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Cai J, Zhao L, Li N, Xiao Z, Huang G. Mendelian randomization analysis separated the independent impact of childhood obesity and adult obesity on socioeconomic status, psychological status, and substance use. Heliyon 2024; 10:e36835. [PMID: 39263080 PMCID: PMC11388778 DOI: 10.1016/j.heliyon.2024.e36835] [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: 12/25/2023] [Revised: 08/06/2024] [Accepted: 08/22/2024] [Indexed: 09/13/2024] Open
Abstract
Background Obesity is linked to a variety of psychosocial and behavioral outcomes but the causalities remain unclear yet. Determining the causalities and distinguishing between the separate effects of childhood and adult obesity is critical to develop more targeted strategies to prevent adverse outcomes. Methods With single nucleotide polymorphisms (SNPs) used as genetic variables, we employed univariable Mendelian randomization (UVMR) to explore the causalities between childhood and adult body mass index (BMI) and socioeconomic status, psychological status, and substance use. Genetic data for childhood and adult BMI came respectively from 47,541 children aged 10 years and 339,224 adult participants. The outcome data were obtained from corresponding consortia. The direct impact of childhood BMI and adult BMI was then examined using a multivariable MR (MVMR). Results UVMR found that higher childhood BMI was linked causally to lower household income (β = -0.06, 95 % CI = -0.08 ∼ -0.03, P = 4.86 × 10-5), decreased subjective well-being (β = -0.07, 95 % CI = -0.12 ∼ -0.03, P = 1.74 × 10-3), and an increased tendency of smoking regularly (OR = 1.12, 95 % CI = 1.04-1.20, P = 1.52 × 10-3). Similar results were observed in adult BMI. MVMR further revealed that after adjusting with adult BMI, childhood BMI remained an isolated impact on household income. The impacts of adult BMI on the outcomes were diminished when adjusting with childhood BMI. Conclusion The findings indicate the impacts of childhood obesity on subjective well-being and smoking initiation are a result of higher BMI sustaining into adulthood, whereas the effect on household income is attributed to a lasting impact of obesity in early life. The results would help facilitate more targeted strategies for obesity management to prevent adverse outcomes.
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Affiliation(s)
- Jiahao Cai
- School of Pediatrics, Guangzhou Medical University, China
- Department of Neurology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Lei Zhao
- The Third Clinical Institute, Guangzhou Medical University, Guangzhou, China
| | - Nanfang Li
- Graduate School of Human Science, Osaka University, Osaka, Japan
| | - Zijin Xiao
- Guangzhou Medical University, Guangzhou, China
| | - Guiwu Huang
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA
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Cheng Y, Justice A, Wang Z, Li B, Hancock DB, Johnson EO, Xu K. Cis-meQTL for cocaine use-associated DNA methylation in an HIV-positive cohort show pleiotropic effects on multiple traits. BMC Genomics 2023; 24:556. [PMID: 37730558 PMCID: PMC10510240 DOI: 10.1186/s12864-023-09661-2] [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: 03/24/2023] [Accepted: 09/08/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Cocaine use (CU) is associated with psychiatric and medical diseases. Little is known about the mechanisms of CU-related comorbidities. Findings from preclinical and clinical studies have suggested that CU is associated with aberrant DNA methylation (DNAm) that may be influenced by genetic variants [i.e., methylation quantitative trait loci (meQTLs)]. In this study, we mapped cis-meQTLs for CU-associated DNAm sites (CpGs) in an HIV-positive cohort (Ntotal = 811) and extended the meQTLs to multiple traits. RESULTS We conducted cis-meQTL analysis for 224 candidate CpGs selected for their association with CU in blood. We identified 7,101 significant meQTLs [false discovery rate (FDR) < 0.05], which mostly mapped to genes involved in immunological functions and were enriched in immune pathways. We followed up the meQTLs using phenome-wide association study and trait enrichment analyses, which revealed 9 significant traits. We tested for causal effects of CU on these 9 traits using Mendelian Randomization and found evidence that CU plays a causal role in increasing hypertension (p-value = 2.35E-08) and decreasing heel bone mineral density (p-value = 1.92E-19). CONCLUSIONS These findings suggest that genetic variants for CU-associated DNAm have pleiotropic effects on other relevant traits and provide new insights into the causal relationships between cocaine use and these complex traits.
