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McMains JT, Liu S, Oshri A, Sweet LH. Childhood maltreatment and substance use risk: A moderated mediation model of autonomic reactivity and distress tolerance. CHILD ABUSE & NEGLECT 2024; 154:106940. [PMID: 39024782 PMCID: PMC11316649 DOI: 10.1016/j.chiabu.2024.106940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 05/20/2024] [Accepted: 07/02/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND/AIMS The link between child maltreatment (CM) and substance use (SU) in young adulthood is established. The sympathetic nervous system (SNS) division of the autonomic nervous system may mediate this link. However, less is known on the indirect link between CM and SU via SNS functioning. Due to individual variability in the link between SNS functioning and SU risk, we aimed to examine the moderating role of distress tolerance (DT). METHODS A longitudinal sample of 118 young adults (YAs) from a low socioeconomic status background were assessed twice (between 9 and 12 months apart). CM, DT, and galvanic skin response (GSR) stress reactivity were measured during the initial study visit, while SU was assessed at both timepoints. Stress reactivity was assessed by measuring the GSR reactivity during a stress task. We tested the indirect associations between CM and changes in SU problems via GSR stress reactivity, and the moderation effects of DT on these indirect associations. A mediation model in the structural equation modeling (SEM) framework was then followed by a moderated mediation model to analyze these data. RESULTS YA's stress reactivity mediated the association between CM and alcohol use problems, and this indirect effect was weaker among YAs who had higher levels of DT. This pattern did not emerge with drug use problems. CONCLUSIONS Findings suggest that intervention and prevention efforts for SU outcomes should consider incorporating strategies that increase at-risk individuals' levels of DT. Providing strategies to help individuals stem their stress reactivity may reduce their risk for alcohol use.
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Affiliation(s)
- Joshua T McMains
- Department of Psychology, University of Georgia, 125 Baldwin St, Athens, GA 30602, USA.
| | - Sihong Liu
- Department of Human Development and Family Science, University of Georgia, 123 Dawson Hall, 305 Sanford Dr., Athens, GA 30602, USA.
| | - Assaf Oshri
- Department of Human Development and Family Science, University of Georgia, 123 Dawson Hall, 305 Sanford Dr., Athens, GA 30602, USA.
| | - Lawrence H Sweet
- Department of Psychology, University of Georgia, 125 Baldwin St, Athens, GA 30602, USA.
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Leri J, Cisler JM, Dodd CG, Clark SL, Taylor L, Theodorou A, Belford A, Liberzon I, Rathouz PJ, Newport DJ, Devargas C, Wagner K, Nemeroff CB. The role of recurrent trauma on post-traumatic stress disorder symptoms and substance use among trauma exposed youth. Psychiatry Res 2024; 338:115980. [PMID: 38833935 DOI: 10.1016/j.psychres.2024.115980] [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: 01/16/2024] [Revised: 05/17/2024] [Accepted: 05/25/2024] [Indexed: 06/06/2024]
Abstract
Comorbidity between post-traumatic stress disorder (PTSD) and substance use disorder may be explained by a prospective trauma risk conferred by both conditions. The current study modeled concurrent and prospective associations of trauma, PTSD symptoms, and substance use (SU) behavior among trauma exposed youth (ages 8-20). Clinical interviews assessed trauma exposure, PTSD symptom severity, and SU behavior at baseline and at six- and 12-month follow up study visits (N = 2,069). Structural equation models assessed the associations of trauma, PTSD symptoms, and SU behavior. Lifetime trauma was associated with more severe PTSD symptoms and SU behaviors, whereas trauma exposure during the study was only associated with PTSD symptoms. PTSD symptom severity was prospectively associated with trauma exposure. PTSD symptom severity and SU behavior at follow-up study visits were prospectively associated. These results highlight the dynamic interplay between trauma, PTSD symptoms, and SU behavior during youth, a developmental period during which complex psychiatric presentations can have longstanding consequences for health.
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Affiliation(s)
- John Leri
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States.
| | - Josh M Cisler
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States
| | - Cody G Dodd
- Department of Psychiatry and Behavioral Sciences, The University of Texas Medical Branch, United States
| | - Shaunna L Clark
- Department of Psychiatry & Behavioral Sciences, Texas A&M University, United States
| | - Leslie Taylor
- Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, United States
| | - Arrian Theodorou
- The University of North Texas Health Science Center, United States
| | - Anissa Belford
- Department of Psychiatry and Behavioral Sciences, The University of Texas at San Antonio, United States
| | - Israel Liberzon
- Department of Psychiatry & Behavioral Sciences, Texas A&M University, United States
| | - Paul J Rathouz
- Department of Population Health, The University of Texas at Austin Dell Medical School, United States
| | - D Jeffrey Newport
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States; Department of Women's Health, The University of Texas at Austin Dell Medical School, United States
| | - Cecilia Devargas
- Department of Psychiatry, Texas Tech University Health Sciences Center El Paso, United States
| | - Karen Wagner
- Department of Psychiatry and Behavioral Sciences, The University of Texas Medical Branch, United States
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States
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Swatek JL, Peterson BL. Drug Trends in the Teenage Postmortem Population From 2017 to 2021. Am J Forensic Med Pathol 2024:00000433-990000000-00209. [PMID: 39042063 DOI: 10.1097/paf.0000000000000977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
ABSTRACT The teenage population is highly vulnerable to drug exposure, use, and misuse due to the physical and emotional development that occurs at those ages. Social influences, like the isolation experienced during the COVID-19 pandemic and social media, can exacerbate this vulnerability. To better understand the potential impact of these influences on teenage drug use, postmortem results reported by a large reference laboratory from 2017 to 2021 corresponding to the teenage population were evaluated for various drugs of misuse. These data revealed a marked increase (385%) in reported fentanyl cases and a 13% increase in positivity rate. Methamphetamine- and cocaine-positive cases also increased 126% and 54%, with a net percent positivity of +0.6% and -0.5%, respectively. Conversely, heroin showed a consistent decline in reported cases (67%) and a net decrease of 1.0% in positivity rate. In addition to commonly misused drugs, trends for other substances that are prevalent in social media and therefore may disproportionally impact teens, MDMA/MDA, mitragynine, and diphenhydramine, were also assessed. A discussion of drug-related social media trends is presented to provide additional context for the data and trends reported herein, ultimately creating a framework through which social influences on teenage drug use can be better understood.
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Rabner J, Olino TM, Albano AM, Keeton CP, Sakolsky D, Birmaher B, Piacentini J, Peris TS, Compton SN, Gosch E, Ginsburg GS, Pinney EL, Kendall PC. Substance use outcomes from the Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS). J Child Psychol Psychiatry 2024; 65:910-920. [PMID: 38217328 DOI: 10.1111/jcpp.13926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND Substance use problems and anxiety disorders are both highly prevalent and frequently cooccur in youth. The present study examined the benefits of successful anxiety treatment at 3-12 years after treatment completion on substance use outcomes (i.e. diagnoses and lifetime expected use). METHODS The sample was from the Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS), a naturalistic follow-up study to the Child/Adolescent Anxiety Multimodal Study (CAMS) which randomized youth to cognitive behavioral therapy (CBT; Coping cat), medication (sertraline), their combination, or pill placebo. The first CAMELS visit occurred an average of 6.5 years following CAMS randomization. Participants were 319 youth (65.4% of the CAMS sample), aged 7-17 years at CAMS baseline assessment with a mean age of 17.6 years (range: 11-26 years) at the time of the first CAMELS follow-up. Substance use outcomes included diagnoses as well as lifetime substance use (i.e. alcohol and tobacco use). RESULTS Eleven of 319 (3.4%) CAMELS participants were diagnosed with a substance use disorder at the initial follow-up visit. When compared to the population lifetime rate of 11.4%, the rate of diagnoses in the posttreated sample was significantly lower. Additionally, rates of lifetime alcohol use were lower than population rates at the initial and final follow-up visits. Rates of lifetime tobacco use were similarly lower than lifetime population rates at the initial visit (driven by significantly lower rates in the CBT treatment condition), but higher by the final visit. Furthermore, treatment remission (but not treatment response) was associated with a lower rate of substance use diagnoses at the initial follow-up visit, although rates of lifetime alcohol and tobacco use did not differ by treatment outcome. CONCLUSIONS Anxiety treatments confer a beneficial impact on problematic substance use (i.e. diagnoses) as well as on expected substance use (i.e. alcohol and tobacco use) for on average, a period of 6.5 years.
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Affiliation(s)
- Jonathan Rabner
- Department of Psychology and Neuorscience, Temple University, Philadelphia, PA, USA
| | - Thomas M Olino
- Department of Psychology and Neuorscience, Temple University, Philadelphia, PA, USA
| | - Anne Marie Albano
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
| | - Courtney P Keeton
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Dara Sakolsky
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Western Psychiatric Institute & Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Boris Birmaher
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Western Psychiatric Institute & Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles School of Medicine, Los Angeles, CA, USA
| | - Tara S Peris
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles School of Medicine, Los Angeles, CA, USA
| | - Scott N Compton
- Department of Psychiatry, Duke University Medical Center, Durham, NC, USA
| | - Elizabeth Gosch
- Department of Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Golda S Ginsburg
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
| | | | - Philip C Kendall
- Department of Psychology and Neuorscience, Temple University, Philadelphia, PA, USA
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Janota M, Pic O, Callahan S, Husky MM. Risky Alcohol Use and Romantic Relationships Among College Students: A Longitudinal Study. Subst Use Misuse 2024:1-12. [PMID: 38914533 DOI: 10.1080/10826084.2024.2369162] [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: 06/26/2024]
Abstract
BACKGROUND Risky alcohol use is frequent among college students and can be associated with functional outcomes. Bidirectional associations have been shown between alcohol use and the stability of romantic relationships, though little is known about the longitudinal association between risky alcohol use and romantic relationships in college and about college students' perceived stress regarding one's love life. Objectives: The present study aims to explore these relationships both cross-sectionally and at one-year follow-up. METHOD Data were drawn, from the French portion of the World Mental Health International College Student Survey initiative (WMH-ICS). First-year college students who completed an online survey (n = 1,624) and a second survey at one-year follow-up (n = 727) were included. Current romantic relationship status and stress regarding one's love life, past-year risky alcohol use, lifetime presence of DSM-5 mental health disorders and sociodemographic correlates were assessed. RESULTS Risky alcohol use was cross-sectionally associated with dating in multivariate models adjusting for lifetime mental disorders (aOR = 1.70, 95%CI = 1.31-2.20), and in particular with unsteady relationships (aOR = 2.87, 95%CI = 2.01-4.10), but was no longer associated with both one year later. Risky alcohol use was, however, not associated with severe perceived stress regarding one's love life in multivariate models adjusting for lifetime mental disorders in both cross-sectional and longitudinal analyses, while it was associated in bivariate models for both analyses. CONCLUSIONS These findings extend our understanding of the association between excessive drinking and romantic relationship patterns among college students underlying the importance of comorbid disorders.
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Affiliation(s)
- Mathilde Janota
- Bordeaux Population Health Research Center, INSERM U1219, Université de Bordeaux, Bordeaux, France
| | - Océane Pic
- Bordeaux Population Health Research Center, INSERM U1219, Université de Bordeaux, Bordeaux, France
| | - Stacey Callahan
- Centre d'études et de recherches en psychopathologie et psychologie de la santé (CERPPS) EA 7411, Université de Toulouse 2-Jean Jaurès, Toulouse, France
| | - Mathilde M Husky
- Bordeaux Population Health Research Center, INSERM U1219, Université de Bordeaux, Bordeaux, France
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Wang SS, Walsh K, Li JJ. A prospective longitudinal study of multidomain resilience among youths with and without maltreatment histories. Dev Psychopathol 2024; 36:750-764. [PMID: 36794372 DOI: 10.1017/s0954579423000032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The majority of children with maltreatment histories do not go on to develop depression in their adolescent and adult years. These individuals are often identified as being "resilient", but this characterization may conceal difficulties that individuals with maltreatment histories might face in their interpersonal relationships, substance use, physical health, and/or socioeconomic outcomes in their later lives. This study examined how adolescents with maltreatment histories who exhibit low levels of depression function in other domains during their adult years. Longitudinal trajectories of depression (across ages 13-32) in individuals with (n = 3,809) and without (n = 8,249) maltreatment histories were modeled in the National Longitudinal Study of Adolescent to Adult Health. The same "Low," "increasing," and "declining" depression trajectories in both individuals with and without maltreatment histories were identified. Youths with maltreatment histories in the "low" depression trajectory reported lower romantic relationship satisfaction, more exposure to intimate partner and sexual violence, more alcohol abuse/dependency, and poorer general physical health compared to individuals without maltreatment histories in the same "low" depression trajectory in adulthood. Findings add further caution against labeling individuals as "resilient" based on a just single domain of functioning (low depression), as childhood maltreatment has harmful effects on a broad spectrum of functional domains.
