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Grogan K, Bramham J. Demographic, developmental and psychosocial predictors of the development of anxiety in adults with ADHD. ACTA ACUST UNITED AC 2015; 8:35-44. [PMID: 26487156 DOI: 10.1007/s12402-015-0183-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 09/10/2015] [Indexed: 10/22/2022]
Abstract
The purpose of this research was to investigate potential demographic, developmental and psychosocial predictors of anxiety in the context of ADHD. Participants included 267 adults with a diagnosis of ADHD (168 males:99 females) and an age range of 18-70 years (M = 31 years; SD = 10.03 years). A background interview, parent questionnaire and rating scales were used to gather participant information. Correlations, independent t tests and one-way analysis of variances were used to identify variables associated with anxiety, and a stepwise multiple regression was used to identify potential predictors of anxiety. Variables associated with anxiety included childhood aggression, employment status, difficulties making friends, number of children and caffeine intake. Childhood aggression and caffeine intake were the potential predictors. Clinicians should be aware of these potential predictors of anxiety in the context of ADHD in order to minimise the likelihood of the development or maintenance of comorbid anxiety. Future research is needed in order to draw any conclusions on cause and effect.
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Affiliation(s)
- Katie Grogan
- UCD School of Psychology, Newman Building, University College Dublin, Dublin 4, Ireland.
| | - Jessica Bramham
- UCD School of Psychology, Newman Building, University College Dublin, Dublin 4, Ireland
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Morozova M, Rabin RA, George TP. Co-morbid tobacco use disorder and depression: A re-evaluation of smoking cessation therapy in depressed smokers. Am J Addict 2015; 24:687-94. [DOI: 10.1111/ajad.12277] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 07/15/2015] [Accepted: 08/08/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- Marya Morozova
- Biobehavioural Addictions and Concurrent Disorders Research Laboratory (BACDRL); Schizophrenia Division; Centre for Addiction and Mental Health (CAMH); Toronto ON Canada
| | - Rachel A. Rabin
- Biobehavioural Addictions and Concurrent Disorders Research Laboratory (BACDRL); Schizophrenia Division; Centre for Addiction and Mental Health (CAMH); Toronto ON Canada
- Institute of Medical Science; University of Toronto; Toronto ON Canada
| | - Tony P. George
- Biobehavioural Addictions and Concurrent Disorders Research Laboratory (BACDRL); Schizophrenia Division; Centre for Addiction and Mental Health (CAMH); Toronto ON Canada
- Institute of Medical Science; University of Toronto; Toronto ON Canada
- Division of Brain and Therapeutics; Department of Psychiatry; University of Toronto; Toronto ON Canada
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Mañanes G, Vallejo MA, Vallejo-Slocker L. Demographic, psychological and smoking characteristics of users of an on-line smoking cessation programme in the Spanish language. GACETA SANITARIA 2015; 30:18-23. [PMID: 26318722 DOI: 10.1016/j.gaceta.2015.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 07/08/2015] [Accepted: 07/10/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the characteristics of users of a smoking cessation programme run by the Open University of Spain (Universidad Nacional de Educación a Distancia [UNED]). METHODS We examined the demographic, psychological and smoking characteristics of 23,763 smokers who participated in the on-line smoking cessation program of the UNED. The programme was open to any smoker, free of charge, and was fully automated and with direct access. RESULTS A total of 93.5% of the users were Spaniards, with an equal percentage of participation among men and women. The mean age was 39 years. Somewhat less than half were married and had a university education. The participants smoked a mean of 19.3 cigarettes per day, showing a mid-range level of nicotine dependence according to the Heaviness of Smoking Index. The results of the Anxiety and Depression subscales of the Symptom Checklist-90-Revised (SCL-90-R) and Perceived Stress Scale were not clinically significant. In a secondary analysis of the data, we found gender differences in all the variables measured. CONCLUSIONS The results of this study confirm the digital divide, with lower participation among people with a lower educational level. No association was observed between stress, anxiety or depression and cigarette consumption.
