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Duncan Z, Ward B, Kippen R, Dietze P, Sutton K. A narrative systematic review of associations and temporality between use of methamphetamine, ecstasy/MDMA, or cocaine with anxiety or depressive symptoms. Addict Behav 2024; 153:107988. [PMID: 38394960 DOI: 10.1016/j.addbeh.2024.107988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/06/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE Anxiety and depression are prevalent mental health problems in people who use illicit stimulants. Improved understanding of the temporal relationship between methamphetamine, ecstasy/MDMA, or cocaine use with anxiety or depression informs public health interventions and treatment options for those experiencing this co-occurrence. This narrative systematic review sought to examine associations and temporality between the use of methamphetamine, ecstasy/MDMA, or cocaine, with anxiety or depressive symptoms. Method Systematic searches of 4 electronic databases were conducted up to August 2023. Study eligibility included the measurement of anxiety and/or depressive symptoms, and frequency of illicit stimulant use (methamphetamine, cocaine, or ecstasy/MDMA) at two separate time points, with data analysis of the association between these variables. The Joanna Briggs Critical Appraisal Checklist was utilised to assess quality. Data was extracted, and a narrative synthesis incorporating an eight-criteria framework to assess associations was conducted. Results 4432 studies were screened for eligibility; 11 studies (3 RCTs and 8 prospective cohort studies) were included. Evidence for an association between depressive symptoms and methamphetamine use was demonstrated in six studies, with temporal evidence in three studies supporting methamphetamine use preceding depressive symptoms. Three studies reported an association between cocaine use and depressive symptoms. Evidence for associations with any of the illicit stimulants and anxiety symptoms was lacking. CONCLUSIONS There was some evidence to support a case for temporality, particularly for methamphetamine use and depressive symptoms. Investing in longitudinal studies is pivotal to understanding the dynamic and reciprocal relationship between illicit stimulant use and anxiety or depressive symptoms. A limitation of the study was the variation in the measurement and analysis of outcomes.
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Affiliation(s)
- Zoe Duncan
- Monash Rural Health, Monash University, Melbourne, Australia.
| | - Bernadette Ward
- Monash Rural Health, Monash University, Melbourne, Australia; Behaviours and Health Risks Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Rebecca Kippen
- Monash Rural Health, Monash University, Melbourne, Australia
| | - Paul Dietze
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Victoria, Australia; National Drug Research Institute, Curtin University, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Keith Sutton
- Monash Rural Health, Monash University, Melbourne, Australia; National Drug Research Institute, Curtin University, Melbourne, Victoria, Australia
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Shiraly R, Jazayeri SA, Seifaei A, Jeihooni AK, Griffiths MD. Suicidal thoughts and behaviors among untreated illicit substance users: a population-based study. Harm Reduct J 2024; 21:96. [PMID: 38755587 PMCID: PMC11097468 DOI: 10.1186/s12954-024-01015-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 05/04/2024] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVES Research regarding the contribution of specific psychoactive substances to suicidality has yielded equivocal results. The present study examined the prevalence and factors associated with suicidal thoughts and behaviors among a population-based sample of untreated illicit substance users. METHODS A total of 616 illicit substance users who were recruited from high-risk areas of Shiraz using snowball sampling participated in the study. Eligible participants were individuals aged 18 years and older who regularly used one illicit psychoactive substance (e.g., opioids, heroin, cannabinoids, stimulants, hallucinogens) for at least one year and who had received no treatment for their drug use during the past year. Data were collected regarding socio-demographic characteristics, mental history, and substance use habits. Data regarding suicidal thoughts and behaviors were assessed using the Beck Suicidal Ideation Scale (BSIS) and self-reports of previous suicide attempts. Multiple logistic regression analysis was used to identify independent variables associated with suicidality. RESULTS Among the participants, 23.6% reported having had suicidal thoughts during the past week and 6.7% reported having attempted suicide during the past year. Methamphetamine was reported as the primary substance of use among approximately half of the participants who attempted suicide during past year (49.2%). Multiple logistic regression analysis showed that current suicidal thoughts were independently associated with having no job, a history of mental health condition, previous suicidal attempts, concurrent use of more than one substance, and using methamphetamine and heroin as the primary substances. Suicidal thoughts were not associated with increased odds of regular opium and cannabis use. CONCLUSION Both methamphetamine and heroin use are significantly associated with current suicidal thoughts. Evaluation of the risk of suicidality by physicians and mental health care professionals in both community and outpatient settings would be especially appropriate among those individuals using these psychoactive substances.
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Affiliation(s)
- Ramin Shiraly
- Community Medicine Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Seyed Amin Jazayeri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Asal Seifaei
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Khani Jeihooni
- Nutrition Research Center, Public Health Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
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Zhang J, Yan J, Li S, Chen Q, Lin J, Peng Y, Liu Y, Wang B, Wei X, Sun C, Niu S. GPR55 activation improves anxiety- and depression-like behaviors of mice during methamphetamine withdrawal. Heliyon 2024; 10:e30462. [PMID: 38720745 PMCID: PMC11077030 DOI: 10.1016/j.heliyon.2024.e30462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 04/26/2024] [Accepted: 04/26/2024] [Indexed: 05/12/2024] Open
Abstract
Methamphetamine is a potent and highly addictive neurotoxic psychostimulant that triggers a spectrum of adverse emotional responses during withdrawal. G-protein coupled receptor 55 (GPR55), a novel endocannabinoid receptor, is closely associated with mood regulation. Herein, we developed a murine model of methamphetamine-induced anxiety- and depressive-like behavior during abstinence which showed a decreased GPR55 expression in the hippocampus. Activation of GPR55 mitigated these behavioral symptoms, concomitantly ameliorating impairments in hippocampal neurogenesis and reducing neuroinflammation. These findings underscore the pivotal role of GPR55 in mediating the neuropsychological consequences of methamphetamine withdrawal, potentially via mechanisms involving the modulation of hippocampal neurogenesis and inflammation.
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Affiliation(s)
- Jinlong Zhang
- Department of Forensic Science, School of Basic Medical Science, Xinjiang Medical University, Urumqi, 830011, China
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, 410000, China
| | - Jie Yan
- Department of Forensic Science, School of Basic Medical Science, Xinjiang Medical University, Urumqi, 830011, China
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, 410000, China
| | - Shuyue Li
- Department of Forensic Science, School of Basic Medical Science, Xinjiang Medical University, Urumqi, 830011, China
| | - Qianqian Chen
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, 410000, China
| | - Jiang Lin
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, 410000, China
| | - Yilin Peng
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, 410000, China
| | - Yuhang Liu
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, 410000, China
| | - Binbin Wang
- Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha, 410000, China
| | - Xinrong Wei
- Department of Forensic Science, School of Basic Medical Science, Xinjiang Medical University, Urumqi, 830011, China
| | - Chen Sun
- School of Public Health, Xinjiang Medical University, Urumqi, 830011, China
| | - Shuliang Niu
- Department of Forensic Science, School of Basic Medical Science, Xinjiang Medical University, Urumqi, 830011, China
- Department of Human Anatomy, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, 830011, China
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Bayazit H, Baronia R, Wakefield SM. Methamphetamine intoxication and suicidal ideation/behavior in the emergency department. Curr Med Res Opin 2024; 40:849-854. [PMID: 38511972 DOI: 10.1080/03007995.2024.2333429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 03/18/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND This study investigates the association between Methamphetamine (MA) intoxication and suicidal ideation/behavior in patients presenting to emergency departments. Amidst rising MA use and co-use with opioids, this "twin epidemic" has manifested in increasing admissions for MA intoxication, often accompanied by psychiatric symptoms that can escalate to suicidal behaviors. METHOD This retrospective study utilized patient records and analyzed data from 629 patients admitted to a Texas emergency department in 2020, with MA intoxication confirmed via urine tests and patient interviews. The suicidal tendencies were assessed using the Columbia-Suicide Severity Scale. The 629 patients were divided into three groups for analysis: Group I (n = 188), MA positive with suicidal ideation (SI) (MA + SI+); Group II (n = 202), MA-positive without SI (MA + SI-); and Group III (n = 239), MA-negative with SI (MA- SI+). Multiple regression analysis was used to elicit clinical features predicting patients presenting to the emergency department with acute MA intoxication. RESULTS Results reveal that approximately half of patients with acute MA intoxication reported suicidal thoughts, indicating a significant association between MA use and suicidal tendencies. Females exhibited higher rates of suicidal thoughts, behavior, and subsequent medical attention compared to males. Sociodemographic characteristics and clinical features differed among MA-positive patients with and without SI. Multivariable regression analysis identified factors influencing MA use, including cannabis use, male gender, agitation, and an inverse association with alcohol use. Notably, the severity and potential lethality of suicidal behavior in MA-intoxicated patients paralleled those observed in psychiatric patients without MA use. CONCLUSION These results underscore the urgent need for targeted interventions to address the complex interplay between MA use and suicidal risks in the emergency department setting, as well as broader public health strategies to combat the increasing prevalence of MA use.
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Affiliation(s)
- Huseyin Bayazit
- Department of Psychiatry, Texas Tech University Health Science Center, Lubbock, TX, USA
- Behavioral Sciences and Psychiatry Department, Duke University, Durham, NC, USA
| | - Regina Baronia
- Department of Psychiatry, Texas Tech University Health Science Center, Lubbock, TX, USA
| | - Sarah M Wakefield
- Department of Psychiatry, Texas Tech University Health Science Center, Lubbock, TX, USA
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Petzold J, Pochon JBF, Ghahremani DG, London ED. Structural indices of brain aging in methamphetamine use disorder. Drug Alcohol Depend 2024; 256:111107. [PMID: 38330525 DOI: 10.1016/j.drugalcdep.2024.111107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 01/01/2024] [Accepted: 01/17/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Methamphetamine use is surging globally. It has been linked to premature stroke, Parkinsonism, and dementia, suggesting that it may accelerate brain aging. METHODS We performed a retrospective study to determine if structural indices of brain aging were more prevalent prior to old age (26 - 54 years) in individuals with Methamphetamine Use Disorder (MUD), who were in early abstinence (M ± SD = 22.1 ± 25.6 days) than in healthy control (HC) participants. We compared T1-weighted MRI brain scans in age- and sex-matched groups (n = 89/group) on three structural features of brain aging: the brain volume/cerebrospinal fluid (BV/CSF) index, volume of white matter hypointensities/lesions, and choroid plexus volume. RESULTS The MUD group had a lower mean BV/CSF index and larger volumes of white matter hypointensities and choroid plexus (p-values < 0.01). Regression analyses showed significant age-by-group effects, indicating different age trajectories of the BV/CSF index and choroid plexus volume, consistent with abnormal global brain atrophy and choroid plexus pathology in the MUD group. Significant age and group main effects reflected a larger volume of white matter hypointensities for older participants across groups and for the MUD group irrespective of age. None of the three measures of brain aging correlated significantly with recent use or duration of recent abstinence from methamphetamine. CONCLUSIONS Premature brain pathology, which may reflect cerebrovascular damage and dysfunction of the choroid plexus, occurs in people with MUD. Such pathology may affect cognition and thereby efficacy of behavioral treatments for MUD.
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Affiliation(s)
- Johannes Petzold
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, and Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Psychotherapy, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Jean-Baptiste F Pochon
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, and Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Dara G Ghahremani
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, and Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Edythe D London
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, and Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA; The Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA; Department of Molecular and Medical Pharmacology, University of California at Los Angeles, Los Angeles, CA, USA.
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Moulis L, Le SM, Hai VV, Huong DT, Minh KP, Oanh KTH, Rapoud D, Quillet C, Thi TTN, Vallo R, Hoang GT, Moles JP, Laureillard D, Feelemyer J, Des Jarlais DC, Michel L, Nagot N. Gender, homelessness, hospitalization and methamphetamine use fuel depression among people who inject drugs: implications for innovative prevention and care strategies. Front Psychiatry 2023; 14:1233844. [PMID: 38025448 PMCID: PMC10661402 DOI: 10.3389/fpsyt.2023.1233844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Background The co-occurrence of substance use disorder and mental disorder, known as dual diagnosis, has a distressingly high prevalence among individuals grappling with either of these conditions. Mood disorders, especially depression, constitute a substantial burden for People Who Inject Drugs (PWID) and a significant public health concern in Vietnam. Identifying risk factors for depression in PWID is imperative for the development of targeted interventions. Methods We enrolled PWID into a cohort using the respondent-driven sampling method. Over a 36-month period, we systematically tracked the emergence of depression and employed multiple imputation in conjunction with a mixed nonlinear model to pinpoint risk factors for depression in this demographic. At inclusion, depression was screened using the PHQ-2 questionnaire, and subsequent episodes of depression were assessed semi-annually using the CES-D8. Results Three hundred and ninety-one PWID (26.6%) were depressed. Major risk factors for depression included being female, not having a permanent residency, having been hospitalized and using methamphetamine more than weekly. Other risk factors included age, being single, not having a health insurance card and not being on methadone. Limitations The exclusion of missing visits and social desirability could have led to selection and information biases. In this observational study, confusion biases are possible despite our best efforts. Conclusion Depression is alarmingly frequent in PWID. In this study taking in account the chronological relationship between sociodemographic and clinical factors and depression, risk factors were identified in this specific setting of low-to-middle income country. The findings highlight the need to develop innovative targeted psychiatric interventions with the help of supporting peers.