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Affiliation(s)
- Sharon S Wang
- Department of Psychology, University of Washington, Washington, DC, USA
| | - Kate Walsh
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
- Department of Gender and Women's Studies, University of Wisconsin-Madison, Madison, WI, USA
| | - James J Li
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA
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Liu W, Wang Z, Wang W, Wang Z, Xing Y, Hölscher C. Liraglutide Reduces Alcohol Consumption, Anxiety, Memory Impairment, and Synapse Loss in Alcohol Dependent Mice. Neurochem Res 2024; 49:1061-1075. [PMID: 38267691 DOI: 10.1007/s11064-023-04093-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/02/2023] [Accepted: 12/22/2023] [Indexed: 01/26/2024]
Abstract
Glucagon-like peptide 1 (GLP-1) analogues have been commercialized for the management of type 2 diabetes. Recent studies have underscored GLP-1's role as a modulator of alcohol-related behavior. However, the role of the GLP-1 analogue liraglutide on alcohol-withdrawal responses have not been fully elucidated. Liraglutide binds to the G-protein-coupled receptor and activates an adenylyl cyclase and the associated classic growth factor signaling pathway, which acts growth factor-like and neuroprotective properties. The underlying neurobiological mechanisms of liraglutide on alcohol withdrawal remains unknown. This study endeavored to explore the effects of liraglutide on the emotion and memory ability of alcohol-withdrawal mice, and synaptic morphology in the medial prefrontal cortex (mPFC) and the hippocampus (HP), and thus affects the relapse-like drinking of alcohol-withdrawal mice. The alcohol-withdrawal group was reintroduced to a 20% v/v alcohol and water through the two-bottle choice for four consecutive days, a period referred to as alcohol re-drinking. Male C57BL/6J mice were exposed to a regimen of 20% alcohol and water for a duration of 6 weeks. This regimen established the two-bottle choice model of alcohol exposure. Learning capabilities, memory proficiency, and anxiety-like behavior were evaluated using the Morris water maze, open field, and elevated plus maze paradigms. Furthermore, synaptic morphology and the levels of synaptic transport-related proteins were assessed via Golgi staining and Western Blot analysis after a two-week alcohol deprivation period. Alcohol re-drinking of alcohol-withdrawal mice was also evaluated using a two-bottle choice paradigm. Our findings indicate that liraglutide can substantially decrease alcohol consumption and preference (p < 0.05) in the alcohol group and enhance learning and memory performance (p < 0.01), as well as alleviate anxiety-like behavior (p < 0.01) of alcohol-withdrawal mice. Alcohol consumption led to a reduction in dendritic spine density in the mPFC and HP, which was restored to normal levels by liraglutide (p < 0.001). Furthermore, liraglutide was found to augment the levels of synaptic transport-related proteins in mice subjected to alcohol withdrawal (p < 0.01). The study findings corroborate that liraglutide has the potential to mitigate alcohol consumption and ameliorate the memory impairments and anxiety induced by alcohol withdrawal. The therapeutic efficacy of liraglutide might be attributed to its role in counteracting synapse loss in the mPFC and HP regions and thus prevented relapse-like drinking in alcohol-withdrawal mice.
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Affiliation(s)
- Weizhen Liu
- Department of Physiology and Neurobiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, 450001, Henan, China
- The Academy of Medical Sciences of Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Ziliang Wang
- Department of Physiology and Neurobiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, 450001, Henan, China
- The Academy of Medical Sciences of Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Wang Wang
- Department of Physiology and Neurobiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, 450001, Henan, China
- The Academy of Medical Sciences of Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Zhiju Wang
- Department of Physiology and Neurobiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Ying Xing
- Department of Physiology and Neurobiology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, 450001, Henan, China.
| | - Christian Hölscher
- Henan Academy of Innovation in Medical Science, XinZheng, 451100, Henan, China.
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Dharma C, Liu E, Grace D, Logie C, Abramovich A, Mitsakakis N, Baskerville B, Chaiton M. Factors associated with the use of psychedelics, ketamine and MDMA among sexual and gender minority youths in Canada: a machine learning analysis. J Epidemiol Community Health 2024; 78:248-254. [PMID: 38262735 DOI: 10.1136/jech-2023-220748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 01/12/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Substance use is increasing among sexual and gender minority youth (SGMY). This increase may be due to changes in social norms and socialisation, or due to SGMY exploring the potential therapeutic value of drugs such as psychedelics. We identified predictors of psychedelics, MDMA and ketamine use. METHODS Data were obtained from 1414 SGMY participants who completed the ongoing longitudinal 2SLGBTQ+ Tobacco Project in Canada between November 2020 to January 2021. We examined the association between 80 potential features (including sociodemographic factors, mental health-related factors and substance use-related factors) with the use of psychedelics, MDMA and ketamine in the past year. Random forest classifier was used to identify the predictors most associated with reported use of these drugs. RESULTS 18.1% of participants have used psychedelics in the past year; 21.9% used at least one of the three drugs. Cannabis and cocaine use were the predictors most strongly associated with any of these drugs, while cannabis, but not cocaine use, was the one most associated with psychedelic use. Other mental health and 2SLGBTQ+ stigma-related factors were also associated with the use of these drugs. CONCLUSION The use of psychedelics, MDMA and ketamine among 2SLGBTQ+ individuals appeared to be largely driven by those who used them together with other drugs. Depression scores also appeared in the top 10 factors associated with these illicit drugs, suggesting that there were individuals who may benefit from the potential therapeutic value of these drugs. These characteristics should be further investigated in future studies.
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Affiliation(s)
- Christoffer Dharma
- University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Esther Liu
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Human Biology, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Grace
- University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Carmen Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- United Nations University Institute for Water Environment and Health, Hamilton, Ontario, Canada
| | - Alex Abramovich
- University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- University of Toronto Department of Psychiatry, Toronto, Ontario, Canada
| | - Nicholas Mitsakakis
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University of Toronto, Toronto, Ontario, Canada
| | - Bruce Baskerville
- School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada
| | - Michael Chaiton
- University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute for Medical Science, University of Toronto, Toronto, Ontario, Canada
- Ontario Tobacco Research Unit, University of Toronto, Toronto, Ontario, Canada
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Morie KP, Zhai ZW, Crowley MJ, Potenza MN, Mayes LC. Relationships Between Prenatal Cocaine Exposure, Cannabis-Use Onset and Emotional and Related Characteristics in Young/Emerging Adults. Subst Use Misuse 2024; 59:388-397. [PMID: 37964628 DOI: 10.1080/10826084.2023.2275558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Background: Exposure to substances in utero may have significant early-life consequences. Less is known about the effects in emerging adulthood, particularly regarding patterns of substance use and related characteristics.Objectives: In this study, we recruited emerging adults, followed since birth, who had been prenatally exposed, or not, to cocaine. Individuals reported on their cannabis, alcohol, and tobacco use, and measures of impulsivity, anhedonia, emotional regulation, and mental health were obtained. Comparisons were made between emerging adults with prenatal cocaine exposure and those without. Correlations were performed between psychological measures and substance use, and regression analyses were conducted to determine potential pathways by which such measures may relate to prenatal exposure or substance use.Results: Individuals with prenatal cocaine exposure (vs. those without) used cannabis at younger ages, reported greater cannabis-use severity, and demonstrated higher impulsivity, state anxiety, and alexithymia. Earlier age of onset of cannabis use was associated with higher impulsivity, state anxiety, alexithymia, and social and physical anhedonia. Cannabis-use age-of-onset mediated the relationship between prenatal cocaine-exposure status and state anxiety and between prenatal cocaine-exposure status and cannabis-use severity in emerging adulthood but not relationships between prenatal cocaine-exposure status and impulsivity or alexithymia in emerging adulthood. Findings suggest that adults with prenatal cocaine exposure may use cannabis at younger ages, which may relate to increased anxiety and more severe use.Conclusions: These findings suggest both mechanisms and possible intervention targets to improve mental health in emerging adults with prenatal cocaine exposure.
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Affiliation(s)
- Kristen P Morie
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Zu Wei Zhai
- Department of Neuroscience, Middlebury College, Middlebury, VT, USA
| | - Michael J Crowley
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Department of Neuroscience, Connecticut Mental Health Center, New Haven, CT, USA
- Department of Neuroscience, Yale School of Medicine, New Haven, CT, USA
| | - Linda C Mayes
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
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Dev AS, Bradford DE, Timpano KR. Sociability Alcohol Expectancies Shape Predictions of Drinking Behavior and Anxiety in a Novel Affective Forecasting Task. Subst Use Misuse 2024; 59:763-774. [PMID: 38233360 DOI: 10.1080/10826084.2024.2302133] [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] [Indexed: 01/19/2024]
Abstract
Background: Existing work proposes that people with higher social anxiety symptoms and sociability alcohol expectancies believe alcohol can lower their anxiety. However, studies have primarily analyzed retrospective reports, not anticipatory motives. Since predictions of future emotion (i.e., affective forecasts) strongly influence behavior, it is critical to understand how people predict alcohol will influence their anxiety. Additionally, intolerance of uncertainty (IU) is related to the use of alcohol as a coping tool, but there is a dearth of work testing whether IU influences alcohol-related forecasts. Objectives: Utilizing a novel affective forecasting task, we tested the prediction that social anxiety symptoms, sociability alcohol expectancies, and IU would relate to predictions about alcohol use. In an initial study and preregistered replication, participants imagined themselves in stressful social scenarios and forecasted how anxious they would feel when drinking and when sober. In the replication, participants also forecasted whether they would drink in the imagined scenarios. Results: Contrary to hypotheses, social anxiety symptoms and IU did not significantly predict higher forecasted anxiety across studies, nor did they predict forecasted drinking. Exploratory analyses showed that participants with higher sociability alcohol expectancies forecasted being more likely to drink, and forecasted feeling less anxious when drinking (versus being sober). Even after statistically controlling for social anxiety, the effect of sociability expectancies remained significant in predicting forecasted anxiety and forecasted drinking. Conclusions: Clinicians could consider specifically targeting sociability expectancies for alcohol use difficulties, and future research should continue utilizing affective forecasting paradigms to test links between social anxiety, alcohol expectancies, and alcohol-use problems.
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Affiliation(s)
- Amelia S Dev
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Daniel E Bradford
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Kiara R Timpano
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
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Moska C, Goudriaan AE, Blanken P, Hendriks V. Accuracy of the Depression, Anxiety and Stress Scale (DASS-21) for Screening on Comorbid Internalizing Disorders among Youth in Substance Use Disorder Treatment. Eur Addict Res 2023; 29:385-393. [PMID: 37848011 DOI: 10.1159/000533726] [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: 02/24/2023] [Accepted: 08/21/2023] [Indexed: 10/19/2023]
Abstract
INTRODUCTION Major depression, anxiety disorders, and post-traumatic stress disorder (PTSD) are among the most prevalent comorbid mental disorders in youth addiction treatment. Hence, screening for these internalizing disorders should be part of the standard routine at intake in substance use disorder treatment. We investigated the usefulness of the Depression, Anxiety and Stress Scale (DASS-21) as a screener for this purpose. METHODS A nationally representative sample of 421 treatment-seeking youths aged 16-22 years with a primary cannabis, alcohol, cocaine, or amphetamine use disorder participated in the study. At intake, we administered the DASS-21 and the Mini International Neuropsychiatric Interview (MINI; Sheehan et al., 1998) based on the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), as "gold standard," as part of a broader baseline assessment of the Youth in transition study [Moska et al. BMC Psychiatry. 2021;21(1):1-11]. RESULTS At comparable sensitivity (0.80-0.84), based on the optimal cut-off value, specificity was higher for the DASS-21 total score detecting any DSM-5 internalizing disorder (0.62) than for the DASS subscales specifically detecting depression, anxiety, or PTSD (0.44, 0.49, and 0.51, respectively). Receiver operating characteristic curve analyses showed an area under the curve (AUC) value of 0.80 for the DASS total score to detect any internalizing disorder ("good discrimination"), compared with AUC values of 0.70-0.75 of the DASS depression and anxiety subscales to detect DSM-5 depression, anxiety, and PTSD ("fair discrimination"). The optimal DASS total score cut-off value of ≥44 for detecting any internalizing disorder resulted in 0.81 sensitivity, 0.62 specificity, 0.80 positive predictive value, and 0.64 negative predictive value. CONCLUSION Given the high prevalence of comorbid internalizing disorders in youth addiction care, the need to address these comorbid disorders in treatment, and the favorable accuracy of the DASS to detect these disorders, we recommend to implement the DASS-21 as routine screener in youth addiction treatment in the Netherlands.
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Affiliation(s)
- Christina Moska
- Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, The Hague, The Netherlands
- LUMC Curium, Leiden University Medical Center, Leiden, The Netherlands
| | - Anna E Goudriaan
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Institute for Addiction Research, Arkin Mental Health Care, Amsterdam, The Netherlands
| | - Peter Blanken
- Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Vincent Hendriks
- Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, The Hague, The Netherlands
- LUMC Curium, Leiden University Medical Center, Leiden, The Netherlands
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12
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Sanz-Martos AB, Fuentes-Verdugo E, Merino B, Morales L, Pérez V, Capellán R, Pellón R, Miguéns M, Del Olmo N. Schedule-induced alcohol intake during adolescence sex dependently impairs hippocampal synaptic plasticity and spatial memory. Behav Brain Res 2023; 452:114576. [PMID: 37423317 DOI: 10.1016/j.bbr.2023.114576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/16/2023] [Accepted: 07/06/2023] [Indexed: 07/11/2023]
Abstract
In a previous study, we demonstrated that intermittent ethanol administration in male adolescent animals impaired hippocampus-dependent spatial memory, particularly under conditions of excessive ethanol administration. In this current study, we subjected adolescent male and female Wistar rats an alcohol schedule-induced drinking (SID) procedure to obtain an elevated rate of alcohol self-administration and assessed their hippocampus-dependent spatial memory. We also studied hippocampal synaptic transmission and plasticity, as well as the expression levels of several genes involved in these mechanisms. Both male and female rats exhibited similar drinking patterns throughout the sessions of the SID protocol reaching similar blood alcohol levels in all the groups. However, only male rats that consumed alcohol showed spatial memory deficits which correlated with inhibition of hippocampal synaptic plasticity as long-term potentiation. In contrast, alcohol did not modify hippocampal gene expression of AMPA and NMDA glutamate receptor subunits, although there are differences in the expression levels of several genes relevant to synaptic plasticity mechanisms underlying learning and memory processes, related to alcohol consumption as Ephb2, sex differences as Pi3k or the interaction of both factors such as Pten. In conclusion, elevated alcohol intake during adolescence seems to have a negative impact on spatial memory and hippocampal synaptic plasticity in a sex dependent manner, even both sexes exhibit similar blood alcohol concentrations and drinking patterns.
