Prevalencia de consumo de hipnosedantes en población ocupada y factores de estrés laboral asociados

Set and setting predict psychopathology, wellbeing and meaningfulness of psychedelic experiences: a correlational study

BACKGROUND

In psychedelic therapy, the importance of set and setting is a fundamental but under-researched assumption. The aim of this study is to correlate variables of set (psychedelic use motivation) and setting (psychedelic use location and type of companion) with psychopathology, wellbeing and personality variables.

RESEARCH DESIGN AND METHODS

A sample of 1022 participants of the Spanish-speaking population was collected through an online survey. A novel instrument, the Psychedelic Use Scale (PUS), was developed to measure substance use variables of LSD, mescaline, psilocybin, DMT, 5-Meo-DMT, ketamine, Salvia divinorum, ibogaine and MDMA. Various personality, well-being and psychopathology instruments were implemented to measure outcome variables.

RESULTS

Growth motivations, natural settings and presence of significant others predicted less psychopathology, greater wellbeing and meaningfulness of psychedelic experiences, whereas problematic motivations predicted greater psychopathology, lower wellbeing and did not predict meaningfulness of psychedelic experiences.

CONCLUSIONS

Based on these results, we suggest experimental hypotheses for future clinical trials and longitudinal studies with potential clinical implications.

Occupational health, frontline workers and COVID-19 lockdown: new gender-related inequalities?

INTRODUCTION

The abrupt onset of COVID-19, with its rapid spread, has had brutal consequences in all areas of society, including the workplace. In this paper, we report the working conditions, health, and tranquilisers and opioid analgesics use of workers during the first months of the ensuing pandemic, according to whether they were frontline workers or not and also according to sex.

METHODS

Our analysis is based on cross-sectional survey data (collected during April and May 2020) from the wage-earning population in Spain (n=15 070). We estimate prevalences, adjusted prevalence differences and adjusted prevalence ratios by sex and according to whether the worker is a frontline worker or not.

RESULTS

Employment and working conditions, exposure to psychosocial risks, as well as health status and the consumption of tranquilisers and opioid analgesics all showed sex and sectoral (frontline vs non-frontline) inequalities, which placed essential women workers in a particularly vulnerable position. Moreover, the consumption of tranquilisers and opioid analgesics increased during the pandemic and health worsened significantly among frontline women workers.

CONCLUSIONS

The exceptional situation caused by the COVID-19 pandemic provides an opportunity to revalue essential sectors and to dignify such employment and working conditions, especially among women. There is an urgent need to improve working conditions and reduce occupational risk, particularly among frontline workers. In addition, this study highlights the public health problem posed by tranquilisers and opioid analgesics consumption, especially among frontline women.

Effect of support groups on caregiver's quality of life

The objective of this study was to evaluate the effect that participating in support groups for caregivers has on the quality of life and psychotropic drug use of family caregivers of adults with limitations in activities of daily living. A controlled quasi-experimental longitudinal design was used with 134 caregivers (64 in the experimental group and 70 in the control group). The outcomes were health-related quality of life (EuroQol 5D3L test) and psychotropic drug use (no/yes). The analyses were performed using SPSS and R statistical software. An interaction was observed between the condition and the level of limitations in activities of daily living of the care receiver, having an effect on the caregiver's psychotropic drug use (p = 0.003), with this use being lower among caregivers who attend support groups when their relatives present fewer limitations in activities of daily living. Moreover, the quality of life was higher in the post-test in the experimental group (B = 8.66, p = 0.015). In conclusion, support groups could improve the caregiver's quality of life and decrease psychotropic drug use when the care receiver has low limitations in activities of daily living.

Occupational stress and burnout among physiotherapists: a cross-sectional survey in Cadiz (Spain)

BACKGROUND

Occupational stress is considered an ongoing epidemic. An inadequate response to a stressful situation can trigger burnout syndrome. In this way, the assistant services (health and teaching) often reach higher levels of burnout. The present study aimed to measure the level of occupational stress and burnout in physiotherapists in the province of Cadiz (Spain), working in the public and/or private sector.

