J Haabrekke, Kristin; Siqveland, Torill; Smith, Lars; Wentzel-Larsen, Tore; Walhovd, Kristine B; Moe, Vibeke
This prospective, longitudinal study with data collected at four time points investigated how maternal psychiatric symptoms, substance abuse and maternal intrusiveness in interaction were related to early child language skills. Three groups of mothers were recruited during pregnancy: One from residential treatment institutions for substance abuse (n = 18), one from psychiatric outpatient treatment (n = 22) and one from well-baby clinics (n = 30). Maternal substance abuse and anti-social and borderline personality traits were assessed during pregnancy, postpartum depression at 3 months, maternal intrusiveness in interaction at 12 months, and child language skills at 2 years. Results showed that the mothers in the substance abuse group had the lowest level of education, they were younger and they were more likely to be single mothers than the mothers in the two other groups. There was a significant difference in expressive language between children born to mothers with substance abuse problems and those born to comparison mothers, however not when controlling for maternal age, education and single parenthood. No group differences in receptive language skills were detected. Results further showed that maternal intrusiveness observed in mother-child interaction at 12 months was significantly related to child expressive language at 2 years, also when controlling for socio-demographic risk factors. This suggests that in addition to addressing substance abuse and psychiatric problems, there is a need for applying treatment models promoting sensitive caregiving, in order to enhance child expressive language skills.
Majer, John M; Rodriguez, Jaclyn; Bloomer, Craig; Jason, Leonard A
Lifetime histories of sexual and physical abuse have been associated with increased HIV-risk sexual behavior, and some studies have identified other variables associated with these relationships. However, there is a dearth of literature that has critically examined abuse histories and HIV-risk sexual behavior in relation to these other variables. Predictors of HIV-risk sexual behavior were analyzed among a sample of ex-offenders who were completing inpatient substance dependence treatment to identify factors related to increases in HIV-risk sexual behavior beyond that of abuse histories. Hierarchical linear regression was conducted to examine sociodemographic characteristics, recent substance use, and current psychiatric problem severity in addition to lifetime histories of sexual/physical abuse in a cross-sectional design. Gender, substance use, and psychiatric problem severity predicted increases in HIV-risk sexual behavior beyond what was predicted by abuse histories. Proportionately more women than men reported abuse histories. In addition, significantly more unprotected sexual than safer sexual practices were observed, but differences in these practices based on lifetime abuse histories and gender were not significant. Findings suggest recent substance use and current psychiatric problem severity are greater risk factors for HIV-risk sexual behavior than lifetime abuse histories among persons who have substance use disorders.
Riggs, Paula D.
Recent research has identified a cluster of standardized approaches that effectively treat adolescents with substance abuse disorders. Many of these approaches share elements that may be adopted to improve outcomes in substance treatment programs. In adolescents, treatment goals should be informed by a comprehensive assessment that includes the adolescent patient?s developmental history and evaluation of psychiatric comorbidity. Treatment for behavioral, psychosocial, and psychiatric problems...
Stewart, D; Bowers, L
Nursing staff on psychiatric wards often attribute patient violence and aggression to substance use. This study examined incidents of alcohol and illicit drug use among acute psychiatric inpatients and associations between substance use and violence or other forms of aggression. A sample of 522 adult psychiatric inpatients was recruited from 84 acute psychiatric wards in England. Data were collected from nursing and medical records for the first 2 weeks of admission. Only a small proportion of the sample was reported to have used or been under the influence of alcohol (5%) or drugs (3%). There was no physical violence during a shift when a patient had used alcohol or drugs. Substance using patients were also no more likely than others to behave violently at any point during the study period. However, incidents of substance use were sometimes followed by verbal aggression. Beliefs that substance using patients are likely to be violent were not supported by this study, and could impact negatively on therapeutic relationships between nurses and this patient group. Future studies are needed to examine how staff intervene and interact with intoxicated patients. © 2014 John Wiley & Sons Ltd.
Caitlin E Carey
Full Text Available Despite evidence of substantial comorbidity between psychiatric disorders and substance involvement, the extent to which common genetic factors contribute to their co-occurrence remains understudied. In the current study, we tested for associations between polygenic risk for psychiatric disorders and substance involvement (i.e., ranging from ever-use to severe dependence among 2573 non-Hispanic European-American participants from the Study of Addiction: Genetics and Environment. Polygenic risk scores (PRS for cross-disorder psychopathology (CROSS were generated based on the Psychiatric Genomics Consortium’s Cross-Disorder meta-analysis and then tested for associations with a factor representing general liability to alcohol, cannabis, cocaine, nicotine, and opioid involvement (GENSUB. Follow-up analyses evaluated specific associations between each of the 5 psychiatric disorders which comprised CROSS—attention deficit hyperactivity disorder (ADHD, autism spectrum disorder (AUT, bipolar disorder (BIP, major depressive disorder (MDD, and schizophrenia (SCZ—and involvement with each component substance included in GENSUB. CROSS PRS explained 1.10% of variance in GENSUB in our sample (p<0.001. After correction for multiple testing in our follow-up analyses of polygenic risk for each individual disorder predicting involvement with each component substance, associations remained between: A MDD PRS and non-problem cannabis use, B MDD PRS and severe cocaine dependence, C SCZ PRS and non-problem cannabis use and severe cannabis dependence, and D SCZ PRS and severe cocaine dependence. These results suggest that shared covariance from common genetic variation contributes to psychiatric and substance involvement comorbidity.
Siqveland, Torill S; Olafsen, Kåre S; Moe, Vibeke
The present prospective longitudinal study aimed to investigate the long-term impact of maternal optimality assessed during pregnancy on parenting stress at infant age 12 months. In this study the concept of optimality was utilized to investigate maternal variations regarding resources during pregnancy in relation to later parenting stress, among three different groups of mothers that were recruited from substance abuse treatment, psychiatric outpatient treatment and well-baby clinics respectively. The influence of infant temperament on parenting stress was also examined. All mothers were interviewed during pregnancy. At 12 months, infant temperament (Colorado Childhood Temperament Inventory; Rowe & Plomin, 1977) and stress in the parent and child domain (Parenting Stress Index; Abidin, 1955) were assessed. Results demonstrated higher levels of parenting stress among mothers in the clinical groups, compared to the non-clinical group. Furthermore, it was the maternal psychiatric optimality index in combination with child temperament characteristics (child emotionality) that contributed uniquely to stress in the parent domain, while stress in the child domain was significantly associated only with child temperament characteristics (both child emotionality and soothability). The association between maternal psychiatric optimality assessed in pregnancy, infant temperament and parenting stress when the infants were 12 months old, points to the importance of simultaneously addressing the mothers' own psychological distress, and to support positive mother-infant interactions. Each woman's individual optimality profile may be used to display needs of follow-up in order to prevent enduring effects of non-optimality on parenting stress. © 2013 The Scandinavian Psychological Associations.
Majer, John M; Komer, Anne C; Jason, Leonard A
The relationship between mental illness and human-immunodeficiency virus (HIV)-risk sexual behavior among persons with substance use disorders is not well-established because of differences in assessing psychiatric factors (types, symptoms, severity), substance use (diagnosis, survey responses, past substance use), and HIV-risk sexual behaviors (individual measures, combination of sex/drug use risk behaviors) across studies. This study utilized a more global and dimensional aspect of psychiatric issues (problem severity) to examine the relationship with HIV-risk sexual behaviors and substance use among persons with substance use disorders. Participants included 224 men and 46 women, with a mean age of 40.4 years (SD = 9.5). The most common substances were heroin/opiates, with 41.4% reporting use of these substances (n = 110), while 27.8% reported using cocaine (n = 74) and 12.8% reported using alcohol (n = 34). Of all participants, 39 (14.4%) were identified as having high psychiatric severity (defined using the psychiatric severity score from the Addiction Severity Index), which was used as an indication of probable comorbid psychiatric and substance use disorders. Among these participants likely to have comorbid disorders, hierarchical linear regression was conducted to examine HIV-risk sexual behaviors (number of partners and unprotected sexual behaviors in the past 30 days) in relation to psychiatric severity, substance use, and gender. Gender (women) and psychiatric severity (higher) were significantly related to greater HIV-risk sexual behaviors. After entering gender and substance use into the regression model, psychiatric severity accounted for another 21.9% of the variance in number of partners and 14.1% of the variance in unprotected sexual behaviors. Overall, the models accounted for 55.5% and 15.6% of the variance, respectively. A significant interaction was found for number of partners (but not frequency of unprotected behavior), such that those higher
Background: Personality and other psychological variables have been suggested to be closely related to drug abuse. An understanding of such relationship could be beneficial in the management of patients with substance abuse. Aim: The study investigated psychological correlates of substance abuse psychiatric patients.
Sørensen, Tina; Jespersen, Hans Søe Riis; Vinberg, Maj
equivalents. Compared to the general population, the psychiatric patients had higher odds of being current smokers and having used illicit drugs within the past month. Women with psychiatric disorders were twice as likely to binge drink on a monthly basis. No significant difference was found in the patients......, 412 psychiatric patients participated in the study, and 33% had an AUDIT-score ≥8, indicating problematic alcohol use according to the AUDIT guidelines. The mean weekly alcohol intake was 9.7 ± 28.3 standard drinks, and 47% were current smokers with a mean daily use of 19.9 ± 13.8 cigarette...
A lifetime prevalence rate of 48.4% use of substances was found. The prevalence rate of current use of alcohol was 36.3%; cannabis 28.3%; cigarette 14.5%; Cocaine 0.8%; snuff/fumes 2.4%; Pain killers and kola nuts 1.6%. About 51.7% of the subjects used two or more substances. Substance use preceded first psychiatric ...
Full Text Available Aim: The aim of this study was to evaluate the prevalence of alcohol and substance use disorders in psychiatric inpatient clinics and determine the frequencies of alcohol and substance use disorder among psychiatric disease groups and find out the differences in between these groups. Material and Methods: Thus all patients admitted to inpatients psychiatric clinics of in one year period were approached for inclusion into this study, and 155 patients with a hospitalization period longer than one day who provided informed consent were included in the study. All patients included in the study were interviewed with a semi structured interview scale to get information regarding the presence of alcohol, nicotine and other substance use disorder. Results: The results of this study confirmed high rates of alcohol, nicotine and substance use disorder comorbidity in psychiatric inpatients. The results of one year prospective follow up study revealed that 57.4% of patients had nicotine dependence, 21.9% alcohol dependence and misuse and 9% had sedative misuse or dependence. The rate of substance use disorder was high among all psychiatric disorder subgroups. Considering all substances including nicotine together, 55% of patients with psychotic disorder had at least one substance use disorder whereas these figures were 61% and 81% for affective disorders and anxiety disorders respectively. Conclusion: Professionals dealing with treatment of psychiatric disorders should always be aware of substance use disorder comorbidity, and start treatment immediately without causing any delay in treatment. Obviously we need future large prospective studies to get more insight into these dual-diagnose disorders. [Cukurova Med J 2012; 37(1.000: 37-48
Full Text Available Introduction & Objective: Substance abuse is believed to be one of the greatest social, economical ,and cultural problems all over the world and it is commonly observed among all social classes especially among mental disorder patients. Substance abuse can influence on the receptive-mental states such as mood and on the external visible activities such as behaviors. The aim of this study is to survey the frequency of Substance abuse in hospitalized mental-psychic patients in psychiatric ward of Farshchian hospital in Hamadan. Materials & Methods: In this descriptive and retrospective study, available sampling method was used along with examining filed records in which the records of 400 hospitalized patients (293 men and 107 women from September 2000 to 2001 were checked and required data such as demographic information, infliction duration, substance abuse duration, psychiatric diagnosis were extracted and registered. The data were analyzed with descriptive statistical methods.Results: About half of the hospitalized patients in the psychiatric ward had simultaneous substance abuse. Men had substance abuse more than women and the youths aged 20-39 more than the other groups. The study showed that widowing had positive relationship and higher education negative relationship with substance abuse.Conclusion: Mood disorders with 90.53%, schizophrenia with 8.29%, and other diagnostics with 1.18% were observed in persons with substance abuse and these diagnostics in non substance abuse persons were 79.22% ,11.26% and 9.52% respectively.
Conclusion: Professionals dealing with treatment of psychiatric disorders should always be aware of substance use disorder comorbidity, and start treatment immediately without causing any delay in treatment. Obviously we need future large prospective studies to get more insight into these dual-diagnose disorders. [Cukurova Med J 2012; 37(1: 37-48
Modestin, J; Nussbaumer, C; Angst, K; Scheidegger, P; Hell, D
A series of 417 consecutively admitted psychiatric inpatients were studied with regard to their use of potentially abusive psychotropic substances in the last 3 months preceding admission. In all patients face-to-face interviews were performed; in 354 of them urine specimens could also be tested. Alcohol and benzodiazepines belonged to the most frequently used substances followed by cannabis, opiates and cocaine. Barbiturates, hallucinogens and amphetamine derivatives were only exceptionally reported. The most important finding of the study is that every fifth patient regularly used "hard" drugs (opiates and/or cocaine), every fourth patient illegal drugs and every third patient alcohol. Substances were found in 54% of all urine specimens; methadone, opiates and cocaine were hardly found alone. For the latter substances excellent agreement was found between interview reports and urine exams. Excluding patients diagnosed as substance-use disorders, there were no statistically significant differences between schizophrenic, affective, neurotic/stress/somatoform and other disorders with regard to the use of "hard" drugs and illegal drugs. Regular substance use correlated with much worse psychosocial adjustment. Substance use has to be explored and considered in every individual psychiatric inpatient.
Fuller, Bret E; Loftis, Jennifer M; Rodriguez, Veronica L; McQuesten, Matthew J; Hauser, Peter
A growing number of veterans in the Veterans Health Administration are coinfected with HIV and hepatitis C virus. This review covers timely research relative to comorbid conditions that are common in this population including psychiatric diagnoses, substance use disorders and neurocognitive problems. Current literature on the psychiatric, substance use disorders and cognitive problems of the coinfected population show that not only are rates of morbidity higher in the coinfected population but that this affects antiviral treatments as well. There is new evidence that brain injuries and infiltration of the virus into the central nervous system may be responsible for cognitive dysfunction. Cotesting, particularly in hepatitis C infected individuals, is not done routinely despite shared risk factors. With this understanding of the comorbidities of the coinfected population, integrated healthcare models involving mental health, internal medicine, substance abuse treatment and internal medicine are crucial to work with these medically and psychologically complex patients.
Ernika G. Quimby
Full Text Available Youth homelessness is a growing problem in the United States. The experience of homelessness appears to have numerous adverse consequences, including psychiatric and substance use disorders. This study compared the frequencies of psychiatric disorders, including substance use, between homeless youth (18–24 years-old in San Francisco (N = 31 and Chicago (N = 56. Subjects were administered the Mini International Neuropsychiatric Interview (M.I.N.I. to assess DSM-IV-TR diagnoses and substance use disorders. Eighty-seven percent of the San Francisco youth, and 81% of the Chicago youth met criteria for at least one M.I.N.I. psychiatric diagnosis. Nearly two-thirds of the youth in both samples met criteria for a mood disorder. Approximately one-third met criteria for an anxiety disorder. Thirty-two percent of the San Francisco sample and 18% of the Chicago met criteria for Antisocial Personality Disorder. Approximately 84% of the San Francisco youth and 48% of the Chicago youth met criteria for a substance-related disorder, and more substances were used by San Francisco youth. In conclusion, the high rate of psychiatric disorders in homeless youth provides clear evidence that the mental health needs of this population are significant. Implications are discussed.
Full Text Available Substance misuse is frequently encountered in the psychiatric emergency service (PES and may take many forms, ranging from formal DSM-IV diagnoses to less obvious entities such as hazardous consumption. Detecting such patients using traditional screening instruments has proved problematic. We therefore undertook this study to more fully characterize substance misuse in the PES and to determine whether certain variables might help better screen these patients. We used a prospectively acquired database of over 18,000 visits made to four PESs during a 2-year period in the province of Quebec, Canada. One of the variables acquired was a subjective rating by the nursing staff as to whether substance misuse was a contributing factor to the visit (graded as direct, indirect, or not at all. Substance misuse accounted for 21% of all diagnoses and alcohol was the most frequent substance used. Patients were divided into those with primary (PSM, comorbid (CSM or no substance misuse (NSM. Depressive disorders were the most frequent primary diagnoses in CSM, whereas personality and substance misuse disorders were frequent secondary diagnoses in PSM. Although many variables significantly differentiated the three groups, few were sufficiently detailed to be used as potential screening tools. Those situations that did have sufficient details included those with a previous history of substance misuse, substance misuse within 48 hours of the visit, and visits graded by the nursing staff as being directly and/or indirectly related to substance misuse. Variables related to substance misuse itself were the primary predictors of PSM and, less significantly, CSM. The nursing staff rating, although promising, was obtained in less than 30% of all visits, rendering its practical use difficult to assess.
Shuler, Monique; Suzuki, Sumihiro; Podesta, Arwen; Qualls-Hampton, Raquel; Wallington, Sherrie Flynt
There is increasing literature supporting the adverse effects of disasters on substance use and psychiatric disorders. The co-occurrence of psychiatric disorders with substance use intensifies the challenge of treatment delivery. Thus the aim of this study was to examine the prevalence of substance use, treatment characteristics, and demographics of discharges from substance abuse treatment in New Orleans, post-Hurricane Katrina. Trends associated with discharges that have a co-occurring psychiatric and substance use disorder (COD) were also assessed. The secondary aim of this study was to examine the association of successful substance abuse treatment completion among those with a COD post-Hurricane Katrina. Substance abuse treatment discharge data (N = 16,507) from New Orleans, Louisiana, for years 2006 through 2011 were obtained from the Treatment Episode Data Set-Discharge. Multiple logistic regression analysis was employed to examine the association of discharges with a COD and completion of substance abuse treatment. Demographic, psychiatric, and treatment characteristics of discharges in 2006 were compared to characteristics in 2011. Trends of characteristics were also assessed through the study period. Roughly a third (35.2%) of all discharges in New Orleans from 2006 to 2011 had a COD. After controlling for race, employment, treatment service setting at discharge, primary substance problem, and the discharge's principal source of referral, discharges with a COD were 29% less likely to complete treatment as compared to those with no COD (AOR = 0.71, 95% CI [0.56, 0.90], p = .004). Treatment completion among discharges with a COD has significantly declined from 36.8% in 2006 to 18.7% in 2011 (p Substance abuse treatment undergoes various changes in the event of a natural disaster. These changes may increase challenges for successful treatment completion for vulnerable populations such as those with a COD. Results of this study demonstrate that discharges
Poudel, Anju; Gautam, Sital
Substance use is generally initiated in adolescence or early adulthood and is commonly associated with several physical, psychological, emotional and social problems. The objective of this study is to assess the age of onset of substance use differences on psychosocial problems among individuals with substance use disorders (SUDs) residing in drug rehabilitation centers. A descriptive cross sectional research design was carried out. Probability Proportional to Size (PPS) sampling technique was used to select the drug rehabilitation centers and all the respondents meeting the inclusion criteria of the selected seven rehabilitation centers were taken as a sample and comprised of 221 diagnosed individuals with SUDs. A semi structured self administered questionnaires were used to collect the information regarding demographic and substance use related characteristics. A standard tool Drug Use Screening Inventory-Revised (DUSI-R) was used to assess the psychosocial problems among individuals with SUDs. Data were analyzed using both descriptive and inferential statistics. Multivariate general linear model (MANOVA and MANCOVA) was used to evaluate differences in psychosocial problems between early vs late onset substance users. The age of onset of substance use was significantly associated with psychosocial problems. The mean psychosocial problem scores were higher in early onset substance user (17 years or younger) than late onset substance user (18 years or higher) in various domains of DUSI-R even after controlling confounding factors. The two groups (early vs late) differed significantly in relation to age, gender, occupational status, current types of substance use, frequency of use, mode of substance use and relapse history. The study indicated that early onset substance users are at higher risk for psychosocial problems in various areas of life such as Behavior Pattern, Psychiatric disorder, Family system, Peer relationship, Leisure/Recreation and Work adjustment
Williams, W; Weiss, T W; Edens, A; Johnson, M; Thornby, J I
The relationship between hospital utilization and psychometric, demographic, and diagnostic data was examined among veterans with psychiatric problems. Data were obtained from the records of 500 psychiatric inpatients admitted to a Veterans Affairs medical center between 1984 and 1987 and followed for four years. All patients completed the Minnesota Multiphasic Personality Inventory, the California Personality Inventory, the Millon Clinical Multiaxial Inventory, and the Psychological Inventory of Personality and Symptoms. Stepwise linear regression analysis was used to predict the number and length of inpatient stays, and Cox and logistic regression analyses predicted rehospitalization. Higher rates of psychiatric hospital utilization were found among patients who were unmarried, who had disabilities connected with their military service, who had lower levels of adaptive functioning, and who were diagnosed as having posttraumatic stress disorder, drug or alcohol use disorder, or passive-aggressive or antisocial personality disorder. Higher utilization was also found among those whom psychometric data characterized as less responsible and more compulsive. The data also predicted the length of subsequent medical hospitalization and identified patients who stayed out of the hospital longer and who were not rehospitalized. Hospital utilization was found to be a function of psychiatric diagnosis, marital status, and various personality factors. Factors relating to social disadvantage also played a role. Axis I diagnoses, particularly substance use disorders, were as important as, if not more important than, axis II diagnoses in predicting utilization.
Of the 169 drug users, 96.44% were brought by family members for treatment while others were brought by Nigerian Drug Law Enforcement Agency for rehabilitation (1.77%) and Court/Federal Road Safety Corps (.59%) for psychiatric rehabilitation. Thirty (17.8%) of the 169 patients with drug-related problems engaged in ...
Breslau, Joshua; Miller, Elizabeth; Joanie Chung, W-J; Schweitzer, Julie B
We examined the joint predictive effects of childhood and adolescent onset psychiatric and substance use disorders on failure to graduate high school (HS) on time. Structured diagnostic interviews were conducted with a US national sample of adults (18 and over). The analysis sample included respondents with at least 8 years of education who were born in the US or arrived in the US prior to age 13 (N = 29,662). Psychiatric disorders, substance use and substance use disorders were examined as predictors of termination or interruption of educational progress prior to HS graduation, with statistical adjustment for demographic characteristics and childhood adversities. Failure to graduate HS on time was more common among respondents with any of the psychiatric and substance use disorders examined, ranging from 18.1% (specific phobia) to 33.2% (ADHD-combined type), compared with respondents with no disorder (15.2%). After adjustment for co-occurring disorders, significant associations with failure to graduate on time remained only for conduct disorder (OR = 1.89, 95% CI 1.57-2.26) and the three ADHD subtypes (Inattentive OR = 1.78, 95% CI 1.44-2.20, Hyperactive-Impulsive OR = 1.38, 95% CI 1.14-1.67, and Combined OR = 2.06, 95% CI 1.66-2.56). Adjusting for prior disorders, tobacco use was associated with failure to graduate on time (OR = 1.97, 95% CI 1.80-2.16). Among substance users, substance use disorders were not associated with on-time graduation. The findings suggest that the adverse impact of childhood and adolescent onset psychiatric disorders on HS graduation is largely accounted for by problems of conduct and inattention. Adjusting for these disorders, smoking remains strongly associated with failure to graduate HS on time. Copyright © 2010 Elsevier Ltd. All rights reserved.
Toftdahl, Nanna Gilliam; Nordentoft, Merete; Hjorthøj, Carsten
PURPOSE: The present study established the national prevalence of substance use disorders (SUDs) among Danish psychiatric patients. Furthermore, patients with SUDs and those without SUDs were compared on a range of socio-demographic, clinical, and treatment characteristics. METHODS: Data were...... obtained from several Danish population-based registers. The study population was defined as all individuals with incidents of schizophrenia, schizotypal disorder, other psychoses, bipolar disorder, depression, anxiety, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD...... % for schizophrenia, 35 % for schizotypal disorder, 28 % for other psychoses, 32 % for bipolar disorder, 25 % for depression, 25 % for anxiety, 11 % for OCD, 17% for PTSD, and 46 % for personality disorders. Alcohol use disorder was the most dominating SUD in every psychiatric category (25 % of all included patients...
Frank, A; Green, V; McNeil, D W
Cognitive ability and cognitive egocentrism were examined as predictors of problem-solving ability in adolescent substance users in a vocational training program. Problem-solving outcome variables were significantly predicted by two cognitive ability measures, as well as by measures of cognitive independence and egocentrism in thinking. Extent of substance use did not affect cognitive ability, cognitive egocentrism, or problem-solving ability.
Albert John Sargent
Full Text Available Objective: Approximately 260,000 of youth in the United States are gang-affiliated. There is a paucity of data available to identify the prevalence of mental health disorders in this population. Gang members share many of the features of “at risk” or juvenile justice involved youth who deny gang membership. The authors identified rates of psychiatric disorders within a juvenile justice population delineated in three categories: gang members, friends of gang members, and non-gang members. Methods: A retrospective review of records obtained by a juvenile probation department. A large detention center conducted mental health screenings on 7,615 youth aged 13–17. The mental health screenings were performed by either a master level or doctoral level mental health professional. Odds ratios were computed as an effect size for gender, race/ethnic differences, and gang-membership associations with self-reported psychiatric and substance use disorders. Logistic regression was used to evaluate the risk for psychiatric and substance use disorders among gang-members and friends of gang members. Diagnostic information was generated through a clinical interview and flexible battery. Results: Of the 7,615 youth in this study, ~50% had contact with gangs; 11% were self-identified gang-members, and 38% acknowledged having at least one friendship with a gang member. Similar to other studies, being male was a risk-factor for gang-membership (2.31 odds. In this multi-racial and ethnic study, Latinos had a greater affiliation with gang membership and association with gang members as friends (1.44 odds. Gang members were found to have increased rates of post-traumatic stress disorder (1.77 odds, current substance abuse (2.58 odds, oppositional defiant disorder, (1.24 odds and conduct disorder (4.05 odds; however, they were less likely to have an adjustment disorder than non-gang members (0.70 odds. Conclusions: Juveniles who received a mental health assessment
Emck, Claudia; Bosscher, Ruud J.; van Wieringen, Piet C. W.; Doreleijers, Theo; Beek, Peter J.
Children with psychiatric disorders often demonstrate gross motor problems. This study investigates if the reverse also holds true by assessing psychiatric symptoms present in children with gross motor problems. Emotional, behavioral, and autism spectrum disorders (ASD), as well as psychosocial problems, were assessed in a sample of 40 children…
Substance abuse co-morbidity with psychiatric disorders is common and has been widely reported, except in Kenya. This study aimed to determine the prevalence, pattern and socio-economic burden of a dual diagnosis of substance abuse disorder and other psychiatric conditions. This was a cross-sectional descriptive ...
Adams, Zachary W.; McCart, Michael R.; Zajac, Kristyn; Danielson, Carla Kmett; Sawyer, Genelle K.; Saunders, Benjamin E.; Kilpatrick, Dean G.
This study examined the prevalence of and associations between specific psychiatric disorders, substance use problems, and trauma exposure in a sample of delinquent and nondelinquent adolescents. A nationally representative sample of adolescents ("n" = 3,614; "M" age = 14.5 years, "SD" = 1.7; 51% male; 71% White,…
Rojas, Julio I; Jeon-Slaughter, Haekyung; Brand, Michael; Koos, Erin
Three impaired health care provider groups (N = 84) (nurses, pharmacists, and providers with prescriptive authority) referred for a substance abuse evaluation at an outpatient-based program were compared on demographic and family factors, substance abuse patterns, and psychiatric symptomology as assessed by the Personality Assessment Inventory. Nurses had the highest rates of family history of addiction, problems with benzodiazepines, and psychiatric comorbidity. Overall, health care professionals endorsed opioids twice as often as alcohol as a preferred substance. Family history of addiction, sex, and psychiatric comorbidity emerged as salient factors among these health care professionals. Clinical implications are examined in light of the current findings.
Quinn, Patrick D; Chang, Zheng; Hur, Kwan; Gibbons, Robert D; Lahey, Benjamin B; Rickert, Martin E; Sjölander, Arvid; Lichtenstein, Paul; Larsson, Henrik; D'Onofrio, Brian M
Substance use disorders are major contributors to excess mortality among individuals with attention deficit hyperactivity disorder (ADHD), yet associations between pharmacological ADHD treatment and substance-related problems remain unclear. This study investigated concurrent and long-term associations between ADHD medication treatment and substance-related events. The authors analyzed 2005-2014 commercial health care claims from 2,993,887 (47.2% female) adolescent and adult ADHD patients. Within-individual analyses compared the risk of substance-related events (i.e., emergency department visits related to substance use disorders) during months in which patients received prescribed stimulant medication or atomoxetine relative to the risk during months in which they did not. In adjusted within-individual comparisons, relative to periods in which patients did not receive ADHD medication, male patients had 35% lower odds of concurrent substance-related events when receiving medication (odds ratio=0.65, 95% CI=0.64-0.67), and female patients had 31% lower odds of concurrent substance-related events (odds ratio=0.69, 95% CI=0.67-0.71). Moreover, male patients had 19% lower odds of substance-related events 2 years after medication periods (odds ratio=0.81, 95% CI=0.78-0.85), and female patients had 14% lower odds of substance-related events 2 years after medication periods (odds ratio=0.86, 95% CI= 0.82-0.91). Sensitivity analyses supported most findings but were less consistent for long-term associations among women. These results provide evidence that receiving ADHD medication is unlikely to be associated with greater risk of substance-related problems in adolescence or adulthood. Rather, medication was associated with lower concurrent risk of substance-related events and, at least among men, lower long-term risk of future substance-related events.
Baldur-Felskov, Birgitte; Kjaer, S K; Albieri, V
Do women who don't succeed in giving birth after an infertility evaluation have a higher risk of psychiatric disorders compared with women who do?......Do women who don't succeed in giving birth after an infertility evaluation have a higher risk of psychiatric disorders compared with women who do?...
Myrbakk, Even; von Tetzchner, Stephen
The relationship between behavior problems and psychiatric disorders in individuals with intellectual disability is still unresolved. The present study compares the prevalence and pattern of psychiatric disorders in individuals with intellectual disability who were assessed on the ABC to have moderate and severe behavior problems and a matched…
Kelly, Lourah M; Becker, Sara J; Wolff, Jennifer C; Graves, Hannah; Spirito, Anthony
Both adolescent and parent psychiatric symptoms are well-established risk factors for adolescent substance use (SU), but the ways that these symptoms interact are not well understood. This study examined the interactive effects of parent and adolescent psychiatric symptoms on adolescent frequency of alcohol and marijuana use, over and above the effects of parental SU. Seventy adolescents presenting to a community mental health center (CMHC) participated. Parent and adolescent psychiatric symptoms were measured with the brief symptom inventory (BSI) and child behavior checklist (CBCL), respectively. Hierarchical regressions revealed different patterns for adolescent alcohol and marijuana use. For alcohol, the BSI parent phobic anxiety subscale predicted increased adolescent use while the parent interpersonal sensitivity subscale predicted decreased use: the effects of these parental symptoms were strongest among adolescents with higher levels of externalizing problems on the CBCL. For marijuana, the BSI parent psychoticism subscale predicted increased adolescent use, whereas paranoid ideation predicted decreased use. Results suggest that adolescent SU treatment and assessment should attend to both adolescent and parent psychiatric symptoms.
Full Text Available Cancer is a physical disorder with concurrent mental and social components. During cancer, the feelings of fear, hopelessness, guilt, helplessness, abandonment perceived as a crisis leading to destruction in the suffering person. Breast cancer is the most common type of cancer among women. Prevalence of psychiatric disorders among cancer patients is approximately 50% and most of disorders are related with the occurrence of cancer and cancer treatment. Majority of patients present with major depression, adjustment disorder, anxiety disorders, sleep disorders, suicidial ideation, and delirium. Treatment of psychiatric disorders and cancer therapy should be conducted along with special consideration of drug interactions. This article reviews the adaptation process experienced by individuals during diagnosis and treatment of breast cancer, it psychological effects, resulting psychiatric comorbidites and their treatments. [Archives Medical Review Journal 2012; 21(3.000: 189-219
Yen, Ju‐Yu; Ko, Chih‐Hung; Yen, Cheng‐Fang; Chen, Sue‐Huei; Chung, Wei‐Lun; Chen, Cheng‐Chung
Aims: The aim of the present study was to compare psychiatric symptoms between adolescents with and without Internet addiction, as well as between analogs with and without substance use. Methods...
Oshri, Assaf; Tubman, Jonathan G; Jaccard, James
Latent profile analysis (LPA) was used to classify 394 adolescents undergoing substance use treatment, based on past year psychiatric symptoms. Relations between profile membership and (a) self-reported childhood maltreatment experiences and (b) current sexual risk behavior were examined. LPA generated three psychiatric symptom profiles: Low-, High- Alcohol-, and High- Internalizing Symptoms profiles. Analyses identified significant associations between profile membership and childhood sexual abuse and emotional neglect ratings, as well as co-occurring sex with substance use and unprotected intercourse. Profiles with elevated psychiatric symptom scores (e.g., internalizing problems, alcohol abuse and dependence symptoms) and more severe maltreatment histories reported higher scores for behavioral risk factors for HIV/STI exposure. Heterogeneity in psychiatric symptom patterns among youth receiving substance use treatment services, and prior histories of childhood maltreatment, have significant implications for the design and delivery of HIV/STI prevention programs to this population.
Hoblyn, Jennifer C; Balt, Steve L; Woodard, Stephanie A; Brooks, John O
This study developed risk profiles of psychiatric hospitalization for veterans diagnosed as having bipolar disorder. This study included 2,963 veterans diagnosed as having bipolar disorder (types I, II, or not otherwise specified) during the 2004 fiscal year. Data were derived from the Veterans Affairs administrative database. Risk profiles for psychiatric hospitalization were generated with an iterative application of the receiver operating characteristic. In this sample 20% of the patients with bipolar disorder were hospitalized psychiatrically during the one-year study period. Patients diagnosed as having both an alcohol use disorder and polysubstance dependence and who also were separated from their spouse or partner had a 100% risk of psychiatric hospitalization; risk of psychiatric hospitalization decreased to 52% if the patients were not separated from their partner. Patients who were not diagnosed as having alcohol use disorders or polysubstance dependence and who were not separated from their partners exhibited the lowest risk of psychiatric hospitalization (12%). Among patients with a psychiatric hospitalization, 41% had longer lengths of stay (<14 days), with the strongest predictor of a longer length of stay being an age older than 77 years, which conferred a 77% risk. Alcohol use and polysubstance dependence can significantly affect the course of bipolar disorder, as evidenced by their associations with psychiatric hospitalizations. Increased focus on substance abuse among older adults with bipolar disorder may decrease length of psychiatric hospitalization. Our findings suggest that implementing substance treatment programs early in the course of bipolar disorder could reduce health service use.
Full Text Available Abstract Background Psychiatric and substance use problems are commonly found to be contributing factors to frequent Emergency Department (ED use, yet little research has focused on the association between substance use and psychiatric comorbidity. This study assesses the association of a psychiatric comorbidity on (ED use among patients with substance use disorders (SUDs. Methods The study focuses on 6,865 patients who were diagnosed with SUDs in the ED of a large urban hospital in the southern United States from January 1994 – June 1998. Patients were grouped by type of substance use disorder. After examining frequency of visits by diagnosis, the sample was assigned to the following groups–alcohol dependence (ICD9 = 303, alcohol abuse (ICD9 = 305.0, cocaine dependence/abuse (ICD9 = 304.2, 305.6, and polysubstance/mixed use (ICD9 = 305.9. A patient was classified with psychiatric comorbidity if a psychiatric diagnosis appeared during any of the patient's visits. The following psychiatric diagnoses were included–schizophrenia/psychoses, bipolar disorder, depression, anxiety, and dementia (ICD-9 codes available upon request. Results Patients with SUDs and psychiatric comorbidity had significantly higher mean number of ER visits (mean = 5.2 SD = 8.7 than SUD patients without psychiatric comorbidity (mean = 2.5, SD = 3.7. In logistic regressions predicting several categorizations of heavier use of the ED (either 4+, 8+, 12+, 16+, or 20+ visits over the span of the study SUD patients with psychiatric comorbidity had adjusted odds ratios of 3.0 to 5.6 (reference group = patients with SUDs but no psychiatric comorbidity. This association was found across all substance use diagnostic categories studied, with the strongest relationship observed among patients with cocaine disorders or alcohol dependence. Conclusion The results provide further support for the notion that the ED could and should serve as an important identification site for cost
Full Text Available Objective. Comorbidities between psychiatric diseases and consumption of traditional substances of abuse (alcohol, cannabis, opioids, and cocaine are common. Nevertheless, there is no data regarding the use of novel psychoactive substances (NPS in the psychiatric population. The purpose of this multicentre survey is to investigate the consumption of a wide variety of psychoactive substances in a young psychiatric sample and in a paired sample of healthy subjects. Methods. A questionnaire has been administered, in different Italian cities, to 206 psychiatric patients aged 18 to 26 years and to a sample of 2615 healthy subjects matched for sex, gender, and living status. Results. Alcohol consumption was more frequent in the healthy young population compared to age-matched subjects suffering from mental illness (79.5% versus 70.7%; P<0.003. Conversely, cocaine and NPS use was significantly more common in the psychiatric population (cocaine 8.7% versus 4.6%; P=0.002 (NPS 9.8% versus 3%; P<0.001. Conclusions. The use of novel psychoactive substances in a young psychiatric population appears to be a frequent phenomenon, probably still underestimated. Therefore, careful and constant monitoring and accurate evaluations of possible clinical effects related to their use are necessary.
Dowling, N A; Merkouris, S S; Lorains, F K
Despite significant psychiatric comorbidity in problem gambling, there is little evidence on which to base treatment recommendations for subpopulations of problem gamblers with comorbid psychiatric disorders. This mini-review draws on two separate systematic searches to identify possible interventions for comorbid problem gambling and psychiatric disorders, highlight the gaps in the currently available evidence base, and stimulate further research in this area. In this mini-review, only 21 studies that have conducted post-hoc analyses to explore the influence of psychiatric disorders or problem gambling subtypes on gambling outcomes from different types of treatment were identified. The findings of these studies suggest that most gambling treatments are not contraindicated by psychiatric disorders. Moreover, only 6 randomized studies comparing the efficacy of interventions targeted towards specific comorbidity subgroups with a control/comparison group were identified. The results of these studies provide preliminary evidence for modified dialectical behavior therapy for comorbid substance use, the addition of naltrexone to cognitive-behavioral therapy (CBT) for comorbid alcohol use problems, and the addition of N-acetylcysteine to tobacco support programs and imaginal desensitisation/motivational interviewing for comorbid nicotine dependence. They also suggest that lithium for comorbid bipolar disorder, escitalopram for comorbid anxiety disorders, and the addition of CBT to standard drug treatment for comorbid schizophrenia may be effective. Future research evaluating interventions sequenced according to disorder severity or the functional relationship between the gambling behavior and comorbid symptomatology, identifying psychiatric disorders as moderators of the efficacy of problem gambling interventions, and evaluating interventions matched to client comorbidity could advance this immature field of study. Copyright © 2016 Elsevier Ltd. All rights reserved.
Benarous, Xavier; Edel, Yves; Consoli, Angèle; Brunelle, Julie; Etter, Jean-François; Cohen, David; Khazaal, Yasser
.... App-based technologies have shown promising results to help reduce substance use in adolescents, but their applicability in youths with associated severe psychiatric disorders is poorly documented...
Unadjusted odds ratios showed that there was a significant association between regular use of alcohol and cannabis and male gender, dropping out of school, previous psychiatric treatment, and an absence of both depression and suicidal ideation; and between regular cannabis use and bizarre behaviour, auditory ...
Owens, Elizabeth B; Hinshaw, Stephen P
Among two large, independent samples of girls with attention-deficit/hyperactivity disorder (ADHD), we examined associations between specific (maternal gestational smoking and drug use, early labor, low birth weight, and infant breathing problems at birth) and cumulative prenatal and perinatal risk factors and psychiatric comorbidity during childhood. Data from the (a) Multimodal Treatment Study of Children with ADHD, a randomized clinical trial with 579 children aged 7 to 9.9 years with combined-type ADHD, and the (b) Berkeley Girls ADHD Longitudinal Sample, a naturalistic study of 140 girls with ADHD (93 combined-type and 47 inattentive-type) who were first seen when they were 6 to 12 years old, were analyzed separately. In each sample, perinatal risk factors were assessed retrospectively by maternal report, and current childhood psychiatric comorbidity was assessed using maternal report on the Diagnostic Interview Schedule for Children. Consistent findings across these two studies show that infant breathing problems, early labor, and total perinatal problems predicted childhood comorbid depression but not comorbid anxiety or externalizing disorders. These associations remained significant, in both samples, with control of family socioeconomic status (SES) and maternal symptoms of ADHD and depression. Results attenuated slightly with control of the number of child comorbidities plus SES and maternal symptoms. Accumulating evidence suggests that perinatal risk factors are important precursors of childhood psychiatric comorbidity and that the association between these risk factors and detrimental psychiatric outcomes cannot be explained by maternal psychiatric symptoms or SES during childhood.
Goodman, R.; Graham, P.
OBJECTIVE--To examine the prevalence and predictors of psychiatric problems in children with hemiplegia. DESIGN--Cross sectional questionnaire survey of an epidemiological sample with individual assessments of a representative subgroup. The questionnaire survey was repeated on school age subjects four years later. SUBJECTS--428 hemiplegic children age 2 1/2-16 years, of whom 149 (aged 6-10 years) were individually assessed. MAIN OUTCOME MEASURES--Psychiatric symptom scores and the occurrence of psychiatric disorder. RESULTS--Psychiatric disorders affected 61% (95% confidence interval 53% to 69%) of subjects as judged by individual assessments and 54% (49% to 59%) and 42% (37% to 47%) as judged from parent and teacher questionnaires, respectively. Few affected children had been in contact with child mental health services. The strongest consistent predictor of psychiatric problems was intelligence quotient (IQ), which was highly correlated with an index of neurological severity; age, sex, and laterality of lesion had little or no predictive power. CONCLUSION--Though most hemiplegic children have considerable emotional or behavioural difficulties, these psychological complications commonly go unrecognised or untreated. Comprehensive health provision for children with chronic neurodevelopmental disorders such as hemiplegia should be psychologically as well as physically oriented. PMID:8616413
Mazza, Elena T.
The professional literature on gatekeeping in social work education has grown; however, there remains a dearth in the literature regarding how educators truly work to engage students who are experiencing a psychiatric disability or other emotional problem. This qualitative study explored the experiences of 26 social work educators from 22 colleges…
Ross, Helen E.; Tisdall, Gordon W.
Examined use and abuse of alcohol and other drugs in university psychiatric health service and patterns of comorbidity with other psychiatric problems. Psychiatric service students (n=110) tended to drink less than did undergraduate comparison group and to report similar frequencies of adverse consequences. Alcohol disorders were significantly…
to the use of cannabis, methaqualone and alcohoL For each ... abused illicit drug! Cannabis users are becoming younger and more adolescents now use cannabis than tobacco,' although geographically there are differences in usage patterns and these ... characteristics of regular substance users compared with non-.
Guldager, Steen; Linneberg, Inger Holm; Hesse, Morten
of Personality – Abbreviated Scale (SAPAS), completed the MCMI-III, the Beck Anxiety Inventory (BAI), and were rated with the Montgomery Åsberg Depression Rating Scale. Age at onset was lowest for conduct disorder/antisocial behaviour, followed by tasting alcohol, trying drugs, post-traumatic stress disorder...... for non-substance related disorder in 72%. Patients reporting that their axis I disorder predated their SUD reported more severe problems currently on the BAI and the SAPAS. Patients reporting that their conduct disorder/antisocial personality disorder criteria predated their SUD reported more aggressive......-sadistic personality traits than patients reporting that SUD predated conduct disorder/antisocial personality, but did not differ in terms of antisocial personality disorder traits. The findings are discussed in terms of their clinical implications....
Polcin, Douglas L.; Korcha, Rachael
Social support and psychiatric severity are known to influence substance abuse. However, little is known about how their influences vary under different conditions. We aimed to study how different types of social support were associated with substance abuse outcomes among persons with low and moderate psychiatric severity who entered Sober Living…
Kelly, Thomas M.; Daley, Dennis C.; Douaihy, Antoine B.
Objective To update clinicians on the latest in evidence-based treatments for substance use disorders (SUD) and non-substance use disorders among adults and suggest how these treatments can be combined into an evidence based process that enhances treatment effectiveness in comorbid patients. Method Articles were extracted from Pubmed using the search terms “dual diagnosis,” “comorbidity” and “co-occurring” and were reviewed for evidence of effectiveness for pharmacologic and psychotherapeutic treatments of comorbidity. Results Twenty-four research reviews and 43 research trials were reviewed. The preponderance of the evidence suggests that antidepressants prescribed to improve substance-related symptoms among patients with mood and anxiety disorders are either not highly effective or involve risk due to high side-effect profiles or toxicity. Second-generation antipsychotics are more effective for treatment of schizophrenia and comorbid substance abuse and current evidence suggests clozapine, olanzapine and risperidone are among the best. Clozapine appears to be the most effective of the antipsychotics for reducing alcohol, cocaine and cannabis abuse among patients with schizophrenia. Motivational interviewing has robust support as a highly effective psychotherapy for establishing a therapeutic alliance. This finding is critical since retention in treatment is essential for maintaining effectiveness. Highly structured therapy programs that integrate intensive outpatient treatments, case management services and behavioral therapies such as Contingency Management (CM) are most effective for treatment of severe comorbid conditions. Conclusions Creative combinations of psychotherapies, behavioral and pharmacological interventions offer the most effective treatment for comorbidity. Intensity of treatment must be increased for severe comorbid conditions such as the schizophrenia/cannabis dependence comorbidity due to the limitations of pharmacological
Baillargeon, Jacques; Williams, Brie A; Mellow, Jeff; Harzke, Amy Jo; Hoge, Steven K; Baillargeon, Gwen; Greifinger, Robert B
This retrospective cohort study examined the association between co-occurring serious mental illness and substance use disorders and parole revocation among inmates from the Texas Department of Criminal Justice, the nation's largest state prison system. The study population included all 8,149 inmates who were released under parole supervision between September 1, 2006, and November 31, 2006. An electronic database was used to identify inmates whose parole was revoked within 12 months of their release. The independent risk of parole revocation attributable to psychiatric disorders, substance use disorders, and other covariates was assessed with logistic regression analysis. Parolees with a dual diagnosis of a major psychiatric disorder (major depressive disorder, bipolar disorder, schizophrenia, or other psychotic disorder) and a substance use disorder had a substantially increased risk of having their parole revoked because of either a technical violation (adjusted odds ratio [OR]=1.7, 95% confidence interval [CI]=1.4-2.4) or commission of a new criminal offense (OR=2.8, 95% CI=1.7-4.5) in the 12 months after their release. However, parolees with a diagnosis of either a major psychiatric disorder alone or a substance use disorder alone demonstrated no such increased risk. These findings highlight the need for future investigations of specific social, behavioral, and other factors that underlie higher rates of parole revocation among individuals with co-occurring serious mental illness and substance use disorders.
Ab Majid Gania
Full Text Available Background: Pattern of substance use, profile of substance users, and treatment-seeking differ across cultures and continents. These differences could potentially affect the pattern and perhaps prevalence of dual diagnosis. However, the study of dual diagnosis from de-addiction clinics in India is limited in number and methodology. In this study, we report the prevalence and patterns of psychiatric disorders in subjects attending a de-addiction clinic in a teaching hospital in Srinagar, Kashmir. Methodology: In this cross-sectional study, 300 subjects (>18 years of age seeking treatment for substance use disorders were screened with Mini International Neuropsychiatric Interview Plus for the presence of psychiatric comorbidity. Subjects were assessed after 4 weeks of complete abstinence from psychoactive substances. Results: Cannabis (26% was the most common single-use substance. It was followed by polysubstance use (22.3% and opioids (21.3%. Among the 300 subjects assessed for the purpose of the study, 174 (58% were found to have dual diagnosis. Psychotic disorders (34% were the most common psychiatric comorbidity, and it was followed by major depressive disorder (16% and bipolar affective disorder (16%. Posttraumatic stress disorder (PTSD was present in 20 (11.5% subjects. When the groups with or without dual diagnosis were compared, cannabis and benzodiazepine dependence was found to be significantly common in the dual diagnosis group. Conclusions: A high prevalence of dual diagnoses, especially psychotic disorders and also PTSD, in our predominantly cannabis-using subjects attending hospital located in a distinct sociocultural setting in India, highlights the importance of taking into consideration the sociocultural context in which substance use as well as dual diagnoses should be understood.
Full Text Available Abstract Background Most help-seeking substance abusers have comorbid psychiatric disorders. The importance of such disorders for the long-term course of substance abuse is, however, still unclear. The aim of this paper is to describe six-year outcomes regarding death and relapse among alcoholics and poly-substance abusers and to analyse the predictive value of lifetime psychiatric disorders on relapse. Methods A consecutive sample of substance-dependent patients who received treatment in two counties in Norway (n = 287 was followed up after approximately six years. Information on socio-demographics, Axis I (CIDI and II disorders (MCMI-II and mental distress (HSCL-25 was gathered at baseline. At follow-up, detailed information regarding socio-demographics, use of substances (AUDIT and DUDIT and mental distress (HSCL-25 was recorded (response rate: 63%. Results At six-year follow-up, 11% had died, most often male alcoholics (18%. Among the surviving patients, 70% had drug or alcohol related problems the year prior to follow-up. These patients were, classified as "relapsers". There were no significant differences in the relapse rate between women and men and among poly-substance abusers and alcoholics. The relapsers had an earlier onset of a substance use disorder, and more frequently major depression and agoraphobia. Multivariate analysis indicated that both psychiatric disorders (major depression and substance use factors (early onset of a substance use disorder were independent predictors of relapse. Conclusion For reducing the risk of long-term relapse, assessment and treatment of major depression (and agoraphobia are important. In addition, we are in need of a comprehensive treatment and rehabilitation program that also focuses on the addictive behaviour.
Ream, Geoffrey L; Elliott, Luther C; Dunlap, Eloise
This study tested the hypothesis that playing video games while using or feeling the effects of a substance--referred to herein as "concurrent use"-is related to substance use problems after controlling for substance use frequency, video gaming as an enthusiastic hobby, and demographic factors. Data were drawn from a nationally representative online survey of adult video gamers conducted by Knowledge Networks, valid n = 2,885. Problem video game playing behavior was operationalized using Tejeiro Salguero and Bersabé Morán's 2002 problem video game play (PVP) measure, and measures for substance use problems were taken from the National Survey of Drug Use and Health (NSDUH). Separate structural equation modeling analyses were conducted for users of caffeine, tobacco, alcohol, and marijuana. In all four models, concurrent use was directly associated with substance use problems, but not with PVP. Video gaming as an enthusiastic hobby was associated with substance use problems via two indirect paths: through PVP for all substances, and through concurrent use for caffeine, tobacco, and alcohol only. Results illustrate the potential for "drug interaction" between self-reinforcing behaviors and addictive substances, with implications for the development of problem use.
Mueser, Kim T.; Glynn, Shirley M.; Cather, Corrine; Xie, Haiyi; Zarate, Roberto; Smith, Lindy Fox; Clark, Robin E.; Gottlieb, Jennifer D.; Wolfe, Rosemarie; Feldman, James
Substance use disorders have a profound impact on the course of severe mental illnesses and on the family, but little research has evaluated the impact of family intervention for this population. To address this question, a randomized controlled trial was conducted comparing a brief (2–3 mo) Family Education (ED) program with a longer-term (9–18 mo) program that combined education with teaching communication and problem-solving skills, Family Intervention for Dual Disorders (FIDD). A total of 108 clients (77% schizophrenia-spectrum) and a key relative were randomized to either ED or FIDD and assessed at baseline and every 6 months for 3 years. Rates of retention of families in both programs were moderate. Intent-to-treat analyses indicated that clients in both programs improved in psychiatric, substance abuse, and functional outcomes, as did key relatives in knowledge of co-occurring disorders, burden, and mental health functioning. Clients in FIDD had significantly less severe overall psychiatric symptoms and psychotic symptoms and tended to improve more in functioning. Relatives in FIDD improved more in mental health functioning and knowledge of co-occurring disorders. There were no consistent differences between the programs in substance abuse severity or family burden. The findings support the utility of family intervention for co-occurring disorders, and the added benefits of communication and problem-solving training, but also suggest the need to modify these programs to retain more families in treatment in order to provide them with the information and skills they need to overcome the effects of these disorders. PMID:22282453
Ream, Geoffrey L.; Elliott, Luther C.; Dunlap, Eloise
This study tested the hypothesis that playing video games while using or feeling the effects of a substance—referred to herein as “concurrent use”—is related to substance use problems after controlling for substance use frequency, video gaming as an enthusiastic hobby, and demographic factors. Data were drawn from a nationally representative online survey of adult video gamers conducted by Knowledge Networks, valid n = 2,885. Problem video game playing behavior was operationalized using Tejeiro Salguero and Bersabé Morán’s 2002 problem video game play (PVP) measure, and measures for substance use problems were taken from the National Survey of Drug Use and Health (NSDUH). Separate structural equation modeling analyses were conducted for users of caffeine, tobacco, alcohol, and marijuana. In all four models, concurrent use was directly associated with substance use problems, but not with PVP. Video gaming as an enthusiastic hobby was associated with substance use problems via two indirect paths: through PVP for all substances, and through concurrent use for caffeine, tobacco, and alcohol only. Results illustrate the potential for “drug interaction” between self-reinforcing behaviors and addictive substances, with implications for the development of problem use. PMID:22073023
Geoffrey L. Ream
Full Text Available This study tested the hypothesis that playing video games while using or feeling the effects of a substance—referred to herein as “concurrent use”—is related to substance use problems after controlling for substance use frequency, video gaming as an enthusiastic hobby, and demographic factors. Data were drawn from a nationally representative online survey of adult video gamers conducted by Knowledge Networks, valid n = 2,885. Problem video game playing behavior was operationalized using Tejeiro Salguero and Bersabé Morán’s 2002 problem video game play (PVP measure, and measures for substance use problems were taken from the National Survey of Drug Use and Health (NSDUH. Separate structural equation modeling analyses were conducted for users of caffeine, tobacco, alcohol, and marijuana. In all four models, concurrent use was directly associated with substance use problems, but not with PVP. Video gaming as an enthusiastic hobby was associated with substance use problems via two indirect paths: through PVP for all substances, and through concurrent use for caffeine, tobacco, and alcohol only. Results illustrate the potential for “drug interaction” between self-reinforcing behaviors and addictive substances, with implications for the development of problem use.
Cowlishaw, Sean; Merkouris, Stephanie; Chapman, Anna; Radermacher, Harriet
Pathological and problem gambling refer to a class of disorders, including those meeting criteria for a psychiatric diagnosis (i.e., pathological gambling), and others comprising a spectrum of severity defined by significant personal and social harm (i.e., problem gambling), that may be common in substance use treatment but are frequently unrecognized. This paper presents a systematic review and meta-analysis of available evidence indicating the prevalence of such gambling disorders in substance use treatment. It provides weighted mean estimates from across studies of clinical samples of substance users, and suggests around 14% of patients that demonstrate comorbid pathological gambling. Around 23% suffer conditions along the broader spectrum of problem gambling. The review also highlights important limitations of existing evidence, including scant data on current versus lifetime comorbidity, as well as reliance on convenience samples and self-administered measures of gambling problems. Notwithstanding a concomitant need for caution when applying these results, the findings suggest a strong need to identify and manage gambling comorbidity in substance use treatment. Strategies for identification of gambling disorders, and therapies that may provide useful adjunctive interventions in substance use treatment are discussed. © 2013.
Hu, Lianne Lian; Sparenborg, Steven; Tai, Betty
Many Americans with substance use problems will have opportunities to receive coordinated health care through the integration of primary care and specialty care for substance use disorders under the Patient Protection and Affordable Care Act of 2010. Sharing of patient health records among care providers is essential to realize the benefits of electronic health records. Health information exchange through meaningful use of electronic health records can improve health care safety, quality, and efficiency. Implementation of electronic health records and health information exchange presents great opportunities for health care integration, but also makes patient privacy potentially vulnerable. Privacy issues are paramount for patients with substance use problems. This paper discusses major differences between two federal privacy laws associated with health care for substance use disorders, identifies health care problems created by privacy policies, and describes potential solutions to these problems through technology innovation and policy improvement.
Barrett Sean P
Full Text Available Abstract Background Ongoing psychiatric symptoms and substance use are common difficulties experienced by clients enrolled in methadone maintenance treatment (MMT. However, little research to date has evaluated if specific types of current substance use are related to specific types of current psychiatric symptoms. The present study investigated these relationships with a sample of clients enrolled in a low-threshold MMT program (i.e., clients are not expelled if they continue to use substances. Some clients enrolled in low-threshold programs may never achieve complete abstinence from all substances. Thus, understanding the possibly perpetuating relationships between concurrent substance use and psychiatric symptoms is important. Understanding such relationships may aid in developing possible target areas of treatment to reduce substance use and/or related harms in this population. Methods Seventy-seven individuals were interviewed regarding methadone usage and current and past substance use. Current psychiatric symptoms were assessed using a modified version of the Psychiatric Diagnostic Screening Questionnaire (PDSQ. Relationships between types of substances used in the past 30 days and the types and number of psychiatric symptoms experienced in the same timeframe were examined. Results The majority of participants (87.0% reported using alcohol, illicit substances, non-prescribed prescription opioids, or non-prescribed benzodiazepines in the past 30 days and 77.9% of participants reported currently experiencing psychiatric symptoms at levels that would likely warrant diagnosis. Current non-prescribed benzodiazepine use was a predictor for increased severity (i.e., symptom count of almost all anxiety and mood disorders assessed. Conversely, number and presence of generalized anxiety symptoms and presence of social phobia symptoms predicted current non-prescribed benzodiazepine and alcohol use, respectively. Conclusions Individuals enrolled in
Harpaz-Rotem, Ilan; Rosenheck, Robert A; Desai, Rani
Limited evidence shows that time-limited residential treatment (RT) is beneficial for homeless people with serious mental illness. The Department of Veterans Affairs has established 11 specialty programs for homeless female veterans. We present data comparing 1-year clinical outcomes in a group of veterans who did and did not receive at least 30 days of RT. Clients of the Homeless Women Veterans Programs were invited to participate in a follow-up study. They were interviewed every 3 months for 1 year. Those who received at least 30 days of RT in the 3 months after program entry (RT group) were compared with other program participants (no or homeless women. This study, in conjunction with others, suggests that provision of stable housing may be an important element of recovery for homeless women with psychiatric problems, excluding substance use.
Ream, Geoffrey L.; Elliott, Luther C.; Eloise Dunlap
This study tested the hypothesis that playing video games while using or feeling the effects of a substance—referred to herein as “concurrent use”—is related to substance use problems after controlling for substance use frequency, video gaming as an enthusiastic hobby, and demographic factors. Data were drawn from a nationally representative online survey of adult video gamers conducted by Knowledge Networks, valid n = 2,885. Problem video game playing behavior was operationalized using Tejei...