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Affiliation(s)
- Guillermo Mañanes
- Faculty of Psychology, National Distance Education University (UNED), Madrid, Spain
| | - Miguel A Vallejo
- Faculty of Psychology, National Distance Education University (UNED), Madrid, Spain.
| | - Laura Vallejo-Slocker
- Faculty of Psychology, Complutense University of Madrid (UCM), Campus of Somosaguas, Madrid, Spain
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Grucza RA, Hur M, Agrawal A, Krauss MJ, Plunk AD, Cavazos-Rehg PA, Chaloupka FJ, Bierut LJ. Medical Marijuana Laws and Suicide. Am J Public Health 2015; 105:e3. [PMID: 26066919 PMCID: PMC4504326 DOI: 10.2105/ajph.2015.302745] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2015] [Indexed: 11/04/2022]
Affiliation(s)
- Richard A Grucza
- Richard A. Grucza, Michael Hur, Arpana Agrawal, Melissa J. Krauss, and Patricia A. Cavazos-Rehg are with the Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. Laura J. Bierut is with the Department of Psychiatry and the Siteman Cancer Center, Washington University School of Medicine. Andrew D. Plunk is with the Department of Pediatrics, Eastern Virginia Medical School, Norfolk. Frank J. Chaloupka is with the Department of Economics and Health Policy Center, University of Illinois at Chicago
| | - Michael Hur
- Richard A. Grucza, Michael Hur, Arpana Agrawal, Melissa J. Krauss, and Patricia A. Cavazos-Rehg are with the Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. Laura J. Bierut is with the Department of Psychiatry and the Siteman Cancer Center, Washington University School of Medicine. Andrew D. Plunk is with the Department of Pediatrics, Eastern Virginia Medical School, Norfolk. Frank J. Chaloupka is with the Department of Economics and Health Policy Center, University of Illinois at Chicago
| | - Arpana Agrawal
- Richard A. Grucza, Michael Hur, Arpana Agrawal, Melissa J. Krauss, and Patricia A. Cavazos-Rehg are with the Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. Laura J. Bierut is with the Department of Psychiatry and the Siteman Cancer Center, Washington University School of Medicine. Andrew D. Plunk is with the Department of Pediatrics, Eastern Virginia Medical School, Norfolk. Frank J. Chaloupka is with the Department of Economics and Health Policy Center, University of Illinois at Chicago
| | - Melissa J Krauss
- Richard A. Grucza, Michael Hur, Arpana Agrawal, Melissa J. Krauss, and Patricia A. Cavazos-Rehg are with the Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. Laura J. Bierut is with the Department of Psychiatry and the Siteman Cancer Center, Washington University School of Medicine. Andrew D. Plunk is with the Department of Pediatrics, Eastern Virginia Medical School, Norfolk. Frank J. Chaloupka is with the Department of Economics and Health Policy Center, University of Illinois at Chicago
| | - Andrew D Plunk
- Richard A. Grucza, Michael Hur, Arpana Agrawal, Melissa J. Krauss, and Patricia A. Cavazos-Rehg are with the Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. Laura J. Bierut is with the Department of Psychiatry and the Siteman Cancer Center, Washington University School of Medicine. Andrew D. Plunk is with the Department of Pediatrics, Eastern Virginia Medical School, Norfolk. Frank J. Chaloupka is with the Department of Economics and Health Policy Center, University of Illinois at Chicago
| | - Patricia A Cavazos-Rehg
- Richard A. Grucza, Michael Hur, Arpana Agrawal, Melissa J. Krauss, and Patricia A. Cavazos-Rehg are with the Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. Laura J. Bierut is with the Department of Psychiatry and the Siteman Cancer Center, Washington University School of Medicine. Andrew D. Plunk is with the Department of Pediatrics, Eastern Virginia Medical School, Norfolk. Frank J. Chaloupka is with the Department of Economics and Health Policy Center, University of Illinois at Chicago
| | - Frank J Chaloupka
- Richard A. Grucza, Michael Hur, Arpana Agrawal, Melissa J. Krauss, and Patricia A. Cavazos-Rehg are with the Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. Laura J. Bierut is with the Department of Psychiatry and the Siteman Cancer Center, Washington University School of Medicine. Andrew D. Plunk is with the Department of Pediatrics, Eastern Virginia Medical School, Norfolk. Frank J. Chaloupka is with the Department of Economics and Health Policy Center, University of Illinois at Chicago