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Affiliation(s)
- Ana Belén Sanz-Martos
- Department of Psychobiology, School of Psychology, UNED, C/Juan del Rosal 10, 28040 Madrid, Spain
| | - Esmeralda Fuentes-Verdugo
- Department of Basic Psychology I, School of Psychology, UNED, C/Juan del Rosal 10, 28040 Madrid, Spain
| | - Beatriz Merino
- Department of Pharmaceutical and Nutritional Sciences, School of Pharmacy, San Pablo-CEU University, Urb. Montepríncipe, Boadilla del Monte, Madrid, Spain
| | - Lidia Morales
- Department of Pharmaceutical and Nutritional Sciences, School of Pharmacy, San Pablo-CEU University, Urb. Montepríncipe, Boadilla del Monte, Madrid, Spain
| | - Vicente Pérez
- Department of Basic Psychology I, School of Psychology, UNED, C/Juan del Rosal 10, 28040 Madrid, Spain
| | - Roberto Capellán
- Department of Psychobiology, School of Psychology, UNED, C/Juan del Rosal 10, 28040 Madrid, Spain
| | - Ricardo Pellón
- Department of Basic Psychology I, School of Psychology, UNED, C/Juan del Rosal 10, 28040 Madrid, Spain
| | - Miguel Miguéns
- Department of Basic Psychology I, School of Psychology, UNED, C/Juan del Rosal 10, 28040 Madrid, Spain
| | - Nuria Del Olmo
- Department of Psychobiology, School of Psychology, UNED, C/Juan del Rosal 10, 28040 Madrid, Spain.
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13
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Mkuu R, Salloum RG, Shenkman E, Schaefer N, Le T, Jorratt A, Meduri Y, Goede D, Lee JH, Staras SA. Screening for cervical cancer among women with behavioral health conditions-A systematic review. Prev Med Rep 2023; 34:102238. [PMID: 37273521 PMCID: PMC10236291 DOI: 10.1016/j.pmedr.2023.102238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 06/06/2023] Open
Abstract
Cervical cancer screening is credited with dramatically reducing cervical cancer mortality in the United States. There is a lack of consensus on whether women with behavioral health conditions (mental health or substance use) receive cervical cancer screening at rates similar to women without the conditions. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we searched for articles and abstracts of conference proceedings in PubMed, EMBASE, Web of Science and the EBSCO databases: CINAHL, PsycINFO, Psychosocial and Behavioral Science Collection, Academic Search Premier Databases, and the ProQuest database Applied Social Sciences Index and Abstracts from January 1, 2000 to July 31, 2020. Eligibility criteria included studies conducted in the United States, published in English, and comparing cervical cancer screening rates of women with and without behavioral health conditions. Of 1,242 unique articles screened, 52 were included in the full text review. And after title/abstract/and full-text review, 14 articles met the eligibility criteria. Six studies examined both mental health and substance use conditions, two studies only examined substance use disorders, and six studies examined only mental health conditions. Substance use disorders were associated with a decreased likelihood of receiving screening. This study yeilded inconclusive findings on the relationship between mental health conditions and cervical cancer screening. More research is needed to better understand the relationship between behavioral health conditions and cervical cancer screening.
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Affiliation(s)
- Rahma Mkuu
- Department of Health Outcomes & Biomedical Informatics, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, United States
- Department of Health Science, University of Alabama, United States
| | - Ramzi G. Salloum
- Department of Health Outcomes & Biomedical Informatics, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, United States
| | - Elizabeth Shenkman
- Department of Health Outcomes & Biomedical Informatics, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, United States
| | - Nancy Schaefer
- Health Science Center Libraries, University of Florida Communicore Building, SW Archer Rd, Gainesville, FL 32610, United States
| | - Tran Le
- Department of Health Outcomes & Biomedical Informatics, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, United States
| | - Andrea Jorratt
- Department of Health Outcomes & Biomedical Informatics, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, United States
| | - Yashaswini Meduri
- Department of Health Outcomes & Biomedical Informatics, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, United States
| | - Dianne Goede
- Internal Medicine, College of Medicine, University of Florida, 1549 Gale Lemerand Drive, 4th Floor, Suite 4592, Gainesville, FL 32610-3008, United States
| | - Ji-Hyun Lee
- Division of Quantitative Sciences at the University of Florida Health Cancer Center, 2033 Mowry Rd, Gainesville, FL 32610, United States
| | - Stephanie A.S. Staras
- Department of Health Outcomes & Biomedical Informatics, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, United States
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Knapp AA, Hersch E, Wijaya C, Herrera MA, Kruzan KP, Carroll AJ, Lee S, Baker A, Gray A, Harris V, Simmons R, Kour Sodhi D, Hannah N, Reddy M, Karnik NS, Smith JD, Brown CH, Mohr DC. "The library is so much more than books": considerations for the design and implementation of teen digital mental health services in public libraries. Front Digit Health 2023; 5:1183319. [PMID: 37560198 PMCID: PMC10409481 DOI: 10.3389/fdgth.2023.1183319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/03/2023] [Indexed: 08/11/2023] Open
Abstract
Background Adolescence is a vulnerable developmental period, characterized by high rates of mental health concerns, yet few adolescents receive treatment. Public libraries support adolescents by providing them with access to teen programming, technological resources, and have recently been providing mental health services. Digital mental health (DMH) services may help libraries provide scalable mental health solutions for their adolescent patrons and could be well positioned to address the mental health needs of historically underrepresented racial and ethnic (HURE) adolescents; however, little research has been conducted on the compatibility of DMH services with adolescent patron mental health needs or resource needs of library workers supporting them. Methods The research team formed a partnership with a public library, which serves a large HURE adolescent population. We conducted needs assessment and implementation readiness interviews with 17 library workers, including leadership, librarians, and workers with specialized areas of practice. Interview questions focused on library infrastructure, as well as library needs and preferences around the design and implementation of DMH services for adolescents. We used the Consolidated Framework for Implementation Research as guiding implementation determinant framework to code and analyze the interview transcripts. Results Our findings revealed library workers play an important role in guiding patrons to desired resources and share a goal of implementing adolescent DMH resources into the library and elevating marginalized adolescents' voices. Existing library resources, such as the library's role as a safe space for adolescents in the community, close relationships with external and community organizations, and availability of no-cost technological resources, could help facilitate the implementation of DMH services. Barriers related to community buy-in, mental health stigma, and library worker confidence in supporting adolescent mental health could affect service implementation. Conclusions Our findings suggest public libraries are highly promising settings to deploy DMH services for adolescents. We identified important determinants that may impact the implementation of DMH services in public library settings. Special considerations are needed to design services to meet the mental health needs of HURE adolescent populations and those adolescents' most experiencing health inequities.
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Affiliation(s)
- Ashley A. Knapp
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Emily Hersch
- Department of Psychology, University of Massachusetts Boston, Boston, MA, United States
| | - Clarisa Wijaya
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Miguel A. Herrera
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Kaylee P. Kruzan
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Allison J. Carroll
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Sydney Lee
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Alex Baker
- Department of Psychology, The University of North Texas, Denton, TX, United States
| | - Alanna Gray
- Oak Park Public Library, Oak Park, IL, United States
| | - Vann Harris
- Oak Park Public Library, Oak Park, IL, United States
| | | | - Deepika Kour Sodhi
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Nanette Hannah
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Madhu Reddy
- Donald Bren School of Information and Computer Sciences, University of California, Irvine, CA, United States
| | - Niranjan S. Karnik
- College of Medicine, University of Illinois Chicago, Chicago, IL, United States
| | - Justin D. Smith
- School of Medicine, University of Utah, Salt Lake City, UT, United States
| | - C. Hendricks Brown
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - David C. Mohr
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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15
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Gaggero A, Gil J, Jiménez-Rubio D, Zucchelli E. Sick and depressed? The causal impact of a diabetes diagnosis on depression. HEALTH ECONOMICS REVIEW 2023; 13:38. [PMID: 37395821 DOI: 10.1186/s13561-023-00451-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/07/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND There is sparse evidence on the impact of health information on mental health as well as on the mechanisms governing this relationship. We estimate the causal impact of health information on mental health via the effect of a diabetes diagnosis on depression. METHODS We employ a fuzzy regression discontinuity design (RDD) exploiting the exogenous cut-off value of a biomarker used to diagnose type-2 diabetes (glycated haemoglobin, HbA1c) and information on psycometrically validated measures of diagnosed clinical depression drawn from rich administrative longitudinal individual-level data from a large municipality in Spain. This approach allows estimating the causal impact of a type-2 diabetes diagnosis on clinica ldepression. RESULTS We find that overall a type-2 diabetes diagnosis increases the probability of becoming depressed, however this effect appears to be driven mostly by women, and in particular those who are relatively younger and obese. Results also appear to differ by changes in lifestyle induced by the diabetes diagnosis: while women who did not lose weight are more likely to develop depression, men who did lose weight present a reduced probability of being depressed. Results are robust to alternative parametric and non-parametric specifications and placebo tests. CONCLUSIONS The study provides novel empirical evidence on the causal impact of health information on mental health, shedding light on gender-based differences in such effects and potential mechanisms through changes in lifestyle behaviours.
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Affiliation(s)
- Alessio Gaggero
- Department of Applied Economics, University of Granada, Granada, Spain
| | - Joan Gil
- Department of Economics and BEAT, Universitat de Barcelona, Diagonal Ave. 696, 08034, Barcelona, Spain.
| | | | - Eugenio Zucchelli
- Madrid Institute for Advanced Study (MIAS) and Department of Economic Analysis, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Lancaster University, Lancaster, UK
- IZA, Bonn, Germany
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16
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Lira D, Caviedes P, Martínez V. Adaptation of a mobile app for early anxiety and depression intervention in university students in Chile: participatory study. BJPsych Int 2023; 20:37-41. [PMID: 38414999 PMCID: PMC10895481 DOI: 10.1192/bji.2023.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/10/2023] [Accepted: 02/08/2023] [Indexed: 02/29/2024] Open
Abstract
The high prevalence of mental health problems among university students poses a challenge when developing effective interventions, with digital technologies emerging as a potential resource to address this problem. The inclusion of student input in the design and development of such interventions is critical to improving their impact. This study contributed to the initial phase of a research project that aims to adapt and evaluate the feasibility and acceptability of an early intervention for anxiety and depression based on digital technologies for university students. Three participatory workshops were conducted with 13 university students in Chile to inquire about the features and content that a mental health mobile app should include to meet their needs and preferences. The workshop transcripts were analysed using inductive thematic analysis. The results of this study highlight the value of modifications such as the personalisation of some features of the app. The students recommended incorporating topics related to university life and the possibility of contacting a mental health professional, as well as the inclusion of peer interaction or other forms of support.
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Affiliation(s)
- Daniela Lira
- Psychologist, PhD(c), Doctoral Programme in Psychotherapy, Pontificia Universidad Católica de Chile, Santiago, Chile and Universidad de Chile, Santiago, Chile
| | - Patricio Caviedes
- Psychologist, MSc., Research Assistant, Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
| | - Vania Martínez
- Child and Adolescent Psychiatrist, PhD, Full Professor, Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente (CEMERA), Facultad de Medicina, Universidad de Chile, Santiago, Chile. Email
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17
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Garcia-Cerde R, Lopes de Oliveira CW, Ferreira-Junior V, Caetano SC, Sanchez ZM. Psychiatric Symptomatology is Associated with Polydrug Use and School Violence in Early Adolescence. Child Psychiatry Hum Dev 2023; 54:109-122. [PMID: 34398344 DOI: 10.1007/s10578-021-01228-0] [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: 03/15/2021] [Accepted: 08/02/2021] [Indexed: 01/25/2023]
Abstract
This study investigated the association between psychiatric symptoms and polydrug use, school violence, and sociodemographic factors among Brazilian early adolescents. Using the baseline data collection from the effectiveness evaluation of PROERD, a school-based drug use prevention program, implemented in 30 public schools in São Paulo (n = 2316, M age = 12.3 years, 48.5% girls), multinomial logistic regressions were performed using Strengths and Difficulties Questionnaire (SDQ) subscales as response variables, and polydrug use, school violence, and sociodemographic characteristics as explanatory variables. In most SDQ subscales, girls and older students were more likely to have psychiatric symptoms. A positive association was identified between polydrug use and psychiatric symptoms. It was found that those who suffered and perpetrated physical violence had a greater likelihood of presenting psychiatric symptoms. Preventive interventions should consider the greater vulnerability related to the mental health of girls, older students, and those who suffer and perpetrate physical violence at school.
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Affiliation(s)
- Rodrigo Garcia-Cerde
- Departamento de Medicina Preventiva, Universidade Federal de São Paulo, Rua Botucatu, 740, 4º Andar, São Paulo, SP, Brazil
| | - Camila W Lopes de Oliveira
- Departamento de Psiquiatria, Universidade Federal de São Paulo, Rua Borges Lagoa, 570 - 1º Andar, São Paulo, SP, Brazil
| | - Valdemir Ferreira-Junior
- Departamento de Psiquiatria, Universidade Federal de São Paulo, Rua Borges Lagoa, 570 - 1º Andar, São Paulo, SP, Brazil
| | - Sheila Cavalcante Caetano
- Departamento de Psiquiatria, Universidade Federal de São Paulo, Rua Borges Lagoa, 570 - 1º Andar, São Paulo, SP, Brazil
| | - Zila M Sanchez
- Departamento de Medicina Preventiva, Universidade Federal de São Paulo, Rua Botucatu, 740, 4º Andar, São Paulo, SP, Brazil.