Simpson, Alan; Bowers, Len; Haglund, Kristina; Muir-Cochrane, Eimear; Nijman, Henk; Van der Merwe, Marie
In this paper we report on the rates of drug/alcohol use on acute psychiatric wards in relation to levels and intensity of exit security measures. Many inpatient wards have become permanently locked, with staff concerned about the risk of patients leaving the ward and harming themselves or others, and of people bringing illicit substances into the therapeutic environment. In 2004/2005, a cross sectional survey on 136 acute psychiatric wards across three areas of England was undertaken. A comprehensive range of data including door locking and drug/alcohol use were collected over 6 months on each ward. In 2006, supplementary data on door locking and exit security were collected. Door locking, additional exit security measures and substance misuse rates of the 136 wards were analysed and the associations between these were investigated. No consistent relationships were found with exit security features, intensity of drug/alcohol monitoring procedures, or the locking of the ward door. There were indications that use of breath testing for alcohol might reduce usage and that the use of 'sniffer' dogs was associated with greater alcohol use. Greater exit security or locking of the ward door had no influence on rates of use of alcohol or illicit drugs by inpatients and thus cannot form part of any strategy to control substance use by inpatients. There are some grounds to believe that a greater use of screening might help reduce the frequency of alcohol/substance use on wards and may lead to a reduction in verbal abuse. © 2010 The Authors. Journal of Advanced Nursing © 2010 Blackwell Publishing Ltd.
Snenghi, Rossella; Forza, Giovanni; Favretto, Donata; Sartore, Daniela; Rodinis, Silvia; Terranova, Claudio; Nalesso, Alessandro; Montisci, Massimo; Ferrara, Santo Davide
The aim of this study was to investigate polydrug use in drunk drivers. The experimental study was conducted on 2,072 drunk drivers undergoing a driving license reissue protocol at the Department of Legal Medicine of Padova University Hospital in the period between January 2011 and December 2012. The study protocol involved anamnesis, clinical examination, toxicological history, and toxicological analyses on multiple biological samples. One thousand eight hundred seventy-seven subjects (90.6%) were assessed as fit to drive, and 195 (9.5%) were declared unfit. Among those unfit, 32 subjects (1.6%) were declared unfit due to recent use of an illicit drug (time span drive after completeness of the protocol was established in 1.2% of cases for alcohol disorders and in 5.7% of cases for illicit drug abuse; only one subject was included in both subgroups. Cocaine was the most widely used substance, followed by cannabis, opiates, and psychotropic pharmaceutical drugs. The application of the protocol presented in this study allowed the identification of underlying polydrug use in drunk drivers. The study led to the identification of 6.8% unfit subjects on the basis of alcohol disorders and/or drug abuse, compared to 1.2% of identifiable unfitness if the protocol were limited to the mere assessment of alcohol consumption. The frequent association of alcohol and cocaine is different from other patterns of use in North Europe countries.
Pieters, S.; Burk, W.J.; Vorst, H. van der; Dahl, R.E.; Wiers, R.W.H.J.; Engels, R.C.M.E.
While research has shown that sleep problems and substance use are reciprocally associated in adults, much less is known about this association in early adolescence. The main aim of the current longitudinal study was to explore bidirectional relationships between sleep problems, substance use,
Pieters, S.; Burk, W.J.; van der Vorst, H.; Dahl, R.E.; Wiers, R.W.; Engels, R.C.M.E.
While research has shown that sleep problems and substance use are reciprocally associated in adults, much less is known about this association in early adolescence. The main aim of the current longitudinal study was to explore bidirectional relationships between sleep problems, substance use,
Cumurcu, Tongabay; Cumurcu, Birgul Elbozan; Ozcan, Ozlem; Demirel, Soner; Duz, Cem; Porgalı, Esra; Doganay, Selim
To investigate the rate of social phobia, anxiety, depression, and other psychiatric problems in children with strabismus. Prospective, cross-sectional, case-control study. Forty-two children with strabismus and 47 control subjects 8-13 years of age were enrolled in this study. After the ophthalmologist's examination, all cases were assessed by a psychiatrist based on the structured interview technique of Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Present and Lifetime Version (Kiddie-SADS-PL). The Screen for Child Anxiety Related Emotional Disorders (SCARED) was administered to each subject to evaluate social phobia. All participants completed the Children's Depression Inventory (CDI). Age as well as sex and income were comparable between the strabismus patients and control groups. Social phobia was diagnosed in 8 (19.04%) of the 42 strabismic children and in 1 (2.12%) of the control subjects. The CDI and SCARED (total score, social phobia, separation anxiety) scores of strabismus patients were significantly higher than the control group (p = 0.001, p = 0.004, p = 0.0001, p = 0.05, respectively). A relationship between strabismus in children and social phobia, depression, and anxiety on a symptom basis was underlined by our data. Copyright © 2011. Published by Elsevier Inc.
Full Text Available Lianne Lian Hu1, Steven Sparenborg2, Betty Tai21Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, 2Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MDAbstract: Many Americans with substance use problems will have opportunities to receive coordinated health care through the integration of primary care and specialty care for substance use disorders under the Patient Protection and Affordable Care Act of 2010. Sharing of patient health records among care providers is essential to realize the benefits of electronic health records. Health information exchange through meaningful use of electronic health records can improve health care safety, quality, and efficiency. Implementation of electronic health records and health information exchange presents great opportunities for health care integration, but also makes patient privacy potentially vulnerable. Privacy issues are paramount for patients with substance use problems. This paper discusses major differences between two federal privacy laws associated with health care for substance use disorders, identifies health care problems created by privacy policies, and describes potential solutions to these problems through technology innovation and policy improvement.Keywords: substance abuse, patient privacy, electronic health records, health information exchange
Miller, Adam B; Esposito-Smythers, Chrstianne
The present study, informed by the cognitive-behavioral theory of suicide, is among the first studies to examine cognitive distortions and substance related problems as potential mediators and moderators of the relation between child maltreatment (CM) and suicidal ideation (SI) in adolescent psychiatric inpatients. The sample included 185 adolescents (71.4% female; 84% White) admitted to a psychiatric inpatient unit. Participants completed self-report measures assessing cognitive errors, negative cognitive triad, substance related problems, and SI. Participants and their parents completed a semi-structured diagnostic interview assessing CM history. In this clinical sample, we found that child maltreatment was associated with suicidal ideation only for youth with current substance abuse problems, indicating moderation. Contrary to predictions, substance related problems did not mediate the association between child maltreatment and adolescent SI. Further, cognitive errors and negative cognitive triad did not mediate or moderate the association between CM and SI. However, there were significant unique effects for both cognitive errors and negative cognitive triad on SI, suggesting that adolescents with more severe cognitive distortions report greater SI, regardless of CM history. Clinically, results suggest that practitioners should carefully screen for and address any substance misuse among victims of maltreatment to prevent clinically significant SI. Study results also suggest that interventions that incorporate cognitive restructuring may help decrease risk for severe SI in adolescent clinical samples in general.
Full Text Available Context: Substance Use Disorders (SUDs are highly prevalent among inpatient adolescents with psychiatric disorders. In this population, substance use and other psychiatric outcomes can reinforce one another. Despite the need for integrated interventions in youths with dual diagnoses, few specific instruments are available. App-based technologies have shown promising results to help reduce substance use in adolescents, but their applicability in youths with associated severe psychiatric disorders is poorly documented. We aim to evaluate the feasibility of an ecological momentary assessment (EMA intervention for all substance users, and of a smart-phone application for cannabis users (Stop-Cannabis, for outpatient treatment after hospital discharge. Methods and analysis: All inpatient adolescents with psychiatric disorders hospitalized between 2016 and 2018 in a university hospital will be systematically screened for SUD and, if positive, will be assessed by an independent specialist addiction team. Participants with confirmed SUDs will be invited and helped to download an EMA app and, if required, the Stop-Cannabis app the week preceding hospital discharge. Information about the acceptability and use of both apps and the validity of EMA data in comparison to clinical assessments will be assessed after 6 months and one year.Discussion: This research has been designed to raise specific issues for consideration regarding the sequence between substance use, contextual factors, and other psychiatric symptoms among adolescents with comorbid severe psychiatric disorders. A better understanding of the mechanisms involved will inform the development of integrated treatment for dual disorders at that age.Ethics and dissemination: The study has already been approved and granted. Dissemination will include presentations at international congresses as well as publications in peer-reviewed journals.Trial registration: European Clinical Trials Database: Number
Benarous, Xavier; Edel, Yves; Consoli, Angèle; Brunelle, Julie; Etter, Jean-François; Cohen, David; Khazaal, Yasser
Substance use disorders (SUDs) are highly prevalent among inpatient adolescents with psychiatric disorders. In this population, substance use and other psychiatric outcomes can reinforce one another. Despite the need for integrated interventions in youths with dual diagnoses, few specific instruments are available. App-based technologies have shown promising results to help reduce substance use in adolescents, but their applicability in youths with associated severe psychiatric disorders is poorly documented. We aim to evaluate the feasibility of an ecological momentary assessment (EMA) intervention for all substance users, and of a smartphone application for cannabis users (Stop-Cannabis), for outpatient treatment after hospital discharge. All inpatient adolescents with psychiatric disorders hospitalized between 2016 and 2018 in a university hospital will be systematically screened for SUD and, if positive, will be assessed by an independent specialist addiction team. Participants with confirmed SUDs will be invited and helped to download an EMA app and, if required, the Stop-Cannabis app, the week preceding hospital discharge. Information about the acceptability and use of both apps and the validity of EMA data in comparison to clinical assessments will be assessed after 6 months and 1 year. This research has been designed to raise specific issues for consideration regarding the sequence between substance use, contextual factors, and other psychiatric symptoms among adolescents with comorbid severe psychiatric disorders. A better understanding of the mechanisms involved will inform the development of integrated treatment for dual disorders at that age. The study has already been approved and granted. Dissemination will include presentations at international congresses as well as publications in peer-reviewed journals. European Clinical Trials Database: Number 2016-001999-30.
Harty, Seth C; Galanopoulos, Stavroula; Newcorn, Jeffrey H; Halperin, Jeffrey M
To measure the degree to which childhood and adolescent ratings of aggression, attention, and delinquency are related to adolescent substance use outcomes in youth diagnosed with attention-deficit/hyperactivity disorder (ADHD). Childhood externalizing disorders have been shown to predict adolescent maladaptive substance use, but few studies have examined the differential predictive utility of two distinct dimensions of externalizing behavior: aggression and delinquency. Ninety-seven clinically referred children with ADHD initially took part in this research protocol when they were on average 9.05 years of age, and were seen again on average 9.30 years later. Participants' parents were administered the Child Behavior Checklist (CBCL) at baseline and follow-up, and youth completed the Youth Self Report (YSR) in adolescence. At follow-up, substance use severity and diagnosis were assessed using semi-structured psychiatric interviews administered separately to parents and adolescents. Linear and binary logistic regressions were used to determine the association of CBCL- and YSR-rated attention problems, aggression, and delinquency to adolescent substance use. Childhood and adolescent delinquency, but not aggression, as rated by parents and youths, predicted adolescent substance use disorders and substance use severity (all p delinquency and aggression with adolescent substance use, ratings of attention problems in childhood and adolescence were negatively associated with substance use outcome. Children with ADHD who exhibit high rates of delinquency are at risk for later substance use and may require targeted prevention, intervention, and follow-up services. Copyright © American Academy of Addiction Psychiatry.
Vrijen, Charlotte; Hartman, Catharina A.; Lodder, Gerine M. A.; Verhagen, Maaike; de Jonge, Peter; Oldehinkel, Albertine J.
Many psychiatric problem domains have been associated with emotion-specific biases or general deficiencies in facial emotion identification. However, both within and between psychiatric problem domains, large variability exists in the types of emotion identification problems that were reported. Moreover, since the domain-specificity of the findings was often not addressed, it remains unclear whether patterns found for specific problem domains can be better explained by co-occurrence of other psychiatric problems or by more generic characteristics of psychopathology, for example, problem severity. In this study, we aimed to investigate associations between emotion identification biases and five psychiatric problem domains, and to determine the domain-specificity of these biases. Data were collected as part of the ‘No Fun No Glory’ study and involved 2,577 young adults. The study participants completed a dynamic facial emotion identification task involving happy, sad, angry, and fearful faces, and filled in the Adult Self-Report Questionnaire, of which we used the scales depressive problems, anxiety problems, avoidance problems, Attention-Deficit Hyperactivity Disorder (ADHD) problems and antisocial problems. Our results suggest that participants with antisocial problems were significantly less sensitive to happy facial emotions, participants with ADHD problems were less sensitive to angry emotions, and participants with avoidance problems were less sensitive to both angry and happy emotions. These effects could not be fully explained by co-occurring psychiatric problems. Whereas this seems to indicate domain-specificity, inspection of the overall pattern of effect sizes regardless of statistical significance reveals generic patterns as well, in that for all psychiatric problem domains the effect sizes for happy and angry emotions were larger than the effect sizes for sad and fearful emotions. As happy and angry emotions are strongly associated with approach and
Full Text Available Many psychiatric problem domains have been associated with emotion-specific biases or general deficiencies in facial emotion identification. However, both within and between psychiatric problem domains, large variability exists in the types of emotion identification problems that were reported. Moreover, since the domain-specificity of the findings was often not addressed, it remains unclear whether patterns found for specific problem domains can be better explained by co-occurrence of other psychiatric problems or by more generic characteristics of psychopathology, for example, problem severity. In this study, we aimed to investigate associations between emotion identification biases and five psychiatric problem domains, and to determine the domain-specificity of these biases. Data were collected as part of the ‘No Fun No Glory’ study and involved 2,577 young adults. The study participants completed a dynamic facial emotion identification task involving happy, sad, angry, and fearful faces, and filled in the Adult Self-Report Questionnaire, of which we used the scales depressive problems, anxiety problems, avoidance problems, Attention-Deficit Hyperactivity Disorder (ADHD problems and antisocial problems. Our results suggest that participants with antisocial problems were significantly less sensitive to happy facial emotions, participants with ADHD problems were less sensitive to angry emotions, and participants with avoidance problems were less sensitive to both angry and happy emotions. These effects could not be fully explained by co-occurring psychiatric problems. Whereas this seems to indicate domain-specificity, inspection of the overall pattern of effect sizes regardless of statistical significance reveals generic patterns as well, in that for all psychiatric problem domains the effect sizes for happy and angry emotions were larger than the effect sizes for sad and fearful emotions. As happy and angry emotions are strongly associated
Niethammer, Oliver; Frank, Reiner
To examine the prevalence of use, abuse, and dependence on legal and illegal psychotropic substances in an adolescent in-patient psychiatric population in relation to age and gender. Participants were all consecutive admissions (patients aged from 14 to 17) to the adolescent psychiatric in-patient unit. Of the 86 patients who met all the criteria for taking part in the study 70 were interviewed, giving a response rate of 81%. Prevalence of use and of substance use disorders were assessed through structured diagnostic interviews (M-CIDI), conducted from March 2000 through July 2000. We found high prevalence of use and of the diagnosis of legal and illegal psychotropic substances. Around 76% reported a regular use of tobacco, 44% regular alcohol use, and 40% regular use of illegal substances. Diagnosis (abuse or dependence) was found in 50% of cases for nicotine, 29% for alcohol, and 26% for illegal substances. The adolescent in-patient psychiatric population is at high risk of use, abuse, and dependence on legal and illegal psychotropic substances. It is important to diagnose these disorders (anamnesis, screening tools) and to install preventive and therapeutic programs in clinical therapeutic settings.
F.P. Velders (Fleur)
textabstractChildhood psychiatric disorders are common, show a high comorbidity and are associated with a long-term vulnerability for mental health problems, which underscores the importance of a better understanding of their etiology. Psychiatric symptoms of the parents place children at risk for
Lien Ingebjørg Aspeland
Full Text Available AIM – Several studies have shown that personality disorders (PDs are frequently occurring among patients with substance use disorders (SUDs. A development from research of co-occurrence estimates in this patient group investigates personality problems as dimensional constructs, which seek to capture the core of personality pathology. The aim of our study was to explore whether personality problems might be assessed among SUD patients in early stages of treatment. We also sought to investigate personality problem severity among Norwegian adult SUD patients.
Olinto, Maria Teresa Anselmo; Garcez, Anderson; Henn, Ruth Liane; Macagnan, Jamile Block Araldi; Paniz, Vera Maria Vieira; Pattussi, Marcos Pascoal
The aim of this study was to explore the association between sleep-related problems with the occurrence of minor psychiatric disorders in shift workers of southern Brazil. A cross-sectional study with 1202 workers (785 females) aged 18-50 years was carried out. Minor psychiatric disorders were assessed using the Self-Reporting Questionnaire (SRQ-20), and four sleep problems were collected and analyzed: sleep deprivation (≤ 5h), difficulty falling asleep, waking up during sleep, and sleep medication use. Results show that the overall prevalence of minor psychiatric disorders was 26.8%, but it was more prevalent among females than males (30.2% vs. 20.4%). Nightshift work was significantly associated with the occurrence of sleep-related problems. After adjusting for confounding factors, the number of sleep-related problems showed a positive linear trend with psychiatric disorders in both sexes. Having two or more sleep-related problems was associated with increased probability of psychiatric disorders approximately three-fold among males and two-fold among females, when compared with those without sleep problems. In conclusion, this study demonstrated that sleep-related problems have a strong and independent association with psychiatric disorders among shift workers. Furthermore, the prevalence of both conditions was higher among females than males; however, the strength of these associations was higher in males. Copyright © 2017 Elsevier B.V. All rights reserved.
Jinjuvadia, Raxitkumar; Jinjuvadia, Chetna; Puangsricharoen, Pimpitcha; Chalasani, Naga; Crabb, David W; Liangpunsakul, Suthat
Despite that the epidemiological studies on the comorbidity of alcohol misuse and psychiatric disorders have been studied, less is known about the magnitude of these disorders among patients with alcoholic liver disease (ALD). Our aim was to determine the prevalence of psychiatric and substance use disorders among hospitalized ALD patients in the United States. We utilized a single-level clinical classification software to identify patients with ALD and psychiatric/substance use disorders from the 2011 National Inpatient Sample data. The primary outcome was the prevalence of these disorders among hospitalized patients with ALD (n = 74,972) compared to those with chronic liver diseases not caused by alcohol (n = 350,140) and those without underlying liver diseases (n = 1,447,063). The prevalence of adjustment disorder, anxiety disorder, posttraumatic stress disorder, and depression was significantly higher among hospitalized patients with ALD when compared to those with chronic liver diseases not caused by alcohol (all with p-values disorders among hospitalized patients with ALD. Hospitalized patients with ALD have significantly high prevalence of concomitant psychiatric and substance abuse disorders when compared to those with chronic liver diseases not caused by alcohol and those without underlying liver diseases. Screening and appropriate intervention should be implemented as part of routine clinical care for these patients. Copyright © 2017 by the Research Society on Alcoholism.
Full Text Available Background and aims: Sexual dissatisfaction is one of the common problems in patients of Substance dependency. The aim of this study was to investigate psychosexual problems in marital relationships in substance dependence patients: Crack, Cristal and Opium and compare with control group. Methods: In this descriptive-analytic study, 56 substance dependences referred to addiction treatment center were selected by convenience sampling and assigned to four groups: 20 Opium consumers, 18 on Crack, 18 on Cristal and 20 patients in control group. The Multidimensional Sexuality Questionnaires (MSQ were completed by participants. Results: Based on subscales of Multidimensional Sexuality Questionnaire, a significant difference was observed in score mean among three groups and between experimental groups and control group in sexual subscales: preoccupation, motivation, assertiveness, depression, monitoring power of other sex, sexual control, external supervision, fear of sexual relationship and satisfaction (P>0.05. Differences between (Cristal and Crack and (Opium and Cristal in sexual subscales: preoccupation, motivation, fear, depression, power-other sexual control, supervision, and fear of sexual relationship and satisfaction were significant (P>0.05. Score mean indicated that the Cristal abusers in all of subscales have higher scores mean than Crack, and Opium. Conclusion: According to the results of current study, the available addicting substance in the market affects the consumer's sexual practices, and will be caused deleterious effects on family and marital sexual health.
Bertolín Guillén, J M; Pretel Piqueras, J; Sánchez Hernández, A; Acebal Gómez, I
An increasing trend in the consumption of psychoactive substances has been observed in psychiatric patients who are hospitalised. The aim of this research is to establish the prevalence and the characteristics of the recent and non-therapeutic consumption of these substances, by detecting their presence in the blood and urine of psychiatric patients admitted to hospital, the influence of such consumption on the clinical manifestations of the mental disorders and to recommend criteria for such a phenomenon. Detection of cannabis, amphetamines, opiates and cocaine, using the ADX system, and in blood through the REA system for alcohol detection, in patients admitted to the Psychiatric Unit of the General University Hospital in Valencia, during the first six months of 1995. The diagnoses were based on the CIE-10 in its research version, and the influence of the consumption of substances detected in the clinical manifestations of the disorders was determined by the majority decision taken be three experienced psychiatrists. the prevalence detected in the consumption of psychotropic substances is high (almost one third of those admitted), and consumption played a part in the admission of most of these patients (nearly 89%), aggravating the mental disorder problem when they were admitted. The variables that were most often associated with the consumption detected, where males hospitalised as a result of a brush with the law. A routine determining of the presence or absence of substances liable to abuse is recommended in patients admitted to psychiatric institutions.
Hansen, Berit Hjelde; Alfstad, Kristin Å; van Roy, Betty; Henning, Oliver; Lossius, Morten I
Sleep problems are common in pediatric epilepsy and may influence seizure control, daytime functioning, and overall quality of life. Knowledge of factors contributing to sleep problems is likely to improve treatment. The aim of this study was to investigate associations between psychiatric comorbidity and parent-reported and self-reported sleep problems in a sample of children and adolescents with epilepsy. Participants were children and adolescents (N=94), aged 10-19years, with generalized or focal epilepsy who had been referred to a tertiary epilepsy treatment center in Norway. Participants underwent a thorough clinical assessment and 24h of EEG registration. Information on sleep problems was obtained from parents using the Children's Sleep Habit Questionnaire (CSHQ) and from self-reporting using the Sleep Self-Report (SSR) questionnaire. Psychiatric diagnoses were established using the semistructured psychiatric interview Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (Kiddie-SADS-PL). Both the total and subdomain CSHQ and SSR scores were high in comparison with scores from population-based samples. Having one or more psychiatric disorder(s) was significantly associated with elevated scores on both the CSHQ and the SSR. With the exception of parent-reported parasomnias, associations between sleep problems and psychiatric disorders remained significant after adjusting for relevant epilepsy variables. Psychiatric comorbidity explained about one-third of the variance of the reported sleep problems in children and adolescents with epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.
Laukkanen, Matti; Hakko, Helinä; Riala, Kaisa; Räsänen, Pirkko
This study investigated whether adolescent's family type was associated with regular smoking or the use of illicit substances (cannabis or hard drugs) among underage adolescent psychiatric in-patients. The sample consisted of 471 adolescents aged 12-17 years admitted to psychiatric hospital between April 2001 and March 2006 at Oulu University Hospital, Finland. The information on family factors and substance use was based on the Schedule for Affective Disorder and Schizophrenia for School-Age Children, Present and Lifetime interview and the European modification of the Addiction Severity Index questionnaire. Compared to adolescent boys from two-parent families, those from child welfare placement were more likely to regularly use both cannabis (odds ratio [OR]=4.4; 95%confidence interval [CI]=1.4-13.7; P=.012) and hard drugs (OR=8.4; 95% CI=1.7-42.1; P=.01).Among girls, no association was found between family type and the use of illicit substances. Two-parent or foster family units may protect adolescents from involvement with illicit substances. In clinical adolescent psychiatric practice more attention should be paid to family interventions and parental support.
Daigre, Constanza; Rodríguez-Cintas, Laia; Tarifa, Núria; Rodríguez-Martos, Lola; Grau-López, Lara; Berenguer, Marta; Casas, Miguel; Roncero, Carlos
Sexual, emotional or physical abuse history is a risk factor for mental disorders in addicted patients. However, the relationship between addiction and abuse lifespan is not well known. This study aims to compare clinical and psychopathological features of addicted patients according to the experience of abuse and to the number of different types of abuse suffered. Bivariate and multivariate analyses were conducted. 512 addicted patients seeking treatment were included, 45.9% reported abuse throughout life (38.9% emotional, 22.3% physical and 13.5% sexual abuse). It was found that female gender; depressive symptoms and borderline personality disorder were independently associated with history of any abuse throughout life. As well, it was found that 14% have been suffered from all three types of abuse (sexual, emotional and physical), 34.5% from two and 55.5% from one type. Female gender and borderline personality disorder were independently associated independently with a greater number of different types of abuse. Results suggest that history of abuse is frequent among substance-dependent patients and these experiences are more prevalent in women and are associated with more psychiatric comorbidity. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Full Text Available The research is about a descriptive study of quantitative boarding, developed in October of 2008 in the Psychiatric Hospital of the city of Criciúma-SC, with the objective to identify to the aspects epidemiologists of the illicit psychoactive substance dependents. The specific objectives of the study had been: to identify illicit psychoactive substance dependents interned through handbooks of the institution; to inquire the number of psychiatric readmissions in the studied population; to identify the types of more common illicit psychoactive substances, To identify to aspects epidemiologists of the psychoactive substance dependents from dependent 0 variable: sex, age, age group, level of instruction, race, civil state, number of children, religion, profession and origin; e changeable independent: type of used substance, time of use, number of internments and clinical patology associates. The interest for the research subject appeared from the comment in field of work for presenting great number of patients interned for abuse or dependence of psychoactive substances and its social repercussion. 193 handbooks had been inquired, being that 13 had been identified with illicit psychoactive substance diagnosis in the period of the collection of data, having the prevalence in the masculine sex (9, of the white race (11, the majority single (7, with a young age group, on average 35 years. The majority interned involuntarily (8 and the number of readmissions was equivalent 50% of patients and others 50% having its first internment. How much to the types of used illicit psychoactive substances more, the most cited they had been marijuana (20%, crack (17% and cocaine (17%. The half of the sample almost possess clinical illnesses associates, as cardiopathy, diabetes, hepatitis C, arterial hypertension and HIV (Virus of the Immunodeficiency Human being. From these results one sees it importance of clarification and organization of preventive programs in
Caldeira, Kimberly M.; Kasperski, Sarah J.; Sharma, Eva; Vincent, Kathryn B.; O’Grady, Kevin E.; Wish, Eric D.; Arria, Amelia M.
The prevalence of substance use disorders (SUD) and aspects of the help-seeking process among a high-risk sample of 946 students at one large public university were assessed in personal interviews during the first three years of college. After statistically adjusting for purposive sampling, an estimated 46.8%wt of all third-year students met DSM-IV criteria for SUD involving alcohol and/or marijuana at least once. Of 548 SUD cases, 3.6% perceived a need for help with substance use problems; 16.4% were encouraged by someone else to seek help. Help-seeking was rare among SUD cases (8.8%), but significantly elevated among individuals who perceived a need (90.0%) or experienced social pressures from parents (32.5%), friends (34.2%), or another person (58.3%). Resources accessed for help included educational programs (38%), health professionals (27%), and twelve-step programs (19%). College students have high rates of substance use problems but rarely recognize a need for treatment or seek help. Results highlight the opportunity for early intervention with college students with SUD. PMID:19553064
Magallón Neri, Ernesto Mijail; Díaz, R.; Forns, Maria, 1946-; Goti, J.; Canalda Sahli, Gloria; Castro Fornieles, Josefina
The main aim of this study was to replicate and extend previous results on subtypes of adolescents with substance use disorders (SUD), according to their Minnesota Multiphasic Personality Inventory for adolescents (MMPI-A) profiles. Sixty patients with SUD and psychiatric comorbidity (41.7% male, mean age = 15.9 years old) completed the MMPI-A, the Teen Addiction Severity Index (T-ASI), the Child Behaviour Checklist (CBCL), and were interviewed in order to determine DSMIV diagnoses and level ...
Full Text Available Neurological and psychiatric symptoms are consequences of substance abuse in schizophrenia and non-schizophrenia patients. The present case-control study examined changes in substance abuse/dependence and neurological and psychiatric symptoms in substance abusers with (DD group, n=26 and without schizophrenia (SUD group, n=24 and in non-abusing schizophrenia patients (SCZ group, n=23 undergoing 12-week treatment with the atypical antipsychotic, quetiapine. Neurological and psychiatric symptoms were evaluated with the Positive and Negative Syndrome Scale, the Calgary Depression Scale for Schizophrenia, the Extrapyramidal Symptoms Rating Scale and the Barnes Akathisia Rating Scale. At endpoint, DD and SCZ patients were receiving significantly higher doses of quetiapine (mean = 554mg/d and 478mg/d, respectively, relative to SUD patients (mean = 150mg/d. We found that SUD patients showed greater improvement in weekly dollars spent on alcohol and drugs and SUD severity, compared to DD patients. At endpoint, there was no significant difference in dollars spent, but DD patients still had a higher mean SUD severity. Interestingly, DD patients had significantly higher Parkinsonism and depression than SCZ patients at baseline and endpoint. On the other hand, we found that SUD patients had significantly more akathisia at baseline, improved more than SCZ patients and this was related to cannabis abuse/dependence. Finally, SUD patients improved more in PANSS positive scores than DD and SCZ patients. Taken together, our results provide evidence for increased vulnerability to the adverse effects of alcohol and drugs in schizophrenia patients. They also suggest that substance abuse/withdrawal may mimic some symptoms of schizophrenia. Future studies will need to determine the role quetiapine played in these improvements.
Full Text Available We retrospectively collected data on the rate and type of psychiatric illness and behavioural problems on 143 adults with learning disability and epilepsy. 55% behavioural problems. 19% verbal aggression and temper tantrums, and 13% injurious behaviour. The overall rates of behavioural problems and different types of behaviours found in the current study cohort are similar to what was found before in learning disabled adults in general, as well as in epileptic and non-epileptic learning disabled adults. Psychiatric diagnosis was made in 12.6% combined diagnosis of schizophrenia, delusional disorder and schizo-affective disorder was most common (5% diagnosis of depressive episode (3% bipolar affective disorder.
Full Text Available Abstract Background Individuals with autism spectrum disorders (ASDs often display symptoms from other diagnostic categories. Studies of clinical and psychosocial outcome in adult patients with ASDs without concomitant intellectual disability are few. The objective of this paper is to describe the clinical psychiatric presentation and important outcome measures of a large group of normal-intelligence adult patients with ASDs. Methods Autistic symptomatology according to the DSM-IV-criteria and the Gillberg & Gillberg research criteria, patterns of comorbid psychopathology and psychosocial outcome were assessed in 122 consecutively referred adults with normal intelligence ASDs. The subjects consisted of 5 patients with autistic disorder (AD, 67 with Asperger's disorder (AS and 50 with pervasive developmental disorder not otherwise specified (PDD NOS. This study group consists of subjects pooled from two studies with highly similar protocols, all seen on an outpatient basis by one of three clinicians. Results Core autistic symptoms were highly prevalent in all ASD subgroups. Though AD subjects had the most pervasive problems, restrictions in non-verbal communication were common across all three subgroups and, contrary to current DSM criteria, so were verbal communication deficits. Lifetime psychiatric axis I comorbidity was very common, most notably mood and anxiety disorders, but also ADHD and psychotic disorders. The frequency of these diagnoses did not differ between the ASD subgroups or between males and females. Antisocial personality disorder and substance abuse were more common in the PDD NOS group. Of all subjects, few led an independent life and very few had ever had a long-term relationship. Female subjects more often reported having been bullied at school than male subjects. Conclusion ASDs are clinical syndromes characterized by impaired social interaction and non-verbal communication in adulthood as well as in childhood. They also
Micucci, Joseph A
This study investigated the accuracy of various indices involving the MMPI-A scales, ACK, MAC-R, and PRO in diagnosing substance abuse in a sample of 79 psychiatric inpatients. In the full sample, 89.9% of the cases were accurately classified by at least one of the three scales. The overall accuracy of classification was similar among males, females, Caucasians, and African Americans, although there was a tendency for more false positive misclassifications among males. Profile code type moderated the accuracy of classification with greatest accuracy for code types including Scales 1, 2, 3, 5, or 0 and least accuracy for code types including Scales 4, 6, or 9. ACK, MAC-R, and PRO were better at screening out cases of substance abuse than in accurately identifying those adolescents who were using substances.
R K Chaudhary
Full Text Available Background: Mental health problems account for 12% of global disease burden and non-psychiatrist medical practitioners deal with a large proportion of this burden. This study was planned to assess the knowledge, attitude and treatment practices of non-psychiatrist medical practitioners regarding mental health problems. Materials and Methods: One hundred Allopathic and 25 each of Homeopathic and Ayurvedic medical practitioners were interviewed and assessed using a semi-structured performa. Results: Majority (95% of them were aware regarding etiology, increasing incidence and treatment facilities available for mental health problems. Treatment modalities include counseling and medication but 69.9% of them had not received any formal training in administering them. Conclusions: 98.5% practitioners providing mental health services at the primary level feel the need to be properly trained and oriented in the management of these patients to improve quality of healthcare.
E.J.M. Vegt, van der (Esther); J. van der Ende (Jan); R.F. Ferdinand (Robert); F.C. Verhulst (Frank); H.W. Tiemeier (Henning)
textabstractThe aim of the present study is to investigate whether early childhood adversities determine the longitudinal course of psychiatric problems from childhood to adulthood; in particular if the impact of early maltreatment on psychopathology decreases as time passes. A sample of 1,984
Social work educators have an ethical responsibility to graduate students who are academically, behaviorally, and professionally prepared to enter the social work profession. Although a student's suitability to the profession is not necessarily hindered because of the effects of a psychiatric disability or an emotional problem, sometimes it is.…
Westerhof, Gerben J.; Beernink, Janny; Sools, Anneke
This article describes an innovative intervention based on narrative and life review therapy that is tailored to people with intellectual disability (ID) and psychiatric problems. The current study provides a first evaluation of the intervention. A symptom checklist (SCL-90) was used in a pre- and post-follow-up design, and a qualitative…
Full Text Available Background: Substance abuse and mental disorder comorbidity is high among patients admitted to acute psychiatric wards. The aim of the study was to identify this co-occurrence as a reason for involuntary admission and if specific substance use-related diagnoses were associated with such admissions.Methods: The study was a part of a multicentre, cross-sectional national study carried out during 2005-2006 within a research network of acute mental health services. Seventy-five percent of Norwegian hospitals providing acute in-patient treatment participated. Substance use was measured using the Clinician Rating Scale and the ICD-10 diagnoses F10-19. Diagnostic assessments were performed by the clinicians during hospital stay.Results: Overall, 33.2% (n=1,187 of the total patient population (3,506 were abusing alcohol or drugs prior to admission according to the Clinician Rating Scale. No difference in the overall prevalence of substance abuserelated diagnoses between the two groups was found. Overall, 310 (26% of the admissions, 216 voluntarily and 94 involuntarily admitted patients received a double diagnosis. Frequent comorbid combinations among voluntarily admitted patients were; a combination of alcohol and either mood disorder (40% or multiple mental disorders (29%. Among involuntarily admitted patients, a combination of poly drug use and schizophrenia was most frequent (47%. Substance abusing patients diagnosed with mental and behavioral disorders due to the use of psychoactive stimulant substances had a significantly higher risk of involuntary hospitalization (OR 2.3.Conclusion: Nearly one third of substance abusing patients are involuntarily admitted to mental hospitals, in particular stimulant drug use was associated with involuntarily admissions.
Full Text Available Obesity and its related emotional and physical consequences are a worldwide problem. Obese individuals are usually stigmatized. This study is proposed to assess the correlation between body mass index, gender and age with psychiatric symptoms among Iranian students. A number of 9172 students aged 10-18 years (53.5% girls and 46.5% boys from all provinces of Iran participated in this study. Data was collected using the global school based health survey questionnaire of the World Health Organization (GSHS-WHO. Overall, prevalence of predictors of having emotional problems, depression and anxiety were 27.8%, 29.7% and 11.5% respectively. Girls had significantly higher prevalence of predictors of psychiatric symptoms. Overall obesity was a protective factor against emotional problems OR (CI95%:0.79(0.65-0.98, but it was attributable to obese boys OR (CI95%:0.72(0.55-0.95. Depression and anxiety symptoms were higher in intermediate school girls and high school girls and boys. More attention should be paid to girls' psychological problems. Besides, obesity had an indirect relation with predictors of having psychiatric problems in Iranian boys and it might be due to: (1 parents beliefs about heaviness as a predictor of healthiness, (2 boys lower vulnerability to psychological consequences of obesity and (3 lower pressure from parents on their obese sons to lose weight.
Miller, Adam Bryant; Williams, Caitlin; Day, Catherine; Esposito-Smythers, Christianne
The purpose of the present study was to examine whether cognitive distortions (e.g., cognitive errors; negative views of self, world, and future) influence the association between dating violence and problematic substance use behaviors in a sample of psychiatrically hospitalized adolescents. Participants included 155 adolescents, aged 13-17 years, who had initiated dating. Adolescents completed measures of dating violence, substance-related problems (alcohol and marijuana), and cognitive distortions. Logistic regressions were conducted to examine the direct and interactive effects of dating violence exposure and cognitive distortions on likelihood of recent problematic substance use. Results suggested a main effect of dating violence on problematic alcohol and other drug use as well as an interactive effect of dating violence and cognitive distortions. Specifically, the relationship between dating violence and odds of substance-related problems was higher among those with greater (vs. fewer) cognitive distortions. Study results suggest the need for careful screening of cognitive distortions among adolescent dating violence victims, particularly those in mental health treatment. © 2016 Wiley Periodicals, Inc.
Gattamorta, Karina A; Varela, Alberto; McCabe, Brian E; Mena, Maite P; Santisteban, Daniel A
In early adolescence, Hispanics self-report higher drug use rates compared to White and African American peers. Among adolescent users, heavy users have more negative behavioral and health consequences. The purpose of this cross-sectional study is to examine whether psychiatric symptoms, parental attachment, and reasons for use predict heavy alcohol and illicit drug use (more than 10 times in the past three months) among Hispanic adolescents. This study examines baseline data from a study evaluating a family based substance abuse treatment program for Hispanic adolescents. Participants were 14-17 years old (N = 156, 44% female). Adolescent reports on the Diagnostic Interview Schedule for Children Predictive Scales measured psychiatric symptoms of major depressive disorder, attention deficit hyperactivity disorder, conduct disorder, and anxiety. The Personal Experiences Inventory measured type and amount of drug use, as well as perceived social and psychological benefits of drug use. The Inventory of Parent and Peer Attachment measured trust, communication, and alienation between adolescents and their mothers. Logistic regression identified correlates of heavy alcohol use and heavy illicit drug use among Hispanic adolescents. Higher social benefits were associated with increased likelihood of heavy alcohol use. Conduct disorder, higher levels of maternal attachment, lower levels of acculturation, and higher levels of psychological benefits of use were associated with an increased likelihood of heavy illicit drug use. These findings support the assumption that substance use treatment among Hispanic adolescents must be capable of addressing co-occurring psychiatric disorders, familial relationships, and the individual reasons/motivators to use.
Kerridge, Bradley T; Pickering, Roger P; Saha, Tulshi D; Ruan, W June; Chou, S Patricia; Zhang, Haitao; Jung, Jeesun; Hasin, Deborah S
The purpose of this study was to present current nationally representative data on the prevalences, sociodemographic correlates and risk of DSM-5 substance use disorders and other psychiatric disorders among sexual minorities (SMs) relative to heterosexuals, and among SMs by gender. Data were derived from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. In the general noninstitutionalized population, 1.5%, 1.3% and 0.5% of individuals self-identified as gay/lesbian, bisexual and not sure sexual orientations. Men were more likely to report gay/lesbian orientation than women (1.8% vs. 1.2%). Women were more likely than men to report bisexual (1.8% vs. 0.8%) and not sure (0.6% vs. 0.4%) sexual orientations. Sociodemographic characteristics varied across sexual orientation and gender. Relative to heterosexuals, disparities in substance use and psychiatric disorders were found across sexual orientations, especially among bisexual women. Greater rates of specific psychiatric disorders were also demonstrated by women reporting bisexual and not sure orientations relative to lesbian women, with fewer differences in rates of psychopathology among SM men. Despite growing acceptance of SMs and SM rights over the past decade, substantial mental health disparities exist among these subgroups of the U.S. noninstitutionalized population, especially among bisexual women. More research is needed to understand these mental health disparities, while considering nuances of multiple intersecting minority identities and unique contextual factors. underscore the importance of advancing future population-based research that includes detailed information on the health and well-being of SMs in the United States. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Simpson, A.; Bowers, L.; Allan, T.; Haglund, K.; Muir-Cochrane, E.; Nijman, H.L.I.; Merwe, M. van der
Aim. In this paper we report on the rates of drug/alcohol use on acute psychiatric wards in relation to levels and intensity of exit security measures. Background. Many inpatient wards have become permanently locked, with staff concerned about the risk of patients leaving the ward and harming
GAU, SUSAN S. F; CHONG, MIAN-YOON; YANG, PINCHENG; YEN, CHENG-FANG; LIANG, KUNG-YEE; CHENG, ANDREW T. A
.... The Cox regression model was used for data analysis. The most significant predictive factors for adolescent substance use disorder included male gender, attention-deficit hyperactivity disorder, conduct disorder and sibling use of tobacco...
Mueser, Kim T; Crocker, Anne G; Frisman, Linda B; Drake, Robert E; Covell, Nancy H; Essock, Susan M
Conduct disorder (CD) and antisocial personality disorder (ASPD) are established risk factors for substance use disorders in both the general population and among persons with schizophrenia and other severe mental illnesses...
Treatment outcomes of a combined cognitive behavior therapy and pharmacotherapy for a sample of women with and without substance abuse histories on an acute psychiatric unit: do therapeutic alliance and motivation matter?
Clarke, Nickeisha; Mun, Eun-Young; Kelly, Shalonda; White, Helene R; Lynch, Katherine
Women with comorbid psychiatric and substance abuse problems (PwSA) experience more consequences from their use and typically have the poorest prognosis and outcome, compared to those with psychiatric problems but without substance abuse problems (PwoSA). The present study examined outcomes of a combined intensive inpatient cognitive behavior therapy (CBT) and pharmacotherapy program for women with PwSA and PwoSA. Sample consisted of 117 women on a women-only acute inpatient unit (PwSA = 50, PwoSA = 67). Women in both groups made significant improvements in psychological functioning. High motivation at admission and therapeutic alliance at discharge were associated with improved psychological functioning at discharge for both groups. Findings provide preliminary support for the efficacy of a combined CBT and pharmacotherapy program for women with psychiatric diagnoses on a women-only acute inpatient unit, and for pre-treatment motivation and therapeutic alliance as important correlates of better treatment outcomes. Copyright © American Academy of Addiction Psychiatry.
Walcott, G; Martin, J; Hickling, F W
To determine the prevalence of personality disorders in patients admitted to the psychiatric wards of the University Hospital of the West Indies (UHWI). Patients (n = 100) sequentially admitted to the psychiatric wards of the UHWI were assessed for personality disorder using the gold standard of a consultant assessment using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM IV-TR) diagnostic criteria for personality disorder, the International Personality Disorder Examination Screening questionnaire (IPDE-S), and the Jamaica Personality Disorder Inventory (JPDI). The three assessment instruments identified a prevalence of personality disorder in the cohort of patients of 51% consultant DSM-IV-TR assessment, 57% JPDI and 86% IPDE-S. The prevalence rate identified by the IPDE-S was significantly higher that the local instruments used (p Jamaica is comparable to the prevalence rate of studies in other countries in a similar population.
Testa, A; Giannuzzi, R; Sollazzo, F; Petrongolo, L; Bernardini, L; Dain, S
In this Part II psychiatric disorders coexisting with organic diseases are discussed. "Comorbidity phenomenon" defines the not univocal interrelation between medical illnesses and psychiatric disorders, each other negatively influencing morbidity and mortality. Most severe psychiatric disorders, such as schizophrenia, bipolar disorder and depression, show increased prevalence of cardiovascular disease, related to poverty, use of psychotropic medication, and higher rate of preventable risk factors such as smoking, addiction, poor diet and lack of exercise. Moreover, psychiatric and organic disorders can develop together in different conditions of toxic substance and prescription drug use or abuse, especially in the emergency setting population. Different combinations with mutual interaction of psychiatric disorders and substance use disorders are defined by the so called "dual diagnosis". The hypotheses that attempt to explain the psychiatric disorders and substance abuse relationship are examined: (1) common risk factors; (2) psychiatric disorders precipitated by substance use; (3) psychiatric disorders precipitating substance use (self-medication hypothesis); and (4) synergistic interaction. Diagnostic and therapeutic difficulty concerning the problem of dual diagnosis, and legal implications, are also discussed. Substance induced psychiatric and organic symptoms can occur both in the intoxication and withdrawal state. Since ancient history, humans selected indigene psychotropic plants for recreational, medicinal, doping or spiritual purpose. After the isolation of active principles or their chemical synthesis, higher blood concentrations reached predispose to substance use, abuse and dependence. Abuse substances have specific molecular targets and very different acute mechanisms of action, mainly involving dopaminergic and serotoninergic systems, but finally converging on the brain's reward pathways, increasing dopamine in nucleus accumbens. The most common
Full Text Available The study's purpose was to determine treatment outcomes for patients who present with drug use vs. those presenting with no drug use at admission to a psychiatric day treatment program. Consecutively admitted patients completed confidential interviews which included psychological distress and quality of life measures and provided urine specimens for toxicology at admission and six month follow-up. Subjects positive by past 30 day self-report or urinalysis were categorized as drug users. Major psychiatric diagnoses were: major depression 25%; bipolar, 13%; other mood 13%; schizoaffective 13%; schizophrenia 13%. Drug use at admission was: cocaine 35%; marijuana 33%; opiates 18%, (methamphetamines, 6% For each of these drugs, the percentage of patients positive at admission who remitted from using the drug significantly exceeded the percentage negative at baseline who initiated using the drug. Overall, there were significant decreases in psychological distress and significant improvement on quality of life, but no change on positive affect. There were no significant differences between drug users and non-drug users on symptom reduction and improvement in quality of life. Psychiatric day treatment appears to benefit comorbid patients by reducing the net number of patients who actively use certain common drugs and by improving psychological status and quality of life to the same degree as for non-drug using patients.
Full Text Available The study’s purpose was to determine treatment outcomes for patients who present with drug use vs. those presenting with no drug use at admission to a psychiatric day treatment program. Consecutively admitted patients completed confidential interviews which included psychological distress and quality of life measures and provided urine specimens for toxicology at admission and six month follow-up. Subjects positive by past 30 day self-report or urinalysis were categorized as drug users. Major psychiatric diagnoses were: major depression 25%; bipolar, 13%; other mood 13%; schizoaffective 13%; schizophrenia 13%. Drug use at admission was: cocaine 35%; marijuana 33%; opiates 18%, (methamphetamines, 6% For each of these drugs, the percentage of patients positive at admission who remitted from using the drug significantly exceeded the percentage negative at baseline who initiated using the drug. Overall, there were significant decreases in psychological distress and significant improvement on quality of life, but no change on positive affect. There were no significant differences between drug users and non-drug users on symptom reduction and improvement in quality of life. Psychiatric day treatment appears to benefit comorbid patients by reducing the net number of patients who actively use certain common drugs and by improving psychological status and quality of life to the same degree as for non-drug using patients.
Prevalence of Axis-1 psychiatric (with focus on depression and anxiety) disorder and symptomatology among non-medical prescription opioid users in substance use treatment: systematic review and meta-analyses.
Goldner, Elliot M; Lusted, Anna; Roerecke, Michael; Rehm, Jürgen; Fischer, Benedikt
Non-medical prescription opioid use (NMPOU) constitutes a substantial clinical and public health concern in North America. Although there is evidence of elevated rates of mental health problems among people with NMPOU, the extent of these correlations specifically in treatment samples has not been systematically assessed. A systematic review and meta-analysis were conducted for Axis-1 psychiatric diagnoses and symptoms with a principal focus on depression and anxiety disorders in substance use treatment samples reporting NMPOU at admission to treatment (both criteria within past 30days). 11 unique studies (all from either the United States or Canada) met inclusion criteria and were included in the meta-analysis. The pooled prevalence of 'any' mental health problems (both diagnosis and symptoms) among substance abuse treatment patients reporting NMPOU was 43% (95% CI: 32%-54%; I(2) for inter-study heterogeneity: 99.5%). The pooled prevalence of depression diagnosis among substance abuse treatment patients reporting NMPOU was 27% (95% CI: 9%-45%; I(2): 99.2%); the pooled prevalence of anxiety diagnosis in the sample was 29% (95% CI: 14%-44%; I(2): 98.7%). The prevalence rates of psychiatric problems (both diagnosis and symptoms), depression diagnosis and anxiety diagnosis are disproportionately high in substance use treatment samples reporting NMPOU relative to general population rates. Adequate and effective clinical strategies are needed to address co-occurring NMPOU and mental health in substance use treatment systems, especially given rising treatment demand for NMPOU. Efforts are needed to better understand the temporal and causal relationships among NMPOU, mental health problems, and treatment seeking in order to improve interventions. Copyright © 2013 Elsevier Ltd. All rights reserved.
Barnow, Sven; Schuckit, Marc A; Lucht, Michael; John, Ulrich; Freyberger, Harald J
The purpose of this study was to test a hypothetical model of alcohol problems in German adolescents. Among 180 offspring, family history of alcoholism, parenting styles, behavioral and emotional problems, peer-group characteristics, feelings of self-esteem, behavioral problems and psychiatric comorbidity of the parents were examined. Data were generated from the Study of Health in Pomerania (SHIP), in which families were randomly selected if 12-18 year old biological offspring were members of the household; a smaller group of subjects was selected from local outpatient treatment centers. Members of 133 families, including 180 (50.6% male) offspring who were appropriate for the current analyses, received personal semistructured diagnostic interviews and several self-rating questionnaires. Analyses compared offspring with alcohol problems (AP; n = 40) and with no alcohol problems (NAP; n = 140), and used structural equation modeling to test a hypothetical model. The comparisons revealed that the AP group had significantly more behavioral problems (e.g., aggression/delinquency), more perceived parental rejection and less emotional warmth, a higher amount of alcohol consumption, were more likely to associate with substance-using peers and more often received a diagnosis of conduct disorder or antisocial personality disorder. Whereas the family history of alcoholism did not differ significantly between groups, parents of offspring with an alcohol use disorder had significantly more additional diagnoses on DSM-IV Axis I. The evaluation of the model supported the importance of aggression/delinquency and association with substance-using peers for alcohol problems in people. An additional diagnosis in the parents was directly and indirectly (through aggression/delinquency) related to alcohol problems of the adolescents. The data indicate that alcohol problems in the offspring are associated with several domains of influence in their environment. Prospective studies
McMillen, J Curtis; Narendorf, Sarah Carter; Robinson, Debra; Havlicek, Judy; Fedoravicius, Nicole; Bertram, Julie; McNelly, David
Older youth in out-of-home care often live in restrictive settings and face psychiatric issues without sufficient family support. This paper reports on the development and piloting of a manualized treatment foster care program designed to step down older youth with high psychiatric needs from residential programs to treatment foster care homes. A team of researchers and agency partners set out to develop a treatment foster care model for older youth based on Multi-dimensional Treatment Foster Care (MTFC). After matching youth by mental health condition and determining for whom randomization would be allowed, 14 youth were randomized to treatment as usual or a treatment foster home intervention. Stakeholders were interviewed qualitatively at multiple time points. Quantitative measures assessed mental health symptoms, days in locked facilities, employment and educational outcomes. Development efforts led to substantial variations from the MTFC model and a new model, Treatment Foster Care for Older Youth was piloted. Feasibility monitoring suggested that it was difficult, but possible to recruit and randomize youth from and out of residential homes and that foster parents could be recruited to serve them. Qualitative data pointed to some qualified clinical successes. Stakeholders viewed two team roles - that of psychiatric nurse and skills coaches - very highly. However, results also suggested that foster parents and some staff did not tolerate the intervention well and struggled to address the emotion dysregulation issues of the young people they served. Quantitative data demonstrated that the intervention was not keeping youth out of locked facilities. The intervention needed further refinement prior to a broader trial. Intervention development work continued until components were developed to help address emotion regulation problems among fostered youth. Psychiatric nurses and skills coaches who work with youth in community settings hold promise as important
Zimmermann, Adam; Lubman, Dan I.; Cox, Merrilee
Previous research has consistently documented high rates of tobacco smoking and substance use disorders among young people with serious mental illness. However, limited studies have been conducted outside traditional clinical settings. In an attempt to address this shortfall and to better understand the needs of young people accessing its…
Cook, Steven; Turner, Nigel E; Ballon, Bruce; Paglia-Boak, Angela; Murray, Robert; Adlaf, Edward M; Ilie, Gabriela; den Dunnen, Wendy; Mann, Robert E
This paper describes gambling problems among Ontario students in 2009 and examines the relationship between gambling problems and substance use problems, mental health problem indicators, and delinquent behaviors. Data were derived from the Ontario Student Drug Use and Health Survey of Ontario students in grades 7-12. Gambling problems were measured as 2 or more of 6 indicators of problem gambling. In total 2.8% of the students surveyed endorsed two or more of the problem gambling items. The odds of problem gamblers reporting mental distress was 4.2 times higher than the rest of the sample and the odds of problem gamblers reporting a suicide attempt were 17.8 times greater than the rest of the sample. In addition compared to the rest of the students, delinquent behaviors were also more common among problem gamblers, including theft (OR = 14.5), selling marijuana (OR = 19.6), gang fights (OR = 11.3) and carrying a handgun (OR = 11.2). In a multivariate analysis, substance-use problems, mental health problems, and the participation in a variety of delinquent behaviors remained significantly associated with youth problem gambling behavior. Students who report problem gambling behaviors show increased substance abuse, mental health, and delinquency/criminal problems that are similar to those seen among adult problem gamblers. The association between these problems suggests that these problems could be addressed in a unified manner.
Self-wise, Other-wise, Streetwise (SOS) training: a novel intervention to reduce victimization in dual diagnosis psychiatric patients with substance use disorders: protocol for a randomized controlled trial
de Waal, M.M.; Kikkert, M.J.; Blankers, M.; Dekker, J.J.M.; Goudriaan, A.E.
Background: Psychiatric patients are more likely to be victims of crime than others in the community. Dual diagnosis patients with comorbid psychiatric and substance use disorders are especially prone to victimization. Victimization is associated with substance abuse, more severe symptomatology and
Seyyed Salman Alavi
Conclusion: Similar to substance abuse prevention, programs aimed at addicted individuals and specialized training can educate adolescents about the warning signs of online addiction, in order to assist the early detection of this disorder. For prevention of behavioral addiction (such as internet addiction authorities, cultural institutions and parents should monitor the use of internet and teach to the adolescent and children, the useful and appropriate methods of internet use.
Magallón-Neri, Ernesto; Díaz, Rosa; Forns, Maria; Goti, Javier; Canalda, Gloria; Castro-Fornieles, Josefina
The main aim of this study was to replicate and extend previous results on subtypes of adolescents with substance use disorders (SUD), according to their Minnesota Multiphasic Personality Inventory for adolescents (MMPI-A) profiles. Sixty patients with SUD and psychiatric comorbidity (41.7% male, mean age = 15.9 years old) completed the MMPI-A, the Teen Addiction Severity Index (T-ASI), the Child Behaviour Checklist (CBCL), and were interviewed in order to determine DSMIV diagnoses and level of substance use. Mean MMPI-A personality profile showed moderate peaks in Psychopathic Deviate, Depression and Hysteria scales. Hierarchical cluster analysis revealed four profiles (acting-out, 35% of the sample; disorganized-conflictive, 15%; normative-impulsive, 15%; and deceptive-concealed, 35%). External correlates were found between cluster 1, CBCL externalizing symptoms at a clinical level and conduct disorders, and between cluster 2 and mixed CBCL internalized/externalized symptoms at a clinical level. Discriminant analysis showed that Depression, Psychopathic Deviate and Psychasthenia MMPI-A scales correctly classified 90% of the patients into the clusters obtained.
Kong, Grace; Smith, Philip H; Pilver, Corey; Hoff, Rani; Potenza, Marc N
Little is known about the association between problem-gambling severity and psychiatric disorders among American-Indian/Alaska-Native (AI/AN) individuals. Thus, we examined these factors among a nationally representative sample of AI/AN and other American adults in the USA. Using the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) data, we conducted separate Wald tests and multinomial logistic regression analyses comparing AI/AN to black/African American, white/Caucasian, and all other racial/ethnic groups, respectively. Relative to other American adults, AI/AN adults were least likely to report non-/low-frequency gambling (NG: AI/AN 66.5%, white/Caucasian 70.5%, black/African American 72.8%, other racial/ethnic group 72.3%) and most likely to report low-risk gambling (LRG: AI/AN 30.1%, white/Caucasian 26.5%, black/African American 23.4%, other racial/ethnic group 24.7%). The association between at-risk/problem-gambling (ARPG) and any past-year Axis-I disorder was stronger among AI/AN versus other American adults. Although ARPG and LRG were associated with multiple past-year Axis-I and lifetime Axis-II psychiatric disorders in both AI/AN and other American adults, LRG was more strongly associated with both Axis-I disorders (particularly major depression, generalized anxiety disorder and nicotine dependence) and Cluster-B Axis-II (particularly antisocial personality disorder) disorders in AI/AN versus other American adults. A stronger association between problem-gambling severity and past-year psychiatric disorders among AI/AN relative to other American adults suggests the importance of enhancing mental health and problem-gambling prevention and treatment strategies that may help AI/AN individuals. Copyright © 2015 Elsevier Ltd. All rights reserved.
Feinstein, Emily C; Richter, Linda; Foster, Susan E
The use of addictive substances-tobacco, alcohol, and other drugs-during adolescence interferes with brain development and increases the risk of serious health and mental health conditions, including addiction. Yet, adolescents live in a culture in which family, social, community, and media influences regularly bombard them with pro-substance use messages, creating an environment in which substance use is considered an expected behavior, rather than a considerable health risk. To prevent the significant harm that falls to teens and young adults because of substance use, The National Center on Addiction and Substance Abuse at Columbia University (CASA Columbia) undertook a study to explore how adolescent brain development relates to the risk of substance use and addiction; the cultural influences that create an environment in which substance use is considered normative behavior; individual factors that make some teens more disposed to substance use and addiction; and evidence-based prevention and treatment strategies for addressing this problem. The recently published report Adolescent Substance Use: America's #1 Public Health Problem concludes that risky substance use is a major public health problem that can be ameliorated through evidence-based public health measures, including education about the disease and its risk factors, screenings, and clinical interventions, and that addiction can be treated and managed effectively within routine health care practice and specialty care. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Full Text Available OBJECTIVE: This study aimed to investigate the occurrence of psychiatric problems in children and adolescents with sickle cell disease (SCD. METHODS: The Child Behavior Checklist for ages 4-18 years (CBCL/4-18, Conners’ Parent Rating Scale (CPRS, Conners’ Teacher Rating Scale (CTRS-R, and The Turgay DSM-IV Based Child and Adolescent Behavior Disorders Screening and Rating Scale, clinician and parent forms (T-DSM-IV-S were given to the caregivers and teachers of 31 children with SCD aged between 7-18 years and the caregivers and teachers of 34 age matched controls with irondeficiency anemia. RESULTS: The SCD patients had higher scores on all 4 of scales. Among the subscales, internalizing problems, and attention problems were more prominent in the SCD patients. CONCLUSION: Children and adolescents with SCD appear to have an increased risk for psychiatric problems. Regular psychological evaluation and referral to child and adolescent psychiatry clinics may facilitate timely diagnosis and effective treatment of at-risk children and adolescents.
Thompson, Laetitia L.; Whitmore, Elizabeth A.; Raymond, Kristen M.; Crowley, Thomas J.
