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Kardaş Ö, Şimşek M, Ögel K. Why Do Adolescents Relapse? A Multicenter, Cross-sectional Study. PSYCHIAT CLIN PSYCH 2023; 33:246-253. [PMID: 38765852 PMCID: PMC11037467 DOI: 10.5152/pcp.2023.23748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/14/2023] [Indexed: 05/22/2024] Open
Abstract
Background Adolescents use drugs once, then use them regularly, then start and stop many times. In addiction treatment, relapse is a major barrier to recovery. Relapse is more common among adolescents and is a major problem. Thus, this study aimed to identify the factors impacting the duration of relapse in adolescents. Methods This is a multicenter, cross-sectional study. A total of 157 adolescents who applied to 4 different child and adolescent addiction treatment centers between January 2020 and March 2020 were included in the study. The "Addiction Profile Survey Adolescent Form" was administered to the participants face to face. According to the duration of relapse determined with this form, the cases were analyzed separately as before and after 1 month. Results The sample consisted of 112 (71.34%) males and 45 (28.66%) females, with a mean age of 17.1 ± 0.8 years. Cannabis use (P = .010), late treatment initiation (P = .003), less psychosocial (P = .001), outpatient (P = .006), and inpatient (P = .006) treatment history were significantly associated with relapse before 1 month. Cannabis users were approximately 4 times more likely to relapse in less than a month, while ecstasy users were approximately 4 times more likely to relapse over a month (OR = 0.26, CI = 0.1-0.69), (OR = 4.16, CI = 1.26-13.78). In the multiple logistic regression analysis performed to determine the factors predicting the duration of relapse, it was found that not attending school (P = .018) and receiving less inpatient treatment (P = .019) predicted relapse occurred within 1 month. Conclusion This study is considered remarkable in terms of demonstrating the necessity of early interventions and post-treatment care services. Currently, there are very few studies in the literature that investigate the factors that contribute to relapse in addicted adolescents. According to our literature review, no study examined factors affecting relapse duration in adolescents.
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Affiliation(s)
- Ömer Kardaş
- Department of Child and Adolescent Psychiatry, Kocaeli University, School of Medicine, Kocaeli, Turkey
| | - Melike Şimşek
- The Turkish Green Crescent Counseling Center, Istanbul, Turkey
| | - Kültegin Ögel
- Department of Psychology, Istanbul Kent University, Istanbul, Turkey
- Alcohol and Substance Addiction Treatment Center, Moodist Psychiatry Hospital, Istanbul, Turkey
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Ellingsen MM, Clausen T, Johannesen SL, Martinsen EW, Hallgren M. Effects of Acute Exercise on Affect, Anxiety, and Self-Esteem in Poly-Substance Dependent Inpatients. Eur Addict Res 2023; 29:285-293. [PMID: 37393901 PMCID: PMC10614242 DOI: 10.1159/000531042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/09/2023] [Indexed: 07/04/2023]
Abstract
INTRODUCTION Negative affect and anxiety frequently precede the onset of drug use in those with substance use disorder (SUD). Low self-esteem may increase the risk of relapse. We examined the short-term effects of exercise on affect, anxiety, and self-esteem in inpatients with poly-SUD. METHODS This is a multicenter randomized control trial (RCT) with a crossover design. Thirty-eight inpatients (37.3 ± 6.4 years; 84% male) from three clinics participated in 45 min of soccer, circuit training, and control condition (psychoeducation) in a random order. Positive and negative affect (PANAS), state anxiety (single item), and self-esteem (Rosenberg SE-scale) were measured immediately before, immediately after, 1-h, 2-h, and 4-h post-exercise. Heart rate and ratings of perceived exertion were taken. Effects were assessed using linear mixed effects models. RESULTS Compared to the control condition, there were significant post-exercise improvements in positive affect (β = 2.99, CI = 0.39: 5.58), self-esteem (β = 1.84, CI = 0.49: 3.20), and anxiety (β = -0.69, CI = -1.34: -0.04) after circuit training (shown) and soccer. Effects persisted 4-h post-exercise. Reductions in negative affect were observed 2-h (circuit training: β = -3.39, CI = -6.35: -1.51) and 4-h (soccer: β = -3.71, CI = -6.03: -1.39) post-exercise, respectively. CONCLUSION Moderately strenuous exercise undertaken in naturalistic settings may improve mental health symptoms in poly-SUD inpatients for up to 4-h post-exercise.