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18
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Argenyi MS, Mereish EH, Watson RJ. Mental and Physical Health Disparities Among Sexual and Gender Minority Adolescents Based on Disability Status. LGBT Health 2023; 10:130-137. [PMID: 36301253 PMCID: PMC9986008 DOI: 10.1089/lgbt.2022.0032] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Sexual and gender minority (SGM) youth and youth with disabilities both experience health disparities. Little data exist on whether SGM youth with disabilities have worse health outcomes compared with SGM youth without disabilities. This study aimed to examine differences in health behaviors and outcomes among a sample of SGM youth by different types of disabilities. Methods: Secondary analyses were conducted with a subset (N = 9418) of the LGBTQ National Teen Survey, a comprehensive survey of risk and protective factors and health outcomes of SGM youth across the United States collected in 2017. Multiple types of disabilities (physical, cognitive, or psychiatric) and mental, behavioral, and physical health outcomes were self-reported. Results: Of the sample, 18.3% reported a disability. Significant findings included higher odds of exercise avoidance, greater depressive symptoms and sleep concerns, and lower self-esteem and overall health ratings among SGM youth who reported any form of disability compared with SGM youth who reported no disability. Youth with cognitive disabilities had lower odds of alcohol use than youth with no disability. Youth with psychiatric disabilities had higher odds of cannabis and cigarette use, and lower physical activity than youth with no disability. Youth with either psychiatric or physical disabilities reported higher body mass index than youth with no disability. Conclusion: SGM youth with disabilities experience greater health disparities than SGM youth with no reported disabilities. Results provide groundwork evidence about the impact of disability status on SGM adolescents. Disability-inclusive or -specific frameworks are needed for future interventions and studies of SGM youth.
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Affiliation(s)
- Michael S Argenyi
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.,Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Ethan H Mereish
- Department of Health Studies, American University, Washington, District of Columbia, USA
| | - Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut, USA
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Qeadan F, English K, Luke A, Egbert J. Eating disorders and substance use: Examining associations among US college students. Int J Eat Disord 2023; 56:956-968. [PMID: 36606314 DOI: 10.1002/eat.23892] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To investigate associations between reported eating disorder (ED) diagnosis and substance use disorder (SUD) diagnosis, substance misuse, and illicit drug use among US college students. METHOD Data consisting of n = 414,299 students' responses to the National College Health Assessment survey conducted by the American College Health Association between fall 2015 and spring 2019 were utilized for this study. Unadjusted and adjusted odds ratios were used to determine the association of reported ED diagnosis with reported SUD diagnosis, misuse of cigarettes, e-cigarettes, alcohol, marijuana, cocaine/methamphetamine, sedatives, hallucinogens, opiates, inhalants, MDMA, and other club drugs, as well as illicit use of prescription pain killers, prescription sedatives, and prescription stimulants. A sensitivity analysis investigating associations between reported anorexia nervosa (AN), bulimia nervosa (BN), and each substance use outcome was also conducted. RESULTS Among all in our analytic cohort, 7.15% reported receiving an ED diagnosis or being treated for an ED in the last 12 months. Students with ED indications were significantly more likely to report each of the substance use outcomes investigated in this study, including SUD diagnosis (aOR: 7.43; 95% CI: 6.98, 7.92; p < .0001), opiate misuse (aOR: 8.35; 95% CI: 7.38, 9.45; p < .0001), and misuse of other club drugs (aOR: 10.37; 95% CI: 9.10, 11.81; p < .0001) than peers without reported EDs. Both AN and BN were associated with an increased likelihood of SUD diagnosis. DISCUSSION These findings demonstrate strong associations between EDs and the most extensive list of substance use outcomes explored in the context of college setting ED research to date.
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Affiliation(s)
- Fares Qeadan
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Chicago, Illinois, USA
| | - Kevin English
- Albuquerque Area Southwest Tribal Epidemiology Center, Albuquerque, New Mexico, USA
| | - Amy Luke
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Chicago, Illinois, USA
| | - Jamie Egbert
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Chicago, Illinois, USA
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20
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Pender E, Kostak L, Sutton K, Naccarato C, Tsai A, Chung T, Daughters S. Resources for the Assessment and Treatment of Substance Use Disorder in Adolescents. WIKIJOURNAL OF MEDICINE 2023. [DOI: 10.15347/wjm/2023.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Abstract
Substance Use Disorder (SUD) is understood as the persistent use of substances to the detriment of the individual's livelihood and wellness. SUD can have serious mental, physical, and social ramifications if not properly addressed. Though SUD can develop at any age, it is especially important to address in adolescents, given rising prevalence of certain substances (e.g. cannabis) in that age group and poor prognosis associated with early-onset SUD.[1][2] Data from the National Survey on Drug Use and Health show the lifetime use of illicit drugs in people ages 12-17 is 20.9%.[3] The same survey found the rate of Substance Use Disorder in the past year for people ages 12-17 who used illicit drugs or alcohol to be 6.3% in 2020.[3] This paper is intended for clinicians and lay people to gain a deeper understanding of SUD in adolescents, particularly relating to alcohol, cannabis, nicotine, and opioids. Though alcohol, cannabis, and nicotine are the substances most commonly used by this age demographic nationally,[4] opioid use – and resulting deaths – have been on the rise. According to the Centers for Disease Control and Prevention (CDC), opioids were connected to about 75% of the nearly 92,000 drug deaths in 2020.[5] Beyond significant death rates in the general population, recent spikes in adolescent death rate tied to the synthetic opioid fentanyl – which held a relatively stable death rate from 2010 to 2019 until seeing a 94% increase from 2019 to 2020 and additional 20% increase to 2021 - warrants inquiry into opioids for this population.[6] Each of these substances can have adverse, long-lasting effects on health if not managed properly, resulting in seriously compromised lifelong wellbeing.[7] This article explores SUD prevalence and reviews diagnostic criteria in relation to adolescence, including a synopsis of changes in SUD classification between the DSM-IV and DSM-5 and discussion of ICD-11 and the Research Domain Criteria (RDoC) as a basis for research related to substance use. Effective assessment and consideration of co-occurring disorders are covered as well. Although the prognosis of SUD varies by an individual's environment and circumstances, a modal developmental course for SUD is discussed. Finally, a curated list of nationally recognized resources including hotlines, treatment locators, informational sites, and support groups is provided, along with tools to compile local resources. By addressing these aspects of adolescent SUD, the research team offers a broader view of its prevalence in the United States, key warning signs and comorbidities, and possible assessments and treatments for adolescents with SUD.
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21
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Haywood D, Pantaleo A, Mullan BA, Heslop KR, Baughman FD. Do Dimensional Measures of Mental Health Symptoms Predict Level of Alcohol Involvement in the General Population? Subst Use Misuse 2023; 58:629-636. [PMID: 36790047 DOI: 10.1080/10826084.2023.2177962] [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: 02/16/2023]
Abstract
Background: There is a limited understanding of what specific mental health symptoms are associated to alcohol involvement. It is important to understand how the severity of different mental health dimensions may differ, and distinguish between, levels of alcohol involvement. Objectives: (a) explore for differences in severity of mental health symptoms between those with lower, and moderate/high alcohol involvement, (b) assess the degree to which mental health dimensions can distinguish between those with lower, and moderate/high alcohol involvement, and (c) examine what mental health dimensions are related to the highest risk of moderate/high alcohol involvement. Results: 400 participants representative of the general population in the USA were recruited online through Prolific and completed the Alcohol, Smoking and Substance Involvement Screening Test and Brief Symptom Inventory. Each of the nine mental health symptom dimensions significantly differed between lower and moderate/high alcohol involvement, with the moderate/high alcohol involvement group reporting greater severity symptoms. The nine symptom dimensions in combination also significantly distinguished lower and moderate/high alcohol involvement, however only somatization offered unique predictive utility. Lastly, global distress was also able to significantly distinguish the alcohol involvement groups, albeit to a lesser accuracy compared to the collection of individual symptom dimensions. Conclusions: These findings suggest that overall mental health distress may be important to understanding alcohol involvement, however individual symptom dimensions can add further explanatory variance. In particular, somatic symptoms may offer unique utility in understanding the relationship between mental health and alcohol involvement.
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Affiliation(s)
- Darren Haywood
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Australia.,Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, Australia
| | - Ashleigh Pantaleo
- School of Population Health, Curtin University, Perth, Australia.,WA Cancer Prevention Research Unit, Curtin University, Perth, Australia
| | - Barbara A Mullan
- School of Population Health, Curtin University, Perth, Australia.,WA Cancer Prevention Research Unit, Curtin University, Perth, Australia
| | - Karen R Heslop
- Curtin School of Nursing, Curtin University, Perth, Australia
| | - Frank D Baughman
- School of Population Health, Curtin University, Perth, Australia
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22
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Boson K, Anderberg M, Melander Hagborg J, Wennberg P, Dahlberg M. Adolescents with substance use problems in outpatient treatment: a one-year prospective follow-up study focusing on mental health and gender differences. Subst Abuse Treat Prev Policy 2022; 17:53. [PMID: 35840967 PMCID: PMC9284845 DOI: 10.1186/s13011-022-00482-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2022] [Indexed: 11/22/2022] Open
Abstract
Background Although several studies have found a high incidence of coexisting mental health problems among adolescents with substance use problems, follow-up studies addressing how these conditions change over time are rare. The study will describe and analyze indications of mental health problems and how various risk factors predict outcomes 1 year after initial treatment contact. In addition, gender-specific risk factors are explored. Methods A clinical sample of 455 adolescents (29% girls, median age 17 years) answered a structural interview at baseline and were followed up using official records 1 year after initiated treatment. Bivariate associations and logistic regressions were conducted to analyse the links between risk factors at the individual, social, and structural levels as well as links between various mental illness symptoms at treatment start and indications of mental health problems 1 year later were analysed. Results The results show that mental health problems among adolescents largely persisted 1 year after start of outpatient care for substance use problems. Forty-two per cent of the sample displayed indications of mental health problems at follow-up, and registrations for both outpatient treatment and psychiatric medication were more common among the girls. Girls also reported more mental illness symptoms at treatment start than boys did, especially anxiety. Depression and suicidal thoughts had predictive values regarding indications of mental health problems and small cumulative effects were found for 6–10 co-occurring risk factors. Conclusions Adolescents with depression and suicidal thoughts at treatment start should yield attention among clinicians as these general risk factors could predict indication of mental health problems at 1 year follow-up effectively. Also, patients with more than six co-occurring risk factors seem more vulnerable for continued mental health problems. Generally, girls displayed a greater mental health and psychosocial burden at treatment initiation and were more likely to show indication of mental health problems at follow-up. These results suggests that girls are more likely to get psychiatric out-treatment parallel to, or after, substance abuse treatment. We recommend further investigation of gender differences and gender-specific needs in substance use treatment.
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Mocanu V, Wood E. Alcohol use disorder with comorbid anxiety disorder: a case report and focused literature review. Addict Sci Clin Pract 2022; 17:62. [DOI: 10.1186/s13722-022-00344-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/19/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract
Background
Alcohol use disorder (AUD) and anxiety disorders (AnxD) are prevalent health concerns in clinical practice which frequently co-occur (AUD-AnxD) and compound one another. Concurrent AUD-AnxD poses a challenge for clinical management as approaches to treatment of one disorder may be ineffective or potentially counterproductive for the other disorder.
Case Presentation
We present the case of a middle-aged man with anxiety disorder, AUD, chronic pain, and gamma-hydroxybutyrate use in context of tapering prescribed benzodiazepines who experienced severe alcohol withdrawal episodes during a complicated course of repeated inpatient withdrawal management. After medical stabilization, the patient found significant improvement in symptoms and no return to alcohol use with a regimen of naltrexone targeting his AUD, gabapentin targeting both his AUD and AnxD, and engagement with integrated psychotherapy, Alcoholics Anonymous, and addictions medicine follow-up.
Conclusion
Proper recognition and interventions for AUD and AnxD, ideally with overlapping efficacy, can benefit individuals with comorbid AUD-AnxD. Gabapentin, tobacco cessation, and integrated psychotherapy have preliminary evidence of synergistic effects in AUD-AnxD. Meta-analysis evidence does not support serotoninergic medications (e.g. selective serotonin reuptake inhibitors) which are commonly prescribed in AnxD and mood disorders as their use has not been associated with improved outcomes for AUD-AnxD. Additionally, several double-blind placebo-controlled randomized trials have suggested that serotonergic medications may worsen alcohol-related outcomes in some individuals with AUD. Areas for future investigation are highlighted.
