients to examine rates of Internet use, interest in using the Internet for health, and respondent characteristics related to Internet use and interest in using the Internet for health. For patients who smoke, preferences for types of smoking cessation programs for use at home and while in hospital were also examined. METHODS An online cross-sectional survey was used to survey 819 orthopedic trauma patients (response rate: 72.61%, 819/1128) from two public hospitals in New South Wales, Australia. Logistic regressions were used to examine associations between variables. RESULTS A total of 72.7% (574/790) of respondents had at least weekly Internet access and more than half (56.6%, 357/631) reported interest in using the Internet for health. Odds of at least weekly Internet usage were higher if the individual was born overseas (OR 2.21, 95% CI 1.27-3.82, P=.005), had a tertiary education (OR 3.75, 95% CI 2.41-5.84, P<.001), or was a nonsmoker (OR 3.75, 95% CI 2.41-5.84, P<.001). Interest in using the Internet for health increased with high school (OR 1.85, 95% CI 1.09-3.15, P=.02) or tertiary education (OR 2.48, 95% CI 1.66-3.70, P<.001), and if household incomes were more than AUS $100,000 (OR 2.5, 95% CI 1.25-4.97, P=.009). Older individuals were less interested in using the Internet for health (OR 0.98, 95% CI 0.97-0.99, P<.001). CONCLUSIONS Online interventions may be a potential tool for health care in this hospitalized population. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12614001147673; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366829&isReview=true (Archived by WebCite at http://www.webcitation.org/6qg26u3En).
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Affiliation(s)
- Sam McCrabb
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - John Attia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, University of Newcastle, New Lambton, Australia.,Department of General Medicine, John Hunter Hospital, New Lambton Heights, Australia
| | - Zsolt J Balogh
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.,Department of Traumatology, John Hunter Hospital, New Lambton Heights, Australia
| | - Natalie Lott
- Department of Traumatology, John Hunter Hospital, New Lambton Heights, Australia
| | - Kerrin Palazzi
- Hunter Medical Research Institute, University of Newcastle, New Lambton, Australia
| | - Justine Naylor
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool Hospital, Liverpool, Australia.,South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Liverpool, Australia
| | - Ian A Harris
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool Hospital, Liverpool, Australia.,South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Liverpool, Australia
| | - Christopher Doran
- School of Human, Health and Social Sciences, Central Queensland University, Brisbane, Australia
| | - Johnson George
- Centre for Medicine Use and Safety, Monash University, Parkville, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.,Hunter New England Population Health, Wallsend, Australia
| | - Eliza Skelton
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
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24
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Copeland J, Rooke S, Rodriquez D, Norberg MM, Gibson L. Comparison of brief versus extended personalised feedback in an online intervention for cannabis users: Short-term findings of a randomised trial. J Subst Abuse Treat 2017; 76:43-48. [PMID: 28162849 DOI: 10.1016/j.jsat.2017.01.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 01/19/2017] [Accepted: 01/20/2017] [Indexed: 12/30/2022]
Abstract
Previous studies have shown brief online self-help interventions to be a useful method of treating cannabis use and related problems; however, no studies have compared the effects of brief versus extended feedback for online brief intervention programs. OBJECTIVES The current study was a two arm randomised trial aimed at testing the short term effectiveness of a brief and extended feedback version of Grassessment, a brief online intervention for cannabis users that provides individualised feedback regarding use, motives, and harms. METHODS Participants (n=287) reporting at least one symptom of DSM IV cannabis abuse or dependence were recruited using online and offline advertising methods. Participants were randomised to receive either a brief or extended feedback version of the Grassessment program and were required to complete a one month follow up questionnaire. RESULTS One hundred and ninety four participants completed the one month follow up. Wilcoxon analyses showed a significant decrease in past month quantity and frequency of cannabis use (ps<0.001; r=-0.41 and -0.40 respectively) and lower severity of dependence scores (p=0.002; r=-0.31) among those in the brief feedback condition. Participants in the extended feedback group also demonstrated significant decreases in patterns of use (ps<0.002; r=-0.39 and -0.33) but not severity of dependence (p=0.09; r=0.18). A Generalized Estimating Equation (GEE) analysis showed no significant interaction between length of feedback received and past month cannabis use frequency (p=0.78), quantity (p=0.73), or severity of dependence (p=0.47). CONCLUSION This study adds support for the use of brief online self-complete interventions to reduce cannabis use and related problems in the short term. The findings suggest that in the case of the brief online screening and feedback program Grassessment, extended feedback does not lead to superior outcomes over brief feedback.
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Affiliation(s)
- Jan Copeland
- National Cannabis Prevention and Information Centre, UNSW Australia, Sydney, NSW 2052, Australia
| | - Sally Rooke
- National Cannabis Prevention and Information Centre, UNSW Australia, Sydney, NSW 2052, Australia; Discipline of Addiction Medicine, University of Sydney, Australia
| | - Dan Rodriquez
- National Cannabis Prevention and Information Centre, UNSW Australia, Sydney, NSW 2052, Australia
| | - Melissa M Norberg
- National Cannabis Prevention and Information Centre, UNSW Australia, Sydney, NSW 2052, Australia; Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney 2109, NSW, Australia
| | - Lisa Gibson
- National Cannabis Prevention and Information Centre, UNSW Australia, Sydney, NSW 2052, Australia.
