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Xu YE, Barron DA, Sudol K, Zisook S, Oquendo MA. Suicidal behavior across a broad range of psychiatric disorders. Mol Psychiatry 2023; 28:2764-2810. [PMID: 36653675 PMCID: PMC10354222 DOI: 10.1038/s41380-022-01935-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 12/12/2022] [Accepted: 12/16/2022] [Indexed: 01/20/2023]
Abstract
Suicide is a leading cause of death worldwide. In 2020, some 12.2 million Americans seriously contemplated suicide, 3.2 million planned suicide attempts, and 1.2 million attempted suicide. Traditionally, the approach to treating suicidal behavior (SB) has been to treat the "underlying" psychiatric disorder. However, the number of diagnoses associated with SB is considerable. We could find no studies describing the range of disorders reported to be comorbid with SB. This narrative review summarizes literature documenting the occurrence of SB across the lifespan and the full range of psychiatric diagnoses, not only BPD and those that comprise MDE, It also describes the relevance of these observations to clinical practice, research, and nosology. The literature searches contained the terms "suicid*" and each individual psychiatric diagnosis and identified 587 studies. We did not include case reports, case series, studies only addressing suicidal ideation or non-suicidal self-injury (NSSI), studies on self-harm, not distinguishing between SB and NSSI and studies that did not include any individuals that met criteria for a specific DSM-5 diagnosis (n = 366). We found that SB (suicide and/or suicide attempt) was reported to be associated with 72 out of 145 diagnoses, although data quality varied. Thus, SB is not exclusively germane to Major Depressive Episode (MDE) and Borderline Personality Disorder (BPD), the only conditions for which it is a diagnostic criterion. That SB co-occurs with so many diagnoses reinforces the need to assess current and past SB regardless of diagnosis, and supports the addition of charting codes to the DSM-5 to indicate current or past SB. It also comports with new data that specific genes are associated with SB independent of psychiatric diagnoses, and suggests that SB should be managed with specific suicide prevention interventions in addition to treatments indicated for co-occurring diagnoses. SB diagnostic codes would help researchers and clinicians document and measure SB's trajectory and response to treatment over time, and, ultimately, help develop secondary and tertiary prevention strategies. As a separate diagnosis, SB would preclude situations in which a potentially life-threatening behavior is not accounted for by a diagnosis, a problem that is particularly salient when no mental disorder is present, as is sometimes the case.
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Affiliation(s)
- Yingcheng E Xu
- Department of Psychiatry and Behavioral Health, Cooper Medical School of Rowan University and Cooper University Health Care, Camden, NJ, 08103, US
| | - Daniel A Barron
- Corporal Michael J. Crescenz Department of Veterans Affairs Medical Center, Philadelphia, PA, 19104, USA
| | - Katherin Sudol
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, 37212, USA
| | - Sidney Zisook
- Department of Psychiatry, University of California San Diego School of Medicine, San Diego, CA, 92103, USA
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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Kemp K, Poindexter B, Ng MY, Correia V, Marshall BDL, Koinis-Mitchell D, Tolou-Shams M. EARLY IDENTIFICATION OF SUICIDE RISK FACTORS AMONG JUSTICE-INVOLVED YOUTH. CRIMINAL JUSTICE AND BEHAVIOR 2022; 49:730-744. [PMID: 35754948 PMCID: PMC9221642 DOI: 10.1177/00938548211059504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Suicidal thoughts and behaviors among juvenile justice populations are elevated. However, the characteristics of justice-involved youth who consider and attempt suicide are not well understood. This study examined suicidal ideation and attempt with first-time, preadjudicated diverted youth, and the relationship with commonly associated risk factors. The sample included 135 youth (50% male, M age = 14.48) that provided complete responses to self-reported lifetime suicidal ideation and attempt items. Analyses examined relationships between suicidal ideation/attempt and mental health, child welfare involvement, delinquency, self-cutting, and substance use. First time, preadjudicated diverted youth reported high rates of lifetime suicidal ideation (27%) and attempt (17%). Suicidal ideation and attempt were associated with sexually minoritized status and self-cutting, while child welfare involvement was only associated with suicidal ideation. This high-risk population would benefit from refined suicide screening and prevention services not always available to justice-involved youth living in the community.
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Wang L, Yin L, Wang Q, Wang R, Liu Z, Dong M, Duan X, Zheng Y, Hong W, Liu F, Tie C. SPECT findings on neuropsychiatric symptoms caused by nitrous oxide abuse. Front Psychiatry 2022; 13:980516. [PMID: 36465302 PMCID: PMC9714330 DOI: 10.3389/fpsyt.2022.980516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 10/21/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The aim of the study was to investigate the clinical, neuropsychological, and regional cerebral blood flow (rCBF) perfusion changes in patients with neuropsychiatric symptoms caused by nitrous oxide (N2O) abuse. METHODS A total of 16 patients with neuropsychiatric symptoms caused by nitrous oxide abuse were recruited for this study. The study was carried out in the withdrawal phase of N2O abuse. A 925-1110 MBq 99mTc-ECD was administered intravenously. SPECT/CT images were collected with a low-energy and high-resolution collimator. The region uptake statistics of different brain regions of interest between patients with N2O abuse and normal people of the databases for younger subjects from the Scenium DB Comparison software were calculated automatically. RESULTS The clinical manifestations of the 16 patients with neuropsychiatric symptoms were mood lability, anxiety, hallucination, delusion, agitation, confusion, and other psychiatric symptoms. In addition, 15 of the patients also complained of memory decline; 14 patients manifested numbness or paresthesia; 14 patients developed limb weakness, and their motor impairments were more severe in the lower limbs than in the upper limbs; and eight patients had urinary and defecation disturbances. In the neuropsychological examination, the BPRS score was 54.69 ± 11.48, the HAMD score was 30.00 ± 11.06, the HAMA score was 18.06 ± 5.77, the MMSE score was 28.06 ± 2.29, and the MoCA score was 25.06 ± 3.40. SPECT showed hypoperfusion in the frontal and temporal lobes, which is consistent with the clinical findings. CONCLUSION This was the first study to demonstrate the obvious effect of N2O abuse on CBF in patients with neuropsychiatric symptoms. CBF perfusion imaging is helpful to detect the changes in the local brain functional activity in patients with N2O abuse.
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Affiliation(s)
- Li Wang
- Department of Neurology, The First Hospital of Tsinghua University, Beijing, China.,Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Lijie Yin
- Department of Nuclear Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Qian Wang
- Department of Neurology, The First Hospital of Tsinghua University, Beijing, China
| | - Renbin Wang
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Zunjing Liu
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Mingrui Dong
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Xiaohui Duan
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Yumin Zheng
- Department of Nuclear Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Wen Hong
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Fang Liu
- Department of Neurology, The First Hospital of Tsinghua University, Beijing, China
| | - Changle Tie
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
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Crossin R. Exploring the link between adolescent inhalant misuse and suicidal behaviour: a behavioural toxicology perspective. Neurotoxicol Teratol 2021; 88:107038. [PMID: 34678460 DOI: 10.1016/j.ntt.2021.107038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 10/20/2022]
Abstract
Adolescent inhalant misuse has a known association with suicidal thoughts and behaviour. This association persists even after inhalant misuse has ceased. Previous studies have hypothesised that this association may derive from socioeconomic disadvantage or vulnerability, and potentially mediated by impulsivity. This association may also be due to the central nervous system depressant effects of inhalants. This review takes a behavioural toxicology perspective, focussed particularly on the serotonergic system and the Hypothalamic-Pituitary-Adrenal (HPA) axis, as potential links between adolescent inhalant misuse and suicidal behaviour. The challenges of bridging the pre-clinical and clinical literature in this area are discussed, along with promising avenues for future research; ultimately aimed at reducing suicide risk in a vulnerable adolescent population group.
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Affiliation(s)
- Rose Crossin
- Department of Population Health, University of Otago (Christchurch), Christchurch 8140, New Zealand.
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Wiener RC, Waters C, Bhandari R, Shockey A. Epidemiology and Characteristics of People with Injury Due to Volatile Substance Use to Induce Euphoria. Subst Use Misuse 2021; 56:169-173. [PMID: 33090072 PMCID: PMC8086584 DOI: 10.1080/10826084.2020.1833927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Unhealthy substance use is a public health challenge. Much of the focus of interventions is upon narcotics, stimulants, hallucinogens, central nervous system depressants, and alcohol. However, inhalants are also commonly used in an unhealthy manner and are under-recognized. The purpose of this study is to describe incident emergency department visits for volatile substance use to induce euphoria (VSUIE) injuries in the U.S. Methods: Data were obtained from the National Electronic Injury Surveillance System (NEISS) for the years 2015 to 2018. Descriptive frequencies, bivariate analyses using Rao-Scott Chi-Square, and multivariable logistic regression analyses were conducted to describe and examine the association between ED visits and VSUIE. Results: The estimated (weighted) number of VSUIE ED visits during 2015-2018 was 13,130 (95% Confidence Interval, CI: 8,383-17876; Coefficient of variation, CV = 0.18) and accounted for 0.02% of all ED visits. Males were more likely than females (p < .0001), and young adults (ages ≥18 to ≤ 35 years) were more likely than older adults to have a VSUIE ED visit (p <.0001). Conclusion: VSUIE ED visits occur more commonly in young adults than older adults and adolescents. The widespread use of volatile substances to induce euphoria is an under-reported public health issue with life-threatening consequences. Use of volatile substances by adolescents is a particular concern which needs attention and interventions to prevent its initiation.