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Affiliation(s)
- Youshu Cheng
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, 06511, USA
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | - Amy Justice
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, 06511, USA
| | - Zuoheng Wang
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, 06511, USA
| | - Boyang Li
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, 06511, USA
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | - Dana B Hancock
- GenOmics, Bioinformatics, and Translational Research Center, RTI International, Research Triangle Park, NC, USA
| | - Eric O Johnson
- GenOmics, Bioinformatics, and Translational Research Center, RTI International, Research Triangle Park, NC, USA
- Fellow Program, RTI International, Research Triangle Park, NC, USA
| | - Ke Xu
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA.
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT, 06511, USA.
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3
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Iranmanesh P, Barlow K, Anvari M. The effect of bariatric surgery on opioid consumption in patients with obesity: a registry-based cohort study. Surg Obes Relat Dis 2023; 19:952-961. [PMID: 37121852 DOI: 10.1016/j.soard.2023.03.004] [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: 12/21/2022] [Revised: 02/21/2023] [Accepted: 03/05/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Misuse of opioid medication has become a major health crisis in several countries. A significant number of patients with obesity use opioid medications, mostly to alleviate symptoms due to obesity-related co-morbidities. OBJECTIVE To compare patterns of opioid drug usage before and after bariatric surgery in this population, hypothesizing that weight loss and improvement of obesity-related co-morbidities could reduce opioid consumption. SETTING The Ontario Bariatric Registry (Ontario, Canada). METHODS In this retrospective cohort study, the Ontario Bariatric Registry was used to compare opioid consumption in adult patients undergoing bariatric surgery between 2010 and 2021. The primary outcome was the number of patients using opioid medication at 1 year after surgery. Multiple logistic regression analyses were performed to identify potential predictors of opioid consumption. RESULTS Data of 11,179 patients were analyzed. Mean age was 45.7 ± 10.2 years, mean baseline body mass index was 48.9 ± 8 kg/m2, and 83.6% of patients were female. Roux-en-Y gastric bypass was performed in the majority of patients (85.6%), followed by sleeve gastrectomy (14.2%). At baseline, opioids were used by 7.7% and nonopioid pain medications by 42.3% of patients. At 1 year after surgery, these numbers significantly decreased (Δ-1.9% and Δ-18.0%, respectively). The decrease in the consumption of nonopioid pain medication needs to be interpreted in the context of the contraindication to nonsteroidal anti-inflammatory drugs after Roux-en-Y gastric bypass, which was the most commonly performed procedure. Presence of musculoskeletal pain and use of nonopioid pain medication at baseline were identified as independent predictors of opioid consumption at 1 year after surgery. CONCLUSIONS At 1 year after bariatric surgery, a significant decrease in opioid and nonopioid pain medication consumption was seen among patients with obesity. Aggressive management of excess weight, especially with bariatric surgery, can potentially reduce the impact of the opioid crisis in this population.
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Affiliation(s)
- Pouya Iranmanesh
- Center for Minimal Access Surgery, St. Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada; Division of Digestive Surgery, Department of Surgery, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland.
| | - Karen Barlow
- Center for Minimal Access Surgery, St. Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada
| | - Mehran Anvari
- Center for Minimal Access Surgery, St. Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada
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Ramsewak S, Moty N, Putteeraj M, Somanah J, Nirmala LP. Parenting style and its effect on eating disorders and substance abuse across the young population. DISCOVER PSYCHOLOGY 2022. [PMCID: PMC8802280 DOI: 10.1007/s44202-022-00025-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This article attempts to examine the occurrence of two behavioural changes, namely, substance abuse and eating disorders in order of onset mediated by ineffective parenting styles during young age. The four parenting styles and their consequential behavioural adverse effects are taken as the focal point of this study and are synthesized to provide an outlook on the status of ineffective parenting and deviant offspring behaviours. A review of literature was primarily undertaken to examine the characteristic features of ineffective parenting. A causal relationship was then drawn between the onset of behavioural disorders with an emphasis on substance abuse and eating disorders, along the parenting spectrum. We probed into the order and directionality of the offspring behavioural changes against ineffective parenting. The current available data shows the superimposition of the parenting style spectrum on a bell-shaped distribution of behavioural outcomes as exemplified by authoritarian, permissive and neglectful parenting as a prime determinant of several disorders among the young age; parenting styles being at the extremities of the parenting spectrum. The sweet spot of parenting, mainly associated to the authoritative approach, bears the most positive effect on the growing child. The extreme ends of parenting as per the varying degree of responsiveness and demandingness, generally observed in authoritarian and neglectful parenting precipitate concomitant deviant behaviours cascading from one another; intricately linking substance abuse and eating disorders. A number of studies describe the isolated effects of ineffective parenting on the development of substance abuse and eating disorders during the adolescent period. However, the relationship between both eating disorders and substance abuse is underplayed and need to be stressed upon to tailor behaviour-specific targeted therapies and restore the normalcy of these altered behaviours. How the parenting style adopted can lead to a concurrent amalgam of disordered eating patterns and substance abuse. How disordered eating behaviours and substance abuse are initiated as coping strategies to deal with the consequences of poor parenting. Isolation of specific risk factors to deter the development of those deviant behaviours in addition to improvement of parenting methods.