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26
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Norström T, Rossow I. Alcohol Consumption as a Risk Factor for Suicidal Behavior: A Systematic Review of Associations at the Individual and at the Population Level. Arch Suicide Res 2016; 20:489-506. [PMID: 26953621 DOI: 10.1080/13811118.2016.1158678] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The objective of this study was to provide an updated review of the magnitude of the relationship between alcohol use and suicidal behaviour at the individual and the population level. Systematic literature searches retrieved 14 reviews of individual level studies and 16 primary population level studies. Alcohol abuse and alcohol intoxication are often present in suicidal behaviour; risk of suicide is elevated in alcohol abusers and increasing population drinking tends to be associated with increase in suicide rates. Estimated magnitude of the relationship differs for men and women and it varies at the population level across cultures with different drinking pattern. These variations probably reflect gender differences and cultural variation in drinking behavior generally. Empirical evidence for a causal relationship is still urgently needed.
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Abstract
This article explores the cognitive process and awakening experience associated with natural recovery from alcohol or drug addiction in English-speaking Hong Kong residents. It is an exploratory study using qualitative research methods. Advertising and snowball sampling recruitment methods yielded two English-speaking Hong Kong residents, one White male expatriate from the United States and one female native Hong Kong resident who is half Chinese and half White American. Reported natural recovery process was evolutionary, occurring over a long period of time with intervals of cognitive appraisal and quit attempts. Awakening interpretations included having a greater insight about their cognitive process, addiction behavior, or emotional experience. The awakening experience played a role in natural recovery and may be used to enhance already existing interventions.
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Sheerin C, Berenz EC, Knudsen GP, Reichborn-Kjennerud T, Kendler KS, Aggen SH, Amstadter AB. A population-based study of help seeking and self-medication among trauma-exposed individuals. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2016; 30:771-777. [PMID: 27269293 DOI: 10.1037/adb0000185] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Epidemiologic studies of trauma highlight the imbalance between prevalence of psychiatric diagnoses and help seeking. We investigated prevalence and correlates of help seeking and self-medication in Norwegian adults with trauma history with a focus on common posttrauma outcomes of posttraumatic stress disorder (PTSD) and substance use disorders (alcohol or drug). Participants reporting at least 1 PTSD symptom (n = 307) were asked if they consulted with a doctor/another professional (help seeking) or used drugs/alcohol (self-medication) for trauma-related problems. PTSD, alcohol abuse or dependence (AUD), and drug use or dependence (DUD) were assessed via structured diagnostic interviews. Help seeking and self-medication were endorsed by 37.4% and 10.4% of the sample, respectively. As compared to the full sample, help seeking was endorsed at a greater rate in individuals with PTSD (χ2 = 8.59, p = .005) and at a lower rate in those with AUD (χ2 = 7.34, p < .004). Self-medication was more likely to be endorsed by individuals with PTSD than without PTSD (χ2 = 25.68, p < .001). In regression analyses, PTSD was associated with increased likelihood of self-medication (odds ratio [OR] = 4.56) and help seeking (OR = 2.29), while AUD was associated with decreased likelihood of help-seeking (OR = .29). When self-medication was included as a predictor, PTSD was no longer associated with help seeking, although AUD remained inversely associated. PTSD and AUDs have a nuanced relationship with formal help seeking as well as the use of substances to cope. Trauma-exposed individuals are likely engaging in adaptive and maladaptive coping strategies, the latter of which may be compounding distress. (PsycINFO Database Record
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Affiliation(s)
- Christina Sheerin
- Mental Illness Research Education and Clinical Center, Richmond Veterans Affairs Medical Center
| | | | | | | | - Kenneth S Kendler
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University
| | - Steven H Aggen
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University
| | - Ananda B Amstadter
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University
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Stallman HM, Kavanagh D, White AM. Internet interventions for treatment of alcohol-related problems. Hippokratia 2016. [DOI: 10.1002/14651858.cd010228.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Helen M Stallman
- The University of Queensland; Schools of Medicine and Pharmacy; Pharmacy Australia Centre of Excellence 20 Cornwall Street Woolloongabba Queensland Australia 4102
| | - David Kavanagh
- Queensland University of Technology; Institute of Health and Biomedical Innovation (IHBI) & School of Psychology and Counselling; GPO Box 2434 Brisbane Queensland Australia 4001
| | - Angela Maree White
- University of Queensland; Centre for Youth Substance Abuse Research, Faculty of Health Sciences; K Floor, Mental Health Centre, University of Queensland, Royal Brisbane Hospital Brisbane Queensland Australia 4006
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McCallum SL, Andrews JM, Gaughwin MD, Turnbull DA, Mikocka-Walus AA. Patient satisfaction with treatment for alcohol use disorders: comparing patients with and without severe mental health symptoms. Patient Prefer Adherence 2016; 10:1489-500. [PMID: 27540281 PMCID: PMC4981161 DOI: 10.2147/ppa.s92902] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Previous studies suggest patients with co-occurring alcohol use disorders (AUDs) and severe mental health symptoms (SMHS) are less satisfied with standard AUD treatment when compared to patients with an AUD alone. This study compared patient satisfaction with standard AUD treatment among patients with and without SMHS and explored how standard treatment might be improved to better address the needs of these patients. METHODS Eighty-nine patients receiving treatment for an AUD either at an inpatient hospital, outpatient clinic, inpatient detoxification, or residential/therapeutic community services were surveyed. Patient satisfaction with treatment was assessed using the Treatment Perception Questionnaire (range: 0-40). Patients were stratified according to their score on the Depression Anxiety Stress Scale. Forty patients scored in the extremely severe range of depression (score >14) and/or anxiety (score >10) (indicating SMHS) and 49 patients did not. An inductive content analysis was also conducted on qualitative data relating to areas of service improvement. RESULTS Patients with SMHS were found to be equally satisfied with treatment (mean =25.10, standard deviation =8.12) as patients with an AUD alone (mean =25.43, standard deviation =6.91). Analysis revealed that being an inpatient in hospital was associated with reduced treatment satisfaction. Patients with SMHS were found to be significantly less satisfied with staffs' understanding of the type of help they wanted in treatment, when compared to patients with AUDs alone. Five areas for service improvement were identified, including staff qualities, informed care, treatment access and continuity, issues relating to inpatient stay, and addressing patients' mental health needs. CONCLUSION While findings suggest that AUD treatment services adequately meet the needs of patients with SMHS in treatment, patients with SMHS do feel that staff lack understanding of their treatment needs. Findings have important implications as to how current health care practice might be improved according to the patient's perspective of care.