| | - Laura J Bierut
- Richard A. Grucza, Michael Hur, Arpana Agrawal, Melissa J. Krauss, and Patricia A. Cavazos-Rehg are with the Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. Laura J. Bierut is with the Department of Psychiatry and the Siteman Cancer Center, Washington University School of Medicine. Andrew D. Plunk is with the Department of Pediatrics, Eastern Virginia Medical School, Norfolk. Frank J. Chaloupka is with the Department of Economics and Health Policy Center, University of Illinois at Chicago
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Wilkinson AV, Koehly LM, Vandewater EA, Yu RK, Fisher-Hoch SP, Prokhorov AV, Kohl HW, Spitz MR, Shete S. Demographic, psychosocial, and genetic risk associated with smokeless tobacco use among Mexican heritage youth. BMC MEDICAL GENETICS 2015; 16:43. [PMID: 26111525 PMCID: PMC4636823 DOI: 10.1186/s12881-015-0188-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 06/11/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Despite well-established negative health consequences of smokeless tobacco use (STU), the number and variety of alternative non-combustible tobacco products on the market have increased tremendously over the last 10 years, as has the market share of these products relative to cigarettes. While STU among non-Hispanic white youth has decreased over the last 10 years, the prevalence has remained constant among Hispanic youth. Here we examine demographic, psychosocial, and genetic risk associated with STU among Mexican heritage youth. METHODS Participants (50.5 % girls) reported on psychosocial risk factors in 2008-09 (n = 1,087, mean age = 14.3 years), and smokeless tobacco use in 2010-11 (mean age = 16.7 years). Participants provided a saliva sample that was genotyped for genes in the dopamine, serotonin and opioid pathways. RESULTS Overall 62 (5.7 %) participants reported lifetime STU. We identified five single nucleotide polymorphisms that increased the risk for lifetime use. Specifically, rs2023902 on SERGEF (OR = 1.93; 95 % CI: 1.05-3.53), rs16941667 on ALDH2 (OR = 3.14; 95 % CI: 1.65-5.94), and rs17721739 on TPH1 (OR = 1.71; 95 % CI: 1.00-2.91) in the dopamine pathway, rs514912 on TRH-DE (OR = 1.84; 95 % CI: 1.25-2.71) in the serotonin pathway, and rs42451417 on the serotonin transporter gene, SLC6A4 (OR = 3.53; 95 % CI: 1.56-7.97). After controlling for genetic risk, being male (OR = 1.86; 95 % CI: 1.02-3.41), obesity status (OR = 2.22; 95 % CI: 1.21-4.09), and both higher levels of anxiety (OR = 1.04; 95 % CI: 1.01-1.08) and social disinhibition (OR = 1.26; 95 % CI: 1.07-1.48) were associated with increased use. High subjective social status (OR = 0.78; 95 % CI: 0.64-0.93) was protective against use, while higher parental education (OR = 2.01; 95 % CI: 1.03-3.93) was associated with increased use. CONCLUSIONS These data suggest that use of genetic risk, along with psychosocial, demographic, and behavioral risk factors may increase our ability to identify youth at increased risk for STU, which in turn may improve our ability to effectively target prevention messages to Mexican heritage youth.
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Affiliation(s)
- Anna V Wilkinson
- Michael & Susan Dell Center for Healthy Living & The University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin, TX, 78701, USA.
| | - Laura M Koehly
- Social and Behavioral Division, National Human Genome Research Institute, Bethesda, MD, USA.
| | - Elizabeth A Vandewater
- Michael & Susan Dell Center for Healthy Living & The University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin, TX, 78701, USA.
| | - Robert K Yu
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Susan P Fisher-Hoch
- The University of Texas School of Public Health Brownsville Regional Campus, Brownsville, TX, USA.
| | - Alexander V Prokhorov
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Harold W Kohl
- Michael & Susan Dell Center for Healthy Living & The University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin, TX, 78701, USA.
