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Jamison RN, Edwards RR, Brown R, Barrett BP, Burzinski CA, Lennon RP, Nakamura Y, Schiefelbein T, Garland EL, Zgierska AE. Risk Factors for Self-Harm Ideation Among Persons Treated With Opioids for Chronic Low Back Pain. Clin J Pain 2023; 39:643-653. [PMID: 37712325 PMCID: PMC10695275 DOI: 10.1097/ajp.0000000000001161] [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: 03/11/2023] [Accepted: 09/06/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVES Chronic pain is a significant health concern that adversely affects all aspects of life, including emotional well-being. Opioids are prescribed for the management of refractory, severe chronic pain, although they have been associated with adverse effects, including addiction and overdose. The aim of this study was to examine factors that predict thoughts of self-harm among adults with chronic pain who are prescribed opioids. MATERIALS AND METHODS Seven hundred sixty-five (N=765) persons with opioid-treated chronic lower back pain completed the Current Opioid Misuse Measure (COMM) and other validated questionnaires as part of a larger study. Response to 1 question from the COMM ("How often have you seriously thought about hurting yourself?") was used to assess suicide risk on a 5-point scale (0=never; 4=very often). RESULTS Participants were categorized into 3 groups according to their responses to the self-harm question: never (N=628; 82.1%), seldom or sometimes (N=74; 9.7%), and often or very often (N=63; 8.2%). Multivariate adjusted odds ratio (aOR) analyses indicated that reports of alcohol or drug overuse within the past month (aOR=1.41,[95% CI 1.11-1.78]), posttraumatic stress (PTSD; aOR=1.24,[1.07 to 1.44]), pain catastrophizing (aOR=1.03,[1.01 to 1.05]), not loving oneself (aOR=0.99,[.98-1.00]) and poor perceived mental health (aOR=0.94,[.92 to 97]) were most associated with thoughts of self-harm. Importantly, the ideation frequency of self-harm was highest among individuals treated with higher daily doses of opioids. DISCUSSION These results support the need for continued monitoring of adults treated with opioids for chronic pain, particularly among those on high-dose opioids who present with increased negative affect and concerns of substance misuse.
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Affiliation(s)
- Robert N. Jamison
- Harvard Medical School, Brigham and Women’s Hospital, Departments of Anesthesiology, Perioperative and Pain Medicine and Psychiatry, 850 Boylston Street, Chestnut Hill, MA 02467
| | - Robert R. Edwards
- Harvard Medical School, Brigham and Women’s Hospital, Departments of Anesthesiology, Perioperative and Pain Medicine and Psychiatry, 850 Boylston Street, Chestnut Hill, MA 02467
| | - Roger Brown
- University of Wisconsin-Madison, School of Medicine and Public Health, and University of Wisconsin-Madison, School of Nursing, 1100 Delaplaine Court, Madison, WI 53715
| | - Bruce P. Barrett
- University of Wisconsin-Madison, School of Medicine and Public Health, and University of Wisconsin-Madison, School of Nursing, 1100 Delaplaine Court, Madison, WI 53715
| | - Cindy A. Burzinski
- University of Wisconsin-Madison, School of Medicine and Public Health, and University of Wisconsin-Madison, School of Nursing, 1100 Delaplaine Court, Madison, WI 53715
| | - Robert P. Lennon
- Pennsylvania State University College of Medicine, Department of Family and Community Medicine, 90 Hope Drive, Hershey, PA 17033
| | - Yoshio Nakamura
- University of Utah School of Medicine, Department of Anesthesiology, Division of Pain Medicine, Pain Research Center, 615 Arapeen Drive, Suite 200, Salt Lake City, UT 84108
| | - Tony Schiefelbein
- Pennsylvania State University College of Medicine, Department of Family and Community Medicine, 90 Hope Drive, Hershey, PA 17033
| | - Eric L. Garland
- University of Utah, Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, 395 1500 E, Salt Lake City, UT 84112
| | - Aleksandra E. Zgierska
- Pennsylvania State University College of Medicine, Department of Family and Community Medicine, 90 Hope Drive, Hershey, PA 17033