METHODS

This was an observational, descriptive and cross-sectional study. A sample of 272 physiotherapists took part in the study. The variables measured were sociodemographic variables, working conditions, level of occupational stress and burnout. Burnout includes three characteristics or dimensions: emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA). Correspondence analysis of the sociodemographic, organizational and psychological variables were analyzed using Chi-squared significance tests. Spearman correlations and a linear regression analysis were also carried out to determine the dependence between occupational stress and burnout.

RESULTS

The results showed that 30.51% of physiotherapists suffered from a high level of occupational stress, while 34.56% suffered from an average level. There was a clear dependence between a high level of stress and professionals who felt stressed during their academic training period (p = 0.02), those who were in temporary work (p = 0.03) and those with over 10 years of professional experience (p = 0.05). The overall level of burnout was low, since only the EE dimension had a high value; the average was 21.64 ± 10.57. The DP (6.57 ± 4.65) and PA (39.52 ± 5.97) levels were low. There was a significant dependence (p < 0.05) between EE and the following sociodemographic variables: work shift, willingness to study the same degree, stress and inadequate academic training, and a stressful job. In addition, a significant correlation was found between occupational stress and the EE and DP dimensions of burnout.

CONCLUSIONS

A high prevalence of occupational stress was detected among physiotherapists in Cadiz (Spain). The levels of occupational stress and its correlation with burnout show that the cumulative effect of stress could lead to burnout. Furthermore, these results regarding occupational stress show the necessity of developing coping strategies for physiotherapists and healthcare staff.

Inequalities and the Impact of Job Insecurity on Health Indicators in the Spanish Workforce

In a context of high job insecurity resulting from social deregulation policies, this research aims to study health and substance abuse inequalities in the workplace from a gender perspective. To this end, a transversal study was carried out based on microdata from the National Health Survey in Spain—2017, selecting the active population and calculating the prevalence of the state of health and consumption, according to socio-occupational factors (work relationship, social occupational class, time and type of working day). Odds ratios adjusted by socio-demographic variables and their 90% confidence intervals were estimated by means of binary logistic regressions stratified by sex. The results obtained showed two differentiated patterns of health and consumption. On the one hand, unemployed people and those from more vulnerable social classes showed a higher prevalence of both chronic depression and anxiety and of hypnosedative and tobacco use. On the other hand, the better positioned social classes reported greater work stress and alcohol consumption. In addition, while unemployment affected men’s health more intensely, women were more affected by the type of working day. The study can be used to design sustainable preventive occupational health policies, which should at least aim at improving the quantity and quality of employment.

Prevalencia de síntomas de sueño y riesgo de apnea obstructiva del sueño en México

Objetivo. Estimar la prevalencia nacional de síntomas asociados con el sueño (SAS) en México, y su distribución por región, localidad y sexo. Material y métodos. Estu­dio transversal con muestreo probabilístico, representativo a nivel nacional en adultos mayores de 20 años. Se aplicó un cuestionario sobre duración de sueño, insomnio, uso de hipnóticos y riesgo de síndrome de apnea obstructiva del sueño (SAOS). Resultados. Los SAS más frecuentes fueron ronquido (48.5%) y dificultad para dormir (36.9%). Se identificó riesgo elevado de SAOS en 27.3% de los adultos, y se incrementa por índice de masa corporal (RM=1.1), edad (RM=1.03) y habitar zona urbana (RM=1.37). Se reportó insomnio en 18.8% de los participantes, que predomina en mujeres (RM=1.88). La duración promedio de sueño fue de 7.6 ± 3 horas; 28.4% de los adultos duermen <7 horas/ noche. Conclusiones. Existe una elevada prevalencia de SAS. Uno de cada cuatro adultos mexicanos tiene elevada probabilidad de padecer SAOS. La detección y tratamiento de SAS pudieran minimizar los efectos deletéreos en la salud.