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Affiliation(s)
- R Constance Wiener
- Department of Dental Practice and Rural Health, West Virginia University, Morgantown, West Virginia, USA
| | - Christopher Waters
- Department of Dental Research, West Virginia University, Morgantown, West Virginia, USA
| | - Ruchi Bhandari
- Department of Epidemiology, West Virginia University, Morgantown, West Virginia, USA
| | - Alcinda Shockey
- Department of Dental Hygiene, West Virginia University, Morgantown, West Virginia, USA
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Baiden P, Xiao Y, Asiedua-Baiden G, LaBrenz CA, Boateng GO, Graaf G, Muehlenkamp JJ. Sex differences in the association between sexual violence victimization and suicidal behaviors among adolescents. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2020. [DOI: 10.1016/j.jadr.2020.100011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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Crossin R, Arunogiri S. Harms associated with inhalant misuse in adolescent females - a review of the pre-clinical and clinical evidence. Drug Alcohol Depend 2020; 216:108232. [PMID: 32862119 DOI: 10.1016/j.drugalcdep.2020.108232] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Inhalant misuse, or the misuse of products containing toluene is common in adolescents, and is associated with diverse physiological and psychological harms. Females comprise over half those who misuse inhalants in adolescence, however, the majority of the evidence has been derived from male-only or mixed-sex studies without exploration of sex differences. Female adolescence is a critical maturational period with potential for growth, reproductive, cognitive and psychological harms that may lead to long-term health consequences. We therefore summarise evidence of female-specific harms arising from inhalant misuse. METHODS We synthesised pre-clinical and clinical studies of inhalant misuse which were conducted in females, or where sex-differences were reported, into a narrative literature review. RESULTS Females experience growth impairments and metabolic dysfunction arising from inhalant misuse, but data on sex-differences are inconclusive. Inhalant misuse in early adolescence may impact menarche and subsequent reproductive capacity, but studies have predominantly focused on the effects of inhalants on offspring rather than on the exposed female. There is limited evidence of sex-differences in relation to cognitive outcomes following exposure to inhalants in pre-clinical models. Females are at an increased risk of psychological harms associated with inhalant misuse, particularly depression and suicidal behaviour. CONCLUSIONS The type and magnitude of harms associated with inhalant misuse are sex-specific, but data are limited. We recommend that both pre-clinical and clinical studies of inhalant misuse include both males and females, and should specifically test for and report sex-differences. This can be used to build an evidence base for screening and interventions tailored to females.
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Affiliation(s)
- Rose Crossin
- Department of Population Health, University of Otago Christchurch campus, 34 Gloucester Street, Christchurch, 8140, New Zealand; Florey Institute of Neuroscience and Mental Health, 30 Royal Parade, Parkville, Melbourne, Victoria, 3052, Australia.
| | - Shalini Arunogiri
- Central Clinical School, Monash Alfred Psychiatry Research Centre, Level 4, 607 St Kilda Road, Melbourne, Victoria, 3004, Australia; Turning Point, Eastern Health, 110 Church Street, Richmond, Melbourne, Victoria, 3121, Australia
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Chien WH, Huang MC, Chen LY. Psychiatric and Other Medical Manifestations of Nitrous Oxide Abuse: Implications From Case Series. J Clin Psychopharmacol 2020; 40:80-83. [PMID: 31809285 DOI: 10.1097/jcp.0000000000001151] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Nitrous oxide (N2O), a commonly used anesthetic agent in dentistry, has emerged as a global public health threat in young population. Although N2O-related neurological sequelae such as spinal cord degeneration and sensorimotor peripheral neuropathy are well known, psychiatric manifestations of heavy N2O use remain unclear. Here, we presented 7 treatment-seeking patients with severe N2O use disorder to delineate the psychiatric profiles of N2O users in Asia. METHODS Seven patients with severe N2O use disorder who sought treatment in Taipei City Psychiatric Center between 2017 and 2018 were enrolled. We used chart review method to retrospectively collect their clinical information including sociodemographics, psychiatric and substance history, urine toxicology findings, and treatment course. RESULTS These N2O users all had diagnoses of severe N2O use disorder. They usually initiated N2O use in late adolescence and early adulthood. Six of them had histories of mood disorders; all of them reported other illicit substance use before using N2O. The main reasons for treatment seeking were irritability, psychotic symptoms, self-harm, or violent behaviors as four of them were given a diagnosis of substance-induced psychotic disorder. Urine drug screen showed negative for other illicit drug use except for 1 positive case for cannabis and 1 for amphetamine. Three of 7 cases were hospitalized because of the severity of their psychiatric symptoms and suicidal risk. CONCLUSIONS These cases with severe N2O use disorder showed high prevalence of psychotic symptoms and dangerous behaviors such as suicide or violence. This study highlights the addiction potential of N2O and its related adverse consequences in the psychiatric aspect.
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Affiliation(s)
- Wan-Hsi Chien
- From the Department of Addiction Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital
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Borschmann R, Janca E, Carter A, Willoughby M, Hughes N, Snow K, Stockings E, Hill NTM, Hocking J, Love A, Patton GC, Sawyer SM, Fazel S, Puljević C, Robinson J, Kinner SA. The health of adolescents in detention: a global scoping review. LANCET PUBLIC HEALTH 2020; 5:e114-e126. [PMID: 31954434 PMCID: PMC7025881 DOI: 10.1016/s2468-2667(19)30217-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/18/2019] [Accepted: 10/18/2019] [Indexed: 12/12/2022]
Abstract
Adolescents detained within the criminal justice system are affected by complex health problems, health-risk behaviours, and high rates of premature death. We did a global synthesis of the evidence regarding the health of this population. We searched Embase, PsycINFO, Education Resources Information Center, PubMed, Web of Science, CINCH, Global Health, the Cochrane Database of Systematic Reviews, the Campbell Library, the National Criminal Justice Reference System Abstract Database, and Google Scholar for peer-reviewed journal articles, including reviews, that reported the prevalence of at least one health outcome (physical, mental, sexual, infectious, and neurocognitive) in adolescents (aged <20 years) in detention, and were published between Jan 1, 1980, and June 30, 2018. The reference lists of published review articles were scrutinised for additional relevant publications. Two reviewers independently screened titles and abstracts, and three reviewed full texts of relevant articles. The protocol for this Review was registered with PROSPERO (CRD42016041392). 245 articles (204 primary research articles and 41 reviews) were included, with most primary research (183 [90%]) done in high-income countries. A high lifetime prevalence of health problems, risks, and conditions was reported in detained adolescents, including mental disorders (0–95%), substance use disorders (22–96%), self-harm (12–65%), neurodevelopmental disabilities (2–47%), infectious diseases (0–34%), and sexual and reproductive conditions (pregnant by age 19 years 20–37%; abnormal cervical screening test result 16%). Various physical and mental health problems and health-risk behaviours are more common among adolescents in detention than among their peers who have not been detained. As the social and structural drivers of poor health overlap somewhat with factors associated with exposure to the criminal justice system, strategies to address these factors could help to reduce both rates of adolescent detention and adolescent health inequalities. Improving the detection of mental and physical disorders, providing appropriate interventions during detention, and optimising transitional health care after release from detention could improve the health outcomes of these vulnerable young people.