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Bushnell GA, Gerhard T, Keyes K, Hasin D, Cerdá M, Olfson M. Association of Benzodiazepine Treatment for Sleep Disorders With Drug Overdose Risk Among Young People. JAMA Netw Open 2022; 5:e2243215. [PMID: 36413369 PMCID: PMC9682430 DOI: 10.1001/jamanetworkopen.2022.43215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IMPORTANCE Benzodiazepines are prescribed for the treatment of adolescent sleep disorders; however, benzodiazepine overdoses occur, often in combination with opioids. OBJECTIVE To evaluate whether benzodiazepine treatment for sleep disorders, compared with alternative pharmacologic treatments (trazodone, hydroxyzine, zolpidem, zaleplon, and eszopiclone), is associated with increased risk of drug overdose for young people. DESIGN, SETTING, AND PARTICIPANTS This cohort study included privately insured people 10 to 29 years of age identified from a US commercial claims database (MarketScan), from January 1, 2009, to December 31, 2018. Young people with a sleep disorder diagnosis initiating benzodiazepine (n = 23 084) or comparator pharmacologic treatments (n = 66 706) were included in the study. Statistical analysis was performed from November 1, 2021, to May 16, 2022. EXPOSURES New use of benzodiazepine treatment or comparator pharmacologic treatments (defined as ≥1 year without a prescription for benzodiazepine or comparator medications). MAIN OUTCOMES AND MEASURES Incident diagnosed drug overdoses were identified from inpatient and emergency department records within 6 months of treatment initiation. The propensity score-adjusted cumulative incidence of overdose and hazard ratios (HRs) were estimated with intention-to-treat (analyzed based on initial treatment) and as-treated analyses (added censoring at treatment discontinuation). Results were stratified by prior prescription opioid fill. RESULTS The cohort included 23 084 young people initiating benzodiazepine treatment (14 444 female participants [62.6%]; mean [SD] age, 23 [4.1] years) and 66 706 initiating a comparator treatment (38 446 female participants [57.6%]; mean [SD] age, 22 [4.4] years). Six months after treatment initiation, 9.7% (95% CI, 9.3%-10.1%) of benzodiazepine users and 12.3% (95% CI, 12.1%-12.6%) of the comparator group were still receiving treatment. The crude incidence of drug overdose at 6 months was 0.9% for benzodiazepine initiators and 0.8% for comparator treatment initiators. In adjusted analyses, an increased risk of drug overdose was associated with benzodiazepines vs comparator treatments (intention-to-treat analysis: HR, 1.25 [95% CI, 1.03-1.51]; as-treated analysis: HR, 1.44 [95% CI, 1.14-1.80]). This association was stronger among young people with a recent prescription opioid fill vs those without a recent prescription opioid fill (as-treated analysis: adjusted HR, 2.01 [95% CI, 1.24-3.25] vs adjusted HR, 1.31 [95% CI, 1.00-1.70]). CONCLUSIONS AND RELEVANCE The findings of this study suggest that benzodiazepines, compared with alternative pharmacologic treatments for common sleep disorders, were associated with an increased risk of drug overdose among young people during the following 6-month period, especially among those with a recent opioid prescription. Drug overdose is an important safety consideration when treating young people with benzodiazepines.
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Affiliation(s)
- Greta A. Bushnell
- Center for Pharmacoepidemiology and Treatment Sciences, Rutgers Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey
- Department of Biostatistics and Epidemiology, Rutgers University School of Public Health, Piscataway, New Jersey
| | - Tobias Gerhard
- Center for Pharmacoepidemiology and Treatment Sciences, Rutgers Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey
- Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Rutgers University, Piscataway, New Jersey
| | - Katherine Keyes
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Deborah Hasin
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York
| | - Magdalena Cerdá
- Center for Opioid Epidemiology and Policy, Department of Population Health, New York University School of Medicine, New York, New York
| | - Mark Olfson
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York
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Beard SJ, Yoon L, Venticinque JS, Shepherd NE, Guyer AE. The brain in social context: A systematic review of substance use and social processing from adolescence to young adulthood. Dev Cogn Neurosci 2022; 57:101147. [PMID: 36030675 PMCID: PMC9434028 DOI: 10.1016/j.dcn.2022.101147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 11/19/2022] Open
Abstract
Substance use escalates between adolescence and young adulthood, and most experimentation occurs among peers. To understand underlying mechanisms, research has focused on neural response during relevant psychological processes. Functional magnetic resonance imaging (fMRI) research provides a wealth of information about brain activity when processing monetary rewards; however, most studies have used tasks devoid of social stimuli. Given that adolescent neurodevelopment is sculpted by the push-and-pull of peers and emotions, identifying neural substrates is important for intervention. We systematically reviewed 28 fMRI studies examining substance use and neural responses to stimuli including social reward, emotional faces, social influence, and social stressors. We found substance use was positively associated with social-reward activity (e.g., in the ventral striatum), and negatively with social-stress activity (e.g., in the amygdala). For emotion, findings were mixed with more use linked to heightened response (e.g., in amygdala), but also with decreased response (e.g., in insula). For social influence, evidence supported both positive (e.g., cannabis and nucleus accumbens during conformity) and negative (e.g., polydrug and ventromedial PFC during peers' choices) relations between activity and use. Based on the literature, we offer recommendations for future research on the neural processing of social information to better identify risks for substance use.
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Affiliation(s)
- Sarah J Beard
- Center for Mind and Brain, University of California, Davis, 267 Cousteau Pl, Davis, CA 95618, USA; Department of Human Ecology, University of California, Davis, 301 Shields Ave, Davis, CA 95616, USA.
| | - Leehyun Yoon
- Center for Mind and Brain, University of California, Davis, 267 Cousteau Pl, Davis, CA 95618, USA.
| | - Joseph S Venticinque
- Center for Mind and Brain, University of California, Davis, 267 Cousteau Pl, Davis, CA 95618, USA; Department of Human Ecology, University of California, Davis, 301 Shields Ave, Davis, CA 95616, USA.
| | - Nathan E Shepherd
- Center for Mind and Brain, University of California, Davis, 267 Cousteau Pl, Davis, CA 95618, USA.
| | - Amanda E Guyer
- Center for Mind and Brain, University of California, Davis, 267 Cousteau Pl, Davis, CA 95618, USA; Department of Human Ecology, University of California, Davis, 301 Shields Ave, Davis, CA 95616, USA.
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Taylor BK, Fung MH, Frenzel MR, Johnson HJ, Willett MP, Badura-Brack AS, White SF, Wilson TW. Increases in Circulating Cortisol during the COVID-19 Pandemic are Associated with Changes in Perceived Positive and Negative Affect among Adolescents. Res Child Adolesc Psychopathol 2022; 50:1543-1555. [PMID: 36048374 PMCID: PMC9435427 DOI: 10.1007/s10802-022-00967-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2022] [Indexed: 11/03/2022]
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic has spread across the world and resulted in over 5 million deaths to date, as well as countless lockdowns, disruptions to daily life, and extended period of social distancing and isolation. The impacts on youth in particular are astounding, with shifts in learning platforms, limited social outlets, and prolonged uncertainty about the future. Surveys have shown that mental health among youth has severely suffered during the pandemic. However, limited research to date has reported on physiological indices of stress surrounding the pandemic, such as cortisol. Cortisol is a stress hormone that typically increases during stressful situations and can have deleterious effects on mental and physical health when chronically heightened. The present study leveraged hair cortisol concentration measurements, which allowed the retrospectiveinvestigation of circulating cortisol prior to- versus after pandemic-related local lockdowns during the first wave of the pandemic. A final sample of 44 youth ages 10- to 18-years-old provided hair samples and reported on their perceived affective well-being and level of concern regarding pandemic-related stressors between May and June of 2020. We found significant levels of concern and decreases in affective well-being following local lockdowns. Moreover, we saw that cortisol robustly increased following local lockdowns, and those increases were predictive of changes in affect. These findings provide critical insights into the underlying neuroendocrinology of stress during the pandemic and support the need for resources to support youths’ mental health and well-being during this globally significant event.
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Olashore AA, Brooks W, Roy H, Adebayo FA, Chiliza B. Psychiatric disorders and associated risk factors in a sample of adolescents in Gaborone, Botswana: a cross-sectional study. BMC Pediatr 2022; 22:381. [PMID: 35768787 PMCID: PMC9244366 DOI: 10.1186/s12887-022-03435-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the high proportion of adolescents living with mental health issues in low- to middle-income countries (LMICs), especially in Botswana, there is a significant deficit of local research to guide an increase in prevention and treatment. We, therefore, aimed to assess the prevalence and associated risk factors of psychiatric disorders (PD) in a sample of secondary school students in Botswana. METHODS This cross-sectional study included 750 students from the 13 public secondary schools in Gaborone using a multi-stage sampling technique. The Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) was used to screen for PDs. RESULTS The participant's mean age was 15.26 and SD 1.57 years, with 53.6% being female. Approximately 34% had a PD, with depression being the commonest, of whom 35% were neither receiving treatment nor aware of the available services. Perinatal complications (AOR = 4.29; 95%CI: 1.04-17.70), a family history of mental illness (AOR = 2.19; 95%CI: 1.17-4.11) and substance-related problems (AOR = 1.80; 95% CI:1.22-2.65) predicted the likelihood of developing PD. CONCLUSIONS Our findings revealed that adolescents in Botswana have many mental health issues which may affect their developmental phases. A multi-sectoral collaboration is needed for the timely detection of identified risk factors and initiation of the necessary prevention and treatment measures.
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Affiliation(s)
- Anthony A Olashore
- Department of Psychiatry, Faculty of Medicine, University of Botswana, Gaborone, Botswana.
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
| | - Wendy Brooks
- Department of Psychiatry, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Hlanganiso Roy
- Department of Psychiatry, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | | | - Bonginkosi Chiliza
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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Thomasius R, Paschke K, Arnaud N. Substance-Use Disorders in Children and Adolescents. DEUTSCHES ARZTEBLATT INTERNATIONAL 2022; 119:440-450. [PMID: 35635442 PMCID: PMC9549893 DOI: 10.3238/arztebl.m2022.0122] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 05/27/2021] [Accepted: 01/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The most common substance use disorders in childhood and adolescence have to do with alcohol and cannabis. These disorders begin as early as puberty, are often accompanied by other mental disorders, and, if untreated, very frequently persist into adulthood. METHODS This review is based on pertinent publications retrieved by a selective search in PubMed on substance use disorders in children and adolescents. RESULTS Substance use disorders are among the commonest mental disorders in childhood and adolescence. In Germany, approximately 10% of adolescents have tried cannabis at least once. The prognosis is negatively affected by individual (bio-)psychological traits, mental comorbidities, laws that facilitate consumption, socioeconomic disadvantage, consuming peers, and parental substance use disorders. A timely diagnosis, motivation by the pediatrician, and referral to specialized child and adolescent psychiatric services helps assure that those affected receive appropriate treatment, with the goal of abstinence from the substance as well as improvement in emotional regulation, affectivity, and attention. According to studies from the English-speaking countries and considering all treatment forms, treatment is completed by approximately 60% to 65% of children and adolescents; 20% to 40% of these patients are abstinent six months after the end of treatment. No studies of this type have been carried out to date in Germany. CONCLUSION As the results of treatment are generally poor, there is a major need for research on the treatment and care of children and adolescents with substance use disorders. In particular, the interfaces between outpatient and inpatient care need further improvement.
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Affiliation(s)
- Rainer Thomasius
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Clinic Hamburg-Eppendorf
| | - Kerstin Paschke
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Clinic Hamburg-Eppendorf
| | - Nicolas Arnaud
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Clinic Hamburg-Eppendorf
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White J. Associations between illicit drug use in early adulthood and mortality: Findings from a National Birth Cohort. Prev Med 2022; 159:107058. [PMID: 35461959 PMCID: PMC9227730 DOI: 10.1016/j.ypmed.2022.107058] [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: 10/19/2021] [Revised: 04/04/2022] [Accepted: 04/15/2022] [Indexed: 11/30/2022]
Abstract
Illicit drug use is known to be associated with premature mortality. Whether exposure to socioeconomic disadvantage and mental health problems in childhood help to explain this association, is unclear. We analysed data from 11,250 participants in the 1970 British Birth Cohort study. At 10-years of age, socioeconomic disadvantage (parental socioeconomic position, material disadvantage, family disruption) and mental health problems with antisocial behaviour, attention, and anxiety were reported by mothers and teachers. At 30-years of age, study members provided information on their illicit drug use, exposure to socioeconomic disadvantage and mental health problems. At 30-years, 19.2% of participants had used an illicit drug in the past year. Mortality was elevated for eight of the twelve drugs assessed. Family disruption, maternal, and teacher assessments of antisocial behaviour at 10-years were associated with illicit drug use at 30-years. There was, however, very little change in these associations when exposure to childhood socioeconomic disadvantage (% change in hazard ratios [HR] 0-10%) or mental health problems (0.4-11.9%) were added to the sex-adjusted model. Adding exposure to socioeconomic disadvantage (0.8-38.9%) and mental health problems (31.7-74.1%) in adulthood to the sex-adjusted model resulted in marked attenuation in HRs for all drugs. These findings imply that interventions which provide opportunities for education, employment and access to effective mental health treatments in early adulthood may help to reduce mortality among drug users.
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Affiliation(s)
- James White
- Centre for Trials Research, Cardiff University, 4th floor, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK.