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Affiliation(s)
- Maren Mikkelsen Ellingsen
- Department for Inpatient Treatment of Substance Misuse, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Thomas Clausen
- Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sunniva Launes Johannesen
- Department for Inpatient Treatment of Substance Misuse, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | | | - Mats Hallgren
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Dessoki HH, Abedlrasoul HA, Dawoud ME, Mohamed AM, Soltan MR. Oxytocin level among patients with opioid use disorder and its correlation with personality traits and perceived childhood trauma. MIDDLE EAST CURRENT PSYCHIATRY 2023. [DOI: 10.1186/s43045-023-00289-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
Abstract
Background
Personality traits and perceived childhood maltreatment are of the predictors of substance use disorder development. Many studies have discussed oxytocin effect on personality traits and its relation with childhood trauma and how both affect the addictive process. The main aim was to compare oxytocin level between patients with opioid use disorder and controls and the potential association of oxytocin level with the basic dimensions of personality traits and perceived childhood adverse experiences in patients group. Forty male patients with opioid use disorder and 40 healthy controls matched in age and gender were assessed and compared regarding serum oxytocin level by ELISA, personality traits using Temperament and character inventory - revised (TCI- R) scale, and childhood adverse events using childhood trauma questionnaire.
Results
A significant difference between the patient group and the control group regarding the serum oxytocin level was found. Negative correlation with p-value <0.05 between oxytocin level and each of novelty seeking, and harm avoidance, in addition to a positive correlation between oxytocin level and each of reward dependence, self-directedness, and cooperativeness items of (TCR-R), among cases were found. Cases did not show statistically significant difference in oxytocin level between different Childhood Trauma Questionnaire (CTQ) items.
Conclusions
The interaction between serum oxytocin levels, personality traits, and childhood trauma has to be considered in management with heroin-dependent patients as it plays a crucial role.
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Jia D, Zhang K, Xu Y. The Relationship Between Social Support and Relapse Tendency Among Those Who Struggle With Drug Addiction: Multiple Mediators of Exercise Self-Efficacy and Health-Related Quality of Life. JOURNAL OF DRUG ISSUES 2023. [DOI: 10.1177/00220426231152912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Based on social support theory and exercise promotion health theory, we verified the mediating role of exercise self-efficacy and health-related quality of life in the relationship between social support and the relapse tendency of Chinese people who struggle with drug addiction. Samples who had received traditional Chinese health-promoting exercise interventions over 3 months were recruited from two drug rehabilitation centres in Zhejiang Province ( n = 415). The participants completed the Social Support Rating Scale, Exercise Self-Efficacy Scale, Health Survey Short Form Questionnaire Chinese version, and Relapse Tendency Scale. Correlation analysis showed significant positive correlations between social support, exercise self-efficacy, and quality of life. In contrast, social support, exercise self-efficacy, and quality of life were negatively correlated with relapse tendency. In addition, intermediary effect analysis showed that social support has a direct negative predictive effect on relapse tendency in two ways: as an independent intermediary of exercise self-efficacy and as a chain intermediary of exercise self-efficacy and quality of life. Good exercise habits and adherence, as well as early establishment of social support, are beneficial not only for reducing craving and relapse behaviour but also for enhancing the quality of life of people who struggle with drug addiction, thereby facilitating the recovery efficacy for maintenance.
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Affiliation(s)
- Dongming Jia
- Zhejiang Police Vocational College, Hangzhou, People’s Republic of China
| | - Kai Zhang
- National Police University for Criminal Justice, Baoding, People’s Republic of China
| | - Yuming Xu
- Affiliated Hospital of Hangzhou Normal University, Hangzhou, People’s Republic of China
- School of Physical Education, Hangzhou Normal University, Hangzhou, People’s Republic of China
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Azad AH, Khan SA, Ali I, Shafi H, Khan NA, Umar SA. Experience of psychologists in the delivery of cognitive behaviour therapy in a non-western culture for treatment of substance abuse: a qualitative study. Int J Ment Health Syst 2022; 16:55. [PMID: 36443829 PMCID: PMC9703777 DOI: 10.1186/s13033-022-00566-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Psychotherapy is the preferred form of treatment for psychological disorders worldwide. Cognitive behaviour therapy (CBT) is one of the most widely used psychotherapies due to its proven efficacy for psychological disorders, including substance abuse. However, CBT was developed in the West according to the culture of developed countries. Therefore, it requires cross-cultural adaptation for non-Western countries. Pakistan is one of the developing non-Western countries where substance use disorders are increasing at an alarming rate. Despite the proven efficacy of CBT for substance use disorders, there is a dearth of its utilization in Pakistan. Therefore, in the present study, in-depth qualitative interviews were conducted with CBT practitioners in Pakistan to understand barriers and challenges in this regard. The study was a part of a broader project aimed at cultural adaptation of CBT for people with substance use disorders (SUDs) in Pakistan. METHODS In-depth qualitative interviews were conducted with CBT practitioners (N = 8) working in rehabilitation centres and hospitals in Islamabad, Pakistan. Thematic content analysis was conducted to develop core themes from the data. RESULTS CBT for SUDs requires some adjustments according to Pakistani culture for successful utilization. The challenges in providing CBT for SUDs revolved around three main themes, i.e., the mental health system, societal practices, and therapeutic issues, and 10 subthemes. CONCLUSION In order to utilize the benefits of CBT for SUDs in Pakistan, cultural adaptation is necessary as an initial step. However, its delivery requires stringent modifications in the health care system to address these challenges.