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Affiliation(s)
- Lionel Moulis
- PCCEI, University of Montpellier, INSERM, EFS, University of Antilles, Montpellier, France
| | - Sao Mai Le
- Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Vinh Vu Hai
- Department of Infectious and Tropical Diseases, Viet Tiep Hospital, Haiphong, Vietnam
| | - Duong Thi Huong
- Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Khuê Pham Minh
- Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | | | - Delphine Rapoud
- PCCEI, University of Montpellier, INSERM, EFS, University of Antilles, Montpellier, France
| | - Catherine Quillet
- PCCEI, University of Montpellier, INSERM, EFS, University of Antilles, Montpellier, France
| | | | - Roselyne Vallo
- PCCEI, University of Montpellier, INSERM, EFS, University of Antilles, Montpellier, France
| | - Giang Thi Hoang
- Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Jean-Pierre Moles
- PCCEI, University of Montpellier, INSERM, EFS, University of Antilles, Montpellier, France
| | - Didier Laureillard
- PCCEI, University of Montpellier, INSERM, EFS, University of Antilles, Montpellier, France
- Infectious Diseases Department, Caremeau University Hospital, Nîmes, France
| | | | | | - Laurent Michel
- CESP Inserm UMRS, Pierre Nicole Center, Paris Saclay University, Fench Red Cross, Paris, France
| | - Nicolas Nagot
- PCCEI, University of Montpellier, INSERM, EFS, University of Antilles, Montpellier, France
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Guerin AA, Bridson T, Plapp HM, Bedi G. A systematic review and meta-analysis of health, functional, and cognitive outcomes in young people who use methamphetamine. Neurosci Biobehav Rev 2023; 153:105380. [PMID: 37678571 DOI: 10.1016/j.neubiorev.2023.105380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/30/2023] [Accepted: 09/01/2023] [Indexed: 09/09/2023]
Abstract
Methamphetamine use typically starts in adolescence, and early onset is associated with worse outcomes. Yet, health, functional, and cognitive outcomes associated with methamphetamine use in young people are not well understood. The aim of this study was to comprehensively assess the evidence on health, functional, and cognitive outcomes in young people (10-25 years-old) who use methamphetamine. Sixty-six studies were included. The strongest association observed was with conduct disorder, with young people who use methamphetamine some 13 times more likely to meet conduct disorder criteria than controls. They were also more likely to have justice system involvement and to perpetrate violence against others. Educational problems were consistently associated with youth methamphetamine use. The cognitive domain most reliably implicated was inhibitory control. Key limitations in the literature were identified, including heterogenous measurement of exposure and outcomes, lack of adequate controls, and limited longitudinal evidence. Outcomes identified in the present review - suggesting complex and clinically significant behavioural issues in this population - are informative for the development of future research and targeted treatments.
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Affiliation(s)
- Alexandre A Guerin
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia; Orygen, Melbourne, Australia.
| | - Tahnee Bridson
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia; Orygen, Melbourne, Australia
| | - Helena M Plapp
- Orygen, Melbourne, Australia; Royal Melbourne Hospital, Melbourne, Australia
| | - Gillinder Bedi
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia; Orygen, Melbourne, Australia
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Chun-Hung L, Guan-Hsiung L, Wu-Chuan Y, Yu-Hsin L. Chatbot-assisted therapy for patients with methamphetamine use disorder: a preliminary randomized controlled trial. Front Psychiatry 2023; 14:1159399. [PMID: 37484677 PMCID: PMC10359989 DOI: 10.3389/fpsyt.2023.1159399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 06/16/2023] [Indexed: 07/25/2023] Open
Abstract
Background Methamphetamine (MA) use disorder is associated with a large public health burden. Despite the therapeutic effects of psychosocial interventions based on current evidence, finding an approach to retain patients in treatment remains a real-world challenge. The rapid development of mobile health (mHealth) systems suggests the potential to provide real-time personalized care at any time and from any location, minimize barriers to treatment, maximize use, and promote the dissemination of accessible therapeutic tools in at-risk populations. Our study aimed to investigate the feasibility and effectiveness of chatbots for the treatment of MA use disorder. Method The inclusion criteria were (a) a diagnosis of MA use disorder as defined by the DSM-5, (b) age between 18 and 65 years, (c) no acute exacerbation of severe mental illness during the initial assessment, such as schizophrenia or bipolar I disorder, (d) willingness to participate in standard outpatient treatment for ≥ 6 months, and (e) an Android phone. Participants were randomly allocated to either a chatbot-assisted therapy via smartphone (CAT) group or a control group following simple randomization procedures (computerized random numbers) without blinding. All participants were followed up for 6 months. Treatment retention and monthly urine test results were analyzed as outcome measures. Participants' satisfaction with CAT was also assessed. Results In total, 50 and 49 participants were allocated to the CAT and control groups, respectively. There were no significant differences in retention time between the two treatment groups (df = 1, p = 0.099). The CAT group had fewer MA-positive urine samples than the control group (19.5% vs. 29.6%, F = 9.116, p = 0.003). The proportion of MA-positive urine samples was positively correlated with the frequency of MA use (r = 0.323, p = 0.001), severity of MA use disorder (r = 0.364, p < 0.001), and polysubstance use (r = 0.212, p = 0.035), and negatively correlated with readiness to change (r = -0.330, p = 0.001). Totally 55 participants completed the study at the 6-month follow-up and 60% reported relative satisfaction. Conclusion Participants in this study had favorable acceptance and generally positive outcomes, which indicates that chatbot is feasible for treating people who use MA.
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Affiliation(s)
- Lee Chun-Hung
- Department of Information Engineering, I-Shou University, Kaohsiung, Taiwan
- Jianan Psychiatric Center, Ministry of Health and Welfare (MOHW), Tainan, Taiwan
| | - Liaw Guan-Hsiung
- Department of Information Engineering, I-Shou University, Kaohsiung, Taiwan
| | - Yang Wu-Chuan
- Department of Information Engineering, I-Shou University, Kaohsiung, Taiwan
| | - Liu Yu-Hsin
- King's College London, Florence Nightingale School of Nursing & Midwifery, London, United Kingdom
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Li J, Wang R, He J, Wang L, Li L. Comparison of the effect of hostility on the level of depression of drug addicts and non-addicts and the mediating role of sense of life meaning between them. BMC Psychiatry 2023; 23:350. [PMID: 37210486 DOI: 10.1186/s12888-023-04856-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: 02/15/2023] [Accepted: 05/09/2023] [Indexed: 05/22/2023] Open
Abstract
BACKGROUND The level of depression among drug addicts is generally higher than normal. Hostility and sense of life meaning may influence depression and become risk factors for depression. This study has three research purposes. First, to analyze whether drug use can aggravate hostility and depression levels. Second, to assess whether the hostility has different effects on depression among drug addicts and non-addicts. Third, to examine whether the sense of life meaning has a mediating role between different groups (drug addicts and non-addicts). METHODS This study was conducted from March to June 2022. 415 drug addicts (233 males and 182 females) and 411 non-addicts (174 males and 237 females) were recruited in Chengdu, Sichuan Province. After signing informed consent, their psychometric data were obtained using the Cook-Medley Hostility Scale (CMI), Beck Depression Inventory (BDI) and Meaning in Life Questionnaire (MLQ) questionnaires. Linear regression models were used to assess the impact of hostility and depression among drug addicts and non-addicts. Bootstrap mediation effect tests were used to further test the mediation effect of sense of life meaning between hostility and depression. RESULTS The results showed four main outcomes. First, compared with non-addicts, drug addicts had higher levels of depression. Second, hostility exacerbated depression in both drug addicts and non-addicts. Compared with non-addicts, hostile affect had a greater effect on depression in drug addicts. Third, the sense of life meaning among females was higher than males. Fourth, for drug addicts, the sense of life meaning showed a mediating effect between social aversion and depression, while for non-addicts, the sense of life meaning showed a mediating effect between cynicism and depression. CONCLUSIONS Depression is more severe in drug addicts. More attention should be paid to the mental health of drug addicts, because the elimination of negative emotions is conducive to reintegration into society. Our results provide a theoretical basis for reducing depression among drug addicts and non-addicts. As a protective factor, we can reduce their hostility and depression by improving the sense of life meaning.
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Affiliation(s)
- Jiaoyang Li
- Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Wenjiang District, Chengdu, China
| | - Rufang Wang
- Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Wenjiang District, Chengdu, China.
| | - Jingzhen He
- Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Wenjiang District, Chengdu, China
| | - Linghui Wang
- The Second Drug Rehabilitation Center in Chengdu, Chengdu, China
| | - Lin Li
- The Drug Rehabilitation Center in Chengdu, Chengdu, China
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Feelemyer J, Jarlais DD, Nagot N, Thi HD, Hai OKT, Minh KP, Thi GH, Tuyet TNT, Cleland CM, Arasteh K, Caniglia E, Chen Y, Bart G, Moles JP, Hai VV, Vallo R, Quillet C, Rapoud D, Sao ML, Michel L, Laureillard D, Khan MR. Association between recent methamphetamine use, antiretroviral therapy and HIV viral load; a mediation analysis from a cohort of HIV positive persons who inject drugs in Hai Phong, Vietnam. Int J STD AIDS 2023; 34:236-244. [PMID: 36637437 PMCID: PMC10089109 DOI: 10.1177/09564624221142366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND There has been a significant increase in methamphetamine use among persons who use drugs in Vietnam in the last 5-10 years. We examined the degree to which adherence to antiretroviral therapy (ART) mediates the relationship between recent methamphetamine use and unsuppressed HIV viral load among people who inject drugs (PWID) in Hai Phong, Vietnam. METHODS We recruited PWID from October 2016-October 2018 and enrolled HIV positive PWID into a cohort, with up to three years of total follow-up. We assessed relationships among recent methamphetamine use frequency, ART adherence and unsuppressed HIV viral load. Mediation analysis was used to estimate the total and natural direct effects of recent methamphetamine use on unsuppressed HIV viral load and the indirect effect proportion. RESULTS We enrolled 792 HIV seropositive PWID into the cohort; approximately 75.9% reported high/perfect ART adherence at baseline and 81.3% were virally suppressed. In mediation analysis, the total effect for the association between methamphetamine use and unsuppressed HIV viral load (1000 copies/mL) was 3.94 (95% CI: 1.95, 7.96); the natural direct effect was 2.14 (95% CI: 1.29, 3.55); the proportion mediated by self-reported ART adherence was 0.444. Similar results were found when examining lower unsuppressed HIV viral load cutpoints of 250 copies/mL and 500 copies/mL. CONCLUSIONS Methamphetamine use is associated with unsuppressed HIV viral load among PWID despite high levels of ART adherence. Further research is needed to better understand these relationships, with emphasis on potential biological pathways that may interact with ART.
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Affiliation(s)
- Jonathan Feelemyer
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Don Des Jarlais
- New York University College of Global Public Health, New York, NY, USA
| | - Nicolas Nagot
- Pathogenesis & Control of Chronic and Emerging Infections, University of Montpellier, INSERM, Antilles University, Montpellier, France
| | - Huong Duong Thi
- Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | | | - Khuê Pham Minh
- Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Giang Hoang Thi
- Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | | | - Charles M Cleland
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Kamyar Arasteh
- New York University College of Global Public Health, New York, NY, USA
| | - Ellen Caniglia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia PA, USA
| | - Yu Chen
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Gavin Bart
- Department of Medicine, University of Minnesota, Minneapolis, USA
| | - Jean Pierre Moles
- Pathogenesis & Control of Chronic and Emerging Infections, University of Montpellier, INSERM, Antilles University, Montpellier, France
| | - Vinh Vu Hai
- Department of Infectious and Tropical Diseases, Viet Tiep Hospital, Haiphong, Vietnam
| | - Roselyne Vallo
- Pathogenesis & Control of Chronic and Emerging Infections, University of Montpellier, INSERM, Antilles University, Montpellier, France
| | - Catherine Quillet
- Pathogenesis & Control of Chronic and Emerging Infections, University of Montpellier, INSERM, Antilles University, Montpellier, France
| | - Delphine Rapoud
- Pathogenesis & Control of Chronic and Emerging Infections, University of Montpellier, INSERM, Antilles University, Montpellier, France
| | - Mai Le Sao
- Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Laurent Michel
- Pierre Nicole Center, French Red Cross, CESP/Inserrm, Paris, France
| | - Didier Laureillard
- Pathogenesis & Control of Chronic and Emerging Infections, University of Montpellier, INSERM, Antilles University, Montpellier, France
- Infectious Diseases Department, Caremeau University Hospital, Nîmes, France
| | - Maria R Khan
- Department of Population Health, New York University School of Medicine, New York, NY, USA
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11
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Xu J, Zhang Y, Lei C, Sun P, Chen R, Yuan T. Using machine learning to identify factors related to nitrous oxide (laughing gas) relapse among adolescents. Gen Psychiatr 2023; 36:e101003. [PMID: 37144158 PMCID: PMC10151853 DOI: 10.1136/gpsych-2022-101003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/06/2023] [Indexed: 05/06/2023] Open
Affiliation(s)
- Jie Xu
- Beijing Gaoxin Hospital, Beijing, China
- Department of Psychology, Tsinghua University, Beijing, China
- Department of Psychiatry and Psychology, Tianjin Medical University, Tianjin, China
| | - Yi Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chang Lei
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Pei Sun
- Department of Psychology, Tsinghua University, Beijing, China
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Tifei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu, China
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12
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Fang T, Liu MN, Tian XY, Lu GY, Li F, Zhang X, Liu F, Hao W, Wu N, Li H, Li J. The association of FKBP5 polymorphisms with the severity of depressive disorder in patients with methamphetamine use disorders. Front Psychiatry 2023; 14:1147060. [PMID: 37051166 PMCID: PMC10083280 DOI: 10.3389/fpsyt.2023.1147060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 02/28/2023] [Indexed: 04/14/2023] Open
Abstract
Background Co-occurring depressive disorder (DD) in patients of methamphetamine use disorder (MAUD) impacts the diagnosis, treatment, and prognosis of the disease. Although FKBP5 has been associated with a variety of psychiatric disorders, whether FKBP5 influences depression susceptibility in MAUD is unknown so far. Methods Here, we sequenced six FKBP5 single-nucleotide polymorphism (SNP) sites (rs4713916, rs6926133, rs9470080, rs737054, rs4713902, and rs9470079) in 282 methamphetamine users. MAUD and DD were evaluated by clinical questionnaires. SPSS was used to analyze the relationship between FKBP5 SNPs and DD in individuals with MAUD. Results Of the 282 methamphetamine users, 161 individuals met the MAUD criteria, and among them, 50 patients (31.1%) had DD co-occurring. Importantly, the incidence of DD in individuals with MAUD was 3.314 times greater than that of the methamphetamine users who did not meet the MAUD criteria (p < 0.001). Although none of the six SNPs of FKBP5 were correlated with the co-occurrence of DD in the population with MAUD, two FKBP5 alleles (rs4713916A and rs6926133A) were substantially associated with the higher DD scores in patients with MAUD (p < 0.05). Moreover, those with the two risk alleles do not have much higher scores than those with a single risk allele, and the strong linkage disequilibrium of the two SNPs may be the underlying cause of this result. Despite having weak linkage disequilibrium with either rs4713916 or rs6926133, FKBP5 rs9470079 became risky when paired with either. Conclusion The results of this study revealed that the FKBP5 risk alleles (rs4713916A and rs6926133A) were associated with a greater probability of severe DD in patients with MAUD. These findings here would help with the development of biological early warning markers and the creation of personalized treatment strategies for MAUD.