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Affiliation(s)
- Shalina Ramsewak
- Psychiatry Department, A.G. Jeetoo Hospital, Port-Louis, Mauritius
| | - Numrata Moty
- Faculty of Law, University of Mauritius, Reduit, Mauritius
| | - Manish Putteeraj
- School of Health Sciences, University of Technology, Port-Louis, Mauritius
| | - Jhoti Somanah
- School of Health Sciences, University of Technology, Port-Louis, Mauritius
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Tinghino B, Lugoboni F, Amatulli A, Biasin C, Bramani Araldi M, Cantiero D, Cremaschini M, Galimberti GL, Giusti S, Grosina C, Mulazzani GEG, Nizzoli U. The FODRAT study (FOod addiction, DRugs, Alcohol and Tobacco): first data on food addiction prevalence among patients with addiction to drugs, tobacco and alcohol. Eat Weight Disord 2021; 26:449-455. [PMID: 32072572 DOI: 10.1007/s40519-020-00865-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 02/01/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES The main focus of this study was to evaluate the prevalence of food addiction (FA) in a population of 575 subjects, all affected by drugs, alcohol and/or tobacco addiction. METHODS Patients were enrolled in Addiction Service Centers and 25 items YFAS questionnaire was administered. Prevalence of FA was studied among patients who already have an addiction and then this prevalence was compared between groups of abusers (by type of substance), comparing mono abusers with polyabusers, as well as regressions by age, BMI, sex, through multiple regression analysis. RESULTS Prevalence of FA in the sample is 20.17%. Risk of FA increases with the number of substances used (polyabuse). Results show a positive correlation, in addicted people, between BMI values and FA, with significant values (OR 1.08; 95% CI 1.04-1.13; p = 0.006). Age is inversely correlated with FA (OR 0.97; 95% CI 0.95-0.99; p = 0.01). Female sex is positively associated (OR 2.60; 95% CI 1.59-4.27, p = 0.000). No significant association appears with any substance, even if the highest prevalence is recorded among cannabis users (31.03%), and heroin (21.07%), followed by cocaine (18.53%), alcohol (14.49%) and tobacco (11.61%). A comparison between the FA prevalence in our study and that from another study in the Italian general population (11%) shows a significant difference (p < 0.001). CONCLUSIONS Prevalence of FA among addicted people is greater than in the general population. Risk of FA increases with the increase in number of used substances (polyabuse). Age is inversely correlated with FA. There is a positive and significant correlation between BMI and FA among substance/tobacco abusers. LEVEL OF EVIDENCE Level V, observational cross-sectional descriptive study.
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Affiliation(s)
- B Tinghino
- UO Alcologia e Nuove Dipendenze, Dipartimento di Salute Mentale e Dipendenze, ASST di Vimercate, Vimercate, Italy.