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Affiliation(s)
- Rohan Borschmann
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
| | - Emilia Janca
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Annie Carter
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Melissa Willoughby
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Nathan Hughes
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | - Kathryn Snow
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Centre for International Child Health, Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
| | | | - Jane Hocking
- Sexual Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Alexander Love
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - George C Patton
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Royal Children's Hospital, Melbourne, VIC, Australia
| | - Susan M Sawyer
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Royal Children's Hospital, Melbourne, VIC, Australia
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Cheneal Puljević
- Centre for Health Services Research, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Jo Robinson
- Orygen Youth Health, Melbourne, VIC, Australia
| | - Stuart A Kinner
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Mater Research Institute-UQ, University of Queensland, Brisbane, QLD, Australia; Griffith Criminology Institute, Griffith University, Brisbane, QLD, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Casiano H, Bolton SL, Katz LY, Bolton JM, Sareen J. Evaluation of a Suicide Risk Assessment Tool in a Large Sample of Detained Youth. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2019; 28:105-114. [PMID: 31798649 PMCID: PMC6863576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 07/12/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES We evaluated the six-item Inmate Security Assessment (ISA) tool used among detained youth in Manitoba, Canada. METHOD Two hundred and forty-one recorded self-harm incidents among all incarcerated youth occurred between January 1, 2005 and December 31, 2010 (N=5102). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR) and negative likelihood ratio (NLR) for three categories of suicide risk (high, medium, and low) as well as each of the six suicide risk evaluation indicators were determined. Receiver operating characteristic (ROC) curves and area under the curve (AUC) calculations for the three suicide risk levels and the six indicators were created. RESULTS Having at least a low suicide risk level (93.8%) or at least one suicide risk factor (94.6%) provided high sensitivity. Specificity was high if an individual had at least a medium suicide risk level (94.2%) or at least three suicide risk indicators (96.7%). The PPV was low (8.9-16.2%) and the NPV was high (94.9-99.3%) for all suicide risk levels. The most sensitive risk factor for self-harm was a prior history of suicidal behavior or a family history of suicide (94.6%). All risk indicators had a low PPV (7.4-23.1%) and a high NPV (95.4-99.5%). A very low NLR was found for those without prior suicidal behavior or a family history of suicide (0.107). The AUC was 0.719 (95%CI = 0.692-0.746), indicating a fair test. CONCLUSION The ISA is a moderately accurate tool for identifying risk for self-harm in detained youth.
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Affiliation(s)
- Hygiea Casiano
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba
| | - Shay-Lee Bolton
- Departments of Community Health Sciences and Psychiatry, University of Manitoba, Winnipeg, Manitoba
| | - Laurence Y Katz
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba
| | - James M Bolton
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba
| | - Jitender Sareen
- Departments of Psychiatry, Psychology, and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba
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Marsiglia FF, Ayers SL, Kiehne E. Reducing inhalant use in Latino adolescents through synchronized parent-adolescent interventions. J Prev Interv Community 2019; 47:182-197. [PMID: 31021304 PMCID: PMC6980717 DOI: 10.1080/10852352.2019.1603675] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This article presents the effects of a synchronized Latino youth/parent intervention on adolescent inhalant use. The analytic sample included only Latino adolescents (n = 487) between the ages of 12 and 14. Randomized at the school-level, the design included three possible conditions: (1) child and parent received the prevention interventions, (2) only the parent received the prevention intervention, (3) neither child or parent received the prevention interventions. Drawing from the eco-developmental perspective, the overall hypothesis was that youth randomly assigned to the condition with both interventions will report the strongest inhalant use prevention outcomes. Descriptive statistics and regression tests of significant group differences by treatment condition confirmed the overall hypothesis. Children receiving the youth intervention and whose parents received the synchronized parenting intervention reported the strongest desired inhalant prevention effects. The findings are interpreted from an eco-developmental perspective and implications for practice, policy, and future research are discussed.
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Affiliation(s)
- Flavio F Marsiglia
- a Southwest Interdisciplinary Research Center, School of Social Work , Arizona State University , Phoenix , Arizona , USA
| | - Stephanie L Ayers
- a Southwest Interdisciplinary Research Center, School of Social Work , Arizona State University , Phoenix , Arizona , USA
| | - Elizabeth Kiehne
- a Southwest Interdisciplinary Research Center, School of Social Work , Arizona State University , Phoenix , Arizona , USA
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Baiden P, Graaf G, Zaami M, Acolatse CK, Adeku Y. Examining the association between prescription opioid misuse and suicidal behaviors among adolescent high school students in the United States. J Psychiatr Res 2019; 112:44-51. [PMID: 30852426 DOI: 10.1016/j.jpsychires.2019.02.018] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 02/07/2019] [Accepted: 02/21/2019] [Indexed: 12/25/2022]
Abstract
Although some studies have examined the association between prescription opioid misuse and mental health outcomes, few studies have examined the effects of prescription opioid misuse on suicidal behaviors among adolescents. The objective of this study was to examine the association between prescription opioid misuse and suicidal ideation, suicide plan, and suicide attempt among adolescents. Data for this study came from the 2017 Youth Risk Behavior Surveillance System. A sample of 8830 adolescents aged 14-18 years (50.9% female) were analyzed using logistic regression with suicidal ideation, suicide plan, and suicide attempt as outcome variables and prescription opioid misuse as the main explanatory variable. Of the 8830 adolescents, 13.3% ever misused prescription opioids; 17.7% experienced suicidal ideation, 13.3% made a suicide plan, and 6.5% attempted suicide during the past 12 months. In the multivariate logistic regression models, adolescent students who misused prescription opioids were 1.50 times more likely to have experienced suicidal ideation, 1.44 times more likely to have made a suicide plan, and 1.58 times more likely to have attempted suicide during the past 12 months when compared to their counterparts who did not misuse prescription opioids. Other significant predictors of suicidal behaviors include sexual minority, history of sexual assault, traditional bullying and cyberbullying victimization, feeling sad or hopeless, cigarette smoking, and illicit drug use. The findings of the present study demonstrate the harmful effects of prescription opioid misuse and its association with suicidal behaviors among adolescents.
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Affiliation(s)
- Philip Baiden
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St., Box 19129, Arlington, TX, 76019, USA.
| | - Genevieve Graaf
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St., Box 19129, Arlington, TX, 76019, USA
| | - Mariama Zaami
- University of Ghana, Department of Geography & Resource Development, P.O. Box LG 59, Legon, Accra, Ghana
| | - Charles K Acolatse
- University of North Texas Health Science Center, School of Public Health, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
| | - Yvonne Adeku
- University of Ghana, Department of Social Work, P. O. Box LG 419, Legon, Accra, Ghana
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Crossin R, Scott D, Witt KG, Duncan JR, Smith K, Lubman DI. Acute harms associated with inhalant misuse: Co-morbidities and trends relative to age and gender among ambulance attendees. Drug Alcohol Depend 2018; 190:46-53. [PMID: 29981942 DOI: 10.1016/j.drugalcdep.2018.05.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 05/17/2018] [Accepted: 05/17/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Inhalant misuse is the deliberate inhalation of products containing toluene to induce intoxication. Chronic harms associated with inhalant misuse are well described; including alcohol and other drug use, mental health disorders, and suicidal behaviours. However, the nature of the acute harms from inhalants and characteristics of people who experience those harms are not well understood. Therefore, this study aimed to identify the acute harms associated with inhalant misuse attendances, and to determine whether these differ by age or gender. METHODS Ambulance attendance data (Victoria, Australia) from January 2012 to June 2017 were extracted from a database of coded ambulance records. 779 ambulance attendances involving inhalant misuse were identified. Attendance characteristics were categorised by age and gender. Co-morbidities of current mental health, self-harm and suicidal behaviour were assessed, plus the involvement of alcohol and other drugs. RESULTS Overall, attendances related to the acute harms of inhalant misuse have decreased over time, although that trend has reversed from January 2015. Gender differentiated the acute harms associated with inhalant misuse. Males were older and presented with concurrent alcohol and other drug use. Females were younger and presented with concurrent suicidal ideation and self-injury. Attendances for under 15-year-olds are increasing; this age group was over-represented, predominantly female, with a strong association with self-injury. CONCLUSIONS Ambulance presentations related to inhalant misuse were associated with acute and serious harms. This study highlights that the acute treatment needs of those misusing inhalants are complex and may need to be tailored to gender and age groups.
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Affiliation(s)
- Rose Crossin
- Eastern Health Clinical School, Monash University, Box Hill, VIC, 3128, Australia; Florey Institute of Neuroscience and Mental Health, Parkville, VIC, 3052, Australia; Turning Point, Eastern Health, Richmond, VIC, 3121, Australia.
| | - Debbie Scott
- Eastern Health Clinical School, Monash University, Box Hill, VIC, 3128, Australia; Turning Point, Eastern Health, Richmond, VIC, 3121, Australia.
| | - Katrina G Witt
- Eastern Health Clinical School, Monash University, Box Hill, VIC, 3128, Australia; Turning Point, Eastern Health, Richmond, VIC, 3121, Australia.
| | - Jhodie R Duncan
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC, 3052, Australia.
| | - Karen Smith
- Ambulance Victoria, Doncaster, VIC, 3108, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, VIC, 3199, Australia.
| | - Dan I Lubman
- Eastern Health Clinical School, Monash University, Box Hill, VIC, 3128, Australia; Turning Point, Eastern Health, Richmond, VIC, 3121, Australia.