Role of common hypnotics on the phenotypic causes of obstructive sleep apnoea: paradoxical effects of zolpidem

Hypnotics are contraindicated in obstructive sleep apnoea (OSA) because of concerns of pharyngeal muscle relaxation and delayed arousal worsening hypoxaemia. However, human data are lacking. This study aimed to determine the effects of three common hypnotics on the respiratory arousal threshold, genioglossus muscle responsiveness and upper airway collapsibility during sleep.21 individuals with and without OSA (18-65 years) completed 84 detailed sleep studies after receiving temazepam (10 mg), zolpidem (10 mg), zopiclone (7.5 mg) and placebo on four occasions in a randomised, double-blind, placebo-controlled, crossover trial (ACTRN12612001004853).The arousal threshold increased with zolpidem and zopiclone versus placebo (mean±sd -18.3±10 and -19.1±9 versus -14.6±7 cmH₂O; p=0.02 and p<0.001) but not with temazepam (-16.8±9 cmH₂O; p=0.17). Genioglossus muscle activity during stable non-REM sleep and responsiveness during airway narrowing was not different with temazepam and zopiclone versus placebo but, paradoxically, zolpidem increased median muscle responsiveness three-fold during airway narrowing (median -0.15 (interquartile range -1.01 to -0.04) versus -0.05 (-0.29 to -0.03)% maximum EMG per cmH₂O epiglottic pressure; p=0.03). The upper airway critical closing pressure did not change with any of the hypnotics.These doses of common hypnotics have differential effects on the respiratory arousal threshold but do not reduce upper airway muscle activity or alter airway collapsibility during sleep. Rather, muscle activity increases during airway narrowing with zolpidem.

Positive Mental Health and Prevalence of Psychological Ill-Being in University Nursing Professors in Catalonia, Spain

The aim of the current study was to examine the prevalence of psychological ill-being among university nursing professors in Spain and determine their grade of positive mental health. A cross-sectional study was conducted from June 2013 to December 2013 with a sample of 263 university nursing professors. Sociodemographic and occupational variables, as well as variables related to daily habits and lifestyle, were collected. Psychological ill-being was measured using the General Health Questionnaire (GHQ-12) and positive mental health was evaluated with the Positive Mental Health Questionnaire (PMHQ). Prevalence of psychological ill-being (GHQ-12 score >2) among the sample was 27% (range = 21.8% to 32.6%), with a higher prevalence in teachers from first and second cycles (Bachelor's degree and Master's degree, respectively) and a lower prevalence in those having very satisfactory social relationships. Significant differences were found in relation to consumption of tranquilizer drugs and Bach flower remedies. PMHQ scores were lower among teachers with a GHQ-12 score >2. Participants presented a good level of positive mental health. Preventive policies should be applied with the aim of reducing psychological ill-being among professors and potentiating positive mental health. [Journal of Psychosocial Nursing and Mental Health Services, 55(7), 38-48.].

Differences between men and women in substance use: the role of educational level and employment status

OBJECTIVE

To determine differences between men and women in hazardous drinking, heavy cannabis use and hypnosedative use according to educational level and employment status in the economically active population in Spain.

METHOD

Cross-sectional study with data from 2013 Spanish Household Survey on Alcohol and Drugs on individuals aged 25-64 [n=14,113 (women=6,171; men=7,942)]. Dependent variables were hazardous drinking, heavy cannabis use and hypnosedative consumption; the main independent variables were educational level and employment situation. Associations between dependent and independent variables were calculated with Poisson regression models with robust variance. All analyses were stratified by sex.

RESULTS

Hazardous drinking and heavy cannabis use were higher in men, while women consumed more hypnosedatives. The lower the educational level, the greater the gender differences in the prevalence of this substances owing to different consumption patterns in men and women. While men with a lower educational level were higher hazardous drinkers [RII=2.57 (95%CI: 1.75-3.78)] and heavy cannabis users [RII=3.03 (95%CI: 1.88-4.89)] compared to higher educational level, in women the prevalence was the same. Women with a lower education level and men with a higher education level had higher hypnosedative consumption. Unemployment was associated with increased heavy cannabis use and hypnosedative use in both women and men and with lower hazardous drinking only in women.