| | - F Lugoboni
- UO Medicina delle Dipendenze, Ospedale Universitario di Verona, Verona, Italy
| | - A Amatulli
- Dipartimento di Salute Mentale e Dipendenze, ASST di Vimercate, Vimercate, Italy
| | - C Biasin
- SER.D ULSS 9 Scaligera, Verona, UOC Bussolengo e Legnago, Legnago, Italy
| | - M Bramani Araldi
- UO Tossicodipendenze, Dipartimento di Salute Mentale e Dipendenze, ASST di Vimercate, Vimercate, Italy
| | - D Cantiero
- SER.D ULSS 9 Scaligera, Verona, UOC Bussolengo e Legnago, Legnago, Italy
| | - M Cremaschini
- Dipartimento Cure Primarie, ATS di Bergamo, Bergamo, Italy
| | - G L Galimberti
- UOSD Dipendenze, Dipartimento di Salute Mentale e Dipendenze, ASST di Monza, Monza, Italy
| | - S Giusti
- UO Medicina delle Dipendenze, Ospedale Universitario di Verona, Verona, Italy
| | - C Grosina
- UO Alcologia e Nuove Dipendenze, Dipartimento di Salute Mentale e Dipendenze, ASST di Vimercate, Vimercate, Italy
| | - G E G Mulazzani
- Medico specializzando in Scienza dell'Alimentazione, Università Statale di Milano, Milano, Italy
| | - U Nizzoli
- Società Italiana Studio Disturbi Comportamento Alimentare, SISDCA, Roma, Italy
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Ross JM, Pacheco-Colón I, Hawes SW, Gonzalez R. Bidirectional Longitudinal Associations Between Cannabis Use and Body Mass Index Among Adolescents. Cannabis Cannabinoid Res 2020; 5:81-88. [PMID: 32322679 PMCID: PMC7173669 DOI: 10.1089/can.2019.0091] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Introduction: Literature on the association between cannabis use and body mass index (BMI) among adults suggests that greater cannabis use is associated with a lower BMI. However, results are mixed among adolescents, with both cross-sectional and longitudinal studies finding positive, negative, and nonsignificant associations between cannabis use and BMI. This longitudinal study aims to shed light on these associations by prospectively examining the associations between cannabis use and BMI across a 2-year window in a large sample of adolescent cannabis users. Methods: Participants were 401 adolescents ages 14-17 at baseline who were at risk for escalation in their use of cannabis. We conducted a parallel process latent growth curve model to examine associations between the cannabis use intercept, BMI intercept, cannabis use slope, and BMI slope. Results: Results showed that baseline BMI predicted a positive and significant association with cannabis use slope. In addition, there was a significant and negative correlation between the cannabis use slope and the BMI slope. These significant associations remained after controlling for relevant covariates. Conclusions: Results are consistent with the adult literature that reports a negative association between cannabis use and BMI. Future research should focus on uncovering the mechanisms that may drive the association between cannabis use and BMI.
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Affiliation(s)
- J. Megan Ross
- Institute for Behavior Genetics, University of Colorado Boulder, Boulder, Colorado
- Center for Children and Families, Department of Psychology, Florida International University, Miami, Florida
| | - Ileana Pacheco-Colón
- Center for Children and Families, Department of Psychology, Florida International University, Miami, Florida
| | - Samuel W. Hawes
- Center for Children and Families, Department of Psychology, Florida International University, Miami, Florida
| | - Raul Gonzalez
- Center for Children and Families, Department of Psychology, Florida International University, Miami, Florida
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7
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Victimization as a mediator in the relationship between sexual orientation and adolescent alcohol use. Arch Psychiatr Nurs 2020; 34:27-34. [PMID: 32035586 DOI: 10.1016/j.apnu.2019.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 11/20/2019] [Accepted: 12/12/2019] [Indexed: 11/23/2022]
Abstract
This study aimed to identify differences in Korean adolescents' alcohol use behaviors according to their sexual orientation and the mediating effect of victimization in this relationship using nationally representative data. Data from the Korea Youth Risk Behavior Web-based Surveys were analyzed using logistic regression analysis. There were significant associations between sexual orientation and alcohol use behaviors. Heterosexual adolescents were significantly more likely to have drinking experience in lifetime than their homosexual and bisexual peers in adjusted analyses. Victimization significantly mediated the relationship between sexual orientation and alcohol use behaviors. Our findings suggest that reducing the prevalence of alcohol use by sexual orientation should involve interventions to prevent victimization in schools.
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Turan N, Özdemir Aydın G, Kaya H, Aksel G, Yılmaz A. Male Nursing Students' Social Appearance Anxiety and Their Coping Attitudes. Am J Mens Health 2019; 13:1557988319825922. [PMID: 30739556 PMCID: PMC6582376 DOI: 10.1177/1557988319825922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study aimed at examining social appearance anxiety levels of male nursing students and their coping attitudes and identifying the relationship between them. A cross-sectional research approach was adopted in a study population of 180; the sample comprised 129 students. Data were collected using a socio-demographic information form, the Social Appearance Anxiety Scale (SAAS), and the Assessment of Coping Attitudes Inventory (COPE). The average age of students was 20.54 ± 1.49 years. The male students' average score obtained from the SAAS measure was 32.64 ± 13.07, while that of the COPE Inventory was 138.11 ± 14.47. Significant correlations were detected between students' SAAS scores and COPE scale scores. There were negative relationships between social anxiety scores and COPE subscales of positive reinterpretation and growth ( p < .05), use of instrumental social support ( p < .05), active coping ( p ≤ .01), and planning ( p ≤ .01). In contrast, there were positive relationships between social anxiety scores and COPE subscales of mental disengagement ( p ≤ .01), denial ( p ≤ .01), behavioral disengagement ( p ≤ .01), restraint ( p ≤ .01), use of emotional social support ( p < .05), substance use ( p ≤ .01), and acceptance ( p < .05). The conclusion was that male students who do not perceive themselves as having an ideal body image face high social appearance anxiety. There is a prejudice that social appearance anxiety has negative effects on these students' self-confidence. In this context, this research revealed concrete results about how male nursing students have battled the prejudices that they have faced throughout their student life.