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Affiliation(s)
- Ting Fang
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Meng-Nan Liu
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Xiao-Yu Tian
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Guan-Yi Lu
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Fei Li
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Xiaojie Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Feng Liu
- Compulsory Detoxification Center of Changsha Public Security Bureau, Changsha, Hunan, China
| | - Wei Hao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ning Wu
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Hong Li
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing, China
- Hong Li
| | - Jin Li
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing, China
- *Correspondence: Jin Li
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Li J, Jiang W, Zhu R, Fan F, Fu F, Wei D, Tang S, Tian Y, Chen J, Li Y, Zhou H, Wang L, Wang D, Zhang XY. Depression in Chinese men with methamphetamine dependence: Prevalence, correlates and relationship with alexithymia. J Affect Disord 2022; 319:235-243. [PMID: 36162653 DOI: 10.1016/j.jad.2022.09.064] [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: 04/25/2022] [Revised: 08/10/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The comorbidity between substance use disorder and major depressive disorder is a typical dual diagnosis in the field of substance addiction. However, the prevalence and correlates of depression in methamphetamine addicts and whether it is associated with drug craving and alexithymia have been rarely reported in the Chinese population. METHODS We recruited 585 methamphetamine-dependent males from a drug rehabilitation center in China and 203 healthy controls. Demographic and drug use data were collected. Depression was assessed using the Mini International Neuropsychiatric Interview (M.I.N·I.). Methamphetamine cravings and alexithymia were assessed using the Desire for Drugs Questionnaire (DDQ) and the Toronto Alexithymia Scale (TAS). RESULTS The prevalence rate of depression in methamphetamine-dependent men was 16.58 % (97/585). The scores of DDQ desire and intention, DDQ negative reinforcement, total DDQ, difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and total TAS score of depressed patients were higher than those of non-depressed patients. However, only DDQ negative reinforcement score, DIF, DDF, and total TAS score remained significant after Bonferroni correction. Additionally, logistic regression analysis found that age, DIF score, and DDQ negative reinforcement score were significant factors contributing to depression in methamphetamine-dependent men. CONCLUSION Our findings suggest that the prevalence of depression is significantly higher in methamphetamine-dependent men than in the healthy Chinese population. Furthermore, age, components of alexithymia and drug craving are risk factors for depression in methamphetamine addicts.
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Affiliation(s)
- Jiaxin Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Wei Jiang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Rongrong Zhu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Fusheng Fan
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Fabing Fu
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Dejun Wei
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | | | - Yang Tian
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jiajing Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yuqing Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Huixia Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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14
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Tatari F, Farnia V, Lalehgni F, Moradi A, Radmehr F, Davarinejad O, Hookari S, Salemi S, Golmohammadi F, Alikhani M. The efficacy of venlafaxine in the treatment of depression, withdrawal symptoms, and craving in individuals with methamphetamine dependence. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2144508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Faezeh Tatari
- Department of Psychiatry, Substance abuse Prevention Research Center, Health institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Vahid Farnia
- Department of Psychiatry, Substance abuse Prevention Research Center, Health institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Lalehgni
- Department of Psychiatry, Substance abuse Prevention Research Center, Health institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Asieh Moradi
- Department of Psychology, Faculty of Social Sciences, Razi University, Kermanshah, Iran
| | - Farnaz Radmehr
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Omran Davarinejad
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sara Hookari
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Safora Salemi
- Department of Psychiatry, Substance abuse Prevention Research Center, Health institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farzaneh Golmohammadi
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Alikhani
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
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15
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Methamphetamine Induces Systemic Inflammation and Anxiety: The Role of the Gut–Immune–Brain Axis. Int J Mol Sci 2022; 23:ijms231911224. [PMID: 36232524 PMCID: PMC9569811 DOI: 10.3390/ijms231911224] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 12/21/2022] Open
Abstract
Methamphetamine (METH) is a highly addictive drug abused by millions of users worldwide, thus becoming a global health concern with limited management options. The inefficiency of existing treatment methods has driven research into understanding the mechanisms underlying METH-induced disorders and finding effective treatments. This study aims to understand the complex interactions of the gastrointestinal–immune–nervous systems following an acute METH dose administration as one of the potential underlying molecular mechanisms concentrating on the impact of METH abuse on gut permeability. Findings showed a decreased expression of tight junction proteins ZO-1 and EpCAm in intestinal tissue and the presence of FABP-1 in sera of METH treated mice suggests intestinal wall disruption. The increased presence of CD45+ immune cells in the intestinal wall further confirms gut wall inflammation/disruption. In the brain, the expression of inflammatory markers Ccl2, Cxcl1, IL-1β, TMEM119, and the presence of albumin were higher in METH mice compared to shams, suggesting METH-induced blood–brain barrier disruption. In the spleen, cellular and gene changes are also noted. In addition, mice treated with an acute dose of METH showed anxious behavior in dark and light, open field, and elevated maze tests compared to sham controls. The findings on METH-induced inflammation and anxiety may provide opportunities to develop effective treatments for METH addiction in the future.
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16
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Petzold J, Dean AC, Pochon JB, Ghahremani DG, De La Garza R, London ED. Cortical thickness and related depressive symptoms in early abstinence from chronic methamphetamine use. Addict Biol 2022; 27:e13205. [PMID: 36001419 PMCID: PMC9413352 DOI: 10.1111/adb.13205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 05/28/2022] [Accepted: 06/19/2022] [Indexed: 11/30/2022]
Abstract
Methamphetamine use is surging globally as a cause of morbidity and mortality. Treatment is typically sought in early abstinence, when craving and depressive symptoms are intense, contributing to relapse and poor outcomes. To advance an understanding of this problem and identify therapeutic targets, we conducted a retrospective analysis of brain structure in 89 adults with Methamphetamine Use Disorder who were in early abstinence and 89 healthy controls. Unlike most prior research, the participants did not significantly differ in age, sex and recent use of alcohol and tobacco (p-values ≥ 0.400). We analysed thickness across the entire cerebral cortex by fitting a general linear model to identify differences between groups. Follow-up regressions were performed to determine whether cortical thickness in regions showing group differences was related to craving, measured on a visual analogue scale, or to the Beck Depression Inventory score. Participants in early methamphetamine abstinence (M ± SD = 22.1 ± 25.6 days) exhibited thinner cortex in clusters within bilateral frontal, parietal, temporal, insular, and right cingulate cortices relative to controls (p-values < 0.001, corrected for multiple comparisons). Unlike craving (β = 0.007, p = 0.947), depressive symptoms were positively correlated with cortical thickness across clusters (β = 0.239, p = 0.030) and with thickness in the anterior cingulate cluster (β = 0.246, p = 0.027) in the methamphetamine-dependent group. Inasmuch as anterior cingulate pathology predicts response to antidepressants for Major Depressive Disorder, cingulate structure may also identify patients with Methamphetamine Use Disorder who can benefit from antidepressant medication.
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Affiliation(s)
- Johannes Petzold
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Andy C. Dean
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
- The Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA
| | - Jean-Baptiste Pochon
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Dara G. Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Richard De La Garza
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
- The Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA
- Department of Molecular and Medical Pharmacology, University of California at Los Angeles, Los Angeles, CA, USA
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17
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Miller AE, Daiwile AP, Cadet JL. Sex-Dependent Alterations in the mRNA Expression of Enzymes Involved in Dopamine Synthesis and Breakdown After Methamphetamine Self-Administration. Neurotox Res 2022; 40:1464-1478. [PMID: 35834057 DOI: 10.1007/s12640-022-00545-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/28/2022] [Accepted: 07/04/2022] [Indexed: 10/17/2022]
Abstract
Sex differences have been reported in methamphetamine (METH) use disorder in humans and in animal models of METH exposure. Specifically, animals that self-administer METH show sex-related dissimilarities in dopamine (DA) metabolism. To better understand the molecular bases for the differences in DA metabolism, we measured the levels of mRNAs of enzymes that catalyze DA synthesis and breakdown in the prefrontal cortex (PFC), nucleus accumbens (NAc), dorsal striatum (dSTR), and hippocampus (HIP) of rats that had self-administered METH. There were significant sex differences in control rats, with males having higher basal levels of Th in the PFC and dSTR, Ddc in the NAc, and MaoB in the HIP. In contrast, female controls showed higher basal levels of Comt in the HIP. Male and female METH SA rats also showed some distinct responses to the drug. Specifically, female METH rats exhibited increased expression of Ddc and MaoB, whereas male METH animals showed higher levels of Comt mRNA in the PFC compared to their respective controls. In the NAc, male METH rats displayed decreased Th and Ddc mRNA levels. Together, our results identified sex-dependent and region-specific changes in the mRNA expression of several enzymes involved in DA synthesis and breakdown in response to METH SA, with the majority of differences being observed in the mesocorticolimbic dopaminergic system. These findings are of significant translational importance providing further support for the inclusion of sex as an important variable when planning and evaluating therapeutic interventions against METH use disorder in human clinical studies.
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Affiliation(s)
- Aaron E Miller
- Molecular Neuropsychiatry Research Branch, NIDA Intramural Research Program, Baltimore, MD, 21224, USA
| | - Atul P Daiwile
- Molecular Neuropsychiatry Research Branch, NIDA Intramural Research Program, Baltimore, MD, 21224, USA
| | - Jean Lud Cadet
- Molecular Neuropsychiatry Research Branch, NIDA Intramural Research Program, Baltimore, MD, 21224, USA.
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18
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Daiwile AP, Jayanthi S, Cadet JL. Sex differences in methamphetamine use disorder perused from pre-clinical and clinical studies: Potential therapeutic impacts. Neurosci Biobehav Rev 2022; 137:104674. [PMID: 35452744 PMCID: PMC9119944 DOI: 10.1016/j.neubiorev.2022.104674] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/14/2022] [Accepted: 04/17/2022] [Indexed: 01/31/2023]
Abstract
Methamphetamine (METH) use, and misuse are associated with severe socioeconomic consequences. METH users develop tolerance, lose control over drug taking behaviors, and suffer frequent relapses even during treatment. The clinical course of METH use disorder is influenced by multifactorial METH-induced effects on the central and peripheral nervous systems. Although these METH-induced consequences are observed in humans of all ages, races, and sexes, sexual dimorphism in these outcomes have been observed in both pre-clinical and clinical settings. In this review, we have provided a detailed presentation of the sex differences reported in human and animal studies. We have therefore presented data that identified the influences of sex on METH pharmacokinetics, METH-induced changes in behaviors, cognitive processes, structural changes in the brain, and the effects of the drug on neurotransmitter systems and molecular mechanisms. Finally, we highlighted the potential significance of sex as a critical variable that should be considered when planning the development of new pharmacotherapeutic approaches against MEH use disorder in humans.
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Affiliation(s)
- Atul P Daiwile
- Molecular Neuropsychiatry Research Branch, NIDA Intramural Research Program, Baltimore, MD 21224, USA.
| | - Subramaniam Jayanthi
- Molecular Neuropsychiatry Research Branch, NIDA Intramural Research Program, Baltimore, MD 21224, USA.
| | - Jean Lud Cadet
- Molecular Neuropsychiatry Research Branch, NIDA Intramural Research Program, Baltimore, MD 21224, USA.
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Ru Q, Xiong Q, Tian X, Xu C, Li C, Chen L, Wu Y. Candidate Chinese Herbal Medicine Alleviates Methamphetamine Addiction via Regulating Dopaminergic and Serotonergic Pathways. Front Mol Neurosci 2022; 15:874080. [PMID: 35422687 PMCID: PMC9002015 DOI: 10.3389/fnmol.2022.874080] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/03/2022] [Indexed: 01/18/2023] Open
Abstract
Methamphetamine (METH) addiction and its induced mental disorders have become a severe worldwide problem. A candidate Chinese herbal medicine (CCHM) in our lab had therapeutic effects on METH-induced locomotor sensitization, however, its chemical and pharmacological profiles remain to be elucidated. The current study aimed to investigate the effect of CCHM on conditioned place preference (CPP) induced by METH and screen the main active ingredients and key targets by using network pharmacology and molecular docking methods. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment, Gene ontology (GO) analysis and protein-protein interaction (PPI) network were performed to discover the potential mechanisms. Results showed that CCHM could significantly inhibit METH-induced CPP behaviors in mice. A total of 123 components and 43 targets were screened. According to the network pharmacology analysis, ten hub targets including D(2) dopamine receptor (DRD2) and 5-hydroxytryptamine receptor 3A (HTR3A) were screened. GO analysis and KEGG enrichment indicated that mechanisms of CCHM treatment of METH addiction were related to multiple pathways such as dopaminergic synapse and serotoninergic synapse. Western blot results showed that the protein expressions of DRD2 in nucleus accumbens and prefrontal cortex were significantly decreased in METH group, while the protein expressions of HTR3A were significantly increased. These changes caused by METH could be prevented by CCHM pretreatment. The results of molecular docking displayed that the five active ingredients such as (S)-Scoulerine, Hyndarin, and Beta-Sitosterol had good affinities with DRD2 and HTR3A. In conclusion, this study constructed the CCHM's pharmacologic network for treating METH addiction based on the method of network analysis and experimental verification, and analyzed its major active ingredients and potential targets, indicating a new direction for further revealing its mechanisms of effect on METH addiction.