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Affiliation(s)
- Stacey L McCallum
- School of Psychology, Faculty of Health Sciences, University of Adelaide
- Correspondence: Stacey L McCallum, Room 715, Hughes Building, School of Psychology, Faculty of Health Sciences, University of Adelaide, North Terrace, Adelaide, SA 5005, Australia, Tel +61 8 8313 5693, Fax +61 8 8313 3770, Email
| | - Jane M Andrews
- Department of Gastroenterology and Hepatology, Royal Adelaide Hospital
- School of Public Health, University of Adelaide
| | - Matthew D Gaughwin
- School of Public Health, University of Adelaide
- Drug and Alcohol Consultation Liaison Service, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Deborah A Turnbull
- School of Psychology, Faculty of Health Sciences, University of Adelaide
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Fielder AL, Mikocka-Walus A, McCallum S, Stewart B, Alvaro P, Esterman A. Pilot CBT trial for anxiety in alcohol use disorders treatment. ADVANCES IN DUAL DIAGNOSIS 2015. [DOI: 10.1108/add-05-2015-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The purpose of this paper is to test the effectiveness of a self-directed cognitive behavioural therapy (CBT) booklet allowing immediate access to treatment for anxiety during alcohol use disorder (AUD) interventions.
Design/methodology/approach
– Parallel pilot randomised controlled trial: 69 individuals in AUD treatment, continued to receive treatment alone (control: n=29) or in addition, a self-directed, four week CBT booklet to manage anxiety (intervention: n=40). Primary outcome measures were changes in state (SAnx) and trait anxiety (TAnx) at four weeks. Secondary outcome measures were changes in adaptive (ACop), maladaptive (MCop) coping and quality of life (QoL, physical (PHQoL), psychological (PSQoL), social (SQoL), environment (EQoL)) at four weeks.
Findings
– Participants had significantly higher SAnx (p
<
0.01) and TAnx (p
<
0.01) baseline scores compared to the general population. There were no statistically significant group changes in SAnx or TAnx (p
>
0.05). Control group allocation predicted improvement in ACop (p
<
0.01), MCop (p
<
0.05), PHQoL (p
<
0.01), PSQoL (p
<
0.05) and SQoL (p
<
0.01); CBT group allocation predicted improvement in EQoL (p=0.05). All effect sizes were small to moderate (Cohen’s d
<
0.50). Percentage of book completion did not determine changes in anxiety, coping or quality of life.
Originality/value
– A four week self-directed CBT booklet did not significantly reduce anxiety during AUD treatment. Larger sample sizes will determine the most suitable treatment delivery mode for this type of CBT.
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The Difference between Anxiolytic and Anxiogenic Effects Induced by Acute and Chronic Alcohol Exposure and Changes in Associative Learning and Memory Based on Color Preference and the Cause of Parkinson-Like Behaviors in Zebrafish. PLoS One 2015; 10:e0141134. [PMID: 26558894 PMCID: PMC4641683 DOI: 10.1371/journal.pone.0141134] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 10/04/2015] [Indexed: 01/29/2023] Open
Abstract
We describe an interdisciplinary comparison of the effects of acute and chronic alcohol exposure in terms of their disturbance of light, dark and color preferences and the occurrence of Parkinson-like behavior in zebrafish through computer visual tracking, data mining, and behavioral and physiological analyses. We found that zebrafish in anxiolytic and anxious states, which are induced by acute and chronic repeated alcohol exposure, respectively, display distinct emotional reactions in light/dark preference tests as well as distinct learning and memory abilities in color-enhanced conditional place preference (CPP) tests. Additionally, compared with the chronic alcohol (1.0%) treatment, acute alcohol exposure had a significant, dose-dependent effect on anxiety, learning and memory (color preference) as well as locomotive activities. Acute exposure doses (0.5%, 1.0%, and 1.5%) generated an “inverted V” dose-dependent pattern in all of the behavioral parameters, with 1.0% having the greatest effect, while the chronic treatment had a moderate effect. Furthermore, by measuring locomotive activity, learning and memory performance, the number of dopaminergic neurons, tyrosine hydroxylase expression, and the change in the photoreceptors in the retina, we found that acute and chronic alcohol exposure induced varying degrees of Parkinson-like symptoms in zebrafish. Taken together, these results illuminated the behavioral and physiological mechanisms underlying the changes associated with learning and memory and the cause of potential Parkinson-like behaviors in zebrafish due to acute and chronic alcohol exposure.