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Affiliation(s)
- Abrar Hussain Azad
- grid.413930.c0000 0004 0606 8575Health Services Academy, Islamabad, Pakistan
| | - Shahzad Ali Khan
- grid.413930.c0000 0004 0606 8575Health Services Academy, Islamabad, Pakistan
| | - Ijaz Ali
- Community Medicine, Mohi-Ud-Din Islamic Medical College, Mirpur, Azad Kashmir Pakistan
| | - Hina Shafi
- Community Medicine, Mohi-Ud-Din Islamic Medical College, Mirpur, Azad Kashmir Pakistan
| | - Nisar Ahmed Khan
- Community Medicine, Abbottabad International Medical College, Abbottabad, Pakistan
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Nagy NES, Ella EIA, Shorab EM, Moneam MHEDA, Tohamy AA. Assessment of addiction management program and predictors of relapse among inpatients of the Psychiatric Institute at Ain Shams University Hospital. MIDDLE EAST CURRENT PSYCHIATRY, AIN SHAMS UNIVERSITY 2022; 29:80. [PMCID: PMC9579533 DOI: 10.1186/s43045-022-00246-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Rehabilitation programs targeted to patients with substance use disorder (SUD) following successful detoxification constitute a global public health concern. This study aimed to examine the effectiveness of a combined pharmacotherapy/cognitive behavior therapy (CBT) model through assessing abstinence/relapse rate and quality of life (QOL) in a sample of patients with SUD. Indeed, we aimed to identify the relapse predictors. Results The relapse rate in the inpatient group was 45.33%, compared to 56% in the outpatient group. Multivariate analysis revealed that patients with educational levels less than secondary school, rural residency, being single or divorced, having cravings lasting for 6 weeks from detoxification, legal history, presence of borderline, antisocial and multiple personality disorder could predict relapse in patients with SUD. Moreover, there was a statistically significant difference between the legal, substance, and social domains of ASI (X2= 12.525, p=0.014; X2= 12.525, p=0.023; and X2= 6.335, p=0.042 respectively) and the majority of QOL domains and relapse. Conclusions Socio-demographic data, legal history, craving, and presence of co-morbid personality disorders along with, legal, substance, and social domains of ASI might be implicated in relapse, suggesting that addiction rehabilitation programs targeting these topics would reduce the risk of relapse.
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Affiliation(s)
- Nahla El Sayed Nagy
- grid.7269.a0000 0004 0621 1570Okasha Institute of Psychiatry, Ain Shams University, Abassia, Ramses street extension, P.O. Box 11657, Dair AL-Malak, Cairo Egypt
| | - Eman Ibrahim Abo Ella
- grid.7269.a0000 0004 0621 1570Okasha Institute of Psychiatry, Ain Shams University, Abassia, Ramses street extension, P.O. Box 11657, Dair AL-Malak, Cairo Egypt
| | - Eman Mohamed Shorab
- grid.7269.a0000 0004 0621 1570Okasha Institute of Psychiatry, Ain Shams University, Abassia, Ramses street extension, P.O. Box 11657, Dair AL-Malak, Cairo Egypt
| | - Mohamed Hossam El-Din Abdel Moneam
- grid.7269.a0000 0004 0621 1570Okasha Institute of Psychiatry, Ain Shams University, Abassia, Ramses street extension, P.O. Box 11657, Dair AL-Malak, Cairo Egypt
| | - Arwa Ahmed Tohamy
- grid.7269.a0000 0004 0621 1570Okasha Institute of Psychiatry, Ain Shams University, Abassia, Ramses street extension, P.O. Box 11657, Dair AL-Malak, Cairo Egypt
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