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30
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Virtanen S, Kuja-Halkola R, Sidorchuk A, Fernández de la Cruz L, Rück C, Lundström S, Suvisaari J, Larsson H, Lichtenstein P, Mataix-Cols D, Latvala A. Association of Obsessive-Compulsive Disorder and Obsessive-Compulsive Symptoms With Substance Misuse in 2 Longitudinal Cohorts in Sweden. JAMA Netw Open 2022; 5:e2214779. [PMID: 35666504 PMCID: PMC9171556 DOI: 10.1001/jamanetworkopen.2022.14779] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Neurobiological models have postulated shared neural mechanisms between obsessive-compulsive disorder (OCD) and substance use disorders, but results from clinical and epidemiological studies are conflicting or even suggest that OCD may be protective against substance misuse. OBJECTIVE To investigate whether OCD and obsessive-compulsive symptoms are associated with substance misuse and the extent to which shared genetic and/or environmental factors account for this association. DESIGN, SETTING, AND PARTICIPANTS In this cohort study, individuals in the general population of Sweden born between January 1, 1932, and December 31, 1997 (population cohort), were followed up through Swedish nationwide registers from January 1, 1997, to December 31, 2013. The second cohort included twin participants in the Child and Adolescent Twin Study in Sweden (CATSS) followed up from ages 18 to 24 years. Data were analyzed from March 1, 2021, to March 31, 2022. EXPOSURES Lifetime International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, diagnosis of OCD in the National Patient Register (population cohort 1), and self-reported obsessive-compulsive symptoms at 18 years of age (CATSS cohort). MAIN OUTCOMES AND MEASURES Substance misuse was defined as registered substance use-related disorder, criminal conviction, or death (population cohort), and self-reported alcohol and drug dependence symptoms at 18 and 24 years of age (CATSS cohort). RESULTS The general population cohort included 6 304 188 individuals (48.9% women and 51.1% men; median baseline age, 30.5 [IQR, 15.0-46.4] years), of whom 27 342 had an OCD diagnosis. Obsessive-compulsive disorder was associated with an elevated risk of substance misuse (hazard ratio, 3.68 [95% CI, 3.52-3.85]). In the 9230 individuals in the CATSS cohort (5551 women [60.1%] and 3679 men [39.9%]), obsessive-compulsive symptoms at 18 years of age were associated with increased symptoms of alcohol dependence (concurrent [n = 9219], β = 0.18 [95% CI, 0.16-0.20]; longitudinal [n = 3381], β = 0.10 [95% CI, 0.06-0.14]) and drug dependence (concurrent [n = 749], β = 0.19 [95% CI, 0.11-0.27]; longitudinal [n = 452], β = 0.15 [95% CI, 0.04-0.25]). Comorbid anxiety and depression did not entirely explain the associations in either cohort. Using data from full siblings and maternal half-siblings (population cohort) and monozygotic and dizygotic twins (CATSS cohort) provided estimates of the relative contribution of genetic and environmental influences to the covariance between OCD and obsessive-compulsive symptoms and substance misuse or dependence. The associations were explained by genetic (56%-68%) and nonshared environmental (32%-44%) factors. CONCLUSIONS AND RELEVANCE The findings of this Swedish population-based cohort study challenge the notion that OCD is protective against developing substance misuse. The association of OCD and obsessive-compulsive symptoms with substance misuse was largely explained by shared genetics but was also compatible with partial environmental mediation.
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Affiliation(s)
- Suvi Virtanen
- Institute of Criminology and Legal Policy, University of Helsinki, Helsinki, Finland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna Sidorchuk
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Lorena Fernández de la Cruz
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Christian Rück
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| | | | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - David Mataix-Cols
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Antti Latvala
- Institute of Criminology and Legal Policy, University of Helsinki, Helsinki, Finland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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31
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Burke CW, Wilens TE. Transitional-Age Youth With Substance Use Disorders. Psychiatr Ann 2022. [DOI: 10.3928/00485713-20220520-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Becker ABC, Lüken LM, Kelker L, Holtmann M, Daseking M, Legenbauer T. Cognitive Profiles of Adolescent Inpatients with Substance Use Disorder. CHILDREN 2022; 9:children9050756. [PMID: 35626933 PMCID: PMC9139439 DOI: 10.3390/children9050756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 11/16/2022]
Abstract
The prevalence of substance abuse is high during adolescence, and several studies have linked the use of alcohol and cannabis in adolescence to different cognitive impairments. To investigate whether specific cognitive deficits can be observed in adolescents with substance use disorder (SUD), we compared the cognitive profiles of inpatient adolescents diagnosed with SUD to a control group matched for sex, age and educational status. The inpatient adolescents received diagnoses of cannabis use disorder, alcohol use disorder or both. We compared the WISC-V profiles of 22 inpatients (45.5% female, Mage: 14.5; SD: 0.8) and the WAIS-IV profiles of 27 inpatients (44.4% female, Mage: 17.1; SD: 0.9) to 49 matched control participants with no diagnosed SUD. At the time of testing, participants were hospitalized for treatment of their SUD and were abstinent for a period of at least 6 weeks. To gain greater power, we jointly analyzed the Verbal Comprehension Index, Working Memory Index, Processing Speed Index and Full Scale IQ as assessed by WISC-V and WAIS-IV. The clinical group performed significantly worse than the control group on all the above indices. When only the group of inpatients was observed, in a model with the factors sex, educational status, presence of a comorbid diagnosis of depression and the number of comorbid diagnoses, only the factor educational status was significantly associated with the Full Scale IQ, whereas the factors sex and a comorbid diagnosis of depression in this group were associated with the Processing Speed Index. The results show that adolescents diagnosed with SUD (cannabis and/or alcohol) display broad cognitive impairments after 6 weeks of abstinence. Future research is required to further explore the role of comorbid diagnoses.
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Affiliation(s)
- Angelika Beate Christiane Becker
- Department of Educational Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces, 22043 Hamburg, Germany; (L.K.); (M.D.)
- Correspondence:
| | - Luisa Marie Lüken
- LWL University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, 59071 Hamm, Germany; (L.M.L.); (M.H.); (T.L.)
- Department of Psychology, University of Münster, 48149 Münster, Germany
| | - Lea Kelker
- Department of Educational Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces, 22043 Hamburg, Germany; (L.K.); (M.D.)
| | - Martin Holtmann
- LWL University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, 59071 Hamm, Germany; (L.M.L.); (M.H.); (T.L.)
| | - Monika Daseking
- Department of Educational Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces, 22043 Hamburg, Germany; (L.K.); (M.D.)
| | - Tanja Legenbauer
- LWL University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, 59071 Hamm, Germany; (L.M.L.); (M.H.); (T.L.)
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Kontu M, Kantojärvi L, Hakko H, Riala K, Riipinen P. Misuse of prescribed psychotropic medication and drug crime offending: A follow-up case-control study of former adolescent psychiatric inpatients. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2022; 32:124-137. [PMID: 35735190 PMCID: PMC9327718 DOI: 10.1002/cbm.2254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Various psychotropic prescription drugs are known to have potential for misuse. Among teenagers, non-medical use of prescription drugs may predate illicit drug use or occur concomitantly. AIMS Our aim was to examine prescriptions of psychotropic medications among drug crime offenders and non-criminal controls in a psychiatric inpatient cohort of 13-17-year-olds. Our research question was: were prescribed psychotropic and potentially addictive drugs associated with later drug crime offending. METHODS Our sample was of all 60 adolescents who had been convicted of a drug crime by young adulthood with a twice-sized control group, matched for gender, age and family-type, from a cohort of 508 adolescents consecutively admitted to a psychiatric inpatient care in Finland between April 2001 and March 2006. Adolescence-related information on substance use and psychiatric disorders was obtained by semi-structured interviews. Follow-up information on crimes and medication purchases was obtained from Finnish nationwide registers. The association of studied factors to drug crime offending was examined using stepwise binary logistic regression analysis. RESULTS 75% of drug crime offenders and 47% of non-criminal controls had used addictive psychotropic medications during the follow-up period (p < 0.001). 74% of all drug crime offenders' purchases of prescribed addictive drugs occurred within the year preceding drug crimes. Of addictive drugs, the use of clonazepam and gabapentinoids was most likely to associate with drug crime offending (AOR 7.77, p < 0.001). Conduct and substance use disorders diagnosed in adolescence (AOR 3.49, p = 0.010; AOR 2.34, p = 0.050) were predictors for drug crime offending. CONCLUSIONS Our findings suggest that, when treating young adults with conduct disorder and a history of substance use, physicians should prescribe addictive medications with caution, favouring instead non-addictive medications complemented by psychosocial interventions.
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Affiliation(s)
- Mikaela Kontu
- Department of PsychiatryResearch Unit of Clinical NeuroscienceUniversity of OuluOuluFinland
| | | | - Helinä Hakko
- Department of PsychiatryOulu University HospitalOuluFinland
| | - Kaisa Riala
- Department of PsychiatryOulu University HospitalOuluFinland
| | - Pirkko Riipinen
- Department of PsychiatryResearch Unit of Clinical NeuroscienceUniversity of OuluOuluFinland
- Department of PsychiatryOulu University HospitalOuluFinland
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Food addiction comorbid to mental disorders in adolescents: a nationwide survey and register-based study. Eat Weight Disord 2022; 27:945-959. [PMID: 34089511 DOI: 10.1007/s40519-021-01212-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/08/2021] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Adolescence is a high-risk period for development of addictive behavior. This may also apply to addiction-like eating of highly processed foods-commonly referred to as "food addiction". Adolescents with mental disorder may be at particularly elevated risk of developing food addiction as addiction often accompanies mental disorder. However, there are only few studies in adolescents investigating this potential comorbidity. Therefore, the primary aim of this study was to examine the food addiction symptom load, as measured by the dimensional Yale Food Addiction Scale for Children-version 2.0 (dYFAS-C 2.0), among adolescents with a clinically verified mental disorder. METHOD A total of 3529 adolescents aged 13-17 were drawn from the Danish Psychiatric Central Research Register, stratified on six major diagnostic categories of mental disorders; psychotic disorders, affective disorders, anxiety disorders, eating disorders, autism spectrum disorders, and attention deficit disorders. Via their parents, these adolescents were invited to participate in a web-based survey. Data on health and socioeconomic factors from the Danish registers were linked to both respondents and non-respondents, allowing for thorough attrition analysis and estimation of weighted dYFAS-C 2.0 scores. RESULTS A total of 423 adolescents participated in the survey (response rate 12.0%). The mean weighted dYFAS-C 2.0 total score was 13.9 (95% CI 12.6; 14.9) for the entire sample and varied substantially across the diagnostic categories being highest for those with psychotic disorder, mean 18.4 (95% CI 14.6; 14.9), and affective disorders, mean 19.4. (95% CI 16.3; 22.5). Furthermore, the dYFAS-C 2.0 total score was positively correlated with body mass index (BMI) (r = 0.33, p < 0.05). CONCLUSION Food addiction symptomatology seems to be prevalent among adolescents with mental disorder, particularly affective and psychotic disorders. As obesity is a tremendous problem in individuals with mental disorder further investigation of food addiction in young people with mental disorder is called for. This could potentially aid in the identification of potential transdiagnostic targets for prevention and treatment of obesity in this group. LEVEL OF EVIDENCE Level IV, Observational cross-sectional descriptive study combined with retrospective register data.
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Jang SK, Saunders G, Liu M, Jiang Y, Liu DJ, Vrieze S. Genetic correlation, pleiotropy, and causal associations between substance use and psychiatric disorder. Psychol Med 2022; 52:968-978. [PMID: 32762793 PMCID: PMC8759148 DOI: 10.1017/s003329172000272x] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Substance use occurs at a high rate in persons with a psychiatric disorder. Genetically informative studies have the potential to elucidate the etiology of these phenomena. Recent developments in genome-wide association studies (GWAS) allow new avenues of investigation. METHOD Using results of GWAS meta-analyses, we performed a factor analysis of the genetic correlation structure, a genome-wide search of shared loci, and causally informative tests for six substance use phenotypes (four smoking, one alcohol, and one cannabis use) and five psychiatric disorders (ADHD, anorexia, depression, bipolar disorder, and schizophrenia). RESULTS Two correlated externalizing and internalizing/psychosis factor were found, although model fit was beneath conventional standards. Of 458 loci reported in previous univariate GWAS of substance use and psychiatric disorders, about 50% (230 loci) were pleiotropic with additional 111 pleiotropic loci not reported from past GWAS. Of the 341 pleiotropic loci, 152 were associated with both substance use and psychiatric disorders, implicating neurodevelopment, cell morphogenesis, biological adhesion pathways, and enrichment in 13 different brain tissues. Seventy-five and 114 pleiotropic loci were specific to either psychiatric disorders or substance use phenotypes, implicating neuronal signaling pathway and clathrin-binding functions/structures, respectively. No consistent evidence for phenotypic causation was found across different Mendelian randomization methods. CONCLUSIONS Genetic etiology of substance use and psychiatric disorders is highly pleiotropic and involves shared neurodevelopmental path, neurotransmission, and intracellular trafficking. In aggregate, the patterns are not consistent with vertical pleiotropy, more likely reflecting horizontal pleiotropy or more complex forms of phenotypic causation.
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Affiliation(s)
- Seon-Kyeong Jang
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Gretchen Saunders
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - MengZhen Liu
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | | | - Yu Jiang
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
- Institute of Personalized Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Dajiang J. Liu
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
- Institute of Personalized Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Scott Vrieze
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
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Auty SG, Lipson SK, Stein MD, Reif S. Mental health service use in a national sample of college students with co-occurring depression or anxiety and substance use. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 2:100025. [PMID: 36845889 PMCID: PMC9948943 DOI: 10.1016/j.dadr.2022.100025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Campus health systems can provide timely and accessible resources for students with co-occurring substance use and mental illness, but little is known about the degree to which students use these systems. This study examined mental health service utilization among students with symptoms of anxiety or depression, stratified by substance use. METHODS This cross-sectional study used data came from the 2017-2020 Healthy Minds Study. Mental health service use was examined among students with clinically significant anxiety or depression (N = 65,969), stratified by substance use type (no use, alcohol or tobacco use, marijuana use, other drug use). We performed a series of weighted logistic regressions to assess the adjusted association of substance use type with past year use of campus, off-campus outpatient, emergency department, and hospital mental health services. RESULTS Among students, 39.3% reported exclusive use of alcohol or tobacco, 22.9% reported use of marijuana, and 5.9% reported use of other drugs. Use of alcohol or tobacco was not associated with mental health service utilization, while students who use marijuana faced increased odds of campus (OR 1.10, 95% CI 1.01, 1.20) and off-campus outpatient mental health service utilization (OR 1.27, 95% CI 1.17, 1.37). Other drug use was associated with increased odds of off-campus outpatient (OR 1.28, 95% CI 1.14, 1.48), emergency department (OR 2.13, 95% CI 1.50, 3.03) and hospital service utilization (OR 1.52, 95% CI 1.13, 2.04). CONCLUSIONS Universities should consider screening for substance use and common mental illnesses to support the health of high-risk students.