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Affiliation(s)
- Qin Ru
- Wuhan Institutes of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan, China,Department of Health and Physical Education, Jianghan University, Wuhan, China
| | - Qi Xiong
- Wuhan Institutes of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan, China
| | - Xiang Tian
- Wuhan Institutes of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan, China
| | - Congyue Xu
- Wuhan Institutes of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan, China
| | - Can Li
- Wuhan Institutes of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan, China
| | - Lin Chen
- Department of Health and Physical Education, Jianghan University, Wuhan, China,*Correspondence: Lin Chen,
| | - Yuxiang Wu
- Department of Health and Physical Education, Jianghan University, Wuhan, China,Yuxiang Wu,
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20
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Healthcare utilization and psychiatric and physical comorbidities before suicide mortality in patients with methamphetamine use disorder: A nationwide case-control study. Addict Behav 2022; 126:107192. [PMID: 34839069 DOI: 10.1016/j.addbeh.2021.107192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/11/2021] [Accepted: 11/19/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Since the late 1990s, methamphetamine use has become a considerable public health concern. Despite high suicide rates among methamphetamine users, studies exploring medical utilization and psychiatric and physical comorbidities before suicide are scant. We aim to examine the pattern of medical utilization and distribution of comorbidities shortly before suicide in methamphetamine users who died of suicide and compared these data with those of living methamphetamine users. METHODS From Taiwan's National Health Insurance Research Database, we identified the cohort with methamphetamine use disorder (n = 23,248) between January 1, 2001, and December 31, 2005. We identified 5972 deceased patients (of whom 745 died of suicide) by linking each patient with the national mortality database during the study period. By conducting a nested case-control study with risk-set sampling, from the methamphetamine cohort, we selected four age- and sex-matched controls for each patient who died of suicide (cases). We applied conditional logistic regression to investigate differences in medical utilization and physical and psychiatric comorbidities between cases and controls. RESULTS Cases had higher medical utilization within 3 months before suicide, particularly in the departments of psychiatry, internal medicine, emergency, and family practice. Cases had higher risks of physical comorbidities, including pneumonia and renal disease, and psychiatric comorbidities, including depressive disorder, sleep disorder, drug-induced mental disorder, schizophrenia, and bipolar disorder. CONCLUSIONS The findings of increased medical utilization and the higher risks of physical and psychiatric comorbidities in cases are crucial for developing specific interventions to prevent suicide in this patient population.
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Franke AG, Neumann S, Proebstl L, Kamp F, Hager L, Manz K, Krause D, Mutschler J, Koller G, Soyka M. Psychiatric Comorbidity and Psychopathology of Methamphetamine Users—Are There Gender Differences? Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-021-00743-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AbstractMethamphetamine use disorder is associated with severe psychiatric symptoms and psychosocial problems. Women seem to be more affected than men. Therefore, this study examined psychiatric comorbidities and psychopathology, drug use patterns, and treatment outcomes in women addicted to methamphetamine compared to men. Data on methamphetamine-dependent inpatients were collected in two centers specialized for addiction treatment at admission (T0) and discharge (T1, after treatment for 24 weeks). Sociodemographic and clinical measures were collected with the semi-structured clinical interview I at baseline; the self-reported standardized questionnaire (SCL-90-R) was administered at admission and discharge and after 24 weeks. During the entire treatment procedure, treatment relevant aspects were monitored. Out of all 108 treatment-seeking participants (86 men, 22 women), 64 completed the study (51 men, 13 women; drop-out rate: 40.7% (n = 44)). Methamphetamine-dependent women used other stimulants more often than men, while men used hallucinogens significantly more frequently than women. Female inpatients differed significantly from men in various sociodemographic variables (e.g., having children, single parenting) and were significantly more often affected by current (p < 0.001) and lifetime mental stress disorders (p < 0.001), as well as specific psychiatric disorders (p < 0.001) (e.g., posttraumatic stress disorder). At discharge, mental symptoms decreased significantly in men but not in women. Both before and after treatment, women seem to be more vulnerable to psychiatric comorbidities and psychopathologic symptoms compared to men. Although this study only provides preliminary data on gender-specific characteristics of methamphetamine-dependent patients and their treatment, it seems appropriate to discuss the development of gender-specific treatment options. Further studies in this field are needed.
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Kotajima‐Murakami H, Takano A, Hirakawa S, Ogai Y, Funada D, Tanibuchi Y, Ban E, Kikuchi M, Tachimori H, Maruo K, Kawashima T, Tomo Y, Sasaki T, Oi H, Matsumoto T, Ikeda K. Ifenprodil for the treatment of methamphetamine use disorder: An exploratory, randomized, double‐blind, placebo‐controlled trial. Neuropsychopharmacol Rep 2022; 42:92-104. [PMID: 35068087 PMCID: PMC8919120 DOI: 10.1002/npr2.12232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 12/03/2021] [Accepted: 12/28/2021] [Indexed: 01/10/2023] Open
Abstract
Aim No effective pharmacological interventions have been developed for patients with methamphetamine use disorder. Ifenprodil is a blocker of G protein‐activated inwardly rectifying potassium channels, which play a key role in the mechanism of action of addictive substances. We conducted a randomized, double‑blind, exploratory, dose‐ranging, placebo‐controlled trial to examine the clinical efficacy of ifenprodil for the treatment of methamphetamine use disorder. Methods Participants were assigned to three groups: placebo, 60 mg/d ifenprodil, or 120 mg/d ifenprodil. The drug administration period was 84 days. The primary outcome was the use or nonuse of methamphetamine during the drug administration period in the placebo group vs 120 mg/d ifenprodil group. We also assessed drug use status, relapse risk based on the Stimulant Relapse Risk Scale (SRRS), drug craving, and methamphetamine in urine as secondary outcomes. We further evaluated drug use status and SRRS subscale scores in patients who were not taking addiction medications during the study. Results Ifenprodil did not affect the primary or secondary outcomes. However, the additional analyses showed that the number of days of methamphetamine use during the follow‐up period and scores on the emotionality problems subscale of the SRRS improved in the 120 mg/d ifenprodil group. The safety of ifenprodil was confirmed in patients with methamphetamine use disorder. Conclusion The present findings did not confirm the efficacy of ifenprodil for methamphetamine use disorder treatment based on the primary or secondary outcomes, but we found evidence of its safety and efficacy in reducing emotionality problems. Clinical trial registration The study was registered at the University Hospital Medical Information Network Clinical Trial Registry (no. UMIN000030849) and Japan Registry of Clinical Trials (no. jRCTs031180080). The main registration site is jRCT (https://jrct.niph.go.jp/). We conducted an exploratory, randomized, double‐blind, placebo‐controlled trial to investigate the clinical safety and efficacy of ifenprodil for the treatment of methamphetamine use disorder in Japanese patients. Our findings confirmed the safety of ifenprodil, and ifenprodil at the highest dose exerted slight efficacy.![]()
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Affiliation(s)
- Hiroko Kotajima‐Murakami
- Addictive Substance Project Tokyo Metropolitan Institute of Medical Science Tokyo Japan
- Department of Drug Dependence Research National Institute of Mental Health National Centre of Neurology and Psychiatry Tokyo Japan
| | - Ayumi Takano
- Department of Drug Dependence Research National Institute of Mental Health National Centre of Neurology and Psychiatry Tokyo Japan
- Department of Mental Health and Psychiatric Nursing Tokyo Medical and Dental University Tokyo Japan
| | - Shinya Hirakawa
- Department of Clinical Data Science Clinical Research & Education Promotion Division National Centre of Neurology and Psychiatry Tokyo Japan
| | - Yasukazu Ogai
- Social Psychiatry and Mental Health Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - Daisuke Funada
- Department of Psychiatry National Centre Hospital National Centre of Neurology and Psychiatry Tokyo Japan
| | - Yuko Tanibuchi
- Department of Drug Dependence Research National Institute of Mental Health National Centre of Neurology and Psychiatry Tokyo Japan
- Department of Psychiatry Chiba Hospital Chiba Japan
| | - Eriko Ban
- Department of Drug Dependence Research National Institute of Mental Health National Centre of Neurology and Psychiatry Tokyo Japan
| | - Minako Kikuchi
- Department of Drug Dependence Research National Institute of Mental Health National Centre of Neurology and Psychiatry Tokyo Japan
| | - Hisateru Tachimori
- Department of Clinical Data Science Clinical Research & Education Promotion Division National Centre of Neurology and Psychiatry Tokyo Japan
| | - Kazushi Maruo
- Department of Biostatistics Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - Takahiro Kawashima
- Department of Clinical Data Science Clinical Research & Education Promotion Division National Centre of Neurology and Psychiatry Tokyo Japan
| | - Yui Tomo
- Department of Clinical Data Science Clinical Research & Education Promotion Division National Centre of Neurology and Psychiatry Tokyo Japan
| | - Tsuyoshi Sasaki
- Department of Child Psychiatry Chiba‐University Hospital Chiba Japan
| | - Hideki Oi
- Department of Clinical Research Promotion Translational Medical Centre National Centre of Neurology and Psychiatry Tokyo Japan
| | - Toshihiko Matsumoto
- Department of Drug Dependence Research National Institute of Mental Health National Centre of Neurology and Psychiatry Tokyo Japan
| | - Kazutaka Ikeda
- Addictive Substance Project Tokyo Metropolitan Institute of Medical Science Tokyo Japan
- Department of Drug Dependence Research National Institute of Mental Health National Centre of Neurology and Psychiatry Tokyo Japan
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Patel RS, Cheema Z, Singla A, Cornejo M, Verma G. Cannabis Use is an Independent Risk Factor for Manic Episode: A Report from 380,265 Bipolar Inpatients. Subst Use Misuse 2022; 57:344-349. [PMID: 34895014 DOI: 10.1080/10826084.2021.2012690] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To evaluate the odds for bipolar disorder (BP) mania and depression-related hospitalization due to cannabis use disorders (CUD). METHODS We conducted a cross-sectional study using the national inpatient sample (NIS), and included adult BP hospitalizations sub-grouped by manic (N = 209,785) versus depressive episodes (N = 170480). A logistic regression model was used to evaluate adjusted odds ratio (aOR) of association between CUD and BP-mania-related hospitalizations and was adjusted for demographics confounders, psychiatric comorbidities and other substance use disorders (SUD). RESULTS Comorbidities were less prevalent in BP mania compared to BP depression: anxiety disorders (22.7% vs. 35.3%), PTSD (8.7% vs. 14.3%), and personality disorders (15.4% vs. 20.5%). Among SUD, methamphetamine (aOR 1.27, 95%CI 1.22 - 1.32) and CUD (aOR 1.53, 95%CI 1.50 - 1.56) had increased odds for hospitalization for BP mania. CONCLUSION CUD increases the odds for hospitalization for BP manic episode by 53%. Due to the rising prevalence of cannabis use among patients with BP it is important to provide substance use counseling/psychoeducation and discourage cannabis use among youth to prevent long-term adverse consequences.
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Affiliation(s)
- Rikinkumar S Patel
- Department of Psychiatry, Griffin Memorial Hospital, Norman, Oklahoma, USA
| | - Zainab Cheema
- Department of Psychiatry, Griffin Memorial Hospital, Norman, Oklahoma, USA
| | - Ashima Singla
- Department of Psychiatry, Griffin Memorial Hospital, Norman, Oklahoma, USA
| | - Miglia Cornejo
- School of Osteopathic Medicine, Arizona, A.T. Still University, Mesa, Arizona, USA
| | - Geetika Verma
- Department of Psychiatry, Griffin Memorial Hospital, Norman, Oklahoma, USA
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24
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Lee WC, Chang HM, Huang MC, Pan CH, Su SS, Tsai SY, Chen CC, Kuo CJ. All-cause and suicide mortality among people with methamphetamine use disorder: a nation-wide cohort study in Taiwan. Addiction 2021; 116:3127-3138. [PMID: 33788344 DOI: 10.1111/add.15501] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/12/2021] [Accepted: 03/17/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND AIMS Although methamphetamine use is a serious public health problem, large-scale cohort studies assessing methamphetamine-related mortality are scant. This study investigated all-cause mortality and suicide methods in people with methamphetamine use disorder. DESIGN A cohort record-linkage study using data from Taiwan's National Health Research Institute Database (NHIRD) linked to Taiwan's National Death Certification System. SETTING Taiwan. PARTICIPANTS A total of 23 248 individuals with methamphetamine use disorder between 1 January 2001 and 31 December 2005. MEASUREMENTS The outcome variables included mortality rates and standardized mortality ratios (SMRs) for all causes of death and for each suicide method. FINDINGS Compared with the general population, the current cohort had an increased all-cause mortality (SMR = 5.4), with the SMR for unnatural causes (14.8) higher than that for natural causes (7.5). Among all causes of death, suicide had the highest SMR (16.3), followed by neurological diseases (9.7). Among the methods of choice for suicide, drug overdose had the highest SMR (24.9). The incidence of charcoal burning and hanging was significantly higher in men and that of jumping from a high place was significantly higher in women. CONCLUSION People in Taiwan with methamphetamine use disorder appear to have a significantly increased all-cause mortality rate compared with the general population, with suicide having the highest contribution, particularly suicide via drug overdose. The methods of choice for suicide revealed distinct patterns between men and women.
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Affiliation(s)
- Wan-Chen Lee
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Hu-Ming Chang
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Ming-Chyi Huang
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chun-Hung Pan
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.,Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Sheng-Siang Su
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Shang-Ying Tsai
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chiao-Chicy Chen
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan.,Department of Psychiatry, Mackay Medical College, Taipei, Taiwan
| | - Chian-Jue Kuo
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
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25
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Chen L, Ru Q, Xiong Q, Zhou M, Yue K, Wu Y. The Role of Chinese Herbal Therapy in Methamphetamine Abuse and its Induced Psychiatric Symptoms. Front Pharmacol 2021; 12:679905. [PMID: 34040537 PMCID: PMC8143530 DOI: 10.3389/fphar.2021.679905] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 04/16/2021] [Indexed: 01/21/2023] Open
Abstract
Repeated intake of methamphetamine (METH) leads to drug addiction, the inability to control intake, and strong drug cravings. It is also likely to cause psychiatric impairments, such as cognitive impairment, depression, and anxiety. Because the specific neurobiological mechanisms involved are complex and have not been fully and systematically elucidated, there is no established pharmacotherapy for METH abuse. Studies have found that a variety of Chinese herbal medicines have significant therapeutic effects on neuropsychiatric symptoms and have the advantage of multitarget comprehensive treatment. We conducted a systematic review, from neurobiological mechanisms to candidate Chinese herbal medicines, hoping to provide new perspectives and ideas for the prevention and treatment of METH abuse.