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA.
| | | | - Sanjay Shete
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Peiper N, Clayton R, Wilson R, Illback R, O'Brien E, Kerber R, Baumgartner R, Hornung C. Empirically derived subtypes of serious emotional disturbance in a large adolescent sample. Soc Psychiatry Psychiatr Epidemiol 2015; 50:983-94. [PMID: 25652591 DOI: 10.1007/s00127-015-1017-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 01/27/2015] [Indexed: 12/26/2022]
Abstract
PURPOSE The heterogeneity of serious emotional disturbance has been thoroughly documented among adolescents with nationally representative data derived from structured interviews, although use of these interviews may not be feasible within the context of brief and self-administered school surveys. This study seeks to identify distinct subtypes of serious emotional disturbance in a large school-based sample. METHODS A total of 108,736 students fully completed the K6 scale that was included on the 2012 Kentucky Incentives for Prevention Survey. Latent class analysis was used to derive subtypes of serious emotional disturbance among students receiving a positive screen (n = 15,147). To determine significant predictors of class membership, adjusted rate ratios and 95 % confidence intervals were calculated using multinomial logistic regression. RESULTS A four-class model was the most parsimonious, with four distinct subtypes emerging that varied by both symptom type and severity: comorbid moderate severity, comorbid high severity, anxious moderate severity, and depressed high severity. Age, gender, race/ethnicity, family structure, substance use, antisocial behavior, role impairments, and peer victimization were significant predictors of class membership, although the magnitude of these effects was stronger for the two high severity groups. CONCLUSIONS Our results suggest heterogeneity of serious emotional disturbance by both symptom type and severity. Prevention programs may benefit by shifting focus from specific disorders to the core features of serious emotional disturbance, including psychological distress, high comorbidity, and role impairments.
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Affiliation(s)
- Nicholas Peiper
- Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, USA,
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Berg SA, Sentir AM, Bell RL, Engleman EA, Chambers RA. Nicotine effects in adolescence and adulthood on cognition and α₄β₂-nicotinic receptors in the neonatal ventral hippocampal lesion rat model of schizophrenia. Psychopharmacology (Berl) 2015; 232:1681-92. [PMID: 25388292 PMCID: PMC4412763 DOI: 10.1007/s00213-014-3800-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 10/31/2014] [Indexed: 11/26/2022]
Abstract
RATIONAL Nicotine use in schizophrenia has traditionally been explained as "self-medication" of cognitive and/or nicotinic acetylcholinergic receptor (nAChR) abnormalities. OBJECTIVES We test this hypothesis in a neurodevelopmental rat model of schizophrenia that shows increased addiction behaviors including enhanced nicotine reinforcement and drug-seeking. METHODS Nicotine transdermal patch (5 mg/kg/day vs. placebo × 10 days in adolescence or adulthood) effects on subsequent radial-arm maze learning (15 sessions) and frontal-cortical-striatal nAChR densities (α4β2; [3H]-epibatidine binding) were examined in neonatal ventral hippocampal lesion (NVHL) and SHAM-operated rats. RESULTS NVHL cognitive deficits were not differentially affected by nicotine history compared to SHAMs. Nicotine history produced minimal cognitive effects while increasing food-reward consumption on the maze, compounding with NVHL-induced overconsumption. Acute nicotine (0.5 mg/kg) delivered before the final maze sessions produced modest improvements in maze performance in rats with nicotine patch histories only, but not differentially so in NVHLs. Consistent with in vivo neuroimaging of β2 nAChR binding in schizophrenia smokers vs. non-smokers and healthy controls, adult NVHLs showed 12% reductions in nAChR binding in MPFC (p < 0.05) but not ventral striatum (<5% changes, p > .40), whereas nicotine history elevated nAChRs across both regions (>30%, p < 0.001) without interacting with NVHLs. Adolescent vs. adult nicotine exposure did not alter nAChRs differentially. CONCLUSIONS Although replicating nicotine-induced upregulation of nAChRs in human smokers and demonstrating NVHL validity in terms of schizophrenia-associated nAChR density patterns, these findings do not support hypotheses explaining increased nicotine use in schizophrenia as reflecting illness-specific effects of nicotine to therapeutically alter cognition or nAChR densities.