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Wilkinson A, Swann A, Graham D, Patriquin M, Salas R, Nielsen D, Kosten T. Emotional self-regulation, impulsivity, 5-HTTLPR and tobacco use behavior among psychiatric inpatients. J Affect Disord 2022; 311:631-636. [PMID: 35623482 PMCID: PMC9842073 DOI: 10.1016/j.jad.2022.05.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/11/2022] [Accepted: 05/19/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND While the serotonin transporter (SLC6A4) gene, 5-HTTLPR, interacts with the social environment to influence both emotional self-regulation and smoking behavior, less is known about interactions between emotional self-regulation and 5-HTTLPR or their joint influence on tobacco use. Here, we examined such interactions among psychiatric inpatients, the population with the highest rates of smoking. METHODS Participants (506 adults) were psychiatric inpatients at The Menninger Clinic in Houston TX between 2012 and 16. Most were white (89%), male (55%), with a mean age of 32.3 years. Participants completed the Difficulties in Emotional Regulation Scale (DERS) at admission. We examined interactions with smoking among three DERS subscales and 5-HTTLPR, controlling for sex, race and age. RESULTS Smoking rates were higher among those with the 5-HTTPLR L'L' genotype compared to peers carrying an S' allele (47.9% vs. 37.4%, respectively). Among S' allele carrying participants, impulse control difficulties (OR = 1.09; 95%CI: 1.03-1.14) and lack of emotion clarity (OR = 1.06; 95%CI: 1.00-1.11) increased risk for ever using tobacco, while accessing more ways to regulate emotion (OR = 0.95; 95%CI: 0.92-0.99) offered a protective effect against ever using tobacco. Neither demographic nor DERS covariates were associated with using tobacco among the L'L' group. LIMITATIONS This ethnically homogenous sample limits generalizability and using a binary outcome can over-estimate a gene environment interaction effect. CONCLUSIONS Emotional self-regulation exerts a stronger influence on using tobacco among carriers of an S' allele of 5-HTTLPR than peers with the L'L' genotype. Promoting emotional self-regulatory skills may have benefits for preventing tobacco use.
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Affiliation(s)
- A.V. Wilkinson
- UTHealth School of Public Health in Austin, Austin, TX, United States of America,Corresponding author. (A.V. Wilkinson)
| | - A.C. Swann
- Michael E. DeBakey VA Medical Center, Houston, TX, United States of America,Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States of America
| | - D.P. Graham
- Michael E. DeBakey VA Medical Center, Houston, TX, United States of America,Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States of America
| | - M.A. Patriquin
- Michael E. DeBakey VA Medical Center, Houston, TX, United States of America,Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States of America,The Menninger Clinic, Houston, TX, United States of America
| | - R. Salas
- Michael E. DeBakey VA Medical Center, Houston, TX, United States of America,Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States of America,The Menninger Clinic, Houston, TX, United States of America
| | - D.A. Nielsen
- Michael E. DeBakey VA Medical Center, Houston, TX, United States of America
| | - T.R. Kosten
- Michael E. DeBakey VA Medical Center, Houston, TX, United States of America,Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States of America
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Baiden P, Szlyk HS, Cavazos-Rehg P, Onyeaka HK, Peoples J, Kasson E. Use of electronic vaping products and mental health among adolescent high school students in the United States: The moderating effect of sex. J Psychiatr Res 2022; 147:24-33. [PMID: 35007808 PMCID: PMC8905685 DOI: 10.1016/j.jpsychires.2021.12.050] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/29/2021] [Accepted: 12/20/2021] [Indexed: 12/30/2022]
Abstract