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Affiliation(s)
- Nuray Turan
- 1 Istanbul University Cerrahpasa, Florence Nightingale Nursing Faculty, Şişli, Istanbul, Turkey
| | | | - Hatice Kaya
- 1 Istanbul University Cerrahpasa, Florence Nightingale Nursing Faculty, Şişli, Istanbul, Turkey
| | - Gayenur Aksel
- 1 Istanbul University Cerrahpasa, Florence Nightingale Nursing Faculty, Şişli, Istanbul, Turkey
| | - Arzu Yılmaz
- 1 Istanbul University Cerrahpasa, Florence Nightingale Nursing Faculty, Şişli, Istanbul, Turkey
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9
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Kirkpatrick R, Booij L, Vance A, Marshall B, Kanellos-Sutton M, Marchand P, Khalid-Khan S. Eating disorders and substance use in adolescents: How substance users differ from nonsubstance users in an outpatient eating disorders treatment clinic. Int J Eat Disord 2019; 52:175-182. [PMID: 30638270 DOI: 10.1002/eat.23017] [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: 07/16/2018] [Revised: 12/16/2018] [Accepted: 12/20/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The relationship between eating disorders (EDs) and substance use (SU) has only been briefly described in literature using mainly adult populations. This study examined the prevalence and characteristics of SU among patients of an adolescent ED outpatient treatment program. METHOD A retrospective chart analysis was conducted to determine and subsequently compare medical status, psychosocial factors, treatment course and outcome between patients with and without SU. RESULTS Over 60% of patients with SU status (n = 203) reported regularly consuming substances. 33.4% of substance users received a diagnosis involving purging behaviors compared to 5.9% of nonusers. Females composed 96.4% and 81.7% of users and nonusers, respectively. Users reported significantly more self-harm (57.7% of users vs. 38.6% of nonusers) but did not differ significantly in terms of trauma (abuse or victimization; 48.3% of users vs. 44.9% of nonusers). The percentage of ideal body weight significantly improved throughout treatment and did not differ by SU with a mean increase of 5.29% (SD = 13.6) among nonusers compared to 5.45% (SD = 7.5) of users. While users and nonusers did not differ before and after treatment in ED severity, users were more likely than nonusers to drop-out of treatment (41.5% of users vs. 25.2% of nonusers). DISCUSSION Adolescents with SU benefit from ED outpatient treatment as much as those without SU, however, users are more likely to drop-out. Therefore, treatment should target these adolescents' emotional dysregulation to improve treatment compliance. Further research is necessary to determine the efficacy of such an approach.
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Affiliation(s)
- Ryan Kirkpatrick
- Division of Child and Youth Psychiatry, Kingston Health Sciences Centre, Hotel Dieu Hospital Site, Kingston, Ontario, Canada.,Department of Psychiatry, Queen's University, Kingston, Ontario, Canada.,Centre for Neuroscience Studies, Queen's University, Botterell Hall, Kingston, Ontario, Canada
| | - Linda Booij
- Department of Psychology, Queen's University, Kingston, Ontario, Canada.,Department of Psychology, Concordia University, Montréal, Québec, Canada.,Sainte-Justine Hospital Research Centre, University of Montréal, Montréal, Québec, Canada
| | - Ashleigh Vance
- Division of Child and Youth Psychiatry, Kingston Health Sciences Centre, Hotel Dieu Hospital Site, Kingston, Ontario, Canada
| | - Brittany Marshall
- Division of Child and Youth Psychiatry, Kingston Health Sciences Centre, Hotel Dieu Hospital Site, Kingston, Ontario, Canada
| | - Marina Kanellos-Sutton
- Division of Child and Youth Psychiatry, Kingston Health Sciences Centre, Hotel Dieu Hospital Site, Kingston, Ontario, Canada.,Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Patricia Marchand
- Division of Child and Youth Psychiatry, Kingston Health Sciences Centre, Hotel Dieu Hospital Site, Kingston, Ontario, Canada.,Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Sarosh Khalid-Khan
- Division of Child and Youth Psychiatry, Kingston Health Sciences Centre, Hotel Dieu Hospital Site, Kingston, Ontario, Canada.,Department of Psychiatry, Queen's University, Kingston, Ontario, Canada.,Centre for Neuroscience Studies, Queen's University, Botterell Hall, Kingston, Ontario, Canada.,Department of Psychology, Queen's University, Kingston, Ontario, Canada
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10