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Affiliation(s)
- Sarah A Berg
- Laboratory for Translational Neuroscience of Dual Diagnosis & Development, Suite 314D, 320 West 16th Street, Indianapolis, IN, 46202, USA,
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Prochaska JJ, Fromont SC, Ramo DE, Young-Wolff KC, Delucchi K, Brown RA, Hall SM. Gender differences in a randomized controlled trial treating tobacco use among adolescents and young adults with mental health concerns. Nicotine Tob Res 2015; 17:479-85. [PMID: 25762759 PMCID: PMC4402352 DOI: 10.1093/ntr/ntu205] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/26/2014] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Treatment of tobacco use in mental health settings is rare despite high rates of comorbidity. With a focus on early intervention, we evaluated a tobacco treatment intervention among adolescents and young adults recruited from outpatient, school-based, and residential mental health settings and tested for gender differences. METHODS Intervention participants received computerized motivational feedback at baseline, 3 months, and 6 months and were offered 12 weeks of cessation counseling and nicotine patches. Usual care participants received a self-help guide and brief cessation advice. We examined 7-day point prevalence abstinence with biochemical confirmation at 3, 6, and 12 months; smoking reduction; and 24-hr quit attempts. RESULTS At baseline, the sample (N = 60, 52% female, mean age = 19.5±2.9 years, 40% non-Hispanic Caucasian) averaged 7±6 cigarettes/day, 62% smoked daily, 38% smoked ≤ 30 min of waking, 12% intended to quit in the next month, 47% had a parent who smoked, and 3 of 5 of participants' closest friends smoked on average. During the 12-month study, 47% of the sample reduced their smoking, 80% quit for 24 hr, and 11%, 13%, and 17% confirmed 7-day point prevalence abstinence at 3-, 6-, and 12-month follow-up, respectively, with no differences by treatment condition (ps > .400). Over time, abstinence was greater among girls (adjusted odds ratio [AOR] = 8.9) than among boys, and abstinence was greater for lighter smokers than heavier smokers (AOR = 4.5) (p < .05). No mental health or other measured variables predicted abstinence. CONCLUSIONS Adolescent and young adult smokers with mental health concerns are a challenging group to engage and to effectively treat for tobacco addiction, particularly heavier smokers and boys. Innovative approaches are needed.
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Affiliation(s)
- Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA;
| | - Sebastien C Fromont
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Danielle E Ramo
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Kelly C Young-Wolff
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA
| | - Kevin Delucchi
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Richard A Brown
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI
| | - Sharon M Hall
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
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Stickley A, Koyanagi A, Roberts B, Leinsalu M, Goryakin Y, McKee M. Smoking status, nicotine dependence and happiness in nine countries of the former Soviet Union. Tob Control 2015; 24:190-7. [DOI: 10.1136/tobaccocontrol-2014-052092] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
BACKGROUND Contemporary literature suggests that medical education might adversely affect students' mental health. Alfaisal University in Riyadh, Saudi Arabia is a developing institution; hence, there has been a concern regarding the mental well-being of the students. OBJECTIVES This study was designed to assess the traits of depression, anxiety, and stress among students in relation to potential underlying reasons. METHODS All 575 medical students across the 5 years of study participated by filling out the Depression, Anxiety, and Stress Scale-21 (DASS-21) questionnaire anonymously twice. Firstly, 2-3 weeks before a major examination (pre-examination), and secondly, during regular classes (post-examination). Correlation was sought regarding sex, year of scholarship, attendance of a premedical university preparatory program (UPP), housing, and smoking. Subjective comments from students were also obtained. RESULTS A total of 76.8% and 74.9% of students participated in pre-and post-examination groups, respectively. The majority were the children of expatriate workers in Saudi Arabia, and included Arabs, South Asians, and North Americans. Prevalence of depression, anxiety, and stress was high (43%, 63%, and 41%, respectively) which reduced (to 30%, 47%, and 30%, respectively) to some extent after examinations. Saudis and those who had attended UPP had higher DASS-21 scores. Smoking and female sex predicted higher levels of "baseline" depression, anxiety, or stress. The students perceived the curriculum and schedule to be the primary causes of their high DASS-21 scores. CONCLUSION The students had high "baseline" traits of depression, anxiety, and stress, and these were higher if an examination was near, especially among Saudis and those who had attended UPP. Smoking and female sex predicted higher levels of "baseline" depression, anxiety, or stress. Students suggested that study burden and a busy schedule were the major reasons for their high DASS-21 scores.