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Abstract
PURPOSE To determine the prevalence of inhalant use in Russian adolescents and to investigate associated psychosocial problems from a gender perspective. METHODS Data on inhalant use and comorbid psychopathology were collected by means of self-reports from 2892 (42.4% boys) sixth to tenth grade students in public schools in Arkhangelsk, Russia. Multivariate analysis of covariance was used to assess differences in the levels of internalizing and externalizing problems in boys and girls, who were non-users and users of inhalants. RESULTS The prevalence of inhalant use was 6.1% among boys and 3.4% among girls. Compared with non-users, inhalant users scored significantly higher on internalizing and externalizing problems, functional impairment and lower on academic motivation, with psychopathology increasing with age. While there were no gender differences for internalizing problems, increased levels of externalizing problems in inhalant users were gender-specific (significantly higher in boys). CONCLUSIONS Inhalant use is related to significantly higher levels of comorbid psychopathology in Russian adolescents. Comprehensive, evidence-based prevention and intervention policies are needed to address inhalant use and its harmful effects.
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Abstract
Inhalant abuse is the intentional inhalation of a volatile substance for the purpose of achieving an altered mental state. As an important, yet underrecognized form of substance abuse, inhalant abuse crosses all demographic, ethnic, and socioeconomic boundaries, causing significant morbidity and mortality in school-aged and older children. This review presents current perspectives on epidemiology, detection, and clinical challenges of inhalant abuse and offers advice regarding the medical and mental health providers' roles in the prevention and management of this substance abuse problem. Also discussed is the misuse of a specific "over-the-counter" dissociative, dextromethorphan.
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Affiliation(s)
- Michael Storck
- Department of Child Psychiatry, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA.
| | - Laura Black
- New York University, Department of Psychiatry, One Park Avenue, 8 th floor, New York, NY 10016, USA
| | - Morgan Liddell
- Department of Child Psychiatry, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA
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Kemp K, Tolou-Shams M, Conrad S, Dauria E, Neel K, Brown L. Suicidal ideation and attempts among court-involved, non-incarcerated youth. JOURNAL OF FORENSIC PSYCHOLOGY PRACTICE 2016; 16:169-181. [PMID: 29142507 PMCID: PMC5682589 DOI: 10.1080/15228932.2016.1172424] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Over the past decade, suicide remains one of the leading causes of death among adolescents and a public health priority. Court-involved non-incarcerated juvenile justice youth frequently present with risk factors for suicide. Among these court-involved youth, 14% (n=50) endorsed a lifetime history of suicide ideation and attempts. Three main factors were associated with increased risk: prior offense, substance use, and childhood sexual abuse histories. This study highlights the importance of understanding suicidal behavior among non-detained juvenile justice populations. Community-based court involvement provides a rare opportunity to coordinate screening and suicide prevention efforts for youth and their families.
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Affiliation(s)
- Kathleen Kemp
- Bradley/Hasbro Children’s Research Center/Rhode Island Hospital and the Warren Alpert Medical School of Brown University, 1 Hoppin Street, Suite 204, Providence, RI 02903
| | - Marina Tolou-Shams
- Bradley/Hasbro Children’s Research Center/Rhode Island Hospital and the Warren Alpert Medical School of Brown University, 1 Hoppin Street, Suite 204, Providence, RI 02903
| | - Selby Conrad
- Bradley/Hasbro Children’s Research Center/Rhode Island Hospital and the Warren Alpert Medical School of Brown University, 1 Hoppin Street, Suite 204, Providence, RI 02903
| | - Emily Dauria
- Bradley/Hasbro Children’s Research Center/Rhode Island Hospital and the Warren Alpert Medical School of Brown University, 1 Hoppin Street, Suite 204, Providence, RI 02903
| | - Kira Neel
- Bradley/Hasbro Children’s Research Center/Rhode Island Hospital and the Warren Alpert Medical School of Brown University, 1 Hoppin Street, Suite 204, Providence, RI 02903
| | - Larry Brown
- Bradley/Hasbro Children’s Research Center/Rhode Island Hospital and the Warren Alpert Medical School of Brown University, 1 Hoppin Street, Suite 204, Providence, RI 02903
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17
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Radeloff D, Lempp T, Rauf A, Bennefeld-Kersten K, Kettner M, Freitag CM. [Suicide and suicide tendencies in adolescent detainees]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2016; 44:9-18; quiz 19-20. [PMID: 26864223 DOI: 10.1024/1422-4917/a000394] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Following accidents, suicide is the second leading cause of death in adolescence. This stage of life has the most suicide attempts of all age groups. In addition to mentally ill juveniles, adolescent delinquents represent a high-risk group for suicidal behavior and completed suicide. In particular, the population of detainees, an extreme form of juvenile delinquency, have a 16- to 18-fold higher risk of suicidal behavior and suicide compared to the general population. Because the composition of juvenile detainees differs greatly from that of detained adults, age-specific scientific approaches and prevention programs are needed. This task cannot be addressed by juvenile detention staff alone, but rather demands close cooperation between adolescent psychiatrists, psychologists, prison medical staff, legal experts and prison officers to use the opportunity for suicide prevention in juvenile detention facilities.
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Affiliation(s)
- Daniel Radeloff
- 1 Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Klinikum der Goethe-Universität Frankfurt am Main
| | - Thomas Lempp
- 1 Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Klinikum der Goethe-Universität Frankfurt am Main
| | - Amna Rauf
- 1 Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Klinikum der Goethe-Universität Frankfurt am Main
| | | | - Mattias Kettner
- 3 Institut für Rechtsmedizin, Klinikum der Goethe-Universität Frankfurt am Main
| | - Christine M Freitag
- 1 Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Klinikum der Goethe-Universität Frankfurt am Main
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18
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Stokes ML, McCoy KP, Abram KM, Byck GR, Teplin LA. Suicidal Ideation and Behavior in Youth in the Juvenile Justice System: A Review of the Literature. JOURNAL OF CORRECTIONAL HEALTH CARE 2016; 21:222-42. [PMID: 26084946 DOI: 10.1177/1078345815587001] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Suicide is prevalent among youth, especially those involved in the juvenile justice system. Although many studies have examined suicidal ideation and behavior in delinquent youth, prevalence rates vary widely. This article reviews studies of suicidal ideation and behavior in youth in the juvenile justice system, focusing on the point of contact: incarceration status and stage of judicial processing. Suicidal ideation and behavior are prevalent and increase with greater involvement in the juvenile justice system. Depression, sexual abuse, and trauma were the most commonly identified predictors of suicidal ideation and behavior. Prevalence rates of suicidal ideation and behavior vary by gender and race/ethnicity, indicating the need for gender-specific and culturally relevant interventions.
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Affiliation(s)
- Marquita L Stokes
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kathleen P McCoy
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Karen M Abram
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Gayle R Byck
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Linda A Teplin
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Snyder SM, Howard MO. Patterns of Inhalant Use among Incarcerated Youth. PLoS One 2015; 10:e0135303. [PMID: 26333159 PMCID: PMC4557982 DOI: 10.1371/journal.pone.0135303] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 07/20/2015] [Indexed: 11/18/2022] Open
Abstract
Inhalant use is especially prevalent among antisocial youth and can have serious health consequences. However, the extant literature has not investigated how use of various inhalants may co-occur among incarcerated youth. This study begins to address this gap in the literature by using latent class analyses to form distinct typologies of inhalant use. Study participants were residents (N = 723) of 27 Missouri Division of Youth Services facilities. Interviews assessed psychiatric symptoms, antisocial traits, delinquency, trauma, suicidality, and substance use behaviors. The mean age of the mostly male, ethnically diverse sample was 15.5 (S.D. = 1.2) years old. The study revealed the following classes of inhalant use: (1) severe polyinhalant use; (2) moderate polyinhalant use; (3) gas and permanent marker use; and (4) low-use. Compared to the low-use class, members of the severe polyinhalant use class had experienced more than double the rate of head injuries, the highest rates of traumatic experiences, and the highest rates of mental illness diagnoses. The gas and markers class had the highest rate of reporting hearing voices, followed by the severe polyinhalant use class, and the moderate polyinhalant use class. Results of this study underscore the need to address the high rate of head injuries and mental health diagnoses that contribute to severe polyinhalant use.