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Affiliation(s)
- Lin Chen
- Department of Health and Physical Education, Jianghan University, Wuhan, China
| | - Qin Ru
- Wuhan Institutes of Biomedical Sciences, Jianghan University, Wuhan, China
| | - Qi Xiong
- Wuhan Institutes of Biomedical Sciences, Jianghan University, Wuhan, China
| | - Mei Zhou
- Wuhan Institutes of Biomedical Sciences, Jianghan University, Wuhan, China
| | - Kai Yue
- Wuhan Institutes of Biomedical Sciences, Jianghan University, Wuhan, China
| | - Yuxiang Wu
- Department of Health and Physical Education, Jianghan University, Wuhan, China
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26
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Hussain MA, Iudicello JE, Morgan EE, Kamat R, Heaton RK, Grant I. Apathy is associated with poorer abstinence self-efficacy in individuals with methamphetamine dependence. Addict Behav Rep 2021; 13:100331. [PMID: 33521229 PMCID: PMC7820030 DOI: 10.1016/j.abrep.2020.100331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/14/2020] [Accepted: 12/20/2020] [Indexed: 12/13/2022] Open
Abstract
Used an apathy composite T-score approach validated in methamphetamine-dependence. Apathy, above other factors, associated with poorer drug abstinence self-efficacy. Methamphetamine use characteristics unrelated to drug abstinence self-efficacy. Social peer pressure was riskiest situation for potential methamphetamine relapse.
Background Confidence in one’s ability to achieve and maintain drug abstinence (i.e., abstinence self-efficacy) is a strong predictor of substance use treatment outcomes. Neurobehavioral factors that may interfere with abstinence self-efficacy are less well established, particularly in methamphetamine (METH). This study investigated whether apathy, which is highly prevalent during active METH use and periods of abstinence, influences abstinence self-efficacy among METH dependent individuals. Methods Sixty-six participants with lifetime METH dependence and METH abuse/METH dependence diagnoses within the last 18 months (mean age [SD] = 39.5 years [10.7]), and no severe psychiatric or neurological diseases, completed the Methamphetamine Self-Efficacy Scale (MSES), alongside a comprehensive neurobehavioral evaluation. The MSES presents six situations that may lead to relapse and collects self-report ratings for two subscales: “Confidence” (i.e., confidence in one’s ability to abstain from using METH, or METH abstinence self-efficacy) and “Temptation” (i.e., how tempted one is to use METH) with regard to each situation. Apathy was measured using a composite T-score comprised of items and scales from three well-validated, self-report assessments. Results Multivariable linear regression found that higher Apathy T-scores were significantly associated with lower Confidence ratings (i.e., poorer METH abstinence self-efficacy; p < .05), independent of potentially relevant factors (e.g., Temptation to use METH, comorbid HIV disease, and neurocognitive impairment). Conclusions Elevated apathy may adversely impact one’s confidence to abstain from METH use. Findings highlight the importance of addressing apathy in order to improve METH abstinence self-efficacy, which may subsequently increase the likelihood of successful METH treatment outcomes.
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Affiliation(s)
- Mariam A Hussain
- University of California San Diego, School of Medicine, Department of Psychiatry, 220 Dickinson Street # B, San Diego, CA 92103, USA.,San Diego State University/University of California San Diego Joint Doctoral Program, Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA 92120, USA
| | - Jennifer E Iudicello
- University of California San Diego, School of Medicine, Department of Psychiatry, 220 Dickinson Street # B, San Diego, CA 92103, USA
| | - Erin E Morgan
- University of California San Diego, School of Medicine, Department of Psychiatry, 220 Dickinson Street # B, San Diego, CA 92103, USA
| | - Rujvi Kamat
- University of California San Diego, School of Medicine, Department of Psychiatry, 220 Dickinson Street # B, San Diego, CA 92103, USA
| | - Robert K Heaton
- University of California San Diego, School of Medicine, Department of Psychiatry, 220 Dickinson Street # B, San Diego, CA 92103, USA
| | - Igor Grant
- University of California San Diego, School of Medicine, Department of Psychiatry, 220 Dickinson Street # B, San Diego, CA 92103, USA
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27
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Petzold J, Spreer M, Krüger M, Sauer C, Kirchner T, Hahn S, Zimmermann US, Pilhatsch M. Integrated Care for Pregnant Women and Parents With Methamphetamine-Related Mental Disorders. Front Psychiatry 2021; 12:762041. [PMID: 34759851 PMCID: PMC8573098 DOI: 10.3389/fpsyt.2021.762041] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/27/2021] [Indexed: 12/20/2022] Open
Abstract
Background: Methamphetamine use is a rapidly increasing cause of morbidity and mortality. Pregnant women and new parents who consume methamphetamine are at high risk since they seldom seek health services despite having multiple needs. We addressed this care gap by implementing an easily accessible program that pools resources from psychiatric, obstetric, and pediatric departments as well as community and government agencies. Method: This real-life observational study evaluated an integrated care program in 27 expecting parents and 57 parents of minors. The outcome criteria were treatment retention, psychosocial functioning, and abstinence. We compared participant demographics according to outcome and applied ordinal logistic regression to predict treatment success. Results: Patients received integrated care for almost 7 months on average. Nearly half achieved stable abstinence and functional recovery. Only one pregnant woman dropped out before a care plan could be implemented, and all women who gave birth during treatment completed it successfully. Three-fourths of patients had psychiatric comorbidities. Patients with depressive disorders were almost 5 times less likely to succeed with treatment. Attention-deficit hyperactivity disorder (ADHD) was diagnosed in nearly 30% of patients who dropped out of a care plan, which was about 4 times more often than in the successful outcome group. Conclusion: Our program engaged pregnant women and parents in treatment and helped them recover from methamphetamine-related mental disorders. Management of comorbid ADHD and depression should be an integral part of care initiatives to counter the methamphetamine crisis that affects parents and children across the globe.
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Affiliation(s)
- Johannes Petzold
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Maik Spreer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Maria Krüger
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Cathrin Sauer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Tobias Kirchner
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Susanna Hahn
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Ulrich S Zimmermann
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany.,Department of Addiction Medicine and Psychotherapy, kbo-Isar-Amper-Klinikum München-Ost, Haar, Germany
| | - Maximilian Pilhatsch
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry and Psychotherapy, Elblandklinikum Radebeul, Radebeul, Germany
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28
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Deng Y, Li X, Liu L, Chui WH. Suicide Attempts and Perceived Social Support among Chinese Drug Users: The Mediating Role of Self-Esteem and Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010208. [PMID: 33396608 PMCID: PMC7796389 DOI: 10.3390/ijerph18010208] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 12/13/2020] [Accepted: 12/25/2020] [Indexed: 11/22/2022]
Abstract
Suicidal behavior is a severe problem among drug users. This study examines influential factors related to suicide attempts and analyzes possible mediators of the relationship between perceived social support and suicide attempts amongst Chinese drug users under compulsory institutional drug treatment. Taking perceived social support as the independent variable, we found that the relationship between suicide attempts and perceived social support is mediated by self-esteem as a protective factor and depression as a risk factor. Path analysis shows that self-esteem contributes relatively more to the indirect effects than depression does, accounting for 31.1% and 24.2% of the total effect, respectively. Generally speaking, the findings of this study point to an urgent need for addressing suicide attempts among Chinese drug users while treating self-esteem as the protective factor that deserves as substantial attention as depression receives.
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Affiliation(s)
- Yali Deng
- School of Social Work, University of Maryland Baltimore, Baltimore, MD 21201, USA;
| | - Xuemeng Li
- The Graduate Center, City University of New York, New York, NY 10016, USA;
| | - Liu Liu
- School of Social and Behavioral Sciences, Nanjing University, Nanjing 210023, China
- Correspondence: ; Tel.: +86-25-896-809-58 (ext. 409)
| | - Wing Hong Chui
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China;
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Thoradeniya MR, Wessel EL, Pourmarzi D, Najman JM, Smirnov A. The prevalence of mental health disorders among young adults who use amphetamine-type stimulants, compared to young adults who do not. Drug Alcohol Rev 2020; 40:557-566. [PMID: 33073466 DOI: 10.1111/dar.13196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/19/2020] [Accepted: 09/21/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND AIMS There is a lack of evidence regarding mental health disorder prevalence in people who use amphetamine-type stimulants (ATS). This study compares prevalence in Australian young adults who used ATS and young adults who had never used, and examines potential predictors. DESIGN AND METHODS Population-based sampling was used to recruit young adults who used ATS (n = 224) and young adults who had never used ATS (n = 125). Thirty-day prevalence of major depressive disorder (MDD), generalised anxiety disorder (GAD), panic disorder (PD), post-traumatic stress disorder (PTSD) and mania/hypomania were assessed using the Composite International Diagnostic Interview Short Scale. Adjusted prevalence ratios (APR) of mental disorders in people who used ATS and the comparison group were examined, and a prediction model was developed for people who used ATS. RESULTS We found higher prevalence of PD (APR 4.67, 95% confidence interval [CI] 1.14-19.07, P = 0.032) and PTSD (APR 1.68, 95% CI 1.10-2.55, P = 0.016) in people who used ATS, compared to the comparison group, adjusting for sociodemographic variables. Baseline methamphetamine use was positively associated with MDD (ARR 6.45, 95% CI 1.51-27.59, P = 0.012) and GAD (ARR 2.76, 95% CI 1.52-5.02, P = 0.001). Baseline ecstasy use was negatively associated with GAD (ARR 0.52, 95% CI 0.30-0.92, P = 0.025) and PD (ARR 0.15, 95% CI 0.05-0.48, P = 0.001). DISCUSSION AND CONCLUSION PTSD and PD appear to be more common in young adults who use ATS. However, the relationship between ATS use and mental disorders is complex, with divergent patterns of association for ecstasy and methamphetamine use. Mental health screening in people using ATS may improve treatment outcomes.
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Affiliation(s)
| | - Ellen L Wessel
- Queensland Alcohol and Drug Research and Education Centre, School of Public Health, The University of Queensland, Brisbane, Australia
| | - Davoud Pourmarzi
- School of Social Science, The University of Queensland, Brisbane, Australia
| | - Jake M Najman
- Queensland Alcohol and Drug Research and Education Centre, School of Public Health, The University of Queensland, Brisbane, Australia.,School of Social Science, The University of Queensland, Brisbane, Australia
| | - Andrew Smirnov
- Queensland Alcohol and Drug Research and Education Centre, School of Public Health, The University of Queensland, Brisbane, Australia
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30
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Saloner R, Cherner M, Iudicello JE, Heaton RK, Letendre SL, Ellis RJ. Cerebrospinal Fluid Norepinephrine and Neurocognition in HIV and Methamphetamine Dependence. J Acquir Immune Defic Syndr 2020; 85:e12-e22. [PMID: 32558666 PMCID: PMC7492443 DOI: 10.1097/qai.0000000000002422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE HIV disease and methamphetamine (METH) dependence share overlapping mechanisms of neurotoxicity that preferentially compromise monoamine-rich frontostriatal circuitry. However, norepinephrine (NE) function is poorly understood in HIV and METH dependence. We evaluated associations between cerebrospinal fluid (CSF) NE and HIV, METH dependence, and neurocognition. METHODS Participants included 125 adults, stratified by HIV serostatus (HIV+/HIV-) and recent METH dependence (METH+/METH-), who underwent comprehensive neurocognitive testing and lumbar puncture. CSF NE was assayed using high-performance liquid chromatography. Multivariable regression modelled NE as a function of HIV, METH, and their interaction, adjusting for demographic and clinical factors. Pearson correlations examined relationships between NE and demographically-adjusted neurocognitive domain scores. RESULTS HIV significantly interacted with METH (P < 0.001) such that compared with HIV-/METH-, CSF NE was markedly elevated in the single risk-groups (HIV+/METH-: d = 0.96; HIV-/METH+: d = 0.79) and modestly elevated in the dual-risk group (HIV+/METH+: d = 0.48). This interaction remained significant after adjustment for lifetime depression, antidepressant use, and race/ethnicity. In the full sample, higher NE levels significantly correlated with worse global function (r = -0.19), learning (r = -0.23), and delayed recall (r = -0.18). Similar relationships between higher NE and worse neurocognition were detected in the METH- groups (ie, HIV-/METH- and HIV+/METH-) and in the virally-suppressed persons HIV+ subgroup, but not in the METH+ groups (ie, HIV-/METH+, HIV+/METH+). DISCUSSION HIV and METH independently, but not additively, relate to noradrenergic excess in the central nervous system, and perturbations to noradrenergic function may represent a pathophysiological mechanism of HIV-related neurocognitive dysfunction. Consistent with prior reports that noradrenergic excess compromises hippocampal and prefrontal function, higher NE related to worse neurocognition, even among successfully treated persons with HIV. Pharmacological and psychosocial interventions that stabilize NE function may improve neurocognition in persons with HIV.