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Trust and people who inject drugs: The perspectives of clients and staff of Needle Syringe Programs. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 27:138-45. [PMID: 26394538 DOI: 10.1016/j.drugpo.2015.08.018] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 05/20/2015] [Accepted: 08/24/2015] [Indexed: 11/21/2022]
Abstract
AIMS Interest in health-care related trust is growing with the recognition that trust is essential for effective therapeutic encounters. While most trust-related research has been conducted with general patient groups, the experiences of people who inject drugs cannot be understood without acknowledging the critical role social stigma plays in shaping (mis)trust, both generally and in regards to health services specifically. This study examined the experiences of trust among clients and staff of Needle and Syringe Programs (NSPs) in one area of Sydney, Australia. METHOD In-depth interviews with 12 NSP staff and 31 NSP clients were conducted. Analysis was informed by a five component model of trust, with particular emphasis on the notion of "global trust" as encompassing experiences of stigma and other negative social processes related to injecting drug use. Participant experiences of trust in NSPs were compared with those within other drug-related health services. Particular attention was paid to understanding the relationship between 'identity' (as a drug user) and 'legitimacy' (as a service user) and the centrality of this relationship to the experience of global trust for PWID. RESULTS Notions of identity and legitimacy were inextricably bound up with the stigmatisation of drug use, shaping participants' experiences and accounts of trust in NSPs and drug treatment services. Client participants reported high levels of trust in NSPs, especially when compared with drug treatment services, describing being treated like "any other person" even when negotiating 'sensitive' issues. NSP staff participants described the establishment of trust as not only underpinning their work with clients but as something that required ongoing renewal and demonstration. CONCLUSION "Global trust" assists us to better understand the complex experiences shaping PWID decisions to engage with and trust health services. The high levels of trust reported between client and NSP need to be recognised as a valuable resource for the delivery of effective health care for people who inject drugs, including encouraging behaviours to support the prevention of blood-borne viruses.
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Lai HMX, Cleary M, Sitharthan T, Hunt GE. Prevalence of comorbid substance use, anxiety and mood disorders in epidemiological surveys, 1990-2014: A systematic review and meta-analysis. Drug Alcohol Depend 2015; 154:1-13. [PMID: 26072219 DOI: 10.1016/j.drugalcdep.2015.05.031] [Citation(s) in RCA: 488] [Impact Index Per Article: 54.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 05/25/2015] [Accepted: 05/27/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND Comorbidity is highly prevalent between substance use disorders (SUDs), mood and anxiety disorders. We conducted a systematic review and meta-analysis to determine the strength of association between SUDs, mood and anxiety disorders in population-based epidemiological surveys. METHODS A comprehensive literature search of Medline, EMBASE, CINAHL, PsychINFO, Web of Science, and Scopus was conducted from 1990 to 2014. Sources were chosen on the basis that they contained original research in non-clinical populations conducted in randomly selected adults living within defined boundaries. Prevalence of comorbid SUDs, mood and anxiety disorders and odds ratios (ORs) were extracted. RESULTS There were 115 articles identified by electronic searches that were reviewed in full text which yielded 22 unique epidemiological surveys to extract lifetime and 12-month prevalence data for psychiatric illness in respondents with an SUD. Meta-analysis indicated the strongest associations were between illicit drug use disorder and major depression (pooled OR 3.80, 95% CI 3.02-4.78), followed by illicit drug use and any anxiety disorder (OR 2.91, 95% CI 2.58-3.28), alcohol use disorders and major depression (OR 2.42, 95% CI 2.22-2.64) and alcohol use disorders and any anxiety disorder (OR 2.11, 95% CI 2.03-2.19). ORs for dependence were higher than those for abuse irrespective to diagnoses based on lifetime or 12-month prevalence. CONCLUSIONS This review confirms the strong association between SUDs, mood and anxiety disorders. The issue has now been recognised worldwide as a factor that affects the profile, course, patterns, severity and outcomes of these disorders.
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Affiliation(s)
| | - Michelle Cleary
- School of Nursing and Midwifery, University of Western Sydney, NSW, Australia.
| | | | - Glenn E Hunt
- Discipline of Psychiatry, University of Sydney, NSW, Australia.
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35
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McCallum SL, Mikocka-Walus AA, Gaughwin MD, Andrews JM, Turnbull DA. 'I'm a sick person, not a bad person': patient experiences of treatments for alcohol use disorders. Health Expect 2015; 19:828-41. [PMID: 26111429 PMCID: PMC5152715 DOI: 10.1111/hex.12379] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2015] [Indexed: 11/27/2022] Open
Abstract
Background Emerging research indicates that standard treatments for alcohol use disorders may not fully meet the needs of patients with co‐occurring severe mental health symptoms. Investigating health quality indicators may provide insight into how current treatment might be improved. Objective To better understand the experiences of patients receiving treatment for alcohol use disorders and compare the experiences of patients with and without co‐occurring severe mental health symptoms. Design Cross‐sectional qualitative research design using semi‐structured interviews methods and framework analysis approach. Setting Inpatient hospital, outpatient service, inpatient detoxification clinic and a residential/ therapeutic community. Participant's Thirty‐four patients receiving treatment for an alcohol use disorder. Main variables studied Themes relating to patients' experiences of continuity of care, treatment need and satisfaction with treatment were studied. The qualitative data were divided into two groups: patients with (n = 15) and without (n = 19) severe mental health symptoms. Results Five themes relating to patient satisfaction with treatment were identified, including: perceived effectiveness of treatment, supportive relationships, specialized but holistic care, patient autonomy and continuity of care. A diverse range of patient treatment needs, staff and service continuity and stigma were also identified as major themes. Five basic themes were identified as more critical to the experiences of patients with severe mental health symptoms. Discussion and conclusions Findings suggest that patients look for supportive relationships with others, to be involved in treatment decisions, effective specialized and holistic approaches to care and a non‐judgemental treatment environment.