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Affiliation(s)
- Samantha G. Auty
- Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Sarah K. Lipson
- Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Michael D. Stein
- Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Sharon Reif
- Heller School for Social Policy and Management, Institute for Behavioral Health, Brandeis University, 415 South Street, Waltham, MA 02453, USA
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Prins SJ, Kajeepeta S, Hatzenbuehler ML, Branas CC, Metsch LR, Russell ST. School Health Predictors of the School-to-Prison Pipeline: Substance Use and Developmental Risk and Resilience Factors. J Adolesc Health 2022; 70:463-469. [PMID: 34836805 PMCID: PMC8860848 DOI: 10.1016/j.jadohealth.2021.09.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 09/21/2021] [Accepted: 09/27/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of the study is to establish prospective relationships among school mean levels of substance use, developmental risk and resilience factors, and school discipline. METHODS We linked 2003-2014 data from the California Healthy Kids Survey and the Civil Rights Data Collection, from more than 4,800 schools and 4,950,000 students. With lagged multilevel linear models, we estimated relationships among standardized school average levels of six substance use measures; eight developmental risk and resilience factors; and the prevalence of total discipline, out-of-school discipline, and police-involved discipline. RESULTS School mean substance use and risk/resilience factors predicted subsequent prevalence of discipline. For example, a one-standard deviation higher school mean level of smoking, binge drinking, and cannabis use was associated, respectively, with 16% (95% confidence interval [CI]: 14%, 18%), 18% (95% CI: 16%, 20%), and 21% (95% CI: 19%, 23%) higher subsequent prevalence of total discipline. A one-standard deviation higher mean level of community support and feeling safe in school was associated, respectively, with 21% (95% CI: 18%, 23%) and 9% (95% CI: 7%, 11%) lower total discipline. Higher violence/harassment was associated with 5% (95% CI: 4%, 7%) higher total discipline. Peer and home support, student resilience, and neighborhood safety were not associated with total discipline. Nearly all associations remained, attenuated, when we restricted to out-of-school and police-involved discipline. CONCLUSIONS Schools with students who, on average, have higher substance use, less school and community support, and feel less safe in schools have a higher prevalence of school discipline and police contact. The public health implications of mass criminalization extend beyond criminal legal system settings and into schools.
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Affiliation(s)
- Seth J Prins
- Departments of Epidemiology and Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York.
| | - Sandhya Kajeepeta
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | | | - Charles C Branas
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Lisa R Metsch
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York
| | - Stephen T Russell
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas
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38
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Roux AM, Tao S, Marcus S, Lushin V, Shea LL. A national profile of substance use disorder among Medicaid enrollees on the autism spectrum or with intellectual disability. Disabil Health J 2022; 15:101289. [DOI: 10.1016/j.dhjo.2022.101289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 08/03/2021] [Accepted: 08/12/2021] [Indexed: 11/27/2022]
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Malla A, Boksa P, Joober R. Meeting the challenges of the new frontier of youth mental health care. World Psychiatry 2022; 21:78-79. [PMID: 35015354 PMCID: PMC8751561 DOI: 10.1002/wps.20927] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Ashok Malla
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Patricia Boksa
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Ridha Joober
- Department of Psychiatry, McGill University, Montreal, QC, Canada
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40
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Berny LM, Tanner-Smith EE. Differential Predictors of Suicidal Ideation and Suicide Attempts: Internalizing Disorders and Substance Use in a Clinical Sample of Adolescents. J Dual Diagn 2022; 18:59-69. [PMID: 34982653 PMCID: PMC8960344 DOI: 10.1080/15504263.2021.2016343] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objective: Dually diagnosed adolescents are a high-risk population for experiencing suicidal thoughts and behavior. Given that research suggests risk factors for suicidal ideation and suicide attempts may be different, this study examined whether internalizing disorder severity, frequency of substance use, and the interaction between them differentiated adolescents who attempted suicide from those who ideated. Methods: Baseline data from 287 adolescents who received formal substance use disorder (SUD) treatment were used in this analysis. Major depressive disorder (MDD) and generalized anxiety disorder (GAD) severity as well as past-3 month use of alcohol, cannabis, and other illicit drugs were considered. The outcome of interest was a three-category measure of suicide risk: no reported suicidal ideation or attempts, suicidal ideation only, and suicide attempts. Results: Over half of the sample disclosed prior suicidal ideation (30.0%) or attempts (27.9%). Multinomial logistic regression models indicated more severe MDD and GAD symptomology differentiated ideators from non-suicidal adolescents, but internalizing disorder severity did not differ between ideators and attempters. Substance use frequency did not differ between suicide risk groups. MDD severity and frequency of alcohol use interacted to increase the risk of attempts, yet the effects were minimal. Instead, prior weapon violence victimization and sexual abuse were the largest differentiators between attempters and ideators. Conclusions: Findings suggest that internalizing disorder severity and prior traumatic experiences put adolescents with SUD histories at higher risk of suicidal thoughts and behaviors. Thus, integrating evidence-based suicide prevention and intervention efforts into SUD treatment is critical, particularly for dually diagnosed adolescents who meet these risk profiles. Psychotherapy and medication may help curtail the development of ideation by reducing symptoms of MDD and GAD, whereas adolescents with prior traumatic experiences may benefit from additional treatments shown to lower risk of suicide attempts.
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Affiliation(s)
- Lauren M Berny
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
| | - Emily E Tanner-Smith
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA.,Prevention Science Institute, University of Oregon, Eugene, OR, USA
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41
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Köck P, Meyer M, Elsner J, Dürsteler KM, Vogel M, Walter M. Co-occurring Mental Disorders in Transitional Aged Youth With Substance Use Disorders - A Narrative Review. Front Psychiatry 2022; 13:827658. [PMID: 35280170 PMCID: PMC8907594 DOI: 10.3389/fpsyt.2022.827658] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/21/2022] [Indexed: 11/28/2022] Open
Abstract
Adolescence and emerging adulthood are often referred to as youth. Transitional psychiatry addresses this target group, which considers patients between 15 and 25 years of age. Substance use usually begins and peaks at this stage of life. Psychiatric disorders, foremost attention-deficit/hyperactivity disorder, and affective disorders, conduct disorders, and first-episodes psychosis frequently appear in early life stages. This review aims to provide a broad overview of transitional-aged youth's most common psychiatric comorbidities with substance use disorders. A literature search was conducted in Embase and Pubmed, and the main findings are described narratively. We present main findings for the following comorbidities: attention-deficit/hyperactivity disorder, conduct disorder, personality disorders, affective disorders, psychotic disorders, and the phenomena of overdose and suicidality. In conclusion, co-occurring mental health disorders are common and appear to facilitate the development of substance use disorders and exacerbate their overall course. Substance use also affects the severity and course of comorbid psychiatric disorders. Overall, data on transition-age youth with substance use disorders are highly inconsistent. Universal screening and treatment guidelines do not yet exist but should be aimed for in the future.
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Affiliation(s)
- Patrick Köck
- Department of Addictive Disorders, University Psychiatric Clinics Basel, Basel, Switzerland
| | - Maximilian Meyer
- Department of Addictive Disorders, University Psychiatric Clinics Basel, Basel, Switzerland
| | - Julie Elsner
- University Psychiatric Clinics Basel, Clinic for Children and Adolescents, University of Basel, Basel, Switzerland
| | - Kenneth M Dürsteler
- Department of Addictive Disorders, University Psychiatric Clinics Basel, Basel, Switzerland.,Department for Psychiatry, Psychotherapy and Psychosomatic, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Marc Vogel
- Department of Addictive Disorders, University Psychiatric Clinics Basel, Basel, Switzerland.,Division of Substance Use Disorders, Psychiatric Clinic, Psychiatric Services of Thurgovia, Münsterlingen, Switzerland
| | - Marc Walter
- Department of Addictive Disorders, University Psychiatric Clinics Basel, Basel, Switzerland.,Department of Psychiatry and Psychotherapy, Psychiatric Services Aargau, Windisch, Switzerland
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42
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Yuen WS, Bruno R, Chan GCK, McCambridge J, Slade T, Clare PJ, Aiken A, Kypri K, Hutchinson D, McBride N, Boland V, Upton E, Farrell M, Mattick RP, Peacock A. The experience of physiological and psychosocial alcohol-related harms across adolescence and its association with alcohol use disorder in early adulthood: A prospective cohort study. Alcohol Clin Exp Res 2021; 45:2518-2527. [PMID: 34921682 DOI: 10.1111/acer.14726] [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: 05/05/2021] [Revised: 08/27/2021] [Accepted: 10/01/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Different forms of alcohol-related harm (e.g., hangovers, fighting) may confer differential risk of clinically relevant alcohol problems. We examine: (i) patterns of transition in experiencing alcohol-related harms across adolescence; (ii) whether factors in early adolescence predict transition patterns; and (iii) whether transition patterns predict later alcohol use disorder (AUD) symptoms. METHODS We used a longitudinal Australian cohort (n = 1828) to model latent class transition patterns of alcohol-related harms across three timepoints (Mage = 13.9, 16.8, 18.8 years). Regression models assessed whether child, peer, and parent factors in early adolescence (Mage = 12.9) predicted harms transition patterns and whether these patterns predicted AUD symptoms in early adulthood (Mage = 19.8). RESULTS Five transition patterns characterized most of the cohort (n ≈ 1609, 88.0%): (i) minimal harms (n ≈ 381, 20.8%); (ii) late physiological harms (n ≈ 702, 38.4%); (iii) early physiological harms (n ≈ 226, 12.4%); (iv) late all harms (n ≈ 131, 7.2%); and (v) gradual all harms (n ≈ 169, 9.2%). With late physiological harms as the reference, females had increased risk of experiencing early physiological harms (relative risk [RR]: 2.15; 99.5% CI: 1.19, 3.90). Late all harms (RR: 1.71; CI: 1.19, 2.47) and gradual all harms (RR: 1.84; CI: 1.37, 2.47) were each associated with increased odds of meeting criteria for AUD, even when patterns of alcohol consumption are considered. CONCLUSIONS Adolescents display heterogeneous transition patterns across physiological and psychosocial alcohol-related harms. Females are at greater risk of experiencing early physiological harms. Experience of both physiological and psychosocial harms in late adolescence is an important and potentially modifiable precursor to clinically relevant alcohol problems in early adulthood.
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Affiliation(s)
- Wing See Yuen
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Raimondo Bruno
- School of Psychological Sciences, University of Tasmania, Sandy Bay, Tasmania, Australia
| | - Gary C K Chan
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Queensland, Australia
| | | | - Tim Slade
- The Matilda Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Philip J Clare
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia.,Prevention Research Collaboration, The Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Alexandra Aiken
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia.,Centre for Social and Early Emotional Development, Deakin University, Burwood, Victoria, Australia.,Department of Paediatrics, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Bentley, Western Australia, Australia
| | - Veronica Boland
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Emily Upton
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Richard P Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia.,School of Psychological Sciences, University of Tasmania, Sandy Bay, Tasmania, Australia
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Abstract
A growing evidence base supports the use of medication to treat opioid use disorder (OUD) in adolescents, but little is known about behavioral therapies for adolescents with OUD. A systematic review using PRISMA methodology was conducted on behavioral therapy for adolescent OUD. Only three studies were identified. Combined evidence from two studies indicates initial efficacy of the Adolescent-Community Reinforcement Approach, motivational enhancement therapy, and cognitive-behavioral therapy for reducing opioid use. The only group therapy identified, which involved adolescents and their parents, demonstrated improvement in participants' knowledge of relapse-prevention strategies, drug-refusal skills, and overall psychosocial functioning. Additional studies that included behavioral therapy but that did not specifically test its efficacy are also highlighted to expand the understanding of the small literature base. This review highlights the sparse evidence base for these therapies in this population. In addition, we highlight promising areas for future research and include evidence from the adult literature that may inform that research. Studies on behavioral therapies that utilize randomized, controlled trials for this population are imperative.
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44
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Dick AS, Lopez DA, Watts AL, Heeringa S, Reuter C, Bartsch H, Fan CC, Kennedy DN, Palmer C, Marshall A, Haist F, Hawes S, Nichols TE, Barch DM, Jernigan TL, Garavan H, Grant S, Pariyadath V, Hoffman E, Neale M, Stuart EA, Paulus MP, Sher KJ, Thompson WK. Meaningful associations in the adolescent brain cognitive development study. Neuroimage 2021; 239:118262. [PMID: 34147629 PMCID: PMC8803401 DOI: 10.1016/j.neuroimage.2021.118262] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/07/2021] [Accepted: 06/10/2021] [Indexed: 02/08/2023] Open
Abstract
The Adolescent Brain Cognitive Development (ABCD) Study is the largest single-cohort prospective longitudinal study of neurodevelopment and children's health in the United States. A cohort of n = 11,880 children aged 9-10 years (and their parents/guardians) were recruited across 22 sites and are being followed with in-person visits on an annual basis for at least 10 years. The study approximates the US population on several key sociodemographic variables, including sex, race, ethnicity, household income, and parental education. Data collected include assessments of health, mental health, substance use, culture and environment and neurocognition, as well as geocoded exposures, structural and functional magnetic resonance imaging (MRI), and whole-genome genotyping. Here, we describe the ABCD Study aims and design, as well as issues surrounding estimation of meaningful associations using its data, including population inferences, hypothesis testing, power and precision, control of covariates, interpretation of associations, and recommended best practices for reproducible research, analytical procedures and reporting of results.
