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Yassa HA, Badea ST. Patterns of drug abuse in Upper Egypt: cause or result of violence? EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2019. [DOI: 10.1186/s41935-019-0117-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Paruk S, Jhazbhay K, Singh K, Sartorius B, Burns JK. A comparative study of socio-demographic and substance use correlates in early-onset psychosis. Early Interv Psychiatry 2018; 12:339-347. [PMID: 27038079 PMCID: PMC5045739 DOI: 10.1111/eip.12330] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 01/14/2016] [Accepted: 02/18/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND Comorbid substance use, particularly cannabis among adolescents with mental illness, is a major public health concern in developing countries with limited mental health resources. Better understanding of the association between cannabis use and other polysubstance use and early mental illness will provide for more targeted early interventions. AIM This aim of this study was to examine the socio-demographic profile and cannabis use characteristics among adolescents with first-episode early-onset psychosis (EOP) and compare with age-matched and gender-matched adolescents with first-episode non-psychotic mental illness (controls). METHOD Forty-five adolescents with first-episode EOP and 45 controls were assessed using a clinical interview, Positive and Negative Syndrome Scale and World Health Organization Alcohol, Smoking and Substance Involvement Screening test (ASSIST) for substance-related problems. RESULTS There were significant socio-demographic differences among the adolescents with EOP (73% Black, 64% from low family income, 44% from rural areas) compared with controls (24% Black, 53% from low family income, 2% from rural areas). Although there was no difference in lifetime cannabis use, EOP adolescents differed in motivation for cannabis use, had increased current cannabis use (38%, P = 0.01) and more frequent use (52%, P = 0.04) compared with controls (16% current and 18% frequent use). EOP adolescents reported more hazardous use with higher ASSIST mean cannabis-specific involvement scores (EOP 10,2; controls 2,3; P = 0.004). CONCLUSION The differences in socio-demographic variables may reflect the marked disparity in access to mental health care for rural Black youth. Psychotic youth may be more vulnerable to comorbid cannabis-related problems than other mentally ill adolescents. The study highlights the need for early introduction of substance use interventions among adolescents with mental illness.
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Affiliation(s)
- Saeeda Paruk
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Khatija Jhazbhay
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Keshika Singh
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Benn Sartorius
- Department of Public Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Jonathan K Burns
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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Taukoor B, Paruk S, Karim E, Burns JK. Substance use in adolescents with mental illness in Durban, South Africa. J Child Adolesc Ment Health 2018. [PMID: 28639495 DOI: 10.2989/17280583.2017.1318395] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Comorbid substance use in adolescents with mental illness is often an indicator of poor treatment outcome. This study aims to determine the prevalence of, and associated risk factors for, substance use in adolescents with mental illness attending a mental health service. Data was collected from hospital records of 162 adolescents, using a structured data sheet, over a two-year period. Substance use was more significant in older adolescents and those with severe mental illness. Sixty-two (38.3%) adolescents used substances. Thirty-seven (38.1%) male adolescents reported substance use compared to 25 (38.5%) female adolescents. Alcohol was the most commonly used substance (n = 48; 29.6%), followed by cannabis (n = 32; 19.8%). There were significant direct associations between substance use and history of abuse or neglect, forensic history, educational setting, admission status, and the psychiatric diagnoses of schizophrenia, other psychotic disorders, and bipolar mood disorder. Inverse associations were found between substance use and adjustment disorders, attention deficit hyperactivity disorder, and intellectual disability. The results of this study indicate an urgent need for substance misuse programmes for at risk youth, and the introduction of dual diagnosis intervention programmes in this age group.
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Affiliation(s)
- Bhoodeo Taukoor
- a Department of Psychiatry, Nelson R. Mandela School of Medicine , University of KwaZulu-Natal , Durban , South Africa
| | - Saeeda Paruk
- a Department of Psychiatry, Nelson R. Mandela School of Medicine , University of KwaZulu-Natal , Durban , South Africa
| | - Enver Karim
- a Department of Psychiatry, Nelson R. Mandela School of Medicine , University of KwaZulu-Natal , Durban , South Africa
| | - Jonathan K Burns
- a Department of Psychiatry, Nelson R. Mandela School of Medicine , University of KwaZulu-Natal , Durban , South Africa
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Balhara YPS, Lev-Ran S, Martínez-Raga J, Benyamina A, Singh S, Blecha L, Szerman N. State of Training, Clinical Services, and Research on Dual Disorders Across France, India, Israel, and Spain. J Dual Diagn 2016; 12:252-260. [PMID: 27797649 DOI: 10.1080/15504263.2016.1254309] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE This article overviews training, clinical services, and research on dual disorders across four countries: France, India, Israel, and Spain. METHODS The current dual disorders systems in each of the four countries were reviewed, with a focus on strengths and limitations of each. RESULTS In France, psychiatric care occurs within the public health care system and involves little training of medical graduates for managing dual disorders. Special courses and forums for specialists have recently started to meet the growing interest of physicians in learning how to manage dual disorders. The Indian health care system grapples with a large treatment gap for mental disorders, and while some treatment services for dual disorders exist, specific research and training efforts on dual disorders are just beginning. Israel has both public- and private sector services for patients with dual disorders, with specialized inpatient and emergency care for the acutely ill as well as day care and therapeutic communities for long-term management. Interest by researchers is growing, but training and education efforts in dual disorders are, however, minimal. Similar to the other countries, addiction and psychiatry disciplines are governed by separate divisions within the National Health System in Spain. There are some dual disorders services available, but they are limited in scope. While medical professionals clearly recognize the importance of dual disorders, there is no such recognition by the national and regional governing bodies. CONCLUSIONS The common thread in various aspects of dual disorder management in each of these four countries is that there is a lower-than-desirable level of attention to dual disorders in terms of care, policy, research, and training. There are growing opportunities for training and continuing education in dual disorders management. We suggest that nations could learn from each other's experiences on how to address the issue of dual disorders.