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Affiliation(s)
- Stacey L McCallum
- School of Psychology, Faculty of Health Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Antonina A Mikocka-Walus
- School of Psychology, Faculty of Health Sciences, University of Adelaide, Adelaide, SA, Australia.,Department of Health Sciences, University of York, York, UK
| | - Matthew D Gaughwin
- Drug and Alcohol Clinical Liaison Service & School of Public Health, University of Adelaide at the Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Jane M Andrews
- Department of Gastroenterology and Hepatology & School of Medicine, University of Adelaide at the Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Deborah A Turnbull
- School of Psychology, Faculty of Health Sciences, University of Adelaide, Adelaide, SA, Australia
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36
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Peña-Sarrionandia A, Mikolajczak M, Gross JJ. Integrating emotion regulation and emotional intelligence traditions: a meta-analysis. Front Psychol 2015; 6:160. [PMID: 25759676 PMCID: PMC4338658 DOI: 10.3389/fpsyg.2015.00160] [Citation(s) in RCA: 162] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 02/01/2015] [Indexed: 12/12/2022] Open
Abstract
Two relatively independent research traditions have developed that address emotion management. The first is the emotion regulation (ER) tradition, which focuses on the processes which permit individuals to influence which emotions they have, when they have them, and how they experience and express these emotions. The second is the emotional intelligence (EI) tradition, which focuses—among other things—on individual differences in ER. To integrate these two traditions, we employed the process model of ER (Gross, 1998b) to review the literature on EI. Two key findings emerged. First, high EI individuals shape their emotions from the earliest possible point in the emotion trajectory and have many strategies at their disposal. Second, high EI individuals regulate their emotions successfully when necessary but they do so flexibly, thereby leaving room for emotions to emerge. We argue that ER and EI traditions stand to benefit substantially from greater integration.
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Affiliation(s)
- Ainize Peña-Sarrionandia
- Faculty of Psychology, Department of Personality, Evaluation and Psychological Treatments, University of the Basque Country Donostia-San Sebastian, Spain
| | - Moïra Mikolajczak
- Department of Psychology, Research Unit for Emotion Cognition and Health, Université Catholique de Louvain Louvain-la-Neuve, Belgium
| | - James J Gross
- Department of Psychology, Standford University Standford, USA
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37
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Moran P, Coffey C, Romaniuk H, Degenhardt L, Borschmann R, Patton GC. Substance use in adulthood following adolescent self-harm: a population-based cohort study. Acta Psychiatr Scand 2015; 131:61-8. [PMID: 24954250 PMCID: PMC4293154 DOI: 10.1111/acps.12306] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/02/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine whether adolescents who self-harm are at increased risk of heavy and dependent substance use in adulthood. METHOD Fifteen-year prospective cohort study of a random sample of 1943 adolescents recruited from secondary schools across the state of Victoria, Australia. Data pertaining to self-harm and substance use was obtained at seven waves of follow-up, from mean age 15.9 years to mean age 29.1 years. RESULTS Substance use and self-harm were strongly associated during the adolescent years (odds ratio (OR): 3.3, 95% CI 2.1-5.0). Moreover, adolescent self-harmers were at increased risk of substance use and dependence syndromes in young adulthood. Self-harm predicted a four-fold increase in the odds of multiple dependence syndromes (sex- and wave-adjusted OR: 4.2, 95% CI: 2.7-6.6). Adjustment for adolescent anxiety/depression attenuated but did not eliminate most associations. Adolescent substance use confounded all associations, with the exception of multiple dependence syndromes, which remained robustly associated with adolescent self-harm (fully adjusted odds ratio: 2.0, 95% CI: 1.2-3.2). CONCLUSION Adolescent self-harm is an independent risk factor for multiple dependence syndromes in adulthood. This level of substance misuse is likely to contribute substantially to the premature mortality and disease burden experienced by individuals who self-harm.
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Affiliation(s)
- P Moran
- King's College London, Health Services & Population Research Department, Institute of PsychiatryLondon, UK
| | - C Coffey
- Centre for Adolescent Health, Royal Children's Hospital Murdoch Children's Research InstituteParkville, Vic., Australia
| | - H Romaniuk
- Clinical Epidemiology & Biostatistics Unit and Centre for Adolescent Health, Royal Children's Hospital, Murdoch Children's Research Institute, University of MelbourneParkville, Vic., Australia,Department of Paediatrics, University of MelbourneParkville, Vic., Australia
| | - L Degenhardt
- National Drug and Alcohol Research Centre, University of New South WalesSydney, NSW, Australia,School of Population and Global Health, University of MelbourneParkville, Vic., Australia
| | - R Borschmann
- King's College London, Health Services & Population Research Department, Institute of PsychiatryLondon, UK
| | - G C Patton
- Centre for Adolescent Health, Royal Children's Hospital Murdoch Children's Research InstituteParkville, Vic., Australia
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Sex differences in first-admission psychiatric inpatients with and without a comorbid substance use disorder. J Addict Med 2014; 8:351-8. [PMID: 25054860 DOI: 10.1097/adm.0000000000000062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We assessed sex differences in a sample of first-admission psychiatric inpatients with and without comorbid substance use disorder (SUD) to identify possible risk factors and targets for sex-tailored treatment interventions. METHODS A retrospective study of first admissions to the University Psychiatry Ward, "Maggiore della Carità" Hospital, Novara, Italy, between 2003 and 2012 was accomplished. The clinical charts of patients with (N = 362) and without comorbid SUD (N = 1111) were reviewed. RESULTS Differences in employment, educational, and marital statuses were found between male and female psychiatric patients with and without comorbid SUD. Having a degree was a protective factor for males, whereas it was a risk factor for females. Being divorced and having family problems were both risk factors for comorbidity in females. Regarding the diagnosis, results overlapped in males and females, and both affective and other disorders were risk factors for a comorbid SUD. CONCLUSIONS A significant difference between male and female psychiatric patients with a comorbid SUD was the males' overall poorer psychosocial functioning. Marital status and family problems were risk factors for comorbid SUD in females. Both males and females showed various pathways of access to and choices of substances and, eventually, experienced different impacts on their lives. Hospitalization might help to set up a targeted intervention for patients with comorbidity, while accounting for sex differences. With respect to males, a treatment approach focused on the substance alone might help improve their functioning; females might have a greater benefit from a treatment approach focused on distress, family problems, and relational issues.