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Prevalence of obesity for opioid- and stimulant-dependent participants in substance use treatment clinical trials. Drug Alcohol Depend 2018; 190:255-262. [PMID: 30077926 DOI: 10.1016/j.drugalcdep.2018.06.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 06/08/2018] [Accepted: 06/13/2018] [Indexed: 12/14/2022]
Abstract
AIMS To estimate obesity prevalence among drug-dependent individuals and to compare prevalence across different types of drug dependence. METHODS 1596 opioid- and/or stimulant-dependent participants were extracted from six clinical trials within the National Drug Abuse Treatment Clinical Trials Network of the National Institute on Drug Abuse (NIDA CTN) to estimate obesity prevalence among drug-dependent users. Age-, sex-, and race-matched National Health and Nutrition Examination Survey (NHANES) samples were used as a general population reference. Standardized prevalence ratios (SPRs) were calculated to compare the CTN sample to NHANES as well as to compare within the CTN sample. Logistic regression estimated associations between the type of drug dependence and obesity. RESULTS The standardized obesity prevalence among the drug-dependent CTN trial participants was 67% of expected for age-, sex- and race-matched NIHANES participants (SPR = 0.67, 95% CI: 0.60-0.74). Obesity was least prevalent among opioid-dependent-only participants (SPR = 0.36, 95% CI: 0.27-0.46 compared to the NHANES, and SPR = 0.33, 95% CI: 0.23-0.46 compared to the stimulant-dependent-only participants). Compared to stimulant-dependent-only users (p < 0.0001), the odds of obesity were 67% lower among opioid-dependent-only users (adjusted odds ratio [AOR] = 0.33, 95% CI: 0.23-0.46) and 33% lower among opioid and stimulant-co-dependent users (AOR = 0.67, 95%CI: 0.49-0.90) after controlling for age, sex, race, education and employment pattern. CONCLUSIONS The prevalence of obesity among drug-dependent clinical trial participants was lower than the general population, and lowest among opioid-dependent-only users, suggesting an inverse relationship between obesity prevalence and drug dependence, most notable among opioid-dependent-only users.
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11
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Phillips G, Turner B, Salamanca P, Birkett M, Hatzenbuehler ML, Newcomb ME, Marro R, Mustanski B. Victimization as a mediator of alcohol use disparities between sexual minority subgroups and sexual majority youth using the 2015 National Youth Risk Behavior Survey. Drug Alcohol Depend 2017; 178:355-362. [PMID: 28692946 PMCID: PMC5555415 DOI: 10.1016/j.drugalcdep.2017.05.040] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/18/2017] [Accepted: 05/18/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Alcohol use among underage youth is a significant public health concern. According to the National Institute on Alcohol Abuse and Alcoholism, alcohol is the "drug of choice" among adolescents, meaning more youth use and abuse alcohol than any other substance. Prevalence of alcohol use is disproportionately higher among sexual minority youth (SMY) than among their heterosexual peers. We examined sexual identity and sexual behavior disparities in alcohol use, and the mediational role of bullying in a sample of high school students. METHODS Data from the 2015 National Youth Risk Behavior Survey were used to assess the association between sexual minority status (identity and behavior) and alcohol use with weighted logistic regression. Due to well-documented differences between males and females, we stratified models by gender. Physical and cyberbullying were examined as mediators of the relationship between sexual minority status and alcohol use. RESULTS We detected associations between certain subgroups of sexual minority youth and alcohol use across all four drinking variables (ever drank alcohol, age at first drink, current alcohol use, and binge drinking). Most of these associations were found among bisexual-identified youth and students with both male and female sexual partners; these individuals had up to twice the odds of engaging in alcohol use behaviors when compared with sexual majority students. Associations were strongest among females. Bullying mediated sexual minority status and alcohol use only among bisexual females. CONCLUSIONS As disparities in alcohol use differ by gender, sexual identity, and sexual behavior, interventions should be targeted accordingly.