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Affiliation(s)
- Yatan Pal Singh Balhara
- a Department of Psychiatry and National Drug Dependence Treatment Centre , WHO Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences , New Delhi , India.,b International Programme in Addiction Studies, Master of Science in Addiction Studies, King's College London , United Kingdom.,c University of Adelaide , Adelaide , South Australia , Australia.,d Virginia Commonwealth University , Richmond , Virginia , USA
| | - Shaul Lev-Ran
- e Addiction Medicine and Dual Disorders Services, Department of Psychiatry , Sheba Medical Center , Tel-Hashomer , Israel.,f Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel
| | - José Martínez-Raga
- g Unidad Docente de Psiquiatría y Psicología Medica, Hospital Universitario Dr. Peset y Universidad de Valencia, & Universidad CEU-UCH , Valencia , Spain
| | - Amine Benyamina
- h National Institute for Medical Research, University Paris-Sud, Hôpital Universitaire Paul Brousse , Villejuif , France
| | - Shalini Singh
- a Department of Psychiatry and National Drug Dependence Treatment Centre , WHO Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences , New Delhi , India
| | - Lisa Blecha
- h National Institute for Medical Research, University Paris-Sud, Hôpital Universitaire Paul Brousse , Villejuif , France
| | - Nestor Szerman
- i Departamento de Psiquiatría , Hospital Universitario Gregorio Marañón, Calle Doctor Esquerdo , Madrid , Spain
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Greydanus DE, Kaplan G, Baxter LE, Patel DR, Feucht CL. Cannabis: The never-ending, nefarious nepenthe of the 21st century: What should the clinician know? Dis Mon 2015; 61:118-75. [DOI: 10.1016/j.disamonth.2015.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Greydanus DE, Hawver EK, Greydanus MM, Merrick J. Marijuana: current concepts(†). Front Public Health 2013; 1:42. [PMID: 24350211 PMCID: PMC3859982 DOI: 10.3389/fpubh.2013.00042] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 09/23/2013] [Indexed: 12/12/2022] Open
Abstract
Marijuana (cannabis) remains a controversial drug in the twenty-first century. This paper considers current research on use of Cannabis sativa and its constituents such as the cannabinoids. Topics reviewed include prevalence of cannabis (pot) use, other drugs consumed with pot, the endocannabinoid system, use of medicinal marijuana, medical adverse effects of cannabis, and psychiatric adverse effects of cannabis use. Treatment of cannabis withdrawal and dependence is difficult and remains mainly based on psychological therapy; current research on pharmacologic management of problems related to cannabis consumption is also considered. The potential role of specific cannabinoids for medical benefit will be revealed as the twenty-first century matures. However, potential dangerous adverse effects from smoking marijuana are well known and should be clearly taught to a public that is often confused by a media-driven, though false message and promise of benign pot consumption.
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Affiliation(s)
- Donald E Greydanus
- Department of Pediatric and Adolescent Medicine, Western Michigan University School of Medicine , Kalamazoo, MI , USA
| | - Elizabeth K Hawver
- Department of Pediatric and Adolescent Medicine, Western Michigan University School of Medicine , Kalamazoo, MI , USA
| | - Megan M Greydanus
- Department of Pediatric and Adolescent Medicine, Western Michigan University School of Medicine , Kalamazoo, MI , USA
| | - Joav Merrick
- National Institute of Child Health and Human Development , Jerusalem , Israel ; Health Services, Division for Intellectual and Developmental Disabilities, Ministry of Social Affairs and Social Services , Jerusalem , Israel ; Division of Pediatrics, Hadassah Hebrew University Medical Center, Mt. Scopus Campus , Jerusalem , Israel ; Kentucky Children's Hospital, University of Kentucky College of Medicine , Lexington, KY , USA
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Pickard H, Fazel S. Substance abuse as a risk factor for violence in mental illness: some implications for forensic psychiatric practice and clinical ethics. Curr Opin Psychiatry 2013; 26:349-54. [PMID: 23722099 PMCID: PMC3907744 DOI: 10.1097/yco.0b013e328361e798] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW To review recent research on the relationship between substance abuse, crime, violence and mental illness, and suggest how this research could aid forensic psychiatrists, psychologists and other mental health professionals in assessing and managing risk, and balancing patient care and public protection. RECENT FINDINGS Substance abuse in mentally ill forensic psychiatric patients should be considered an important risk factor for violence and re-offending. SUMMARY Improved treatment for substance abuse in forensic psychiatric patients and other mentally disordered offenders together with the offer of monitored abstinence as a condition of leave or discharge could be usefully considered as a means of reducing and managing risk. This may improve patient care by addressing mental health needs and increasing opportunity and likelihood of successful re-integration into the community and better life prospects; protect the public by reducing risk of re-offending and offering real time monitoring and potential intervention when risk is heightened; and help forensic psychiatrists strike a balance between patient care and public protection, potentially alleviating some of the difficulty and anxiety that decisions to grant leave or discharge can create.
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Affiliation(s)
- Hanna Pickard
- aDepartment of Philosophy, Oxford Centre for Neuroethics, University of Oxford, Oxford, UK.
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