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Affiliation(s)
- Rowan Saloner
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
- Department of Psychiatry, University of California, San Diego, HIV Neurobehavioral Research Program, San Diego, California
| | - Mariana Cherner
- Department of Psychiatry, University of California, San Diego, HIV Neurobehavioral Research Program, San Diego, California
| | - Jennifer E. Iudicello
- Department of Psychiatry, University of California, San Diego, HIV Neurobehavioral Research Program, San Diego, California
| | - Robert K. Heaton
- Department of Psychiatry, University of California, San Diego, HIV Neurobehavioral Research Program, San Diego, California
| | - Scott L. Letendre
- Department of Psychiatry, University of California, San Diego, HIV Neurobehavioral Research Program, San Diego, California
| | - Ronald J. Ellis
- Department of Psychiatry, University of California, San Diego, HIV Neurobehavioral Research Program, San Diego, California
- Department of Neurosciences, University of California, San Diego
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Aryan N, Banafshe HR, Farnia V, Shakeri J, Alikhani M, Rahimi H, Sehat M, Mamsharifi P, Ghaderi A, Omidi A. The therapeutic effects of methylphenidate and matrix-methylphenidate on addiction severity, craving, relapse and mental health in the methamphetamine use disorder. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2020; 15:72. [PMID: 32977820 PMCID: PMC7519552 DOI: 10.1186/s13011-020-00317-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 09/18/2020] [Indexed: 11/17/2022]
Abstract
Background Little evidence has examined the therapeutic effects of methylphenidate (MPH) and Matrix Model treatment on addiction severity, craving, relapse and mental health in people who use methamphetamine (PWUM). This study was conducted to determine the effects of MPH, Matrix Model treatment, and Matrix-MPH on addiction severity, craving, relapse and mental health in PWUM. Methods This clinical trial was conducted among 100 patients with METH users. Participants were randomly divided into four groups who received: 1) 22 sessions of 45-min, twice a week for Matrix Model treatment (n = 25); 2) MPH 10 mg/day in the first month, 7.5 mg/day in the second month and 5 mg/day in the third month (n = 25); 3) Matrix Model treatment combined with MPH (n = 25); 4) control group (n = 25) for 12 weeks. Addiction severity, craving, relapse and mental status were evaluated at baseline and end-of-trial. Results Matrix Model treatment combined with MPH significantly reduced MA craving (P < 0.001) and addiction severity (P < 0.001). In addition, Matrix Model treatment combined with MPH resulted in a significant increase of mental health (P = 0.001), compared with Matrix Model treatment, MPH, and control group. Also, negative METH urine test significantly increased in the Matrix Model treatment combined with MPH group compared with the other groups (P < 0.001). Conclusions In conclusion, Matrix Model treatment combined with MPH for 12 weeks had beneficial effects on addiction severity, craving, relapse, and mental health in PWUM, compared with Matrix Model treatment, MPH, and control group. Trial registration This study was retrospectively registered in the Iranian website (www.irct.ir) for clinical trials registration (http://www.irct.ir: IRCT20171105037245N1). Registration date: 9 December 2017.
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Affiliation(s)
- Nazanin Aryan
- Department of Addiction studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamid Reza Banafshe
- Department of Addiction studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran.,Department of Pharmacology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Vahid Farnia
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jalal Shakeri
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Alikhani
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Habibollah Rahimi
- Department of Biostatistics and Epidemiology, School of Public Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Mojtaba Sehat
- Department of Community Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Peyman Mamsharifi
- Department of Psychology, Allameh Tabataba'i University, Tehran, Iran
| | - Amir Ghaderi
- Department of Addiction studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran.,Clinical Research development unit-Matini/Kargarnejad Hospital, Kashan University of Medical Sciences, Kashan, Iran
| | - Abdollah Omidi
- Department of clinical psychology, School of Medicine, Kashan University of Medical Science, Kashan, Iran.
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He Y, Zhai J, Liu Y. Association of methamphetamine use with depressive symptoms and gender differences in this association: a meta-analysis. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1736659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Yiqin He
- School of Education, Education Science Research Center, Tianjin University, Tianjin, China
| | - Jin Zhai
- Department of Social Work, Changzhou University, Changzhou, China
| | - Yangyang Liu
- School of Education, Education Science Research Center, Tianjin University, Tianjin, China
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May AC, Aupperle RL, Stewart JL. Dark Times: The Role of Negative Reinforcement in Methamphetamine Addiction. Front Psychiatry 2020; 11:114. [PMID: 32256392 PMCID: PMC7090143 DOI: 10.3389/fpsyt.2020.00114] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 02/10/2020] [Indexed: 12/01/2022] Open
Abstract
Methamphetamine use is associated with substantial adverse outcomes including poor mental and physical health, financial difficulties, and societal costs. Despite deleterious long-term consequences associated with methamphetamine, many people use drugs for short-term reduction of unpleasant physical or emotional sensations. By removing these aversive states, drug use behaviors are negatively reinforced. Abstinence from methamphetamine can then result in a return to previous aversive emotional states linked to withdrawal and craving, often contributing to an increased likelihood for relapse. This negative reinforcement cycle is hypothesized to be a motivating and maintaining factor for addiction. Thus, this review highlights the current evidence for negative reinforcement mechanisms in methamphetamine use disorder by integrating studies of subjective experience, behavior, functional magnetic resonance imaging, positron emission tomography, and event-related potentials and examining the efficacy of treatments targeting aspects of negative reinforcement. Overall, the literature demonstrates that individuals who use methamphetamine have diminished cognitive control and process emotions, loss of reward, and interoceptive information differently than non-using individuals. These differences are reflected in behavioral and subjective experiments as well as brain-based experiments which report significant differences in various frontal regions, insula, anterior cingulate cortex, and striatum. Together, the results suggest methamphetamine users have an altered experience of negative outcomes, difficulties employing effective emotion regulation, and difficulty engaging in adaptive or goal-directed decision-making. Suggestions for future research to improve our understanding of how negative reinforcement contributes to methamphetamine addiction and to develop effective interventions are provided.
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Affiliation(s)
- April C. May
- Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California, San Diego, San Diego, CA, United States
| | - Robin L. Aupperle
- Laureate Institute for Brain Research, Tulsa, OK, United States
- Department of Community Medicine, University of Tulsa, Tulsa, OK, United States
| | - Jennifer L. Stewart
- Laureate Institute for Brain Research, Tulsa, OK, United States
- Department of Community Medicine, University of Tulsa, Tulsa, OK, United States
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Coffin PO, Santos GM, Hern J, Vittinghoff E, Walker JE, Matheson T, Santos D, Colfax G, Batki SL. Effects of Mirtazapine for Methamphetamine Use Disorder Among Cisgender Men and Transgender Women Who Have Sex With Men: A Placebo-Controlled Randomized Clinical Trial. JAMA Psychiatry 2020; 77:246-255. [PMID: 31825466 PMCID: PMC6990973 DOI: 10.1001/jamapsychiatry.2019.3655] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Methamphetamine use is increasingly prevalent and associated with HIV transmission. A previous phase 2a study of mirtazapine demonstrated reductions in methamphetamine use and sexual risk behaviors among men who have sex with men. OBJECTIVE To determine the efficacy of mirtazapine for treatment of methamphetamine use disorder and reduction in HIV risk behaviors. DESIGN, SETTING, AND PARTICIPANTS This double-blind randomized clinical trial of mirtazapine vs placebo took place from August 2013 to September 2017 in an outpatient research clinic in San Francisco, California. Participants were community-recruited adults who were sexually active; cisgender men, transgender men, and transgender women who (1) had sex with men, (2) had methamphetamine use disorder, and (3) were actively using methamphetamine were eligible. Participants were randomized to receive the study drug or placebo for 24 weeks, with 12 more weeks of follow-up. Data analysis took place from February to June 2018. EXPOSURES Mirtazapine, 30 mg, or matched placebo orally once daily for 24 weeks, with background counseling. MAIN OUTCOMES AND MEASURES Positive urine test results for methamphetamine over 12, 24, and 36 weeks (primary outcomes) and sexual risk behaviors (secondary outcomes). Sleep, methamphetamine craving, dependence severity, and adverse events were assessed. RESULTS Of 241 persons assessed, 120 were enrolled (5 transgender women and 115 cisgender men). The mean (SD) age was 43.3 (9.8) years; 61 (50.8%) were white, 31 (25.8%) were African American, and 15 (12.5%) were Latinx. A mean (SD) of 66% (47%) of visits were completed overall. By week 12, the rate of methamphetamine-positive urine test results significantly declined among participants randomized to mirtazapine vs placebo (risk ratio [RR], 0.67 [95% CI, 0.51-0.87]). Mirtazapine resulted in reductions in positive urine test results at 24 weeks (RR, 0.75 [95% CI, 0.56-1.00]) and 36 weeks (RR, 0.73 [95% CI, 0.57-0.96]) vs placebo. Mean (SD) medication adherence by WisePill dispenser was 38.5% (27.0%) in the mirtazapine group vs 39.5% (26.2%) in the placebo group (P = .77) over 2 to 12 weeks and 28.1% (23.4%) vs 38.5% (27.0%) (P = .59) over 13 to 24 weeks. Changes in sexual risk behaviors were not significantly different by study arm at 12 weeks, but those assigned to receive mirtazapine had fewer sexual partners (RR, 0.52 [95% CI, 0.27-0.97]; P = .04), fewer episodes of condomless anal sex with partners who were serodiscordant (RR, 0.47 [95% CI, 0.23-0.97]; P = .04), and fewer episodes of condomless receptive anal sex with partners who were serodiscordant (RR, 0.37 [95% CI, 0.14-0.93]; P = .04) at week 24. Participants assigned to mirtazapine had net reductions in depressive symptoms (Center for Epidemiologic Studies Depression Scale score, 6.2 [95% CI, 1.3-11.1] points lower; P = .01) and insomnia severity (Athens score, 1.4 [95% CI, 0.1-2.7] points lower; P = .04) at week 24. There were no serious adverse events associated with the study drug. CONCLUSIONS AND RELEVANCE In this expanded replication trial, adding mirtazapine to substance use counseling reduced methamphetamine use and some HIV risk behaviors among cisgender men and transgender women who have sex with men, with benefits extending after treatment despite suboptimal medication adherence. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01888835.
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Affiliation(s)
- Phillip O. Coffin
- San Francisco Department of Public Health, San Francisco, California,Department of Medicine, University of California, San Francisco, San Francisco
| | - Glenn-Milo Santos
- San Francisco Department of Public Health, San Francisco, California,School of Nursing, University of California, San Francisco, San Francisco
| | - Jaclyn Hern
- San Francisco Department of Public Health, San Francisco, California
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
| | - John E. Walker
- San Francisco Department of Public Health, San Francisco, California
| | - Tim Matheson
- San Francisco Department of Public Health, San Francisco, California
| | - Deirdre Santos
- San Francisco Department of Public Health, San Francisco, California
| | - Grant Colfax
- San Francisco Department of Public Health, San Francisco, California
| | - Steven L. Batki
- Department of Psychiatry, University of California, San Francisco, San Francisco
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Pirnia B, Khosravani V, Maleki F, Kalbasi R, Pirnia K, Malekanmehr P, Zahiroddin A. The role of childhood maltreatment in cortisol in the hypothalamic-pituitary-adrenal (HPA) axis in methamphetamine-dependent individuals with and without depression comorbidity and suicide attempts. J Affect Disord 2020; 263:274-281. [PMID: 31818789 DOI: 10.1016/j.jad.2019.11.168] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 09/21/2019] [Accepted: 11/30/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND The hypothalamic-pituitary-adrenal (HPA) axis dysregulation which was found to have an important role in the pathophysiology of depression, suicide, and substance dependence, may be influenced by childhood maltreatment (CM). The present study aimed to investigate the relationship between CM and cortisol changes in methamphetamine-dependent individuals. METHODS In a cross-sectional study, methamphetamine-dependent individuals (n = =195) with or without both comorbid major depressive disorder (MDD) and a history of suicide attempts were selected and completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Beck Scale for Suicide Ideation (BSSI), and the Beck Depression Inventory-II (BDI-II). To assess cortisol levels, saliva samples were collected at six time intervals for two consecutive days. RESULTS A history of CM significantly predicted wake-up cortisol level, cortisol awakening response (CAR), and diurnal cortisol slope. Methamphetamine-dependent individuals with both MDD and lifetime suicide attempts had higher CM and higher cortisol levels with a blunted diurnal cortisol slope than individuals who were merely methamphetamine-dependent. Individuals with high CM showed higher cortisol levels with a blunted diurnal slope than those with low or without CM. LIMITATIONS Cross-sectional data and use of self-report scales, especially retrospective measurements (e.g., the CTQ-SF), were important limitations of this study. CONCLUSION Findings suggest that methamphetamine-dependent individuals with adverse psychological factors such as CM, MDD, and suicide attempts may show dysregulation in biological factors including cortisol level. In addition, CM and its effects on cortisol in the HPA axis may emerge as important factors regarding psychopathological use of methamphetamine.
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Affiliation(s)
- Bijan Pirnia
- Department of Psychology, Faculty of Humanities, University of Science and Culture, Tehran, Iran; Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Vahid Khosravani
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Faezeh Maleki
- Division of Cognitive Neuroscience, Faculty of Educational Sciences and Psychology, University of Tabriz, Tabriz, Iran
| | - Rozita Kalbasi
- Department of Psychology, Islamic Azad University, Kish International Branch, Kish Island, Iran
| | - Kambiz Pirnia
- Internal disease specialist, Technical Assistant in Bijan Center for Substance Abuse Treatment, Tehran, Iran
| | - Parastoo Malekanmehr
- Department of Psychology, Faculty of Psychology, Islamic Azad University, Tonekabon Branch, Mazandaran, Iran
| | - Alireza Zahiroddin
- Department of Psychiatry, Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Depressive symptoms and cannabis use in a placebo-controlled trial of N-Acetylcysteine for adult cannabis use disorder. Psychopharmacology (Berl) 2020; 237:479-490. [PMID: 31712969 PMCID: PMC7024037 DOI: 10.1007/s00213-019-05384-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 10/21/2019] [Indexed: 02/06/2023]
Abstract
RATIONALE Depression is common among individuals with cannabis use disorder (CUD), particularly individuals who present to CUD treatment. Treatments that consider this comorbidity are essential. OBJECTIVES The goal of this secondary analysis was to examine whether N-acetylcysteine (NAC) reduced depressive symptoms among adults (age 18-50) with CUD (N = 302) and whether the effect of NAC on cannabis cessation varied as a result of baseline levels of depression. Bidirectional associations between cannabis use amount and depression were also examined. METHODS Data for this secondary analysis were from a National Drug Abuse Treatment Clinical Trials Network (NIDA CTN) multi-site clinical trial for CUD. Adults with CUD (N = 302) were randomized to receive 2400 mg of NAC daily or matched placebo for 12 weeks. All participants received abstinence-based contingency management. Cannabis quantity was measured by self-report, and weekly urinary cannabinoid levels (11-nor-9-carboxy-Δ9-tetrahydrocannabinol) confirmed abstinence. Depressive symptoms were measured by the Hospital Anxiety and Depression Scale. RESULTS Depressive symptoms did not differ between the NAC and placebo groups during treatment. There was no significant interaction between treatment and baseline depression predicting cannabis abstinence during treatment. Higher baseline depression was associated with decreased abstinence throughout treatment and a significant gender interaction suggested that this may be particularly true for females. Cross-lagged panel models suggested that depressive symptoms preceded increased cannabis use amounts (in grams) during the subsequent month. The reverse pathway was not significant (i.e., greater cannabis use preceding depressive symptoms). CONCLUSIONS Results from this study suggest that depression may be a risk factor for poor CUD treatment outcome and therefore should be addressed in the context of treatment. However, results do not support the use of NAC to concurrently treat co-occurring depressive symptoms and CUD in adults. TRIAL REGISTRATION Clinicaltrials.gov: NCT01675661.