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Affiliation(s)
- Gregory Phillips
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave., 14th Floor, Chicago, IL, 60611, USA.
| | - Blair Turner
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave., 14th Floor, Chicago, IL, 60611, USA
| | - Paul Salamanca
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave., 14th Floor, Chicago, IL, 60611, USA
| | - Michelle Birkett
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave., 14th Floor, Chicago, IL, 60611, USA
| | - Mark L Hatzenbuehler
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th St., New York City, NY 10032, USA
| | - Michael E Newcomb
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave., 14th Floor, Chicago, IL, 60611, USA
| | - Rachel Marro
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave., 14th Floor, Chicago, IL, 60611, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave., 14th Floor, Chicago, IL, 60611, USA
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The Impact of a 24 Month Housing First Intervention on Participants' Body Mass Index and Waist Circumference: Results from the At Home / Chez Soi Toronto Site Randomized Controlled Trial. PLoS One 2015; 10:e0137069. [PMID: 26418677 PMCID: PMC4587845 DOI: 10.1371/journal.pone.0137069] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 07/30/2015] [Indexed: 11/19/2022] Open
Abstract
UNLABELLED Research suggests that individuals experiencing homelessness have high rates of overweight and obesity. Unhealthy weights and homelessness are both associated with increased risk of poor health and mortality. Using longitudinal data from 575 participants at the Toronto site of the At Home/Chez Soi randomized controlled trial, we investigate the impact of receiving a Housing First intervention on the Body Mass Index (BMI) and waist circumference of participants with moderate and high needs for mental health support services. The ANCOVA results indicate that the intervention resulted in no significant change in BMI or waist circumference from baseline to 24 months. The findings suggest a need for a better understanding of factors contributing to overweight, obesity, and high waist circumference in populations who have histories of housing precarity and experience low-income in tandem with other concerns such as mental illness and addictions. TRIAL REGISTRATION International Standard Randomized Control Trial Number Register ISRCTN42520374.
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Blackstone SR, Herrmann LK. Relationships Between Illicit Drug Use and Body Mass Index Among Adolescents. HEALTH EDUCATION & BEHAVIOR 2015; 43:21-4. [DOI: 10.1177/1090198115579414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Prior research has established associations between body mass index (BMI) and use of alcohol, tobacco, and marijuana. However, little research has been done investigating the relationship between other common illicit drugs and BMI trends. The present study investigated whether adolescents who reported using illicit drugs showed differences in BMI compared to peers who reported no drug use. There was a positive relationship between drug use and BMI as well as the number of drugs used and BMI. The results suggested that the positive relationship between the use of illicit drugs and BMI is largely due to smoking. Further research needs to ascertain whether smoking, illicit drug use, or both are among the first of many unhealthy behaviors that can subsequently lead to greater gains in BMI. Implications for health educators are discussed.
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N'Goran AA, Studer J, Deline S, Henchoz Y, Baggio S, Mohler-Kuo M, Daeppen JB, Gmel G. Bidirectional relationship between the body mass index and substance use in young men. Subst Abus 2015; 37:190-6. [DOI: 10.1080/08897077.2015.1013204] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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15
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Mogul A, Irby MB, Skelton JA. A systematic review of pediatric obesity and family communication through the lens of addiction literature. Child Obes 2014; 10:197-206. [PMID: 24809221 PMCID: PMC4038995 DOI: 10.1089/chi.2013.0157] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Both treatment of addiction and treatment of pediatric obesity often integrate the family unit. Thus, addiction therapies may provide a model to guide treatment of pediatric obesity, particularly issues of family communication, weight, and weight-related behaviors. The aim of this systematic review is to assess what knowledge in the field of addiction treatment can be translated to pediatric weight management, particularly in relation to family-based approaches and communication. METHODS A systematic review of family communication and food addiction in obese children was conducted using MEDLINE and other databases, including all English-language studies published after 1990 meeting search criteria and related to family factors or family communication, and addiction treatment strategies used in obesity interventions. RESULTS Three reviews, two survey studies, and two observational studies were included. Most focused on family communication; less-healthy communication patterns and parental restriction were related to maladaptive eating behaviors in children and attrition from weight management programs. A few studies suggested family communication interventions to improve unhealthy eating patterns in children, using therapies common in family treatment of addiction (e.g., motivational interviewing and cognitive behavioral therapy). No studies presented concrete suggestions to aid family communication around issues of food and weight management. Potential contributions of addiction therapies are discussed. CONCLUSIONS Though the addictive properties of food have not been fully delineated and obesity is not classified as a disease of addiction, the field of addiction offers many approaches that may prove useful in the treatment of obesity.