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Lee KSK, Chikritzhs T, Wilson S, Wilkes Ao E, Gray D, Room R, Conigrave KM. Better methods to collect self-reported alcohol and other drug use data from Aboriginal and Torres Strait Islander Australians. Drug Alcohol Rev 2014; 33:466-72. [PMID: 24849378 DOI: 10.1111/dar.12159] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kim San Kylie Lee
- Aboriginal and Torres Strait Health, Discipline of Addiction Medicine, Sydney Medical School, University of Sydney, Sydney, Australia.
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40
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Abstract
In recent years, there has been significant progress and expansion in the development of evidence-based psychosocial treatments for substance abuse and dependence. A literature review was undertaken using the several electronic databases (PubMed, Cochrane Database of systemic reviews and specific journals, which pertain to psychosocial issues in addictive disorders and guidelines on this topic). Overall psychosocial interventions have been found to be effective. Some interventions, such as cognitive behavior therapy, motivational interviewing and relapse prevention, appear to be effective across many drugs of abuse. Psychological treatment is more effective when prescribed with substitute prescribing than when medication or psychological treatment is used alone, particularly for opiate users. The evidence base for psychological treatment needs to be expanded and should also include research on optimal combinations of psychological therapies and any particular matching effects, if any. Psychological interventions are an essential part of the treatment regimen and efforts should be made to integrate evidence-based interventions in all substance use disorder treatment programs.
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Affiliation(s)
- Sonali Jhanjee
- Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
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41
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Munn-Chernoff MA, Duncan AE, Grant JD, Wade TD, Agrawal A, Bucholz KK, Madden PAF, Martin NG, Heath AC. A twin study of alcohol dependence, binge eating, and compensatory behaviors. J Stud Alcohol Drugs 2014; 74:664-73. [PMID: 23948525 DOI: 10.15288/jsad.2013.74.664] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Rates of alcohol dependence are elevated in women with eating disorders who engage in binge eating or compensatory behaviors compared with women with eating disorders who do not report binge eating or compensatory behaviors and with healthy controls. Alcohol dependence, binge eating, and compensatory behaviors are heritable; however, it is unclear whether a shared genetic liability contributes to the phenotypic association among these traits, and little information exists regarding this shared liability in men. We investigated genetic and environmental correlations among alcohol dependence, binge eating, and compensatory behaviors in male and female twins. METHOD Participants included 5,993 same- and opposite-sex twins from the Australian Twin Registry who completed a modified version of the Semi-Structured Assessment for the Genetics of Alcoholism that assessed lifetime alcohol dependence and binge eating as defined in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Compensatory behaviors were assessed via a general health questionnaire in women only. Biometrical twin models estimated genetic and environmental influences on alcohol dependence, binge eating, and compensatory behaviors. RESULTS In women, the multivariate twin model suggested that additive genetic and nonshared environmental effects influenced alcohol dependence, binge eating, and compensatory behaviors, with heritability estimates ranging from 38% to 53%. The best-fitting sex-limitation model was a common effects model that equated all genetic and nonshared environmental influences in men and women. The heritability estimates were 50% and 38% for alcohol dependence and binge eating, respectively. Overall, there were significant genetic correlations between alcohol dependence and binge eating, alcohol dependence and compensatory behaviors, and binge eating and compensatory behaviors. CONCLUSIONS These findings indicate that common genetic factors may underlie the vulnerability to alcohol dependence and the liability to binge eating and compensatory behaviors.
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Affiliation(s)
- Melissa A Munn-Chernoff
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri 63110, USA.
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Staiger PK, Kyrios M, Williams JS, Kambouropoulos N, Howard A, Gruenert S. Improving the retention rate for residential treatment of substance abuse by sequential intervention for social anxiety. BMC Psychiatry 2014; 14:43. [PMID: 24533512 PMCID: PMC3936994 DOI: 10.1186/1471-244x-14-43] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 02/12/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Residential drug rehabilitation is often seen as a treatment of last resort for people with severe substance abuse issues. These clients present with more severe symptoms, and frequent psychiatric comorbidities relative to outpatients. Given the complex nature of this client group, a high proportion of clients seeking treatment often do not enter treatment, and of those who do, many exit prematurely. Given the highly social nature of residential drug rehabilitation services, it has been argued that social anxieties might decrease the likelihood of an individual entering treatment, or increase the likelihood of them prematurely exiting treatment. The current paper reports on the protocol of a Randomised Control Trial which examined whether treatment of social anxiety prior to entry to treatment improves entry rates and retention in residential drug rehabilitation. METHOD/DESIGN A Randomised Control Trial comparing a social skills treatment with a treatment as usual control group was employed. The social skills training program was based on the principles of Cognitive Behaviour Therapy, and was adapted from Ron Rapee's social skills training program. A permutated block randomisation procedure was utilised. Participants are followed up at the completion of the program (or baseline plus six weeks for controls) and at three months following entry into residential rehabilitation (or six months post-baseline for participants who do not enter treatment). DISCUSSION The current study could potentially have implications for addressing social anxiety within residential drug treatment services in order to improve entry and retention in treatment. The results might suggest that the use of additional screening tools in intake assessments, a focus on coping with social anxieties in support groups for clients waiting to enter treatment, and greater awareness of social anxiety issues is warranted. AUSTRALIAN NEW ZEALAND CLINICAL TRIALS REGISTRY Australian New Zealand Clinical Trials Registry (ACTRN) registration number: ACTRN12611000579998.