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Affiliation(s)
- Susan M. Snyder
- School of Social Work, Georgia State University, Atlanta, GA, United States of America
- * E-mail:
| | - Matthew O. Howard
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
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20
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Kim S, Kim H, Seo DC, Lee DH, Cho HI. Suicidal Ideation and its Correlates among Juvenile Delinquents in South Korea. Osong Public Health Res Perspect 2014; 5:258-65. [PMID: 25389511 PMCID: PMC4225588 DOI: 10.1016/j.phrp.2014.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 08/24/2014] [Accepted: 08/25/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES This study investigated suicidal ideation and its correlates among juvenile delinquents in South Korea. METHODS Suicidal ideation, psychological health status, and health-related behaviors were assessed using a self-administered questionnaire in 1682 juvenile offenders aged between 15 and 18 years in 2012. RESULTS The prevalence of suicidal ideation in juvenile delinquents was 15.2%. Girls were more likely to report suicidal thoughts than boys (30.3% vs. 12.7%). Suicidal ideation was more common among adolescents who were not living with their family prior to entering detention centers (22.6% vs. 13.2%) than their counterparts. The likelihood of suicidal ideation was significantly associated with problem drinking [odds ratio (OR) = 1.84], psychedelic drug use (OR = 2.04), feeling unhappy (OR = 3.05), feeling sad or depressed (OR = 13.37) after controlling for sociodemographic factors, other health behaviors and perceptions. CONCLUSION The present study provides evidence for an association between suicidal ideation and psychological health and health risk behaviors among juvenile delinquents. It also highlights the importance of mental health and behavioral interventions for this population to prevent suicidality.
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Affiliation(s)
- Suyoung Kim
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea
| | - Hyekyeong Kim
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea
| | - Dong-Chul Seo
- Department of Health Education and Management, Ewha Womans University, Seoul, Korea
| | - Dong Hwan Lee
- Juvenile Division, Ministry of Justice, Seoul, Korea
| | - Han-Ik Cho
- Korea Association of Health Promotion, College of Medicine, Seoul National University, Seoul, Korea
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21
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Silva-Oliveira F, Jorge KO, Ferreira EFE, Vale MP, Kawachi I, Zarzar PM. The prevalence of inhalant use and associated factors among adolescents in Belo Horizonte, Brazil. CIENCIA & SAUDE COLETIVA 2014; 19:881-90. [DOI: 10.1590/1413-81232014193.07542013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 09/15/2013] [Indexed: 11/22/2022] Open
Abstract
The scope of this study was to establish the prevalence of inhalant use among adolescents and its association with marijuana use, alcohol consumption, socioeconomic status and gender. A cross-sectional study was performed with a representative sample of 891 adolescents from public and private schools in the city of Belo Horizonte, Brazil. Data were collected using two self-administered questionnaires: the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the Alcohol Use Disorders Identification Test (AUDIT C). The socioeconomic status was evaluated using the Social Vulnerability Index, mother's education level and type of school (public or private). The data were analyzed using the chi-square test (p < 0.05) and logistic regression analysis. The prevalence of inhalant use was 7.9%. No significant association was found between the use of inhalants and socioeconomic status after the logistic regression analysis. Inhalant use among adolescents was associated with marijuana use (OR: 4.61; 95% CI: 2.27 - 9.36) and with binge drinking (OR: 5.02; 95% CI: 2.57 - 9.81).
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22
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Bhatta MP, Jefferis E, Kavadas A, Alemagno SA, Shaffer-King P. Suicidal behaviors among adolescents in juvenile detention: role of adverse life experiences. PLoS One 2014; 9:e89408. [PMID: 24586756 PMCID: PMC3933541 DOI: 10.1371/journal.pone.0089408] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 01/20/2014] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of this study was to assess the influence of multiple adverse life experiences (sexual abuse, homelessness, running away, and substance abuse in the family) on suicide ideation and suicide attempt among adolescents at an urban juvenile detention facility in the United States. MATERIALS AND METHODS The study sample included a total of 3,156 adolescents processed at a juvenile detention facility in an urban area in Ohio between 2003 and 2007. The participants, interacting anonymously with a voice enabled computer, self-administered a questionnaire with 100 items related to health risk behaviors. RESULTS Overall 19.0% reported ever having thought about suicide (suicide ideation) and 11.9% reported ever having attempted suicide (suicide attempt). In the multivariable logistic regression analysis those reporting sexual abuse (Odds Ratio = 2.75; 95% confidence interval = 2.08-3.63) and homelessness (1.51; 1.17-1.94) were associated with increased odds of suicide ideation, while sexual abuse (3.01; 2.22-4.08), homelessness (1.49; 1.12-1.98), and running away from home (1.38; 1.06-1.81) were associated with increased odds of a suicide attempt. Those experiencing all four adverse events were 7.81 times more likely (2.41-25.37) to report having ever attempted suicide than those who experienced none of the adverse events. CONCLUSIONS Considering the high prevalence of adverse life experiences and their association with suicidal behaviors in detained adolescents, these factors should not only be included in the suicide screening tools at the intake and during detention, but should also be used for the intervention programming for suicide prevention.
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Affiliation(s)
- Madhav P. Bhatta
- Department of Biostatistics, Environmental Health Sciences and Epidemiology, College of Public Health, Kent State University, Kent, Ohio, United States of America
| | - Eric Jefferis
- Department of Social and Behavioral Sciences, College of Public Health, Kent State University, Kent, Ohio, United States of America
| | - Angela Kavadas
- Department of Social and Behavioral Sciences, College of Public Health, Kent State University, Kent, Ohio, United States of America
| | - Sonia A. Alemagno
- Department of Health Policy and Management, College of Public Health, Kent State University, Kent, Ohio, United States of America
| | - Peggy Shaffer-King
- Department of Social and Behavioral Sciences, College of Public Health, Kent State University, Kent, Ohio, United States of America
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Beckley JT, Woodward JJ. Volatile solvents as drugs of abuse: focus on the cortico-mesolimbic circuitry. Neuropsychopharmacology 2013; 38:2555-67. [PMID: 23954847 PMCID: PMC3828545 DOI: 10.1038/npp.2013.206] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 08/12/2013] [Accepted: 08/13/2013] [Indexed: 12/15/2022]
Abstract
Volatile solvents such as those found in fuels, paints, and thinners are found throughout the world and are used in a variety of industrial applications. However, these compounds are also often intentionally inhaled at high concentrations to produce intoxication. While solvent use has been recognized as a potential drug problem for many years, research on the sites and mechanisms of action of these compounds lags behind that of other drugs of abuse. In this review, we first discuss the epidemiology of voluntary solvent use throughout the world and then consider what is known about their basic pharmacology and how this may explain their use as drugs of abuse. We next present data from preclinical and clinical studies indicating that these substances induce common addiction sequelae such as dependence, withdrawal, and cognitive impairments. We describe how toluene, the most commonly studied psychoactive volatile solvent, alters synaptic transmission in key brain circuits such as the mesolimbic dopamine system and medial prefrontal cortex (mPFC) that are thought to underlie addiction pathology. Finally, we make the case that activity in mPFC circuits is a critical regulator of the mesolimbic dopamine system's ability to respond to volatile solvents like toluene. Overall, this review provides evidence that volatile solvents have high abuse liability because of their selective effects on critical nodes of the addiction neurocircuitry, and underscores the need for more research into how these compounds induce adaptations in neural circuits that underlie addiction pathology.
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Affiliation(s)
- Jacob T Beckley
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC, USA,Center for Drug and Alcohol Programs, Department of Psychiatry/Neurosciences, Medical University of South Carolina, Charleston, SC, USA
| | - John J Woodward
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC, USA,Center for Drug and Alcohol Programs, Department of Psychiatry/Neurosciences, Medical University of South Carolina, Charleston, SC, USA,Department of Neurosciences, Medical University of South Carolina, IOP 4 North, 67 President Street, MSC 861, Charleston, SC 29425, USA, Tel: +(843) 792 5225, Fax: +(843) 792 7353, E-mail:
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Casiano H, Katz LY, Globerman D, Sareen J. Suicide and Deliberate Self-injurious Behavior in Juvenile Correctional Facilities: A Review. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2013; 22:118-24. [PMID: 23667357 PMCID: PMC3647627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 09/06/2012] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Describe the rates of suicidal ideation, self-injury, and suicide among detained youth as well as risk factors and preventive measures that have been attempted. METHOD Literature searches in PubMed, PsycINFO, and the Social Science Citation Index were undertaken to identify published studies written in English. Governmental data was also included from English-speaking nations. RESULTS The adjusted risk of suicide was 3 to 18 times higher than age-matched controls. The prevalence of lifetime suicidal ideation ranged from 16.9% to 59% while lifetime self-injury ranged from 6.2% to 44%. Affective disorders, borderline personality traits, substance use disorders, impulse control disorders, and anxiety disorders were associated with suicidal thoughts and self-injury. Screening for suicidal ideation upon entry was associated with a decreased rate of suicide. CONCLUSIONS All youth should be screened upon admission. Identified co-morbid disorders should also be treated.