Adolescents with substance use and conduct disorders have high rates of aggression and attention deficit hyperactivity disorder (ADHD), all of which have been characterized in part by impulsivity. Developing measures that capture impulsivity behaviorally and correlate with self-reported impulsivity has been difficult. One promising behavioral…
2007). Problem use of alcohol and other substances is a key risk factor for homelessness among veterans (Edens et al., 2011). Particularly...Rosenheck, R. A. (2011). Associa- tion of substance use and VA service-connected disability benefi ts with risk of homelessness among veterans...improve the outcomes of standard care for young people with comorbid depression and substance misuse? Medical Journal of Australia , 195, S31–S37. Hien, D
Dhawan, Anju; Balhara, Yatan Pal Singh; Natasha, M. Phil.
Adolescent substance abuse is a major public health concern. It is associated with an increased incidence of various psychiatric disorders like depressive disorders, anxiety disorders, attention deficit hyperactivity disorder, and conduct disorders and the relationship between mental and behavioral disorders and the substance use problems seems…
Full Text Available Background The upbringing and sociocultural factors determine the initial stages of habit formation in a child. Type of family, peer company, environment at school, and surroundings tend to influence adolescent’s tendency for substance experimentation and use. Aim Our aim was to identify the extent of experimental substance use and catalytic effect of interpersonal relational problems among adolescents. Methods A self-administered health risk screening questionnaire was used. The questionnaire focused on problems related to substance use; type of substances experimented with; and interpersonal problems with parents, peers, at school, and in the neighbourhood. A cross-sectional study design was adopted (n=1770, age 16–19 years. Data obtained was entered and analysed using SPSS 15. Results The proportion of experimentation with substance was found out to be more in boys as compared to girls. Alcohol was mostly consumed by them followed by cigarettes, pan masala and other substances. Interpersonal issues with mothers, fathers, at home, school and residing town were found to be significant factors that influenced adolescents for substance experimentation and use. Higher age group among adolescents sex (male were strong socio demographic predictors of adolescent substance use. Conclusion Cordial environment at home especially with parents, age, sex (male, residing town/neighbourhood were found to be very significant predictors of substance use by adolescents.
Maslowsky, Julie; Schulenberg, John E.; Zucker, Robert A.
The identification of developmentally specific windows at which key predictors of adolescent substance use are most influential is a crucial task for informing the design of appropriately targeted substance use prevention and intervention programs. The current study examined effects of conduct problems and depressive symptomatology on changes in…
Few studies in Nigeria have investigated the relationship between psychiatric disorders and substance use. Yet, evidence worldwide suggests that substance related problems might be a major burden among persons with psychiatric disorders. One hundred and five persons with mental illness (105) were evaluated for ...
Moussas, G I; Papadopoulou, A G; Christodoulaki, A G; Karkanias, A P
Cancer may be localized in a variety of areas in the human body. This localization is associated with significant issues concerning not only therapy and prognosis but also psychological and psychiatric problems that the patient may be confronted with. The psychic impact on the patient is determined to a significant degree by the symbolism the affected organ carries. The symbolic significance of a sick body area triggers emotions and sets in motion self-defence mechanisms. In this way, patients deal with the new psychic reality that cancer creates. Therapeutic choices may include interventions, involving mutilation, which cause disfigurement and major consequences in the body image which result in narcissistic injuries. The phenomenology of anxiety and depressive disorders is connected to the affected body area. The appearance of cancer not only in sexual organs but also in other body areas, may disturb sexual function and therefore lead to sexual disorders. Especially, head and neck are connected with vital functions. This area of the body has had a major impact on psychic reality since early life. Complicated psychic functions have developed in relation to organs of the head and neck. Therefore, localization of cancer in this area leads to individual psychological and psychiatric problems, since eating and breathing are harmed, verbal communication becomes difficult and body image alters. Also, increased incidence of alcohol and nicotine abuse in these patients reflects special aspects of psychic structure and personality. Because of severe somatic symptoms and poor prognosis, lung cancer patients feel hopelessness and helplessness. Patients with gynaecological cancer are confronted with a disease that affects organs like breast and internal female sexual organs associated with femininity, attractiveness and fertility. Dietary habits are often a source of guilt for patients who suffer from cancer of the gastrointestinal tract. Additionally, stomas, as colostomy
Cowlishaw, Sean; Jackson, Alun C; Merkouris, Stephanie S; Francis, Kate L; Christensen, Darren R
Objective: The aim of this paper was to systematically review and meta-analyse the prevalence of co-morbid psychiatric disorders (DSM-IV Axis I disorders) among treatment-seeking problem gamblers. Methods: A systematic search was conducted for peer-reviewed studies that provided prevalence estimates of Axis I psychiatric disorders in individuals seeking psychological or pharmacological treatment for problem gambling (including pathological gambling). Meta-analytic techniques were performed to estimate the weighted mean effect size and heterogeneity across studies. Results: Results from 36 studies identified high rates of co-morbid current (74.8%, 95% CI 36.5–93.9) and lifetime (75.5%, 95% CI 46.5–91.8) Axis I disorders. There were high rates of current mood disorders (23.1%, 95% CI 14.9–34.0), alcohol use disorders (21.2%, 95% CI 15.6–28.1), anxiety disorders (17.6%, 95% CI 10.8–27.3) and substance (non-alcohol) use disorders (7.0%, 95% CI 1.7–24.9). Specifically, the highest mean prevalence of current psychiatric disorders was for nicotine dependence (56.4%, 95% CI 35.7–75.2) and major depressive disorder (29.9%, 95% CI 20.5–41.3), with smaller estimates for alcohol abuse (18.2%, 95% CI 13.4–24.2), alcohol dependence (15.2%, 95% CI 10.2–22.0), social phobia (14.9%, 95% CI 2.0–59.8), generalised anxiety disorder (14.4%, 95% CI 3.9–40.8), panic disorder (13.7%, 95% CI 6.7–26.0), post-traumatic stress disorder (12.3%, 95% CI 3.4–35.7), cannabis use disorder (11.5%, 95% CI 4.8–25.0), attention-deficit hyperactivity disorder (9.3%, 95% CI 4.1–19.6), adjustment disorder (9.2%, 95% CI 4.8–17.2), bipolar disorder (8.8%, 95% CI 4.4–17.1) and obsessive-compulsive disorder (8.2%, 95% CI 3.4–18.6). There were no consistent patterns according to gambling problem severity, type of treatment facility and study jurisdiction. Although these estimates were robust to the inclusion of studies with non-representative sampling biases, they should
C. Quispel (Chantal)
markdownabstract__Abstract__ The overall aim of the present thesis is to demonstrate the feasibility of an innovative screenand- advice instrument, for routine screening and subsequent referral to tailored care of pregnant women with psychopathology, psychosocial problems and substance
Mason, Michael J.
This study tested a mediation model of the relationship with school problems, social network quality, and substance use with a primary care sample of 301 urban adolescents. It was theorized that social network quality (level of risk or protection in network) would mediate the effects of school problems, accounting for internalizing problems and…
Brandt, Laura; Fischer, Gabriele
The aim of this study is as follows: (a) exploring retrospective childhood and adult ADHD symptomatology in treatment-seeking gamblers, (b) providing detailed characteristics of the association between pathological gambling (PG) and ADHD, and (c) identifying risk factors for a history of ADHD. Eighty problem gamblers (20% female) were examined using a standardized interview (PG: Diagnostic and Statistical Manual of Mental Disorders [4th ed.; DSM-IV] criteria, Gambling Attitudes and Beliefs Survey; ADHD: Wender Utah Rating Scale- deutsche Kurzform, Adult ADHD Self-Report Scale; comorbidities: Mini International Neuropsychiatric Interview). Forty-three percentage of patients screened positive for childhood ADHD, and in 11%, ADHD persisted in adulthood. Patients with adult ADHD had more severe gambling problems ( p = .009, d = 1.03) and a higher number of psychiatric comorbidities ( p gamblers.
Kendler, K S
The soft medical model for psychiatric illness, which was operationalized in DSM-III, defines psychiatric disorders as syndromes with shared symptoms, signs, course of illness and response to treatment...
Deux, Natalie; Schlarb, Angelika A; Martin, Franziska; Holtmann, Martin; Hebebrand, Johannes; Legenbauer, Tanja
Adolescent psychiatric patients are vulnerable to weight problems and show an overrepresentation of overweight compared to the healthy population. One potential factor that can contribute to the etiology of overweight is higher impulsivity. As of yet, it is unclear whether it is a general impulse control deficit or weight-related aspects such as lower impulse control in response to food that have an impact on body weight. As this may have therapeutic implications, the current study investigated differences between overweight and non-overweight adolescent psychiatric inpatients (N = 98; aged 12-20) in relation to trait impulsivity and behavioral inhibition performance. The Barratt Impulsiveness Scale and two go/no-go paradigms with neutral and food-related stimulus materials were applied. Results indicated no significant differences concerning trait impulsivity, but revealed that overweight inpatients had significantly more difficulties in inhibition performance (i.e. they reacted more impulsively) in response to both food and neutral stimuli compared to non-overweight inpatients. Furthermore, no specific inhibition deficit for high-caloric vs. low-caloric food cues emerged in overweight inpatients, whereas non-overweight participants showed significantly lower inhibition skills in response to high-caloric than low-caloric food stimuli. The results highlight a rather general, non-food-specific reduced inhibition performance in an overweight adolescent psychiatric population. Further research is necessary to enhance the understanding of the role of impulsivity in terms of body weight status in this high-risk group of adolescent inpatients. Copyright © 2017 Elsevier Ltd. All rights reserved.
Offord, D R; Boyle, M H
This paper focuses on problems that can be encountered in conceptualizing, executing and writing up large-scale psychiatric epidemiological studies. It makes no attempt to cover fundamental issues of design and analysis, rather it centers on problems associated with projects of considerable size. In the conceptual area, it discusses the prerequisites to be considered before deciding to launch such a study. It notes the administrative and scientific uses of epidemiological studies and considers the strengths and weaknesses of large-scale studies to address those concerns. Issues in carrying out such studies are discussed including decisions about study design, sampling method and instrumentation. All are dependent on the central purpose of the study but trade-offs between feasibility and scientific rigor are always present. Data collection and analysis problems highlighted in large-scale studies are examined. They include the difficulty, in the former, of adequately motivating and supervising field personnel and, in the latter, of dealing with problems that accompany missing data and complicated sampling strategies. Potential problems in data access and use and writing up the results are seen as arising from the presence of a large investigative team with diverse interests. Lastly, the comparative worth of these studies is considered.
Nijhawan, Ank; Kim, Soyun; Rich, Josiah D.
Although highly active antiretroviral therapy (HAART) has greatly reduced overall morbidity and mortality in patients with HIV, patients with substance use issues have been less likely than other patients with HIV to realize these benefits. Social obstacles (eg, lack of housing, minimal social support), and medical comorbidities (eg, mental illness, hepatitis), complicate the management of this group of patients. Not only are drug and alcohol users less likely to access medical care, initiation of HAART may be delayed due to concerns for adherence and the potential development of drug resistance. Ultimately, a multidisciplinary comprehensive approach is needed to both engage and retain this population in care. Through the integration of case management, addiction therapy, and medical treatment of HIV, we may be able to improve outcomes for patients with HIV and addiction. PMID:18687208
Jagt-Jelsma, W. van der; Vries-Schot, M.R. de; Jong, R. de; Hartman, C.A.; Verhulst, F.C.; Klip, H.; Deurzen, P.A. van; Buitelaar, J.K.
BACKGROUND: This study investigated the association between the religiosity of parents and pre-adolescents, and pre-adolescents' psychiatric problems. METHOD: In a clinic-referred cohort of 543 pre-adolescents at least once referred to a mental health outpatient clinic mental health problems were
van der Jagt-Jelsma, W.; de Vries-Schot, M. R.; de Jong, Rint; Hartman, C. A.; Verhulst, F. C.; Klip, H.; van Deurzen, P. A. M.; Buitelaar, J. K.
Background: This study investigated the association between the religiosity of parents and pre-adolescents, and pre-adolescents' psychiatric problems. Method: In a clinic-referred cohort of 543 pre-adolescents at least once referred to a mental health outpatient clinic mental health problems were
Cuijpers, P; Langendoen, Y; Bijl, R V
(1) To confirm the increased risk of psychiatric disorders in Adult Children of Alcoholics (ACOAs); (2) to test if the age of onset of the disorders differs for ACOAs versus non-ACOAs; (3) to estimate the weight of being an ACOA compared to other risk factors including childhood traumas, other parental problem behaviours and current risk factors. A random sample of the Dutch population (N = 7147) was interviewed (response rate: 69.7%). Psychiatric disorders were assessed using the CIDI. Parental problem drinking, other parental problem behaviours and childhood traumas were assessed using self-report measures. (1) ACOAs had a significantly higher life-time, 12-month and 1-month prevalence of mood, anxiety and abuse/dependence disorders. Sons of problem drinkers also had a higher prevalence of eating disorders and schizophrenia. The prevalence rates were particularly high for the children of fathers with drinking problems. (2) The first onset of the mood and anxiety disorders took place at a younger age in ACOAs than in non-ACOAs. (3) Relative to other parental problem behaviours and childhood traumas, parental problem drinking is a strong predictor of psychiatric disorders, in particular abuse/dependence disorders. Children of fathers with a drinking problem are a high-risk group for psychiatric disorder. From a public health perspective it is an important target to break through this continuing circle. The further development of prevention and early treatment interventions at schools, youth care and addiction treatment centres is an important issue.
Raitakari, Suvi; Günther, Kirsi; Juhila, Kirsi; Saario, Sirpa
Professionals in human service work are at the centre of complicated client cases. The ways client cases are constructed and the problems explained form the basis for professionals' assessments, decisions, actions and interventions. In this article the ways professionals make sense of dual-diagnosis client cases are examined. Applying the concept of causal accounting, it is argued that 'theories of cause' are embedded in professional discourse and profoundly shape professionals' understandings of social and health problems, as well as of their own roles and responsibilities and of what interventions and outcomes are possible. The data consist of 48 tape-recorded weekly team meetings among professionals in a supported housing unit targeted for clients with both mental health and substance abuse problems. It was found that professionals reason about the relationship between these two problems in four different ways: (1) substance abuse causes or makes mental health problems worse; (2) substance abuse eases mental health problems; (3) mental health problems cause or make substance abuse worse; or (4) good mental health reduces substance abuse. Causal account research makes visible the ways professionals do institutional work by categorizing clients, accounting for responsibilities as well as assessing their work and clients' achievements according to moral expectations of a 'good'professional and a worthy client.
Full Text Available The objective of this study was to describe a 12-year (1997-2008 observation of substance-related incidents occurring at rave parties in the Netherlands, including length of visits to first-aid stations, substances used, and severity of the incidents. During rave parties, specifically trained medical and paramedical personnel staffed first aid stations. Visitors were diagnosed and treated, and their data were recorded using standardized methods. During the 12-year period with 249 rave parties involving about 3,800,000 visitors, 27,897 people visited a first aid station, of whom 10,100 reported having a substance-related problem. The mean age of these people was 22.3+/-5.4 years; 52.4% of them were male. Most (66.7% substance-related problems were associated with ecstasy or alcohol use or both. Among 10,100 substance-related cases, 515 required professional medical care, and 16 of these cases were life threatening. People with a substance-related problem stayed 20 min at the first aid station, which was significantly longer than the 5 min that those without a substance-related health problem stayed. These unique data from the Netherlands identify a variety of acute health problems related to the use of alcohol, amphetamines, cannabis, cocaine, ecstasy, and GHB. Although most problems were minor, people using GHB more often required professional medical care those using the other substances. We recommended adherence to harm and risk reduction policy, and the use of first aid stations with specially trained staff for both minor and serious incidents.
Carey, Kathleen; Montez-Rath, Maria E; Rosen, Amy K; Christiansen, Cindy L; Loveland, Susan; Ettner, Susan L
To examine how service accessibility measured by geographic distance affects service sector choices for veterans who are dually eligible for veterans affairs (VA) and Medicare services and who are diagnosed with mental health and/or substance abuse (MH/SA) disorders. Primary VA data sources were the Patient Treatment (acute care), Extended Care (long-term care), and Outpatient Clinic files. VA cost data were obtained from (1) inpatient and outpatient cost files developed by the VA Health Economics and Resource Center and (2) outpatient VA Decision Support System files. Medicare data sources were the denominator, Medicare Provider Analysis Review (MEDPAR), Provider-of-Service, Outpatient Standard Analytic and Physician/Supplier Standard Analytic files. Additional sources included the Area Resource File and Census Bureau data. We identified dually eligible veterans who had either an inpatient or outpatient MH/SA diagnosis in the VA system during fiscal year (FY)'99. We then estimated one- and two-part regression models to explain the effects of geographic distance on both VA and Medicare total and MH/SA costs. Results provide evidence for substitution between the VA and Medicare, demonstrating that poorer geographic access to VA inpatient and outpatient clinics decreased VA expenditures but increased Medicare expenditures, while poorer access to Medicare-certified general and psychiatric hospitals decreased Medicare expenditures but increased VA expenditures. As geographic distance to VA medical facility increases, Medicare plays an increasingly important role in providing mental health services to veterans.
Stone, Andrea L; Becker, Linda G; Huber, Alice M; Catalano, Richard F
This review examines the evidence for longitudinal predictors of substance use and abuse in emerging adulthood. Nationally representative data from the 2007 National Survey on Drug use and Health suggest that many substance use problems reach their peak prevalence during emerging adulthood (usually defined as the period from age 18 to age 26). This stage of development is characterized by rapid transitions into new social contexts that involve greater freedom and less social control than experienced during adolescence. Concurrent with this newfound independence is an increase in rates of substance use and abuse. Understanding the risk and protective factors associated with emerging adult substance use problems is an important step in developing interventions targeting those problems. While multiple reviews have examined risk and protective factors for substance use during adolescence, and many of these earlier predictors may predict emerging adult substance use, few studies have focused primarily on the emerging adult outcomes examining predictors from both adolescence and emerging adulthood. This review used the databases PubMed and PsycInfo to identify articles pertaining to longitudinal predictors of substance use problems in emerging adulthood, building from the conceptual framework presented in a review on risk and protective factors for adolescent substance abuse by Hawkins and colleagues (Hawkins, Catalano, & Miller, 1992). Predictors identified as predictors of substance use in adolescence, sometimes decreased in strength and in one case reversed direction. Unique predictors in emerging adulthood were also identified. Implications for prevention science during adolescence and emerging adulthood are discussed as well as suggestions for future research. Copyright © 2012 Elsevier Ltd. All rights reserved.
D'Onofrio, Brian M; Rickert, Martin E; Langström, Niklas; Donahue, Kelly L; Coyne, Claire A; Larsson, Henrik; Ellingson, Jarrod M; Van Hulle, Carol A; Iliadou, Anastasia N; Rathouz, Paul J; Lahey, Benjamin B; Lichtenstein, Paul
Previous epidemiological, animal, and human cognitive neuroscience research suggests that maternal smoking during pregnancy (SDP) causes increased risk of substance use/problems in offspring. To determine the extent to which the association between SDP and offspring substance use/problems depends on confounded familial background factors by using a quasi-experimental design. We used 2 separate samples from the United States and Sweden. The analyses prospectively predicted multiple indices of substance use and problems while controlling for statistical covariates and comparing differentially exposed siblings to minimize confounding. Offspring of a representative sample of women in the United States (sample 1) and the total Swedish population born during the period from January 1, 1983, to December 31, 1995 (sample 2). Adolescent offspring of the women in the National Longitudinal Survey of Youth 1979 (n = 6904) and all offspring born in Sweden during the 13-year period (n = 1,187,360). Self-reported adolescent alcohol, cigarette, and marijuana use and early onset (before 14 years of age) of each substance (sample 1) and substance-related convictions and hospitalizations for an alcohol- or other drug-related problem (sample 2). The same pattern emerged for each index of substance use/problems across the 2 samples. At the population level, maternal SDP predicted every measure of offspring substance use/problems in both samples, ranging from adolescent alcohol use (hazard ratio [HR](moderate), 1.32 [95% CI, 1.22-1.43]; HR(high), 1.33 [1.17-1.53]) to a narcotics-related conviction (HR(moderate), 2.23 [2.14-2.31]; HR(high), 2.97 [2.86-3.09]). When comparing differentially exposed siblings to minimize genetic and environmental confounds, however, the association between SDP and each measure of substance use/problems was minimal and not statistically significant. The association between maternal SDP and offspring substance use/problems is likely due to familial background
Durazzo, Timothy C; Rothlind, Johannes C; Gazdzinski, Stefan; Meyerhoff, Dieter J
Co-morbidities that commonly accompany those afflicted with an alcohol use disorder (AUD) may promote variability in the pattern and magnitude of neurocognitive abnormalities demonstrated. The goal of this study was to investigate the influence of several common co-morbid medical conditions (primarily hypertension and hepatitis C), psychiatric (primarily unipolar mood and anxiety disorders), and substance use (primarily psychostimulant and cannabis) disorders, and chronic cigarette smoking on the neurocognitive functioning in short-term abstinent, treatment-seeking individuals with AUD. Seventy-five alcohol-dependent participants (ALC; 51+/-9 years of age; three females) completed comprehensive neurocognitive testing after approximately 1 month of abstinence. Multivariate multiple linear regression evaluated the relationships among neurocognitive variables and medical conditions, psychiatric, and substance-use disorders, controlling for sociodemographic factors. Sixty-four percent of ALC had at least one medical, psychiatric, or substance-abuse co-morbidity (excluding smoking). Smoking status (smoker or nonsmoker) and age were significant independent predictors of cognitive efficiency, general intelligence, postural stability, processing speed, and visuospatial memory after age-normed adjustment and control for estimated pre-morbid verbal intelligence, education, alcohol consumption, and medical, psychiatric, and substance-misuse co-morbidities. Results indicated that chronic smoking accounted for a significant portion of the variance in the neurocognitive performance of this middle-aged AUD cohort. The age-related findings for ALC suggest that alcohol dependence, per se, was associated with diminished neurocognitive functioning with increasing age. The study of participants who demonstrate common co-morbidities observed in AUD is necessary to fully understand how AUD, as a clinical syndrome, affects neurocognition, brain neurobiology, and their changes with
Storholm, Erik D.; Silverberg, Michael J.; Satre, Derek D.
Access to substance use disorder (SUD) treatment is a critical issue for women with HIV. This study examined differences in SUD diagnoses, comorbid psychiatric diagnoses, and predictors of SUD treatment initiation among a racial/ethnically diverse sample of HIV-positive women (N=228) and a demographically similar cohort of HIV-negative women (N=693). Diagnoses and service utilization data were obtained from electronic health records of members of a large integrated healthcare system in Northe...
Full Text Available Abstract Background General Practitioners (GPs are well placed to care for patients with (chronic substance use problems. This pilot was carried out to study the feasibility and usefulness of a continuous surveillance of substance use problems among general practice patients. The objectives were (i to describe variables with missing values exceeding 1% and whether patients were reported without substance-related problems; (ii the profile and the magnitude of the patient population that is treated for substance use problems. Methods Observational study by the Belgian Network of Sentinel General Practices (SGP in 2013. Baseline (at the first encounter and 7-month follow-up data were reported of all patients treated for substance use problems. Two main measurements were type of substance use and patient status at follow-up. Multiple logistic regression analysis was used to examine patient status at follow-up. Results Of 479 patients, 47.2% had problems with alcohol alone, 20.3% with prescription drugs, 16.7% with illicit drugs other than heroin or methadone and 15.9% with heroin or methadone. Problems with alcohol alone were more prevalent in Flanders (53.0%; 95% confidence interval (CI 46.8–59.1% than in Wallonia-Brussels (39.8%; 95% CI 33.1–46.8%, while problems with heroin or methadone were more prevalent in Wallonia-Brussels (27.0%; 95% CI 21.1–33.5% than in Flanders (7.1%; 95% CI 4.3–10.9%. At follow-up, 32.8% of the patients had dropped out, 29.0% had discontinued GP treatment and 38.2% had continued GP treatment. Overall, 32.4% of 479 patients had continued GP treatment for substance use problems during the study period. In Wallonia-Brussels, this proportion was higher (42.7%; 95% CI 35.9–49.6% than in Flanders (24.3%; 95% CI 19.2–29.8%. Conclusions A continuous surveillance of the general practice population treated for substance use problems seems to be feasible and useful. The latter is suggested by the specific profile and
Beckford Jarrett, Sharlene; De La Haye, Winston; Miller, Zahra; Figueroa, J Peter; Duncan, Jacqueline; Harvey, Kevin
This cross-sectional study explored the range of psychiatric and substance use disorders and unmet need for mental health care among 84 HIV-positive and 44 HIV-negative public clinic attendees in Jamaica. We used a brief interviewer-administered diagnostic tool, the Client Diagnostic Questionnaire. Two-thirds (65.6%) screened positive for at least one psychiatric disorder; 30.5% screened positive for multiple disorders. The most common disorders were post-traumatic stress disorder (PTSD) (41.4%), alcohol abuse (22.7%), and depressive disorders (21.9%). One in fourteen (7.1%) participants with at least one diagnosis received care in the last 6 months. Adjusting for age and sex, PTSD was associated with non-adherence to antiretroviral treatment (AOR = 5.32), anxiety disorders (AOR = 5.82), depression (AOR = 4.29), and suicidal ideation (AOR = 8.17). Psychiatric and substance use disorders, particularly PTSD, were common among STI/HIV clinic attendees in Jamaica. Such clinics may be efficient places to screen, identify, and treat patients with psychiatric disorders in low- and middle- income countries.
Manish S Dalwani
Full Text Available Structural neuroimaging studies have demonstrated lower regional gray matter volume in adolescents with severe substance and conduct problems. These research studies, including ours, have generally focused on male-only or mixed-sex samples of adolescents with conduct and/or substance problems. Here we compare gray matter volume between female adolescents with severe substance and conduct problems and female healthy controls of similar ages.Female adolescents with severe substance and conduct problems will show significantly less gray matter volume in frontal regions critical to inhibition (i.e. dorsolateral prefrontal cortex and ventrolateral prefrontal cortex, conflict processing (i.e., anterior cingulate, valuation of expected outcomes (i.e., medial orbitofrontal cortex and the dopamine reward system (i.e. striatum.We conducted whole-brain voxel-based morphometric comparison of structural MR images of 22 patients (14-18 years with severe substance and conduct problems and 21 controls of similar age using statistical parametric mapping (SPM and voxel-based morphometric (VBM8 toolbox. We tested group differences in regional gray matter volume with analyses of covariance, adjusting for age and IQ at p<0.05, corrected for multiple comparisons at whole-brain cluster-level threshold.Female adolescents with severe substance and conduct problems compared to controls showed significantly less gray matter volume in right dorsolateral prefrontal cortex, left ventrolateral prefrontal cortex, medial orbitofrontal cortex, anterior cingulate, bilateral somatosensory cortex, left supramarginal gyrus, and bilateral angular gyrus. Considering the entire brain, patients had 9.5% less overall gray matter volume compared to controls.Female adolescents with severe substance and conduct problems in comparison to similarly aged female healthy controls showed substantially lower gray matter volume in brain regions involved in inhibition, conflict processing, valuation
Dalwani, Manish S; McMahon, Mary Agnes; Mikulich-Gilbertson, Susan K; Young, Susan E; Regner, Michael F; Raymond, Kristen M; McWilliams, Shannon K; Banich, Marie T; Tanabe, Jody L; Crowley, Thomas J; Sakai, Joseph T
Structural neuroimaging studies have demonstrated lower regional gray matter volume in adolescents with severe substance and conduct problems. These research studies, including ours, have generally focused on male-only or mixed-sex samples of adolescents with conduct and/or substance problems. Here we compare gray matter volume between female adolescents with severe substance and conduct problems and female healthy controls of similar ages. Female adolescents with severe substance and conduct problems will show significantly less gray matter volume in frontal regions critical to inhibition (i.e. dorsolateral prefrontal cortex and ventrolateral prefrontal cortex), conflict processing (i.e., anterior cingulate), valuation of expected outcomes (i.e., medial orbitofrontal cortex) and the dopamine reward system (i.e. striatum). We conducted whole-brain voxel-based morphometric comparison of structural MR images of 22 patients (14-18 years) with severe substance and conduct problems and 21 controls of similar age using statistical parametric mapping (SPM) and voxel-based morphometric (VBM8) toolbox. We tested group differences in regional gray matter volume with analyses of covariance, adjusting for age and IQ at pbrain cluster-level threshold. Female adolescents with severe substance and conduct problems compared to controls showed significantly less gray matter volume in right dorsolateral prefrontal cortex, left ventrolateral prefrontal cortex, medial orbitofrontal cortex, anterior cingulate, bilateral somatosensory cortex, left supramarginal gyrus, and bilateral angular gyrus. Considering the entire brain, patients had 9.5% less overall gray matter volume compared to controls. Female adolescents with severe substance and conduct problems in comparison to similarly aged female healthy controls showed substantially lower gray matter volume in brain regions involved in inhibition, conflict processing, valuation of outcomes, decision-making, reward, risk-taking, and rule
Frank C Bandiera
Full Text Available The rate of cigarette smoking is greater among persons with mental health and/or substance abuse problems. There are few population-based datasets with which to study tobacco mortality in these vulnerable groups. The Oregon Health Authority identified persons who received publicly-funded mental health or substance abuse services from January 1996 through December 2005. These cases were then matched to Oregon Vital Statistics records for all deaths (N= 148,761 in the period 1999-2005. The rate of tobacco-related death rates was higher among persons with substance abuse problems only (53.6% and those with both substance abuse and mental health problems (46.8%, as compared to the general population (30.7%. The rate of tobacco-related deaths among persons with mental health problems (30% was similar to that in the general population. Persons receiving substance abuse treatment alone, or receiving both substance abuse and mental health treatment, were more likely to die and more likely to die prematurely of tobacco-related causes as compared to the general population. Persons receiving mental health services alone were not more likely to die of tobacco-related causes, but tobacco-related deaths occurred earlier in this population.
Bandiera, Frank C; Anteneh, Berhanu; Le, Thao; Delucchi, Kevin; Guydish, Joseph
The rate of cigarette smoking is greater among persons with mental health and/or substance abuse problems. There are few population-based datasets with which to study tobacco mortality in these vulnerable groups. The Oregon Health Authority identified persons who received publicly-funded mental health or substance abuse services from January 1996 through December 2005. These cases were then matched to Oregon Vital Statistics records for all deaths (N= 148,761) in the period 1999-2005. The rate of tobacco-related death rates was higher among persons with substance abuse problems only (53.6%) and those with both substance abuse and mental health problems (46.8%), as compared to the general population (30.7%). The rate of tobacco-related deaths among persons with mental health problems (30%) was similar to that in the general population. Persons receiving substance abuse treatment alone, or receiving both substance abuse and mental health treatment, were more likely to die and more likely to die prematurely of tobacco-related causes as compared to the general population. Persons receiving mental health services alone were not more likely to die of tobacco-related causes, but tobacco-related deaths occurred earlier in this population.
National Center on Addiction and Substance Abuse at Columbia University, 2011
This report finds that adolescent smoking, drinking, misusing prescription drugs and using illegal drugs is, by any measure, a public health problem of epidemic proportion, presenting clear and present danger to millions of America's teenagers and severe and expensive long-range consequences for the entire population. This report is a wake-up call…
The CIDI auto is a computer program which could concurrently generate both ICD 10 and DSM IIIR diagnoses using various indices which include physical and social health problems. Focus group discussion and direct observation were also conducted in each of the study parks. Results: Their median age was 39 years, ...
Mezzich, Ada C; Bretz, Walter A; Day, Bang-Shiuh; Corby, Patricia M; Kirisci, Levent; Swaney, Michelle; Cornelius, Jack R; Weyant, Robert J
This study examined (1) orodental (OD) problems in 10-19-year-old children of substance use disorder (SUD) (n = 127) and non-SUD fathers (n = 111) and (2) the moderating effect of child's substance use (SU) involvement in the associations of paternal SUD and neglectful parenting with OD problems in the offspring. The results showed that periodontal problems differentiated between groups and the interactions between child's SU involvement and paternal SUD and neglectful parenting were respectively associated with hard/soft tissue lesions and carious lesions in the offspring, indicating that SU involvement increases risk for OD due to paternal SUD and neglectful parenting.
Colizzi, Marco; Costa, Rosalia; Scaramuzzi, Francesca; Palumbo, Claudia; Tyropani, Margarita; Pace, Valeria; Quagliarella, Luca; Brescia, Francesco; Natilla, Lilia Carmen; Loverro, Giuseppe; Todarello, Orlando
Several studies indicate increased prevalence of metabolic syndrome (MetS) among patients with psychiatric disorders as well as among individuals with gender dysphoria (GD) treated by cross-sex hormonal treatment. However, the MetS prevalence among hormone treated GD individuals suffering from psychiatric problems has not been detected. From a sample of 146 GD patients we selected 122 metabolically healthy individuals in order to investigate the prevalence of MetS after the beginning of the cross-sex hormonal treatment in a 2 year follow-up assessment. Furthermore, we assessed differences in MetS prevalence between hormone treated GD patients with and without concomitant psychiatric problems. When treated with hormone therapy, GD patients reported changes in several parameters which are clustered in MetS, with statistically significant differences compared to baseline. Glyco-insulinemic alterations were more pronounced in male to female patients (MtFs). However, weight gain, waist circumference increases, blood pressure increases, and lipid alterations were similar in MtFs and female to male patients (FtMs). 14.8% of the sample at year 1 and 17.2% at year 2 developed MetS. Among patients with concomitant psychiatric problems, 50% at year 1 and 55% at year 2 developed MetS against 8% at year 1 and 10% at year 2 of patients without concomitant psychiatric problems. This study indicates that sex hormones induce MetS in a relatively low proportion of healthy GD individuals and especially during the first year of hormonal treatment. Most importantly, concomitant psychiatric problems are associated with considerably greater MetS prevalence in hormone treated GD individuals. Copyright © 2015 Elsevier Inc. All rights reserved.
Mak, Winnie W S; Ho, Connie Y Y; Wong, Venus U T; Law, Rita W; Chan, Randolph C H
Substance use is regarded as one of the most stigmatizing conditions worldwide. To achieve recovery, individuals with substance use problems must learn to cope with stigma. Despite the potential importance of cultural factors in the internalization process of stigma, few studies have incorporated culturally salient factors in understanding self-stigma. We responded to this gap in the literature by investigating a mechanism of self-stigma that focused on a cultural value salient to the Chinese-face concern. Specifically, we hypothesized that two types of face concern (mianzi concern and lian concern) would affect self-stigma and mental health through self-conscious moral emotions and rumination. A total of 199 Hong Kong Chinese adults with substance use problems completed standardized questionnaires. Test of the proposed model using structural equation modeling showed excellent fit to the data. The findings support the role of face concern in affecting self-stigma and mental health among Chinese with substance use problems. In particular, the findings showed significant indirect effects of lian concern on rumination, self-stigma, and mental health via moral emotions. The present study provides preliminary empirical support for the importance of cultural factors in the internalization process of stigma and the maintenance of mental health among individuals with substance use problems. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Huurre, Taina; Santalahti, Päivi; Kiviruusu, Olli; Solantaus, Tytti
The study investigated whether cuts to school resources made during economic recession contribute to children's psychiatric and economic problems in early adulthood. The cohort consisted of 817 Finnish children. Data was gathered from teachers during a recession (child age 12) and from national registers on children's post-recession use of…
Storholm, Erik David; Silverberg, Michael J; Satre, Derek D
Access to substance use disorder (SUD) treatment is a critical issue for women with HIV. This study examined differences in SUD diagnoses, comorbid psychiatric diagnoses, and predictors of SUD treatment initiation among a diverse sample of HIV-positive women (n = 228) and a demographically similar cohort of HIV-negative women (n = 693). Diagnoses and service utilization data were obtained from electronic health records of members of a large integrated healthcare system in Northern California. HIV-positive women were less likely to initiate SUD treatment. Significant racial/ethnic differences were found among both HIV-positive and HIV-negative women with respect to SUD diagnosis type and diagnosis of comorbid psychiatric disorders. Among the HIV-negative women, rates of SUD treatment initiation were lower for black women than for white or Latina women. Multivariable logistic regression models showed that alcohol, cannabis, and opiate diagnoses were predictive of SUD treatment initiation for both cohorts, while amphetamine diagnoses, comorbid depressive disorder, and being white or Latina were predictive of SUD treatment initiation for HIV-negative, but not HIV-positive, women. Findings suggest that clinicians need to be aware of differences in substances of abuse, comorbid psychiatric disorders, and to consider the demographic and social factors that may contribute to differences in SUD treatment initiation among HIV-positive and HIV-negative women.
Pearson, Frank S; Cleland, Charles M; Chaple, Michael; Hamilton, Zachary; Prendergast, Michael L; Rich, Josiah D
This study examined the relationships between substance abuse, mental health problems and HIV risk behavior in offenders discharged from prison and referred to substance abuse treatment programs. Data from 34 sites (n = 1,358) in a federally-funded cooperative agreement, the Criminal Justice Drug Abuse Treatment Studies (CJDATS), were analyzed. Among parolees referred to substance abuse treatment, self reports for the six-month period before the arrest resulting in their incarceration revealed frequent problems with both substance use and mental health. HIV risk behavior was operationalized as either (a) unsafe injection drug use, e.g., sharing needles and/or sharing injection equipment, or (b) unsafe sex, e.g., sex without a condom. The findings were that (1) unsafe injection drug use was associated with unsafe sex and vice versa, (2) unsafe sex behavior was related to frequency of drug use, and (3) unsafe sex behavior was related to frequency of alcohol use. In these samples, mental health problems did not have a significant effect on risk behavior, controlling for other variables. Future research should probe this "nonfinding" using standardized diagnostic and symptom measures to provide greater detail on the mental health problems (e.g., age of onset, frequency, and severity of the problem).
Burstein, Marcy; Stanger, Catherine; Dumenci, Levent
The present study: (1) examined relations between parent psychopathology and adolescent internalizing problems, externalizing problems, and substance use in substance-abusing families; and (2) tested family functioning problems as mediators of these relations. Structural equation modeling was used to estimate the independent effects of parent…
Garland, Eric L; Roberts-Lewis, Amelia; Tronnier, Christine D; Graves, Rebecca; Kelley, Karen
In many clinical settings, there is a high comorbidity between substance use disorders, psychiatric disorders, and traumatic stress. Novel therapies are needed to address these co-occurring issues efficiently. The aim of the present study was to conduct a pragmatic randomized controlled trial comparing Mindfulness-Oriented Recovery Enhancement (MORE) to group Cognitive-Behavioral Therapy (CBT) and treatment-as-usual (TAU) for previously homeless men residing in a therapeutic community. Men with co-occurring substance use and psychiatric disorders, as well as extensive trauma histories, were randomly assigned to 10 weeks of group treatment with MORE (n = 64), CBT (n = 64), or TAU (n = 52). Study findings indicated that from pre-to post-treatment MORE was associated with modest yet significantly greater improvements in substance craving, post-traumatic stress, and negative affect than CBT, and greater improvements in post-traumatic stress and positive affect than TAU. A significant indirect effect of MORE on decreasing craving and post-traumatic stress by increasing dispositional mindfulness was observed, suggesting that MORE may target these issues via enhancing mindful awareness in everyday life. This pragmatic trial represents the first head-to-head comparison of MORE against an empirically-supported treatment for co-occurring disorders. Results suggest that MORE, as an integrative therapy designed to bolster self-regulatory capacity, may hold promise as a treatment for intersecting clinical conditions. Copyright © 2015 Elsevier Ltd. All rights reserved.
Daniel T. L. Shek
Full Text Available Problem gambling is complex and often comorbid with other mental health problems. Unfortunately, gambling studies on comorbid psychiatric disorders among Chinese communities are extremely limited. The objectives of this study were to (a determine the prevalence of comorbid psychiatric disorders among treatment-seeking pathological gamblers; (b compare the demographic profiles and clinical features of pathological gamblers with and without comorbid psychiatric disorders; (c explore the associations between pathological gambling and psychiatric disorders and their temporal relationship. Participants (N=201 who sought gambling counseling were examined by making Axis-I diagnoses including mood disorders, schizophrenia spectrum disorders, substance use disorders, anxiety disorders, and adjustment disorder. Results showed that 63.7% of participants had lifetime comorbid psychiatric disorder. The most common comorbid psychiatric mental disorders were mood disorders, adjustment disorder, and substance use disorders. Pathological gamblers with psychiatric comorbidities were significantly more severe in psychopathology, psychosocial functioning impairment, and gambling problems than those without the disorders.
Fakier, Nuraan; Wild, Lauren G.
This study investigated the relationships among sleep problems, learning difficulties and substance use in adolescence. Previous research suggests that these variables share an association with executive functioning deficits, and are intertwined. The sample comprised 427 adolescents (M age = 16 years) attending remedial schools and 276 adolescents…
Rosenkranz, Susan E.; Muller, Robert T.; Henderson, Joanna L.
Objectives: Research has demonstrated that experiences of childhood maltreatment are prevalent in the life histories of youth with substance use problems; however, most of this research has focused on sexual or physical abuse. The purpose of the current study was to extend the scope of previous investigations to include psychological maltreatment…
Boendermaker, W.J.; Prins, P.J.M.; Wiers, R.W.
Background and Objectives: Excessive use of psychoactive substances and resulting disorders are a major societal problem, and the most prevalent mental disorder in young men. Recent reviews have concluded that Cognitive Bias Modification (CBM) shows promise as an intervention method in this field.
Haddock, Gillian; Eisner, Emily; Davies, Gabriel; Coupe, Nia; Barrowclough, Christine
When schizophrenia is combined with substance misuse, rates are consistently higher. However research findings on the relationship between violence, self-harm and schizophrenia are inconclusive. This study aimed to examine links between specific psychotic symptoms, substance misuse and violence in people dually diagnosed with schizophrenia and substance misuse. Presence and frequency of violence to self and others were examined in relation to the type and severity of psychotic symptoms and level of substance use over a 24 month period in 327 people with schizophrenia and substance misuse problems. 32.3% had an incident of violence to others during the study period and 28.6% had a self-harm/suicide incident. 39 (11.9%) participants reported command hallucinations (CH) and 157 (48.0%) had threat control override symptoms (TCOS). Presence of TCOS and presence of CH were not associated with violence to others but were both associated with self-harm. Different command hallucination sub-types were associated with different types of violence. Delusional and hallucination severity and distress were mainly associated with self-harm. These findings suggest that specific symptoms are related to different outcomes, particularly in relation to self-harm, and these effects remain even after substance use is controlled for. This has important implications for assessment and treatment of this group. © 2013.
Saberi, Seyed Mehdi; Sheikhazadi, Ardeshir; Ghorbani, Mazaher; Nasrabadi, Zaynab Nasri; Meysamie, Ali Pasha
Objective In many jurisdictions, psychiatric problems are intended for commutation. Therefore, a forensic psychiatrist has an important role in detection of malingering. While several studies evaluate diagnostic tests, it is less known what symptoms are more likely to be imitated by malingerers. Method In a prospective study 45 malingerers, who were diagnosed according to interviews by two forensic psychiatrists, from defendants with a judicial order for evaluation of mental status and criminal responsibility during a period of eighteen months were examined in legal medicine center of Tehran. Participants were assessed in another interview to determine symptoms. Dichotomous symptoms in felony and misdemeanor groups were analyzed using fisher's exact test. The level of statistical significance was set at P < 0.05. Results Thirty-eight malingerers were charged with misdemeanors and seven with felonies. Behavioral symptoms were most frequently faked by 35 participants (77.8%). Participants charged with criminal accusation had a significantly lower mean age (P=0.032) and a higher level of education (P=0.008) than other non-criminal defendants. A statistically significant increase in memory function problems was demonstrated in the misdemeanor group (P=0.040). With regard to dual symptom imitation, statistically significant correlations were observed between thought content and perceptual symptoms (P=0.048) for felonies and mood & affect and thought process symptoms (P=0.034), mood & affect and behavioral symptoms (P=0.000) and cognitive function and behavioral symptoms (P=0.039) for misdemeanors. In general, many simulators attempted to mimic simple symptoms of behavioral disorders. Probably felony offenses need less accurate programming; therefore, their rates are higher in older, less educated participants. Conclusion This study demonstrated that differences between presenting symptoms among different offenses may not be useful in detection of malingering,; however
Seyed Mehdi Saberi
Full Text Available Objective: In many jurisdictions, psychiatric problems are intended for commutation. Therefore, a forensic psychiatrist has an important role in detection of malingering. While several studies evaluate diagnostic tests, it is less known what symptoms are more likely to be imitated by malingerers.Method: In a prospective study [t1] 45 [t2] malingerers, who were diagnosed according to interviews by two forensic psychiatrists, from defendants [t3] with a judicial order for evaluation of mental status and criminal responsibility during a period of eighteen months were examined in legal medicine center of Tehran.[t4] [t5] Participants were assessed in another interview to determine symptoms. Dichotomous symptoms in felony and misdemeanor groups were analyzed using fisher’s exact test. The level of statistical significance was set at P<0.05. [t6] Results: Thirty-eight malingerers were charged with misdemeanors and seven with felonies. Behavioral symptoms were most frequently faked by 35 participants (77.8%. Participants charged with criminal accusation had a significantly lower mean age (P=0.032 and a higher level of education (P=0.008 than other non-criminal defendants. A statistically significant increase in memory function problems was demonstrated in the misdemeanor group (P=0.040. With regard to dual symptom imitation, statistically significant correlations were observed between thought content and perceptual symptoms (P=0.048 for felonies and mood & affect and thought process symptoms (P=0.034, mood & affect and behavioral symptoms (P=0.000 and cognitive function and behavioral symptoms (P=0.039 for misdemeanors. In general, many simulators attempted to mimic simple symptoms of behavioral disorders. Probably felony offenses need less accurate programming; therefore, their rates are higher in older, less educated participants.Conclusion: This study demonstrated that differences between presenting symptoms among different offenses may not be
Linn, Braden K; Nochajski, Thomas; Wieczorek, William
Driving under the influence remains a pervasive problem. Approximately 30% of those arrested for impaired driving offenses each year are repeat offenders, suggesting that current rehabilitative efforts are not sufficiently effective for reducing driving while intoxicated (DWI) recidivism. Aggression, negative affect, substance use problems, and childhood delinquency have been noted in the population of impaired drivers, but study of these variables on recidivism has been limited. The aim of the current study was to examine the effects of aggression, negative affect, substance use problems, and childhood delinquency on DWI recidivism among first time offenders. In 1992, 6436 individuals in impaired driver programs in New York State were surveyed. A total of 3511 individuals provided names so that state driver abstracts could be reviewed in the future. A total of 2043 matches were found and 1770 remained after excluding those with previous DWI convictions. Driver records were reviewed in 2010 and 2012, providing between 18 and 20 years of follow-up. During the follow-up period, 16.5% of individuals were arrested for an impaired driving offense. Multivariate analysis suggested that recidivism was a function of several problems, including: alcohol problem severity, aggression, negative affect, drug problem severity, criminal history, and childhood delinquency. Impaired driving programs should assess for childhood delinquency, aggressive tendencies, and negative affect as these constructs, along with substance use, are evident among impaired drivers who recidivate. Interventions addressing aggression and negative affect may ultimately prove useful in reducing recidivism.
Matsumoto, Toshihiko; Matsushita, Sachio; Okudaira, Kenichi; Naruse, Nobuya; Cho, Tetsuji; Muto, Takeo; Ashizawa, Takeshi; Konuma, Kyohei; Morita, Nobuaki; Ino, Aro
The present study used a self-reporting questionnaire to compare suicide risk in outpatients being treated for substance use disorder at specialized hospitals to suicide risk in outpatients being treated for depressive disorder at general psychiatric clinics. Although patients in both groups exhibited an equal severity of depression, the patients with drug use disorder had a higher suicide risk than those with depressive disorder. These findings indicate that drug-abusing patients at specialized hospitals may have a severe risk of committing suicide, suggesting that carefully assessing the comorbidity of depression with drug abuse may be required for preventing suicide in drug-abusing patients.
Sandler, Irwin; Wolchik, Sharlene A.; Cruden, Gracelyn; Mahrer, Nicole E.; Ahn, Soyeon; Brincks, Ahnalee; Brown, C. Hendricks
This paper presents findings from an overview of meta-analyses of the effects of prevention and promotion programs to prevent mental health, substance use and conduct problems. The review of 48 meta-analyses found small but significant effects to reduce depression, anxiety, anti-social behavior and substance use. Further, the effects are sustained over time. Meta-analyses often found that the effects were heterogeneous. A conceptual model is proposed to guide the study of moderators of program effects in future meta-analyses and methodological issues in synthesizing findings across preventive interventions are discussed. PMID:24471372
Nyhlén, Anna; Fridell, Mats; Bäckström, Martin
with a decreased risk. Neurosis, mainly depression and/or anxiety disorders, predicted drug related premature death while chronic psychosis and personality disorders did not. Chronic alcohol addiction was associated with increased risk of non drug related death. Conclusions The cohort of drug abusers had...... an increased risk of premature death to the age of 69. Drug related premature death was predicted by male gender, the use of opiates or barbiturates and depression and anxiety disorders at first admission. The predicted cumulative incidence of drug related death was significantly higher in opiate......Background Few longitudinal cohort studies have focused on the impact of substances abused and psychiatric disorders on premature mortality. The aim of the present study was to identify predictors of increased risk of drug related death and non drug related death in substance abusers of opiates...
Jones, Rebecca; Reupert, Andrea; Sutton, Keith; Maybery, Darryl
People with mental illness and substance use problems form a significant subgroup of the homeless population. International research has begun to document the complex experiences of this vulnerable group; however, less attention has focused on those living in rural areas. This study sought to determine the experiences of people with mental illness and/or substance use issues, experiencing significant housing problems in rural areas. Within a qualitative framework, individual interviews were conducted with 40 respondents in Australia. Themes generated a discussion around three main areas; (1) current housing problems, (2) pathways into unsuitable housing, and (3) factors contributing to appropriate accommodation. The need for agency staff to identify and assist with the housing issues of their clients is underscored.
Conners-Burrow, Nicola; McKelvey, Lorraine; Kyzer, Angela; Swindle, Taren; Cheerla, Rajalakshmi; Kraleti, Shashank
We explore the associations between exposure to conflict and crime in the home and community, and child anxiety and self-control problems among 60 children whose mothers were in treatment for substance abuse problems. Experiences with violence and crime were widespread, with many children exposed to multiple incidents. Approximately one-third (35.5%) of children exhibited clinically elevated anxiety. Controlling for other potential predictors, both children's exposure to violence and the number of years the mother had been using substances predicted higher anxiety in children, while only exposure to violence predicted problems in self-control. Results highlight the importance of screening for violence exposure. Copyright © 2013 Elsevier Inc. All rights reserved.
McMillen, J Curtis; Narendorf, Sarah Carter; Robinson, Debra; Havlicek, Judy; Fedoravicius, Nicole; Bertram, Julie; McNelly, David
.... This paper reports on the development and piloting of a manualized treatment foster care program designed to step down older youth with high psychiatric needs from residential programs to treatment foster care homes...
A retrospective chart review of the clinical and psychosocial profile of psychotic adolescents with co-morbid substance use disorders presenting to acute adolescent psychiatric services at Tygerberg Hospital
Full Text Available Background. A large number of adolescents meet criteria for ‘dual diagnosis’ (a psychiatric disorder plus co-morbid substance use disorder (SUD, which prolongs treatment response and complicates intervention strategies. The current service model in Cape Town divides the care of such patients into psychiatric treatment and a separate substance use intervention. Child and adolescent mental health services face the challenge of high rates of readmission of adolescents into psychiatric facilities before utilisation of community-based substance abuse services. Objective. There is a scarcity of available treatment guidelines for dual-diagnosis adolescents, and a lack of systematically documented epidemiological and clinical data in South African adolescent populations. Method. A retrospective chart review of adolescent psychiatric admissions to the Tygerberg Adolescent Psychiatric Unit during 2010 was conducted. Relevant epidemiological, clinical and demographic data for those presenting with a dual diagnosis (specifically psychotic disorders and SUD was recorded. Results. Results suggest a high prevalence of SUD among adolescents presenting with a first-episode psychosis. Statistically significant correlations with lower levels of education were found in those with ongoing substance abuse (specifically cannabis and methamphetamine, and a significant relationship between choice of debut drug and ongoing drug use was also demonstrated. Risk factors for SUD (psychosocial adversities, childhood trauma, family and community exposure to substances, early debut drug ages, risky sexual behaviours, and clinical psychiatric profiles of adolescents with dual diagnosis are described. Conclusions. This cohort had an enhanced risk as a result of genetic vulnerability and environmental availability of substances, and the findings emphasise the differences in presentation, choice of drugs of abuse and psychosocial difficulties of adolescents with a dual
Martin, Ryan J; Usdan, Stuart; Cremeens, Jennifer; Vail-Smith, Karen
We assessed the occurrence of co-morbid psychiatric disorders (i.e., problem drinking, anxiety, and depression) among college students who met the threshold for disordered gambling. The participants included a large sample of undergraduate students (n = 1,430) who were enrolled in an introductory health course at a large, southeastern university in Spring 2011 and completed an online assessment that included scales to assess disordered gambling, problem drinking, anxiety, and depression. We calculated screening scores, computed prevalence rates for each disorder, and calculated Pearson correlations and Chi square tests to examine correlations and co-morbid relationships between the four disorders. Analyses indicated that all disorders were significantly associated (p college students who experience disordered gambling (and other psychiatric disorders) are at increased risk of experiencing co-occurring disorders, it might be useful for college health professionals to concurrently screen and intervene for co-occurring disorders.
Webster, J Matthew; Pimentel, Jody H; Harp, Kathi L H; Clark, David B; Staton-Tindall, Michele
Although there has been an overall decline in the rates of driving under the influence (DUI) over the past two decades, this decrease has not occurred uniformly across all groups of DUI offenders. For example, the proportion of female DUI offenders has significantly increased. Furthermore, DUI arrest rates remain higher in less populated areas of the country. The present study examines indicators of problem severity among female DUI offenders across graduated levels of rurality. A total of 19,094 substance abuse assessment records from females convicted of DUI between 2002 and 2006 in Kentucky were examined. Beale codes were used to define the extent to which the county of conviction was rural. Rurality was significantly and positively associated with multiple DUI offenses, being underage, drug problems, prevalence of DSM-IV-TR substance dependence and abuse criteria, being referred to substance abuse treatment rather than an education only intervention, and referral noncompliance. Blood alcohol concentration and alcohol problems were inversely related to rurality. The study suggests that problem severity among female DUI offenders may be greater in rural areas and could produce challenges for practitioners who assess and treat rural female DUI offenders.
Burstein, Marcy; Stanger, Catherine; Dumenci, Levent
The present study: (1) examined relations between parent psychopathology and adolescent internalizing problems, externalizing problems, and substance use in substance-abusing families; and (2) tested family functioning problems as mediators of these relations. Structural equation modeling was used to estimate the independent effects of parent psychopathology and family functioning problems by parent gender. Participants included 242 parents in treatment for substance abuse and/or dependence and 59 of their coparents (16.9% in treatment for substance-abuse/dependence) from middle income households (SES: M = 4.7; SD = 2.1). Ratings were obtained for 325 adolescents (48% female; 27.8% non-Caucasian) between the ages of 10 and 18 years (M = 13.5 years; SD = 2.5 years). Parent psychopathology, family functioning problems, and adolescent problems were assessed with parent and coparent ratings on the Symptom Checklist (SCL-90)/Brief Symptom Inventory (BSI), the Family Relationship Measure, and the Child Behavior Checklist, respectively. Results indicated that maternal psychopathology was directly related to adolescent internalizing problems and substance use, but maternal perceptions of family functioning problems failed to mediate relations between maternal psychopathology and adolescent problems. By contrast, paternal perceptions of family functioning problems uniquely mediated relations between paternal psychopathology and adolescent externalizing problems. Findings underscore the importance of examining how mothers and fathers may differentially impact adolescent problems in substance-abusing families.
Manning, Victoria; Dowling, Nicki A; Lee, Stuart; Rodda, Simone; Garfield, Joshua Benjamin Bernard; Volberg, Rachel; Kulkarni, Jayashri; Lubman, Dan Ian
Background and aims Relatively little is known about co-occurring gambling problems and their overlap with other addictive behaviors among individuals attending mental health services. We aimed to determine rates of gambling and substance use problems in patients accessing mental health services in Victoria, Australia. Methods A total of 837 adult patients were surveyed about their gambling and administered standardized screening tools for problem gambling and harmful tobacco, alcohol, and drug use. Prevalence of gambling problems was estimated and regression models used to determine predictors of problem gambling. Results The gambling participation rate was 41.6% [95% CI = 38.2-44.9]. The Problem Gambling Severity Index identified 19.7% [CI = 17.0-22.4] as "non-problem gamblers," 7.2% [CI = 5.4-8.9] as "low-risk" gamblers, 8.4% [CI = 6.5-10.2] as "moderate-risk" gamblers, and 6.3% [CI = 4.7-8.0] as "problem gamblers." One-fifth (21.9%) of the sample and 52.6% of all gamblers were identified as either low-risk, moderate-risk, or problem gamblers (PGs). Patients classified as problem and moderate-risk gamblers had significantly elevated rates of nicotine and illicit drug dependence (p gambling. Discussion and conclusions Patients were less likely to gamble, but eight times as likely to be classified as PG, relative to Victoria's adult general population. Elevated rates of harmful substance use among moderate-risk and PG suggest overlapping vulnerability to addictive behaviors. These findings suggest mental health services should embed routine screening into clinical practice, and train clinicians in the management of problem gambling.