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Affiliation(s)
- Ashley Mogul
- Wake Forest School of Medicine, Winston-Salem, NC
| | - Megan B. Irby
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC.,Brenner FIT (Families In Training) Program, Brenner Children's Hospital, Winston-Salem, NC
| | - Joseph A. Skelton
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC.,Brenner FIT (Families In Training) Program, Brenner Children's Hospital, Winston-Salem, NC.,Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
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Gregorowski C, Seedat S, Jordaan GP. A clinical approach to the assessment and management of co-morbid eating disorders and substance use disorders. BMC Psychiatry 2013; 13:289. [PMID: 24200300 PMCID: PMC4226257 DOI: 10.1186/1471-244x-13-289] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 07/31/2013] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Research has shown that eating disorder (ED) patients who abuse substances demonstrate worse ED symptomatology and poorer outcomes than those with EDs alone, including increased general medical complications and psychopathology, longer recovery times, poorer functional outcomes and higher relapse rates. This article provides a broad overview of the prevalence, aetiology, assessment and management of co-morbid EDs and substance use disorders (SUDs). REVIEW The co-occurrence of EDs and SUDs is high. The functional relationship between EDs and SUDs vary within and across ED subtypes, depends on the class of substance, and needs to be carefully assessed for each patient. Substances such as caffeine, tobacco, insulin, thyroid medications, stimulants or over the counter medications (laxatives, diuretics) may be used to aid weight loss and/or provide energy, and alcohol or psychoactive substances could be used for emotional regulation or as part of a pattern of impulsive behaviour. A key message conveyed in the current literature is the importance of screening and assessment for co-morbid SUDs and EDs in patients presenting with either disorder. There is a paucity of treatment studies on the management of co-occurring EDs and SUDs. Overall, the literature indicates that the ED and SUD should be addressed simultaneously using a multi-disciplinary approach. The need for medical stabilization, hospitalization or inpatient treatment needs to be assessed based on general medical and psychiatric considerations. Common features across therapeutic interventions include psycho-education about the aetiological commonalities, risks and sequelae of concurrent ED behaviours and substance abuse, dietary education and planning, cognitive challenging of eating disordered attitudes and beliefs, building of skills and coping mechanisms, addressing obstacles to improvement and the prevention of relapse. Emphasis should be placed on building a collaborative therapeutic relationship and avoiding power struggles. Cognitive behavioural therapy has been frequently used in the treatment of co-morbid EDs and SUDs, however there are no randomized controlled trials. More recently evidence has been found for the efficacy of dialectical behavioural therapy in reducing both ED and substance use behaviours. CONCLUSION Future research would benefit from a meta-analysis of the current research in order to better understand the relationships between these two commonly co-occurring disorders.
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Affiliation(s)
- Claire Gregorowski
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Gerhard P Jordaan
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
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Relationship between obesity and depression: characteristics and treatment outcomes with antidepressant medication. Psychosom Med 2013; 75:863-72. [PMID: 24163386 PMCID: PMC3905462 DOI: 10.1097/psy.0000000000000000] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Obesity and major depressive disorder often co-occur. However, differences between obese and normal-weight depressed patients and the moderating effect of obesity on antidepressant treatment outcome are not well studied. METHODS Adults (n = 662) with major depressive disorder in the Combining Medications to Enhance Depression Outcomes study were randomized to treatment with escitalopram plus placebo, bupropion plus escitalopram, or venlafaxine plus mirtazapine for a 12-week primary treatment phase and 16-week follow-up. Body mass index (BMI) was calculated at baseline and categorized according to World Health Organization criteria: normal or low weight (NW), overweight, Obese I and Obese II+. A repeated-effects model, unadjusted and adjusted for baseline variables, assessed outcomes. RESULTS Obesity was common (46.2%), only 25.5% were NW. Higher BMI was associated with greater medical illness (p < .001), social phobia (p = .003), and bulimia (p = .026). Lower BMI was associated with more frequent post-traumatic stress disorder (p = .002) and drug abuse (p < .001). Treatment outcomes did not differ including Week 12 remission rates (NW 36%, overweight 40%, Obese I 43%, Obese II+ 37%; p = .69). Lower BMI was associated with more frequent (p = .024 [unadjusted] and .053 [adjusted]) and more severe (p = .008 [unadjusted] and .053 [adjusted]) adverse effects. CONCLUSIONS BMI was related to clinical presentation and prevalence of comorbidities, but not antidepressant outcomes. Lower BMI classes had more psychiatric comorbidities, potentially obscuring the relationship between BMI and antidepressant effects. Trial Registration ClinicalTrials.gov identifier: NCT00590863.
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