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Affiliation(s)
- Bibi Kulsoom
- Department of Biochemistry, Alfaisal University, Riyadh, Saudi Arabia
| | - Nasir Ali Afsar
- Department of Pharmacology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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Luger TM, Suls J, Vander Weg MW. How robust is the association between smoking and depression in adults? A meta-analysis using linear mixed-effects models. Addict Behav 2014; 39:1418-29. [PMID: 24935795 DOI: 10.1016/j.addbeh.2014.05.011] [Citation(s) in RCA: 142] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Revised: 04/29/2014] [Accepted: 05/21/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Our objective was to use meta-analytic techniques to assess the strength of the overall relationship and role of potential moderators in the association between smoking and depression in adults. METHODS Two popular health and social science databases (PubMed and PsycINFO) were systematically searched to identify studies which examined the association between adult smoking behavior and major depressive disorder (MDD) or depressive symptoms. A total of 85 relevant studies were selected for inclusion. Studies were analyzed using a linear mixed effects modeling package ("lme4" for R) and the Comprehensive Meta-Analysis program version 2. RESULTS Multiple nested linear mixed-effects models were compared. The best fitting models were those that included only random study effects and smoking status. In cross-sectional studies, current smokers were more likely to be depressed than never smokers (OR=1.50, CI=1.39-1.60), and current smokers were more likely to be depressed than former smokers (OR=1.76, CI=1.48-2.09). The few available prospective studies, that used the requisite statistical adjustments, also showed smokers at baseline had greater odds of incident depression at follow-up than never smokers (OR=1.62, CI=1.10-2.40). CONCLUSIONS In cross-sectional studies, smoking was associated with a nearly two-fold increased risk of depression relative to both never smokers and former smokers. In the smaller set of prospective studies, the odds of subsequent depression were also higher for current than never smokers. Attesting to its robustness, the relationship between smoking and depression was exhibited across several moderators. Findings could help health care providers to more effectively anticipate co-occurring health issues of their patients. Several methodological recommendations for future research are offered.
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Attwood AS, Ataya AF, Bailey JE, Lightman SL, Munafò MR. Effects of 7.5% carbon dioxide inhalation on anxiety and mood in cigarette smokers. J Psychopharmacol 2014; 28:763-72. [PMID: 24763184 PMCID: PMC4986884 DOI: 10.1177/0269881114529378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cigarette smoking is associated with elevated risk of anxiety and mood disorder. Using the 7.5% carbon dioxide (CO2) inhalation model of anxiety induction, we examined the effects of smoking status and abstinence from smoking on anxiety responses. Physiological and subjective responses to CO2 and medical air were compared in smokers and non-smokers (Experiment One) and in overnight abstinent and non-abstinent smokers (Experiment Two). CO2 induced greater increases in blood pressure in non-smokers compared with smokers (ps < 0.043), and greater increases in anxiety (p = 0.005) and negative affect (p = 0.054) in non-abstinent compared with abstinent smokers. CO2 increased physiological and subjective indices of anxiety. There were differences across smoking groups indicating that the CO2 inhalation model is a useful tool for examining the relationship between smoking and anxiety. The findings suggested that both acute smoking and acute abstinence may protect against anxious responding. Further investigation is needed in long-term heavy smokers.
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Affiliation(s)
- Angela S. Attwood
- MRC Integrative Epidemiology Unit, University of Bristol, United Kingdom,UK Centre for Tobacco and Alcohol Studies, United Kingdom,School of Experimental Psychology, University of Bristol, United Kingdom
| | - Alia F. Ataya
- MRC Integrative Epidemiology Unit, University of Bristol, United Kingdom,UK Centre for Tobacco and Alcohol Studies, United Kingdom,School of Experimental Psychology, University of Bristol, United Kingdom
| | - Jayne E. Bailey
- School of Social and Community Medicine, University of Bristol, United Kingdom
| | | | - Marcus R. Munafò
- MRC Integrative Epidemiology Unit, University of Bristol, United Kingdom,UK Centre for Tobacco and Alcohol Studies, United Kingdom,School of Experimental Psychology, University of Bristol, United Kingdom
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Grucza RA, Plunk AD, Krauss MJ, Cavazos-Rehg PA, Deak J, Gebhardt K, Chaloupka FJ, Bierut LJ. Probing the smoking-suicide association: do smoking policy interventions affect suicide risk? Nicotine Tob Res 2014; 16:1487-94. [PMID: 25031313 DOI: 10.1093/ntr/ntu106] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Smokers exhibit elevated risk for suicide, but it is unknown whether smoking interventions reduce suicide risk. We examined whether state-level policy interventions-increases in cigarette excise taxes and strengthening of smoke-free air laws-corresponded to a reduction in suicide risk during the 1990s and the early 2000s. We also examined whether the magnitude of such reductions correlated with individuals' predicted probability of smoking, which would be expected if the associations stemmed from changes in smoking behavior. METHODS We paired individual-level data on suicide deaths from the U.S. Multiple Cause of Death files, years 1990-2004, with living population data from the same period. These were linked with state data on cigarette excise taxes and smoke-free air policies. Utilizing a quasiexperimental analytical approach, we estimated the association between changes in policy and suicide risk. To examine whether associations correlated with individuals' probability of smoking, we used external survey data to derive a predicted probability of smoking function from demographic variables, which was then used to stratify the population by predicted smoking prevalence. RESULTS Cigarette excise taxes, smoke-free air policies, and an index combining the two policies all exhibited protective associations with suicide. The associations were strongest in segments of the population where predicted smoking prevalence was the highest and weaker in segments of the population where predicted smoking prevalence was the lowest, suggesting that the protective associations were related to changes in smoking behavior. CONCLUSION These results provide support for the proposition that population interventions for smoking could reduce risk for suicide.