Ho, Samuel B; Bräu, Norbert; Cheung, Ramsey; Liu, Lin; Sanchez, Courtney; Sklar, Marisa; Phelps, Tyler E; Marcus, Sonja G; Wasil, Michelene M; Tisi, Amelia; Huynh, Lia; Robinson, Shannon K; Gifford, Allen L; Asch, Steven M; Groessl, Erik J
Patients with hepatitis C virus (HCV) infection with psychiatric disorders and/or substance abuse face significant barriers to antiviral treatment. New strategies are needed to improve treatment rates and outcomes. We investigated whether an integrated care (IC) protocol, which includes multidisciplinary care coordination and patient case management, could increase the proportion of patients with chronic HCV infection who receive antiviral treatment (a combination of interferon-based and direct-acting antiviral agents) and achieve a sustained virologic response (SVR). We performed a prospective randomized trial at 3 medical centers in the United States. Participants (n = 363 patients attending HCV clinics) had been screened and tested positive for depression, post-traumatic stress disorder, and/or substance use; they were assigned randomly to groups that received IC or usual care (controls) from March 2009 through February 2011. A midlevel mental health practitioner was placed at each HCV clinic to provide IC with brief mental health interventions and case management, according to formal protocol. The primary end point was SVR. Of the study participants, 63% were non-white, 51% were homeless in the past 5 years, 64% had psychiatric illness, 65% were substance abusers within 1 year before enrollment, 57% were at risk for post-traumatic stress disorder, 71% had active depression, 80% were infected with HCV genotype 1, and 23% had advanced fibrosis. Over a mean follow-up period of 28 months, a greater proportion of patients in the IC group began receiving antiviral therapy (31.9% vs 18.8% for controls; P = .005) and achieved a SVR (15.9% vs 7.7% of controls; odds ratio, 2.26; 95% confidence interval, 1.15-4.44; P = .018). There were no differences in serious adverse events between groups. Integrated care increases the proportion of patients with HCV infection and psychiatric illness and/or substance abuse who begin antiviral therapy and achieve SVRs, without serious
Green, Carla A; Yarborough, Micah T; Polen, Michael R; Janoff, Shannon L; Yarborough, Bobbi Jo H
Individuals with serious mental illnesses are more likely to have substance-related problems than those without mental health problems. They also face more difficult recovery trajectories as they cope with dual disorders. Nevertheless, little is known about individuals' perspectives regarding their dual recovery experiences. This qualitative analysis was conducted as part of an exploratory mixed-methods study of mental health recovery. Members of Kaiser Permanente Northwest (a group-model, not-for-profit, integrated health plan) who had serious mental illness diagnoses were interviewed four times over two years about factors affecting their mental health recovery. Interviews were recorded, transcribed, and coded with inductively derived codes. Themes were identified by reviewing text coded "alcohol or other drugs." Participants (N = 177) had diagnosed schizophrenia/schizoaffective disorder (n = 75, 42%), bipolar I/II disorder (n = 84, 48%), or affective psychosis (n = 18, 10%). At baseline, 63% (n = 112) spontaneously described addressing substance use as part of their mental health recovery. When asked at follow-up, 97% (n = 171) provided codeable answers about substances and mental health. We identified differing pathways to recovery, including through formal treatment, self-help groups or peer support, "natural" recovery (without the help of others), and continued but controlled use of alcohol. We found three overarching themes in participants' experiences of recovering from serious mental illnesses and substance-related problems: Learning about the effects of alcohol and drugs provided motivation and a foundation for sobriety; achieving sobriety helped people to initiate their mental health recovery processes; and achieving and maintaining sobriety built self-efficacy, self-confidence, improved functioning and a sense of personal growth. Non-judgmental support from clinicians adopting chronic disease approaches also facilitated recovery. Irrespective of how
Weert-van Oene, G.H. de; Gongora, V.; Sternberg, K. von; Jong, C.A.J. de
The aims of this study were to examine the relationship between motivation for treatment and for change, and to explore their role in the prediction of treatment completion. The sample was composed of 560 predominantly polydrug-using inpatients with co-occurring psychiatric disorders. Motivation for
Tubman, Jonathan G; Oshri, Assaf; Taylor, Heather L; Morris, Staci L
The purpose of the current study was to describe the use of a brief maltreatment assessment instrument to classify adolescents receiving alcohol or other drug (AOD) treatment services based on the extensiveness and severity of prior maltreatment. This goal is significant because maltreatment reduces the effectiveness of AOD treatment and is associated significantly with co-occurring patterns of psychiatric symptoms and sexual risk behaviors. Structured interviews were administered to 300 adolescent treatment clients (202 males, 98 females; M = 16.22 years; SD = 1.13 years) to assess childhood maltreatment experiences, past year psychiatric symptoms, and sexual risk behaviors during the past 180 days. Cluster analysis classified adolescents into unique groups via self-reported sexual abuse, physical punishment, and parental neglect/negative home environment. Significant between-cluster differences in psychiatric symptoms and sexual risk behaviors were documented using MANOVA and chi-square analyses. More severe maltreatment profiles were associated with higher scores for psychiatric symptoms and unprotected intercourse. Significant heterogeneity and distinct types within this treatment sample of adolescents supports the adaptation of selected prevention efforts to promote HIV/STI risk reduction.
Sen, Bisakha; Swaminathan, Shailender
Prenatal exposure to smoking and alcohol consumption is associated with various adverse physical health consequences for children. Numerous studies find that prenatal substance use is associated with low birthweight, as well as subsequent developmental and cognitive problems. A growing body of literature has also begun to show associations between prenatal exposure to smoking or/and alcohol and behavior problems among children. However, it is not clear whether these latter associations arise from underlying confounding factors that can impact both the mother's decision to smoke or drink during pregnancy and subsequent child behavior. This study investigate the relationship between prenatal substance use and subsequent children's behavior problems in early childhood (4-6.5 years) and in later childhood (8-10.5 years). The datasets used are the Children of the National Longitudinal Survey (CNLSY), linked with the National Longitudinal Survey of Youth (NLSY79). Prenatal substance use is measured by binary indicators of smoking during pregnancy and alcohol-use during pregnancy. The outcome of interest is the age and gender specific standardized Behavior Problem Index (BPI) scale that is constructed using 32 mother-reported items on the child's behavior, as well as six sub-scales of problem behavior. Initially OLS regressions are estimated to verify the positive association between prenatal substance use and higher-levels of behavior problems. Thereafter, maternal fixed effects, maternal household fixed effects, propensity score matching, and propensity score inclusive regressions are all employed to obtain estimates of the effects of prenatal smoking and alcohol-use after reducing bias from unobserved confounding factors. Initial OLS results find very strong associations between prenatal smoking and alcohol-use and higher levels of behavioral problems among both younger and older children. However, when we use fixed-effects, propensity-score matching and propensity
Monahan, Kathryn C.; Rhew, Isaac C.; Hawkins, J. David; Brown, Eric C.
Delinquency and substance use are more likely to co-occur in adolescence compared to earlier and later developmental periods. The present study examined developmental pathways to co-occurring problem behavior from 6th-10th grade (N=2,002), testing how peer delinquency and substance use were linked to transitioning between abstaining, delinquency, substance use, and co-occurring problem behavior. Developmentally, most youth transition from abstinence to delinquent behavior, and then escalate to co-occurring problem behavior. Once co-occurring problem behavior onsets, remitting to single problem behavior or abstinence is unlikely. The impact of peers on problem behavior are domain specific when individuals transition from abstaining to a single problem behavior, but are more general with respect to escalation of and desistance from problem behavior. PMID:25506186
Suchman, Nancy; McMahon, Thomas; DeCoste, Cindy; Castiglioni, Nicole; Luthar, Suniya
The authors examined maternal ego development in relation to psychopathology and parenting problems in a sample of substance abusing mothers. Given predilections at higher levels of ego development for introspection and guilt, the authors expected mothers at higher levels to report more psychopathology. Given predilections at lower levels of ego development for dichotomous perceptions and limited conceptions of causation, the authors expected mothers at low levels to report more problematic parenting behaviors. Intelligence was expected to correlate but not overlap with ego development. Subjects were 182 mothers who expressed interest in a randomized clinical trial for a new parenting intervention. Measures included the Washington University Sentence Completion Task—Short Form, the Parental Acceptance-Rejection Questionnaire, the Brief Symptom Inventory and the Kaufman Brief Intelligence Test. Results of correlation and multivariate analyses of variance confirmed predictions. Implications for future development of interventions for substance abusing mothers are discussed. PMID:18444723
Mereish, Ethan H; O'Cleirigh, Conall; Bradford, Judith B
Research has documented significant relationships between sexual and gender minority stress and higher rates of suicidality (i.e. suicidal ideation and attempts) and substance use problems. We examined the potential mediating role of substance use problems on the relationship between sexual and gender minority stress (i.e. victimization based on lesbian, gay, bisexual, or transgender identity [LGBT]) and suicidality. A nonprobability sample of LGBT patients from a community health center (N = 1457) ranged in age from 19-70 years. Participants reported history of lifetime suicidal ideation and attempts, substance use problems, as well as experiences of LGBT-based verbal and physical attacks. Substance use problems were a significant partial mediator between LGBT-based victimization and suicidal ideation and between LGBT-based victimization and suicide attempts for sexual and gender minorities. Nuanced gender differences revealed that substance use problems did not significantly mediate the relationship between victimization and suicide attempts for sexual minority men. Substance use problems may be one insidious pathway that partially mediates the risk effects of sexual and gender minority stress on suicidality. Substances might be a temporary and deleterious coping resource in response to LGBT-based victimization, which have serious effects on suicidal ideation and behaviors.
O'Donoghue, J M
In the Western World self-immolation is an uncommon but dramatic method of attempting suicide. In-patients who attempt suicide by fire-setting tend to be female with severe psychopathology. In a previous study from the South of Ireland, seven cases from a psychiatric and prison population were identified in a five year period from 1984 to 1989. This would represent an annual rate of 1.07 per cent of burns treated in the burns unit at Cork University Hospital. In this study 12 cases were identified for the years 1994 and 1995. This represents an increase of 3.5 per cent from 1.07 to 4.6 per cent of all burns treated at the same institution. Ten of these patients had a previous psychiatric history and eight of them were resident on a psychiatric ward when they committed the act. Seven of the patients were found to have a high degree of suicide intent of whom four died of their injuries, which gives a mortality rate for this group of 33 per cent. Effective prevention policies are necessary if this increasing problem is to be curtailed.
Albayrak, Ozgür; Wölfle, Sebastian Mathias; Hebebrand, Johannes
The relationship between overeating, substance abuse and (behavioral) addiction is controversial. Medically established forms of addiction so far pertain to substance use disorders only. But the preliminary Diagnostic and Statistical Manual for Mental Disorders V (DSM V) suggests replacing the previous category 'Substance-Related Disorders' with 'Addiction and Related Disorders', thus for the first time allowing the diagnosis of behavioral addictions. In the past psychiatrists and psychologists have been reluctant to systematically delineate and classify the term behavioral addiction. However, there is a broad overlap between chemical and behavioral addiction including phenomenological, therapeutic, genetic, and neurobiological aspects. It is of interest to point out that the hormone leptin in itself has a pronounced effect on the reward system, thus suggesting an indirect link between overeating and 'chemical' addiction. Thus, leptin-deficient individuals could be classified as fulfilling criteria for food addiction. In our overview we first review psychological findings in chemical (substance-based) and subsequently in behavioral addiction to analyze the overlap. We discuss the diagnostic validity of food addiction, which in theory can be chemically and/or behaviorally based. Copyright © 2012 S. Karger GmbH, Freiburg.
Zebrak, Katarzyna A; Green, Kerry M
African Americans are disproportionately affected by HIV/AIDS and other sexually transmitted infections relative to other racial groups. Although substance use has been linked to risky sexual behavior, the understanding of how these associations develop over the life course remains limited, particularly the role of social bonds. This study uses structural equation modeling to examine pathways from adolescent substance use to young adult sexual risk, substance problems, and social bonds and then to midlife risky sexual behavior among African American men and women, controlling for childhood confounders. Data come from 4 assessments, 1 per developmental period, of a community-based urban African American cohort (N = 1,242) followed prospectively from ages 6 to 42 years. We found that greater adolescent substance use predicts greater young adult substance problems and increased risky sexual behavior, both of which in turn predict greater midlife sexual risk. Although greater adolescent substance use predicts fewer young adult social bonds for both genders, less young adult social bonding is unexpectedly associated with decreased midlife risky sexual behavior among women and not related for men. Substance use interventions among urban African American adolescents may have both immediate and long-term effects on decreasing sexual risk behaviors. Given the association between young adult social bonding and midlife risky sex among females, number of social bonds should not be used as a criterion for determining whom to screen for sexual risk among African American women. Future studies should explore other aspects of social bonding in linking substance use and risky sexual behavior over time. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Helena Ferreira Moura
Full Text Available OBJECTIVES:To evaluate family problems among crack/cocaine users compared with alcohol and other substance users.METHODS:A cross-sectional multi-center study selected 741 current adult substance users from outpatient and inpatient Brazilian specialized clinics. Subjects were evaluated with the sixth version of the Addiction Severity Index, and 293 crack users were compared with 126 cocaine snorters and 322 alcohol and other drug users.RESULTS:Cocaine users showed more family problems when compared with other drug users, with no significant difference between routes of administration. These problems included arguing (crack 66.5%, powder cocaine 63.3%, other drugs 50.3%, p= 0.004, having trouble getting along with partners (61.5%×64.6%×48.7%, p= 0.013, and the need for additional childcare services in order to attend treatment (13.3%×10.3%×5.1%, p= 0.002. Additionally, the majority of crack/cocaine users had spent time with relatives in the last month (84.6%×86.5%×76.6%, p= 0.011.CONCLUSIONS:Brazilian treatment programs should enhance family treatment strategies, and childcare services need to be included.
Evers, L J M; De Die-Smulders, C E M; Smeets, E E J; Clerkx, M G M; Curfs, L M G
The velo-cardio-facial syndrome: the spectrum of psychiatric problems and cognitive deterioration at adult age: Deletion 22q11.2 syndrome, or the velo-cardio-facial syndrome (VCFS), is a syndrome with a known but varied clinical and behavioral phenotype. We report 7 patients with 22q11.2 deletion syndrome and an intellectual disability. Aside from the described behavioral phenotype in literature, a moderate, severe or profound intellectual disability may be present. Special attention should be given to cognitive deterioration.
Powers, Gregory; Berger, Lisa; Fuhrmann, Daniel; Fendrich, Michael
A family history of alcoholism has been found associated with problematic alcohol use among college students, but less research has examined the effects of family history density of substance use problems in this population. This study examined the prevalence of family history density of substance use problems and its associations with heavy alcohol use, negative alcohol consequences, and alcohol use disorder in a college sample. Based on a secondary analysis of a probability sample, data were analyzed from 606 undergraduate students. Family history density of substance use problems included both first and second degree biological relatives. Heavy alcohol use was the total number of days in which participants drank five/four or more drinks for men/women, negative alcohol consequences were derived from items commonly asked in college student surveys, and an alcohol use disorder was defined as meeting diagnostic criteria for alcohol abuse or dependence. Point prevalence estimated rates of family history density of substance use problems, and negative binomial, ANCOVA, and logistic regression models examined associations between family history density and the alcohol variables while adjusting for sociodemographic variables. Family history density of substance use problems was not significantly associated with total days of heavy alcohol use. Having a second degree, a first degree, or both a first and second degree relative(s) with a substance use problem, however, was significantly associated with experiencing negative alcohol consequences. In addition, having both a first and second degree relative(s) with a substance use problem significantly increased the odds of having an alcohol use disorder. Family history density of substance use problems may play a role in experiencing negative alcohol consequences and in having an alcohol use disorder among undergraduate college students and may be an important risk factor to assess by college health professionals. Copyright
Baldur-Felskov, B; Kjaer, S K; Albieri, V; Steding-Jessen, M; Kjaer, T; Johansen, C; Dalton, S O; Jensen, A
Do women who don't succeed in giving birth after an infertility evaluation have a higher risk of psychiatric disorders compared with women who do? The results indicated that being unsuccessful in giving birth after an infertility evaluation could be an important risk factor for psychiatric disorders. Several studies have investigated the association between fertility treatment and psychological distress, but the results from these studies show substantial variation and lack of homogeneity that may be due to methodological limitations. A retrospective cohort study was designed using data from a cohort of 98 320 Danish women evaluated for fertility problems during 1973-2008 and linked to several Danish population-based registries. All women were followed from the date of first infertility evaluation until date of hospitalization for the psychiatric disorder in question, date of emigration, date of death or 31 December 2008, whichever occurred first. Owing to the precise linkage between the infertility cohort and the Danish population-based registries, using the unique Danish personal identification number, virtually no women were lost to follow-up. Information on reproductive status for all women in the infertility cohort was obtained by linkage to the Danish Medical Birth Registry. A total of 53 547 (54.5%) women gave birth after the initial infertility evaluation, whereas 44 773 (45.5%) women did not gave birth after the evaluation. To determine psychiatric disorders diagnosed in the women after enrolment in the infertility cohort, the cohort was linked to the Danish Psychiatric Central Registry. A total of 4633 women were hospitalized for a psychiatric disorder. The Cox proportional hazard regression model was applied to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for the association between parity status after the initial infertility evaluation and risk of hospitalization for various groups of psychiatric disorders, including
Harty, Laura; Duckworth, Rebecca; Thompson, Aaron; Stuewig, Jeffrey; Tangney, June P.
Previous research investigating the relationship between Borderline Personality Disorder (BPD) and sleep problems, independent of depression, has been conducted on small atypical samples with mixed results. This study extends the literature by utilizing a much larger sample and by statistically controlling for depression and substance dependence. Subjective reports of sleep problems were obtained from 513 jail inmates (70% male) incarcerated on felony charges. Symptoms of BPD were significantly associated with sleep problems even when controlling for depression. Thus, sleep problems associated with BPD cannot be attributed simply to co-morbid symptoms of depression and substance dependence was ruled out as proximal causes for this relationship. Symptoms of depression, but not Antisocial Personality features, were related to sleep problems independent of substance dependence. Treatment of individuals with BPD may be more effective if sleep problems are explicitly addressed in the treatment plan. PMID:20198127
Full Text Available Background: Trauma is commonly associated with substance-related problems, yet associations between specific substances and specific posttraumatic stress disorder symptoms (PTSSs are understudied. We hypothesized that substance-related problems are associated with PTSS severities, interpersonal traumas, and benzodiazepine prescriptions. Methods: Using a cross-sectional survey methodology in a consecutive sample of adult outpatients with trauma histories (n = 472, we used logistic regression to examine substance-related problems in general (primary, confirmatory analysis, as well as alcohol, tobacco, and illicit drug problems specifically (secondary, exploratory analyses in relation to demographics, trauma type, PTSSs, and benzodiazepine prescriptions. Results: After adjusting for multiple testing, several factors were significantly associated with substance-related problems, particularly benzodiazepines (AOR = 2.78; 1.99 for alcohol, 2.42 for tobacco, 8.02 for illicit drugs, DSM-5 PTSD diagnosis (AOR = 1.92; 2.38 for alcohol, 2.00 for tobacco, 2.14 for illicit drugs, most PTSSs (especially negative beliefs, recklessness, and avoidance, and interpersonal traumas (e.g., assaults and child abuse. Conclusion: In this clinical sample, there were consistent and strong associations between several trauma-related variables and substance-related problems, consistent with our hypotheses. We discuss possible explanations and implications of these findings, which we hope will stimulate further research, and improve screening and treatment.
Wu, Jie; Wu, Hong; Wang, Juan; Deng, Jianxiong; Gao, Xue; Xu, Yan; Huang, Guoliang; Huang, Jinghui; Guo, Lan; Lu, Ciyong
A growing body of studies have indicated the associations between substance use and psychosocial problems in adolescents. However, few of them have examined whether these psychosocial problems form a syndemic, which means the co-occurrence of psychosocial problems accompanied by additional effects on substance use.We conducted a cross-sectional survey with 82,812 Chinese adolescents who were selected using a multistage random procedure. Bivariate associations were estimated between selected syndemic indicators and adolescent substance use. Multivariate logistic regression was used to estimate the association between the syndemic indicator count score (the count of syndemic indicators) and adolescent substance use. In addition, cluster analysis was used to partition participants reporting at least one of syndemic indicators to assess associations between resolved cluster memberships and adolescent substance use.All selected syndemic indicators were associated with each other and with adolescent substance use. As the number of syndemic indicators increases, stronger associations with substance use were found in our analysis: the range of adjusted OR was from 1.57 (95% CI: 1.38-1.79) for 1 syndemic indicator to 9.45 (95% CI: 7.60-11.76) for 5 or 6 syndemic indicators. There was no effect modification of gender on these additive associations. The multivariate logistic regression indicated that the cluster membership of nonlow SES academic failures has the highest odds of using substance (OR = 2.26, 95% CI: 2.12-2.41), compared to students reporting none syndemic indicators.Our findings support the syndemic hypothesis that adolescents bearing multiple psychosocial problems experience additive risks of using substance. Our findings support that a comprehensive approach to substance use prevention in adolescents would necessitate the involvement of a variety of providers.
Chantelle J Giesbrecht
Full Text Available Rates of psychopathology are elevated in marginalized and unstably housed persons, underscoring the need for applicable clinical measures for these populations. The Positive and Negative Syndrome Scale (PANSS is a clinical instrument principally developed for use in schizophrenia to identify the presence and severity of psychopathology symptoms. The current study investigates whether a reliable and valid PANSS factor structure emerges in a marginally housed, heterogeneous sample recruited from the Downtown Eastside of Vancouver where substance use disorders and psychiatric illness are pervasive. Participants (n = 270 underwent structured clinical assessments including the PANSS and then were randomly assigned to either exploratory (EFA or confirmatory factor analytic (CFA subsamples. EFA pointed to a novel three factor PANSS. This solution was supported by CFA. All retained items (28 out of 30 load significantly upon hypothesized factors and model goodness of fit analyses are in the acceptable to good range. Each of the three first-order factor constructs, labeled Psychosis/Disorganized, Negative Symptoms/Hostility, and Insight/Awareness, contributed significantly to measurement of a higher-order psychopathology construct. Further, the latent structure of this 3-factor solution appears temporally consistent over one-year. This PANSS factor structure appears valid and reliable for use in persons with multimorbidity, including substance use disorders. The structure is somewhat distinct from existing solutions likely due to the unique characteristics of this marginally housed sample.
Ricardo Abrantes do Amaral
Full Text Available OBJETIVO: Transtornos por uso de substâncias são prevalentes em setores de emergência gerais e psiquiátricos, atingindo taxas de 28% das ocorrências em prontos-socorros gerais. Todavia, profissionais dos setores de emergência identificam menos que 50% dos casos de problemas relacionados ao álcool. Este artigo visa fornecer base fundamentada em evidências para o tratamento específico a pacientes que preencham os critérios diagnósticos de transtornos por uso de substâncias e que se apresentam ao pronto-socorro em quadros de intoxicação ou abstinência. MÉTODO: Uma revisão sobre o tema foi realizada na base de dados Medline, usando-se os descritores "intoxicação aguda", "abstinência", "álcool", "cocaína", "cannabis", "opioides", "inalantes" e "manejo", tendo o inglês como idioma. RESULTADOS E CONCLUSÃO: O cuidado de pessoas com transtornos por uso de substâncias deve conter: avaliação completa (médica geral e psiquiátrica, tratamento dos quadros diagnosticados (abstinência, intoxicação e quadros clínicos que caracterizem uma emergência, sensibilização do paciente para realizar tratamento, se for necessário, e elaboração de encaminhamento.OBJECTIVE: Substance use disorders are prevalent in emergency departments in medical and psychiatric services, reaching rates of 28% of cases in medical emergency departments. However, professionals in the emergency department identify less than 50% of cases of alcohol-related problems. This article aims to provide evidence-based interventions for the specific treatment to patients who meet diagnostic criteria for substance use disorders and who present to emergency rooms during intoxication or abstinence. METHOD: A literature review was performed on Medline database, using the descriptors "acute intoxication", "withdrawal", "alcohol", "cocaine", "cannabis", "opioid", "inhalant", "management", using English as the language. RESULTS: AND CONCLUSION: The care of persons with
Charles M. Cleland
Full Text Available Substance use problems tend to co-occur with risk factors that are especially prevalent in urban communities with high rates of poverty. The present study draws on Syndemics Theory to understand profiles of risk and resilience and their associations with substance use problems in a population at risk for adverse outcomes. African-American/Black and Hispanic heterosexual adults (N = 2,853 were recruited by respondent-driven sampling from an urban area with elevated poverty rates, and completed a structured assessment battery covering sociodemographics, syndemic factors (that is, multiple, co-occurring risk factors, and substance use. More than one-third of participants (36% met criteria for either an alcohol or a drug problem in the past year. Latent class analysis identified profiles of risk and resilience, separately for women and men, which were associated with the probability of a substance use problem. Almost a third of women (27% and 38% of men had lower risk profiles—patterns of resilience not apparent in other types of analyses. Profiles with more risk and fewer resilience factors were associated with an increased probability of substance use problems, but profiles with fewer risk and more resilience factors had rates of substance use problems that were very similar to the general adult population. Relative to the lowest risk profile, profiles with the most risk and fewest resilience factors were associated with increased odds of a substance use problem for both women [adjusted odds ratio (aOR = 8.50; 95% CI: 3.85–18.74] and men (aOR = 11.68; 95% CI: 6.91–19.74. Addressing syndemic factors in substance use treatment and prevention may yield improved outcomes.
Håkansson, Anders; Jesionowska, Virginia
The present study aimed to study the associations between substance use patterns and types of crimes in prisoners with substance use problems, and specifically whether substance use patterns were different in violent offenders. Interview data of prisoners with substance use problems (N=4,202, mean age 33.5 years, SD 9.8), derived from the Addiction Severity Index, were run against criminal register data on main types of crimes in the verdict. In binary analyses, compared to those with acquisitive and drug crimes, violent offenders had lower prevalence of illicit drugs and homelessness, but higher prevalence of binge drinking, and higher prevalence of sedative use than clients sentenced with drug crimes. Clients with violent crime had lower prevalence of injecting drug use, compared to all other crimes. In logistic regression, binge drinking and sedatives were positively associated with violent crime (as opposed to non-violent crime), whereas heroin, amphetamine, cocaine, and injecting drug use were negatively associated with violent crime. Among violent offenders only, sedatives tended to be associated with fatal violence ( p =0.06), whereas amphetamine, homelessness, age, and (marginally significant, p =0.05) heroin were negatively associated with fatal violence, as opposed to non-fatal violence. Treatment and risk assessment in violent perpetrators with substance use may need to address sedatives and alcohol specifically. Limitations of the study are due to self-reported and cross-sectional data and because a large majority of the prison sample studied here are men.
Sinclair, Katerina O; Bauman, Sheri; Poteat, V Paul; Koenig, Brian; Russell, Stephen T
To examine how two forms of interstudent harassment, cyber and bias-based harassment, are associated with academic, substance use, and mental health problems. We used a population-based survey of 17,366 middle and high school students that assessed harassment due to race/ethnicity or sexual orientation, and harassment through the Internet or text messaging along with other forms of interstudent harassment. Odds ratios indicated that students experiencing both cyber and bias-based harassment were at the greatest risk for adjustment problems across all indicators, with suicidal ideation and attempts having the largest risk differences. Assessments of adolescent health and adjustment should include questions regarding both cyber and bias-based harassment. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
VAN Rooij, Antonius J; Kuss, Daria J; Griffiths, Mark D; Shorter, Gillian W; Schoenmakers, M Tim; VAN DE Mheen, Dike
The current study explored the nature of problematic (addictive) video gaming (PVG) and the association with game type, psychosocial health, and substance use. Data were collected using a paper and pencil survey in the classroom setting. Three samples were aggregated to achieve a total sample of 8478 unique adolescents. Scales included measures of game use, game type, the Video game Addiction Test (VAT), depressive mood, negative self-esteem, loneliness, social anxiety, education performance, and use of cannabis, alcohol and nicotine (smoking). Findings confirmed problematic gaming is most common amongst adolescent gamers who play multiplayer online games. Boys (60%) were more likely to play online games than girls (14%) and problematic gamers were more likely to be boys (5%) than girls (1%). High problematic gamers showed higher scores on depressive mood, loneliness, social anxiety, negative self-esteem, and self-reported lower school performance. Nicotine, alcohol, and cannabis using boys were almost twice more likely to report high PVG than non-users. It appears that online gaming in general is not necessarily associated with problems. However, problematic gamers do seem to play online games more often, and a small subgroup of gamers - specifically boys - showed lower psychosocial functioning and lower grades. Moreover, associations with alcohol, nicotine, and cannabis use are found. It would appear that problematic gaming is an undesirable problem for a small subgroup of gamers. The findings encourage further exploration of the role of psychoactive substance use in problematic gaming.
VAN ROOIJ, ANTONIUS J.; KUSS, DARIA J.; GRIFFITHS, MARK D.; SHORTER, GILLIAN W.; SCHOENMAKERS, M. TIM; VAN DE MHEEN, DIKE
Abstract Aims: The current study explored the nature of problematic (addictive) video gaming (PVG) and the association with game type, psychosocial health, and substance use. Methods: Data were collected using a paper and pencil survey in the classroom setting. Three samples were aggregated to achieve a total sample of 8478 unique adolescents. Scales included measures of game use, game type, the Video game Addiction Test (VAT), depressive mood, negative self-esteem, loneliness, social anxiety, education performance, and use of cannabis, alcohol and nicotine (smoking). Results: Findings confirmed problematic gaming is most common amongst adolescent gamers who play multiplayer online games. Boys (60%) were more likely to play online games than girls (14%) and problematic gamers were more likely to be boys (5%) than girls (1%). High problematic gamers showed higher scores on depressive mood, loneliness, social anxiety, negative self-esteem, and self-reported lower school performance. Nicotine, alcohol, and cannabis using boys were almost twice more likely to report high PVG than non-users. Conclusions: It appears that online gaming in general is not necessarily associated with problems. However, problematic gamers do seem to play online games more often, and a small subgroup of gamers – specifically boys – showed lower psychosocial functioning and lower grades. Moreover, associations with alcohol, nicotine, and cannabis use are found. It would appear that problematic gaming is an undesirable problem for a small subgroup of gamers. The findings encourage further exploration of the role of psychoactive substance use in problematic gaming. PMID:25317339
Hamerlynck, S M J J; Doreleijers, Th A H; Vermeiren, R R J M; Cohen-Kettenis, P T
As from 2008, juveniles sentenced under civil law and juveniles sentenced under criminal law can no longer be assigned to the same juvenile detention centres. The reasoning runs as follows: the centres are unlikely to provide adequate treatment for the 'civil' group, and the 'criminal' group may exert a negative influence on the 'civil' group. Hitherto, there has been no research into the question of whether the problems and treatment requirements of girls in the two categories call for detention in the same detention centres or in different ones. The aim of this study is to investigate differences between the two groups of girls with regard to offence history, sociodemographic characteristics, contact with the social services, psychiatric disorders and trauma. Investigation of a representative sample of 211 female minors in three juvenile detention centres using standard instruments. results 82% of the girls were detained under civil law, 18% under criminal law. There were strong similarities between the groups. However, the 'criminal' group more often had a violent history of delinquency and a non-Dutch background, whereas the 'civil' group more often had a background of residential placements, oppositional-defiant disorder, suicidality and self-harm. Girls detained under civil and under criminal law differed in characteristics such as criminal record, but there were striking similarities in the girls' behavioural problems and psychiatric disorders. It is argued that assignment to a particular type of detention centre should depend on treatment requirements rather than on measures imposed by civil or criminal law.
Matali, José Luis; Andión, Oscar; Pardo, Marta; Iniesta, Raquel; Serrano, Eduard; San, Luis
In recent years, both the prevalence of drug use and related child and adolescent psychiatric emergencies have risen sharply. There are few studies about the impact on child and adolescent emergency services. This study has a twofold aim. The first is to describe the prevalence of substance use disorders, mental disorders and dual diagnosis (substance use problems plus mental disorder) in adolescents in psychiatric emergency service. The second is to analyze clinical and healthcare differences between patients with dual diagnosis and patients with a mental disorder without substance use disorder.We retrospectively reviewed 4012 discharge forms for emergencies treated at the psychiatric emergency department during the period 2007-2009. We obtained a sample of 1795 visits. This sample was divided into two groups: the dual diagnosis group (n = 477) and the psychiatric disorder group (n = 1318).The dual diagnosis group accounted for 26.5% of psychiatric emergencies analyzed. Compared to the psychiatric disorder group,the dual diagnosis group had significantly more conduct disorders, social problems, involuntariness in the visit, less hospital admissions and less connection with the healthcare network.Adolescents with a dual diagnosis account for a high percentage of visits at child and adolescent psychiatric emergency services. This patient group requires specialized care both at emergency services and in specific units. Accordingly, these units should play a triple role when handling dual diagnosis: detection, brief treatment and referral to a specialised unit.
Sarver, Dustin E; McCart, Michael R; Sheidow, Ashli J; Letourneau, Elizabeth J
Recent studies have linked attention-deficit/hyperactivity disorder (ADHD) to elevated rates of risky sexual behavior (RSB) in adult samples. The current study tested whether ADHD symptoms were associated with RSB among adolescents, and examined comorbid conduct problems and problematic substance use as joint mediators of this association. ADHD symptoms, conduct problems (oppositional defiant disorder/conduct disorder symptoms), problematic alcohol use (alcohol use disorder symptoms, alcohol use frequency), problematic marijuana use (marijuana use disorder symptoms, marijuana use frequency), and RSB were assessed among an ethnically diverse cross-sectional sample of adolescents (N = 115; mean age = 14.9 years) involved in the juvenile justice system. Bootstrapped mediation models revealed an initial association between ADHD symptoms and RSB that was accounted for fully by the influence of problematic alcohol and marijuana use, but not conduct problems. A follow-up multiple groups mediation analysis demonstrated that the relationship between ADHD symptoms and RSB emerged only among youth with clinically elevated conduct problems, and that problematic marijuana use fully accounted for this relationship. Hyperactive/impulsive, but not inattentive, symptoms were related to RSB, although the pattern of indirect effects was consistent with the multiple groups analysis. The association between ADHD and adolescent RSB is restricted to youth with elevated comorbid conduct problems and reflects the contributions of comorbid marijuana use problems, and to a lesser extent alcohol use problems. Early identification and treatment of these comorbid conditions may be important for the prevention of negative sexual health outcomes among youth with ADHD. © 2014 The Authors. Journal of Child Psychology and Psychiatry. © 2014 Association for Child and Adolescent Mental Health.
Zellner, Margaret R; Watt, Douglas F; Solms, Mark; Panksepp, Jaak
The affective foundations of depression and addictions are discussed from a cross-species - animal to human - perspective of translational psychiatric research. Depression is hypothesized to arise from an evolutionarily conserved mechanism to terminate protracted activation of separation-distress (PANIC/GRIEF) systems of the brain, a shutdown mechanism which may be in part mediated by down-regulation of dopamine based reward-SEEKING resources. This shutdown of the brain's core motivational machinery is organized by shifts in multiple peptide systems, particularly increased dynorphin (kappa opioids). Addictions are conceived to be primarily mediated by obsessive behaviors sustained by reward-SEEKING circuits in the case of psychostimulant abuse, and also powerful consummatory-PLEASURE responses in the case of opioid abuse, which in turn capture SEEKING circuits. Both forms of addiction, as well as others, eventually deplete reward-SEEKING resources, leading to a state of dysphoria which can only temporarily be reversed by drugs of abuse, thereby promoting a negative affect that sustains addictive cycles. In other words, the opponent affective process - the dysphoria of diminished SEEKING resources - that can be aroused by sustained over-arousal of separation-distress (PANIC/GRIEF) as well as direct pharmacological over-stimulation and depletion of SEEKING resources, may be a common denominator for the genesis of both depression and addiction. Envisioning the foundation of such psychiatric problems as being in imbalances of the basic mammalian emotional systems that engender prototype affective states may provide more robust translational research strategies, coordinated with, rather than simply focusing on, the underlying molecular dynamics. Emotional vocalizations might be one of the best ways to monitor the underlying affective dynamics in commonly used rodent models of psychiatric disorders. Copyright © 2011 Elsevier Ltd. All rights reserved.
Appleyard, Karen; Berlin, Lisa J.; Rosanbalm, Katherine D.; Dodge, Kenneth A.
In the interest of improving child maltreatment prevention science, this longitudinal, community based study of 499 mothers and their infants tested the hypothesis that mothers’ childhood history of maltreatment would predict maternal substance use problems, which in turn would predict offspring victimization. Mothers (35% White/non-Latina, 34% Black/non-Latina, 23% Latina, 7% other) were recruited and interviewed during pregnancy, and child protective services records were reviewed for the presence of the participants’ target infants between birth and age 26 months. Mediating pathways were examined through structural equation modeling and tested using the products of the coefficients approach. The mediated pathway from maternal history of sexual abuse to substance use problems to offspring victimization was significant (standardized mediated path [ab]=.07, 95% CI [.02, .14]; effect size=.26), as was the mediated pathway from maternal history of physical abuse to substance use problems to offspring victimization (standardized mediated path [ab]=.05, 95% CI [.01, .11]; effect size =.19). There was no significant mediated pathway from maternal history of neglect. Findings are discussed in terms of specific implications for child maltreatment prevention, including the importance of assessment and early intervention for maternal history of maltreatment and substance use problems, targeting women with maltreatment histories for substance use services, and integrating child welfare and parenting programs with substance use treatment. PMID:21240556
de Weert-van Oene, Gerdien H; Gongora, Vanesa; von Sternberg, Kirk; de Jong, Cor A J
The aims of this study were to examine the relationship between motivation for treatment and for change, and to explore their role in the prediction of treatment completion. The sample was composed of 560 predominantly polydrug-using inpatients with co-occurring psychiatric disorders. Motivation for treatment was assessed with the Motivation for Treatment Scales, and motivation for change was measured with the Readiness to Change Questionnaire. Patients indicated strong motivation to change illegal drug and alcohol use. In initial factor analysis, motivation for treatment and for change did not load on the same factors, confirming that these are distinct domains. Four categories were discerned with respect to readiness for treatment and for change, with low agreement between the two. In performing survival analysis, we found that being in readiness category 4 (RT↑RC↑) was associated with a greater chance of remaining in treatment for a period of 105 days without premature attrition (Log Rank chi-sq=5.000; p=0.02). To a limited extent, intake measures of motivation can be used to predict attrition from treatment. Clinicians can use motivation assessment both for clinical purposes and in the prediction of those who need extra monitoring due to increased risk of premature attrition.
Shao, Jihai; Li, Renhui; Lepo, Joe Eugene; Gu, Ji-Dong
Water blooms of cyanobacteria have posed a worldwide environmental threat and a human health hazard in recent decades. Many biologically derived (but non-antibiotic) bioactive substances are known to inhibit the growth of aquatic bloom-forming cyanobacteria. Some of these biologically derived substances (BDSs) have no or low toxicity to aquatic animals and humans. Most BDSs are easily biodegradable in aquatic environments. These characteristics indicate that they may have potential for control and removal of harmful algae. However, BDSs also have the disadvantages of high cost of preparation, and possible damage to non-target aquatic organisms, and sometimes, low efficiency of algae removal. The ecological risks of most BDSs are still unknown. Here, we review recent research progress relative to the inhibitory effects of BDSs on cyanobacteria, and critically analyze the potential of BDSs as algicides with an emphasis on possible problems during the process of controlling harmful cyanobacteria. We suggest avenues of study to enhance effective use of BDSs in controlling of cyanobacterial blooms; these include guidelines for isolation and characterization of new effective BDSs, exploiting the synergistic effects of BDSs, the merits of controlling harmful cyanobacteria at the early stages of proliferation and evaluation of ecological risks of BDSs. Copyright © 2013 Elsevier Ltd. All rights reserved.
Papalia, Nina L; Luebbers, Stefan; Ogloff, James Rp; Cutajar, Margaret; Mullen, Paul E
There is a growing body of research investigating the relationship between child sexual abuse and a range of adverse outcomes. However, very little is known about the long-term co-occurrence of psychiatric disorders and behavioral problems among this vulnerable population, or the interaction between characteristics of the abuse, such as the nature and timing of the child sexual abuse, and the extent of subsequent adversities. This study aimed to determine the rate and co-occurrence of mental health morbidity, criminal justice system contact, and fatal self-harm among medically confirmed victims of child sexual abuse, and to identify abuse variables associated with a greater likelihood of cumulative adverse experiences. The forensic medical records of 2759 cases of child sexual abuse assessed between 1964 and 1995 were linked with public psychiatric, criminal justice and coronial administrative databases between 13 and 44 years following abuse. Cases were compared to 2677 matched comparisons from the general population. Abuse victims were more likely (odds ratio = 7.2, 95% confidence interval = [4.9, 10.4], p mental illness. Relative to comparisons, female victims demonstrated the largest increase in odds for cumulative outcomes (odds ratio = 9.8, 95% confidence interval = [5.8, 16.8], p Sexual abuse, particularly during adolescence (ages 12-16 years), appears to be a risk factor for co-occurring adverse experiences. This study identifies particular groups of child sexual abuse victims as at-risk and requiring targeted intervention.
Hefner, Kathryn; Valentine, Gerald; Sofuoglu, Mehmet
Adults with mental illness (MI) use combustible tobacco at increased rates and have greater difficulty quitting smoking. Given the increasing popularity of electronic cigarettes (e-cigarettes), their use by those with MI has important health implications. While preliminary evidence suggests potential benefits of e-cigarette use for those with MI, well-controlled, systematic research examining appeal, correlates, and consequences of e-cigarette use in this vulnerable population is lacking. This review evaluated current knowledge of e-cigarette use and potential for help and/or harm among adults with MI. The search strategy resulted in k = 88 reports, of which k = 9 were deemed relevant. E-cigarette use is prevalent among those with MI, as is concurrent use of e-cigarettes and combustibles. E-cigarettes appeal to those with MI as a viable alternative to combustible tobacco, and their use does not appear to exacerbate nicotine addiction or psychiatric symptoms. However, the long-term impact of e-cigarette use on combustible tobacco use and other health indices is largely unknown. Rigorous research and improved knowledge regarding risks and benefits of e-cigarette use within this vulnerable population are needed to inform whether special consideration is warranted towards those with MI in developing tobacco control policies and health communications. Recommendations for future e-cigarette research include improved assessment of the following: 1) psychodiagnostic variability, 2) flavor preferences, 3) the longitudinal impact on combustible tobacco use, and 4) impact of tobacco product communications. As with combustible cigarettes, individuals with MI may display unique e-cigarette use patterns from that of the general population. (Am J Addict 2017;26:306-315). Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
Kassai, Szilvia; Rácz, József; Nagy, Alexandra; Bíbók, Tamás; Galambvári, Éva; Kilián, Csillag; Gyarmathy, V Anna
Media monitoring is an important method to inform public health and prevention services about emerging health issues, such as new psychoactive substances (NPS). This study assessed the portrayal of NPS in online Hungarian media in 2015 using qualitative content analysis. Hungarian online media considers the dealer to be the main cause of drug use, which is portrayed as a problem for youth, poor people, minorities, and rural populations. The point of view of the articles is externalized, and so is the solution offered by them. From the perspective of the police or using a biomedical approach, the articles suggest that drug use is an individual (someone else's) problem, and the perspectives of insiders (such as users or addiction treatment professionals) are absent. The media portrays low socioeconomic background and the hopelessness of disadvantaged rural and mostly minority populations as the roots of NPS use, and misses the pressing incapability of health care emergency and drug treatment services to cope with the problem. The dominant portrayal of police raids is rarely counterbalanced by voices of active or recovering drug users or professionals in addiction treatment and harm reduction, who could offer a systematic solution to the apparent rapid spread of NPS use.
Dunne, Eugene M; Burrell, Larry E; Diggins, Allyson D; Whitehead, Nicole Ennis; Latimer, William W
The first aim of this study was to compare self-reported causes of homelessness between veterans and nonveterans. A second aim examined whether homeless male veterans were more likely than homeless male nonveterans to experience current problems with addictions, mental health, and physical health. Additionally, a third aim was to compare frequency of emergency room visits and treatment needs between the two groups. Secondary data analyses compared male homeless veterans and nonveterans (N = 353) enrolled in the Alachua County Point in Time study in central Florida. Participants completed a questionnaire on demographics and health variables. Additional questions included recent emergency room visits and medical or other needs not being met. Veterans reported higher rates of substance use and mental health problems as a primary cause of homelessness when compared to nonveterans. Homeless veterans were more likely than nonveterans to report current problems with addictions (OR = 6.29, 95% CI: 3.43-11.53, p homeless veterans (53.1%) reported an ER visit in the past year compared to only 40.9% of nonveterans (OR = 1.73, 95% CI: 1.07-2.80, p Veterans may be more likely to become homeless due to addiction and mental health and over half of homeless veterans are presenting to hospital emergency rooms. Given the greater utilization among homeless veterans, emergency rooms may serve as a prime opportunity to provide brief treatment and referrals for needed services. © American Academy of Addiction Psychiatry.
Boden, M Tyler; Moos, Rudolf
Few studies have investigated whether dually diagnosed patients with co-occurring substance use and psychiatric disorders (DD) respond as well to substance use disorder (SUD) treatments as patients with SUD do. Here we assessed whether male veteran DD and SUD patients with alcohol dependence diagnoses differed in the process and outcomes of residential SUD treatment. The main findings showed that (a) DD patients did not perceive SUD programs as positively as patients with SUD did and had worse proximal outcomes at discharge from treatment; (b) DD patients did as well as SUD patients on 1- and 5-year substance use outcomes but had worse psychiatric outcomes; and (c) patients who perceived treatment more positively and had better outcomes at discharge had better longer term outcomes. Thus, residential SUD programs are relatively effective in reducing DD patients' substance use problems; however, they are less successful in engaging DD patients in treatment and addressing their psychiatric problems.
Carletto, Sara; Oliva, Francesco; Barnato, Micaela; Antonelli, Teresa; Cardia, Antonina; Mazzaferro, Paolo; Raho, Carolina; Ostacoli, Luca; Fernandez, Isabel; Pagani, Marco
Background: Substance use disorders (SUD) are patterns of substance use leading to severe impairment on social, working and economic levels. In vivo and clinical findings have enhanced the role of the brain's stress-related system in maintaining SUD behaviors. Several studies have also revealed a high prevalence of post-traumatic symptoms among SUD patients, suggesting that a trauma-informed treatment approach could lead to better treatment outcomes. However, only few studies have evaluated the use of eye movement desensitization and reprocessing (EMDR) in SUD without consistent results. The aim of the present pilot study was to assess the efficacy of a combined trauma-focused (TF) and addiction-focused (AF) EMDR intervention in treating post-traumatic and stress-related symptoms of patients with SUD. Methods: Forty patients with different SUD were enrolled in the study. Twenty patients underwent treatment as usual (TAU), the other 20 patients were treated with TAU plus 24 weekly sessions of EMDR. All patients were assessed before and after intervention for several psychological dimensions using specific tools (i.e., BDI-II, DES, IES-R, STAI, and SCL-90-GSI). A repeated measure MANOVA was performed to evaluate both between groups (TAU + EMDR vs. TAU) and within group (pre- vs. post-intervention) effects and interactions. A secondary outcome was the dichotomous variable yielded by the urine drug testing immunoassay (yes/no). Results: The RM-MANOVA revealed both a significant pre–post main effect (p EMDR group than TAU group. No differences were found between TAU and TAU + EMDR groups in terms of urine drug immunoassay results before and after the interventions. Conclusions: The TAU + EMDR group showed a significant improvement of post-traumatic and dissociative symptoms, accompanied by a reduction in anxiety and overall psychopathology levels, whereas TAU group showed a significant reduction only in post-traumatic symptoms. Although our results can only be
Full Text Available Background: Substance use disorders (SUD are patterns of substance use leading to severe impairment on social, working and economic levels. In vivo and clinical findings have enhanced the role of the brain's stress-related system in maintaining SUD behaviors. Several studies have also revealed a high prevalence of post-traumatic symptoms among SUD patients, suggesting that a trauma-informed treatment approach could lead to better treatment outcomes. However, only few studies have evaluated the use of eye movement desensitization and reprocessing (EMDR in SUD without consistent results. The aim of the present pilot study was to assess the efficacy of a combined trauma-focused (TF and addiction-focused (AF EMDR intervention in treating post-traumatic and stress-related symptoms of patients with SUD.Methods: Forty patients with different SUD were enrolled in the study. Twenty patients underwent treatment as usual (TAU, the other 20 patients were treated with TAU plus 24 weekly sessions of EMDR. All patients were assessed before and after intervention for several psychological dimensions using specific tools (i.e., BDI-II, DES, IES-R, STAI, and SCL-90-GSI. A repeated measure MANOVA was performed to evaluate both between groups (TAU + EMDR vs. TAU and within group (pre- vs. post-intervention effects and interactions. A secondary outcome was the dichotomous variable yielded by the urine drug testing immunoassay (yes/no.Results: The RM-MANOVA revealed both a significant pre–post main effect (p < 0.001, and a significant group-by-time main effect (p < 0.001. Significant improvements on IES-R, DES, and SCL-90-GSI scales were shown in both groups according to time effects (p < 0.05. However, significant greater effects were found for TAU + EMDR group than TAU group. No differences were found between TAU and TAU + EMDR groups in terms of urine drug immunoassay results before and after the interventions.Conclusions: The TAU + EMDR group showed a
Labrum, Travis; Solomon, Phyllis L; Bressi, Sara K
Persons with psychiatric disorders (PD) are known to be at an increased risk of committing elder abuse, with much of this abuse occurring toward women. However, there is no evidence available speaking to the extent of this problem. The objective of the present study is to explore rates of abuse committed against older women by a relative with PD. In conjunction with the University of Pennsylvania, 217 women residing across the United States who are at least 55 years of age and who have a relative with PD completed an online survey. Analyses found that in the past 6 months 15% of survey respondents experienced physical abuse committed by their relative with PD, 20% experienced financial abuse, and 42% experienced psychological abuse. Given these high rates of abuse it is imperative that research into factors predicting abuse be conducted, as such information would help target and determine the nature of interventions.
M.Cur. (Psychiatric Nursing) Globally, the use of substances which seem to be harmful in all life dimensions appear to be an alarming problem. Recent studies indicate that the use and abuse of these substances is more prevalent among adolescents than any other age group. This is so because there are enormous changes to the physical, psychological and social dimensions at this stage. The use of these substances is a daily occurrence and reality for many people. However, for some individuals...
Håkansson, Anders; Jesionowska, Virginia
Aim The present study aimed to study the associations between substance use patterns and types of crimes in prisoners with substance use problems, and specifically whether substance use patterns were different in violent offenders. Methods Interview data of prisoners with substance use problems (N=4,202, mean age 33.5 years, SD 9.8), derived from the Addiction Severity Index, were run against criminal register data on main types of crimes in the verdict. Results In binary analyses, compared to those with acquisitive and drug crimes, violent offenders had lower prevalence of illicit drugs and homelessness, but higher prevalence of binge drinking, and higher prevalence of sedative use than clients sentenced with drug crimes. Clients with violent crime had lower prevalence of injecting drug use, compared to all other crimes. In logistic regression, binge drinking and sedatives were positively associated with violent crime (as opposed to non-violent crime), whereas heroin, amphetamine, cocaine, and injecting drug use were negatively associated with violent crime. Among violent offenders only, sedatives tended to be associated with fatal violence (p=0.06), whereas amphetamine, homelessness, age, and (marginally significant, p=0.05) heroin were negatively associated with fatal violence, as opposed to non-fatal violence. Conclusion Treatment and risk assessment in violent perpetrators with substance use may need to address sedatives and alcohol specifically. Limitations of the study are due to self-reported and cross-sectional data and because a large majority of the prison sample studied here are men. PMID:29391843
Jaquier, Véronique; Flanagan, Julianne C; Sullivan, Tami P
Although intimate partner violence (IPV) has demonstrated strong associations with anxiety and posttraumatic stress, these constructs have rarely been examined simultaneously in IPV research. Gaps in knowledge remain as to their differential associations to substance use problems among IPV-victimized women. A sample of 143 community women self-reported on their current IPV victimization, mental health and substance use problems. Hierarchical entry multiple regressions were used to test for the direct and indirect effects of psychological, physical, and sexual IPV to alcohol and drug problems through anxiety and posttraumatic stress. Higher anxiety symptom severity and higher physical IPV severity were associated with greater alcohol and drug problems. Higher posttraumatic stress symptom severity was associated with greater alcohol and drug problems. Mediation analyses indicated (i) significant indirect pathways of IPV types to alcohol problems through posttraumatic stress symptom severity controlling for anxiety symptom severity and (ii) significant indirect pathways of IPV types to drug problems through anxiety symptom severity controlling for posttraumatic stress symptom severity. In examining the indirect pathways of psychological, physical, and sexual IPV to substance use problems this study highlights that anxiety and posttraumatic stress symptom severity have unique effects on alcohol and drug problems among IPV-victimized women.
Gavriel-Fried, Belle; Rabayov, Tal
Aims: People with gambling as well as substance use problems who are exposed to public stigmatization may internalize and apply it to themselves through a mechanism known as self-stigma. This study implemented the Progressive Model for Self-Stigma which consists four sequential interrelated stages: awareness, agreement, application and harm on three groups of individuals with gambling, alcohol and other substance use problems. It explored whether the two guiding assumptions of this model (each stage is precondition for the following stage which are trickle-down in nature, and correlations between proximal stages should be larger than correlations between more distant stages) would differentiate people with gambling problems from those with alcohol and other substance use problems in terms of their patterns of self-stigma and in terms of the stages in the model. Method: 37 individuals with gambling problems, 60 with alcohol problems and 51 with drug problems who applied for treatment in rehabilitation centers in Israel in 2015-2016 were recruited. They completed the Self-stigma of Mental Illness Scale-Short Form which was adapted by changing the term "mental health" to gambling, alcohol or drugs, and the DSM-5-diagnostic criteria for gambling, alcohol or drug disorder. Results: The assumptions of the model were broadly confirmed: a repeated measures ANCOVA revealed that in all three groups there was a difference between first two stages (aware and agree) and the latter stages (apply and harm). In addition, the gambling group differed from the drug use and alcohol groups on the awareness stage: individuals with gambling problems were less likely to be aware of stigma than people with substance use or alcohol problems. Conclusion: The internalization of stigma among individuals with gambling problems tends to work in a similar way as for those with alcohol or drug problems. The differences between the gambling group and the alcohol and other substance groups at the
Full Text Available Aims: People with gambling as well as substance use problems who are exposed to public stigmatization may internalize and apply it to themselves through a mechanism known as self-stigma. This study implemented the Progressive Model for Self-Stigma which consists four sequential interrelated stages: awareness, agreement, application and harm on three groups of individuals with gambling, alcohol and other substance use problems. It explored whether the two guiding assumptions of this model (each stage is precondition for the following stage which are trickle-down in nature, and correlations between proximal stages should be larger than correlations between more distant stages would differentiate people with gambling problems from those with alcohol and other substance use problems in terms of their patterns of self-stigma and in terms of the stages in the model.Method: 37 individuals with gambling problems, 60 with alcohol problems and 51 with drug problems who applied for treatment in rehabilitation centers in Israel in 2015–2016 were recruited. They completed the Self-stigma of Mental Illness Scale-Short Form which was adapted by changing the term “mental health” to gambling, alcohol or drugs, and the DSM-5-diagnostic criteria for gambling, alcohol or drug disorder.Results: The assumptions of the model were broadly confirmed: a repeated measures ANCOVA revealed that in all three groups there was a difference between first two stages (aware and agree and the latter stages (apply and harm. In addition, the gambling group differed from the drug use and alcohol groups on the awareness stage: individuals with gambling problems were less likely to be aware of stigma than people with substance use or alcohol problems.Conclusion: The internalization of stigma among individuals with gambling problems tends to work in a similar way as for those with alcohol or drug problems. The differences between the gambling group and the alcohol and other
Cranford, James A; Eisenberg, Daniel; Serras, Alisha M
This research examined 1) the prevalence of substance use behaviors in college students, 2) gender and academic level as moderators of the associations between mental health problems and substance use, and 3) mental health service use among those with co-occurring frequent binge drinking and mental health problems. As part of the Healthy Minds Study, a probability sample of 2843 college students completed an Internet survey on mental health problems, substance use behaviors, and utilization of mental health care. Response propensity weights were used to adjust for differences between respondents and non-respondents. Major depression, panic disorder, and generalized anxiety disorder were positively associated with cigarette smoking. Frequent binge drinking was negatively associated with major depression and positively associated with generalized anxiety disorder, and these associations were significantly stronger for males than females. Among students with co-occurring frequent binge drinking and mental health problems, 67% perceived a need for mental health services but only 38% received services in the previous year. There may be substantial unmet needs for treatment of mental health problems and substance use among college students.
Five years after an elected government took over from a military regime, Chile has enjoyed booming economic growth and some measure of political stability but the scars of the legacy left by the regime of Augusto Pinochet run deep. Alcohol and drug abuse, family violence, depression and other mental-health problems are reported by a large proportion of the population. Fear is one of the permanent consequences of the military regime, says one sociologist.
Thompson, Ronald G; Hasin, Deborah
Although foster care placement is often preceded by stressful events such as child abuse, foster care itself often exposes children to additional severe stressors. A history of foster care, as well as the childhood abuse that often precedes it, is common among homeless young adults. This study examined whether a history of foster care was associated with psychiatric disorders, prior psychiatric counseling, prescription of psychiatric medications, and prior psychiatric hospitalization among newly homeless young adults. A consecutive sample of 423 adults aged 18 to 21 years who sought emergency shelter for the first time between October 1, 2007, and February 29, 2008, were assessed at intake. Logistic regression analyses determined the associations between foster care and any psychiatric disorder (affective, anxiety, personality, and psychotic) and psychiatric treatment. The analyses adjusted for demographic characteristics, childhood abuse, substance use, prior arrest, unemployment, lack of high school diploma, and histories of psychiatric disorders and drug abuse among biological relatives. Homeless young adults with histories of foster care were 70% more likely than those without such histories to report any psychiatric disorder. They were more than twice as likely to have received mental health counseling for a psychiatric disorder, to have been prescribed psychiatric medication, and to have been hospitalized for psychiatric problems. Histories of foster care among homeless young adults should trigger screening for psychiatric disorders to aid in the provision of treatment (counseling, medication, and hospitalization) tailored to the psychiatric needs of this highly vulnerable population.
Bailey, S Kathleen; Mushquash, Christopher J; Haggarty, John M
The relationship between male sex and employment as barriers to accessing mental health care is unclear. The aim of this research was to examine (1) whether the clinical features of men referred to a shared mental health care (SMHC) service through primary care differed when symptoms were affecting them in the work domain; and (2) empirically re-evaluate the effectiveness of a SMHC model for work-related disability using a pre-post chart review of N = 3960 referrals to SMHC. ANOVA and logistic regression were performed to examine symptoms (Patient Health Questionnaire, PHQ) and disability (World Health Organization Disability Assessment Schedule, WHODAS 2) at entry and discharge. Men were RR (relative risk) = 1.8 (95% C.I.: 1.60-2.05) times more likely to be referred to SMHC with work problems than women. Having greater disability and more severe somatic symptoms increased the likelihood of a work-related referral. There were no significant differences after treatment. Problems in the work domain may play an important role in men's treatment seeking and clinicians' recognition of a mental health care need. This study is relevant because men are underrepresented in mental health (MH) treatment and primary care is the main gateway to accessing MH care. Asking men about functioning in the work domain may increase access to helpful psychiatric services.
Friedrichs, Bettina; Igl, Wilmar; Larsson, Henrik; Larsson, Jan-Olov
Objective: To explore the associations of subtypes of adult ADHD with other psychiatric problems, stressful life events, and sex differences. Method: Odds ratios were calculated using information from 17,899 participants from a population-based survey of adult twins born in Sweden between 1959 and 1985. Results: Symptoms of attention deficit…
Halmoy, Anne; Fasmer, Ole Bernt; Gillberg, Christopher; Haavik, Jan
Objective: To determine the effects of symptom profile, comorbid psychiatric problems, and treatment on occupational outcome in adult ADHD patients. Method: Adult ADHD patients (N = 414) responded to questionnaires rating past and present symptoms of ADHD, comorbid conditions, treatment history, and work status. Results: Of the patients, 24%…
Evaluating a selective prevention program for substance use and comorbid behavioral problems in adolescents with mild to borderline intellectual disabilities: Study protocol of a randomized controlled trial
Schijven, E.P.; Engels, R.C.M.E.; Kleinjan, M.; Poelen, E.A.P.
Background: Substance use and abuse is a growing problem among adolescents with mild to borderline intellectual disabilities (ID). Substance use patterns in general population are similar to patterns among non-disabled peers, but substance use has more negative consequences for adolescents with mild
Thompson, Ronald G., Jr.; Auslander, Wendy F.
This study examined the relationship between substance use, mental health problems, and HIV sexual risk behaviors among a sample of foster care adolescents. Data were collected through structured baseline interviews with 320 adolescents (ages 15 to 18 years) who resided in foster care placements and participated in a larger evaluation study of an…
Asadullin, Azat R.; Galeeva, Elena Kh.; Achmetova, Elvina A.; Nikolaev, Ivan V.