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Affiliation(s)
- Hygiea Casiano
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba
| | - Laurence Y. Katz
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba
| | - Daniel Globerman
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba
| | - Jitender Sareen
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba
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Volatile substance misuse : clinical considerations, neuropsychopharmacology and potential role of pharmacotherapy in management. CNS Drugs 2012; 26:927-35. [PMID: 23018545 DOI: 10.1007/s40263-012-0001-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Volatile substance misuse is among the most prevalent and toxic forms of psychoactive drug use, and often results in highly deleterious social, psychological and medical consequences. The prevalence of this pernicious form of substance misuse owes in part to the fact that volatile substances of misuse are ubiquitous in the natural environment. Commonly misused commercial products include glue, shoe polish, nail polish remover, butane lighter fluid, gasoline and computer duster spray. National samples of volatile substance misusers tend to exhibit high rates of psychiatric problems and antisocial behaviour. In addition, cognitive impairments and affective dysregulation are often observed among these individuals. Volatile substances exert their complex neuropharmacological effects on dopaminergic, glutamatergic, GABAergic and serotoninergic receptor systems, as well as on cell membranes and ion channels. Concomitantly, pharmacotherapies for volatile substance abuse might profitably target a number of mechanisms, including reward circuitry in the brain, symptoms of craving and withdrawal, neuropsychiatric and emotional impairments that promote volatile substance abuse, and cognitive enhancement to rectify deficits in executive function. This review details the modes of use, subjective effects, epidemiology, adverse consequences, neuropsychopharmacology and drug treatment of volatile substance misuse, and discusses the potential role of novel forms of pharmacological intervention for this oft-overlooked public health threat of epidemic proportions.
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Reyes JC, Negrón JL, Colón HM, Padilla AM, Millán MY, Matos TD, Robles RR. The emerging of xylazine as a new drug of abuse and its health consequences among drug users in Puerto Rico. J Urban Health 2012; 89:519-26. [PMID: 22391983 PMCID: PMC3368046 DOI: 10.1007/s11524-011-9662-6] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
During the last decade, the veterinary anesthetics have gained popularity as recreational drugs. The aim of this study was to document the use of "anestecia de caballo" (xylazine) and its consequences among drug users in Puerto Rico. The study combined a cross-sectional survey with 89 drug users and two focus groups conducted in Mayagüez with frontline drug treatment providers. Drug users were recruited from communities of the San Juan metropolitan area using a variety of ethnographic and outreach strategies. A short questionnaire developed for the study collected information on sociodemographics, xylazine use, and its consequences. The two focus groups were conducted to discuss the details related to xylazine use, its consequences, and utilization awareness. The sample comprised 63 males (70.8%) and 26 females with a mean age of 37.2 years. The mean number of years of drug use was 14.3, with a mean frequency of drug use of 5.9 times daily. More than 65% reported speedball as the principal drug of use. The prevalence of xylazine use was 80.7%. More than 42% of the sample used xylazine in a mixture with speedball. The main route of administration of xylazine was injection but 14% reported the use of xylazine by inhalation. More than 35% of the sample reported skin lesions and 21.1% reported at least one overdose episode. Multiple logistic regression analysis revealed that males (OR = 3.47, CI = 1.10-12.00) and those who reported speedball as their main drug of use (OR = 9.34, CI = 2.51-34.70) were significantly more likely to be xylazine users. Focus groups revealed that drug users claimed to recognize the presence of xylaxine in a mixture of speedball based on its effects, taste, the color of the drug (dark brown), and its odor. In conclusion, the use of xylazine among drug users in Puerto Rico seems to be an emerging trend with potentially serious health consequences.
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Affiliation(s)
- J C Reyes
- Medical Science Campus Universidad de Puerto Rico, San Juan, Puerto Rico.
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27
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Inhalant abuse of computer cleaner manifested as angioedema. Am J Emerg Med 2012; 30:265.e3-5. [DOI: 10.1016/j.ajem.2010.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 12/10/2010] [Indexed: 11/19/2022] Open
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Rossi R, Suadoni F, Pieroni L, De-Giorgio F, Lancia M. Two Cases of Acute Propane/Butane Poisoning in Prison. J Forensic Sci 2011; 57:832-4. [DOI: 10.1111/j.1556-4029.2011.02003.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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29
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Dingwall KM, Cairney S. Detecting psychological symptoms related to substance use among Indigenous Australians. Drug Alcohol Rev 2011; 30:33-9. [PMID: 21219495 DOI: 10.1111/j.1465-3362.2010.00194.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND AIMS Substance misuse and psychological comorbidities can be common and may impact negatively on treatment outcomes. However, without appropriate tools, detecting psychological symptoms for Indigenous people can be difficult. This study assessed the appropriateness of an eight-item screening tool (based on Strong Souls) for measuring any relationships between substance use and psychiatric symptoms for Indigenous Australians. DESIGN AND METHODS Indigenous Australians attending secondary or tertiary education institutions or substance use rehabilitation facilities in the Northern Territory (n = 407; mean age = 27.82) were assessed for depressive, anxiety and psychotic symptoms. The group represented 45 language groups from 95 urban and remote communities. English comprehension was measured on a scale from 0 (no understanding) to 10 (excellent understanding; M = 7.99, SD = 2.31). Ordinal regression analyses examined any associations between demographic and substance use factors and psychological symptoms. RESULTS Compared with non-users, current cannabis users were significantly more likely [odds ratios (ORs) = 2.2-4.4] to experience depressive or anxiety symptoms. Frequent cannabis users experienced more symptoms than occasional users. Prior-inhalant users were more likely to feel lonely (OR = 2.18) compared with non-inhalant users. Frequent alcohol users were less likely (OR = 0.44) to feel sad than non-users. These results are interpreted with respect to previous research and methodological limitations. DISCUSSION AND CONCLUSIONS Symptoms of depression or anxiety may be common for individuals seeking treatment for substance misuse and with minor improvement, these eight-items may provide a useful screen for psychological symptoms in Indigenous Australians.
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Affiliation(s)
- Kylie M Dingwall
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, Australia.
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Howard MO, Bowen SE, Garland EL, Perron BE, Vaughn MG. Inhalant use and inhalant use disorders in the United States. Addict Sci Clin Pract 2011; 6:18-31. [PMID: 22003419 PMCID: PMC3188822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
More than 22 million Americans age 12 and older have used inhalants, and every year more than 750,000 use inhalants for the first time. Despite the substantial prevalence and serious toxicities of inhalant use, it has been termed "the forgotten epidemic." Inhalant abuse remains the least-studied form of substance abuse, although research on its epidemiology, neurobiology, treatment, and prevention has accelerated in recent years. This review examines current findings in these areas, identifies gaps in the research and clinical literatures pertaining to inhalant use, and discusses future directions for inhalant-related research and practice efforts.
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Affiliation(s)
- Matthew O Howard
- University of North Carolina, Chapel Hill, North Carolina 27599, USA.
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Perron BE, Vaughn MG, Howard MO, Bohnert A, Guerrero E. Item response theory analysis of DSM-IV criteria for inhalant-use disorders in adolescents. J Stud Alcohol Drugs 2011; 71:607-14. [PMID: 20553671 DOI: 10.15288/jsad.2010.71.607] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Inhalants are a serious public health concern and a dangerous form of substance use. An important unresolved issue in the inhalant literature concerns the validity of inhalant-use diagnoses and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, distinction between inhalant abuse and inhalant dependence. To address these limitations and provide the foundation for helping build stronger diagnostic and assessment tools related to inhalant problems, this study examined the dimensionality of the criteria set and the abuse-dependence distinction using item response theory (IRT) analysis. METHOD This study used data from a survey of the population of Missouri Division of Youth Services' residents of the residential treatment system. The current study focused on adolescents and young adults who reported a lifetime history of inhalant use (N = 279). RESULTS The results from the IRT analysis showed no consistent hierarchical ordering of abuse and dependence criteria, providing strong evidence against the abuse-dependence distinction. The abuse criterion of legal problems associated with use represented the item with the highest level of inhalant severity. The dependence criterion that was related to giving up important social, occupational, or recreational activities provided the most accurate discrimination between individuals at different levels of severity. CONCLUSIONS Inhalant-use disorders are best represented using a dimensional versus a categorical approach. IRT analysis provides guidance for selecting criteria that can be useful for brief assessments of inhalant-use problems.
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Affiliation(s)
- Brian E Perron
- School of Social Work, University of Michigan, 1080 South University Avenue, #3849, Ann Arbor, Michigan 48109-1106, USA.