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Affiliation(s)
- Richard A Grucza
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO;
| | - Andrew D Plunk
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Melissa J Krauss
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | | | - Joseph Deak
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Kacie Gebhardt
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Frank J Chaloupka
- Department of Economics and Health Policy Center, University of Illinois at Chicago, Chicago, IL
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
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Abstract
The prevalence of smoking is higher in patients with psychiatric illness compared with the general population. Smoking causes chronic illnesses, which lead to premature mortality in those with psychiatric illness, is associated with greater burden of psychiatric symptoms, and contributes to the social isolation experienced by individuals with psychiatric disorders. Most patients with a psychiatric illness present initially to primary care rather than specialty care settings, and some patients receive care exclusively in the primary care setting. Therefore, family physicians and other primary care clinicians have an important role in the recognition and treatment of tobacco use disorders in patients with psychiatric illnesses. In this article we review common myths associated with smoking and psychiatric illness, techniques for implementing evidence-based tobacco use treatments, the evidence base for tobacco use treatment for patients with specific psychiatric diagnoses, and factors to consider when treating tobacco use disorders in patients with psychiatric illness.
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Affiliation(s)
- Joseph M Cerimele
- the Department of Psychiatry and Behavioral Sciences, the Department of Family Medicine, School of Medicine, and the Department of Health Services, School of Public Health, University of Washington, Seattle; and the Veteran's Affairs Puget Sound Health Care System, Seattle, WA
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Silberbauer C, Grunbacher E. [Consequences of hospitalisations on smoking behaviour in psychiatric and somatic inpatients]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2014; 28:56-62. [PMID: 24659186 DOI: 10.1007/s40211-014-0102-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 02/22/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND To examine the differences and potential changes that occur in smoking habits among psychiatric and somatic patients due to and during their hospital stay in a general hospital. METHODS Inpatients of three departments (psychiatry,cardiology, pulmology) were given a questionnaire that asked for epidemiologic data and their smoking habits,including the Fagerstrom-Test. In order to achieve sufficient data, the questionnaire was administered twice on two different dates. Primary goal of this examination was to determine a potential change in smoking behaviour whereas the secondary goal was to check for differences between psychiatric and somatic inpatients and within the psychiatric diagnostic groups according to their smoking habits respectively. According to a lack of normal distribution of the data non parametric tests undvisual classifying were used for statistical analysis. RESULTS A substantial proportion (26.4 %) of psychiatric inpatients reported an increase in cigarette consumption or have restarted or newly started smoking cigarettes are due to their admission. On the other hand, none of the somatic patients did so, actually they showed higher proportion of being non-smokers. There were statistically significant differences between psychiatric and somatic patients in two age-groups due to their change in smoking habits and severity of nicotine dependence as measured by the Fagerstrom-test. Among the psychiatric patients sampled, those with schizophrenia and affective disorders showed high prevalence of being highly addicted smokers in 85.7 and 44.4 % respectively. CONCLUSIONS As a result of this small sample and hindered comparability of somatic and psychiatric groups of inpatients further investigations are needed to evaluate the influence of hospitalisations on smoking behaviour and to tailor suitable actions
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