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Affiliation(s)
- Petra K Staiger
- Deakin University, School of Psychology, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Burwood, Australia.
| | - Michael Kyrios
- Swinburne University, Brain and Psychological Sciences Research Centre, Hawthorn, Australia
| | - James S Williams
- Deakin University, School of Psychology, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Burwood, Australia
| | - Nicolas Kambouropoulos
- Deakin University, School of Psychology, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Burwood, Australia
| | - Alexandra Howard
- Deakin University, School of Psychology, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Burwood, Australia
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Jenner L, Cameron J, K. Lee N, Nielsen S. Test-retest reliability of PsyCheck: a mental health screening tool for substance use treatment clients. ADVANCES IN DUAL DIAGNOSIS 2013. [DOI: 10.1108/add-03-2013-0008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Rooke SE, Gates PJ, Norberg MM, Copeland J. Applying technology to the treatment of cannabis use disorder: comparing telephone versus Internet delivery using data from two completed trials. J Subst Abuse Treat 2013; 46:78-84. [PMID: 24051076 DOI: 10.1016/j.jsat.2013.08.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 07/30/2013] [Accepted: 08/01/2013] [Indexed: 11/16/2022]
Abstract
Technology-based interventions such as those delivered by telephone or online may assist in removing significant barriers to treatment seeking for cannabis use disorder. Little research, however, has addressed differing technology-based treatments regarding their comparative effectiveness, and how user profiles may affect compliance and treatment satisfaction. This study addressed this issue by examining these factors in online (N=225) versus telephone (N=160) delivered interventions for cannabis use, using data obtained from two previously published randomized controlled trials conducted by the current authors. Several differences emerged including stronger treatment effects (medium to large effect sizes in the telephone study versus small effect sizes in the Web study) and lower dropout in the telephone intervention (38% vs. 46%). Additionally, around half of the telephone study participants sought concurrent treatment, compared with 2% of participants in the Web study. Demographics and predictors of treatment engagement, retention and satisfaction also varied between the studies. Findings indicate that both telephone and Web-based treatments can be effective in assisting cannabis users to quit or reduce their use; however, participant characteristics may have important implications for treatment preference and outcome, with those who elect telephone-based treatment experiencing stronger outcomes. Thus, participant preference may shape study populations, adherence, and outcome.
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Affiliation(s)
- Sally E Rooke
- National Cannabis Prevention and Information Centre, University of New South Wales, PO Box 684, Randwick NSW, 2031, Australia.
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Mellor D, McCabe M, Ricciardelli LA, Brumby S, Head A, Mercer-Grant C, Kennedy A. Evaluation of an alcohol intervention training program for nurses in rural Australia. J Res Nurs 2013. [DOI: 10.1177/1744987112465883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Aim This paper reports on the development, implementation and evaluation of the Alcohol Intervention Training Program (AITP) designed to enhance nurses’ capacity to work with farming men and women who misuse alcohol. Background In rural and regional areas where alcohol-related behaviours and problems are relatively elevated, nurses may be the key health professionals dealing with individuals who misuse alcohol. However, they are often ill-equipped to do this, have low confidence in their ability to do so, and perceive numerous barriers. Training is required for these nurses. Methods We developed the AITP to enhance nurses’ capacity to work with people with alcohol-related problems. The data were collected during 2010. An intervention group of 15 rural nurses completed the AITP. Nurses’ perceived barriers, attitudes, and perceived performance in working with clients with alcohol problems, and the frequency of engaging with this client group were evaluated. Scores on these measures were compared to those of a control group of 17 nurses’ pre-treatment, post-treatment and at 3-month follow-up. Results Participation in the AITP resulted in initial improvements in attitudes to working with alcohol problems, but no change in perceived barriers to doing so. The level of engagement with clients having alcohol-related problems increased, as did perceptions of work performance. Conclusion The AITP enhances the ability of rural nurses to address the alcohol and associated health issues of clients in rural and regional areas. However, the program needs refinement and further evaluation.
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Affiliation(s)
- David Mellor
- Professor of Psychology, School of Psychology, Deakin University, Australia
| | - Marita McCabe
- Professor of Psychology, School of Psychology, Deakin University, Australia
| | - Lina A Ricciardelli
- Associate Professor of Psychology, School of Psychology, Deakin University, Australia
| | - Susan Brumby
- Clinical Associate Professor, School of Medicine, Deakin University, Australia; National Centre for Farmer Health, Australia
| | - Alexandra Head
- Research Assistant and PhD candidate, School of Psychology, Deakin University, Australia
| | | | - Alison Kennedy
- Research Assistant and PhD candidate, School of Psychology, Deakin University, Australia; National Centre for Farmer Health, Australia
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Housing instability among people who inject drugs: results from the Australian needle and syringe program survey. J Urban Health 2013; 90:699-716. [PMID: 22733170 PMCID: PMC3732681 DOI: 10.1007/s11524-012-9730-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
High rates of substance dependence are consistently documented among homeless people, and are associated with a broad range of negative outcomes among this population. Investigations of homelessness among drug users are less readily available. This study examined the prevalence and correlates of housing instability among clients of needle syringe programs (NSPs) via the Australian NSP Survey, annual cross-sectional seroprevalence studies among NSP attendees. Following self-completion of a brief, anonymous survey and provision of a capillary blood sample by 2,396 NSP clients, multivariate logistic regressions identified the variables independently associated with housing instability. Nineteen percent of ANSPS participants reported current unstable housing, with primary ('sleeping rough'; 5 %), secondary (staying with friends/relatives or in specialist homelessness services; 8 %), and tertiary (residential arrangements involving neither secure lease nor private facilities; 6 %) homelessness all evident. Extensive histories of housing instability were apparent among the sample: 66 % reported at least one period of sleeping rough, while 77 % had shifted between friends/relatives (73 %) and/or resided in crisis accommodation (52 %). Participants with a history of homelessness had cycled in and out of homelessness over an average of 10 years; and one third reported first being homeless before age 15. Compared to their stably housed counterparts, unstably housed participants were younger, more likely to be male, of Indigenous Australian descent, and to report previous incarceration; they also reported higher rates of key risk behaviors including public injecting and receptive sharing of injecting equipment. The high prevalence of both historical and current housing instability among this group, particularly when considered in the light of other research documenting the many adverse outcomes associated with this particular form of disadvantage, highlights the need for increased supply of secure, affordable public housing in locations removed from established drug markets and serviced by health, social, and welfare support agencies.