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Vaszari JM, Bradford S, Callahan O'Leary C, Ben Abdallah A, Cottler LB. Risk factors for suicidal ideation in a population of community-recruited female cocaine users. Compr Psychiatry 2011; 52:238-46. [PMID: 21497216 PMCID: PMC3806049 DOI: 10.1016/j.comppsych.2010.07.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Revised: 06/25/2010] [Accepted: 07/09/2010] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Suicide, as the 11th leading cause of death in America, is a significant public health concern. Previous studies have shown that drug users are a population at especially high risk for suicidal ideation (SI). Although most people who think about killing themselves do not ultimately commit suicide, identifying those at risk for such thoughts is important. METHODS In this analysis, data from a sample of 462 cocaine-using women (87% African American) recruited using street outreach methods for a National Institute on Drug Abuse-funded study were examined to identify risk factors for lifetime SI. Sociodemographic factors, adverse childhood experiences, sexual behaviors, psychiatric comorbidities, and drug abuse and dependence were examined as potential risk factors using both bivariate and logistic regression analysis. RESULTS Fifty percent of the sample met at least one criterion for lifetime SI, and 32% of the sample reported a lifetime suicide attempt. In the final logistic regression model, childhood physical abuse, childhood sexual abuse, rape after the age of 15 years, posttraumatic stress disorder, and number of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, depression criteria met emerged as significant independent predictors of lifetime SI. CONCLUSION These findings identify important risk factors for SI among female substance abusers in community settings.
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Affiliation(s)
- John M Vaszari
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63108, USA.
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Neumark Y, Bar-Hamburger R. Volatile substance misuse among youth in Israel: results of a national school survey. Subst Use Misuse 2011; 46 Suppl 1:21-6. [PMID: 21609141 DOI: 10.3109/10826084.2011.580175] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Volatile substance misuse (VSM) among Israeli youth has been identified as widespread and growing. Using data from the 2009 National School Survey of 12-18 year olds (N = 7,166), this study describes VSM prevalence among Jews and Arabs, examining relationships between past-month VSM and sociodemographic, behavioral, psychological, and interpersonal characteristics. Past-month VSM, reported by 7.5% of respondents, was significantly associated with other risky behaviors including past-month illicit drug use (Adjusted odds ratios (AOR) = 5.41, 95% CI: 3.5-8.1), Internet gambling (AOR = 2.12, 95% CI: 1.5-3.1), smoking, binge drinking, and truancy. National drug policy must address VSM and develop strategies to reduce demand and supply. Potential study limitations are noted.
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Affiliation(s)
- Yehuda Neumark
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel.
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Abstract
Volatile substance misuse (VSM) is prevalent in the United States and associated with manifold deleterious outcomes. This review summarizes research on: (1) the prevalence of VSM in the United States and its trends since 1975, (2) population subgroups at an elevated risk for VSM, (3) key correlates of VSM, (4) psychosocial consequences of VSM, including emerging public health threats, and (5) etiological and contextual considerations of VSM use. Implications for future research and practice with volatile substance misusers in the United States are identified.
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Affiliation(s)
- Eric L Garland
- Trinity Institute for the Addictions, College of Social Work, Florida State University, Tallahassee, Florida, USA
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Cruz SL. The latest evidence in the neuroscience of solvent misuse: an article written for service providers. Subst Use Misuse 2011; 46 Suppl 1:62-7. [PMID: 21609148 DOI: 10.3109/10826084.2011.580215] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This work reviews preclinical and clinical studies published during the past two decades on the cellular and behavioral effects of commonly misused solvents. In animals, acute solvent exposure produces motor impairment and antidepressant- and anxiolytic-like effects. Human intoxication from misusing solvents is similar to that of ethanol; however, hallucinations and sudden sniffing death may occur at high solvent concentrations. Among chronic misusers, there is evidence of impaired memory, increased prevalence of psychiatric disorders, and neurological damage. Solvents facilitate inhibitory neurotransmission and block excitatory mechanisms. Toluene, in particular, increases brain dopamine levels and its effects occur at concentrations that do not dissolve cell membranes; therefore, neuronal damage is not an immediate, unavoidable consequence of solvent misuse.
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Affiliation(s)
- Silvia L Cruz
- Departamento de Farmacobiología, Cinvestav, Mexico DF, Mexico.
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Zubaran C, Foresti K, Thorell MR, Franceschini P, Homero W. Depressive Symptoms in Crack and Inhalant Users in Southern Brazil. J Ethn Subst Abuse 2010; 9:221-36. [PMID: 20737347 DOI: 10.1080/15332640.2010.501626] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Carlos Zubaran
- a University of Western Sydney & Sydney West Area Health Service , New South Wales, Australia
| | - Katia Foresti
- b Sydney West Area Health Service , New South Wales, Australia
| | | | - Paulo Franceschini
- c Hospital Santa Casa de Misericórdia , Porto Alegre, Rio Grand do Sul, Brazil
| | - Wagner Homero
- d University of Caxias do Sul , Rio Grand do Sul, Brazil
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Howard MO, Perron BE, Vaughn MG, Bender KA, Garland E. Inhalant use, inhalant-use disorders, and antisocial behavior: findings from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). J Stud Alcohol Drugs 2010; 71:201-9. [PMID: 20230717 DOI: 10.15288/jsad.2010.71.201] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Few studies have explored the topography of antisocial behavior in a nationally representative sample of inhalant users. We examined (a) the lifetime prevalence of 20 childhood and adult antisocial behaviors in inhalant users with inhalant-use disorders (IUD+) and without IUDs (IUD-); (b) the nature and strength of associations between inhalant use, IUDs, and specific antisocial behaviors in multivariate analyses; and (c) the relationships between inhalant use, IUDs, and antisocial behaviors in a national sample of adults with antisocial personality disorder. METHOD The National Epidemiologic Survey on Alcohol and Related Conditions was a multistage national survey of 43,093 U.S. residents. Respondents completed a structured psychiatric interview. RESULTS IUD+ and IUD- respondents were significantly younger and more likely to be unemployed, to be male, to have never married, and to report family and personal histories of alcohol and drug problems than inhalant nonusers. Family histories of alcohol problems and personal histories of drug problems were significantly more prevalent among IUD+ respondents, compared with IUD- respondents. In bivariate analyses, IUD+ and IUD- respondents evidenced significantly higher lifetime levels of all childhood and adult antisocial behaviors than inhalant nonusers. IUD+ respondents were significantly more likely than their IUD- counterparts to report bullying behavior, starting physical fights, using dangerous weapons, physical cruelty to people, staying out all night without permission, running away, and frequent truancy in childhood, as well as greater deceitfulness, impulsivity, irritability/aggressiveness, recklessness, and irresponsibility in adulthood. Multivariate analyses indicated that IUD+ respondents had a significantly elevated risk for childhood and adult antisocial behaviors, compared with inhalant nonusers, with the strongest effects for using dangerous weapons, physical cruelty to animals, and physical cruelty to people. Similarly, IUD+ respondents differed significantly from their IUD- counterparts primarily across measures of interpersonal violence. Among persons with antisocial personality disorder, inhalant use and IUDs were associated with greater antisocial behavior, albeit with fewer and weaker effects. CONCLUSIONS Respondents with IUDs had pervasively elevated levels of antisocial conduct, including diverse forms of early-onset and interpersonally violent behavior.
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Affiliation(s)
- Matthew O Howard
- School of Social Work, Tate-Turner-Kuralt Building, Campus Box 3550, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-3550, USA.
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Howard MO, Perron BE, Sacco P, Ilgen M, Vaughn MG, Garland E, Freedentahl S. Suicide ideation and attempts among inhalant users: results from the national epidemiologic survey on alcohol and related conditions. Suicide Life Threat Behav 2010; 40:276-86. [PMID: 20560749 DOI: 10.1521/suli.2010.40.3.276] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Few studies have examined associations of inhalant use and inhalant use disorders (IUDs) to suicide ideation and attempts. We investigated these relationships in the largest comorbidity survey conducted in the United States. Suicidal ideation was significantly more prevalent among inhalant users than nonusers and severity of inhalant use problems was positively related to suicidal ideation. Among persons with IUDs, 67.4% had thought about committing suicide and 20.2% had attempted suicide. Multivariate logistic regression analyses indicated that respondents with IUDs reported significantly higher levels of suicide ideation than inhalant nonusers. Inhalant use is associated with significantly increased risk for suicide ideation, especially among women and persons with DSM-IV IUDs.