The urgency of this study has become vivid in the light of the growing problem of prevalence and use of new synthetic drug types. Lately there has been a tendency of expanding the range of psychologically active substances (PAS) used by addicts with the purpose of their illegal taking. The aim of this research is an attempt of systematizing and…
Gromet, Dena M.; Ramchand, Rajeev; Griffin, Beth Ann; Morral, Andrew R.
This study investigates whether high-risk young adults' perceptions of their likelihood of living to age 35 and of acquiring HIV are related to their substance abuse problems and risky sexual behaviors. The sample consists of data from the 72- and 87-month follow-up assessments of 449 juvenile offenders referred to probation in 1999 and 2000.…
Donohue, Brad; Azrin, Nathan; Allen, Daniel N.; Romero, Valerie; Hill, Heather H.; Tracy, Kendra; Lapota, Holly; Gorney, Suzanne; Abdel-al, Ruweida; Caldas, Diana; Herdzik, Karen; Bradshaw, Kelsey; Valdez, Robby; Van Hasselt, Vincent B.
A comprehensive evidence-based treatment for substance abuse and other associated problems (Family Behavior Therapy) is described, including its application to both adolescents and adults across a wide range of clinical contexts (i.e., criminal justice, child welfare). Relevant to practitioners and applied clinical researchers, topic areas include…
Butwicka, Agnieszka; Långström, Niklas; Larsson, Henrik; Lundström, Sebastian; Serlachius, Eva; Almqvist, Catarina; Frisén, Louise; Lichtenstein, Paul
Despite limited and ambiguous empirical data, substance use-related problems have been assumed to be rare among patients with autism spectrum disorders (ASD). Using Swedish population-based registers we identified 26,986 individuals diagnosed with ASD during 1973-2009, and their 96,557 non-ASD relatives. ASD, without diagnosed comorbidity of…
Jasper, Stefanie; Rennekampff, Hans-Oliver; de Zwaan, Martina
Due to progress in burn treatment, more patients even with severe burn injuries survive. Despite this positive development, however, there are still negative somatic and mental consequences. These include the life-long care of scars and pain. In addition, posttraumatic-stress disorder and depression are common consequences. Also distress due to disfigurement and body image problems have to be considered, since this is likely to result in social withdrawal, low self-esteem, and reduction of quality of life. Overall, the impact of mental strain on burn victims is quite high. Therefore, psychotherapeutic treatment approaches should be integrated into the care of patients with burns. This might be helpful for both coping and compliance with long-term treatment. This paper provides a review of the mental co-morbidity of burn victims and of psychotherapeutic treatment approaches focusing on changes in body image and the respective social consequences. © Georg Thieme Verlag KG Stuttgart · New York.
Orwat, John; Saitz, Richard; Tompkins, Christopher P; Cheng, Debbie M; Dentato, Michael P; Samet, Jeffrey H
This is a prospective cohort study to identify factors associated with receipt of substance abuse treatment (SAT) among adults with alcohol problems and HIV/AIDS. Data from the HIV Longitudinal Interrelationships of Viruses and Ethanol study were analyzed. Generalized estimating equation logistic regression models were fit to identify factors associated with any service utilization. An alcohol dependence diagnosis had a negative association with SAT (adjusted odds ratio [AOR] = 0.36, 95% confidence interval [95% CI] = 0.19-0.67), as did identifying sexual orientation other than heterosexual (AOR = 0.46, CI = 0.29-0.72) and having social supports that use alcohol/drugs (AOR = 0.62, CI = 0.45-0.83). Positive associations with SAT include presence of hepatitis C antibody (AOR = 3.37, CI = 2.24-5.06), physical or sexual abuse (AOR = 2.12, CI = 1.22-3.69), social supports that help with sobriety (AOR = 1.92, CI = 1.28-2.87), homelessness (AOR = 2.40, CI = 1.60-3.62), drug dependence diagnosis (AOR = 2.64, CI = 1.88-3.70), and clinically important depressive symptoms (AOR = 1.52, CI = 1.08-2.15). While reassuring that factors indicating need for SAT among people with HIV and alcohol problems (e.g., drug dependence) are associated with receipt, nonneed factors (e.g., sexual orientation, age) that should not decrease likelihood of receipt of treatment were identified. Copyright © 2011 Elsevier Inc. All rights reserved.
Niccols, Alison; Dell, Colleen Anne; Clarke, Sharon
In many cultures, approximately one third of people with drug dependence are women of child-bearing age. Substance use among pregnant and parenting women is a major public health concern. Aboriginal people have some of the highest rates of substance abuse in Canada, increasing concern for detrimental health impacts, including those for women and…
Wills, Thomas A.; Pokhrel, Pallav; Morehouse, Ellen; Fenster, Bonnie
In a structural model, we tested how relations of predictors to level of adolescent substance use (tobacco, alcohol, marijuana), and to substance-related impaired-control and behavior problems, are moderated by good self-control and poor regulation in behavioral and emotional domains. The participants were a sample of 1,116 public high-school students. In a multiple-group analysis for good self-control, the paths from negative life events to substance use level and from level to behavior problems were lower among persons scoring higher on good behavioral self-control. In a multiple-group analysis for poor regulation, the paths from negative life events to level and from peer substance use to level were greater among persons scoring higher on poor behavioral (but not emotional) regulation; an inverse path from academic competence to level was greater among persons scoring higher on both aspects of poor regulation. Paths from level to impaired-control and behavior problems were greater among persons scoring higher on both poor behavioral and poor emotional regulation. Theoretical implications for the basis of moderation effects are discussed. PMID:21443302
Knecht, Carlos; de Alvaro, Raquel; Martinez-Raga, Jose; Balanza-Martinez, Vicent
The association between attention-deficit hyperactivity disorder (ADHD) and criminality has been increasingly recognized as an important societal concern. Studies conducted in different settings have revealed high rates of ADHD among adolescent offenders. The risk for criminal behavior among individuals with ADHD is increased when there is psychiatric comorbidity, particularly conduct disorder and substance use disorder. In the present report, it is aimed to systematically review the literature on the epidemiological, neurobiological, and other risk factors contributing to this association, as well as the key aspects of the assessment, diagnosis, and treatment of ADHD among offenders. A systematic literature search of electronic databases (PubMed, EMBASE, and PsycINFO) was conducted to identify potentially relevant studies published in English, in peer-reviewed journals. Studies conducted in various settings within the judicial system and in many different countries suggest that the rate of adolescent and adult inmates with ADHD far exceeds that reported in the general population; however, underdiagnosis is common. Similarly, follow-up studies of children with ADHD have revealed high rates of criminal behaviors, arrests, convictions, and imprisonment in adolescence and adulthood. Assessment of ADHD and comorbid condition requires an ongoing and careful process. When treating offenders or inmates with ADHD, who commonly present other comorbid psychiatric disorder complex, comprehensive and tailored interventions, combining pharmacological and psychosocial strategies are likely to be needed.
Stratton, Kelcey Jane; Edwards, Alexis Christine; Overstreet, Cassie; Richardson, Lisa; Tran, Trinh Luong; Trung, Lam Tu; Tam, Nguyen Thanh; Tuan, Tran; Buoi, La Thi; Ha, Tran Thu; Thach, Tran Duc; Amstadter, Ananda Beth
Little is known about risk factors for adolescent mental health in Vietnam. The present study investigated the relationship between caretaker mental health and adolescent mental health in a cross-sectional Vietnamese sample. Primary caretakers completed measures of their own mental distress and general health status using the Self-Reporting Questionnaire-20 (SRQ-20) as well as reports of adolescent mental health using the parent version of the Strengths and Difficulties Questionnaire (SDQ). Multivariate regression models were used to examine the relationships between the caretaker and adolescent health variables. The demographic factors of age, sex, ethnicity, religious affiliation, and household wealth status demonstrated significant relationships with SDQ subscale scores. Caretaker mental health was positively associated with adolescent mental health, and this association remained significant even after accounting for other relevant demographic variables and caretaker general health status. Understanding correlates of adolescent mental health difficulties may help identify youth and families at risk for developing psychiatric problems and inform mental health interventions in Vietnam. Published by Elsevier Ireland Ltd.
Bonnaire, C; Kovess-Masfety, V; Guignard, R; Richard, J B; du Roscoät, E; Beck, F
Many studies carried out on treatment-seeking problem gamblers (PG) have reported high levels of comorbid substance use disorders, and mental and physical health problems. Nevertheless, general population studies are still sparse, most of them have been carried out in the United States or Canada, and gender differences have not always been considered. Thus, the aim of this study was to describe the type of games, and psychological and physical correlates in male and female PG in a nationally representative French sample. The total sample studied involved 25,647 subjects aged 15-85 years, including 333 PG and 25,314 non-problem gamblers (NPG). Data were extracted from a large survey of a representative sample of the French general population. They were evaluated for sociodemographic variables, gambling behavior, type of gambling activity, substance use, psychological distress, body mass index, chronic disease, and lack of sleep. Overall, there were significant differences between PG and NPG in gender, age, education, employment and marital status, substance use disorders (alcohol, tobacco, cannabis, cocaine and heroin), psychological distress, obesity, lack of sleep and type of gambling activity. Although male and female PG had different profiles, the gambling type, especially strategic games, appeared as an important variable in the relationship between gender and problem gambling. This research underlines the importance of considering gender differences and gambling type in the study of gambling disorders. Identifying specific factors in the relationship between gender, gambling type and gambling problems may help improve clinical interventions and health promotion strategies.
Glen P. Davis
Full Text Available Background: Substance use and psychiatric disorders cause significant burden of disease in low- and middle-income countries. Co-morbid psychopathology and longer duration of untreated psychosis (DUP can negatively affect treatment outcomes. Objectives: The study assessed substance use amongst adults with severe mental illness receiving services at a regional psychiatric hospital in KwaZulu-Natal (South Africa. We describe the prevalence and correlates of lifetime substance use and examine the association between substance use and DUP. Methods: A cross-sectional survey recruited adults diagnosed with severe mental illness and assessed lifetime and past 3-month substance use using the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test. Regression analyses were conducted to determine associations between lifetime substance use (other than alcohol and tobacco and DUP as measured by the World Health Organization Encounter Form. Results: Amongst 87 participants, alcohol (81.6%, tobacco (75.6% and cannabis (49.4% were the most common substances reported for lifetime use. Risk of health-related problems (health, social, financial, legal and relationship of cannabis use was associated with younger age, single marital status and lower education. Adjusted regression analyses indicated that use of amphetamines and methaqualone is associated with longer DUP. Conclusions: Substance use is prevalent amongst psychiatric patients in KwaZulu-Natal and may contribute to longer DUP. Mental health services in this region should address co-morbid substance use and psychiatric disorders. Keywords: Substance Use; Psychosis; KwaZulu-Natal
Campos, Michael D; Podus, Deborah; Anglin, M Douglas; Warda, Umme
Recipients of welfare benefits have elevated rates of mental health and substance-related problems relative to the general public; however, low acculturation among Latinos may be a protective factor for both conditions. Lower acculturation among Latinos is associated with lower levels of mental health and substance-related problems relative to highly acculturated individuals. To our knowledge, there are few published studies examining the potential protective effects of low acculturation, defined herein as Spanish language preference, among Latina participants in welfare programs. Screening and treatment of mental health and substance-related problems in this population are important because work requirements for benefits receipt have been implemented and mental health or substance-related problems may be barriers to meeting these requirements. This analysis assesses the prevalence of mental health and substance-related problems among female participants in California's response to 1990s federal welfare reform legislation--the California Work Opportunity and Responsibility to Kids (CalWORKs). Although mental health needs may be similar among CalWORKs recipients regardless of acculturation, substance-related problems may be less frequent among Spanish-speaking Latinas participating in the CalWORKs program. Low acculturation was not a significant predictor of mental health need but had a protective effect with regard to substance-problem risk after controlling for several other substance-problem risk variables.
Vaaler Arne E
Full Text Available Abstract Background In the psychiatric acute and emergency services patients present in severe crisis often complicated by behavioral problems, substance use, and multiple axis 1 diagnoses. In these clinical settings both legal and illegal use of benzodiazepines are difficult to evaluate since benzodiazepines could in some patients be regarded as first line treatment and in other patients as the cause of the acute psychiatric condition. The aims of this study were to evaluate the frequency and clinical effects of both legal and illegal use of benzodiazepines at admittance to a psychiatric acute department. Methods All patients acutely admitted to a Norwegian acute psychiatric university department serving a catchment area were asked about use of benzodiazepines, other medications and substances before admission. Patients were asked to give urine samples for analyses of benzodiazepines and substances. Results In 227 consecutive admissions there was legal use of benzodiazepines before admission in 39%, illegal use in 13% and no use in 48%. Patients with legal use of benzodiazepines were older, used more often antidepressants and a higher number of prescribed psychotropic medications. Illegal users of benzodiazepines more often used other illegal substances, were evaluated as clinically affected by a substance at admittance and were diagnosed with a substance use disorder. Patients with psychoses or major affective disorders treated with adequate medication (antidepressants, antipsychotics or mood-stabilizers before admission more often received benzodiazepines than patients without adequate medication. Conclusions The patients using benzodiazepines at admittance to psychiatric acute departments could be divided in illegal and legal users. The illegal users were young, used illegal substances and were more often regarded clinically affected by substances at admittance. The legal users were older, did not use other substances and were not regarded
Van Eck, Kathryn; Markle, Robert S; Dattilo, Lauren; Flory, Kate
Although extensive research suggests that attention-deficit/hyperactivity disorder (ADHD) and conduct problems (CP; symptoms of oppositional defiant disorder, conduct disorder, and antisocial personality disorder) contribute to risk for substance use, why these symptoms increase risk for substance use remains unclear. Given that research indicates that perceived peer tolerance and perceived peer substance use affect substance use, we evaluated the degree to which these peer-perception constructs mediated the association that ADHD symptoms, CP symptoms, and their interaction share with substance use (i.e., alcohol use, marijuana use, and illicit drug use). Participants were college students (N = 627; 60% female; 47% European American) with a mean age of 20.23 years. Results indicated that perceived peer use significantly mediated the association of ADHD symptoms with alcohol, marijuana, and illicit drug use, whereas perceived peer use only mediated the association between CP symptoms and alcohol use. Perceived peer tolerance significantly mediated the association that both CP and ADHD symptoms had with marijuana use, but not alcohol or illicit drug use. Finally, CP symptoms moderated the indirect effect that ADHD symptoms had on alcohol use through perceived peer tolerance. At low levels of CP symptoms, increases in ADHD symptoms corresponded to increases in perceived peer tolerance, which was related to increased alcohol use. However, at high levels of CP symptoms, increases in ADHD symptoms corresponded to decreases in perceived peer tolerance, which was associated with decreased alcohol use. Implications of findings are discussed.
Duran, Şahut; Fıstıkcı, Nurhan; Keyvan, Ali; Bilici, Mustafa; Çalışkan, Mecit
This study aimed to investigate the prevalence of attention-deficit/hyperactivity disorder (ADHD) in adult psychiatric outpatients. Moreover, comorbid psychiatric diagnoses in adults with ADHD were determined. Patients with and without ADHD were compared regarding DSM Axis I-II comorbidity and sociodemographic characteristics. The study included patients that presented for the first time to a psychiatric outpatient clinic during a 3-month period and were evaluated for adult ADHD. A sociodemographic form, Wender Utah Rating Scale, Turgay's Adult ADD/ADHD Evaluation Scale, Structured Clinical Interview I and II, Symptom Check List-90-R, and Beck Depression Inventory were administered. The study included 246 patients. Among the 39 patients diagnosed with ADHD, 25 were female (64.1%) and 14 were male (35.9%), and the mean age was 27.38 ± 8.3 years. The prevalence of ADHD in adult psychiatric patients was 15.9%. Adults with ADHD usually presented due to comorbid psychiatric problems; major depression (43%), generalized anxiety disorder (23%), and obsessive-compulsive disorder (17%) were the most common comorbid diagnoses. Substance abuse (58.9%) and attempted suicide (38.5%) were among the most prevalent psychiatric problems. The present findings show that ADHD is an important comorbidity in adult patients that present to psychiatric clinics, and may cause serious mental health problems or complicate mental illness.
Lee, Jungeun Olivia; Hill, Karl G.; Hartigan, Lacey. A.; Boden, Joseph; Guttmannova, Katarina; Kosterman, Rick; Bailey, Jennifer A.; Catalano, Richard F.
The current study tested whether unemployment predicted young adults’ heavy episodic drinking, cigarette smoking, and cannabis use after taking into account individual development in substance use. Furthermore, building on the life course perspective, this study examined whether the link between unemployment and substance use among young adults differed for those who experienced low childhood SES compared to those who did not. Data for the present study came from the Seattle Social Development Project (SSDP), a panel study examining a broad range of developmental outcomes from ages 10 to 33. A life history calendar (LHC) was administered to assess substance use and unemployment status during young adulthood. Covariates included baseline symptoms of psychopathology, baseline substance use, gender, ethnicity, and adult educational attainment. Results suggest that unemployment is associated with young adults’ heavy episodic drinking and possibly cigarette use, but not cannabis use. Moreover, for all three substances, the detrimental impact of unemployment on substance use seems to be exacerbated among young adults who spent their childhood and adolescence in a lower SES household. Public health efforts that provide other viable and affordable options to cope with unemployment among young adults from low SES backgrounds are needed to address this disproportionate concentration of adverse impacts of unemployment on behavioral health. PMID:26342911
Lee, Jungeun Olivia; Hill, Karl G; Hartigan, Lacey A; Boden, Joseph M; Guttmannova, Katarina; Kosterman, Rick; Bailey, Jennifer A; Catalano, Richard F
The current study tested whether unemployment predicted young adults' heavy episodic drinking, cigarette smoking, and cannabis use after taking into account individual development in substance use. Furthermore, building on the life course perspective, this study examined whether the link between unemployment and substance use among young adults differed for those who experienced low childhood SES compared to those who did not. Data for the present study came from the Seattle Social Development Project (SSDP), a panel study examining a broad range of developmental outcomes from ages 10 to 33. A life history calendar (LHC) was administered to assess substance use and unemployment status during young adulthood. Covariates included baseline symptoms of psychopathology, baseline substance use, gender, ethnicity, and adult educational attainment. Results suggest that unemployment is associated with young adults' heavy episodic drinking and possibly cigarette use, but not cannabis use. Moreover, for all three substances, the detrimental impact of unemployment on substance use seems to be exacerbated among young adults who spent their childhood and adolescence in a lower SES household. Public health efforts that provide other viable and affordable options to cope with unemployment among young adults from low SES backgrounds are needed to address this disproportionate concentration of adverse impacts of unemployment on behavioral health. Copyright © 2015 Elsevier Ltd. All rights reserved.
Krystal, Andrew D.
SYNOPSIS Psychiatric disorders and sleep are related in important ways. In contrast to the longstanding view of this relationship which viewed sleep problems as symptoms of psychiatric disorders, there is growing experimental evidence that the relationship between psychiatric disorders and sleep is complex and includes bi-directional causation. In this article we provide the evidence that supports this point of view, reviewing the data on the sleep disturbances seen in patients with psychiatric disorders but also reviewing the data on the impact of sleep disturbances on psychiatric conditions. Although much has been learned about the psychiatric disorders-sleep relationship, additional research is needed to better understand these relationships. This work promises to improve our ability to understand both of these phenomena and to allow us to better treat the many patients with sleep disorders and with psychiatric disorders. PMID:23099143
van der Put, Claudia E; Creemers, Hanneke E; Hoeve, Machteld
Little is known about the needs of substance-using juveniles in treatment aimed at reducing criminal recidivism. Therefore, we aimed to examine treatment needs of substance-using juvenile offenders. Differences were examined between juvenile offenders who abstain from substance use (ASU; n=1974) and substance-using juvenile offenders without (SU; n=7000) and with substance use problems (SUP; n=3317), in the prevalence of risk/protective factors for criminal recidivism and strength of associations between risk/protective factors and criminal recidivism. We conducted secondary data analysis on recidivism risk assessments, collected with the Washington State Juvenile Court Assessment, and re-offending data. Analyses of variance and Partial correlations, adjusted for age, gender and ethnicity were applied, as well as Fisher's z tests and logistic regression analyses. Results showed that substance-using offenders, especially those with substance use problems, had more risk factors and less protective factors than ASU youths in the domains of school, use of free time, relationships, family, attitude, aggression and skills. The associations between most of the risk/protective factors and recidivism were stronger in the ASU group than in the SUP group. Substance use uniquely predicted recidivism, net of risk factors. These results suggest that general interventions for juvenile offenders addressing risk and protective factors with the aim to reduce recidivism may be less effective for offenders with substance use problems, and that substance use (problems) should be addressed, too. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
L.D. Breeman (Linda)
markdownabstract__Abstract__ Children with psychiatric disorders are at risk for experiencing poor psychosocial, emotional, and behavioral adjustment after leaving school (Heijmens Visser, Van der Ende, Koot, & Verhulst, 2003; Wielemaker, 2009). These children thus need a good educational
S.T. Lo (Sinddie)
markdownabstract__Abstract__ This thesis includes studies about developmental, behavioral and psychiatric characteristics in children with Prader-Willi syndrome (PWS). Endocrinologists Prader, Labhart, and Willi were the first describing the combination of neonatal hypotonia, short
Gokce Nur Say
Full Text Available Oxytocin is a neuropeptide that plays critical role in mother-infant bonding, pair bonding and prosocial behaviors. Several neuropsychiatric disorders such as autism, schizophrenia, affective disorders, anxiety disorders, attention deficit/hyperactivity disorder, alcohol/substance addiction, aggression, suicide, eating disorders and personality disorders show abnormalities of oxytocin system. These findings have given rise to the studies searching therapeutic use of oxytocin for psychi-atric disorders. The studies of oxytocin interventions in psychiatric disorders yielded potentially promising findings. This paper reviews the role of oxytocin in emotions, behavior and its effects in psychiatric disorders. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(2: 102-113
Luk, Jeremy W; King, Kevin M; McCarty, Carolyn A; McCauley, Elizabeth; Vander Stoep, Ann
Parental warmth and knowledge are protective factors against substance use, whereas parental psychological control is a risk factor. However, the interpretation of parenting and its effects on developmental outcomes may vary cross-culturally. This study examined direct and indirect effects of three parenting dimensions on substance use across Asian/Pacific Islander (API) and European Americans. A community sample of 97 API and 255 European Americans were followed from Grades 6 to 12. Participants reported on parenting in Grade 7, academic achievement and externalizing behaviors in Grades 7 and 8, and substance use behaviors in Grades 7, 9, and 12. Direct effects of parenting were not moderated by race. Overall, mother psychological control was a risk factor for substance use problems in Grade 9, whereas father knowledge was protective against alcohol use in Grade 9, substance use problems in Grades 9 and 12, and alcohol dependence in Grade 12. Moderated mediation analyses indicated significant mediational links among European Americans only: Mother knowledge predicted fewer externalizing problems in Grade 8, which in turn predicted fewer substance use problems in Grades 9 and 12. Father warmth predicted better academic achievement in Grade 8, which in turn predicted fewer substance use problems in Grades 9 and 12, as well as alcohol and marijuana dependence in Grade 12. Better academic achievement and fewer externalizing behaviors explain how positive parenting reduces substance use risk among European Americans. Promoting father knowledge of adolescents' whereabouts can reduce substance use risk among both European and API Americans.
Full Text Available Abstract Background Attachment theory allows specific predictions about the role of attachment representations in organizing behavior. Insecure attachment is hypothesized to predict maladaptive emotional regulation whereas secure attachment is hypothesized to predict adaptive emotional regulation. In this paper, we test specific hypotheses about the role of attachment representations in substance abuse/dependence and treatment participation. Based on theory, we expect divergence between levels of maladaptive functioning and adaptive methods of regulating negative emotions. Methods Participants for this study consist of a sample of adoptees participating in an ongoing longitudinal adoption study (n = 208. The Semi-Structured Assessment of the Genetics of Alcohol-II 41 was used to determine lifetime substance abuse/dependence and treatment participation. Attachment representations were derived by the Adult Attachment Interview [AAI; 16]. We constructed a prior contrasts reflecting theoretical predictions for the association between attachment representations, substance abuse/dependence and treatment participation. Results Logistic regression was used to test our hypotheses. As predicted, individuals classified as dismissing, preoccupied or earned-secure reported the highest rates of substance abuse/dependence. Individuals classified as dismissing reported significantly lower rates of treatment participation despite their high rates of substance abuse/dependence. As expected, the continuous-secure group reported lowest rates of both substance abuse/dependence and treatment participation. Conclusion The findings from this study identify attachment representations as an influential factor in understanding the divergence between problematic substance use and treatment utilization. The findings further imply that treatment may need to take attachment representations into account to promote successful recovery.
Kertesz Stefan G
Full Text Available Abstract Background Comorbid psychiatric illness can undermine outcomes among homeless persons undergoing addiction treatment, and psychiatric specialty care is not always readily available. The prognosis for nonsubstance abuse psychiatric diagnoses among homeless persons receiving behaviorally-based addiction treatment, however, is little studied. Results Data from an addiction treatment trial for 95 cocaine-dependent homeless persons (1996–1998 were used to profile psychiatric diagnoses at baseline and 6 months, including mood-related disorders (e.g. depression and anxiety-related disorders (e.g. post-traumatic stress disorder. Treatment interventions, including systematic reinforcement for goal attainment, were behavioral in orientation. There was a 32% reduction in the prevalence of comorbid non-addiction psychiatric disorder from baseline to 6 months, with similar reductions in the prevalence of mood (-32% and anxiety-related disorders (-20% (p = 0.12. Conclusion Among cocaine-dependent homeless persons with psychiatric comorbidity undergoing behavioral addiction treatment, a reduction in comorbid psychiatric disorder prevalence was observed over 6 months. Not all participants improved, suggesting that even evidence-based addiction treatment will prove insufficient for a meaningful proportion of the dually diagnosed homeless population.
Windle, Michael; Windle, Rebecca C
A limited number of measures exist to assess alcohol problems during adolescence. Item response theory modeling was used to scale a measure of adolescent alcohol problems, including drinking and driving, and then related to alcohol and other psychiatric disorders that occurred over a 15-year period. High school students (N = 832) completed the 13-item Alcohol Problems Index (API) at age 18 years as part of a long-term longitudinal study of predictors of alcohol use and alcohol disorders. Frequency of drinking and driving was also measured during adolescence. Lifetime psychiatric disorders, including alcohol disorders, were measured during young adulthood. Rasch modeling was used to scale the severity of alcohol problems, and the scaled total score was used to prospectively predict alcohol disorders. The area under the receiver operating characteristic (ROC) curve was also computed between the adolescent alcohol problems and alcohol and other psychiatric disorders across a 15-year period. The prevalence of alcohol disorders was 38.7% (for alcohol dependence, it was 27.7%). Rasch modeling indicated that the API assessed a range of severity of alcohol problems and that drinking and driving were among the less severe indicators. Age 18 API scores significantly correlated with an alcohol diagnosis (0.34), and ROC curve analysis indicated that for adolescent alcohol problem scores, the diagnostic accuracy (or area under the curve) for an alcohol diagnosis by age 33 was 0.70. Our findings supported the unidimensionality and reliability of the API, and statistically significant prospective prediction of young adult alcohol disorders. The measurement of alcohol problems during adolescence, in addition to drinking and driving, may be beneficial in understanding adverse consequences of drinking during adolescence as well as transitions in alcohol use and alcohol disorders across the lifespan. Copyright © 2017 by the Research Society on Alcoholism.
Davis, Glen P; Tomita, Andrew; Baumgartner, Joy Noel; Mtshemla, Sisanda; Nene, Siphumelele; King, Howard; Susser, Ezra; Burns, Jonathan K
Substance use and psychiatric disorders cause significant burden of disease in low- and middle-income countries. Co-morbid psychopathology and longer duration of untreated psychosis (DUP) can negatively affect treatment outcomes. The study assessed substance use amongst adults with severe mental illness receiving services at a regional psychiatric hospital in KwaZulu-Natal (South Africa). We describe the prevalence and correlates of lifetime substance use and examine the association between substance use and DUP. A cross-sectional survey recruited adults diagnosed with severe mental illness and assessed lifetime and past 3-month substance use using the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test. Regression analyses were conducted to determine associations between lifetime substance use (other than alcohol and tobacco) and DUP as measured by the World Health Organization Encounter Form. Amongst 87 participants, alcohol (81.6%), tobacco (75.6%) and cannabis (49.4%) were the most common substances reported for lifetime use. Risk of health-related problems (health, social, financial, legal and relationship) of cannabis use was associated with younger age, single marital status and lower education. Adjusted regression analyses indicated that use of amphetamines and methaqualone is associated with longer DUP. Substance use is prevalent amongst psychiatric patients in KwaZulu-Natal and may contribute to longer DUP. Mental health services in this region should address co-morbid substance use and psychiatric disorders.
van den Bosch, Louisa M C; Verheul, Roel; Schippers, Gerard M; van den Brink, Wim
The aim of this article is to examine whether standard Dialectical Behavior Therapy (DBT) (1) can be successfully implemented in a mixed population of borderline patients with or without comorbid substance abuse (SA), (2) is equally efficacious in reducing borderline symptomatology among those with and those without comorbid SA, and (3) is efficacious in reducing the severity of the substance use problems. The implementation of DBT is examined qualitatively. The impact of comorbid SA on its efficacy, as well as on its efficacy in terms of reducing SA, is investigated in a randomized clinical trial comparing DBT with treatment-as-usual (TAU) in 58 female borderline patients with (n = 31) and without (n = 27) SA. Standard DBT can be applied in a group of borderline patients with and without comorbid SA. Major implementation problems did not occur. DBT resulted in greater reductions of severe borderline symptoms than TAU, and this effect was not modified by the presence of comorbid SA. Standard DBT, as it was delivered in our study, however, had no effect on SA problems. Standard DBT can be effectively applied with borderline patients with comorbid SA problems, as well as those without. Standard DBT, however, is not more efficacious than TAU in reducing substance use problems. We propose that, rather than developing separate treatment programs for dual diagnosis patients, DBT should be "multitargeted." This means that therapists ought to be trained in addressing a range of severe manifestations of personality pathology in the impulse control spectrum, including suicidal and self-damaging behaviors, binge eating, and SA.
Substance abusers often face substantial systematic and personal barriers to receiving required substance abuse treatment services as well as other services; hence, various linkage mechanisms have been proposed for drug abuse treatment programs to overcome such barriers. Although there is a growing interest in the use of case management with a substance abuse background, its effectiveness in child welfare has yet to be explored. In this study the author attempts to investigate the effectiveness of case management in service utilization by systematically evaluating the five-year Alcohol and Other Drug Abuse (AODA) waiver demonstration project with Recovery Coaches in Illinois. A classic experimental design with a control group was used. Random assignment occurs at the agency level. Parents in the experimental group (N = 1562) received recovery coaches in addition to traditional child welfare services while parents in the control group (N = 598) only received traditional child welfare services. Bivariate and multivariate analyses (Ordinary Last Square regressions) were used. Compared to parents in the control group, parents in the experimental group were more likely to utilize substance abuse treatment. The results suggest that gender, education level, employment status, and the number of service needs were significantly associated with service utilization. Controlling other factors, recovery coaches improved overall service utilization. Because the outcome of child welfare often depends on the improvement of risks or resolution, it is important for parents to utilize the needed services. Future studies need to address what aspects of recovery coaches facilitate the services utilization.
Rooij, A.J. van; Kuss, D.J.; Griffiths, M.D.; Shorter, G.W.; Schoenmakers, T.M.; Mheen, D. van de
Aims: The current study explored the nature of problematic (addictive) video gaming (PVG) and the association with game type, psychosocial health, and substance use. Methods: Data were collected using a paper and pencil survey in the classroom setting. Three samples were aggregated to achieve a
A.J. van Rooij (Antonius); O. Kuss (Oliver); M. Griffiths (Mark); G.W. Shorter (Gillian); T.M. Schoenmakers (Tim); H. van de Mheen (Dike)
textabstractAims: The current study explored the nature of problematic (addictive) video gaming (PVG) and the association with game type, psychosocial health, and substance use. Methods: Data were collected using a paper and pencil survey in the classroom setting. Three samples were aggregated to
Guthmann, Debra; Graham, Vicki
Current research indicates that D/deaf and hard of hearing clients seeking treatment for substance abuse often encounter obstacles in receiving the help they need. Many of these obstacles are the result of a lack of knowledge and experience with regard to treating D/deaf and hard of hearing people. Programs designed for hearing people that attempt…
Sarkola, Taisto; Kahila, Hanna; Gissler, Mika; Halmesmäki, Erja
To study the risk of children to mothers with alcohol and/or substance abuse related problems for early childhood out-of-home care in Finland. A population-based cross-sectional retrospective analysis of 526 pregnant women attending special outpatient clinics during 1992-2001 and their 626 offspring, with out-of-home care data until 2003 provided by the National Child Welfare Register. Fifty percent (95% confidence interval 46-54%) were at some point and 38% (34-42%) by the age of two years, in out-of-home care. Out-of-home care was associated with maternal care for substance abuse after delivery, nonemployment, housing, daily smoking during pregnancy, increasing number of previous births, mother in custody in her childhood, maternal education, previous child in custody, drug in urine during pregnancy, unplanned pregnancy, partner with significant abuse, regular health-care contact for abuse, daily alcohol consumption before and/or during pregnancy, newborn not discharged with mother, neonatal abstinence symptoms (NAS), intensified perinatal surveillance or NICU, and delayed discharge from hospital. There is a substantial risk of children born to mothers with significant alcohol and/or substance abuse related problems for out-of-home care during early childhood. Factors identified during the pre- and perinatal period are associated with this risk.
Mereish, Ethan H.; O'Cleirigh, C; Bradford, Judith B.
Research has documented significant relationships between sexual and gender minority stress and higher rates of suicidality (i.e., suicidal ideation and attempts) and substance use problems. We examined the potential mediating role of substance use problems on the relationship between sexual and gender minority stress (i.e., victimization based on lesbian, gay, bisexual, or transgender identity; LGBT) and suicidality. A non-probability sample of LGBT patients from a community health center (N = 1457) ranged in age 19 to 70 years. Participants reported history of lifetime suicidal ideation and attempts, and substance use problems, as well as experiences of LGBT-based verbal and physical attacks. Substance use problems were a significant partial mediator between LGBT-based victimization and suicidal ideation and between LGBT-based victimization and suicide attempts for sexual and gender minorities. Nuanced gender differences revealed that substance use problems did not significantly mediate the relationship between victimization and suicide attempts for sexual minority men. Substance use problems may be one insidious pathway that partially mediates the risk effects of sexual and gender minority stress on suicidality. Substances might be a temporary and deleterious coping resource in response to LGBT-based victimization, which have serious effects on suicidal ideation and behaviors. PMID:23535038
Konkolÿ Thege, Barna; Hodgins, David C; Wild, T Cameron
Background and aims The aims of this study were (a) to describe the prevalence of single versus multiple addiction problems in a large representative sample and (b) to identify distinct subgroups of people experiencing substance-related and behavioral addiction problems. Methods A random sample of 6,000 respondents from Alberta, Canada, completed survey items assessing self-attributed problems experienced in the past year with four substances (alcohol, tobacco, marijuana, and cocaine) and six behaviors (gambling, eating, shopping, sex, video gaming, and work). Hierarchical cluster analyses were used to classify patterns of co-occurring addiction problems on an analytic subsample of 2,728 respondents (1,696 women and 1032 men; Mage = 45.1 years, SDage = 13.5 years) who reported problems with one or more of the addictive behaviors in the previous year. Results In the total sample, 49.2% of the respondents reported zero, 29.8% reported one, 13.1% reported two, and 7.9% reported three or more addiction problems in the previous year. Cluster-analytic results suggested a 7-group solution. Members of most clusters were characterized by multiple addiction problems; the average number of past year addictive behaviors in cluster members ranged between 1 (Cluster II: excessive eating only) and 2.5 (Cluster VII: excessive video game playing with the frequent co-occurrence of smoking, excessive eating and work). Discussion and conclusions Our findings replicate previous results indicating that about half of the adult population struggles with at least one excessive behavior in a given year; however, our analyses revealed a higher number of co-occurring addiction clusters than typically found in previous studies.
Konkolÿ Thege, Barna; Hodgins, David C.; Wild, T. Cameron
Background and aims The aims of this study were (a) to describe the prevalence of single versus multiple addiction problems in a large representative sample and (b) to identify distinct subgroups of people experiencing substance-related and behavioral addiction problems. Methods A random sample of 6,000 respondents from Alberta, Canada, completed survey items assessing self-attributed problems experienced in the past year with four substances (alcohol, tobacco, marijuana, and cocaine) and six behaviors (gambling, eating, shopping, sex, video gaming, and work). Hierarchical cluster analyses were used to classify patterns of co-occurring addiction problems on an analytic subsample of 2,728 respondents (1,696 women and 1032 men; Mage = 45.1 years, SDage = 13.5 years) who reported problems with one or more of the addictive behaviors in the previous year. Results In the total sample, 49.2% of the respondents reported zero, 29.8% reported one, 13.1% reported two, and 7.9% reported three or more addiction problems in the previous year. Cluster-analytic results suggested a 7-group solution. Members of most clusters were characterized by multiple addiction problems; the average number of past year addictive behaviors in cluster members ranged between 1 (Cluster II: excessive eating only) and 2.5 (Cluster VII: excessive video game playing with the frequent co-occurrence of smoking, excessive eating and work). Discussion and conclusions Our findings replicate previous results indicating that about half of the adult population struggles with at least one excessive behavior in a given year; however, our analyses revealed a higher number of co-occurring addiction clusters than typically found in previous studies. PMID:27829288
Full Text Available AIMS - Starting from the notion of the Finnish “non-medical approach” in the handling of alcohol and drug problems, this article analyses expressions of the medicalisation of drug problems and drug users in Finnish social work and specialised substance abuse treatment. The article focuses on the first drug wave, in the 1960s, and the second, at the end of the 1990s. DESIGN - The data consists of all texts on illegal drugs found in the years 1968-1972 and 1997-2001 in two leading journals of social work, one from the social care and social service field, the other issued by the key provider of specialist substance abuse treatment. The texts were systematically analysed (author(s, problem descriptions, suggested solutions, and words used for the problem and the drug user. RESULTS - In both periods, we found in the journals a social perspective on drugs and drug problems. There is more emphasis on prevention and more optimism on the possibilities of prevention in the first than in the second period. During the first period the call for medicine or medical solutions are few and the medical voices rare. Medical expertise gets more space in both journals in the second period. The predominant understanding of the problem changes from drugs as part of a new youth culture, possibly an epidemic in the first period, to a dependence/ addiction in the second. The description of the user shifts from a young person to a (marginalised dependent or addict. The proposed solutions in the 1960s are (youth focused social policy and social change, while the 1990s solutions highlight refined treatment and more specific interventions. The society seems difficult to change, and so do the established institutions. CONCLUSIONS - The medicalisation of the Finnish perspective on drugs in the 1990s is expressed through a narrowing of perspective on illegal drugs as social problems. While present, the social perspective is impotent.
Khoddam, Rubin; Jackson, Nicholas J; Leventhal, Adam M
The complex interplay of externalizing and internalizing problems in substance use risk is not well understood. This study tested whether the relationship of conduct problems and several internalizing disorders with future substance use is redundant, incremental, or interactive in adolescents. Two semiannual waves of data from the Happiness and Health Study were used, which included 3383 adolescents (M age=14.1years old; 53% females) in Los Angeles who were beginning high school at baseline. Logistic regression models tested the likelihood of past six-month alcohol, tobacco, marijuana, and any substance use at follow-up conditional on baseline conduct problems, symptoms of one of several internalizing disorders (i.e., Social Phobia and Major Depressive, Generalized Anxiety, Panic, and Obsessive-Compulsive Disorder), and their interaction adjusting for baseline use and other covariates. Conduct problems were a robust and consistent risk factor of each substance use outcome at follow-up. When adjusting for the internalizing-conduct comorbidity, depressive symptoms were the only internalizing problem whose risk for alcohol, tobacco, and any substance use was incremental to conduct problems. With the exception of social phobia, antagonistic interactive relationships between each internalizing disorder and conduct problems were found when predicting any substance use; internalizing symptoms was a more robust risk factor for substance use in teens with low (vs. high) conduct problems. Although internalizing and externalizing problems both generally increase risk of substance use, a closer look reveals important nuances in these risk pathways, particularly among teens with comorbid externalizing and internalizing problems. Copyright Â© 2016 Elsevier Ireland Ltd. All rights reserved.
Lee, Kyoung Hag; Hines, Lisa D
This study explored the racial disparity of substance dependency and psychological health among White, African American, and Hispanic Temporary Assistance to Needy Families (TANF) recipients as well as the relationship between substance dependency and psychological health. It analyzed 1,286 TANF recipients from the 2006 National Survey on Drug Use and Health data. Analysis of variance indicated that Whites were experiencing more nicotine and alcohol dependency and psychological distress than others, but African Americans and Hispanics were experiencing more cocaine dependency than Whites. Ordinary least squares regression revealed that nicotine dependency is significantly related to the psychological distress of Whites. Alcohol dependency is significantly associated with the psychological distress of three groups. Culturally competent programs are suggested.
Van Rooij, AJ; Kuss, DJ; Griffiths, MD; Shorter, GW; Schoenmakers, TM; van de Mheen, D.
Aims: The current study explored the nature of problematic (addictive) video gaming (PVG) and the association with game type, psychosocial health, and substance use. Methods: Data were collected using a paper and pencil survey in the classroom setting. Three samples were aggregated to achieve a total sample of 8478 unique adolescents. Scales included measures of game use, game type, the Video game Addiction Test (VAT), depressive mood, negative self-esteem, loneliness, social anxiety, educati...
Maynard, Brandy R; Salas-Wright, Christopher P; Vaughn, Michael G
This study examined the distribution of substance use, mental health, and criminal behavior among dropouts derived from a nationally representative sample of 18-25 year old (N = 19,312) emerging adults in the United States. Using public-use data from the 2010 National Survey on Drug Use and Health, this study employed multiple logistic regression with adjustments for complex survey sampling and compared high school dropouts with graduates with respect to substance use, mental health, and criminal behavior. After controlling for the effects of age, gender, race/ethnicity, family income, receipt of government assistance, employment status, and metropolitan population density, dropouts were more likely to meet criteria for nicotine dependence and report daily cigarette use, and more likely to report having attempted suicide in the previous year, been arrested for larceny, assault, drug possession or drug sales relative to their high school graduate counterparts. The findings of this study provide important insights and an initial epidemiologic portrait of mental health, substance use, and criminal behaviors of dropouts during emerging adulthood.
Kanayama, Gen; Cohane, Geoffrey H; Weiss, Roger D; Pope, Harrison G
Recent reports suggest that anabolic-androgenic steroids (AAS) may cause mood disorders or dependence syndromes and may help to introduce some individuals to opioid abuse. At present, however, little is known about prior AAS use among men entering inpatient substance abuse treatment. We assessed lifetime AAS use in 223 male substance abusers admitted to a substance abuse treatment unit primarily for treatment of alcohol, cocaine, and opioid dependence. Subjects reporting definite or possible AAS use were then asked to participate in a detailed semistructured interview that covered demographics, drug use history, and symptoms experienced during AAS use and withdrawal, and whether AAS use had helped introduce the subject to other classes of drugs. Twenty-nine men (13%) reported prior AAS use, but this history was documented on physicians' admission evaluations in only 4 cases. Among 88 men listing opioids as their drug of choice, 22 (25%) acknowledged AAS use, versus only 7 (5%) of the other 135 men (p abuse treatment, especially those with opioid dependence. AAS use may serve as a "gateway" to opioid abuse in some cases and may also cause morbidity in its own right.
van Emmerik-van Oortmerssen, Katelijne; van de Glind, Geurt; Koeter, Maarten W. J.; Allsop, Steve; Auriacombe, Marc; Barta, Csaba; Bu, Eli Torild H.; Burren, Yuliya; Carpentier, Pieter-Jan; Carruthers, Susan; Casas, Miguel; Demetrovics, Zsolt; Dom, Geert; Faraone, Stephen V.; Fatseas, Melina; Franck, Johan; Johnson, Brian; Kapitany-Foeveny, Mate; Kaye, Sharlene; Konstenius, Maija; Levin, Frances R.; Moggi, Franz; Moller, Merete; Ramos-Quiroga, J. Antoni; Schillinger, Arild; Skutle, Arvid; Verspreet, Sofie; van den Brink, Wim; Schoevers, Robert A.
AimsTo determine comorbidity patterns in treatment-seeking substance use disorder (SUD) patients with and without adult attention deficit hyperactivity disorder (ADHD), with an emphasis on subgroups defined by ADHD subtype, taking into account differences related to gender and primary substance of
Emmerik-van Oortmerssen, K. van; Glind, G. van de; Koeter, M.W.; Allsop, S.; Auriacombe, M.; Barta, C.; Bu, E.T.; Burren, Y.; Carpentier, P.J.; Carruthers, S.; Casas, M.; Demetrovics, Z.; Dom, G.; Faraone, S.V.; Fatseas, M.; Franck, J.; Johnson, B.; Kapitany-Foveny, M.; Kaye, S.; Konstenius, M.; Levin, F.R.; Moggi, F.; Moller, M.; Ramos-Quiroga, J.A.; Schillinger, A.; Skutle, A.; Verspreet, S.; Brink, W. van den; Schoevers, R.A.; Gaag, R.J. van der; et al.,
AIMS: To determine comorbidity patterns in treatment-seeking substance use disorder (SUD) patients with and without adult attention deficit hyperactivity disorder (ADHD), with an emphasis on subgroups defined by ADHD subtype, taking into account differences related to gender and primary substance of
Substance Abuse in Brief, 2003
Alcohol use is legal for persons age 21 and older, and the majority of people who drink do so without incident. However, there is a continuum of potential problems associated with alcohol consumption. This brief addresses the definition of an "alcohol problem" and problems associated with "risky drinking." It also addresses the…
Sensitivity and specificity of a brief personality screening instrument in predicting future substance use, emotional, and behavioral problems: 18-month predictive validity of the Substance Use Risk Profile Scale.
Castellanos-Ryan, Natalie; O'Leary-Barrett, Maeve; Sully, Laura; Conrod, Patricia
This study assessed the validity, sensitivity, and specificity of the Substance Use Risk Profile Scale (SURPS), a measure of personality risk factors for substance use and other behavioral problems in adolescence. The concurrent and predictive validity of the SURPS was tested in a sample of 1,162 adolescents (mean age: 13.7 years) using linear and logistic regressions, while its sensitivity and specificity were examined using the receiver operating characteristics curve analyses. Concurrent and predictive validity tests showed that all 4 brief scales-hopelessness (H), anxiety sensitivity (AS), impulsivity (IMP), and sensation seeking (SS)-were related, in theoretically expected ways, to measures of substance use and other behavioral and emotional problems. Results also showed that when using the 4 SURPS subscales to identify adolescents "at risk," one can identify a high number of those who developed problems (high sensitivity scores ranging from 72 to 91%). And, as predicted, because each scale is related to specific substance and mental health problems, good specificity was obtained when using the individual personality subscales (e.g., most adolescents identified at high risk by the IMP scale developed conduct or drug use problems within the next 18 months [a high specificity score of 70 to 80%]). The SURPS is a valuable tool for identifying adolescents at high risk for substance misuse and other emotional and behavioral problems. Implications of findings for the use of this measure in future research and prevention interventions are discussed. Copyright © 2012 by the Research Society on Alcoholism.
Full Text Available The etiology of these dermatological diseases is entirely psychiatric origin. These patients show overconcern to their skin or self inflicted dermatoses unconsciously instead of facing with their real problems. In this group, delusions, dermatitis artefacta, trichotillomania, body dysmorphic disorder can be seen. They use denial as defence mechanism to their real psychiatric problems and prefer to apply dermatology instead of psychiatry. Dermatologist should be very careful before asking psychiatric consultation. Denial mechanism help patients to overcome agressive impulses like suicide or prevent further psychiatric damage like psychosis. Dermatologist should see these patients with short and frequent intervals with a good empathic approach. This will help to progress a powerful patient doctor relationship which will lead to a psychiatric evaluation.
Nygaard, Egil; Slinning, Kari; Moe, Vibeke; Walhovd, Kristine B
Multiple studies have found that children born to mothers with opioid or poly-substance use during pregnancy have more behavior and attention problems and lower cognitive functioning than non-exposed children...
Full Text Available Esta pesquisa visou a avaliar a associação entre o consumo de substâncias (álcool, tabaco e drogas ilícitas e problemas familiares numa amostra de 965 adolescentes em 50 escolas públicas de dois municípios do Estado de São Paulo, Brasil, em 2007. Foi utilizado o Drug Use Screening Inventory (DUSI para a coleta de dados. O uso de álcool, tabaco e drogas ilícitas foi associado à avaliação negativa da relação familiar, à falta de suporte/monitoramento e ao uso de substâncias por familiares (p This study aimed to evaluate the association between substance use (alcohol, tobacco, and illicit drugs and family problems among 965 adolescents from 50 public schools in two cities in São Paulo State, Brazil, in 2007. The Drug Use Screening Inventory (DUSI was used for data collection. Use of alcohol, tobacco, and illicit drugs was associated with a negative assessment of the family relationship, lack of monitoring/support, and psychoactive substance use by family members (p < 0.05. Adolescents that reported having used alcohol, tobacco, and illicit drugs had more family problems than those who did not consume any substance (p < 0.001. Adolescents that used alcohol and tobacco (p = 0.028 and illicit drugs (p < 0.001 reported having more family problems than those who used only alcohol. The results highlight the importance of awareness of alcohol and tobacco use by adolescents, since such use was associated with significant family impairments, similar to illicit drug use.
Banducci, Anne N; Hoffman, Elana; Lejuez, C W; Koenen, Karestan C
Adults with substance use disorders (SUDs) report higher rates of child abuse than adults without SUDs. Prior work suggests that this abuse is associated with higher rates of psychosis, posttraumatic stress disorder, physical health problems, alcohol dependence, and cannabis dependence among substance users. Little is known about other problems associated with child abuse experienced by substance users. We hypothesized that among adults with SUDs, child abuse would be associated with elevated rates of all Diagnostic and Statistical Manual (DSM-IV-TR) psychiatric disorders, substance dependencies, and comorbidities assessed. We assessed 280 inpatients in substance use treatment with the Structured Clinical Interview for the DSM-IV-TR, the Diagnostic Instrument for Personality Disorders, and Childhood Trauma Questionnaire (CTQ). We used chi-square and regression analyses to establish whether rates of psychiatric disorders, substance dependencies, and comorbidities differed as a function of child abuse. Consistent with our hypotheses, higher scores on the CTQ were associated with elevated rates of psychiatric disorders (mood disorders, anxiety disorders, psychotic symptoms, and personality disorders) and substance dependencies (alcohol dependence and cocaine dependence). Moreover, higher rates of all comorbidity patterns (e.g. comorbid alcohol dependence and anxiety) were observed among individuals who reported experiencing child abuse. Across all substance dependencies examined, individuals who had been abused had significantly higher rates of all psychiatric disorders assessed. Individuals with substance use disorders who have been abused have particularly elevated rates of psychiatric and substance use disorders as a function of their abuse experiences. These findings have important treatment implications for individuals in residential substance use treatment settings. Copyright © 2014 Elsevier Ltd. All rights reserved.
Hounslow, Vanessa; Smith, David; Battersby, Malcolm; Morefield, Kate
Problem gambling has become a widespread problem following the rapid expansion of electronic gaming machines into hotels and clubs over the last 10 years. Recent literature indicates that certain factors can influence problem gambling severity, such as psychiatric co-morbidity and personality traits, gambling related cognitions, substance use and…
Zhang, Jing; Slesnick, Natasha; Feng, Xin
This study examined the effects of a family systems therapy (Ecologically-Based Family Therapy [EBFT]) on the co-occurring trajectory of mothers' substance use and psychological control, and its association with children's problem behaviors. Participants included 183 mothers with a substance use disorder who had at least one biological child in their care. Mothers were randomly assigned to one of the three intervention conditions: EBFT-home, n = 62; EBFT-office, n = 61; or Women's Health Education, n = 60. Participants were assessed at baseline, 3, 6, 12, and 18 months post-baseline. A dual-trajectory class growth analysis identified three groups of mothers in regard to their change trajectories. The majority of the mothers exhibited a synchronous decrease in substance use and psychological control (n = 107). In all, 46 mothers exhibited a synchronous increase in substance use and psychological control. For the remaining 30 mothers, substance use and psychological control remained stable. Mothers in the family therapy condition were more likely to show reduced substance use and psychological control compared to mothers in the control condition. Moreover, children with mothers who showed decreased substance use and psychological control exhibited lower levels of problem behaviors compared to children with mothers showing increased substance use and psychological control. The findings provide evidence for the effectiveness of family systems therapy, EBFT, in treating mothers' substance use, improving parenting behaviors, and subsequently improving child behavioral outcomes. © 2017 Family Process Institute.
Mereish, Ethan H.; O'Cleirigh, C; Bradford, Judith B.
Research has documented significant relationships between sexual and gender minority stress and higher rates of suicidality (i.e., suicidal ideation and attempts) and substance use problems. We examined the potential mediating role of substance use problems on the relationship between sexual and gender minority stress (i.e., victimization based on lesbian, gay, bisexual, or transgender identity; LGBT) and suicidality. A non-probability sample of LGBT patients from a community health center (N...
Family intervention for co-occurring substance use and severe psychiatric disorders: participant characteristics and correlates of initial engagement and more extended exposure in a randomized controlled trial.
Mueser, Kim T; Glynn, Shirley M; Cather, Corinne; Zarate, Roberto; Fox, Lindy; Feldman, James; Wolfe, Rosemarie; Clark, Robin E
Clients with severe mental illness and substance use disorder (i.e., dual disorders) frequently have contact with family members, who may provide valuable emotional and material support, but have limited skills and knowledge to promote recovery. Furthermore, high levels of family conflict and stress are related to higher rates of relapse. The present study was a two-site randomized controlled trial comparing a comprehensive, behaviorally-based family intervention for dual disorders program (FIDD) to a shorter-term family psychoeducational program (FPE). The modal family was a single male son in his early 30s diagnosed with both alcohol and drug problems and a schizophrenia-spectrum disorder participating with his middle-aged mother, with whom he lived. Initial engagement rates following consent to participate in the study and the family intervention programs were moderately high for both programs (88% and 84%, respectively), but rates of longer term retention and exposure to the core elements of each treatment model were lower (61% and 55%, respectively). Characteristics of the relatives were the strongest predictors of successful initial engagement in the family programs with the most important predictor being relatives who reported higher levels of benefit related to the relationship with the client. Subsequent successful exposure to the family treatment models was more strongly associated with client factors, including less severity of drug abuse and male client gender. The results suggest that attention to issues of motivating relatives to participate in family intervention, and more focused efforts to address the disruptive effects of drug abuse on the family could improve rates of engagement and retention in family programs for dual disorders.
Ogle, Richard L; Baer, John S
Two personalized substance abuse assessment and feedback interventions were tested for effectiveness in engaging female domestic violence shelter residents in substance abuse treatment. One hundred forty-seven residents were assessed for quantity andfrequency of substance use, negative consequences due to use, motivation to change substance use behavior, and psychopathological symptoms related to substance abuse. Assessment identified (33) 22% of participants as heavy substance users. Twenty of the 33 heavy-using residents received one of two personalized substance use feedback interventions:face-to-face feedback or writtenfeedbackplaced in shelter mailboxes. Treatment engagement was defined as attending at least one substance abuse treatment session within 30 days after the intervention. Results showed a significant difference in treatment engagement rates in favor of the face-to-face feedback group (60% vs. 0%). The results provide preliminary data suggesting that substance abuse assessment can be effectively accomplished in the shelter environment and that the face-to-face feedback procedure may be an effective intervention to bridge the service linkage problem between domestic violence services and substance abuse treatment.
Miettunen, J; Murray, G K; Jones, P B; Mäki, P; Ebeling, H; Taanila, A; Joukamaa, M; Savolainen, J; Törmänen, S; Järvelin, M-R; Veijola, J; Moilanen, I
Emotional and behavioral problems are commonly associated with substance use in adolescence but it is unclear whether substance use precedes or follows mental health problems. The aim was to investigate longitudinal associations between externalizing and internalizing psychopathology and substance use in a prospective population study design. The sample was the Northern Finland Birth Cohort 1986 Study (NFBC 1986; n = 6349; 3103 males). Externalizing and internalizing mental health problems were assessed at age 8 years (Rutter scales), substance use and externalizing and internalizing problems [Youth Self-Report (YSR)] at age 15-16 years, and hospital diagnoses for internalizing disorders (age 25) and criminal offences (age 20) from nationwide registers in adulthood. Externalizing problems at age 8 were associated with later substance use. After adjustment for sociodemographic factors, parental alcohol use and psychiatric disorders, and earlier externalizing and internalizing problems, substance use predicted criminality, especially among males, with the highest odds ratio (OR) for cannabis use [adjusted OR 6.2, 95% confidence interval (CI) 3.1-12.7]. Early internalizing problems were not a risk for later substance use. Female adolescent cannabis (OR 3.2, 95% CI 1.4-7.3) and alcohol (OR 2.1, 95% CI 1.1-4.2) use predicted internalizing disorders in adulthood. Externalizing problems precede adolescent substance use in both genders, whereas, among boys, substance use also precedes criminal offences. Internalizing problems may follow substance use in females. These associations were robust even when taking into account previous mental health problems.
Relative contributions of parent substance use and childhood maltreatment to chronic homelessness, depression, and substance abuse problems among homeless women: mediating roles of self-esteem and abuse in adulthood.
Stein, Judith A; Leslie, Michelle Burden; Nyamathi, Adeline
This study, using latent variable methodology, explores simultaneously the relative effects of childhood abuse and early parental substance abuse on later chronic homelessness, depression, and substance abuse problems in a sample of homeless women. We also examine whether self-esteem and recent violence can serve as mediators between the childhood predictors and the dysfunctional outcomes. The sample consists of 581 homeless women residing in shelters or sober living centers in Los Angeles (54% African-American, 23% Latina, 22% White, mean age=33.5 years). Multiple-indicator latent variables served as predictors and outcomes in structural models. Childhood abuse was indicated by sexual, physical, and verbal abuse. Childhood abuse directly predicted later physical abuse, chronic homelessness, depression, and less self-esteem. Parent substance use directly predicted later substance use problems among the women. Recent physical abuse predicted chronic homelessness, depression, and substance use problems. Greater self-esteem predicted less depression and fewer substance use problems. Childhood abuse also had significant indirect effects on depression, chronic homelessness, and drug and alcohol problems mediated through later physical abuse and self-esteem. Although there was a strong relationship between childhood abuse and parent drug use, childhood abuse was the more pervasive and devastating predictor of dysfunctional outcomes. Childhood abuse predicted a wider range of problems including lower self-esteem, more victimization, more depression, and chronic homelessness, and indirectly predicted drug and alcohol problems. The mediating roles of recent physical abuse and self-esteem suggest salient leverage points for change through empowerment training and self-esteem enhancement in homeless women.