Although studies have investigated the association between conventional tobacco smoking and mental health outcomes among adolescents in the United States, few studies have examined the association between electronic vaping products (EVPs) and mental health among adolescents. This study aimed to investigate the cross-sectional association between EVPs use, symptoms of depression, and suicidal behaviors among adolescents. Data were pooled from the 2017 and 2019 Youth Risk Behavior Survey. An analytic sample of 14,285 adolescents (50.3% female) was analyzed using binary logistic regression. The outcome variables investigated were symptoms of depression, suicidal ideation, suicide plan, and suicide attempts, and the main explanatory variable was EVPs use. Of the 14,285 adolescents, 22.2%, 19.2%, and 58.8% were current, former and never users of EVPs, respectively. Controlling for other factors, current users of EVPs were significantly more likely to report having symptoms of depression (AOR = 1.82, 95% CI = 1.58-2.09), having suicidal ideation (AOR = 1.55, 95% CI = 1.30-1.86), making a suicide plan (AOR = 1.62, 95% CI = 1.34-1.97), or attempting suicide (AOR = 1.75, 95% CI = 1.41-2.18) when compared to never users of EVPs. Gender moderated the association between EVPs use, symptoms of depression, suicidal ideation, and suicide plan. Racial minority identity, sexual minority identity, sexual violence victimization, victim of school and cyberbullying, alcohol use, and cigarette smoking were all significantly associated with depression and suicidal behaviors. Study findings support the association between EVPs use and adolescent mental health. Future studies that employ longitudinal designs may offer more insight into the mechanisms underlying this association.
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Affiliation(s)
- Philip Baiden
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St., Box 19129, Arlington, TX, 76019, USA.
| | - Hannah S. Szlyk
- Rutgers, The State University of New Jersey, School of Social Work, 120 Albany St, New Brunswick, NJ 08901
| | - Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO 63110
| | - Henry K. Onyeaka
- Harvard Medical School, Department of Psychiatry, Massachusetts General Hospital/McLean Hospital, Boston, MA, USA, 02115
| | - JaNiene Peoples
- The Brown School at Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130
| | - Erin Kasson
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO 63110
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ElShahawi HH, Amin GR, Khalil SA, Morsy MH, Farwiez MG, Nawara MM. Prevalence of tobacco smoking in a sample of general secondary school students in Cairo and its correlation to other psychiatric disorders. MIDDLE EAST CURRENT PSYCHIATRY, AIN SHAMS UNIVERSITY 2022; 29:87. [PMCID: PMC9558021 DOI: 10.1186/s43045-022-00252-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background Tobacco smoking is considered currently a global public health concern among youth especially school students. There is a scarcity of data about the impact of this global phenomenon in Middle Eastern countries. This study assesses the prevalence of tobacco smoking, including conventional cigarettes, E-cigarettes, and water pipe and its sociodemographic and psychiatric correlates among a sample of general secondary school students in Cairo, Egypt. Results A convenient sample of 391 Egyptian general secondary students from different areas of Greater Cairo were assessed using the Socioeconomic scale, Fagerstrom Test For Nicotine Dependence, The Lebanon Water pipe Dependence Scale, questionnaire for electronic cigarette use, Barratt impulsivity scale 11, and The MINI International Neuropsychiatric Interview for Children and Adolescents. 12.8% (n = 50) were smokers. There is a significant relation between family history of smoking and substance use and smoking and significant relation between smoking, impulsivity, and mood symptoms. Conclusions Prevalence of tobacco smoking in Egyptian adolescents was 12.8% with significant relation between smoking and impulsivity and mood symptoms.
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Affiliation(s)
- Heba Hamed ElShahawi
- grid.7269.a0000 0004 0621 1570Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ghada Refaat Amin
- grid.7269.a0000 0004 0621 1570Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Sherien Ahmed Khalil
- grid.7269.a0000 0004 0621 1570Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mahmoud Hassan Morsy
- grid.7269.a0000 0004 0621 1570Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Gamal Farwiez
- grid.7269.a0000 0004 0621 1570Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt ,grid.7269.a0000 0004 0621 1570Okasha Institute of Psychiatry, Ain Shams University, 22, Dair Al-Malak, Abbassia, Cairo, 11657 Egypt
| | - Mayar Medhat Nawara
- grid.7269.a0000 0004 0621 1570Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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