CONCLUSIONS

There are differences between men and women in the use of psychoactive substances that can be explained by the unequal distribution of substance use in them according to educational level. Unemployment was associated with substance use in both men and women.

Gender differences in the use of alcohol and prescription drugs in relation to job insecurity. Testing a model of mediating factors

BACKGROUND

The results of several studies suggest that economy-related stressors are less distressing for women compared with men. This study proposed to examine the relationship of perceived job insecurity with the use of licit drugs using a theoretical model that considered antecedents and mediators of this association, in order to identify differences between working men and women.

METHODS

Using information from the Catalan Health Survey (2010-2014), we selected working individuals aged 16-64 who were primary providers of household income (N=5315). The outcomes were two measures of alcohol consumption (heavy drinking and binge drinking) and the use of hypnotics/sedatives. As antecedents of the exposure to job insecurity we considered the type of contractual relationship and occupational class. The mediating factors were poor mental health, household structure and the hours of housework per week. The theoretical model was assessed using path analysis where the moderating effect of gender was considered in all the associations.

RESULTS

No differences in the prevalence of job insecurity were found between men and women (17%). Job insecurity (Odds ratio [OR]=1.35, 95% confidence interval [CI]=1.23-1.48) and house workload (OR=1.01, 95% CI=1.00-1.02) were positively associated with poor mental health, with no significant interactions with gender. Poor mental health was significantly associated with binge drinking (OR=1.23, 95% CI=1.13-1.33) and with the use of hypnotics/sedatives (OR=1.71, 95% CI=1.53-1.91). House workload showed a direct negative association with binge drinking (OR=0.99, 95% CI=0.98-1.00), while those in households with no children were more likely to be binge drinkers, with no significant interactions with gender. An alternative model had better fitting results for heavy drinking.

CONCLUSION

No gender differences were found in the association of job insecurity with mental health nor with the use of substances among primary providers of household income, emphasising the importance of social roles when assessing differences in mental health among men and women.

Economic crisis and changes in drug use in the Spanish economically active population

AIMS

To examine changes in the use of alcohol, cannabis and hypnotics/sedatives between two periods (before and during Spain's economic crisis), and to identify differences in the change between employed and unemployed individuals.

DESIGN

Using cross-sectional data from four editions of the Spanish Household Survey on Alcohol and Drugs, we selected economically active individuals aged 16-64 years (total sample = 62 440) and defined two periods, pre-crisis [period 1 (P1) = 2005-07] and crisis (P2 = 2009-11). Poisson regression models with robust variance were fitted to obtain prevalence ratios (PR) of heavy and binge drinking and multinomial regression models to obtain relative risk ratios (RRR) of cannabis and hypnotic/sedative use between the two periods, also considering the interaction between period and employment status.

FINDINGS

While the prevalence of alcohol use remained stable, heavy drinking declined in P2 in men both overall [PR = 0.73; 95% confidence interval (CI) = 0.67-0.79] and in the two age groups (16-34 and 35-64 years), and also in women overall (PR = 0.86; 95% CI = 0.75-0.99) and in the older age group. In contrast, binge drinking increased overall in P2 in men (PR = 1.17; 95% CI = 1.12-1.22) and in women (PR = 1.62; 95% CI = 1.49-1.76), and in both age groups. No differences in the change were observed between employed and unemployed individuals. Overall cannabis use remained stable in P2, but unemployed men and women of the older age group were more likely to have increased sporadic use compared to their employed counterparts (RRR = 2.24; 95% CI = 1.36-3.68 and RRR = 3.21; 95% CI = 1.30-7.93, respectively). Hypnotic/sedative use remained stable in P2 in men, but unemployed men were less likely to have increased heavy use in P2 compared with employed men (RRR = 0.69; 95% CI = 0.49-0.97). In women, heavy use increased in P2 overall and in the older age group, irrespective of employment status.

CONCLUSION

During a period of economic recession in Spain, heavy drinking decreased and binge drinking increased. Sporadic cannabis use increased among older unemployed men and women. Heavy use of hypnotics/sedatives increased among employed men while older women increased use irrespective of employment status.