Carey, Mary G; Al-Zaiti, Salah S; Dean, Grace E; Sessanna, Loralee; Finnell, Deborah S
Little attention has been given to factors contributing to firefighters' psychosomatic well-being. Objective The purpose of this descriptive study was to examine such contributing factors in a sample of professional firefighters. Methods Measures assessing sleep, depression, substance use, social bonding, and quality of life were examined in 112 firefighters. Results Overall, many firefighters reported sleep deprivation (59%), binge drinking behavior (58%), poor mental well-being (21%), current nicotine use (20%), hazardous drinking behavior (14%), depression (11%), poor physical well-being (8%), caffeine overuse (5%), or poor social bonding (4%). Conclusions Small-to-medium correlations were identified between sleep deprivation, depression, physical/mental well-being, and drinking behaviors. High-risk behaviors that impact psychosomatic well-being are prevalent in professional firefighters, which require environmental and individual-based health promotion interventions. The inter-correlation relationships between such behaviors, therefore, need to be explored in further details. PMID:21785370
Elliott, Jennifer C; Carey, Kate B; Bonafide, Katherine E
Family history of alcohol use problems is a reliable determinant of alcohol use and problems in the population at large, but findings are inconsistent when this issue is examined in college and university students. No quantitative summary of this literature has been reported to date. The purpose of this study was to conduct a meta-analysis on the effects of family history on substance use and abuse in college and university students. A two-group contrast meta-analysis was conducted to evaluate the differences in substance use and abuse between family history-positive and -negative students pursuing higher education. The studies that contributed data to this meta-analysis were conducted in five countries, with the majority of studies from the United States. A total of 65 published papers (53 samples) contributed data from 89 766 participants attending university or college. Effect sizes were coded for alcohol consumption, problems and use disorder symptoms, as well as other illegal drug use and abuse. Two independent coders calculated effect sizes and coded descriptive content about the papers, and discrepancies were reconciled. Family history was used as the grouping variable. Family history had a minimal effect on alcohol consumption, with stronger effects on alcohol consequences (Cohen's d: 0.21-0.25), alcohol use disorder symptoms (Cohen's d: 0.24) and other drug involvement (Cohen's d: 0.37-0.86). Relative to students without a family history of alcohol problems, students with positive family histories do not drink more, but may be at greater risk for difficulties with alcohol and drugs. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.
This project aims to enhance the capacity of the Air Force (AP) to reduce death, injury, and degraded force readiness via reduction of he prevalence and impact of family - maltreatment, suicidality, and alcohol/drug problems...
Henriksen, Ingvild Oxås; Ranøyen, Ingunn; Indredavik, Marit Sæbø; Stenseng, Frode
Self-esteem is fundamentally linked to mental health, but its' role in trajectories of psychiatric problems is unclear. In particular, few studies have addressed the role of self-esteem in the development of attention problems. Hence, we examined the role of global self-esteem in the development of symptoms of anxiety/depression and attention problems, simultaneously, in a clinical sample of adolescents while accounting for gender, therapy, and medication. Longitudinal data were obtained from a sample of 201 adolescents-aged 13-18-referred to the Department of Child and Adolescent Psychiatry in Trondheim, Norway. In the baseline study, self-esteem, and symptoms of anxiety/depression and attention problems were measured by means of self-report. Participants were reassessed 3 years later, with a participation rate of 77% in the clinical sample. Analyses showed that high self-esteem at baseline predicted fewer symptoms of both anxiety/depression and attention problems 3 years later after controlling for prior symptom levels, gender, therapy (or not), and medication. Results highlight the relevance of global self-esteem in the clinical practice, not only with regard to emotional problems, but also to attention problems. Implications for clinicians, parents, and others are discussed.
Kopak, Albert M; Chen, Angela Chia-Chen; Haas, Steven A; Gillmore, Mary Rogers
This study examined the ability of family cohesion, parental control, and parent-child attachment to prevent adolescents with a history of drug or alcohol use from experiencing subsequent problems related to their use. Data came from Wave I and Wave II of the National Longitudinal Study of Adolescent Health and included Mexican heritage and White adolescents who reported alcohol use (n = 4894, 25% prevalence) or any other drug use (n = 2875, 14% prevalence) in their lifetime. Logistic regression results indicate greater parent-child attachment predicted lower risk of experiencing drug use problems (OR = 0.87, 95% CI = 0.77-0.98) while stronger family cohesion predicted lower odds of experiencing drug- (OR = 0.82, 95% CI = 0.70-0.97) or alcohol-related (OR = 0.74, 95% CI = 0.65-0.84) problems. Parental control was also negatively associated with odds of problems related to drug use (OR = 0.93, 95% CI = 0.86-0.99) or alcohol use (OR = 0.94, 95% CI = 0.90-0.99). Results also indicated family cohesion was the only protective factor for Mexican heritage youth while family cohesion and parent-child attachment were protective among White youth. Parental control protected White female adolescents from drug use problems more than males. Mexican heritage male adolescents experienced more protection from drug problems compared to females. Findings highlight the need for prevention interventions to emphasize parent-child attachment for White youth and family cohesion for both Mexican-heritage and White youth to decrease adolescent substance users' drug- and alcohol-related problems. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Kopak, Albert M.; Chen, Angela Chia-Chen; Haas, Steven A.; Gillmore, Mary Rogers
INTRODUCTION This study examined the ability of family cohesion, parental control, and parent-child attachment to prevent adolescents with a history of drug or alcohol use from experiencing subsequent problems related to their use. METHODS Data came from Wave I and Wave II of the National Longitudinal Study of Adolescent Health and included Mexican heritage and White adolescents who reported alcohol use (n = 4,894, 25% prevalence) or any other drug use (n = 2,875, 14% prevalence) in their lifetime. RESULTS Logistic regression results indicate greater parent-child attachment predicted lower risk of experiencing drug use problems (OR = 0.87, 95% CI = 0.77 – 0.98) while stronger family cohesion predicted lower odds of experiencing drug- (OR = 0.82, 95% CI = 0.70 – 0.97) or alcohol-related (OR = 0.74, 95% CI = 0.65 – 0.84) problems. Parental control was also negatively associated with odds of problems related to drug use (OR = 0.93, 95% CI = 0.86 – 0.99) or alcohol use (OR = 0.94, 95% CI = 0.90 – 0.99). Results also indicated family cohesion was the only protective factor for Mexican heritage youth while family cohesion and parent-child attachment were protective among White youth. Parental control protected White female adolescents from drug use problems more than males. Mexican heritage male adolescents experienced more protection from drug problems compared to females. CONCLUSION Findings highlight the need for prevention interventions to emphasize parent-child attachment for White youth and family cohesion for both Mexican-heritage and White youth to decrease adolescent substance users’ drug- and alcohol-related problems. PMID:22222253
Weiss, Nicole H; Duke, Aaron A; Overstreet, Nicole M; Swan, Suzanne C; Sullivan, Tami P
A dearth of literature has examined the consequences of women's use of aggression in intimate relationships. Women's use of aggression against their intimate partners, regardless of their motivation (e.g., self-defense, retaliation), may elicit shame. Shame, in turn, may contribute to the maintenance and/or exacerbation of posttraumatic stress disorder (PTSD) symptoms, which are commonly experienced in this population. Further, emerging research suggests that emotionally avoidant coping strategies, such as substance use, may strengthen the relation between shame and PTSD symptoms. The goal of the present study was to examine whether women's shame concerning their use of intimate partner aggression is associated with their PTSD symptoms, and whether drug and alcohol use problems moderate this association. Participants were 369 community women who had used and been victimized by physical aggression in an intimate relationship with a male partner in the past six months. The intimate partner aggression-related shame × drug (but not alcohol) use problems interaction on PTSD symptom severity was significant. Analysis of simple slopes revealed that women's intimate partner aggression-related shame was positively associated with their PTSD symptoms when drug use problems were high, but not when drug use problems were low. Findings have implications for the potential utility of PTSD treatments targeting a reduction in shame and maladaptive shame regulation strategies (i.e., drug use) in this population. Aggr. Behav. 42:427-440, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.
Weiss, Nicole H.; Duke, Aaron A.; Overstreet, Nicole M.; Swan, Suzanne C.; Sullivan, Tami P.
A dearth of literature has examined the consequences of women’s use of aggression in intimate relationships. Women’s use of aggression against their intimate partners, regardless of their motivation (e.g., self-defense, retaliation), may elicit shame. Shame, in turn, may contribute to the maintenance and/or exacerbation of posttraumatic stress disorder (PTSD) symptoms, which are commonly experienced in this population. Further, emerging research suggests that emotionally-avoidant coping strategies, such as substance use, may strengthen the relation between shame and PTSD symptoms. The goal of the present study was to examine whether women’s shame concerning their use of intimate partner aggression is associated with their PTSD symptoms, and whether drug and alcohol use problems moderate this association. Participants were 369 community women who had used and been victimized by physical aggression in an intimate relationship with a male partner in the past six months. The intimate partner aggression-related shame × drug (but not alcohol) use problems interaction on PTSD symptom severity was significant. Analysis of simple slopes revealed that women’s intimate partner aggression-related shame was positively associated with their PTSD symptoms when drug use problems were high, but not when drug use problems were low. Findings have implications for the potential utility of PTSD treatments targeting a reduction in shame and maladaptive shame regulation strategies (i.e., drug use) in this population. PMID:26699821
Henry, Kimberly L; Knight, Kelly E; Thornberry, Terence P
Over the past 5 years, a great deal of attention has been paid to the development of early warning systems for dropout prevention. These warning systems use a set of indicators based on official school records to identify youth at risk for dropout and then appropriately target intervention. The current study builds on this work by assessing the extent to which a school disengagement warning index predicts not only dropout but also other problem behaviors during middle adolescence, late adolescence, and early adulthood. Data from the Rochester Youth Development Study (N = 911, 73% male, 68% African American, and 17% Latino) were used to examine the effects of a school disengagement warning index based on official 8th and 9th grade school records on subsequent dropout, as well as serious delinquency, official offending, and problem substance use during middle adolescence, late adolescence, and early adulthood. Results indicate that the school disengagement warning index is robustly related to dropout as well as serious problem behaviors across the three developmental stages, even after controlling for important potential confounders. High school dropout mediates the effect of the warning index on serious problem behaviors in early adulthood.
Winstanley, Erin L.; Steinwachs, Donald M.; Stitzer, Maxine L.; Fishman, Marc J.
The purpose of this study is to identify factors associated with adolescent alcohol or drug (AOD) abuse/dependence, mental health and co-occurring problems, as well as factors associated with access to treatment. This is a secondary analysis of data from the National Survey on Drug Use and Health (NSDUH) 2000. The 12-month prevalence rate of…
Shihabuddin, Bashar S; Hack, Clare M; Sivitz, Adam B
Our primary objective was to investigate whether urine drug screen (UDS) results affected the medical management of pediatric psychiatric patients presenting to the pediatric emergency department (ED) for psychiatric evaluation and whether it affected the final disposition of these patients. This was a retrospective chart review of patients who presented to an urban pediatric ED in Newark, NJ, with psychiatric or behavior problems for medical clearance before psychiatric evaluation between June 3, 2008, and June 3, 2009. Inclusion criteria were any patient between the ages of 0 to 20 years who presented to the pediatric ED and had a UDS performed. Exclusion criteria were if the UDS was obtained for a primary medical workup such as altered mental status, known or admitted overdose, or accidental ingestions, or no psychiatric consultation was made from the ED. Abstracted descriptive data include patient's age, sex, race, and insurance status. Visit-specific data include patient's reason for visit, results of the UDS, psychiatric diagnosis if any, history of substance abuse if any, and management decisions other than psychiatric evaluation after medical clearance. A total of 875 charts were identified from laboratory records; 539 of those patients presented to the pediatric ED for psychiatric evaluation. A total of 62 patients had at least 1 substance detected on the UDS and were referred to psychiatry. All of the patients who had presented for psychiatric evaluation, including those with a positive result on the UDS, were medically cleared with no documented change in management or medical intervention in the pediatric ED. Obtaining a UDS on patients who presented to the pediatric ED for medical clearance before psychiatric evaluation did not alter medical decision for clearance nor necessitate any change in management or interventions before psychiatric evaluation.
Didden, Robert; Embregts, Petri; van der Toorn, Mirjam; Laarhoven, Nina
Many clients with mild to borderline intellectual disability (ID) who are admitted to a treatment facility show serious problems in alcohol and/or drugs use. In the present case file study, we explored differences in coping strategies, adaptive skills and emotional and behavioral problems between clients who showed substance abuse and clients who…
Carrà, Giuseppe; Crocamo, Cristina; Borrelli, Paola; Tabacchi, Tommaso; Bartoli, Francesco; Popa, Ioana; Montomoli, Cristina; Clerici, Massimo
Environmental factors may operate with individual ones to influence the risk of substance use. Research has focused on severe adverse consequences influenced by contextual variables. However, the literature on community level factors influencing substance use behaviors is relatively limited across Europe so far. We capitalized on data from a National survey, exploring individual and contextual characteristics, to study adverse consequences among people with substance use disorders. The impact of area-level deprivation on nonfatal overdose, hepatitis C or B infections, and major involvement with the criminal justice system, was explored. Logistic regression models with cluster-robust errors, modeling subject-level and area-level effects, were used. Living in deprived and intermediate areas, as compared with affluent ones, was associated with greater likelihood of both nonfatal overdose and jail sentences longer than 6 months, though not of active viral hepatitis. Area-level deprivation may play an important role in determining adverse consequences in people with substance use disorders, also after controlling for individual-level characteristics. More research is needed to understand the aspects of social and physical environments that matter for drug outcomes before effective policy and research interventions can be developed.
Blackson, Timothy C; De La Rosa, Mario; Sanchez, Mariana; Li, Tan
No studies to date have assessed whether recent young adult (aged 18-34) Latino immigrants' biological parents' histories of substance use problems (BPHSUP) in their country of origin predict their alcohol use problems at pre- and post-immigration to the United States (US). BPHSUP in their country of origin were assessed via interviews conducted by bilingual Latino researchers with recent Latino immigrants primarily from Cuba and Central and South America recruited through respondent-driven sampling at the time of their immigration to southeastern US. Three waves of data were collected to document Latino immigrants' severity of alcohol use problems at pre-immigration and 2 annual post-immigration follow-up assessments. BPHSUP+/- status was used as a predictor of Latinos' (N = 452; 45.8% female, 54.2% male) Alcohol Use Disorders Identification Test (AUDIT) scores at pre- and post-immigration with age, education, and income as covariates as wells as odds ratios for AUDIT classifications of hazardous use, harmful use, and dependence. BPHSUP+ status predicted Latino immigrants' higher AUDIT scores pre- and post-immigration by gender (P immigrants of BPHSUP- status, controlling for age, education, and income. BPHSUP+ status predicted odds ratios of 3.45 and 2.91 for AUDIT alcohol dependence classification for men and women, respectively. This study documents that BPHSUP+/- status in their country of origin predict their young adult Latino offspring's severity of alcohol use problems pre- and post-immigration. These results may inform (1) community-based health care providers to screen recent young adult Latino immigrants for their BPHSUP+/- status and severity of alcohol use problems to redirect trajectories away from alcohol use disorders toward more normative post-immigration outcomes through culturally relevant prevention services and (2) future research advantages of differential susceptibility theory. Implications for future research and the need for replication
Ross, Amélie; Dion, Jacinthe; Cantinotti, Michael; Collin-Vézina, Delphine; Paquette, Linda
Residential schools were the institutions, in operation from the 19th century to the late 20th century, which Indigenous children in Canada were forced to attend. The literature shows that many young people who attended these institutions were victims of neglect and abuse. Negative psychological effects resulting from child abuse have been amply documented. However, very few studies on this subject have been carried out among Canada's Indigenous Peoples. The objective of this study is to evaluate, for an Indigenous population in Quebec (Canada), the impact of residential schooling as well as self-reported experiences of sexual and physical abuse during childhood on the development of alcohol and drug use problems in adulthood. A total of 358 Indigenous participants were interviewed (164 men [45.8%] and 194 women [54.2%]). Alcoholism was evaluated using the Michigan Alcoholism Screening Test (MAST). Drug abuse was assessed with the Drug Abuse Screening Test-20 (DAST). Child abuse and residential schooling were assessed with dichotomous questions (yes/no). Among the participants, 28.5% (n=102) had attended residential schools, 35.2% (n=121) reported having experienced sexual abuse, and 34.1% (n=117) reported having experienced physical abuse before adulthood. Results of the exact logistic regression analyses indicated that residential school attendance was linked to alcohol problems, while child abuse was related to drug use problems. The results of this study highlight the importance of considering the consequences of historical traumas related to residential schools to better understand the current situation of Indigenous Peoples in Canada. Copyright © 2015 Elsevier Ltd. All rights reserved.
Lee, W. R.
ABSTRACT Exposure of persons to conditions at work may involve some risk to health. It is not possible always to ensure that exposure can be kept below a level from which it may be categorically stated that there is no risk. The decision that has to be made, what ought to be done, poses an ethical problem. What principles are available for examining such ethical problems? Two theories from the study of ethics seem relevant. On the one hand Intuitionism asserts that we possess a moral sense which, correctly applied, enables us to determine what is a right action. The familiar use of 'conscience' and the teachings of some of the influential Western religions follow this theory. On the other hand Utilitarianism (in particular Objective Utilitarianism) asserts that we may judge the rightness of an action by looking at its consequences. This theory, translated into legislative reform, has provided a substantial basis for much of the social reforming legislation of the last century. In economic terms it appears as cost benefit analysis. Despite its attraction and almost plausible objectivity, Utilitarianism requires the quantification and even costing of consequences which cannot always be measured (for example, emotions) but which from an important part of the totality of life. Decisions about the right course of action are required politically but cannot always be made objectively. They may require an element of judgement—a correct application of the moral sense—to use the Intuitionists' phrase. Doctors, used to making ethical decisions in the clinical setting, must examine carefully their role when contributing to ethical decisions in the industrial setting. PMID:588483
Thaler, Nicholas S.; Sayegh, Philip; Kim, Michelle S.; Castellon, Steven A.; Hinkin, Charles H.
While numerous studies have established the adverse independent effects of clinical conditions including neurocognitive dysfunction, psychiatric illness, and substance abuse/dependence on medication adherence among HIV-infected adults, fewer have studied their interactive effects. The current study examined this issue among 204 HIV-infected participants based upon current neurocognitive functioning and DSM-IV-diagnosed psychiatric illness and current substance abuse or dependence. Results confirmed that participants with any of these risk factors demonstrated poorer adherence than individuals with no risk factors. A neurocognitive status × substance abuse/dependence interaction was also identified such that participants with impaired neurocognition and a co-occurring substance abuse/dependence diagnosis demonstrated the poorest adherence. Results confirm the deleterious impact of these risk factors in isolation and also identify a specific interactive effect for individuals with comorbid neurocognitive impairment and a substance abuse/dependence disorder. Findings highlight the need for interventions that simultaneously address these problems. PMID:25589442
Newton, Amanda S; Soleimani, Amir; Kirkland, Scott W; Gokiert, Rebecca J
Specialized instruments to screen and diagnose mental health problems in children and adolescents are not yet standard components of clinical assessments in emergency departments (EDs). We conducted a systematic review to investigate the psychometric properties, accuracy, and performance metrics of instruments used in the ED to identify pediatric mental health and substance use problems. We searched seven electronic databases and the gray literature for psychometric validation studies, diagnostic studies, and cohort studies that assessed any instrument to screen for or diagnose mental illness, emotional or behavioral problems, or substance use disorders. Studies had to include children and adolescents with mental health presentations or positive screens for substance use. Two reviewers independently screened studies for relevance and quality. Diagnostic study quality was assessed with the four QUADAS-2 domains. Psychometric study quality was assessed with published criteria for instrument reliability, validity, and usability. We present a descriptive analysis of the reported psychometric properties and diagnostic performance of instruments for each study. Of the 4,832 references screened, 14 met inclusion criteria. Included studies evaluate 18 instruments for identifying suicide risk (six studies), alcohol use disorders (six studies), mood disorders (one study), and ED decision making (need for assessment, admission; one study). Nine studies include a psychometric focus but quality varies, with no studies fully meeting criteria for reliability, validity, and usability. Seven studies examine diagnostic performance of an instrument, but no study has a low risk of bias for all QUADAS-2 domains. The HEADS-ED instrument has good inter-rater reliability (r = 0.785) for identifying general mental health problems and modest evidence for ruling in patients requiring hospital admission (positive likelihood ratio [LR+] = 6.30). Internal consistency (reliability) varies
Disease (particularly HIV) has increased our motivation to reconsider how the current help system deals with drug-related problems. A more concrete focus on disease prevention as an additional goal has, for many, lead to a reevaluation of the goals of drug help work. Such a critical examination shows how much there is to improve within the system even in the absence of blood borne disease. Integrating the heart of harm reduction--respecting work on any positive change as a person defines it for his/herself--into treatment fashions a health sensitive alternative to the predominant practice of abstinence-only assistance for the relief of drug problems. This new approach is called substance use management (SUM), as it no longer requires abstinence but instead focuses on a range of options for improvements while still including abstinence among the possible self-selected outcomes. SUM is suggested as a framework for change within the treatment system that would maximize treatment's constructive impact, cost-effectiveness and maturation as a distinct discipline that can appropriately attract support and gain stature for making society healthier. This article describes a formalized system for applying some of the main principles of harm reduction within the treatment system. Viable options for a SUM treatment focus are suggested herein as well as a critical process, based on respect and collaboration, for use with these options.
Blackson, Timothy C.; De La Rosa, Mario; Sanchez, Mariana; Li, Tan
Background No studies to date have assessed whether recent young adult (ages 18–34) Latino immigrants’ biological parents’ histories of substance use problems (BPHSUP) in their country of origin predict their alcohol use problems at pre- and post-immigration to the United States (U.S.). Methods BPHSUP in their country of origin was assessed via interviews conducted by bilingual Latino researchers with recent Latino immigrants primarily from Cuba, Central and South America recruited through respondent driven sampling at the time of their immigration to southeastern U.S. Three-waves of data were collected to document Latino immigrants’ severity of alcohol use problems at pre-immigration and two annual post-immigration follow-up assessments. BPHSUP +/− status was used as a predictor of Latinos’ (N=452; 45.8% female, 54.2% male) Alcohol Use Disorders Identification Test (AUDIT) scores at pre- and post-immigration with age, education and income as covariates as wells as odds ratios for AUDIT classifications of hazardous use, harmful use and dependence. Results BPHSUP+ status predicted Latino immigrants’ higher AUDIT scores pre- and post-immigration by gender (pLatino immigrants of BPHSUP− status controlling for age, education and income. BPHSUP+ status predicted odds ratios of 3.45 and 2.91 for alcohol dependence AUDIT classification for men and women respectively (T3). Conclusions This study documents that BPHSUP +/− status in their country of origin predict their young adult Latino offspring’s severity of alcohol use problems pre-and post-immigration. These results may inform (1) community-based health care providers to screen recent young adult Latino immigrants for their BPHSUP+/− status and severity of alcohol use problems to redirect trajectories away from alcohol use disorders toward more normative post-immigration outcomes through culturally relevant prevention services and (2) future research advantages of differential susceptibility
Kang, Sung-Yeon; Magura, Stephen; Laudet, Alexandre; Whitney, Shirley
Study examined adverse effects of childhood sexual/physical abuse among substance-abusing women with children. Several significant differences between abused and nonabused women were found in service outcomes. Abused women had more problems relating to drug use and psychiatric/psychological adjustment at follow-up. Findings support a need for…
Ingunn O. Lund
Full Text Available Background Women in opioid maintenance treatment (OMT have a past characterized by drug abuse, which is a challenging start for parenthood. Studies of mothers in OMT are typically limited to pregnancy and early infancy. Knowledge about how they cope with substance use and related problems in the years following birth is therefore important. The aims of the study were to examine changes in mothers’ substance use, psychological problems, and other challenges; from one to four years after their children were born, and describe kindergarten attendance and prevalence and type of child protective services involvement when the children were four years old. Method A four-year prospective cohort study of mothers in OMT. The European severity index was used to map substance use and related problems during the third trimester of pregnancy, one and four years after birth. Results At the four-year follow-up, use of illegal substances remained low (4% and use of legal substances (39% was similar to the one-year follow-up. The proportion of women with psychological problems was significantly higher than at one-year follow-up (69 vs. 39%, P = .009. At age four, most children (89% attended kindergarten, and the child protective services were following 73% of the families, mostly with voluntary measures. Conclusion Mothers in OMT cope well with substance use over time, given access to sufficient support. The findings imply that a preventive governmental strategy with close support of mother and child, have a positive impact contributing to making OMT and motherhood more compatible.
Fickenscher, Alexandra; Novins, Douglas K; Manson, Spero M
Few studies to date have addressed illicit (i.e., nonceremonial) peyote use among American Indians (AIs). Participants were 89 AI adolescents admitted to a tribally operated residential substance abuse treatment program (RSATP) between 1998 and 2001. The RSATP is designed to provide specialized treatment of patients with substance use and other comorbid psychiatric disorders and is infused with a culturally sensitive approach to treatment. The participants completed a series of interviews that collected information on psychiatric diagnostic status, history of substance use, and ethnic identity. The majority of participants were male (65%), did not come from a two-parent household (75%), reported a mean use of 5.4 substances, and met full criteria for a median of 2.9 substance use disorders. Of 89 clients, 10 (11.2%) reported illicit use of peyote. The vast majority of these youth (n = 8) reported using peyote only once or twice in their lifetime. Illicit peyote users did not differ from nonusers in terms of age, gender, other substance use, prevalence of either other substance abuse/dependence or other nonsubstance use psychiatric disorders. However, illicit peyote users were more likely to report low levels of social support, low levels of self-esteem, and low identification with AI culture yet comparable involvement in AI traditional practices. The results of this exploratory study suggest that illicit peyote use is uncommon among AI adolescents with serious substance abuse problems.
Pizzarello, Scott; Taylor, Jeanette
Objective: To determine if the substance use patterns of one's close friends and romantic partners would be a significant contributor to the co-occurrence of borderline personality disorder (BPD) features and drug use problems above and beyond impulsivity and negative emotionality. Participants: Participants were 2,202 undergraduates who attended…
Brody, Gene H.; Yu, Tianyi; Chen, Yi-fu; Kogan, Steven M.; Smith, Karen
Objective: This report addresses the long-term efficacy of the Adults in the Making (AIM) prevention program on deterring the escalation of alcohol use and development of substance use problems, particularly among rural African American emerging adults confronting high levels of contextual risk. Method: African American youths (M age, pretest =…
Baskin-Sommers, Arielle R; Waller, Rebecca; Fish, Ari M; Hyde, Luke W
Callous-unemotional (CU) traits, conduct problems (CP), and deficits in executive control are all linked to the development of more severe antisocial behavior, including violence and substance use. Though previous research has examined the impact of these factors on antisocial outcomes, little work has examined trajectories of CU traits across adolescence and how these trajectories predict greater antisocial behavior in adulthood. Moreover, no study has assessed how severity of early CP and executive control may exacerbate these pathways and increase risk for later violence and substance use. The current study (a) identified trajectories of CU traits among a large, high-risk sample of adolescent males, (b) examined the relationship between CU traits trajectories and future violence and substance use, and (c) examined whether early CP and executive control moderated the effects of a high CU traits trajectory membership and high CP on violence and substance use. Results indicated that: (a) CU traits could be grouped into three stable trajectories across adolescence, (b) the 'high' CU traits trajectory, particularly in the presence of 'elevated' CP, was related to higher violence and substance use, over and above a variety of environmental risk factors, and (c) the effects the 'high' CU traits trajectory on both violence and substance and in the presence of 'elevated' CP was stronger among youth with high executive control. These findings highlight the utility of identifying subgroups of youth who differ on trajectories of CU traits for understanding the development and maintenance of severe antisocial behavior.
Information obtained included the sociodemographic characteristics, type of injury, durations of unconsciousness (LOC) and posttraumatic amnesia (PTA), psychiatric and psychoactive substance use history. Psychiatric diagnosis was based on the criteria of the 10th edition of the International Classification of Diseases ...
Tobias H. Elgán
Full Text Available Abstract Background Depending on the definitions used, between 5 and 20 % of all Swedish children grow up with at least one parent suffering from alcohol problems, while 6 % have at least one parent who has received inpatient psychiatric care, conditions that may affect the children negatively. Nine out of ten Swedish municipalities therefore provide support resources, but less than 2 % of these children are reached by such support. Delivering intervention programs via the Internet is a promising strategy. However, web-based programs targeting this at-risk group of children are scarce. We have previously developed a 1.5-h-long web-based self-help program, Alcohol & Coping, which appears to be effective with regards to adolescents’ own alcohol consumption. However, there is a need for a more intense program, and therefore we adapted Kopstoring, a comprehensive Dutch web-based psycho-educative prevention program, to fit the Swedish context. The purpose of the program, which in Swedish has been called Grubbel, is to strengthen protective factors, such as coping skills and psychological well-being, prevent the development of psychological disorders, and reduce alcohol consumption. Methods/design The aim of the current study is to evaluate the effectiveness of Grubbel, which targets 15–25-year-olds whose parents have substance use problems and/or mental illness. Specific research questions relate to the participants’ own coping strategies, mental health status and substance use. The study was initiated in the spring of 2016 and uses a two-armed RCT design. Participants will be recruited via social media and also through existing agencies that provide support to this target group. The assessment will consist of a baseline measurement (t0 and three follow-ups after six (t1, 12 (t2, and 24 months (t3. Measures include YSR, CES-DC, Ladder of Life, Brief COPE, AUDIT-C, and WHOQOL-BREF. Discussion Studies have revealed that the majority of
Elgán, Tobias H; Kartengren, Nicklas; Strandberg, Anna K; Ingemarson, Maria; Hansson, Helena; Zetterlind, Ulla; Gripenberg, Johanna
Depending on the definitions used, between 5 and 20 % of all Swedish children grow up with at least one parent suffering from alcohol problems, while 6 % have at least one parent who has received inpatient psychiatric care, conditions that may affect the children negatively. Nine out of ten Swedish municipalities therefore provide support resources, but less than 2 % of these children are reached by such support. Delivering intervention programs via the Internet is a promising strategy. However, web-based programs targeting this at-risk group of children are scarce. We have previously developed a 1.5-h-long web-based self-help program, Alcohol & Coping, which appears to be effective with regards to adolescents' own alcohol consumption. However, there is a need for a more intense program, and therefore we adapted Kopstoring, a comprehensive Dutch web-based psycho-educative prevention program, to fit the Swedish context. The purpose of the program, which in Swedish has been called Grubbel, is to strengthen protective factors, such as coping skills and psychological well-being, prevent the development of psychological disorders, and reduce alcohol consumption. The aim of the current study is to evaluate the effectiveness of Grubbel, which targets 15-25-year-olds whose parents have substance use problems and/or mental illness. Specific research questions relate to the participants' own coping strategies, mental health status and substance use. The study was initiated in the spring of 2016 and uses a two-armed RCT design. Participants will be recruited via social media and also through existing agencies that provide support to this target group. The assessment will consist of a baseline measurement (t0) and three follow-ups after six (t1), 12 (t2), and 24 months (t3). Measures include YSR, CES-DC, Ladder of Life, Brief COPE, AUDIT-C, and WHOQOL-BREF. Studies have revealed that the majority of children whose parents have substance use or mental health problems are
Battista, Susan R.; Pencer, Alissa; McGonnell, Melissa; Durdle, Heather; Stewart, Sherry H.
There is a high overlap between substance misuse and mental health disorders in adolescents. Certain personality traits (i.e., sensation seeking, impulsivity, hopelessness, and anxiety sensitivity) may be related to increased risk for mental health symptoms and/or substance misuse. The current study examined the relationships between personality…
Tripodi, Stephen J.; Pettus-Davis, Carrie
Women are entering US prisons at nearly double the rate of men and are the fastest growing prison population. Current extant literature focuses on the prevalence of the incarceration of women, but few studies exist that emphasize the different trajectories to prison. For example, women prisoners have greater experiences of prior victimization, more reports of mental illness, and higher rates of illicit substance use. The purpose of this study was to understand the prevalence of childhood victimization and its association with adult mental health problems, substance abuse disorders, and further sexual victimization. The research team interviewed a random sample of 125 women prisoners soon to release from prison to gather information on their childhood physical and sexual victimization, mental health and substance abuse problems as an adult, and sexual victimization in the year preceding incarceration. Results indicate that women prisoners in this sample who were both physically and sexually victimized as a child were more likely to be hospitalized as an adult for a psychological or emotional problem. Women who were sexually victimized or both physically and sexually victimized were more likely to attempt suicide. Women who experienced physical victimization as children and women who were both physically and sexually victimized were more likely to have a substance use disorder and women who were sexually abused as children or both physically and sexually victimized were more likely to be sexually abused in the year preceding prison. This article ends with a discussion about prisons’ role in providing treatment for women prisoners and basing this treatment on women’s trajectories to prison, which disproportionately includes childhood victimization and subsequent mental health and substance use problems. PMID:23196054
Over the last few years, a range of so-called new psychoactive substances (NPS) have established themselves on the German recreational drug scene, causing increased concern. At the same time, a great number of Internet shops have come into existence offering these substances for sale online, ensuring a high level of availability. A number of these substances derived from pharmaceutical research which did not result in marketing authorization, presumably due to unfavourable properties. There are hardly any reliable data on long-term health damage, addictive potential, and other aspects of these scientifically unexplored substances. A number of fatal intoxications have also become known. As a rule, the mostly young consumers do not know what substance they are taking and in what concentration, thus exposing themselves to incalculable health risks and consequences. The punishability of the handling of NPS depends on the actual content: the Narcotic Drugs Act (BtMG) is applicable if a product contains narcotic drugs. If similarly effective substances are contained, which are not classified as narcotic drugs, the (penal) provisions of the Medicinal Products Act might be applicable, if the product has a pharmaceutical effect. Experience gained so far has shown that manufacturers of these intoxicating substances react immediately to inclusions in the German BtMG and put new substances on the market which are chemically similar to the known substances thus circumventing legislation. In view of the immense variety of NPS and the enormous profits derived from their sale, an end to this development is not in sight. Copyright © 2014 John Wiley & Sons, Ltd.
The compound Chinese materia medica is the medication pattern of the traditional Chinese medicine for the disease prevention and treatment. The single Chinese materia medica (mostly in decoction pieces) is the prescription composition of the compound Chinese materia medica. The study of the effective substance basis of Chinese materia medica should be based on the chemical compositions of the compound Chinese materia medica as an entry point considering the different status of "Monarch, Minister, Assistant, and Guide" for a certain single Chinese materia medica in the different compound Chinese materia medica while substance basis research of a certain single Chinese materia medica should be a full component analysis as well as both stable and controllable quality. Substance basis research on Chinese materia medica is one of key scientific problems of inheriting, development and innovation of Chinese materia medica.
Schwarz, Karoline; Fuchs, Martin; Veraar, Maria; Menz, Wolfgang; Kemmler, Georg; Simma, Burkhard
Clinical experience has repeatedly shown evidence for continuity between mental disorders in children and adolescents and mental disorders in adulthood. Up to now, Austria has had no epidemiologic data on psychiatric diseases in children and adolescents and their development into adulthood. How often do children and adolescents with psychiatric diseases have psychiatric diseases in adulthood? Is there any association between psychiatric diagnoses in childhood/adolescence and adulthood? Electronic medical records provided us with data on 2210 children and adolescents who were admitted to any hospital in the State of Vorarlberg, Austria, between 1997 and 2012 because of psychiatric diseases. In this cross-sectional study, diagnoses were coded according to ICD-10 and ICD-9 criteria. The three main reasons for admission of children and adolescents were substance abuse, emotional disorders and conduct disorders. Of the admitted children and adolescents, 9.8 % were readmitted to a psychiatric institution in adulthood. The main reason for readmission in adulthood appears to be disorders due to psychoactive substances (42.1 %). Of young patients with psychoactive substance use, 9.7 % were rehospitalized in adulthood, 70.8 % of them showed a diagnosis in the same category (F1) on admission. Children and adolescents admitted for schizophrenia, schizotypal, and delusional disorders (F2) were significantly more likely to be readmitted in adulthood (40.9 %) compared to any other child psychiatric diagnosis. This study once again shows the continuity of psychiatric disorders from childhood and adolescence to adulthood. It also gives further information about the transmission of diagnoses when patients reached the age of 18 years and their outcome. Until now, there is hardly any information about the outcome of children and adolescents with psychiatric diagnoses in Austria. We want to bring up more knowledge on that issue. Research findings may improve prevention and clinical
Breeman, Linda D.; van Lier, Pol A C; Wubbels, Theo; Verhulst, Frank C.; van der Ende, Jan; Maras, Athanasios; Struiksma, A. J Chris; Hopman, Juliette A B; Tick, Nouchka T.
Teaching children with psychiatric disorders can be a challenging task. The purpose of this study was to examine the impact of the Good Behavior Game (GBG) in children with psychiatric disorders, and their teachers, in special education. Teachers were trained by licensed school consultants to
Breeman, L.D.; Van Lier, Pol; Wubbels, T.; Verhulst, Frank C.; van der Ende, Jan; Maras, Athanasios; Struiksma, Chris; Hopman, J.A.B.; Tick, Nouchka
Teaching children with psychiatric disorders can be a challenging task. The purpose of this study was to examine the impact of the Good Behavior Game (GBG) in children with psychiatric disorders, and their teachers, in special education. Teachers were trained by licensed school consultants to
Breeman, Linda D.; van Lier, Pol A. C.; Wubbels, Theo; Verhulst, Frank C.; van der Ende, Jan; Maras, Athanasios; Struiksma, A. J. Chris; Hopman, Juliette A. B.; Tick, Nouchka T.
Teaching children with psychiatric disorders can be a challenging task. The purpose of this study was to examine the impact of the Good Behavior Game (GBG) in children with psychiatric disorders, and their teachers, in special education. Teachers were trained by licensed school consultants to implement positive behavior support strategies to…
Martínez, Isabel; Fuentes, María C; García, Fernando; Madrid, Ignacio
The aim of this study was to analyze the parental socialization styles as a protective or a risk factor for substance use in a sample of 673 Spanish adolescents (51.7% were women) aged 14-17 (M = 15.49, SD = 1.06). All participants completed the Parental Socialization Scale (ESPA29) and a scale of substance use. Additionally, they also completed a scale of delinquency and another one of school misconduct. A multivariate (4×2×2) analysis of variance (MANOVA) was applied for substance use, delinquency and school misconduct with parenting style, sex and age. Results from this study showed that indulgent parenting style was a protective factor for substance use whereas authoritarian style was identified as a risk factor. Moreover, results from protective and risk parenting styles on delinquency and school misconduct were consistent with those obtained on substance use. These findings have important implications for the development of family-based substance use prevention programs among Spanish adolescents and other similar cultures where indulgent parenting style is currently displaying a beneficial impact.
Studer, Joseph; Baggio, Stéphanie; Mohler-Kuo, Meichun; Simon, Olivier; Daeppen, Jean-Bernard; Gmel, Gerhard
The study aimed to identify different patterns of gambling activities (PGAs) and to investigate how PGAs differed in gambling problems, substance use outcomes, personality traits and coping strategies. A representative sample of 4989 young Swiss males completed a questionnaire assessing seven distinct gambling activities, gambling problems, substance use outcomes, personality traits and coping strategies. PGAs were identified using latent class analysis (LCA). Differences between PGAs in gambling and substance use outcomes, personality traits and coping strategies were tested. LCA identified six different PGAs. With regard to gambling and substance use outcomes, the three most problematic PGAs were extensive gamblers, followed by private gamblers, and electronic lottery and casino gamblers, respectively. By contrast, the three least detrimental PGAs were rare or non-gamblers, lottery only gamblers and casino gamblers. With regard to personality traits, compared with rare or non-gamblers, private and casino gamblers reported higher levels of sensation seeking. Electronic lottery and casino gamblers, private gamblers and extensive gamblers had higher levels of aggression-hostility. Extensive and casino gamblers reported higher levels of sociability, whereas casino gamblers reported lower levels of anxiety-neuroticism. Extensive gamblers used more maladaptive and less adaptive coping strategies than other groups. Results suggest that gambling is not a homogeneous activity since different types of gamblers exist according to the PGA they are engaged in. Extensive gamblers, electronic and casino gamblers and private gamblers may have the most problematic PGAs. Personality traits and coping skills may predispose individuals to PGAs associated with more or less negative outcomes.
Full Text Available Almost half of the people suffering traumatic brain injury (TBI may later be diagnosed with psychiatric disorders. The literature (PubMed, IndMed of past 30 years on psychiatric disturbances associated with TBI is reviewed. The authors highlight the close link between head injury and psychiatry and provide an overview of the epidemiology, risk-factors, and mechanisms of psychiatric sequelae including, cognitive deficits, substance abuse, psychoses, mood disorders, suicide, anxiety disorders, dissociative disorders, post-concussion syndrome, and personality changes following head injury. The various psychiatric sequelae are briefly discussed.
Full Text Available Infertility can be defined as a crisis with cultural, religious, and class related aspects, which coexists with medical, psychiatric, psychological, and social problems. Relation between psychiatric and psychological factors stem from a mutual interaction of both. Family is an important institution in maintaining human existence and raising individuals in line with society's expectations. Fertility and reproduction are seen as universal functions unique to women with raising children as the expected result of the family institution. Incidence of infertility has increased recently and can become a life crisis for a couple. Even though not being able to have a child affects both sexes emotionally, women feel greater amounts of stress, pressure, anxiety, and depression.Consequences of infertility arise from short and long-term devastating effects on both individual's physical and mental health, and marital system. Many studies focus on infertility related psychological and psychiatric disorders (depression, anxiety, grief, marital conflict, gender differences, relation between the causes of infertility and psychopathology, the effects of psychiatric evaluation and intervention -when necessaryon the course of infertility treatment, pregnancy rates, and childbirth. The most important underlying causes of high levels of stress and anxiety that infertile women experience are the loss of maternity, reproduction, sense of self, and genetic continuity. In this review article is to investigate the relationship between medically unexplained symptoms and psychiatric symptoms. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 165-185
Sullivan, Patrick F; Agrawal, Arpana; Bulik, Cynthia M
into biologically, clinically, and therapeutically meaningful insights. The emerging findings suggest that we are entering a phase of accelerated genetic discovery for multiple psychiatric disorders. These findings are likely to elucidate the genetic portions of these truly complex traits, and this knowledge can...... then be mined for its relevance for improved therapeutics and its impact on psychiatric practice within a precision medicine framework. [AJP at 175: Remembering Our Past As We Envision Our Future November 1946: The Genetic Theory of Schizophrenia Franz Kallmann's influential twin study of schizophrenia in 691...
Unger, J B; Kipke, M D; Simon, T R; Montgomery, S B; Johnson, C J
Although understanding of the subsistence patterns, service utilization, and HIV-risk behaviors of homeless youths and young adults in increasing, relatively little is known about the epidemiology of mental health problems in this group or the relationships between mental health problems and substance use. This study measured symptoms of depression, low self-esteem, ADHD, suicidality, self-injurious behavior (SIB), and drug and alcohol use disorder in a sample of homeless youth and young adults living in Hollywood, CA. Results indicated extremely high prevalences of mental health problems as compared with corresponding rates of mental health problems found among housed youths in previous studies. Prevalence of mental health problems differed by age and ethnicity. African Americans were at lower risk of suicidal thoughts and SIB than were those of other ethnicities. Older respondents and females were at increased risk of depressive symptoms, and younger respondents were at increased risk of SIB. Previous history of sexual abuse and/or assault was associated with increased risk of suicidality and SIB. Risk factors for drug abuse disorders included ethnicity other than African American, homelessness for 1 year or more, suicidality, SIB, depressive symptoms, and low self-esteem. Risk factors for alcohol abuse disorder included male gender, white ethnicity, homelessness for 1 year or more, suicidality, and SIB. Extremely high rates of mental health problems and substance abuse disorders in this sample suggest the need for street-based and nontraditional mental health services targeted toward these youths and young adults.
Zhang, Jing; Slesnick, Natasha
Substance using mothers vary in their exposure to an accumulation of contextual risks associated with their drug-using life styles, likely leading to variability in their children?s behavioral outcomes. The present study examined a mediation model interrelating mothers? cumulative risk exposure, children?s behavior problems, and coping strategies of both mothers and children. Findings showed that mothers? greater exposure to cumulative risk was associated with lower utilization of task-orient...
Avasthi, Ajit; Sarkar, Siddharth; Grover, Sandeep
Psychiatric nosology is required for communication among clinicians and researchers, understanding etiology, testing treatment efficacy, knowing the prevalence of the problems and disorders, health...
Carpentier, P.J.; Gogh, M.T. van; Knapen, L.J.; Buitelaar, J.K.; Jong, C.A.J. de
BACKGROUND: Persistent attention deficit hyperactivity disorder (ADHD) and a history of conduct disorder (CD) are highly prevalent among patients with substance use disorders (SUD). We examined the influence of both diagnoses on problem severity, psychiatric comorbidity, and quality of life in
Aagaard, Jørgen; Buus, Niels; Wernlund, Andreas Glahn
OBJECTIVE: The aim of this study was to examine changes in the distribution of causes of death and mortality rates among psychiatric patients visiting a psychiatric emergency room (PER), to determine clinically useful predictors for avoiding premature mortality among these patients and to discuss...... by substance use disorder is preventable, and PERs are ideal points of early intervention. Systematic screening for substance use disorder at the PER and/or crisis intervention teams may be effective intervention strategies....
Dhana Ratna Shakya
Full Text Available Introduction: Husband working abroad may have not only favorable outcomes for wives and other family members but also adverse consequences, including psychological problems. Present study intended to look into psychiatric morbidity profiles of the Nepalese female psychiatric patients and the stressors related with their husband working abroad. Materials and Methods: This is a hospital-based descriptive study with convenient sampling method. Hundred consecutive female psychiatric patients, with the particular stressor, coming into the contact of the investigating team were enrolled within the study period of 12 months. The psychiatric morbidities/diagnoses were sorted out according to the International classification of disease and infirmity, 10 th edition (ICD-10 criteria. Results: Average age of the enrolled cases was 29 years. Nearly half of the women were illiterate or barely literate. Some other stressors, besides the one of husband working abroad were found to precipitate the illness in about 60%, main being relational and health problems. Common presenting complaints were mood, anxiety, and physical symptoms. Almost 30% of the subjects had some mental illness in their past too and similar proportion had in their blood relatives. About one-third admitted to use substances, mainly alcohol and cigarettes. The common psychiatric diagnoses were mood, anxiety, neurotic, and stress-related disorders. Nearly 10% had presented for suicide attempt. Conclusions: The status of husband working abroad may have adverse consequences in mental health of women. Mood affect, anxiety, and stress-related disorders are common psychiatric illness among them.
Shakya, Dhana Ratna
Husband working abroad may have not only favorable outcomes for wives and other family members but also adverse consequences, including psychological problems. Present study intended to look into psychiatric morbidity profiles of the Nepalese female psychiatric patients and the stressors related with their husband working abroad. This is a hospital-based descriptive study with convenient sampling method. Hundred consecutive female psychiatric patients, with the particular stressor, coming into the contact of the investigating team were enrolled within the study period of 12 months. The psychiatric morbidities/diagnoses were sorted out according to the International classification of disease and infirmity, 10(th) edition (ICD-10) criteria. Average age of the enrolled cases was 29 years. Nearly half of the women were illiterate or barely literate. Some other stressors, besides the one of husband working abroad were found to precipitate the illness in about 60%, main being relational and health problems. Common presenting complaints were mood, anxiety, and physical symptoms. Almost 30% of the subjects had some mental illness in their past too and similar proportion had in their blood relatives. About one-third admitted to use substances, mainly alcohol and cigarettes. The common psychiatric diagnoses were mood, anxiety, neurotic, and stress-related disorders. Nearly 10% had presented for suicide attempt. The status of husband working abroad may have adverse consequences in mental health of women. Mood affect, anxiety, and stress-related disorders are common psychiatric illness among them.
Zhang, Jing; Slesnick, Natasha
Substance using mothers vary in their exposure to an accumulation of contextual risks associated with their drug-using lifestyles, likely leading to variability in their children's behavioral outcomes. The present study examined a mediation model interrelating mothers' cumulative risk exposure, children's behavior problems, and coping strategies of both mothers and children. Findings showed that mothers' greater exposure to cumulative risk was associated with lower utilization of task-oriented coping and higher utilization of emotion-oriented coping. Further, mothers' emotion-oriented coping mediated the association between mothers' cumulative risk exposure and children's behavior problems. These findings underscore the importance of considering the family socialization context in understanding children's problem behaviors in a high-risk population. The finding that mothers' emotion-oriented coping exerted a strong influence on children's behavior problems suggests that emotion-oriented coping may be a critical intervention target for family based prevention interventions. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Martínez, Isabel; Fuentes, María C; García, Fernando; Madrid, Ignacio
The aim of this study was to analyze the parental socialization styles as a protective or a risk factor for substance use in a sample of 673 Spanish adolescents (51.7% were women) aged 14-17 (M = 15.49, SD = 1.06...
van den Bosch, Louisa M. C.; Verheul, Roel; Schippers, Gerard M.; van den Brink, Wim
Objective: The aim of this article is to examine whether standard Dialectical Behavior Therapy (DBT) (1) can be successfully implemented in a mixed population of borderline patients with or without comorbid substance abuse (SA), (2) is equally efficacious in reducing borderline symptomatology among
Dembo, Richard; Briones, Rhissa; Gulledge, Laura; Karas, Lora; Winters, Ken C.; Belenko, Steven; Greenbaum, Paul E.
Reflective of interest in mental health and substance abuse issues among youths involved with the justice system, we performed a latent class analysis on baseline information collected on 100 youths involved in two diversion programs. Results identified two groups of youths: Group 1: a majority of the youths, who had high levels of delinquency,…
Alvarenga, Pedro G; do Rosario, Maria C; Cesar, Raony C; Manfro, Gisele G; Moriyama, Tais S; Bloch, Michael H; Shavitt, Roseli G; Hoexter, Marcelo Q; Coughlin, Catherine G; Leckman, James F; Miguel, Euripedes C
Pediatric-onset obsessive-compulsive disorder (OCD) is underdiagnosed, and many affected children are untreated. The present study seeks to evaluate the presence and the clinical impact of OCD and obsessive-compulsive symptoms (OCS) in a large sample of school-age children. In Phase I, we performed an initial screening using the Family History Screen (FHS). In Phase II, we identified an "at-risk" sample, as well as a randomly selected group of children. A total of 2,512 children (6-12 years old) were assessed using the FHS, the Development and Well-Being Assessment (DAWBA), the Strengths and Difficulties Questionnaire (SDQ), and the Child Behavior Checklist (CBCL). Data analyses included descriptive and multivariate analytical techniques. 2,512 children (mean age: 8.86 ± 1.84 years; 55.0% male) were categorized into one of the three diagnostic groups: OCD (n = 77), OCS (n = 488), and unaffected controls (n = 1,947). There were no significant socio-demographic differences (age, gender, socioeconomic status) across groups. The OCS group resembled the OCD on overall impairment, including school problems and delinquent behaviors. However, the OCD group did have significantly higher rates of several comorbid psychiatric disorders, including separation anxiety, generalized anxiety, and major depressive disorder, than OCS or unaffected controls. Moreover, the OCD group also scored higher than the SDQ, as well as on each of CBCL items rated by the parent. Our findings suggest that there is a psychopathological continuum between OCS and OCD in school-aged children. The presence of OCS is associated with functional impairment, which needs further investigation in longitudinal studies.
Saddichha, Sahoo; Sur, Shravani; Sinha, Baxi Neeraj Prasad; Khess, Christoday Raja Jayant
Substance use in mentally ill patients is now a major problem that influences the course and outcome of psychosis. With prevalence ranging up to 60%, several theories were postulated to explain the link. It would be interesting to know if substances have different effects in persons with psychosis than in those without. This study aimed to explore patterns of symptomatology of dependence and comorbid psychiatric illness by comparing and contrasting it with a group suffering from pure substance dependence. Consecutively admitted patients who were matched for age, sex, and tobacco use were divided into 3 groups. These were substance dependence without any comorbid psychiatric disorder (SD; n = 32), schizophrenia with substance dependence (SC; n = 31), and bipolar disorder with substance dependence (BD; n = 31). Patients were administered the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and Mini International Neuropsychiatric Inventory (MINI) to evaluate the chronology of criterion of International Classification of Diseases (ICD)-10 dependence. Results showed that cannabis was the most common substance used by both the SC (100%) and BD (80%) groups. This was followed by alcohol as the most common substance used, with prevalence of 87% in SC and 77% in BD groups. There was a significant difference in the pattern of use of cannabis in patients with psychosis, who developed tolerance much faster (P = .018) and had longer durations of cannabis use (P = .001) than the SD group. The presence of "loss of control" over drug use criterion seems to be a specific marker predicting development of dependence and psychosis. Cannabis use is more strongly associated with development of psychosis than any other substance.
Martone, Christine A; Mulvey, Edward P; Yang, Suzanne; Nemoianu, Andrei; Shugarman, Ryan; Soliman, Layla
The authors examined the rate of mental disorders in an unselected sample of homicide defendants in a U.S. jurisdiction, seeking to identify psychiatric factors associated with offense characteristics and court outcomes. Defendants charged with homicide in a U.S. urban county between 2001 and 2005 received a psychiatric evaluation after arrest. Demographic, historical, and psychiatric variables as well as offense characteristics and legal outcomes were described. Bivariate analyses examined differences by age group and by race, and logistic models examined predictors of multiple victims, firearm use, guilty plea, and guilty verdict. Fifty-eight percent of the sample had at least one axis I or II diagnosis, most often a substance use disorder (47%). Axis I or II diagnoses were more common (78%) among defendants over age 40. Although 37% of the sample had prior psychiatric treatment, only 8% of the defendants with diagnosed axis I disorders had outpatient treatment during the 3 months preceding the homicide; African Americans were less likely than non-African Americans to be in treatment. African American males were more likely to use a firearm and to have a male victim. In exploratory analyses, psychiatric factors did not predict multiple victims, firearm use in the crime, or a guilty verdict. Rates of axis I disorders were lower than reported in previous studies. Few homicide defendants were in psychiatric treatment at the time of the crime, suggesting limited opportunities for prevention by mental health providers.
Nilsson, Sandra Feodor; Laursen, Thomas Munk; Hjorthøj, Carsten
additional adjustment for factors including parental psychiatric disorders. IRRs in offspring were increased for most specific psychiatric disorders, with the highest risk for attachment disorder when both parents had a history of homelessness (IRR 32·5 [95% CI 24·6–42·9]) and substance use disorder when......Background Children and adolescents from deprived backgrounds have high rates of psychiatric problems. Parental and social factors are crucial for children's healthy and positive development, but whether psychiatric morbidity is associated with parental social marginalisation is unknown. We aimed......–16 years, who were living or born in Denmark between Jan 1, 1999, and Dec 31, 2015. Parental homelessness was the primary exposure, data on which were obtained from the Danish Homeless Register. The Danish Civil Registration System was used to extract the population and link offspring to parental...
Full Text Available Objective: The aim of this study was to further investigate the relationship between internet addiction and substance use disorder by exploring the prevalence of internet addiction among patients in a substance use disorder treatment clinic and to investigate the frequency with which internet addiction co-occurs with other psychiatric disorders in this population. Method: A survey, containing questions based on the nine criteria for internet gaming disorder proposed in the research appendix to DSM-5, was administered at 24 outpatient clinics for substance use disorders within the Stockholm Centre for Dependency Disorders. Data concerning additional psychiatric diagnoses was collected from patient medical records. A total of 569 patients participated, after excluding those with missing data as well as participants who primarily gambled online, the final sample size was N=462. Results: In total, 4.1% of the surveyed patients with substance use disorder met at least five out of nine internet addiction criteria at a level of “Fairly true” or higher, and reported at least “Some suffering” as a consequence of their internet use. An independent-samples t-test comparing the mean of the total internet addiction score between groups of patients with additional psychiatric diagnoses and the rest of the sample showed that participants with any one additional non-substance related psychiatric diagnose as well as those with an anxiety diagnose had significantly higher internet addiction scores than the rest of the sample. There were no significant differences in mean internet addiction scores between participants with ADHD or depression and the remaining sample. Conclusions: This study provides preliminary evidence to suggest that internet addiction does not constitute a major clinical issue for patients in treatment for substance use disorder, lending little support to the suggestion that internet-related problem behaviours share pathophysiology with
Full Text Available Abstract Background Patients admitted to a psychiatric hospital with suicidal behavior (SB are considered to be especially at high risk of suicide. However, the number of studies that have addressed this patient population remains insufficient compared to that of studies on suicidal patients in emergency or medical settings. The purpose of this study is to seek features of a sample of newly admitted suicidal psychiatric patients in a metropolitan area of Japan. Method 155 suicidal patients consecutively admitted to a large psychiatric center during a 20-month period, admission styles of whom were mostly involuntary, were assessed using Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID-I CV and SCID-II and SB-related psychiatric measures. Associations of the psychiatric diagnoses and SB-related characteristics with gender and age were examined. Results The common DSM-IV axis I diagnoses were affective disorders 62%, anxiety disorders 56% and substance-related disorders 38%. 56% of the subjects were diagnosed as having borderline PD, and 87% of them, at least one type of personality disorder (PD. SB methods used prior to admission were self-cutting 41%, overdosing 32%, self-strangulation 15%, jumping from a height 12% and attempting traffic death 10%, the first two of which were frequent among young females. The median (range of the total number of SBs in the lifetime history was 7 (1-141. Severity of depressive symptomatology, suicidal intent and other symptoms, proportions of the subjects who reported SB-preceding life events and life problems, and childhood and adolescent abuse were comparable to those of the previous studies conducted in medical or emergency service settings. Gender and age-relevant life-problems and life events were identified. Conclusions Features of the studied sample were the high prevalence of affective disorders, anxiety disorders and borderline PD, a variety of SB methods used prior to admission
Sikorski, Claudia; Glaesmer, Heide
This article addresses the usage of qualitative methods in psychiatric research and presents the qualitative approach in more detail. Recent original empirical work of a German psychiatric journal was systematically reviewed. Methods used to collect and analyse the information are detailed. One third of the articles used a solely qualitative research design. One further article applied a combination of quantitative and qualitative approaches. Three kinds of the qualitative interviews were used (in depth, narrative and problem-focussed interview). Additionally, focus groups (group discussions) and qualitative content analysis were applied by studies. Qualitative approaches are an integral part of psychiatric research. Further work should assure to use adequate sampling strategies.
Israelsson, Magnus; Nordlöf, Kerstin; Gerdner, Arne
Laws on compulsory commitment to care (CCC) in mental health, social and criminal legislation for adult persons with alcohol and/or drug dependence or misuse problems are constructed to address different scenarios related to substance use disorders. This study examines how such CCC laws in European states vary in terms of legal rights, formal orders of decision and criteria for involuntary admission, and assesses whether three legal frameworks (criminal, mental and social law) equally well ensure human and civil rights. Thirty-nine laws, from 38 countries, were analysed. Respondents replied in web-based questionnaires concerning a) legal rights afforded the persons with substance use problems during commitment proceedings, b) sources of formal application, c) instances for decision on admission, and d) whether or not 36 different criteria could function as grounds for decisions on CCC according to the law in question. Analysis of a-c were conducted in bivariate cross-tabulations. The 36 criteria for admission were sorted in criteria groups based on principal component analysis (PCA). To investigate whether legal rights, decision-making authorities or legal criteria may discriminate between types of law on CCC, discriminant analyses (DA) were conducted. There are few differences between the three types of law on CCC concerning legal rights afforded the individual. However, proper safeguards of the rights against unlawful detention seem still to be lacking in some CCC laws, regardless type of law. Courts are the decision-making body in 80 % of the laws, but this varies clearly between law types. Criteria for CCC also differ between types of law, i.e. concerning who should be treated: dependent offenders, persons with substance use problems with acting out or aggressive behaviors, or other vulnerable persons with alcohol or drug problems. The study raises questions concerning whether various European CCC laws in relation to substance use disorder or misuse problems
Sullivan, Christopher J; Veysey, Bonita M; Hamilton, Zachary K; Grillo, Michele
For a number of reasons, researchers and policy makers are now focusing on diversion of youth from the juvenile justice system. This study examines New York State's diversion efforts focused on youth with mental health and substance abuse problems who are at risk of out-of-community placement (N = 2,309). Twelve counties participated in the Mental Health Juvenile Justice (MH/JJ) Diversion Project. Overall, the initiative was successful in reducing out-of-community placement and recidivism for diverted youth. In regression analysis site, services received, and problem-profile variables were important predictors of out-of-community placement. Prior record, prior placement, and significant mental health problems were statistically significant predictors of recidivism. This suggests some contrasts in explaining the results of two important goals of the MH/JJ project. Study results and implications for future research and intervention are discussed.