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Baillie AJ, Sannibale C, Stapinski LA, Teesson M, Rapee RM, Haber PS. An investigator-blinded, randomized study to compare the efficacy of combined CBT for alcohol use disorders and social anxiety disorder versus CBT focused on alcohol alone in adults with comorbid disorders: the Combined Alcohol Social Phobia (CASP) trial protocol. BMC Psychiatry 2013; 13:199. [PMID: 23895258 PMCID: PMC3729492 DOI: 10.1186/1471-244x-13-199] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 07/24/2013] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Alcohol use disorders and social anxiety disorder are common and disabling conditions that frequently co-exist. Although there are efficacious treatments for each disorder, only two randomized controlled trials of interventions for these combined problems have been published. We developed a new integrated treatment for comorbid Social Anxiety Disorder and Alcohol Use Disorder based on established Motivational Interviewing (MI) and Cognitive Behaviour Therapy (CBT) interventions for the separate disorders. Compared to established MI/CBT for alcohol use disorders this new intervention is hypothesised to lead to greater reductions in symptoms of social anxiety and alcohol use disorder and to produce greater improvements in quality of life. Higher levels of alcohol dependence will result in relatively poorer outcomes for the new integrated treatment. METHODS/DESIGN A randomised controlled trial comparing 9 sessions of individual integrated treatment for alcohol and social phobia with 9 sessions of treatment for alcohol use problems alone is proposed. Randomisation will be stratified for stable antidepressant use. Post treatment clinical assessments of alcohol consumption and diagnostic status at 3 and 6 month follow-up will be blind to allocation. DISCUSSION The proposed trial addresses a serious gap in treatment evidence and could potentially define the appropriate treatment for a large proportion of adults affected by these problems. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12608000228381.
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Affiliation(s)
- Andrew J Baillie
- Centre for Emotional Health, Psychology Department, Macquarie University, Sydney, Australia
| | - Claudia Sannibale
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia,Drug Health Services, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Lexine A Stapinski
- Centre for Emotional Health, Psychology Department, Macquarie University, Sydney, Australia
| | - Maree Teesson
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Psychology Department, Macquarie University, Sydney, Australia
| | - Paul S Haber
- Drug Health Services, Royal Prince Alfred Hospital, Camperdown, Australia,Sydney Medical School, University of Sydney, Camperdown, Australia
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Fernández-Artamendi S, Secades-Villa R, Fernández Hermida JR, García-Fernández G, García-Rodríguez O. Gender differences in early alcohol and tobacco use as a risk factor in Spanish adolescents. Subst Use Misuse 2013; 48:429-37. [PMID: 23517404 DOI: 10.3109/10826084.2013.776085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The sample is made up of 1,190 adolescents (52.8% boys; mean age = 16.81) from 37 random schools in the urban and rural areas of Asturias (northern Spain). The survey was conducted in 2008, assessing the use and patterns of use of alcohol and other drugs, age at onset of use, and psychosocial consequences. Items from the ESPAD and FRIDA questionnaires were employed. Univariate analyses and binary logistic regression analyses were carried out to determine the different predictive value for boys and girls of early-onset alcohol and tobacco use. The study's limitations and implications are noted.
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Crooke AHD, Reid SC, Kauer SD, McKenzie DP, Hearps SJC, Khor AS, Forbes AB. Temporal mood changes associated with different levels of adolescent drinking: Using mobile phones and experience sampling methods to explore motivations for adolescent alcohol use. Drug Alcohol Rev 2013; 32:262-8. [DOI: 10.1111/dar.12034] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 01/19/2013] [Indexed: 11/28/2022]
Affiliation(s)
| | - Sophie C. Reid
- Murdoch Childrens' Research Institute; Royal Children's Hospital; Melbourne; Australia
| | - Sylvia D. Kauer
- Murdoch Childrens' Research Institute; Royal Children's Hospital; Melbourne; Australia
| | | | - Stephen J. C. Hearps
- Murdoch Childrens' Research Institute; Royal Children's Hospital; Melbourne; Australia
| | - Angela S. Khor
- Murdoch Childrens' Research Institute; Royal Children's Hospital; Melbourne; Australia
| | - Andrew B. Forbes
- Department of Epidemiology and Preventive Medicine; Monash University The Alfred Centre; Melbourne; Australia
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Affiliation(s)
- Maree Teesson
- NDARC, University of New South Wales, Randwick, Australia.
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