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Han B, Gfroerer JC, Colliver JD. Associations between duration of illicit drug use and health conditions: results from the 2005-2007 national surveys on drug use and health. Ann Epidemiol 2010; 20:289-97. [PMID: 20171900 DOI: 10.1016/j.annepidem.2010.01.003] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Revised: 12/11/2009] [Accepted: 01/06/2010] [Indexed: 11/30/2022]
Abstract
PURPOSE To estimate and compare prevalence rates of lifetime health conditions by inferred duration of illicit drug use among the general U.S. adult population and to investigate associations between duration of use of each specific illicit drug (marijuana, cocaine, heroin, hallucinogens, or inhalant) and each lifetime health condition after controlling for potential confounding factors. METHODS Data from respondents aged 35 to 49 (N = 29,195) from the 2005-2007 National Surveys on Drug Use and Health (NSDUH) were analyzed. RESULTS The prevalence rates of a broad range of health conditions by duration of use of specific illicit drug among persons 35 to 49 years of age in the United States were estimated and compared. After adjustment for potential confounding factors, the results of 20 multivariate logistic regression models indicated positive associations between duration of marijuana use and anxiety, depression, sexually transmitted disease (STD), bronchitis, and lung cancer; between duration of cocaine use and anxiety and pancreatitis; between duration of heroin use and anxiety, hepatitis, and tuberculosis; between duration of hallucinogen use and tinnitus and STD; and between duration of inhalant use and anxiety, depression, HIV/AIDS, STD, tuberculosis, bronchitis, asthma, sinusitis, and tinnitus. CONCLUSIONS This study provides initial analyses on the relationships between illicit drug use and health conditions based on a large nationally representative sample. These results can help prepare for treating health problems among former and continuing illicit drug users.
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Affiliation(s)
- Beth Han
- Office of Applied Studies, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, Rockville, MD 20857, USA.
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Chavira DA, Accurso EC, Garland AF, Hough R. Suicidal Behaviour Among Youth in Five Public Sectors of Care. Child Adolesc Ment Health 2010; 15:44-51. [PMID: 20221303 PMCID: PMC2835344 DOI: 10.1111/j.1475-3588.2009.00532.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND: Rates of suicidal ideation and behaviours as well as associated risk factors are examined among youth recruited from five public sectors of care (i.e. child welfare, juvenile justice, special education services, alcohol and drug services, and county mental health). METHOD: 1057 youth (ages 11-18) completed a diagnostic interview and questionnaires assessing relevant suicide risk factors at baseline and 2-year follow-up. RESULTS: While past year thoughts about death (28%) and talking about killing oneself (7.1%) were comparable to community norms, rates of lifetime suicide attempts (20.1%) were considerably higher in this sample. However, youth in the special education sector reported significantly more suicidal thoughts and behaviours relative to the other sectors. In multivariate analyses, longitudinal predictors of suicidality included major depression, female gender, and involvement in the special education sector. CONCLUSIONS: Efforts to implement screening and evidence based interventions for depression and suicide in the public sector, particularly special education services, are necessary.
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Affiliation(s)
- Denise A Chavira
- University of California San Diego, Department of Psychiatry, 8939 Villa La Jolla Drive, Ste 200, La Jolla, CA 92037, USA
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Epstein JA, Spirito A. Risk factors for suicidality among a nationally representative sample of high school students. Suicide Life Threat Behav 2009; 39:241-51. [PMID: 19606917 DOI: 10.1521/suli.2009.39.3.241] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Using the 2005 Youth Risk Behavior Surveillance data (n = 13,917) of high school students, we examined the association between four domains of risk factors (alcohol/drug use, aggression, HIV risk-related behaviors, and health problems) and indicators of suicidality (considering a suicide attempt, making a plan to attempt suicide, and actually attempting suicide). Logistic regressions showed that drug use (e.g., recent smoking, drinking before 13), victimization (e.g., threatened at school, hit by girl/boyfriend), risky sexual behavior (e.g., forced to have sex, used a condom) and two health problems (health as fair/poor, has disability/health problem) were associated with all three indicators of suicidality. These findings suggest that programs to prevent alcohol/drug use, address aggression, promote safety, and prevent unsafe sexual practices may also prevent suicidality.
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Affiliation(s)
- Jennifer A Epstein
- Department of Public Health, Division of Prevention and Health Behavior, Cornelll University, Weill Medical College, New York, NY, USA.
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Howard MO, Perron BE. A survey of inhalant use disorders among delinquent youth: prevalence, clinical features, and latent structure of DSM-IV diagnostic criteria. BMC Psychiatry 2009; 9:8. [PMID: 19267939 PMCID: PMC2657136 DOI: 10.1186/1471-244x-9-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2008] [Accepted: 03/08/2009] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Inhalant use is among the most pernicious and poorly understood forms of adolescent substance use. Many youth in the juvenile justice system have used inhalants, but little is known about inhalant use disorders (IUDs) in antisocial youth populations. The purpose of this study was to examine the prevalence, clinical features, and latent structure of DSM-IV IUDs in a state population of antisocial youth. METHODS Cross-sectional survey conducted in 2003. Of 740 youth residing in Missouri State Division of Youth Services' (MDYS) residential treatment facilities at the time the study was conducted, 723 (97.7%) completed interviews. Eighty-seven percent were male, with a mean age of 15.5 (SD = 1.2). Nearly 4 in 10 youth (38.5%; n = 279) reported lifetime inhalant use. Youth ranged from very mildly to severely antisocial. RESULTS Of 279 inhalant users, 52 (18.6%) met DSM-IV inhalant abuse criteria and 79 (28.3%) met inhalant dependence criteria. Five of 10 IUD criteria were met by > 10% of the total sample. Latent class analyses demonstrated a substantial concordance between DSM-IV-defined IUDs and an empirically-derived classification based on responses to DSM-IV IUD diagnostic criteria. CONCLUSION IUDs and constituent criteria were prevalent among youth in the juvenile justice system. Two groups of problem inhalant users were identified, symptomatic users-DSM-IV inhalant abuse and highly symptomatic users-DSM-IV inhalant dependence, which differed primarily in severity of inhalant-related problems. Inhalant screening, prevention and treatment efforts in juvenile justice settings are rarely delivered, but critically needed.
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Affiliation(s)
- Matthew O Howard
- University of North Carolina at Chapel Hill, Tate-Turner-Kuralt Building, Campus Box 3550, 325 Pittsboro Street, Chapel Hill, NC 27599-3550, USA.
| | - Brian E Perron
- University of Michigan, School of Social Work, 1080 S. University Avenue, Ann Arbor, MI 48109, USA
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Perron BE, Howard MO, Maitra S, Vaughn MG. Prevalence, timing, and predictors of transitions from inhalant use to inhalant use disorders. Drug Alcohol Depend 2009; 100:277-84. [PMID: 19091490 DOI: 10.1016/j.drugalcdep.2008.10.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2008] [Revised: 10/04/2008] [Accepted: 10/18/2008] [Indexed: 11/25/2022]
Abstract
BACKGROUND Few studies of the natural history of DSM-IV inhalant substance use disorders (I-SUDs) have been conducted. This investigation examined the prevalence, timing, and predictors of transitions from inhalant use to formal I-SUDs among inhalant users within a nationally representative sample. METHODS Participants were 664 U.S. residents participating in the 2000-2001 National Epidemiologic Survey on Alcohol and Related Conditions who reported lifetime inhalant use. Respondents completed structured interviews assessing DSM-IV psychiatric/substance use disorders. Bivariate and Cox regression analyses were conducted to identify risk factors for transitions from inhalant use to I-SUDs. RESULTS Nearly one in five (19.4%) persons initiating inhalant use developed an I-SUD. Most I-SUD transitions were to inhalant abuse rather than inhalant dependence. Risk for development of I-SUDs was greatest in the first year following initiation of inhalant use and low thereafter. Multivariate proportional hazards models indicated that presence of a mood/anxiety disorder (HR=7.7, CI=3.1-18.9) or alcohol use disorder (HR=11.9, CI=5.46-26.00) antedating initiation of inhalant use predicted significantly elevated risk for I-SUDs, whereas being married conferred a lower risk for onset of I-SUDs. CONCLUSIONS I-SUDs were relatively common among inhalant users, generally occurred in the year following initiation of inhalant use, and were associated with early-onset mood/anxiety and alcohol use disorders. Given the young average age at onset of inhalant use and the rapidity with which most I-SUDs developed, interventions directed to adolescents who have initiated inhalant use might be effective in reducing the proportion of inhalant users who develop I-SUDs.
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Abstract
PURPOSE OF REVIEW The aim of the present article is to review recent research on the prevalence and correlates of inhalant use. RECENT FINDINGS During the review period more prevalence studies have been conducted in the developing world, adding information to the ongoing studies that are periodically undertaken in the more developed countries. These studies suggest that inhalant use is widespread among children and adolescents and is increasing among females in the developing and developed world. Not all surveys report inhalants as a separate group from other illegal substances; data by type of inhalants are even rarer, and few studies address abuse or dependence. New evidence suggests lower reliability rates for the diagnostic criteria of dependence as compared with other substances, suggesting the need for a review including the evidence of withdrawal. Studies conducted in the period identify vulnerable groups and suggest an increased risk of injecting drug use, HIV, suicidality and psychiatric disorders among inhalant users. SUMMARY The extension of inhalant abuse and its adverse consequences argues for greater efforts to advance classification and to increase knowledge through research, including the evaluation of prevention and treatment models.
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