Bailey, J A; Samek, D R; Keyes, M A; Hill, K G; Hicks, B M; McGue, M; Iacono, W G; Epstein, M; Catalano, R F; Haggerty, K P; Hawkins, J D
This paper presents two replications of a heuristic model for measuring environment in studies of gene-environment interplay in the etiology of young adult problem behaviors. Data were drawn from two longitudinal, U.S. studies of the etiology of substance use and related behaviors: the Raising Healthy Children study (RHC; N=1040, 47% female) and the Minnesota Twin Family Study (MTFS; N=1512, 50% female). RHC included a Pacific Northwest, school-based, community sample. MTFS included twins identified from state birth records in Minnesota. Both studies included commensurate measures of general family environment and family substance-specific environments in adolescence (RHC ages 10-18; MTFS age 18), as well as young adult nicotine dependence, alcohol and illicit drug use disorders, HIV sexual risk behavior, and antisocial behavior (RHC ages 24, 25; MTFS age 25). Results from the two samples were highly consistent and largely supported the heuristic model proposed by Bailey et al. (2011). Adolescent general family environment, family smoking environment, and family drinking environment predicted shared variance in problem behaviors in young adulthood. Family smoking environment predicted unique variance in young adult nicotine dependence. Family drinking environment did not appear to predict unique variance in young adult alcohol use disorder. Organizing environmental predictors and outcomes into general and substance-specific measures provides a useful way forward in modeling complex environments and phenotypes. Results suggest that programs aimed at preventing young adult problem behaviors should target general family environment and family smoking and drinking environments in adolescence. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Dunne, Eugene M; Hearn, Lauren E; Rose, Jonathan J; Latimer, William W
The primary aims of the present study were to assess ADHD history as a risk factor for earlier initiation and current use of licit and illicit substances among a sample of drug using adults. It was hypothesized that ADHD history would accelerate the Gateway Theory of drug use. Participants included 941 drug-using African American and Caucasian individuals in Baltimore, Maryland. The sample consisted of 124 (13.2%) participants who reported a history of ADHD and 817 (86.8%) who reported no history of ADHD. The accelerated gateway hypothesis was supported, as a history of self-reported ADHD was significantly associated with younger ages of initiation for alcohol, cigarettes, marijuana, and cocaine use. Participants with a history of ADHD were also more likely to engage in recent HIV-risk behavior, such as injection drug use and needle sharing. This study provides compelling data in support of an accelerated gateway model for substance use related to ADHD history and increased problem severity in adulthood. Targeted substance use prevention and intervention may be beneficial for those with ADHD. Copyright © 2014 Elsevier Ltd. All rights reserved.
Conway, Kevin P; Green, Victoria R; Kasza, Karin A; Silveira, Marushka L; Borek, Nicolette; Kimmel, Heather L; Sargent, James D; Stanton, Cassandra A; Lambert, Elizabeth; Hilmi, Nahla; Reissig, Chad J; Jackson, Kia J; Tanski, Susanne E; Maklan, David; Hyland, Andrew J; Compton, Wilson M
Cigarette use is associated with substance use and mental health problems among youth, but associations are unknown for non-cigarette tobacco product use, as well as the increasingly common poly-tobacco use. The current study examined co-occurrence of substance use and mental health problems across tobacco products among 13,617 youth aged 12-17years from Wave 1 (2013-2014) of the nationally representative Population Assessment of Tobacco and Health (PATH) Study. Participants self-reported ever cigarette, e-cigarette, smokeless tobacco, traditional cigar, cigarillo, filtered cigar, hookah, and other tobacco product use; alcohol, marijuana, and other drugs; and lifetime substance use, internalizing and externalizing problems. In multivariable regression analyses, use of each tobacco product was associated with substance use, particularly cigarillos and marijuana (AOR=18.9, 95% CI: 15.3-23.4). Cigarette (AOR=14.7, 95% CI: 11.8-18.2) and cigarillo (AOR=8.1, 95% CI: 6.3-10.3) use were strongly associated with substance use problems and tobacco users were more likely to report internalizing (AOR=1.6, 95% CI: 1.4-1.8) and externalizing (AOR=1.4, 95% CI: 1.3-1.6) problems. Female tobacco users were more likely to have internalizing problems than male tobacco users. Poly-tobacco users were more likely than exclusive users to use substances (AOR=3.4, 95% CI: 2.7-4.3) and have mental health (AOR=1.2, 95% CI: 1.0-1.5) and substance use (AOR=4.7, 95% CI: 3.4-6.6) problems. Regardless of the tobacco product used, findings reveal high co-occurrence of substance use and mental health problems among youth tobacco users, especially poly-tobacco users. These findings suggest the need to address comorbidities among high risk youth in prevention and treatment settings. Copyright © 2017 Elsevier Ltd. All rights reserved.
correlated with physical exhaustion, sleep disorder, substance abuse and family problems.3. Earlier studies report that risk factors for burnout included younger age, lack of role clarity, perceived inadequacy of resources, lack of personal support and workloadi5 On the other hand, hardiness, which is the individual's relative ...
Kelly, Sharon M; O'Grady, Kevin E; Gryczynski, Jan; Mitchell, Shannon Gwin; Kirk, Arethusa; Schwartz, Robert P
The Problem Oriented Screening Instrument for Teenagers (POSIT) substance use/abuse subscale has been validated with high school students, adolescents with criminal justice involvement, and adolescent substance use treatment samples using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-III-R and DSM-IV. This study examines the concurrent validity of the POSIT's standard 17-item substance use/abuse subscale and a revised, shorter 11-item version using DSM-5 substance use disorder diagnoses. Adolescents (N = 525; 93% African American, 55% female) 12-17 years of age awaiting primary care appointments at a Federally Qualified Health Center in Baltimore, Maryland completed the 17-item POSIT substance use/abuse subscale and items from a modified World Mental Health Composite International Diagnostic Interview corresponding to DSM-5 alcohol use disorder (AUD) and cannabis use disorder (CUD). Receiver operating characteristic curves, sensitivities, and specificities were examined with DSM-5 AUD, CUD, and a diagnosis of either or both disorders for the standard and revised subscales using risk cutoffs of either 1 or 2 POSIT "yes" responses. For the 17-item subscale, sensitivities were generally high using either cutoff (range: 0.79-1.00), although a cutoff of 1 was superior (sensitivities were 1.00 for AUD, CUD, and for either disorder). Specificities were also high using either cutoff (range: 0.81-0.95) but were higher using a cutoff of 2. For the 11-item subscale, a cutoff of 1 yielded higher sensitivities than a cutoff of 2 (ranges for 1 and 2: 0.96-1.00 and 0.79-0.86, respectively). Specificities for this subscale were higher using a cutoff of 2 (ranges for 1 and 2: 0.82-0.89 and 0.89-0.96, respectively). Findings suggest that the POSIT's substance use/abuse subscale is a potentially useful tool for screening adolescents in primary care for AUD or CUD using a cutoff of 1 or 2. The briefer, revised subscale may be preferable to the standard subscale in
Jaquier, Véronique; Flanagan, Julianne C.; Sullivan, Tami P.
This study examines effects of psychological, physical, and sexual intimate partner violence (IPV) to alcohol and drug problems through anxiety and posttraumatic stress symptom severity among 143 community women currently experiencing IPV. Anxiety and posttraumatic stress symptom severity had unique effects on alcohol and drug problems. Higher anxiety symptom severity and higher physical IPV severity were associated with greater alcohol and drug problems. Higher posttraumatic stress symptom s...
Kane, Jeremy C; Ventevogel, Peter; Spiegel, Paul; Bass, Judith K; van Ommeren, Mark; Tol, Wietse A
Population-based epidemiological research has established that refugees in low- and middle-income countries (LMIC) are at increased risk for a range of mental, neurological and substance use (MNS) problems. Improved knowledge of rates for MNS problems that are treated in refugee camp primary care settings is needed to identify service gaps and inform resource allocation. This study estimates contact coverage of MNS services in refugee camps by presenting rates of visits to camp primary care centers for treatment of MNS problems utilizing surveillance data from the Health Information System (HIS) of the United Nations High Commissioner for Refugees. Data were collected between January 2009 and March 2013 from 90 refugee camps across 15 LMIC. Visits to primary care settings were recorded for seven MNS categories: epilepsy/seizure; alcohol/substance use; mental retardation/intellectual disability; psychotic disorder; emotional disorder; medically unexplained somatic complaint; and other psychological complaint. The proportion of MNS visits attributable to each of the seven categories is presented by country, sex and age group. The data were combined with camp population data to generate rates of MNS visits per 1,000 persons per month, an estimate of contact coverage. Rates of visits for MNS problems ranged widely across countries, from 0.24 per 1,000 persons per month in Zambia to 23.69 in Liberia. Rates of visits for epilepsy were higher than any of the other MNS categories in nine of fifteen countries. The largest proportion of MNS visits overall was attributable to epilepsy/seizure (46.91% male/35.13% female) and psychotic disorders (25.88% male/19.98% female). Among children under five, epilepsy/seizure (82.74% male/82.29% female) also accounted for the largest proportion of MNS visits. Refugee health systems must be prepared to manage severe neuropsychiatric disorders in addition to mental conditions associated with stress. Relatively low rates of emotional and
Verweij, Karin J H; Creemers, Hanneke E; Korhonen, Tellervo; Latvala, Antti; Dick, Danielle M; Rose, Richard J; Huizink, Anja C; Kaprio, Jaakko
To determine (1) the prospective associations of conduct problems during early adolescence with tobacco, alcohol and cannabis use in young adulthood and (2) to what extent these associations are due to overlapping genetic versus environmental influences. A prospective twin study using biometric twin modelling. Finland. A total of 1847 Finnish twins (943 males and 904 females) were interviewed in early adolescence, 73% of whom (n = 1353, 640 males and 713 females) were retained in young adulthood. Symptom counts of conduct disorder (CD) criteria were obtained from a semi-structured clinical interview in early adolescence [age 14-15 years, mean = 14.2, standard deviation (SD) = 0.15]. Frequency of alcohol, tobacco and cannabis use was obtained from a semi-structured clinical interview in young adulthood (age 19.9-26.6 years, mean = 22.4, SD = 0.7). We found modest to moderate phenotypical correlations (r = 0.16-0.35) between early adolescent CD symptoms and substance use in young adulthood. In males, the phenotypical correlations of CD symptoms with all three substance use variables are explained largely by overlapping genetic influences. In females, overlapping shared environmental influences predominantly explain the phenotypical correlation between CD symptoms and tobacco and cannabis use. Conduct disorder symptoms in early adolescence appear to moderately predict substance use in early adulthood. In males, genetic influences seem to be most important in explaining the relationship between conduct disorder symptoms and substance use whereas in females, shared environmental influences seem to be most important. © 2016 Society for the Study of Addiction.
Copeland, William E.; Wolke, Dieter; Angold, Adrian; Costello, E. Jane
Context Both bullies and victims of bullying are at risk for psychiatric problems in childhood, but it is unclear if this elevated risk extends into early adulthood. Objective To test whether bullying and being bullied in childhood predicts psychiatric and suicidality in young adulthood after accounting for childhood psychiatric problems and family hardships. Design Prospective, population-based study of 1420 subjects with being bullied and bullying assessed four to six times between ages 9 and 16. Subjects were categorized as bullies only, victims only, bullies and victims (bully-victims), or neither. Setting and population Community sample Main Outcome Measure Psychiatric outcomes included depression, anxiety, antisocial personality disorder, substance disorders, and suicidality (including recurrent thoughts of death, suicidal ideation, or a suicide attempt) were assessed in young adulthood (ages 19, 21, and 24/25/26) by structured diagnostic interviews. Results Victims and bully-victims had elevated rates of young adult psychiatric disorder, but also elevated rates of childhood psychiatric disorders and family hardships. After controlling for childhood psychiatric problems or family hardship, victims continued to have higher prevalence of agoraphobia (odds ratio (OR), 4.6; 95% confidence interval (CI), 1.7–12.5, p suicidality (males only: OR, 18.5; 95% CI, 6.2–55.1, p Bullies were at risk for antisocial personality disorder only (OR, 4.1; 95% CI, 1.1–15.8, p bullied are direct, pleiotropic and long- lasting with the worst effects for those who are both victims and bullies. PMID:23426798
Full Text Available Background. There is a lack of studies addressing the frequency and correlates of comorbidities among heroin users admitted for treatment in South Africa (SA. Objective. To assess the frequency and correlates of psychiatric comorbidity among patients with heroin use disorder admitted to the Opioid Detoxification Unit at Stikland Hospital in the Western Cape, SA. Method. Participants (N=141 were assessed for psychiatric illness (Mini International Neuropsychiatric Interview, comorbid substance use disorders (World Health Organization’s Alcohol Smoking Substance Involvement Screening Tool, and legal and social problems (Maudsley Addiction Profile. Demographic, personal, psychiatric and substance-use history, in addition to mental state examination on admission, were collected from the case notes. Results. The largest group of patients (n=56, 40% had not been abstinent from heroin use since drug debut, and most had been arrested for drug-related activities (n=117, 83% and had family conflicts related to use (n=135, 96%. Nicotine was the most common comorbid substance of dependence (n=137, 97% and methamphetamine was the most common comorbid substance abused (n=73, 52%. The most common comorbid psychiatric illness was previous substance-induced psychosis (n=42, 30% and current major depressive disorder (n=37, 26%. Current major depressive disorder was significantly associated with females (p=0.03, intravenous drug use (p=0.03, alcohol use (p=0.02, and a higher number of previous rehabilitation attempts (p=0.008. Conclusion. Patients with heroin use disorders present with high rates of psychiatric comorbidities, which underscores the need for substance treatment services with the capacity to diagnose and manage these comorbidities.
Sørensen, Holger J; Mortensen, Erik L; Reinisch, June M
The risk of schizophrenia has been linked with a family history of schizophrenia and less strongly with other psychiatric disorders in family members. Using data from the Copenhagen Perinatal Cohort and from the Danish Psychiatric Case Register, we studied the relationship between offspring risk...... of schizophrenia and a range of psychotic and non-psychotic psychiatric diagnoses in parents. Psychiatric admission data after 1969 were available for 7047 cohort members born between 1959 and 1961, and for 7006 mothers and 6993 fathers. Univariate analysis showed that neurosis, alcohol and substance dependence...... in both parents were associated with elevated risk of offspring schizophrenia; in addition, maternal schizophrenia, affective disorder and personality disorder were associated with elevated risk. Controlling for parental age, parental social status, and parental psychiatric co-diagnosis, offspring risk...
Norquist, G S; Hough, R L; Golding, J M; Escobar, J I
Prevalences of Diagnostic Interview Schedule/DSM-III psychiatric disorders for male veterans and nonveterans from four war eras were estimated using data from over 7500 male community respondents interviewed by the Epidemiologic Catchment Area program at five geographic areas across the country. Veterans serving after Vietnam (Post-Vietnam era) had greater lifetime and 6-month prevalences of psychiatric disorder than their nonveteran counterparts, whereas the reverse tended to be the case for the Vietnam, Korean, and World War II war eras. Comparisons across war eras revealed a trend for more psychiatric disorder, especially substance abuse, in younger veterans and nonveterans than in older respondents.
Stotland, Nada L
Approximately one third of the women in the United States have an abortion during their lives. In the year 2008, 1.21 million abortions were performed in the United States (Jones and Koolstra, Perspect Sex Reprod Health 43:41-50, 2011). The psychiatric outcomes of abortion are scientifically well established (Adler et al., Science 248:41-43, 1990). Despite assertions to the contrary, there is no evidence that abortion causes psychiatric problems (Dagg, Am J Psychiatry 148:578-585, 1991). Those studies that report psychiatric sequelae suffer from severe methodological defects (Lagakos, N Engl J Med 354:1667-1669, 2006). Methodologically sound studies have demonstrated that there is a very low incidence of frank psychiatric illness after an abortion; women experience a wide variety of feelings over time, including, for some, transient sadness and grieving. However, the circumstances that lead a woman to terminate a pregnancy, including previous and/or ongoing psychiatric illness, are independently stressful and increase the likelihood of psychiatric illness over the already high baseline incidence and prevalence of mood and anxiety disorders among women of childbearing age. For optimal psychological outcomes, women, including adolescents, need to make autonomous and supported decisions about problem pregnancies. Clinicians can help patients facing these decisions and those who are working through feelings about having had abortions in the past.
Hoytema van Konijnenburg, E M M; van der Lee, J H; Teeuw, A H; Lindeboom, R; Brilleslijper-Kater, S N; Sieswerda-Hoogendoorn, T; van Goudoever, J B; Lindauer, R J L
High levels of maltreatment are found in children who are identified because their parents visit the emergency department due to partner violence, substance abuse or suicide attempt. However, it is unknown if these children experience psychosocial problems. This study aims to assess their levels of post-traumatic stress, anxiety, depression, behavioural problems and health-related quality of life. A cross-sectional study was conducted in six hospitals. All consecutive families of which a parent visited the emergency department due to partner violence, substance abuse or suicide attempt between 1 July 2012 and 1 March 2014 with children aged 1.5-17 years were approached for participation. Parents and children aged 8 years and older filled out questionnaires measuring post-traumatic stress [13-item version of Children's Revised Impact of Event Scale (CRIES-13)], anxiety, depression (Revised Child Anxiety and Depression Scale), behavioural problems [Child Behavior Checklist (CBCL) and Youth Self-Report (YSR)] and health-related quality of life (PedsQL). Scores of participants were compared with reference data obtained in children in similar age ranges from representative Dutch community samples (CRIES-13, Revised Child Anxiety and Depression Scale, PedsQL and CBCL) and to a normed cutoff score (CRIES-13). Of 195 eligible families, 89 (46%) participated in the study. Participating children did not score different from community children, both on child-reported and parent-reported instruments. Standardized mean differences of total sum scores were 0 (CRIES-13 and CBCL 1.5-5), 0.1 (YSR), 0.2 (CBCL 6-18) and -0.3 (PedsQL) and not statistically different from community children. Thirty-five percent of the participating children scored above the cutoff score on the CRIES-13, indicating post-traumatic stress disorder, but this difference was not statistically significant from community children (mean difference 8%; 95% CI -4-22%). We found no differences in psychosocial
Baylé, Franck J; Caci, Hervé; Millet, Bruno; Richa, Sami; Olié, Jean-Pierre
OBJECTIVE: This study compared patients with kleptomania, patients with alcohol abuse or dependence, and psychiatric patients without impulse-control disorders or substance-related disorders on several key...
Full Text Available Abstract Background Substance use in general has been shown to predict criminal recidivism. The present study aimed to examine potential predictors of criminal recidivism, including substance-specific substance use patterns, in prisoners with substance use. Methods A cohort of prisoners with substance use problems (N = 4,152 were assessed with the Addiction Severity Index (ASI in the Swedish criminal justice system. Clients were followed for an average of 2.7 years. Criminal recidivism was defined as any return to the criminal justice system. Results During follow-up, 69 percent (n = 2,862 returned to the criminal justice system. Recidivism was associated with amphetamine and heroin use, with an additive risk for injectors, and with polysubstance use. Also, recidivism was negatively associated with alcohol, other opioids than heroin/methadone and with hallucinogenic drugs, and positively associated with previous psychiatric in-patient treatment, violent behaviour, and with a shorter index sentence. Associations remained when controlling for type of crime. Conclusions Even when controlling for type and severity of crime, and for psychiatric problems, risk of criminal relapse was increased by substance use variables, including amphetamine, heroin and polysubstance use, and an additional risk was shown for injection drug users. These findings have implications for the need for substance abuse treatment after release from prison.
Background Substance use in general has been shown to predict criminal recidivism. The present study aimed to examine potential predictors of criminal recidivism, including substance-specific substance use patterns, in prisoners with substance use. Methods A cohort of prisoners with substance use problems (N = 4,152) were assessed with the Addiction Severity Index (ASI) in the Swedish criminal justice system. Clients were followed for an average of 2.7 years. Criminal recidivism was defined as any return to the criminal justice system. Results During follow-up, 69 percent (n = 2,862) returned to the criminal justice system. Recidivism was associated with amphetamine and heroin use, with an additive risk for injectors, and with polysubstance use. Also, recidivism was negatively associated with alcohol, other opioids than heroin/methadone and with hallucinogenic drugs, and positively associated with previous psychiatric in-patient treatment, violent behaviour, and with a shorter index sentence. Associations remained when controlling for type of crime. Conclusions Even when controlling for type and severity of crime, and for psychiatric problems, risk of criminal relapse was increased by substance use variables, including amphetamine, heroin and polysubstance use, and an additional risk was shown for injection drug users. These findings have implications for the need for substance abuse treatment after release from prison. PMID:22894706
Lee, J O; Herrenkohl, T I; Kosterman, R; Small, C M; Hawkins, J D
To examine the relationship between the co-occurrence of mental health and substance use problems and socio-economic status (SES). A prospective longitudinal study of 808 males and females followed to age 30. Survey data were used to derive latent classes (profiles) of mental health (depression, anxiety) and substance use (alcohol, nicotine, and marijuana [cannabis]) problems at age 27. Analyses examined the associations of these profiles with earlier educational attainment (high school diploma) and indicators of SES at age 30. Latent Class Analysis produced four profiles: a low disorder symptoms group, a licit substance use disorder symptoms group (alcohol and nicotine), a mental health disorder symptoms group, and a comorbid group. Earning a high school diploma by age 21 decreased the odds of belonging to the comorbid group or the licit substance use disorder symptoms group when compared to the low disorder symptoms group. These disorder profiles also were found to adversely impact subsequent adult SES. The adverse impact was more evident in income maintenance and wealth accumulation by age 30 than market or non-market labour force participation. Earning a high school diploma lessens the risk of co-occurring mental health and substance use problems which contribute to economic instability in young adulthood. Findings underscore the importance of public health programmes to reduce the incidence of mental health and substance use problems and their associated high costs to individuals and to society. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Kanayama, Gen; Hudson, James I; Pope, Harrison G
The problem of anabolic-androgenic steroid (AAS) abuse has recently generated widespread public and media attention. Most AAS abusers, however, are not elite athletes like those portrayed in the media, and many are not competitive athletes at all. This larger but less visible population of ordinary AAS users began to emerge in about 1980. The senior members of this population are now entering middle age; they represent the leading wave of a new type of aging former substance abusers, with specific medical and psychiatric risks. We reviewed the evolving literature on long-term psychiatric and medical consequences of AAS abuse. Long-term use of supraphysiologic doses of AAS may cause irreversible cardiovascular toxicity, especially atherosclerotic effects and cardiomyopathy. In other organ systems, evidence of persistent toxicity is more modest, and interestingly, there is little evidence for an increased risk of prostate cancer. High concentrations of AAS, comparable to those likely sustained by many AAS abusers, produce apoptotic effects on various cell types, including neuronal cells--raising the specter of possibly irreversible neuropsychiatric toxicity. Finally, AAS abuse appears to be associated with a range of potentially prolonged psychiatric effects, including dependence syndromes, mood syndromes, and progression to other forms of substance abuse. However, the prevalence and severity of these various effects remains poorly understood. As the first large wave of former AAS users now moves into middle age, it will be important to obtain more systematic data on the long-term psychiatric and medical consequences of this form of substance abuse.
Romero, Estrella; Rodríguez, Concepción; Villar, Paula; Gómez-Fraguela, X Antón
The aim of this study is to evaluate the long-term effects of a manualised program which intervenes on children with early-onset conduct problems, their families and teachers. The program evaluation involved 14 primary schools which were randomly assigned to the intervention (45 participating families) and control (30 families) conditions during 2007-2008. After a screening process which identified children with significant conduct problems both at home with their family and at school, the program was implemented in eight schools. Seven years later, 58 families (37 from the intervention group and 21 from the control group), with characteristics equivalent to those of the study's entire initial group, were contacted again. With measures administered to the children and their parents, comparisons through multivariate analyses of variance between intervention and control groups supported the program's efficacy in reducing both conduct problems and relations with antisocial peers. Furthermore, the program fostered social and communication skills. As regards drug use, the intervention group showed less favourable attitudes towards drugs, lower intention of drug use, lower frequency of tobacco use and lower intensity of alcohol use. These results support the usefulness of multicomponent programs for conduct problems as a way to prevent, in the long term, unfavourable developmental trajectories, where drug use is a key element.
Shillington, Audrey M.; Clapp, John D.
This study examines the risk for alcohol and other drug (AOD) problems resulting from alcohol plus marijuana use compared to alcohol-only use. Data are from telephone interviews with 1113 randomly selected college students attending two large urban universities in the southwestern United States. Alcohol and marijuana users (dual users) were more…
Validation of the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test in a Swedish sample of suspected offenders with signs of mental health problems: results from the Mental Disorder, Substance Abuse and Crime study.
Durbeej, Natalie; Berman, Anne H; Gumpert, Clara H; Palmstierna, Tom; Kristiansson, Marianne; Alm, Charlotte
Substance abuse is common among offenders. One method widely used for the detection of substance abuse is screening. This study explored the concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) screening tools in relation to (a) substance abuse and dependency diagnoses and (b) three problem severity domains of the sixth version of the Addiction Severity Index in a sample of 181 suspected offenders with signs of mental health problems. The screening tools showed moderate to high accuracy for identification of dependency diagnoses. The AUDIT was associated with alcohol problem severity, whereas the DUDIT was associated with drug and legal problem severity. Administering the screening tools in the current population yields valid results. However, the suggested cutoff scores should be applied with caution due to the discrepancy between present and previous findings. Copyright © 2010 Elsevier Inc. All rights reserved.
Background: Psychotropic medication adherence is a major challenge in psychiatric patients with comorbidity. Objective: The objective was to determine medication adherence behavior among psychiatric out‑patients with psychoactive substance use comorbidity in a Nigerian Tertiary Hospital. Settings and Design: A ...
Hartnett, Dan; Carr, Alan; Hamilton, Elena; O'Reilly, Gary
A systematic review of published and unpublished English language articles identified 14 studies containing 18 comparisons between functional family therapy (FFT) and another condition in the treatment of adolescent disruptive behavior and substance use disorders. In 11 of these comparisons, assignment to conditions was random, while nonrandom assignment occurred in seven studies. For both random and nonrandom comparisons, separate meta-analyses were conducted for subgroups of studies depending on the type of comparison group used. Data from studies of untreated control groups (CTL), treatment as usual (TAU), and well-defined alternative treatments (ALTs) were analyzed separately. Effect sizes from these six meta-analyses were as follows: random assignment FFT versus CTL (k = 3, d = 0.48, p < .01); random assignment FFT versus TAU (k = 3, d = .20, ns); random assignment FFT versus ALT (k = 5, d = .35, p < .05); nonrandom assignment FFT versus CTL (k = 2, d = .90, ns); nonrandom assignment FFT versus TAU (k = 2, d = .08, ns); and nonrandom assignment FFT versus ALT (k = 3, d = .75, p < .001). These results provide support for the effectiveness of FFT compared with untreated controls and well-defined ALTs, such as cognitive behavior therapy, other models of family therapy, and individual and group therapy for adolescents. © 2016 Family Process Institute.
Konishi, Chiaki; Saewyc, Elizabeth; Homma, Yuko; Poon, Colleen
Objective This study examined whether students’ odds of recent substance use were lower in the presence of GSAs or explicit anti-homophobia policy that had been established at their school recently, or at least three years prior. Methods We analyzed a population-based sample of students in grades 8 through 12 from the British Columbia Adolescent Health Survey of 2008 (weighted N = 21,708). We used multi-nomial logistic regressions to test the hypothesized effects of GSAs and policies on substance use outcomes for LGB and 100% heterosexual students separately. Results Results indicated that GSAs and anti-homophobic bullying policies were linked to significantly lower odds of some but not all types of recent risky alcohol use, and past-year harms from alcohol or drug use, for LGB adolescents, but these were predominantly among girls, and almost exclusively in schools where the policies or GSAs had been established for at least three years. Conclusions Our findings suggest that these school-based strategies (GSAs and anti-homophobia policies) to reduce homophobia and foster school inclusion may be beneficial in reducing problem alcohol use among all students, not just sexual minority students. PMID:23850517
Konishi, Chiaki; Saewyc, Elizabeth; Homma, Yuko; Poon, Colleen
This study examined whether students' odds of recent substance use were lower in the presence of gay-straight alliances or explicit anti-homophobia policy that had been established at their school recently, or at least 3 years prior. We analyzed a population-based sample of students in grades 8 through 12 from the British Columbia Adolescent Health Survey of 2008 (weighted N=21,708). We used multi-nomial logistic regressions to test the hypothesized effects of gay-straight alliances and policies on substance use outcomes for lesbian, gay and bisexual students, and heterosexual students separately. Results indicated that gay-straight alliances and anti-homophobic bullying policies were linked to significantly lower odds of some but not all types of recent risky alcohol use, and past-year harms from alcohol or drug use, but almost exclusively in schools where the policies or gay-straight alliances had been established for at least 3 years; and among lesbian, gay and bisexual adolescents, only for girls. Our findings suggest that these school-based strategies (gay-straight alliances and anti-homophobia policies) to reduce homophobia and foster school inclusion may be beneficial in reducing problem alcohol use among all students, not just sexual minority students. © 2013.
Psychiatric and substance use disorders in HIV/hepatitis C virus (HCV)-coinfected patients: does HCV clearance matter? [Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS) HEPAVIH CO13 cohort].
Michel, L; Lions, C; Winnock, M; Lang, J-P; Loko, M-A; Rosenthal, E; Marchou, B; Valantin, M-A; Morlat, P; Roux, P; Sogni, P; Spire, B; Poizot-Martin, I; Lacombe, K; Lascoux-Combe, C; Duvivier, C; Neau, D; Dabis, F; Salmon-Ceron, D; Carrieri, M P
The objective of this nested study was to assess the prevalence of psychiatric disorders in a sample of HIV/hepatitis C virus (HCV)-coinfected patients according to their HCV status. The nested cross-sectional study, untitled HEPAVIH-Psy survey, was performed in a subset of HIV/HCV-coinfected patients enrolled in the French Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS) CO13 HEPAVIH cohort. Psychiatric disorders were screened for using the Mini International Neuropsychiatric Interview (MINI 5.0.0). Among the 286 patients enrolled in the study, 68 (24%) had never received HCV treatment, 87 (30%) were treatment nonresponders, 44 (15%) were currently being treated and 87 (30%) had a sustained virological response (SVR). Of the 286 patients enrolled, 121 patients (42%) screened positive for a psychiatric disorder other than suicidality and alcohol/drug abuse/dependence, 40 (14%) screened positive for alcohol abuse/dependence, 50 (18%) screened positive for drug abuse/dependence, 50 (17.5%) were receiving an antidepressant treatment and 69 (24%) were receiving an anxiolytic. Patients with an SVR did not significantly differ from the other groups in terms of psychiatric disorders. Patients receiving HCV treatment screened positive less often for an anxiety disorder. The highest rate of drug dependence/abuse was among HCV treatment-naïve patients. Psychiatric disorders were frequent in HIV/HCV-coinfected patients and their rates were comparable between groups, even for patients achieving an SVR. Our results emphasize the need for continuous assessment and care of coinfected patients, even after HCV clearance. Drug addiction remains an obstacle to access to HCV treatment. Despite the recent advent and continued development of directly acting antiviral agents (DAAs), it is still crucial to offer screening and comprehensive care for psychiatric and addictive disorders. © 2016 British HIV Association.
Okpych, Nathanael J; Courtney, Mark E
This study evaluates foster care history characteristics as risk factors for psychopathology. We examine characteristics of youths' foster care histories separately and as a gestalt (i.e., identification of latent classes). Six mental health disorders and lifetime suicide attempt were assessed via in-person interviews with a representative sample of older adolescents in California foster care (n = 706). Information on respondents' foster care histories were obtained from state administrative data. Half of the sample (47.3%) screened positive for a psychiatric disorder and 1/4 (25.2%) had attempted suicide. When assessed individually, placement instability predicted posttraumatic stress disorder (PTSD), alcohol and substance use problems, and suicide attempt. Primary placement type and maltreatment type were also associated with 1 or more psychiatric disorders. When foster care characteristics were considered in concert, 6 latent classes were identified: veterans, returners, treated stayers, midrangers, late stayers, and disquieted drifters. Three latent classes (returners, late stayers, and disquieted drifters) were at increased risk of psychiatric problems relative to 1 or more of the other latent classes. Both separate foster care characteristics and the gestalt of youths' foster care histories identified risks of psychiatric problems. Results from these analyses can inform the development of risk assessment tools. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Dec 23, 2011 ... Objective: Traumatic brain injury (TBI) is a public health problem and is associated with many complications. However little is known about the psychiatric sequelae of TBI in Nigeria. This study described the pattern and determinants of psychiatric sequelae among subjects with TBI. Materials and Methods: ...
de Niet, G. J. (Gerrit); Tiemens, B. G. (Bea); Lendemeijer, H. H. G. M. (Bert); Hutschemaekers, G. J. M. (Giel)
This paper aims at acquiring knowledge about the quality of sleep of adult and elderly psychiatric patients who receive clinical or outpatient nursing care, and identifying key factors in perceiving a sleep problem. To do so, a sample of 1699 psychiatric patients were asked whether they perceived a
Prinz, R J; Dumas, J E; Smith, E P; Laughlin, J E
This paper describes a preventive intervention trial called EARLY ALLIANCE which is aimed at reducing risk for three adverse outcomes in childhood and adolescence: conduct problems, substance abuse, and school failure. The structure of the prevention trial is unique because two linked designs are being implemented concurrently. The primary design focuses on children at elevated risk for adverse outcomes, and compares a targeted, multicontextual preventive intervention with family, classroom, peer relational, and academic components to a universal, schoolwide preventive intervention that emphasizes peaceful conflict management and serves as a "usual care" control condition. The secondary design focuses on children at lower risk for adverse outcomes and compares a universally administered classroom program to the control condition. The paper describes the theoretical foundation for EARLY ALLIANCE, the goals of the prevention trial, the rationale for design choices, and the methods employed.
countries including Ethiopia are alcohol, tobacco,. Substance use and associated problems are of current cannabis or marihuana and khat (2, 3). Reports showed global concern. It has become an epidemic in some parts that these substances are widely used among students of of the African region with adolescents being ...
Flentje, Annesa; Heck, Nicholas C; Sorensen, James L
Little is known about the needs or characteristics of transgender individuals in substance abuse treatment settings. Transgender (n=199) and non-transgender (cisgender, n=13,440) individuals were compared on psychosocial factors related to treatment, health risk behaviors, medical and mental health status and utilization, and substance use behaviors within a database that documented individuals entering substance abuse treatment in San Francisco, CA from 2007 to 2009 using logistic and linear regression analyses (run separately by identified gender). Transgender men (assigned birth sex of female) differed from cisgender men across many psychosocial factors, including having more recent employment, less legal system involvement, greater incidence of living with a substance abuser, and greater family conflict, while transgender women (assigned birth sex of male) were less likely to have minor children than cisgender women. Transgender women reported greater needle use, and HIV testing rates were greater among transgender women. Transgender men and women reported higher rates of physical health problems, mental health diagnoses, and psychiatric medications, but there were no differences in service utilization. There were no differences in substance use behaviors except that transgender women were more likely to endorse primary methamphetamine use. Transgender individuals evidence unique strengths and challenges that could inform targeted services in substance abuse treatment. Copyright © 2014 Elsevier Ltd. All rights reserved.
Kraus, Ludwig; Baumeister, Sebastian E; Pabst, Alexander; Orth, Boris
The present study investigates the combined effect of average volume and binge drinking in predicting alcohol-related social problems and estimates the proportion of alcohol-related harms related to specific drinking patterns that could be prevented if transferred to a low-risk drinking group. Data came from the 1997 and 2000 German Epidemiological Survey of Substance Abuse (ESA) (age: 18-59 years; response rate: 65% and 51%, respectively). The pooled sample consisted of 12,668 current drinkers. By using nine categories of average daily intake and three groups of binge drinking, individuals were grouped into 22 mutual exclusive groups. Social problems were defined as the occurrence of 'repeated family quarrels', 'concern of family members or friends', 'loss of partner or friend' or 'physical fight or injury' in relation to alcohol. The effect of average daily intake is modified by binge drinking frequency such that the association was strongest in those with four or more binge drinking occasions during the last 30 days. Within each binge drinking group, adjusted relative risks (aRR) increased with alcohol intake up to a certain threshold and decreased thereafter. Overall, compared to the reference group (alcohol-related social problems than volume. Alcohol-related social harms especially among drinkers with moderate volume per day may be reduced by targeting prevention strategies towards episodic heavy drinkers.
Math, Suresh Bada; Srinivasaraju, Ravindra
The objective of this paper is to provide a systematic review on the epidemiology of psychiatric disorders in India based on the data published from 1960 to 2009. Extensive search of PubMed, NeuroMed, Indian Journal of Psychiatry website and MEDLARS using search terms "psychiatry" "prevalence", "community", and "epidemiology" was done along with the manual search of journals and cross-references. Retrieved articles were systematically selected using specific inclusion and exclusion criteria. Epidemiological studies report prevalence rates for psychiatric disorders varying from 9.5 to 370/1000 population in India. These varying prevalence rates of mental disorders are not only specific to Indian studies but are also seen in international studies. Despite variations in the design of studies, available data from the Indian studies suggests that about 20% of the adult population in the community is affected with one or the other psychiatric disorder. Mental healthcare priorities need to be shifted from psychotic disorders to common mental disorders and from mental hospitals to primary health centers. Increase in invisible mental problems such as suicidal attempts, aggression and violence, widespread use of substances, increasing marital discord and divorce rates emphasize on the need to prioritize and make a paradigm shift in the strategies to promote and provide appropriate mental health services in the community. Future epidemiological research need to focus on the general population from longitudinal prospective involving multi-centers with assessment of disability, co-morbidity, functioning, family burden and quality of life.
Full Text Available Abstract Background In 2013, around 40 % of the schools in Sweden had structured programs to prevent tobacco and alcohol debut in compulsory school. There has unfortunately been a lack of scientific evidence to support most of the prevention methods focusing on primary prevention in schools in Sweden. The aim and purpose of the present study is to evaluate the effectiveness of the Non-Governmental Organization SMART contract-signing strategy in reducing the growth of youth substance use and other problem behaviors amongst Swedish adolescents. Methods Students from five schools in a medium-sized Swedish municipality were surveyed in three waves from 7th to 9th grade of compulsory school. We used General Linear Model (GLM repeated-measures ANOVA to test if the outcome measures smoking, use of snus and alcohol, drunkenness, delinquency, and bullying significantly changed different amounts over time in groups that had participated in the SMART program for long time, a short time, sporadically- or not at all. Groups were compared on demographic background variables, and outcome measures were assessed on all measurement occasions by a one-way ANOVA. The magnitude of group differences at the end of the study was estimated according to Cohen’s d. Results Number of years with a contract has an effect on the levels of self-reported youth problems in 9th grade. We found small to medium-sized differences in measured outcomes between students who participated in the program for the longest period of time, 5 years, and who participated for the shortest time, 0–2 years. Conclusion Findings suggests that the SMART program has preventive effects on adolescent substance use.
Lubman, Dan I; Berridge, Bonita J; Blee, Fiona; Jorm, Anthony F; Wilson, Coralie J; Allen, Nicholas B; McKay-Brown, Lisa; Proimos, Jenny; Cheetham, Ali; Wolfe, Rory
Adolescence is a high-risk time for the development of mental health and substance use problems. However, fewer than one in four 16-24 year-olds with a current disorder access health services, with those experiencing a substance use disorder being the least likely to seek professional help. Research indicates that young people are keeping their problems to themselves or alternatively, turning to peers or trusted adults in their lives for help. These help-seeking preferences highlight the need to build the mental health literacy of adolescents, to ensure that they know when and how to assist themselves and their peers to access support. The MAKINGtheLINK intervention aims to introduce these skills to adolescents within a classroom environment. This is a cluster randomised controlled trial (RCT) with schools as clusters and individual students as participants from 22 secondary schools in Victoria, Australia. Schools will be randomly assigned to either the MAKINGtheLINK intervention group or the waitlist control group. All students will complete a self-report questionnaire at baseline, immediately post intervention and 6 and 12 months post baseline. The primary outcome to be assessed is increased help-seeking behaviour (from both formal and informal sources) for alcohol and mental health issues, measured at 12 months post baseline. The findings from this research will provide evidence on the effectiveness of the MAKINGtheLINK intervention for teaching school students how to overcome prominent barriers associated with seeking help, as well as how to effectively support their peers. If deemed effective, the MAKINGtheLINK programme will be the first evidence-informed resource that is able to address critical gaps in the knowledge and behaviour of adolescents in relation to help-seeking. It could, therefore, be a valuable resource that could be readily implemented by classroom teachers. Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12613000235707
Schnittker, Jason; Massoglia, Michael; Uggen, Christopher
Psychiatric disorders are unusually prevalent among current and former inmates, but it is not known what this relationship reflects. A putative causal relationship is contaminated by assorted influences, including childhood disadvantage, the early onset of most disorders, and the criminalization of substance use. Using the National Comorbidity…
Wetterling, Tilman; Schneider, Barbara
Due to demographic changes there will be a fraction of elderly patients with substance use disorders. However, only a few data have been published about elderly abusers of prescription drugs. Since substance abuse is frequently comorbid with psychiatric disorders, treatment in a psychiatric hospital is often needed. In this explorative study elderly people with prescription drug abuse who required psychiatric inpatient treatment should be characterized. This study was part of the gerontopsychiatry study Berlin (Gepsy-B), an investigation of the data of all older inpatients (≥ 65 years) admitted to a psychiatric hospital within a period of 3 years. Among 1266 documented admissions in 110 cases (8.7 %) (mean age: 75.7 ± 7.1 years) prescription drug abuse, mostly of benzodiazepines was diagnosed. Females showed benzodiazepine abuse more often than males. In only a small proportion of the cases the reason for admission was withdrawal of prescribed drugs. 85.5 % suffered from psychiatric comorbidity, mostly depression. As risk factors for abuse depressive symptoms (OR: 3.32) as well as concurrent nicotine (OR: 2.69) or alcohol abuse (OR: 2.14) were calculated. Psychiatric inpatient treatment was primarily not necessary because of prescription drug abuse but because of other psychopathological symptoms. © Georg Thieme Verlag KG Stuttgart · New York.
Bullying is a complex phenomenon moderated not only by the personal characteristics and behavioral traits of the individual but also by family rearing practices, as well as by situational factors such as the frequency and type of bullying. The phenomenon is also affected by group processes among the individuals present during the event. Bullying is a distressing experience that is often continuous over years and predicts both concurrent and future psychiatric symptoms and disorders, even in adulthood. At young ages, attention-deficit hyperactivity disorder and depression, as well as anxiety, are prevalent concurrently with bullying among the children involved. Later in young adulthood, male victims are at risk for anxiety, male bullies for personality disorders, and male bully-victims for both personality disorders and anxiety, and the risk is especially increased if the child is disturbed when involved in bullying at school age. Rarely does any single behavior predict future problems as clearly as bullying does, and additional assessment of psychiatric problems is always warranted, if the child is involved in bullying as a bully, victim or bully-victim. Based on our current knowledge, school-based interventions regulating the behavior of the child, increasing pro-social skills and promoting peer relationships are recommended for those without concurrent psychiatric disturbance, but those displaying psychiatric symptoms and disorders should be referred for psychiatric consultation and intervention.
Choi, Namkee G; DiNitto, Diana M; Marti, C Nathan
This study examined age group differences in and correlates of treatment use and perceived treatment need for substance use disorders (SUD) and mental health (MH) problems as well as self-reported barriers to treatment among people 65+ years old vs. 26-34, 35-49, and 50-64 years old. Data are from the 2008 to 2012 National Survey on Drug Use and Health (NSDUH) (N = 96,966). Age group differences were examined using descriptive bivariate analyses and binary logistic regression analyses. The 65+ age group was least likely to use treatment and perceive treatment need, but the 50-64 age group was more similar to the younger age groups than the 65+ age group. Controlling for age, other predisposing, and enabling factors, alcohol and illicit drug dependence and comorbid SUD and MH problems increased the odds of SUD treatment use. Of MH problems, anxiety disorder had the largest odds for MH treatment use. Bivariate analyses showed that lack of readiness to stop using and cost/limited insurance were the most frequent barriers to SUD and MH treatment, respectively, among older adults, and they were less likely than younger age groups to report stigma/confidentiality concerns for MH treatment. Older adults will become a larger portion of the total U.S. population with SUD and/or MH problems. Healthcare providers should be alert to the need to help older adults with SUD and/or MH problems obtain treatment. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Solomon, P; Draine, J
This study examines the extent to which sociodemographic characteristics, clinical characteristics, substance abuse problems, and the array of lifetime criminal behavior may explain lifetime arrests among offenders supervised by the psychiatric probation and parole service. Three hundred twenty-five clients with new cases at a psychiatric probation and parole service in a large urban center were screened for major psychiatric disorders. They were also interviewed for socio-demographic characteristics, mental health treatment history, criminal behavior, and arrest history. Hierarchical block multiple regression analysis tested a model explaining lifetime arrests. After controlling for age and other demographic variables, the number of lifetime psychiatric hospitalizations and lifetime occurrences of mania diagnosis significantly explained lifetime arrests. The total model explained about 10 percent of the variance in lifetime arrests after controlling for opportunity variables, which explained 45 percent. The explanatory power of lifetime hospitalizations and mania support the contention that symptoms, rather than diagnosis, may be the most important clinical factor in explaining criminal arrest among persons with mental illness. Implications for psychiatric services include the development of effective jail diversion programs.
Benyamina, Amine; Bouchez, Jacques; Rahioui, Hassan; Reynaud, Michel
The practitioner is very frequently confronted by emergencies in drug-addicted patients also having psychiatric symptomatology. In this article the authors will address emergencies related to alcohol (notably intoxication, pre-DTs and the encephalopathies); emergencies related to cannabis (notably intoxication, psychotic states and panic attacks); and emergencies related to other psycho-active substances (overdoses, drug-withdrawal, psychiatric complications related to cocaine or amphetamines). In the domain of drug addiction, as in psychiatry, the practitioner must give as much importance to the organisation of the long-term healthcare plan for the drug addict, ulterior to the management of the immediate emergency. For example, whereas 90% of subjects presenting to the emergency department for acute alcoholic intoxication have a pathological consumption of alcohol (abuse or dependance), management of the alcoholism is proposed in only 2% of them.
Full Text Available Abstract Background To investigate factors associated with involuntary admissions to hospital pursuant to a social services act of patients with substance use disorder by comparing the socio-demographic characteristics, substance use, and psychiatric comorbidities with voluntarily admitted patients. Methods This cross-sectional study compared two groups admitted to combined substance use disorder and psychiatry wards. Sixty-five patients were involuntarily admitted pursuant to the Social Services Act and 137 were voluntarily admitted. The International Classification of Diseases and Related Health Problems was used for diagnostic purposes regarding substance use disorders, type and severity of psychiatric problems, and level of functioning. Socio-demographic variables were measured using the European Addiction Severity Index, and the Symptom Checklist-90-R instruments were used to evaluate the range of psychological problems and psychopathological symptoms. Logistic regression was performed to investigate the relationship between involuntary admissions and patients characteristics. Results Patients who had been involuntarily admitted were more likely to be females, had utilized public welfare services more often, presented more severe substance use patterns, and had a history of more frequent visits to physicians for somatic complaints in the last 6 months, they also had fewer comorbid mental disorders. Still, considerable burdens of comorbid substance use disorders and mental disorders were observed both among involuntary and voluntary admitted patients. Conclusions More attention is required for involuntarily admitted patients in order to meet the needs associated with complex and mixed disorders. In addition, treatment centers should offer diagnostic options and therapy regarding substance use, psychiatric and somatic disorders.
Background Most studies of psychiatric disorders associated with HIV/AIDS have been carried out in the USA and Europe in patients on anti-retroviral drugs. Few studies have looked at psychiatric disorders and substance use in Africa and a dearth of literature exists on HIV/AIDS and psychiatric morbidity in Nigeria.
van der Put, C.E.; Creemers, H.E.; Hoeve, M.
Background: Little is known about the needs of substance-using juveniles in treatment aimed at reducing criminal recidivism. Therefore, we aimed to examine treatment needs of substance-using juvenile offenders. Methods: Differences were examined between juvenile offenders who abstain from substance
Bell, G; Reinstein, D Z; Rajiyah, G; Rosser, R
One hundred medical and surgical patients admitted to an accident and emergency ward were screened for psychiatric disorder. A psychiatric diagnosis was made in 37 patients, 32 of whom were correctly identified by the GHQ. Psychiatric morbidity was associated with being single, lower social class, unemployment, homelessness and living in Bloomsbury Health District or north-east London. It was also associated with not being registered with a GP. The 14 overdose patients were no more likely to receive a psychiatric diagnosis than other patients, yet constituted most of the psychiatric referrals. Few patients were asked by medical staff about emotional worries or problems. A desire to be asked such questions and a past psychiatric history were associated with a psychiatric diagnosis. Routine screening of psychiatric morbidity in both medical and surgical patients and appropriate psychiatric referral of identified patients is recommended. A system of facilitating GP registration is necessary, as much of the morbidity identified could be contained within primary care.
Suzi Roseli Kerber
Full Text Available OBJETIVO: Estudar a associação entre transtornos mentais pós-parto e fatores demográficos e psicossociais, pré e perinatais. MÉTODOS: Todas as familias com crianças de quatro meses da Vila Jardim - Porto Alegre (RS - nascidos entre novembro de 1998 e dezembro de 1999 foram avaliadas. Utilizou-se o Self Report Questionnaire (SRQ-20 e entrevistas clínicas semiestruturadas individuais e do casal para fundamentar uma hipótese diagnóstica segundo os critérios do da quarta edição do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-IV. Realizou-se a avaliação da relação conjugal e do relacionamento da mãe com as famílias de origem e a rede social utilizando-se a Escala de Avaliação Global do Funcionamento Relacional (GARF. RESULTADOS: Foram avaliadas 148 mães e os 116 pais que coabitavam. Segundo o SRQ, 34,4% das mães e 25,4% dos pais apresentaram suspeita de transtorno psiquiátrico. Clinicamente os percentuais foram maiores. Coabitar ou não com companheiro não esteve associado com transtorno mental materno. Na análise da totalidade do grupo de mulheres, estiveram associados: baixa renda familiar (OR=0,8; pPURPOSE: To study the association between postpartum psychiatric disorder and demographic and psychosocial, pre- and perinatal factors. METHODS: All families having 4-month-old infants in Vila Jardim, a district of Porto Alegre, Brazil, born at a public hospital from November 1998 through December 1999 were assessed. The Self-Report Questionnaire (SRQ-20 and semi-structured interviews were used for the psychiatric assessment that included a possible diagnosis using Diagnostic and Statistical Manual of Mental Disorders IV (DSM- IV criteria. Relational functioning between couples, the relationship with mother's family of origin and social network were assessed using the DSM-IV Global Assessment of Relational Functioning Scale (GARF. RESULTS: A total of 148 mothers and 116 cohabiting fathers were assessed
Padoin Cintia V
Full Text Available Abstract Objective Children whose parents have psychiatric disorders experience an increased risk of developing psychiatric disorders, and have higher rates of developmental problems and mortality. Assessing the size of this population is important for planning of preventive strategies which target these children. Methods National survey data (CCHS 1.2 was used to estimate the number of children exposed to parental psychiatric disorders. Disorders were diagnosed using the World Psychiatric Health Composite International Diagnostic Interview (WMH-CIDI (12 month prevalence. Data on the number of children below 12 years of age in the home, and the relationship of the respondents with the children, was used to estimate exposure. Parent-child relations were identified, as was single parenthood. Using a design-based analysis, the number of children exposed to parental psychiatric disorders was calculated. Results Almost 570,000 children under 12 live in households where the survey respondent met criteria for one or more mood, anxiety or substance use disorders in the previous 12 months, corresponding to 12.1% of Canadian children under the age of 12. Almost 3/4 of these children have parents that report receiving no mental health care in the 12 months preceding the survey. For 17% of all Canadian children under age 12, the individual experiencing a psychiatric disorder is the only parent in the household. Conclusion The high number of children exposed causes major concern and has important implications. Although these children will not necessarily experience adversities, they possess an elevated risk of accidents, mortality, and of developing psychiatric disorders. We expect these estimates will promote further research and stimulate discussion at both health policy and planning tables.
Veldhuizen, Scott; Rush, Brian; Urbanoski, Karen
Mental disorders are common among people presenting for the treatment of substance-related problems, and guidelines recommend systematic screening for these conditions. However, even short screens impose a considerable burden on clients and staff. In this study, we evaluated the performance of a single screening question (SSQ) relative to longer instruments. We analyzed a sample of 544 adults recruited from outpatient substance use disorder treatment centers in Ontario, Canada. Clients were asked a simple SSQ, followed by the Kessler Screening Scale for Psychological Distress (K6) and the Global Appraisal of Individual Needs Short Screener (GAIN-SS). Caseness was ascertained using the Structured Clinical Interview for DSMIV (SCID). We measured and compared performance using receiver operating characteristic (ROC) curve analysis and explored client characteristics associated with screen performance using ROC regression. Last, we used logistic regression to test whether SSQs can be usefully combined with other measures. The prevalence of past-month disorder was 71%. The performance of the SSQ (AUC = 0.77, 95% CI [0.72, 0.83]) was similar to, and not significantly different from, those of the K6 (AUC = 0.78) and the GAIN (AUC = 0.79). The K6 and the GAIN performed better than the SSQ among people with a psychotic disorder. The addition of the SSQ slightly improved the performance of the other measures. SSQs can offer screening performance comparable to that of longer instruments. Reasons for caution include the small number of possible thresholds, lower accuracy than other measures in identifying psychotic disorder, and possible differential functioning in different populations. Performance of all three screens was also moderate; when prevalence is high and resources are available, offering full assessments may be preferable to screening. Nevertheless, SSQs offer an intriguing area for further evaluation.
Suicide Mortality of Suicide Attempt Patients Discharged from Emergency Room, Nonsuicidal Psychiatric Patients Discharged from Emergency Room, Admitted Suicide Attempt Patients, and Admitted Nonsuicidal Psychiatric Patients
Choi, Jae W.; Park, Subin; Yi, Ki K.; Hong, Jin P.
The suicide mortality rate and risk factors for suicide completion of patients who presented to an emergency room (ER) for suicide attempt and were discharged without psychiatric admission, patients who presented to an ER for psychiatric problems other than suicide attempt and were discharged without psychiatric admission, psychiatric inpatients…
Shacham, Enbal; Önen, Nur F; Donovan, Michael F; Rosenburg, Neal; Overton, E Turner
As individuals with HIV infection are living longer, the management of psychiatric disorders has increasingly been incorporated into comprehensive care. Individuals were recruited from an outpatient HIV clinic to assess the prevalence and related associations of current psychiatric disorders and biomarkers. Of the 201 participants who completed the interviews, the median age was 43.5 years, and the majority was male and African American. Most were receiving HIV therapy and 78% of those had achieved virologic suppression. Prevalent psychiatric diagnoses included major depressive disorder, generalized anxiety, and agoraphobia. Alcohol and cocaine/crack abuse and dependence were common substance use disorders. Current receipt of HIV therapy was less common among those diagnosed with generalized anxiety disorder. Agoraphobia was the only disorder associated with unsuppressed viral load. Psychiatric and substance use disorders are highly prevalent among an urban HIV clinic population, although we identified few associations between psychiatric diagnoses and HIV diseases status. © The Author(s) 2014.
Full Text Available Introduction: Severe Psychiatricillness is accompanied by gross disturbances in patient's occupational role. This study presents a comparative picture of work performance before and after psychiatric hospitalization. Method: Subjects comprised 440 psychiatric admitters from Noor Medical center - Isfahan - Iran, who were followed from November 1999 to November 2000. Their work adjustment was measured by means of Weiss man's index. Data were computer analyzed using SPSS by running paired t- student and ANOVA. Results: Majority of the patients (53 % were without permanent sources of income before psychiatric hospitalization, about 12 percent of those who were working prior to hospitalization lost their job after being discharged from hospital. Better work adjustment before hospitalization was positively correlated with better work adjustment after discharge for working patients (r =0/66. Working ability of the patients after discharge was lesser than before the attack f9r patients with regular and irregular job (P < 001. Discussion: Job loss or poor working ability after psychiatric admission reported by several researchers and has bean confirmed in this study as well. These observatoins have been discussed in view of the current socio economic problems in the society and nature of psychiatric disturbances.
Leventhal, Adam M; Strong, David R; Sussman, Steve; Kirkpatrick, Matthew G; Unger, Jennifer B; Barrington-Trimis, Jessica L; Audrain-McGovern, Janet
The popularity of electronic (e-) cigarettes has greatly increased recently, particularly in adolescents. However, the extent of psychiatric comorbidity with adolescent e-cigarette use and dual use of conventional (combustible) and e-cigarettes is unknown. This study characterized psychiatric comorbidity in adolescent conventional and e-cigarette use. Ninth grade students attending high schools in Los Angeles, CA (M age = 14) completed self-report measures of conventional/e-cigarette use, emotional disorders, substance use/problems, and transdiagnostic psychiatric phenotypes consistent with the NIMH-Research Domain Criteria Initiative. Outcomes were compared by lifetime use of: (1) neither conventional nor e-cigarettes (non-use; N = 2557, 77.3%); (2) e-cigarettes only (N = 412, 12.4%); (3) conventional cigarettes only (N = 152, 4.6%); and (4) conventional and e-cigarettes (dual use; N = 189, 5.6%). In comparison to adolescents who used conventional cigarettes only, e-cigarette only users reported lower levels of internalizing syndromes (depression, generalized anxiety, panic, social phobia, and obsessive-compulsive disorder) and transdiagnostic phenotypes (i.e., distress intolerance, anxiety sensitivity, rash action during negative affect). Depression, panic disorder, and anhedonia were higher in e-cigarette only vs. non-users. For several externalizing outcomes (mania, rash action during positive affect, alcohol drug use/abuse) and anhedonia, an ordered pattern was observed, whereby comorbidity was lowest in non-users, moderate in single product users (conventional or e-cigarette), and highest in dual users. These findings: (1) raise question of whether emotionally-healthier ('lower-risk') adolescents who are not interested in conventional cigarettes are being attracted to e-cigarettes; (2) indicate that research, intervention, and policy dedicated to adolescent tobacco-psychiatric comorbidity should distinguish conventional cigarette, e-cigarette, and dual use
Kanayama, Gen; Hudson, James I.; Pope, Harrison G.