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McKetin R, Leung J, Stockings E, Huo Y, Foulds J, Lappin JM, Cumming C, Arunogiri S, Young JT, Sara G, Farrell M, Degenhardt L. Mental health outcomes associated with of the use of amphetamines: A systematic review and meta-analysis. EClinicalMedicine 2019; 16:81-97. [PMID: 31832623 PMCID: PMC6890973 DOI: 10.1016/j.eclinm.2019.09.014] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/20/2019] [Accepted: 09/20/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The use of amphetamines is a global public health concern. We summarise global data on use of amphetamines and mental health outcomes. METHODS A systematic review and meta-analysis (CRD 42017081893). We searched Medline, EMBASE, PsycInfo for methamphetamine or amphetamine combined with psychosis, violence, suicidality, depression or anxiety. Included studies were human empirical cross-sectional surveys, case-control studies, cohort studies and randomised controlled trials that assessed the association between methamphetamine and one of the mental health outcomes. Random effects meta-analysis was used to pool results for any use of amphetamines and amphetamine use disorders. FINDINGS 149 studies were eligible and 59 were included in meta-analyses. There was significant heterogeneity in effects. Evidence came mostly from cross-sectional studies. Any use of amphetamines was associated with higher odds of psychosis (odds ratio [OR] = 2.0, 95%CI 1.3-3.3), violence (OR = 2.2, 95%CI 1.2-4.1; adjusted OR [AOR] = 1.4, 95%CI 0.8-2.4), suicidality OR = 4.4, 95%CI 2.4-8.2; AOR = 1.7, 95%CI 1.0-2.9) and depression (OR = 1.6, 95%CI 1.1-2.2; AOR = 1.3, 95%CI 1.2-1.4). Having an amphetamine use disorder was associated with higher odds of psychosis (OR = 3.0, 95%CI 1.9-4.8; AOR = 2.4, 95%CI 1.6-3.5), violence (OR = 6.2, 95%CI 3.1-12.3), and suicidality (OR = 2.3, 95%CI 1.8-2.9; AOR = 1.5, 95%CI 1.3-1.8). INTERPRETATION Methamphetamine use is an important risk factor for poor mental health. High quality population-level studies are needed to more accurately quantify this risk. Clinical responses to methamphetamine use need to address mental health harms.
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Affiliation(s)
- Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Corresponding author.
| | - Janni Leung
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Faculty of Health and Behavioural Sciences, The University of Queensland, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Yan Huo
- Faculty of Health and Behavioural Sciences, The University of Queensland, Australia
| | - James Foulds
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Julia M. Lappin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- School of Psychiatry, University of NSW, Sydney, Australia
| | - Craig Cumming
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Shalini Arunogiri
- Turning Point, Eastern Health, Richmond, VIC, Australia
- Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Jesse T. Young
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Grant Sara
- Northern Clinical School, Sydney Medical School, University of Sydney, Australia
- InforMH, System Information and Analytics Branch, NSW Ministry of Health, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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The relationship between childhood abuse and depression in a sample of Chinese people who use methamphetamine. Int J Clin Health Psychol 2019; 19:181-188. [PMID: 31516496 PMCID: PMC6732768 DOI: 10.1016/j.ijchp.2019.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 06/12/2019] [Indexed: 01/20/2023] Open
Abstract
Background/Objective Previous studies have shown that childhood abuse is associated with symptoms of depression. This study aims to examine the prevalence of childhood abuse or neglect and its correlation with depression among a sample of Chinese people who use methamphetamine. Method People who use methamphetamine (MA) (N = 1,173) were recruited from government-operated drug rehabilitation centres in Anhui province, China. Participants were assessed using the short form of Childhood Trauma Questionnaire and the Beck Depression Inventory-II for childhood abuse or neglect and depression symptoms. Results A total of 44.6% of people who use MA reported moderate/severe childhood abuse or neglect, and 56.9% of this sample were diagnosed with depression. Emotional abuse, sexual abuse, emotional neglect and physical neglect were revealed to increase the risk of depression. Multivariable regression analyses showed that depression scores were significantly predicted by gender, duration of drug use, sexual abuse and emotional neglect (model R2 = .08, p < .001). The interaction between emotional neglect and duration of drug use on the depression was statistically significant. Conclusions These analyses indicate that sexual abuse and emotional neglect increase the severity of depression in individuals who use MA in drug rehabilitation centres of China.
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Mental health and cognitive function responses to quetiapine in patients with methamphetamine abuse under methadone maintenance treatment. J Affect Disord 2019; 251:235-241. [PMID: 30928863 DOI: 10.1016/j.jad.2019.03.078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/24/2019] [Accepted: 03/25/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Patients with methamphetamine (MA) abuse under methadone maintenance treatment (MMT) are susceptible to several complications including cognitive disturbance and mental health disorder. This trial was designed to determine the impacts of quetiapine administration on cognitive function and mental health scale in patients with MA abuse under MMT. METHODS This study was carried out in 60 MA abusers under MMT. Patients were randomly allocated to receive either 100 mg quetiapine (n = 30) or control (n = 30) daily for 8 weeks. Cognitive function and mental health scale were taken at baseline and post-treatment to evaluate relevant variables. RESULTS Quetiapine significantly decreased depression (b -3.94; 95% CI, -7.73, -0.16; P = 0.04) and sleep disorder (b -2.18; 95% CI, -2.89, -1.47; P < 0.001). Also, quetiapine administration resulted in a significant reduction in Iowa Gambling Task (b -2.70; 95% CI, -4.69, -0.71; P = 0.009), and significant increases in Verbal Fluency Test (b 3.04; 95% CI, 1.24, 4.85; P = 0.001), Reverse Digit Span (b 2.80; 95% CI, 2.13, 3.47; P = 0.001) compared with the placebo. CONCLUSION Overall, taking 100 mg quetiapine daily for 8 weeks by patients MA abuse in MMT had favorable effects on some of cognitive functions and mental health parameters.
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Ru Q, Xiong Q, Zhou M, Chen L, Tian X, Xiao H, Li C, Li Y. Withdrawal from chronic treatment with methamphetamine induces anxiety and depression-like behavior in mice. Psychiatry Res 2019; 271:476-483. [PMID: 30544074 DOI: 10.1016/j.psychres.2018.11.072] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 08/20/2018] [Accepted: 11/30/2018] [Indexed: 01/25/2023]
Abstract
Methamphetamine (METH) is an illicit psychostimulant that is widely abused. After producing extreme pleasure, METH abuse leads to negative emotional states during withdrawal in clinical survey. However, the mood behavioral consequences of withdrawal from chronic METH exposure in animal experiments and related mechanisms have not been clarified yet. The aim of this study was to investigate the anxiety and depression-like phenotype in mice induced by withdrawal from chronic METH treatment and the potential molecular mechanism. We found that withdrawal from chronic METH treatment increased the immobility time during the forced swimming test and decreased central activities in open field test, indicating increased anxiety and depression-like behavior. Additional experiments showed that expression of brain-derived neurotrophic factor (BDNF), phosphorylated tropomyosin receptor kinase B (p-TrkB), phosphorylated extracellular signal-related kinase 1/2 (p-ERK1/2) and phosphorylated cAMP-response element binding protein (p-CREB) were decreased in the hippocampus and prefrontal cortex of mice in METH group and the level of mitogen activated protein kinase phosphatase-1 (MKP-1) was increased. Combined, our data show that withdrawal from chronic METH exposure induces anxiety and depression-like behavior associated with aberrant changes of proteins in BDNF-ERK-CREB pathway, providing new evidence for the involvement of BDNF pathway in the negative emotional states induced by withdrawal from METH.
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Affiliation(s)
- Qin Ru
- Wuhan Institutes of Biomedical Sciences, Jianghan University, Wuhan 430056, China.
| | - Qi Xiong
- Wuhan Institutes of Biomedical Sciences, Jianghan University, Wuhan 430056, China
| | - Mei Zhou
- Wuhan Institutes of Biomedical Sciences, Jianghan University, Wuhan 430056, China
| | - Lin Chen
- Wuhan Institutes of Biomedical Sciences, Jianghan University, Wuhan 430056, China
| | - Xiang Tian
- Wuhan Institutes of Biomedical Sciences, Jianghan University, Wuhan 430056, China
| | - Huqiao Xiao
- Wan Ji Psychiatric Hospital, Wuhan 430051, China
| | - Chaoying Li
- Wuhan Institutes of Biomedical Sciences, Jianghan University, Wuhan 430056, China
| | - Yi Li
- Wuhan Mental Health Center, Wuhan 430022, China.
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Tang J, O’Neill J, Alger JR, Shen Z, Johnson MC, London ED. N-Acetyl and Glutamatergic Neurometabolites in Perisylvian Brain Regions of Methamphetamine Users. Int J Neuropsychopharmacol 2019; 22:1-9. [PMID: 29788422 PMCID: PMC6313110 DOI: 10.1093/ijnp/pyy042] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 03/21/2018] [Accepted: 05/15/2018] [Indexed: 02/05/2023] Open
Abstract
Background Methamphetamine induces neuronal N-acetyl-aspartate synthesis in preclinical studies. In a preliminary human proton magnetic resonance spectroscopic imaging investigation, we also observed that N-acetyl-aspartate+N-acetyl-aspartyl-glutamate in right inferior frontal cortex correlated with years of heavy methamphetamine abuse. In the same brain region, glutamate+glutamine is lower in methamphetamine users than in controls and is negatively correlated with depression. N-acetyl and glutamatergic neurochemistries therefore merit further investigation in methamphetamine abuse and the associated mood symptoms. Methods Magnetic resonance spectroscopic imaging was used to measure N-acetyl-aspartate+N-acetyl-aspartyl-glutamate and glutamate+glutamine in bilateral inferior frontal cortex and insula, a neighboring perisylvian region affected by methamphetamine, of 45 abstinent methamphetamine-dependent and 45 healthy control participants. Regional neurometabolite levels were tested for group differences and associations with duration of heavy methamphetamine use, depressive symptoms, and state anxiety. Results In right inferior frontal cortex, N-acetyl-aspartate+N-acetyl-aspartyl-glutamate correlated with years of heavy methamphetamine use (r = +0.45); glutamate+glutamine was lower in methamphetamine users than in controls (9.3%) and correlated negatively with depressive symptoms (r = -0.44). In left insula, N-acetyl-aspartate+N-acetyl-aspartyl-glutamate was 9.1% higher in methamphetamine users than controls. In right insula, glutamate+glutamine was 12.3% lower in methamphetamine users than controls and correlated negatively with depressive symptoms (r = -0.51) and state anxiety (r = -0.47). Conclusions The inferior frontal cortex and insula show methamphetamine-related abnormalities, consistent with prior observations of increased cortical N-acetyl-aspartate in methamphetamine-exposed animal models and associations between cortical glutamate and mood in human methamphetamine users.
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Affiliation(s)
- Jinsong Tang
- Laboratory of Molecular Neuroimaging, Semel Institute for Neuroscience and Human Behavior and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California
- Second Xiangya Hospital, Central South University, Changsha, China
| | - Joseph O’Neill
- Division of Child and Adolescent Psychiatry, Semel Institute for Neuroscience and Human Behavior and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California
| | | | - Zhiwei Shen
- The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Maritza C Johnson
- Laboratory of Molecular Neuroimaging, Semel Institute for Neuroscience and Human Behavior and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California
| | - Edythe D London
- Laboratory of Molecular Neuroimaging, Semel Institute for Neuroscience and Human Behavior and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California
- Brain Research Institute, University of California, Los Angeles, California
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Jalali F, Hashemi SF. The Effect of Saffron on Depression among Recovered Consumers of Methamphetamine Living with HIV/AIDS. Subst Use Misuse 2018. [PMID: 29543538 DOI: 10.1080/10826084.2018.1447583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND From one hand, depression is one of the symptoms that occur after abstinence from methamphetamine. On the other people living with HIV/AIDS are in isolation due to the nature of their illness and depression is one of the most common mental health problems they experience. OBJECTIVES This study was aimed at determining the effectiveness of saffron on reducing depression among recovered consumers of methamphetamine living with HIV/AIDS. METHODS The design of this study was semi-experimental with pre-test, post-test and control (placebo) groups. The statistical population consisted of all recovered consumers of methamphetamine living with HIV/AIDS who were referred to the Positive Club. Fifty-seven (57) recovered consumers of methamphetamine, living with HIV/AIDS, were selected by convenience sampling method. They were randomly assigned to an experimental (saffron) group and a control (placebo) group. The experimental group received 30 ml of saffron per day for 8 weeks, whereas the control (placebo) group received placebo the same way. BDI-II was used in this study as a measurement instrument. ANCOVA models were used for statistical inference. RESULTS The findings showed that saffron and its ingredients had been effective in reducing depression among this group (P < 0.05). CONCLUSION In fact, saffron with its active ingredients (Crusin and Saffranal) by serotonin and dopamine secretion in the brain, help in reducing depression among recovered consumers of methamphetamine living with HIV/AIDS.
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Affiliation(s)
- Farzad Jalali
- a Research Center , Negahe Mosbat Social Health Institute , Mashhad , Iran
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Martínez-Vispo C, Martínez Ú, López-Durán A, Fernández del Río E, Becoña E. Effects of behavioural activation on substance use and depression: a systematic review. Subst Abuse Treat Prev Policy 2018; 13:36. [PMID: 30268136 PMCID: PMC6162964 DOI: 10.1186/s13011-018-0173-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 09/21/2018] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Substance use and depression co-occurrence is a frequent phenomenon and an important public health concern. Given the clinical implications and the high prevalence of both disorders, effective interventions are needed. METHODS The aim of this study is to review Behavioural Activation (BA) intervention effects to improve substance use behaviour and depression. A systematic review was conducted using MEDLINE, EMBASE, and PsycINFO. The Effective Public Health Practice Project Quality Assessment Tool (EPHPP) was used to assess the methodological quality of included studies. Two authors independently screened titles and abstracts, reviewed selected studies, and extracted data. RESULTS Of the 7286 studies identified, eight met inclusion criteria. Designs of the studies included six randomized controlled trials (RCTs), and two pre-post design studies. One trial received weak methodological quality, six moderate, and one strong. Three studies addressed smoking behaviour; two targeted opiate dependence; two focused on alcohol/drug dependence; and, one on crystal methamphetamine abuse. Results showed that BA had a positive effect on substance use outcomes in seven of the eight reviewed studies, and improved depression over time in six studies. CONCLUSIONS Although studies conducted so far are limited by their heterogeneity and sample sizes, results are promising. There is a need of well controlled and powered studies to establish and to confirm the effectiveness of BA for the treatment of substance use and depression. Future studies should include stronger methodological designs, larger sample sizes, and long-term follow-ups. TRIAL REGISTRATION PROSPERO registration number: CRD42016039412 .
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Affiliation(s)
- Carmela Martínez-Vispo
- Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Úrsula Martínez
- Tobacco Research and Intervention Program. Department of Health Outcomes and Behaviour, H. Lee Moffitt Cancer Center, Fl, Tampa, USA
| | - Ana López-Durán
- Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Elisardo Becoña
- Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
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Zhang L, Cao X, Liang Q, Li X, Yang J, Yuan J. High-frequency repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex restores attention bias to negative information in methamphetamine addicts. Psychiatry Res 2018; 265:151-160. [PMID: 29709789 DOI: 10.1016/j.psychres.2018.04.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 04/06/2018] [Accepted: 04/11/2018] [Indexed: 12/17/2022]
Abstract
Methamphetamine (hereafter, meth) addiction results in various emotional problems linked to structural impairments in the prefrontal cortex (PFC). In this paper, we investigated whether high-frequency (10 Hz) repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral PFC (DLPFC) can improve emotional attention. Thirty-one meth addicts were randomly assigned to a 10 Hz or sham rTMS group; additionally, 31 healthy participants were enrolled, who were required to respond as correctly and quickly as possible to a yellow arrow embedded in an image depicting emotional content (neutral, fear, sadness, or disgust). Results showed that the healthy participants responded more rapidly to negative compared to neutral stimuli, while meth addicts responded indiscriminately to stimuli representing disgust, fear, and neutral content. The randomization check showed no significant differences in the pretest of emotional attention measures between the 10 Hz and sham groups. However, 10 Hz rTMS yielded faster response to negative pictures than to neutral pictures, which was similar to the performance of healthy participants but Sham not. However, this attention bias effect persisted in the 10 Hz group 2 weeks later. These results demonstrate that high-frequency rTMS of the left DLPFC can improve the emotional attention of meth addicts.
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Affiliation(s)
- Ling Zhang
- The Laboratory for Affect Cognition and Regulation, Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing,400715, China
| | - Xinyu Cao
- Da Lian Shan Institute of Addiction Rehabilitation, Nanjing, China
| | - Qiongdan Liang
- The Laboratory for Affect Cognition and Regulation, Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing,400715, China
| | - Xiang Li
- The Laboratory for Affect Cognition and Regulation, Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing,400715, China
| | - Jiemin Yang
- The Laboratory for Affect Cognition and Regulation, Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing,400715, China
| | - Jiajin Yuan
- The Laboratory for Affect Cognition and Regulation, Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing,400715, China.
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Fletcher JB, Swendeman D, Reback CJ. Mental Health and Substance Use Disorder Comorbidity among Methamphetamine-Using Men Who have Sex with Men. J Psychoactive Drugs 2018; 50:206-213. [PMID: 29608132 DOI: 10.1080/02791072.2018.1447173] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Men who have sex with men (MSM) exhibit elevated rates of mental health and substance use disorder relative to their non-MSM male counterparts. Methamphetamine use in particular has been associated with both neuronal damage and mental health disorders among MSM, and this study reports on the prevalence and comorbidity of DSM-5 mental health and substance use disorders in a sample of methamphetamine-using MSM. From March 2014 through January 2015, 286 methamphetamine-using MSM enrolled in a study to reduce methamphetamine use and sexual risk behaviors. At baseline, participants demonstrated high rates of current major depressive episode (35.8%), antisocial personality disorder (23.9%), suicide risk (23.2%), obsessive-compulsive disorder (23.2%), and social phobia (20.4%), as well as methamphetamine use disorder (89.1%), marijuana use disorder (41.0%), alcohol use disorder (39.6%), cocaine use disorder (30.9%), and inhalants use disorder (15.4%). Analyses revealed significant (p < 0.05) associations between methamphetamine use disorder severity and all listed mental health disorders, as well as between alcohol use disorder and all listed mental health disorders. Mental health disorder prevalence and substance use disorder severity were both elevated, and both methamphetamine and alcohol use disorder severity were associated with increased likelihood of comorbid mental health disorder.
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Affiliation(s)
| | - Dallas Swendeman
- b Center for HIV Identification, Prevention and Treatment Services , University of California , Los Angeles , CA , USA
| | - Cathy J Reback
- c Friends Research Institute, Inc; David Geffen School of Medicine, Semel Institute of Neuroscience and Human Behavior , University of California , Los Angeles , CA , USA
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Ren W, Luan X, Zhang J, Gutteea P, Cai Y, Zhao J, Gu Y, Wu C, Su H, Tao J, Xie Y, Lv D, Feng L, He J. Brain-derived neurotrophic factor levels and depression during methamphetamine withdrawal. J Affect Disord 2017. [PMID: 28647666 DOI: 10.1016/j.jad.2017.06.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Depression symptoms is highly comorbid with methamphetamine (METH) dependence. Except for the role in the pathophysiology of depression symptoms, brain-derived neurotrophic factor (BDNF) is also involved in the METH dependence. The present study aims to explore whether BDNF plays a role in the development of depression symptoms during METH withdrawal. METHODS We recruited 179 patients with METH dependence who were followed up for two weeks. Ultimately, 131 (73.2%) patients finished the follow-up. Besides, 90 healthy controls were also recruited. Serum BDNF levels were measured by DuoSet ELISA Development System upon admission. The short form (13 items) of the Beck Depression Inventory (BDI) and Amphetamine Withdrawal Questionnaire (AWQ) were used to measure the depression and withdrawal symptoms. Patients with BDI score ≥ 8 were identified to have depression symptoms. RESULTS Of the 131 patients, 64 (48.9%) were identified to have depression symptoms at the two-week endpoint. Patients with depression symptoms showed significantly lower BDNF levels than those with no depression symptoms. Serum BDNF levels (≤ 1251.0pg/ml) were independently associated with the development of depression symptoms during METH withdrawal (OR = 3.50, 95% CI, 1.14-10.73, p = 0.028). LIMITATIONS BDNF levels were tested in serum but not in brain and the baseline BDI and AWQ scores between the depression and non-depression groups were not matched. Besides, the follow-up time was relatively short. CONCLUSIONS Our study demonstrated that patients with serum BDNF levels ≤ 1251.0pg/ml had higher risk of depression symptoms during METH withdrawal.
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Affiliation(s)
- Wenwei Ren
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Xiaoqian Luan
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Jie Zhang
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai 200000, China
| | - Priyanka Gutteea
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Yan Cai
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Jiyun Zhao
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Yingying Gu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Chaowen Wu
- Department of Neurology, Ruian People's Hospital, Wenzhou 325000, China
| | - Hang Su
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Jingyan Tao
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Ying Xie
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Dezhao Lv
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Liang Feng
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
| | - Jincai He
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
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Hartwell EE, Moallem NR, Courtney KE, Glasner-Edwards S, Ray LA. Sex Differences in the Association Between Internalizing Symptoms and Craving in Methamphetamine Users. J Addict Med 2017; 10:395-401. [PMID: 27504928 PMCID: PMC5083163 DOI: 10.1097/adm.0000000000000250] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Methamphetamine (MA) users often have substantial psychiatric comorbidities, with nearly a third reporting lifetime mood disorders and over a quarter reporting lifetime anxiety disorders. Female MA users are more likely to endorse depression and anxiety symptoms compared with men. Craving has been related to mood/anxiety symptoms in MA users. To extend the literature on sex differences in MA use disorder, the present study examines the role of sex as a moderator of the relationship between mood/anxiety symptoms and MA craving. METHODS Participants (N = 203) were nontreatment-seeking, current MA users, recruited from the Los Angeles community for enrollment in a larger pharmacotherapy trial. At the assessment visit, participants completed multiple measures including the Methamphetamine Urge Questionnaire, the Beck Depression Inventory, and the Beck Anxiety Inventory. RESULTS The relationship between depression symptomatology and MA craving was moderated by sex (F = 6.18, P = 0.01), such that the relationship was positive and significant for men (P < 0.001), but was not significant for women. Similarly, sex significantly moderated the relationship between anxiety and MA craving (F = 5.99, P = 0.02), such that the relationship was also positive and significant in men, but not in women (P < 0.001). CONCLUSIONS These results suggest that men may be more sensitive to the effects of internalizing symptoms on MA craving than women. Given craving's propensity to predict relapse, these initial findings indicate the necessity of treating comorbid psychiatric problems in male MA users, which may in turn assist in the attenuation of craving.
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Affiliation(s)
- Emily E. Hartwell
- Department of Psychology, University of California, Los Angeles
- Integrated Substance Abuse Programs, University of California, Los Angeles
| | | | | | | | - Lara A. Ray
- Department of Psychology, University of California, Los Angeles
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
- Brain Research Institute, University of California, Los Angeles
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Krawczyk N, Feder KA, Saloner B, Crum RM, Kealhofer M, Mojtabai R. The association of psychiatric comorbidity with treatment completion among clients admitted to substance use treatment programs in a U.S. national sample. Drug Alcohol Depend 2017; 175:157-163. [PMID: 28432939 PMCID: PMC5490486 DOI: 10.1016/j.drugalcdep.2017.02.006] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 12/19/2016] [Accepted: 02/02/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Psychiatric disorders are highly comorbid with substance use disorders and play an important role in their course and recovery. However, the impact of comorbidity on treatment outcomes has not been examined in a U.S. national sample. This study explores the impact of psychiatric comorbidity on treatment completion among individuals admitted to publicly funded substance use treatment facilities across the United States. METHODS Using data on first-time treatment episodes in the U.S. from the Treatment Episode Dataset-Discharges (TEDS-D) for the years 2009-2011, logistic regression was used to assess the association between psychiatric comorbidity and treatment non-completion, and Cox proportional hazards regression was used to assess the association between comorbidity and rate of attrition. Analyses were performed for all substances together and then stratified by primary substance of abuse (alcohol, cannabis, stimulants, or opioids). RESULTS Of 856,385 client treatment episodes included in our analysis, 28% had a psychiatric comorbidity and 38% did not complete treatment. After adjusting for socio-demographic and treatment characteristics, clients with psychiatric comorbidity had higher odds of not completing treatment relative to those without comorbidity [OR=1.28 (1.27-1.29)], and had an earlier time to attrition [HR=1.14 (1.13-1.15)]. Psychiatric comorbidity was most strongly associated with treatment non-completion and rate of attrition in those admitted primarily for alcohol [OR=1.37 (1.34-1.39); HR=1.19 (1.17-1.21), respectively]. CONCLUSIONS Individuals with psychiatric comorbidities receiving treatment for substance use disorders face unique challenges that impact their ability to complete treatment. The findings call for further efforts to integrate treatment for psychiatric comorbidities in substance use treatment settings.
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Affiliation(s)
- Noa Krawczyk
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA.
| | - Kenneth A Feder
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA
| | - Brendan Saloner
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA
| | - Rosa M Crum
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans St., Baltimore, MD 21287, USA
| | - Marc Kealhofer
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, USA
| | - Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans St., Baltimore, MD 21287, USA
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High prevalence of depressive symptoms and impulsivity as well as their relationship during subacute methamphetamine withdrawal in chronic abusers. J Clin Neurosci 2017; 39:1-3. [DOI: 10.1016/j.jocn.2017.02.062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 02/15/2017] [Indexed: 11/18/2022]
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50
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Lin C, Cao X, Li L. Psychoactive Substance Use among Methadone Maintenance Therapy Clients in China. Int J Ment Health Addict 2017; 15:801-811. [PMID: 28761409 DOI: 10.1007/s11469-017-9758-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
A proportion of methadone maintenance therapy (MMT) clients in China shifted their substance use habit from opiate to psychoactive substances. The objective of this study was to examine the pattern and associated factors of psychoactive substance use among MMT clients. The study was conducted among 2,448 clients from 68 MMT clinics of China. The type and frequency of psychoactive substance use were self-reported. About 38.1% (N=933) of the participants reported psychoactive substance use in lifetime, and 6.5% (N=158) in the previous 30 days. The most commonly used psychoactive substances were sedative/hypnotic/antidiarrheal agent and amphetamine. Psychoactive substance use in the past 30 days was correlated with younger age, recent heroin use, having psychoactive substance using friend(s), and depressive symptoms. The finding suggested that urinalysis of psychoactive substances should be routinely administered in the MMT clinics. Young clients, concurrent heroin users, and clients with depressive symptoms deserve more screening and intervention efforts.
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Affiliation(s)
- Chunqing Lin
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California, U.S.A
| | - Xiaobin Cao
- National Center for AIDS Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Li Li
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California, U.S.A
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