Background The problem of anabolic-androgenic steroid (AAS) abuse has recently generated widespread public and media attention. Most AAS abusers, however, are not elite athletes like those portrayed in the media, and many are not competitive athletes at all. This larger but less visible population of ordinary AAS users began to emerge in about 1980. The senior members of this population are now entering middle age; they represent the leading wave of a new type of aging former substance abusers, with specific medical and psychiatric risks. Methods We reviewed the evolving literature on long-term psychiatric and medical consequences of AAS abuse. Results Long-term use of supraphysiologic doses of AAS may cause irreversible cardiovascular toxicity, especially atherosclerotic effects and cardiomyopathy. In other organ systems, evidence of persistent toxicity is more modest, and interestingly, there is little evidence for an increased risk of prostate cancer. High concentrations of AAS, comparable to those likely sustained by many AAS abusers, produce apoptotic effects on various cell types, including neuronal cells - raising the specter of possibly irreversible neuropsychiatric toxicity. Finally, AAS abuse appears to be associated with a range of potentially prolonged psychiatric effects, including dependence syndromes, mood syndromes, and progression to other forms of substance abuse. However, the prevalence and severity of these various effects remains poorly understood. Conclusions As the first large wave of former AAS users now moves into middle age, it will be important to obtain more systematic data on the long-term psychiatric and medical consequences of this form of substance abuse. PMID:18599224
Full Text Available BackgroundFew studies have assessed treatment-seeking behavior and patient characteristics in pathological gambling focusing on psychiatric comorbidity, particularly in a setting of heavy exposure to online gambling. This study aimed to address patient characteristics in a novel health care-based treatment modality for pathological gambling, including potential associations between gambling types, psychiatric comorbidity, and gender.MethodsAll patients undergoing structured assessment between January 2016 and April 2017 were included (N = 106, and patient records were reviewed for cooccurring psychiatric disorders and types of problem games.ResultsEighty percent were men, and 58% received a psychiatric disorder apart from pathological gambling. Problematic gambling on online casino and online sports betting represented 84% of patients. Non-substance-related psychiatric comorbidity was significantly associated with female gender.ConclusionOnline gambling is more clearly predominating in this setting than in studies from other countries. High rates of comorbidity call for structured psychiatric assessment in problem gambling, with a particular focus on female patients with pathological gambling.
Müller, Matthias J; Olschinski, Christiane; Kundermann, Bernd; Cabanel, Nicole
Sleep complaints and sleep disturbances are highly prevalent in patients with psychiatric disorders. During hospitalization the patients? condition may be even worse but little is known about the subjective sleep quality in psychiatric hospitals. Thus, we have investigated subjective sleep quality and mean sleep duration in patients with different psychiatric disorders at the end of hospitalization. For a period of one year, inpatients of a psychiatric hospital with diagnosis of substance use...
Thorne, Craig R.; DeBlassie, Richard R.
Cummings (1979), citing evidence from the National Institute of Drug Abuse, reports that one of every eleven adult Americans suffers from a severe addictive problem. Drug addiction is epidemic among teenagers; one of every six teenagers suffers from a severe addictive problem. This paper focuses on adolescent drug/substance abuse. (Author)
Sociodemographic and psychiatric diagnostic predictors of 3-year incidence of DSM-IV substance use disorders among men and women in the National Epidemiologic Survey on Alcohol and Related Conditions.
Goldstein, Risë B; Smith, Sharon M; Dawson, Deborah A; Grant, Bridget F
Incidence rates of alcohol and drug use disorders (AUDs and DUDs) are consistently higher in men than women, but information on whether sociodemographic and psychiatric diagnostic predictors of AUD and DUD incidence differ by sex is limited. Using data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, sex-specific 3-year incidence rates of AUDs and DUDs among United States adults were compared by sociodemographic variables and baseline psychiatric disorders. Sex-specific logistic regression models estimated odds ratios for prediction of incident AUDs and DUDs, adjusting for potentially confounding baseline sociodemographic and diagnostic variables. Few statistically significant sex differences in predictive relationships were identified and those observed were generally modest. Prospective research is needed to identify predictors of incident DSM-5 AUDs and DUDs and their underlying mechanisms, including whether there is sex specificity by developmental phase, in the role of additional comorbidity in etiology and course, and in outcomes of prevention and treatment. (c) 2016 APA, all rights reserved).
Lang, J-P; Bonnewitz, M-L; Kusterer, M; Lalanne-Tongio, L
Alcohol consumption in France exceeds the European average (12.7L of pure alcohol/habitant/year in 2009 for an average of 12.5 L). This consumption has a major professional, social and health impact on the individuals and their families. The cost of such, estimated in Europe to be of 155.8 billion Euros in 2010, is the highest among the central nervous system diseases in Europe, far higher than that of depression or dementia. Patients suffering from psychiatric disorders are more frequently affected by problems related to alcohol use than the general population. They are also more vulnerable to the immediate and subsequent consequences of their consumption. The alcohol related disorders that are often accompanied by risk taking and other addictive behaviour require a global assessment of the addiction, with and without substance, and of the complications. These have a strong impact on risk taking, compliance with care, and the morbidity of somatic and psychiatric disorders, as well as access to optimal care and the life span of patients suffering from psychiatric disorders. The development of addictology care, with integrative treatment programs, is recommended in response to these public health issues. Nevertheless, specific addictology practices and partners with addictology care structures are still scarcely developed in psychiatry. Firstly, it would be necessary to set up such integrated treatments through the systematisation of an "addictology" checkup on admission, a global assessment of addictive behaviour and cognitive disorders, using pragmatic tools that are user-friendly for the care teams, maintain the reduction in risk taking, and apply prescriptions for addiction to psychotropic treatments, in liaison with the referring general practitioner. As early as possible, accompanied by specific training in addictology for the psychiatrists and the mental health nursing teams, such care could be enhanced by the development of liaison and advanced psychiatric
Ramtekkar, Ujjwal; Ivanenko, Anna
Sleep disturbances are common in pediatric psychiatric disorders and constitute key elements in diagnostic symptomatology of various primary psychiatric disorders including bipolar disorder, depression, and anxiety disorder. Although sleep is not included in key defining criteria of some impairing illnesses such as obsessive-compulsive disorder and schizophrenia, these disorders present with a very high prevalence of sleep disturbances. The interaction between sleep and psychopathology is very complex with significant interrelationship in development, severity, and prognosis of psychiatric disorders and comorbid sleep disturbances. The research ranging from small intervention case series to large epidemiologic studies have demonstrated the role of specific sleep complaints in specific psychiatric diagnoses. However, the research using objective instruments such as polysomnography and actigraphy remains limited in youth with psychiatric disorders. The intervention studies using pharmaceutical treatment specifically focusing on sleep disturbances in psychiatric disorders are also sparse in the pediatric literature. Early identification of sleep disturbances and behavioral management using cognitive behavior therapy-based tools appear to be the most effective approach for treatment. The use of psychotropic medications such as selective serotonin reuptake inhibitors for the treatment of primary psychiatric disorder often alleviate the psychological barriers for sleep but may lead to emergence of other sleep issues such as restless leg syndrome. The safety and efficacy data of hypnotics for primary sleep disorders are limited in pediatrics and should be avoided or used with extreme caution in children with comorbid sleep and psychiatric problems. Copyright © 2015 Elsevier Inc. All rights reserved.
Sarajlic Vukovic, Iris; Boricevic Maršanic, Vlatka; Aukst Margetic, Branka; Paradžik, Ljubica; Vidovic, Domagoj; Buljan Flander, Gordana
Background: Posttraumatic stress disorder (PTSD) in male veterans has been linked with impaired family relationships and psychopathology in their children. Less is known about symptoms in children of veterans with partial PTSD. Objective: To compare mental health problems, family functioning and parent-child bonding among adolescent offspring of…
Full Text Available Abstract Background Substance use disorders seem to be an under considered health problem amongst the elderly. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST, was developed by the World Health Organization to detect substance use disorders. The present study evaluates the psychometric properties of the French version of ASSIST in a sample of elderly people attending geriatric outpatient facilities (primary care or psychiatric facilities. Methods One hundred persons older than 65 years were recruited from clients attending a geriatric policlinic day care centre and from geriatric psychiatric facilities. Measures included ASSIST, Addiction Severity Index (ASI, Mini-International Neuropsychiatric Interview (MINI-Plus, Alcohol Use Disorders Identification Test (AUDIT, Revised Fagerstrom Tolerance Questionnaire-Smoking (RTQ and MiniMental State(MMS. Results Concurrent validity was established with significant correlations between ASSIST scores, scores from ASI, AUDIT, RTQ, and significantly higher ASSIST scores for patients with a MINI-Plus diagnosis of abuse or dependence. The ASSIST questionnaire was found to have high internal consistency for the total substance involvement along with specific substance involvement as assessed by Cronbach’s α, ranging from 0.66, to 0.89 . Conclusions The findings demonstrate that ASSIST is a valid screening test for identifying substance use disorders in elderly.
Horwitz, Allan V; Grob, Gerald N
American psychiatry has been fascinated with statistics ever since the specialty was created in the early nineteenth century. Initially, psychiatrists hoped that statistics would reveal the benefits of institutional care. Nevertheless, their fascination with statistics was far removed from the growing importance of epidemiology generally. The impetus to create an epidemiology of mental disorders came from the emerging social sciences, whose members were concerned with developing a scientific understanding of individual and social behavior and applying it to a series of pressing social problems. Beginning in the 1920s, the interest of psychiatric epidemiologists shifted to the ways that social environments contributed to the development of mental disorders. This emphasis dramatically changed after 1980 when the policy focus of psychiatric epidemiology became the early identification and prevention of mental illness in individuals. This article reviews the major developments in psychiatric epidemiology over the past century and a half. The lack of an adequate classification system for mental illness has precluded the field of psychiatric epidemiology from providing causal understandings that could contribute to more adequate policies to remediate psychiatric disorders. Because of this gap, the policy influence of psychiatric epidemiology has stemmed more from institutional and ideological concerns than from knowledge about the causes of mental disorders. Most of the problems that have bedeviled psychiatric epidemiology since its inception remain unresolved. In particular, until epidemiologists develop adequate methods to measure mental illnesses in community populations, the policy contributions of this field will not be fully realized. © 2011 Milbank Memorial Fund.
Full Text Available The aim of this study was to describe the characteristics of children and adolescents admitted to the psychiatric emergency department (ED of a French public teaching hospital over a six-year study period (2001–2006. Data for all episodes of care in the psychiatric ED from January 1, 2001, to December 31, 2006, delivered to adolescents aged less than 18 years were retrospectively analyzed. During the six-year study period, 335 episodes of care in the psychiatric ED were experienced by 264 different adolescents. They accounted for 2.0% of the 16,754 care episodes of the ED; 164 patients (62.1 were female and the average age was 16.5 (SD = 1.6. The neurotic, stress-related, and somatoform disorders were the most frequent (25.4% and concerned mainly anxiety disorders (15.2%. The frequency of the absence of psychiatric diagnosis (22.7% was high. A total of 48 children and adolescents (18.2% benefited from more than one episode of care. Several factors were associated to a higher number of visits to the ED: substance use, schizophrenia, disorders of adult personality and behaviour, disorders occurring in childhood and adolescence, and dual diagnosis. In conclusion, mental health disorders in children and adolescents are a serious problem associated with several potentially modifiable factors.
Feldman, M J; Bird, H R; Hoven, C; Moore, R E; Bin, F
Using an epidemiological sample of adolescents, this study examined associations between the acceptability of potential sex partners and psychiatric status. Subjects aged 14 to 17 years (N = 161) from the Columbia site of the National Institute of Mental Health (NIMH) Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study were grouped according to their responses about the acceptability of youths their age having sex with partners of (1) the opposite sex, (2) neither sex, and (3) either sex. Youths endorsing either sex were compared with youths endorsing the other two types of partners according to psychiatric indicators obtained from the Diagnostic Interview Schedule for Children Version 2.3. Higher-than-expected proportions of male and female youths endorsed sex partners of either sex as potentially acceptable for peers. Youths who did so abused substances and used mental health services more than peers but did not differ in rates of suicidal ideation or attempts. Males endorsing either sex also had higher rates of mood disorders and, compared with males endorsing only the opposite sex, a higher intelligence level. Attitudes about the potential acceptability of sex partners for peers are associated with psychiatric morbidity and mental health service use in the respondent as well as with intelligence level in males. Youths who endorsed potential sex partners of either sex, especially males, appear to be at higher risk for multiple psychiatric problems.
Cederlöf, Martin; Maughan, Barbara; Larsson, Henrik; D'Onofrio, Brian M; Plomin, Robert
Reading problems often co-occur with ADHD and conduct disorder. However, the patterns of co-occurrence and familial overlap between reading problems and other psychiatric disorders have not been systematically explored. We conducted a register-based cohort study including 8719 individuals with reading problems and their siblings, along with matched comparison individuals. Conditional logistic regressions estimated risks for ADHD, autism, obsessive-compulsive disorder, anorexia nervosa, schizophrenia, bipolar disorder, depression, substance use disorder, and violent/non-violent criminality in individuals with reading problems and their siblings. Diagnoses of psychiatric disorders were physician-assigned and ascertained from the Swedish National Patient Register, and crime convictions from the Swedish National Crime Register. We found that individuals with reading problems had excess risks for all psychiatric disorders (except anorexia nervosa) and criminality, with risk ratios between 1.34 and 4.91. Siblings of individuals with reading problems showed excess risks for ADHD, autism, schizophrenia, bipolar disorder, depression, substance use disorder, and non-violent criminality, with risk ratios between 1.14 and 1.70. In summary, individuals with reading problems had increased risks of virtually all psychiatric disorders, and criminality. The origin of most of these overlaps was familial, in that siblings of individuals with reading problems also had elevated risks of ADHD, autism, schizophrenia, bipolar disorder, depression, substance use disorder, and non-violent criminality. These findings have implications for gene-searching efforts, and suggest that health care practitioners should be alert for signs of psychiatric disorders in families where reading problems exist. Copyright © 2017 Elsevier Ltd. All rights reserved.
Lewis, K.E.; Lubetsky, M.J.; Wenger, S.L.; Steele, M.W. [Univ. of Pittsburgh Medical Center, PA (United States)
Over a 3.5 year period of time, 345 patients hospitalized for psychiatric problems were evaluated cytogenetically. The patient population included 76% males and 94% children with a mean age of 12 years. The criteria for testing was an undiagnosed etiology for mental retardation and/or autism. Cytogenetic studies identified 11, or 3%, with abnormal karyotypes, including 4 fragile X positive individuals (2 males, 2 females), and 8 with chromosomal aneuploidy, rearrangements, or deletions. While individuals with chromosomal abnormalities do not demonstrate specific behavioral, psychiatric, or developmental problems relative to other psychiatric patients, our results demonstrate the need for an increased awareness to order chromosomal analysis and fragile X testing in those individuals who have combinations of behavioral/psychiatric, learning, communication, or cognitive disturbance. 5 refs., 1 fig., 2 tabs.
Carpenter, Lindsey M; Hubbard, Grace B
The purpose of this article is to inform and educate psychiatric nurse practitioners about the pervasiveness of the rapidly increasing problem of cyberbullying. As more children and adolescents obtain access to the Internet, mobile devices, and social networking sites, the exposure to bullying in the virtual format increases. Cyberbullying is a growing public health concern and can affect mental health and school performance. Cyberbullying often results in a range of psychiatric symptoms and has been linked to suicide attempts and completions. The psychiatric nurse practitioner is uniquely prepared to provide a range of interventions for patients, families, and communities who have experienced cyberbullying. © 2014 Wiley Periodicals, Inc.
Chaturvedi, P. K.; Agarwal, A. K; Gupta, S. C.
SUMMARY Sixty-two inmates of a children's home were examined by using a symptom check list and Hindi adaptation of Stanford Binet Intelligence Scale—Form LM (1960). A high proportion (69.4%) of the inmates had one or other psychiatric problem. Mild mental retardation (I. Q. 50—70) was most common (40.3%), 11.3% were diagnosed as having unsocialized disturbance of conduct. Four most common psychiatric symptoms were stealing, quarrelsome behaviour, destructive behaviour and bed wetting. No significant correlation was found between psychiatric illnesses and present age, duration of stay and age at entry into the home. PMID:22058478
Mallett, Kimberly A; Turrisi, Rob; Hultgren, Brittney A; Sell, Nichole; Reavy, Racheal; Cleveland, Michael
While alcohol remains the drug of choice for most college students, national data show that 40% of college students also use other substances (e.g., marijuana, cocaine, etc.). Longitudinal studies indicate that students who report use of both alcohol and other substances experience more consequences (e.g., blackout, arrests). The current study expands upon this research by using a multilevel approach to examine average and event-level alcohol combined with other substance use (ALC+) and its role on consequences experienced. In addition, the research examined which substance combined with alcohol posed the most risk. A total of 461 students reported on alcohol use, substance use, and consequences experienced (e.g., Young Adult Alcohol Consequences Questionnaire [YAACQ]) on 12 weekend nights (Thursday, Friday, Saturday) across 4 weekends in an academic year. Multilevel model analyses revealed a positive association between both average and event-level ALC+ use and the number of consequences experienced. A significant cross-level interaction was also revealed indicating students who typically combine alcohol and other substances experienced more consequences on occasions when they use more substances relative to students who typically use alcohol only. Finally, alcohol plus nicotine, or marijuana, or attention-deficit/hyperactivity disorder (ADHD) medications, or cocaine were all significantly positively related to increased consequences. These findings provide consistent evidence that ALC+ use is a highly prevalent behavior among college students that increases risk of problematic consequences. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Nishimura, Katsuji; Kobayashi, Sayaka; Ishigooka, Jun
To critically discuss recent studies of living kidney donor candidates with a past or current psychiatric history and to offer guidance for the psychosocial evaluation of such donors. A global consensus has been developed that active, significant mental illness and substance abuse are absolute contraindications to organ donation due to diminished ability to make a well informed, rational decision about donation or to maintain health status after donation. However, to date, there has been little information published on the suitability for donation and the long-term psychosocial and medical outcomes after donation in donors with mental health issues, especially relatively milder psychiatric disorders, or past significant psychiatric history. To resolve the ethical dilemma of whether living donor candidates with mental health issues should be allowed to donate as is their right or be considered a vulnerable group in need of protection, we need more information. Information should include careful evaluation, possible intervention and follow-up to optimize donation.
Šprah, Lilijana; Dernovšek, Mojca Zvezdana; Wahlbeck, Kristian; Haaramo, Peija
Comorbidity between mental and physical disorder conditions is the rule rather than the exception. It is estimated that 25% of adult population have mental health condition and 68% of them suffer from comorbid medical condition. Readmission rates in psychiatric patients are high and we still lack understanding potential predictors of recidivism. Physical comorbidity could be one of important risk factors for psychiatric readmission. The aim of the present study was to review the impact of physical comorbidity variables on readmission after discharge from psychiatric or general inpatient care among patients with co-occurring psychiatric and medical conditions. A comprehensive database search from January 1990 to June 2014 was performed in the following bibliographic databases: Ovid Medline, PsycINFO, ProQuest Health Management, OpenGrey and Google Scholar. An integrative research review was conducted on 23 observational studies. Six studies documented physical comorbidity variables only at admission/discharge and 17 also at readmission. The main body of studies supported the hypothesis that patients with mental disorders are at increased risk of readmission if they had co-occurring medical condition. The impact of physical comorbidity variables on psychiatric readmission was most frequently studied in in patients with affective and substance use disorders (SUD). Most common physical comorbidity variables with higher probability for psychiatric readmission were associated with certain category of psychiatric diagnoses. Chronic lung conditions, hepatitis C virus infection, hypertension and number of medical diagnoses were associated with increased risk of readmission in SUD; Charlson Comorbidity Index, somatic complaints, physical health problems with serious mental illnesses (schizophrenia, schizoaffective disorder, personality disorders); not specified medical illness, somatic complaints, number of medical diagnoses, hyperthyroidism with affective disorders
Svanum, S; McGrew, J; Ehrmann, L
This study assessed the validity of three Minnesota Multiphasic Personality Inventory-2-based (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) substance abuse scales. The scales were the MacAndrew Alcoholism Scale-Revised (MAC-R; Butcher et al., 1989) and the recently developed Addiction Acknowledgment Scale and Addiction Potential Scale (AAS & APS; Weed, Butcher, McKenna, & Ben-Porath, 1992). Study participants were 308 male and female college students who completed the MMPI-2 and the substance use disorder modules of the Diagnostic Interview Schedule. The MAC-R and the APS had a nonsignificant-to-weak relationship with substance dependence as defined by the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1980). The AAS had a moderate ability to identify the 33 study participants who met DSM-III-R criteria for a substance use disorder, primarily alcoholism. Broadening the definition of substance abuse to a continuum of alcohol/drug problems did not alter the character of findings. These results highlight the relative superiority of direct (AAS) versus subtle (APS, MAC-R) scales to detect substance dependence and support studies that question the overall utility of traditional MMPI scales to identify substance abuse.
Foster, Juliet L H
Continuing debates regarding advertising and the pharmaceutical industry, and others detailing the continued stigmatization of mental health problems. To establish whether there are any differences in advertisements for psychiatric and non-psychiatric medication aimed at health professionals. Quantitative (t-tests, Chi-squared) and qualitative analysis of all unique advertisements for medication that appeared in two professional journals (the British Medical Journal and the British Journal of Psychiatry) between October 2005 and September 2006 was undertaken. Close attention was paid to both images and text used in the advertisements. Significant differences were found between advertisements for psychiatric and non-psychiatric medication in both quantitative and qualitative analysis: advertisements for psychiatric medication contain less text and are less likely to include specific information about the actual drug than non-psychiatric medication advertisements; images used in advertisements for psychiatric medication are more negative than those used for non-psychiatric medication, and are less likely to portray people in everyday situations. A distinction between mental health problems and other forms of ill health is clearly being maintained in medication advertisements; this has potentially stigmatizing consequences, both for professional and public perceptions. There are also troubling implications in light of the debates surrounding Direct to Consumer Advertising.
Fergusson, D M; McLeod, G F H; Horwood, L J; Swain, N R; Chapple, S; Poulton, R
Previous research has found that mental health is strongly associated with life satisfaction. In this study we examine associations between mental health problems and life satisfaction in a birth cohort studied from 18 to 35 years. Data were gathered during the Christchurch Health and Development Study, which is a longitudinal study of a birth cohort of 1265 children, born in Christchurch, New Zealand, in 1977. Assessments of psychiatric disorder (major depression, anxiety disorder, suicidality, alcohol dependence and illicit substance dependence) using DSM diagnostic criteria and life satisfaction were obtained at 18, 21, 25, 30 and 35 years. Significant associations (p life satisfaction and the psychiatric disorders major depression, anxiety disorder, suicidality, alcohol dependence and substance dependence. After adjustment for non-observed sources of confounding by fixed effects, statistically significant associations (p life satisfaction and major depression, anxiety disorder, suicidality and substance dependence. Overall, those reporting three or more mental health disorders had mean life satisfaction scores that were nearly 0.60 standard deviations below those without mental health problems. A structural equation model examined the direction of causation between life satisfaction and mental health problems. Statistically significant (p life satisfaction and mental health problems. After adjustment for confounding, robust and reciprocal associations were found between mental health problems and life satisfaction. Overall, this study showed evidence that life satisfaction influences mental disorder, and that mental disorder influences life satisfaction.
Khazaie, Habibolah; Rezaie, Leeba; de Jong, Desiree M
Outpatient psychiatric treatment provides both psychotherapy and pharmacotherapy for a large portion of psychiatric patients. Dropping out, or early termination of treatment, may be considered a common barrier to outpatient's psychiatric treatment. There are limited studies on this issue in Iran. The current study aimed to examine rates, predictors and reasons of dropping out of an outpatient psychiatric treatment. In this 6-month cohort study, 1500 outpatients who visited 10 psychiatrist's offices in the Iranian city of Kermanshah were recruited and followed for 2 years (2009-2011) for recommended treatments including admission to hospital, pharmacotherapy, psychotherapy and a combination of both psychotherapy and pharmacotherapy. Characteristics of patients who dropped out of the current study were collected, and reasons for dropping out were collected via phone or in person interview. Dropouts were prevalent in prescribed treatments. Pretreatment (primary) dropout rates in psychotherapy treatment were 4 times greater than dropout rates in pharmacotherapy treatment (80% and 20%, respectively). There were significance differences between dropouts and non-dropouts of pharmacotherapy with respect to patient characteristics; younger age, male gender, low level of education, unemployment, lack of insurance, new cases and divorce were more prevalent among dropouts (P<.001). With regard to diagnosis, dropping out was more prevalent among patients with substance-related disorders, schizophrenia and other psychotic disorders when compared to other diagnoses (P<.001). Commonly reported reasons for dropping out included overslept and too ill to attend treatment and fear of becoming addicted to prescribed psychotropic medication (30% and 18%, respectively). Lack of confidence in therapist ability and lack of confidence in the efficacy of the treatment were more prevalent in patients who dropped out of psychotherapy (P<.001). Patient dropout is a common problem in outpatient
Full Text Available Abstract Background Bariatric surgery is the only procedure that has significant results in weight loss and improvements in medical comorbidities in morbid obese patients. Severely obese patients are also associated with a higher prevalence of psychiatric disorders and poor quality of life. Objective To evaluate specific areas of psychopathology in individuals undergoing bariatric surgery. Methods A review of the literature was conducted from January 2002 to March 2014 by researching PubMed database using the following query: “morbid AND obesity AND bariatric AND surgery AND (psychiatry OR psychology”. Results Overall improvements in eating behaviors, mood disorders and body image are reported after bariatric surgery, and the mechanism is not enlightened. Risk of suicide and consumption of substances of abuse, especially alcohol, after gastric bypass surgery are problems that clinicians must be aware. Discussion Bariatric patients should be monitored after surgery to identify who did not show the expected benefits postoperatively and the ones who develop psychiatric symptoms after an initial positive response.
Kokai, Masahiro [Hyogo Coll. of Medicine, Nishinomiya (Japan); Soejima, Toshinori; Wang, Shangdong; Shinfuku, Naotaka
This review focuses on the mental and psychological effects of medical radiation exposure, the nuclear accident at Three Mile Island, the Chernobyl disaster, atomic bomb explosions at Nagasaki and Hiroshima, and accidents at nuclear power plants and nuclear waste plants. Studies have shown that anxiety about the adverse effects of radiation in medicine (such as infertility, carcinogenicity, and genotoxicity) and fear for exposure has caused psychiatric disorders. Several studies on the mental health effects of the nuclear accident at Three Mile Island were conducted, and the results indicated that psychiatric distress persisted for a certain period of time, particularly in pregnant women and women who have children, even when no evidence of substantial of radiation exposure is seen clinically. The psychological consequences of the Chernobyl disaster have been investigated continuously, and various problems, e.g., acute stress reaction, neurosis, and psychosis, have been identified, although no physical damage due to the radiation or PTSD have been reported. By contrast, PTSD has been seen in survivors of the Nagasaki and Hiroshima nuclear explosions. A study in Ohio, (United States), which has a nuclear waste plant, investigated PTSD in people living near the plant and found that the symptom level was mild. In general, the most common symptoms among people with mental and psychological disorders due to radiation exposure are depression and anxiety, with many people having associated somatoform disorders, and some people complain of PTSD. Vague anxiety and fear of sequelae, regardless of the exposure dose, appears to cause such psychiatric disorders. Although it is rare for psychiatrists to see such cases of psychiatric disorders due to radiation exposure, their number may increase as psychiatric services become more widely available. (K.H.)
substances, such as chlorpromazine , reserpine, meprobamate, and 1,2,3,4-tetrahydro-9-amino- acridine. From the results which have been arrived at up... synthesis - 32 - of structural and functional elements, such as proteins, lipids, or trans- mitter substances. Table 28/6 Influence of the Replacement
Pascual, Juan Carlos; Malagón, Angeles; Arcega, Jose M; Gines, Jose M; Navinés, Ricard; Gurrea, Alfredo; Garcia-Ribera, Carlos; Bulbena, Antoni
Studies examining the relationship between homeless persons and the use of psychiatric emergency services (PES) in a country with universal access to health care are lacking. This study aimed to determine the prevalence of homelessness in adults visiting a PES in Spain, identify the differences between homeless and non-homeless patients in the use of PES and analyze the factors associated with homelessness and the decision to hospitalize. The study included a total of 11 578 consecutive admissions to a PES in a tertiary hospital in Barcelona, Spain, over a 4-year period. Data collected included socio-demographic and clinical information, and score on the Severity of Psychiatric Illness (SPI) scale. Multivariate logistic regression analyses were used to calculate odds ratios for the factors associated with homelessness and the decision to hospitalize. Five hundred sixty (4.8%) admissions were considered homeless. Homeless patients had more psychotic and drug abuse disorders, greater severity of symptoms, more risk of being a danger to others and more frequent hospitalization needs than non-homeless patients. Factors related to homelessness were male gender, substance abuse and immigrant status from North Africa, Sub-Sahara Africa and Western countries. The decision to hospitalize homeless patients was associated with psychosis diagnosis, suicide risk, danger to others, symptom severity, medical problems and noncompliance with treatment. In an attempt to decrease the use of emergency resources and prevent the risk of homelessness, mental health planners in a universal healthcare system should improve outpatient access for populations with risk factors such as substance abuse and immigration.
The purpose of this paper is to describe the nature of medical care within the German penal system. German prison services provide health care for all inmates, including psychiatric care. The reached level of equivalence of care and ethical problems and resource limitations are discussed and the way of legislation in this field since 2006 reform on federal law is described. The article summarizes basic data on German prison health care for mentally ill inmates. The legislation process and factors of influence are pointed out. A description of how psychiatric care is organized in German prisons follows. It focuses on the actual legal situation including European standards of prison health care and prevention of torture, psychiatric care in German prisons themselves, self harm and addiction. Associated problems such as blood born diseases and tuberculosis are included. The interactions between prison staff and health care personal and ethic aspects are discussed. The legislation process is still going on and there is still a chance to improve psychiatric care. Mental health problems are the major challenge for prison health care. Factors such as special problems of migrants, shortage of professionals and pure statistic data are considered. The paper provides a general overview on psychiatric services in prison and names weak points and strengths of the system.
Marrie, Ruth Ann; Reingold, Stephen; Cohen, Jeffrey
-based studies, the prevalence of anxiety was 21.9% (95% CI: 8.76%-35.0%), while it was 14.8% for alcohol abuse, 5.83% for bipolar disorder, 23.7% (95% CI: 17.4%-30.0%) for depression, 2.5% for substance abuse, and 4.3% (95% CI: 0%-10.3%) for psychosis. CONCLUSION: This review confirms that psychiatric...... comorbidity, particularly depression and anxiety, is common in MS. However, the incidence of psychiatric comorbidity remains understudied. Future comparisons across studies would be enhanced by developing a consistent approach to measuring psychiatric comorbidity, and reporting of age-, sex-, and ethnicity...
Muramatsu, Russ S; Thomas, Kelly Jones; Leong, Stephanie L; Ragukonis, Frank
A service dog is defined as "any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability." Some psychiatric patients may depend on a service dog for day-to-day functioning. The Americans with Disabilities Act (ADA) established certain rights and responsibilities for individuals with disabilities and health care providers. Psychiatric hospitalization of a patient with a service dog may pose a problem and involves balancing the requirement to provide safe and appropriate psychiatric care with the rights of individuals with disabilities. This Open Forum examines issues that arise in such circumstances, reviews the literature, and provides a foundation for the development of policies and procedures.
Full Text Available Psychiatric illnesses are very common in prevalence. But not everyone who has a mental illness gets a psychiatric consultation. The causes are many. First, many time people don’t recognise and accept mental illnesses in them as a result of lack of insight and awareness. Secondly, even if they know they have a mental illness, they don’t feel comfortable in disclosing it. Third, after knowing that they have some problems which require help from a doctor, they don’t know whom to consult, where to consult, and how to consult. Fourth, in spite of all possible awareness, there may not be psychiatric facilities nearby. Thus, it becomes utmost necessary to discuss those factors which stop people with psychiatric illnesses to get adequate help so that remedial steps could be taken.
The paper describes the current provision of psychiatric services in Algeria - in particular, in-patient and out-patient facilities, child psychiatry and human resources. Education, training, associations and research in the field of mental health are also briefly presented. The challenges that must dealt with to improve psychiatric care and to comply with international standards are listed, by way of conclusion.
Full Text Available Time perception is an ability which we use in every moment of daily life, that guides the formation and continuation of our behaviors and from an evolutionary perspective ensures survival. Internal clock models help us to understand time perception. Time perception is known to vary between individuals and particular situations. This variability is explained with the mechanisms which is associated with the processes related to attention, the speed of the internal clock and the memory unit. It is suggested that time perception is mainly associated with the activities of dopamine and acetylcholine. Some dopaminergic psychoactive substances like cocaine and amphetamine have all been shown to change time perception by increasing the speed of internal clock while on the other hand some antipsychotic drugs make an opposite change in time perception by descreasing the speed of the clock. Similarly, time perception is affected in some psychiatric disorders and an ethiopathological relationship between time perception disturbances and psychiatric disorders is suggested. In this article time perception changes in schizophrenia, attention deficit/hyperactivity syndrome, depression, anxiety disorders and personality disorders are briefly reviewed.
Berlin, Lisa J; Shanahan, Meghan; Appleyard Carmody, Karen
This pilot randomized trial tested the feasibility and efficacy of supplementing residential substance-abuse treatment for new mothers with a brief, yet rigorous, attachment-based parenting program. Twenty-one predominantly (86%) White mothers and their infants living together in residential substance-abuse treatment were randomly assigned to the program (n = 11) or control (n = 10) group. Program mothers received 10 home-based sessions of Dozier's Attachment and Biobehavioral Catch-up (ABC) intervention. Postintervention observations revealed more supportive parenting behaviors among the randomly assigned ABC mothers. © 2013 Michigan Association for Infant Mental Health.
Full Text Available Psychiatric disorders are common in women during their childbearing years. Special considerations are needed when psychotic disorders present during pregnancy. Early identification and treatment of psychiatric disorders in pregnancy can prevent morbidity in pregnancy and in postpartum with the concomitant risks to mother and baby. Nevertheless, diagnosis of psychiatric illnesses during pregnancy is made more difficult by the overlap between symptoms of the disorders and symptoms of pregnancy. In majority of cases both psychotherapy and pharmacotherapy should be considered. However, psychiatric disorders in pregnancy are often under treated because of concerns about potential harmful effects of medication. This paper reviews findings about the presentation and course of major psychiatric disorders during pregnancy.
Munk-Olsen, Trine; Maegbaek, M L; Johannsen, B M
and childbirth, which suggests differences in the underlying etiology. We further speculate varying treatment incidence and prevalence in pregnancy vs postpartum may indicate that the current Diagnostic and Statistical Manual of Mental Disorders-5 peripartum specifier not adequately describes at-risk periods......Perinatal psychiatric episodes comprise various disorders and symptom severity, which are diagnosed and treated in multiple treatment settings. To date, no studies have quantified the incidence and prevalence of perinatal psychiatric episodes treated in primary and secondary care, which we aimed...... psychiatric facilities, 2.5 births were followed by an episode treated at outpatient psychiatric facility and 12 births by GP-provided pharmacological treatment. We interpret our results the following way: treated severe and moderate psychiatric disorders have different risk patterns in relation to pregnancy...
Poirier, Marie-France; Canceil, Olivier; Baylé, Franck; Millet, Bruno; Bourdel, Marie-Chantal; Moatti, Cécile; Olié, Jean-Pierre; Attar-Lévy, Dominique
Compelling evidence that tobacco-smoking is a form of drug addiction exists. The aim of this study is to determine the following: (1) prevalence of tobacco-smoking and of nicotine dependence in French psychiatric patients; (2) rates and patterns of tobacco smoking and of nicotine dependence according to diagnosis; (3) relationship between current smoking status and antipsychotic medications; and (4) relationship between cigarette smoking and neurological side effects induced by neuroleptics. A population of 711 psychiatric in- and outpatients was assessed using: (1) a detailed smoking self-questionnaire for smoking history and nicotine dependence; and (2) a questionnaire for staff covering treatments and DSMIII-R diagnoses. Data were analyzed using chi2 analysis of variance (ANOVA) tests (one factor) for quantitative comparisons between groups of patients, and analysis of covariance (ANCOVA) test with age covariate was performed for age-dependent variables. Prevalence of smoking in the population of psychiatric patients was significantly higher than in the French general population. Diagnoses among current smokers were mainly substance-related disorder and schizophrenia. The authors established correlations between prevalence of smoking and age, sex, marital and socioeconomic status, alcohol use, coffee consumption and other psychoactive substance use or abuse. The authors did not find relationship between smoking prevalence and institutionalization. Neuroleptic neurological side effects were significantly fewer among smokers compared to nonsmokers. However, the rate of smokers was significantly higher in psychiatric patients receiving neuroleptic drugs. Nicotine abuse in psychiatric patients, and especially in schizophrenic patients, could support the hypothesis that smoking is consistent with self-medication.
Wade, Jordan L.; Cox, Neill Broderick; Reeve, Ronald E.; Hull, Michael
Using data from the Simons Simplex Collection, the present study examined the impact of child externalizing behavior and parental broad autism phenotype traits on substance use among parents of children with autism spectrum disorder (n = 2,388). For both fathers and mothers, child externalizing behaviors predicted tobacco use (OR = 1.01 and OR =…
Fergusson, David M; Horwood, L. John; Ridder, Elizabeth M
... for potentially confounding factors. These outcomes span: crime (e.g. Caspi, 2000; Farrington, 1998; Fergusson and Lynskey, 1998 ); substance use (e.g. Flory et al., 2003; Lynskey and Fergusson, 1995 ; e.g. Molina and Pelham, 2003 ); mental disorders (e.g. Fergusson and Lynskey, 1998; Kim-Cohen et al., 2003; Kratzer and Hodgins, 1997 ); sui...
Martin, Christopher S; Chung, Tammy; Langenbucher, James W
This article reviews literature on the validity and performance characteristics of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) diagnostic criteria for substance use disorders (SUDs) and recommends changes in these criteria that should be considered for the next edition of the DSM (DSM-V). Substantial data indicate that DSM-IV substance abuse and substance dependence are not distinct categories and that SUD criteria are best modeled as reflecting a unidimensional continuum of substance-problem severity. The conceptually and empirically problematic substance abuse diagnosis should be abandoned in the DSM-V, with substance dependence defined by a single set of criteria. Data also indicate that various individual SUD criteria should be revised, dropped, or considered for inclusion in the DSM-V. The DSM-V should provide a framework that allows the integration of categorical and dimensional approaches to diagnosis. Important areas for further research are noted. Copyright (c) 2008 APA, all rights reserved.
Talih, Farid; Ajaltouni, Jean
The misuse of nootropics—any substance that may alter, improve, or augment cognitive performance, mainly through the stimulation or inhibition of certain neurotransmitters—may potentially be dangerous and deleterious to the human brain, and certain individuals with a history of mental or substance use disorders might be particularly vulnerable to their adverse effects. We describe four cases of probable nootropic-induced psychiatric adverse effects to illustrate this theory. To the best of ou...
Schluter, Magdalen G; Hodgins, David C; Wolfe, Jody; Cameron Wild, T
There is currently no well-validated measure that assesses a broad spectrum of substance-related and behavioural addictions in general populations. This study aimed to develop a brief self-attribution Screener for Substance and Behavioural Addictions (SSBA) to screen for 4 substances and 6 behaviours, and to compare its performance with established individual-behaviour screening instruments. A small, psychometrically optimal set of items to assess self-attributed indicators of addiction across alcohol, tobacco, cannabis, cocaine, gambling, shopping, videogaming, overeating, sexual activity, and over-working were identified from a broader pool that was developed using a lay epidemiology qualitative approach. The suitability of the 4-item single factor solution was tested for each behaviour and scores were compared with those obtained from the sample using individual-behaviour screening instruments. Participants (N = 6,000), broadly representative of the Canadian English-speaking adult population, were recruited through the Ipsos Reid Canadian Online Panel. Participants completed an item pool of 15 indicators of addiction for each target behaviour and a validation instrument for one randomly assigned behaviour. A set of four items identified using principal component and confirmatory factor analyses demonstrated good fit and excellent internal consistency (α = .87-.95) across behaviours, and good convergent validity (rs = .44 - .8) with extant instruments measuring similar constructs with only one exception (r = .26). The proposed Screener for Substance and Behavioural Addiction is a reliable and valid measure assessing the lay public's self-attributed indicators of addiction across 10 substances and behaviours. This article is protected by copyright. All rights reserved.
Meshberg-Cohen, Sarah; Reid-Quiñones, Kathryn; Black, Anne C; Rosen, Marc I
Veterans deemed disabled for conditions resulting from, or aggravated by, their service in the military are eligible for service-connected disability payments. Despite many positive effects of disability payments, one concern is that Veterans with psychiatric conditions who receive disability payments are less likely to be employed compared to those who are denied benefits. Little is known about the attitudes of substance using Veterans, for whom work is a particularly important part of recovery, toward work and disability compensation. This study compared the responses of Veterans with (n=33) and without substance use problems (n=51) to questions about work's significance and its relationship to disability payments. T- and chi-square tests were conducted to determine if Veterans with substance use problems differed from the others on work-related attitudes and perceptions of the relation between work and Veterans' benefits. Veterans endorsed high levels of agreement with statements that working would lead to loss of benefits. Veterans with substance use agreed more strongly that they would rather turn down a job offer than lose financial benefits. The greater preference for disability payments among substance-using Veterans may reflect a realistic concern that they are particularly likely to have difficulty maintaining employment. The widespread concern among Veterans that work will lead to loss of VA disability payments is striking given the ambiguity about how likely loss of benefits actually is, and should be addressed during the service-connection application process. © 2013.
Arria, Amelia M.; Mericle, Amy A.; Meyers, Kathleen; Winters, Ken C.
Using data from a nationally representative sample, this study investigated substance use disorder (SUD) among respondents ages 15-54 as a function of their parents’ substance-related impairment and parents’ treatment history. Additionally, associations among maternal and paternal substance-related impairment, specific parenting behaviors, and the risk for SUD in the proband were examined. As expected, parental substance-related impairment was associated with SUD. Paternal treatment history was associated with a decreased risk for SUD in the proband, but did not appear to be associated with positive parenting practices. Results of post-hoc analyses suggested that parenting behaviors might operate differently to influence SUD risk in children where parents are affected by substance use problems compared to non-affected families. Future research is warranted to better understand the complex relationships among parental substance use, treatment, parenting behaviors, and SUD risk in offspring. Opportunities might exist within treatment settings to improve parenting skills. PMID:22112506
In addition, a diagnosis of a substance-induced psychiatric disorder was made in 8% of these patients, 1% of who was diagnosed with a substance-induced mood disorder, while 7% was diagnosed with a substanceinduced psychotic disorder. Patients diagnosed with a co-morbid SUD were younger than those without a ...
Da Silveira, Dartiu Xavier; Grob, Charles S; de Rios, Marlene Dobkin; Lopez, Enrique; Alonso, Luisa K; Tacla, Cristiane; Doering-Silveira, Evelyn
Ayahuasca is believed to be harmless for those (including adolescents) drinking it within a religious setting. Nevertheless controlled studies on the mental/ psychiatric status of ritual hallucinogenic ayahuasca concoction consumers are still lacking. In this study, 40 adolescents from a Brazilian ayahuasca sect were compared with 40 controls matched on sex, age, and educational background for psychiatric symptomatology. Screening scales for depression, anxiety, alcohol consumption patterns (abuse), attentional problems, and body dysmorphic disorders were used. It was found that, compared to controls, considerable lower frequencies of positive scoring for anxiety, body dismorphism, and attentional problems were detected among ayahuasca-using adolescents despite overall similar psychopathological profiles displayed by both study groups. Low frequencies of psychiatric symptoms detected among adolescents consuming ayahuasca within a religious context may reflect a protective effect due to their religious affiliation. However further studies on the possible interference of other variables in the outcome are necessary.
Fabrega Jr, Horacio
Psychiatric conditions and the institutions and practices that modern society has evolved to handle them originated during the nineteenth century in Anglo European societies. They are products of a historically contingent and culture specific formulation of a class of social problems of behavior that came to the fore in relation to intellectual and political economic changes of those societies. However, such problems have a long ancestry. They are intrinsic to human species and the social and cultural systems that its members have evolved since their emergence. This article reviews intellectual quandaries raised by evolutionary study of psychiatric conditions, those of crossing the human/animal divide and crossing historically contingent cultures; and of framing history of psychiatry in terms of social and cultural evolution. The biological architecture underlying psychiatric conditions and the breakthroughs that indigenous psychiatry of different types of societies underwent in formulating signs and symptoms are discussed. Copyright (c) 2004 S. Karger AG, Basel.
Nilsson, Sandra Feodor; Laursen, Thomas Munk; Hjorthøj, Carsten; Thorup, Anne; Nordentoft, Merete
Children and adolescents from deprived backgrounds have high rates of psychiatric problems. Parental and social factors are crucial for children's healthy and positive development, but whether psychiatric morbidity is associated with parental social marginalisation is unknown. We aimed to analyse the association between mother's and father's history of homelessness and the offspring's risk of psychiatric disorders, including substance use disorder, during childhood and adolescence. We did a nationwide, register-based cohort study of 1 072 882 children and adolescents aged 0-16 years, who were living or born in Denmark between Jan 1, 1999, and Dec 31, 2015. Parental homelessness was the primary exposure, data on which were obtained from the Danish Homeless Register. The Danish Civil Registration System was used to extract the population and link offspring to parental information, and the outcome, psychiatric disorders in the offspring, was obtained from the Danish Psychiatric Central Research Register and the Danish National Patient Register. We analysed the association between parental history of homelessness and risk of psychiatric disorders in offspring by survival analysis using Poisson regression and incidence rate ratios (IRRs), adjusted for year and offspring characteristics, and additionally adjusted for parental factors (age at offspring's birth and parental psychiatric disorders). 17 238 (2%) offspring had either one or two parents with a history of homelessness, and 56 330 (5%) children and adolescents were diagnosed with any psychiatric disorder during the study period. The incidence of any psychiatric disorder was 15·1 cases per 1000 person-years (95% CI 14·4-15·8) in offspring with at least one parent with a history of homelessness, compared with 6·0 per 1000 person-years (95% CI 6·0-6·1) in those whose parents had no such history (IRR 2·5 [95% CI 2·3-2·7] for mother homeless, 2·3 [2·2-2·5] for father homeless, and 2·8 [2·4-3·2
Sandra Feodor Nilsson, MSc
Full Text Available Summary: Background: Children and adolescents from deprived backgrounds have high rates of psychiatric problems. Parental and social factors are crucial for children's healthy and positive development, but whether psychiatric morbidity is associated with parental social marginalisation is unknown. We aimed to analyse the association between mother's and father's history of homelessness and the offspring's risk of psychiatric disorders, including substance use disorder, during childhood and adolescence. Methods: We did a nationwide, register-based cohort study of 1â072â882 children and adolescents aged 0â16 years, who were living or born in Denmark between Jan 1, 1999, and Dec 31, 2015. Parental homelessness was the primary exposure, data on which were obtained from the Danish Homeless Register. The Danish Civil Registration System was used to extract the population and link offspring to parental information, and the outcome, psychiatric disorders in the offspring, was obtained from the Danish Psychiatric Central Research Register and the Danish National Patient Register. We analysed the association between parental history of homelessness and risk of psychiatric disorders in offspring by survival analysis using Poisson regression and incidence rate ratios (IRRs, adjusted for year and offspring characteristics, and additionally adjusted for parental factors (age at offspring's birth and parental psychiatric disorders. Findings: 17â238 (2% offspring had either one or two parents with a history of homelessness, and 56â330 (5% children and adolescents were diagnosed with any psychiatric disorder during the study period. The incidence of any psychiatric disorder was 15Â·1 cases per 1000 person-years (95% CI 14Â·4â15Â·8 in offspring with at least one parent with a history of homelessness, compared with 6Â·0 per 1000 person-years (95% CI 6Â·0â6Â·1 in those whose parents had no such history (IRR 2Â·5 [95
Psychiatric evaluation of intellectually disabled offenders referred to the Free State Psychiatric Complex, 1993 - 2003. ... Increased crime is a problem in South Africa and complications arise when the accused is intellectually disabled. The accountability and fitness to stand trial of such individuals is an important facet that ...
Background: Even though intimate partner violence represents a major public health problem in Nigeria, much of its associated burden of psychiatric morbidity presenting in the clinical setting goes unrecognized and untreated. Objectives: The purpose of this paper is to clarify the psychiatric perspectives on intimate partner ...
Alfano, Candice A.; Gamble, Amanda L.
Although sleep problems often comprise core features of psychiatric disorders, inadequate attention has been paid to the complex, reciprocal relationships involved in the early regulation of sleep, emotion, and behavior. In this paper, we review the pediatric literature examining sleep in children with primary psychiatric disorders as well as…
The biopsychosocial model, the current method in psychiatric assessments, is reviewed and critiqued. The history and original intents leading to the conception of the biopsychosocial model are briefly discussed. Five inherent problems with the use of the biopsychosocial model in psychiatric assessments and training programs are presented. Two alternative approaches are discussed and promoted for clinical, educational, and research practices in medicine. PMID:19724745
... Guide - Table of Contents Facts For Families Guide - View by Topic Chinese Facts for Families Guide ... Psychiatric Evaluation No. 52; Updated October 2017 Evaluation by a child and adolescent psychiatrist is appropriate for any child or adolescent ...
Bimenyimana, E; Poggenpoel, M; Myburgh, C; van Niekerk, V
Caring for good people is difficult enough; to care for people who are either aggressive or violent is even more difficult. This is what psychiatric nurses working in the psychiatric institution in which research was done are exposed to on a daily basis. The aim of the research was to explore and describe the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. A qualitative, explorative, descriptive, and contextual study design was utilised. Data was collected by means of semi-structured interviews and naïve sketches. Tesch 's (Creswell, 2004: 256) method of open coding and an independent coder were utilised for data analysis. This study shed some light on the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. The findings show that the level of violence and aggression to which psychiatric nurses are exposed is overwhelming and the consequences are alarming. The contributing factors to this violence and aggression are: the mental status and the conditions in which patients are admitted; the staff shortage; the lack of support among the members of the multidisciplinary team (MDT); and the lack of structured and comprehensive orientation among newly appointed staff members. As a result, psychiatric nurses are emotionally, psychologically, and physically affected. They then respond with the following emotions and behaviour: fear, anger, frustration, despair, hopelessness and helplessness, substance abuse, absenteeism, retaliation and the development of an "I don't care" attitude.
Lewis-Fernández, Roberto; Aggarwal, Neil Krishan
Since the publication of DSM-IV in 1994, a number of components related to psychiatric diagnosis have come under criticism for their inaccuracies and inadequacies. Neurobiologists and anthropologists have particularly criticized the rigidity of DSM-IV diagnostic criteria that appear to exclude whole classes of alternate illness presentations as well as the lack of attention in contemporary psychiatric nosology to the role of contextual factors in the emergence and characteristics of psychopat...
Brandt, Frans; Thvilum, Marianne; Pedersen, Dorthe Almind
Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity.......Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity....
Chan, Oliver; Chow, Kavin Kit-wan
Institutional aggression in forensic psychiatric setting is an under-researched subject, despite the magnitude of the problem. No studies have been conducted on the assessment of risk and the examination of predictors of aggression among the Chinese forensic psychiatric population. Our study aimed to examine the determinants of aggression in the only forensic psychiatric institution in Hong Kong, and to test the psychometric properties of a risk-assessment instrument, the Dynamic Appraisal of Situational Aggression (DASA). We recruited a representative sample of 530 consecutively admitted detainees. Qualified nurses completed two risk-assessment instruments, the DASA and the Brøset Violence Checklist (BVC), once daily during the participants׳ first 14 days of admission. Aggressive incidents were recorded using the revised Staff Observation Aggression Scale (SOAS-R), and participants׳ data were collected for multivariate analyses. We showed that female gender, diagnoses of personality disorder and substance-related disorder, and admission at other correctional institutions were associated with institutional aggression. Aggression was perpetrated by 17.7% of the participants, and the DASA was demonstrated to have good psychometric properties in assessing and predicting aggressive incidents. Our findings preliminarily support the use of daily in-patient risk-assessment and affirm the role of dynamic factors in institutional aggression. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Biancosino, Bruno; Delmonte, Sara; Grassi, Luigi; Santone, Giovanni; Preti, Antonio; Miglio, Rossella; de Girolamo, Giovanni
Violence committed by acute psychiatric inpatients represents an important and challenging problem in clinical practice. Sociodemographic, clinical, and treatment information were collected for 1324 patients (677 men and 647 women) admitted to Italian public and private acute psychiatric inpatient facilities during an index period in 2004, and the sample divided into 3 groups: nonhostile patients (no episodes of violent behavior during hospitalization), hostile patients (verbal aggression or violent acts against objects), and violent patients (authors of physical assault). Ten percent (N = 129) of patients showed hostile behavior during hospitalization and 3% (N = 37) physically assaulted other patients or staff members. Variables associated with violent behavior were: male gender, attitude at admission, and a diagnosis of schizophrenia, bipolar disorder, personality disorder, mental retardation, organic brain disorder or substance/alcohol abuse. Violent behavior during hospitalization was a predictive factor for higher Brief Psychiatric Rating Scale scores and for lower Personal and Social Performance scale scores at discharge. Despite the low percentage of violent and hostile behavior observed in Italian acute inpatient units, this study shed light on a need for the careful assessment of clinical and treatment variables, and greater effort aimed at improving specific prevention and treatment programs of violent behavior.
Introduction. In psychiatric practice, some mentally ill patients spend their life in continuous or prolonged hospitalization; that is, as long stay patients.1,2 This is due among other reasons to severe mental illness with poor symptom control, substance dependence, homelessness and abandonment by the patients' relatives.3 ...
Dew, Rachel Elizabeth; Daniel, Stephanie S.; Armstrong, Tonya D.; Goldston, David B.; Triplett, Mary Frances; Koenig, Harold G.
The aim of the current article is to review the literature on religion and spirituality as it pertains to adolescent psychiatric symptoms. One hundred and fifteen articles were reviewed that examined relationships between religion/spirituality and adolescent substance use, delinquency, depression, suicidality, and anxiety. Ninety-two percent of…
Results: Patients with HIV infection are at an increased risk of psychiatric illness. Major depressive disorder and subsyndromal depressive symptoms, as well as anxiety disorder and substance abuse are more prevalent among HIV infected individuals than among the general population. HIV-associated neurocognitive ...
Oct 24, 2014 ... Objective: The objective was to determine medication adherence behavior among psychiatric out‑patients with psychoactive substance use comorbidity in a Nigerian Tertiary Hospital. .... the hospital, neighboring peripheral hospitals, and other parts of the country. An ethical clearance was obtained for.
Aagaard, Jørgen; Aagaard, Andreas; Buus, Niels
of the psychiatric emergency room throughout the whole period. Furthermore, the emergence and continual presence of the predictors: severe mental illness (1999-onwards), substance abuse (2002-onwards) and sheltered housing (2002-2003-2005-onwards) indicated changes in the general profile of frequent visitors...
Toxicology screening has clinical and forensic applications in evaluating severe or life-threatening symptoms in patients presenting with signs and symptoms suggestive of intoxication or overdose. In both acute psychiatric and medical settings, urine toxicology has been found helpful in detection of substances of abuse.
Oct 24, 2014 ... and disabilities.[2,3] It has also been reported that patients with this comorbidity have poor adherence to prescribed psychotropic medications used to treat the coexisting psychiatric disorder.. Medication .... Substances were mostly used in multiple combinations, and the lifetime prevalence of the use of at ...
Demographic, personal, psychiatric and substance-use history, in addition to mental state examination on admission, were collected from the case notes. Results. The largest group of patients (n=56, 40%) had not been abstinent from heroin use since drug debut, and most had been arrested for drug-related activities ...
generalized anxiety disorders.8 Other psychiatric disorders that may be seen among this group of people include substance and alcohol use disorders and chronic sleep disturbances.9,10. In a study of over 2000 families caring for a family member with seriously poor health in the United States, nearly 20% of caregivers ...
Beek, J. van; Vuijk, P.J.; Harte, J.M.; Smit, B.L.; Nijman, H.L.I.; Scherder, E.J.A.
Severe behavioral problems, aggression, unlawful behavior, and uncooperativeness make the forensic psychiatric population both hard to treat and study. To fine-tune treatment and evaluate results, valid measurement is vital. The Brief Psychiatric Rating Scale-Extended (BPRS-E) is a widely used scale
van Beek, J.; Vuijk, P.J.; Harte, J.M.; Smit, B.L.; Nijman, H.; Scherder, E.J.A.
Severe behavioral problems, aggression, unlawful behavior, and uncooperativeness make the forensic psychiatric population both hard to treat and study. To fine-tune treatment and evaluate results, valid measurement is vital. The Brief Psychiatric Rating Scale-Extended (BPRS-E) is a widely used scale
Garber, J; Zeman, J; Walker, L S
Approximately 12% of children report recurrent episodes of abdominal pain. In only about 10% of these cases, however, can an organic etiology be identified, and therefore it often is assumed that these children have emotional problems. To test this hypothesis, children with recurrent abdominal pain (RAP) with no identifiable organic cause were compared to children with an organic diagnosis for their abdominal pain, children with psychiatric disorders, and healthy controls. Both groups of children with abdominal pain had significantly more psychiatric disorders (predominantly anxiety and depression) than did the healthy group. Both RAP and psychiatric children had significantly higher Child Behavior Checklist internalizing scores; psychiatric children were rated as significantly more maladjusted on the Children's Global Assessment Scale. Mothers of RAP children were significantly more anxious than mothers of organic pain and healthy children. Psychiatric children were significantly more likely than the other three groups to underreport their psychiatric symptoms relative to their mothers.
Sutton, Eliza L
Sleep issues are common in people with psychiatric disorders, and the interaction is complex. Sleep disorders, particularly insomnia, can precede and predispose to psychiatric disorders, can be comorbid with and exacerbate psychiatric disorders, and can occur as part of psychiatric disorders. Sleep disorders can mimic psychiatric disorders or result from medication given for psychiatric disorders. Impairment of sleep and of mental health may be different manifestations of the same underlying neurobiological processes. For the primary care physician, key tools include recognition of potential sleep effects of psychiatric medications and familiarity with treatment approaches for insomnia in depression and anxiety. Copyright © 2014 Elsevier Inc. All rights reserved.
Gómez-Durán, Esperanza L; Forti-Buratti, M Azul; Gutiérrez-López, Beatriz; Belmonte-Ibáñez, Anna; Martin-Fumadó, Carles
Suicide is an important Public Health problem. One of the most relevant known risk factors for suicide is suffering from a mental health disorder, identified in up to 90-95% of completed suicides, with this risk being increased if comorbidity is present. Findings from international research on the most common psychiatric disorders are dichotomous, divided into mood disorders and psychotic disorders. In Spain, data of this kind are scarce. This study describes the psychiatric and forensic characteristics of completed suicide cases (n=79) ocurred in a psychiatric hospital healthcare area (in Spain), between 2007 and 2010. The forensic data were obtained from the Institute of Legal Medicine of Catalonia and the clinical data by reviewing the clinical records. Most of the subjects in this sample were males (78.5%, 95% CI; 68.4%-87.3%). Almost half of the sample (45.4%, 95% CI; 33.8%-57.1%, 35/77)