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Affiliation(s)
- Anthony Steven Dick
- Department of Psychology and Center for Children and Families, Florida International University, Miami, FL, United States
| | - Daniel A Lopez
- Division of Epidemiology, Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, United States
| | - Ashley L Watts
- Department of Psychology, University of Missouri, MO, United States
| | - Steven Heeringa
- Institute for Social Research, University of Michigan, Ann Arbor, MI 48109, United States
| | - Chase Reuter
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA 92093, United States
| | - Hauke Bartsch
- Mohn Medical Imaging and Visualization Center, Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Chun Chieh Fan
- Population Neuroscience and Genetics Lab, University of California, San Diego, La Jolla, CA 92093, United States
| | - David N Kennedy
- Department of Psychiatry, University of Massachusetts Medical School, MA United States, 01604
| | - Clare Palmer
- Center for Human Development, University of California, San Diego, La Jolla, CA 92093, United States
| | - Andrew Marshall
- Children's Hospital Los Angeles, and the Department of Pediatrics, University of Southern California, Los Angeles, CA, United States
| | - Frank Haist
- Department of Radiology, University of California, San Diego, La Jolla, CA 92093, United States
| | - Samuel Hawes
- Department of Psychology and Center for Children and Families, Florida International University, Miami, FL, United States
| | - Thomas E Nichols
- Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Deanna M Barch
- Departments of Psychological & Brain Sciences, Psychiatry and Radiology, Washington University, St. Louis, MO 63130, United States
| | - Terry L Jernigan
- Department of Psychiatry, University of Massachusetts Medical School, MA United States, 01604
| | - Hugh Garavan
- Department of Psychiatry, University of Vermont, Burlington, VT, 05405, United States
| | - Steven Grant
- Behavioral and Cognitive Neuroscience Branch, Division of Neuroscience and Behavior, National Institute on Drug Abuse, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, United States
| | - Vani Pariyadath
- Behavioral and Cognitive Neuroscience Branch, Division of Neuroscience and Behavior, National Institute on Drug Abuse, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, United States
| | - Elizabeth Hoffman
- National Institute on Drug Abuse, National Institutes of Health, Department of Heatlh and Human Services, Bethesda, MD, United States
| | - Michael Neale
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA 23298, United States
| | - Elizabeth A Stuart
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Kenneth J Sher
- Department of Psychology, University of Missouri, MO, United States
| | - Wesley K Thompson
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA 92093, United States; Population Neuroscience and Genetics Lab, University of California, San Diego, La Jolla, CA 92093, United States.
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Taylor BK, Eastman JA, Frenzel MR, Embury CM, Wang YP, Stephen JM, Calhoun VD, Badura-Brack AS, Wilson TW. Subclinical Anxiety and Posttraumatic Stress Influence Cortical Thinning During Adolescence. J Am Acad Child Adolesc Psychiatry 2021; 60:1288-1299. [PMID: 33383162 PMCID: PMC8236497 DOI: 10.1016/j.jaac.2020.11.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 11/17/2020] [Accepted: 12/22/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Adolescence is a sensitive period for the development and emergence of anxiety and mood disorders. Research suggests that symptoms ranging from subclinical to clinical levels are associated with pathological developmental changes in the neocortex. However, much of this research has been cross-sectional, limiting the field's ability to identify the neurodevelopmental impacts of these symptoms. The present study examined how early reported symptoms predict baseline cortical thickness and surface area, and trajectories of change in these measures during adolescence. METHOD A total of 205 typically developing individuals 9 to 15 years of age (103 male and 102 female participants) completed 3T structural magnetic resonance imaging annually for 3 years. From these, we extracted mean cortical thickness and total surface area for each year. Youth self-reported their anxiety, depressive, and posttraumatic stress symptoms during their first visit. We used latent growth curve modeling to determine how these symptoms along with sex interactions predicted baseline thickness and surface area, and rates of change in these measures over the 3-year period. RESULTS Higher anxiety was associated with lower baseline thickness and slowed cortical thinning over time. Conversely, greater posttraumatic stress predicted higher baseline thickness and accelerated thinning over time. Sex interactions suggested that the effects were dampened among female compared to male participants. Depressive symptoms were not related to cortical thickness or surface area. CONCLUSION Female adolescents may express more regionally specific effects of symptoms sets on cortical thickness, although this requires further investigation. Cortical thickness in male adolescents appears to be preferentially susceptible to anxiety and posttraumatic stress symptoms, exhibiting global changes across multiple years.
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Stapinski LA, Prior K, Newton NC, Biswas RK, Kelly E, Deady M, Lees B, Teesson M, Baillie AJ. Are we making Inroads? A randomized controlled trial of a psychologist-supported, web-based, cognitive behavioral therapy intervention to reduce anxiety and hazardous alcohol use among emerging adults. EClinicalMedicine 2021; 39:101048. [PMID: 34622183 PMCID: PMC8478683 DOI: 10.1016/j.eclinm.2021.101048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Anxiety and alcohol use disorders are common and disabling conditions that people typically endure for many years before accessing treatment. The link between anxiety and alcohol use is well-established, with these issues commonly emerging and/or escalating during emerging adulthood. This randomized controlled trial evaluated a psychologist-supported, web-based intervention, designed with and for emerging adults, that aims to promote adaptive coping strategies, and prevent anxiety and alcohol use from progressing to chronic, mutually-reinforcing disorders. METHODS Between December 2017 and September 2018, 123 emerging adults (aged 17-24) reporting anxiety symptoms and hazardous alcohol use were randomized to receive the Inroads or control (assessment plus alcohol information) intervention. The Inroads program combined five web-based cognitive behavioral therapy modules with weekly psychologist support via email/phone. Primary outcomes were alcohol consumption, severity of alcohol-related consequences, and general anxiety symptoms, assessed at baseline, 2 and 6-months post-baseline. Secondary outcomes included hazardous alcohol use and social anxiety. Trial Registration: Prospectively registered in the Australian New Zealand Clinical Trials Registry, ACTRN12617001609347. FINDINGS Alcohol consumption and associated consequences reduced in both groups, with the Inroads group reporting greater alcohol reductions by 6-month follow-up (mean difference -0.74, 95% CI: -1.47 to -0.01, d = 0.24). Relative to controls, hazardous alcohol use reduced among Inroads participants at both follow-ups (2-month mean difference -2.14, 95% CI: -4.06 to -0.22). Inroads participants also reported reduced symptoms of general (mean difference -3.06, 95% CI: -4.97 to -1.15, d = 0.88) and social anxiety (mean difference -3.21, 95% CI: -6.34 to -0.07, d = 0.32) at 2-month follow-up, with improvements in social anxiety sustained at 6-months. INTERPRETATION The Inroads program demonstrated beneficial effects on alcohol consumption, hazardous alcohol use, and anxiety symptoms. The web-based format is aligned with youth treatment preferences and can be delivered at scale to achieve wide dissemination and reduce the significant burden associated with these chronic, mutually reinforcing conditions. FUNDING Australian Rotary Health, Australian National Health and Medical Research Council.
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Affiliation(s)
- Lexine A. Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
- Corresponding author.
| | - Katrina Prior
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Nicola C. Newton
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Raaj Kishore Biswas
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
- Transport and Road Safety (TARS) Research Centre, School of Aviation, University of New South Wales, Sydney 2052, Australia
| | - Erin Kelly
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Mark Deady
- Black Dog Institute, University of New South Wales, Sydney 2052, Australia
| | - Briana Lees
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Andrew J. Baillie
- Sydney School of Health Sciences, University of Sydney, Sydney 2006, Australia
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Rowe AT, Khazvand S, Wu W, Barnes-Najor J, Zapolski TCB. Dieting and substance use among White and Black adolescent girls. Eat Behav 2021; 42:101515. [PMID: 34023665 PMCID: PMC8868504 DOI: 10.1016/j.eatbeh.2021.101515] [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: 08/16/2020] [Revised: 04/20/2021] [Accepted: 04/26/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Previous research has found an increasing co-occurrence of dieting and substance use behavior among adolescent girls. However, to date few studies have examined the temporal ordering of these behaviors. Further, limited research has been conducted to explore whether the pathways are similar among both White and Black girls. METHOD For the current study 1580 girls (grade 6-11; 78.2% White; 21.8% Black) provided data on their dieting behavior and substance use. A cross-lagged panel design was used to examine the concurrent and prospective relationship between dieting behavior and substance use across one year, then by race. RESULTS Among the full sample of girls, there was a significant concurrent relationship. Additionally, dieting behavior predicted substance use one year later, but the inverse relationship was not found. For the stratified analysis, dieting behavior and substance use were not correlated among Black girls at either time point, however concurrent relationships were found for White girls. For the prospective pathways non-significant effects were found for both groups. DISCUSSION These findings provide support for a temporal relationship between dieting behavior and substance use, such that the former predicts risk for the latter. However, when examined by race, some pathways of the full sample were found for White girls, whereas Black girls did not report an association between study variables. Thus, future studies should consider the impact of race within risk pathways.
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Affiliation(s)
- Alia T Rowe
- Department of Psychology, Indiana University-Purdue University Indianapolis, United States.
| | - Shirin Khazvand
- Department of Psychology, Indiana University-Purdue University Indianapolis, United States
| | - Wei Wu
- Department of Psychology, Indiana University-Purdue University Indianapolis, United States
| | - Jessica Barnes-Najor
- Community Partnerships, Office for Public Engagement and Scholarship, Michigan State University, United States
| | - Tamika C B Zapolski
- Department of Psychology, Indiana University-Purdue University Indianapolis, United States
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Ganson KT, Murray SB, Nagata JM. Associations between eating disorders and illicit drug use among college students. Int J Eat Disord 2021; 54:1127-1134. [PMID: 33638571 DOI: 10.1002/eat.23493] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To estimate the associations between a positive eating disorder screen and any lifetime eating disorder diagnosis and illicit drug use among a large, diverse sample of college students. METHOD We analyzed data from the national (United States), cross-sectional 2018-2019 Healthy Minds Study (HMS; n = 42,618; response rate: 16%). HMS collects information on the physical, mental, and social health of college students. Multiple logistic regression analyses were used to estimate the association between a positive eating disorder screen (measured using the SCOFF) and any self-reported lifetime eating disorder diagnosis and self-reported illicit drug use in the past 30 days (any illicit drug use and use of marijuana, cocaine, heroin, methamphetamines, stimulants, ecstasy, opioids, benzodiazepines), while adjusting for potential confounders. RESULTS Among the sample, 54.34% (n = 28,608) were female and the mean age of participants was 23.30 (SE ± 0.05) years. Logistic regression analyses revealed unique associations between a positive eating disorder screen and any lifetime eating disorder diagnosis and illicit drug use among the sample of college student participants. A positive eating disorder screen was most strongly associated with methamphetamine use (adjusted odds ratio [AOR] 3.93, 95% confidence interval [CI] 1.43-10.78), and any lifetime eating disorder diagnosis was most strongly associated with benzodiazepine use (AOR 3.42, 95% CI 2.28-5.13). DISCUSSION Illicit drug use is common among college students who screen positive for an eating disorder and report any lifetime eating disorder diagnosis. The co-occurring nature of eating disorders and illicit drug use may complicate treatment and lead to compounded adverse health outcomes.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
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Luo X, Zhou Y, Zheng R, Li X, Dai Y, Narayan A, Huang X, Tian X, Jin X, Mei L, Xie X, Gu H, Hou F, Liu L, Luo X, Meng H, Zhang J, Song R. Association of health-risk behaviors and depressive symptoms and anxiety symptoms: a school-based sample of Chinese adolescents. J Public Health (Oxf) 2021; 42:e189-e198. [PMID: 31641762 DOI: 10.1093/pubmed/fdz115] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 07/08/2019] [Accepted: 08/13/2019] [Indexed: 02/06/2023] Open
Abstract
Background Depressive symptoms and anxiety symptoms of adolescents not only affect youth but also have wide-ranging impacts on the health of adults. The study was carried out to determine the epidemiological characteristics of depressive symptoms and anxiety symptoms and the associations between the two and health-risk behaviors in Chinese adolescents. Methods Participants were recruited from the junior and senior high schools in China. Data were collected by self-designed questionnaires. The questionnaires included questions about demographic characteristics, depressive symptom scales, anxiety symptom scales and nine categories of health-risk behaviors. Descriptive analysis and binary logistic regression were performed by SPSS 21.0 software. Results There were 4.4% of the participants with depressive symptoms. Approximately 32.0% of the participants had anxiety symptoms. Girls and general senior school students were risk factors for depressive symptoms and anxiety symptoms. Multiple health-risk behaviors were associated with depressive symptoms and anxiety symptoms in Chinese adolescents. Conclusion Depressive symptoms and anxiety symptoms were prevalent in Chinese adolescents. Their distribution was affected by certain health-risk behaviors. Multiple health-risk behaviors were associated with depressive symptoms and anxiety symptoms in Chinese adolescents.
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Affiliation(s)
- Xiaomin Luo
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yu Zhou
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ruimin Zheng
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xin Li
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue Dai
- National Health Commission of the People's Republic of China, Beijing, China
| | - Anuradha Narayan
- Health, Nutrition & WASH Section of UNICEF China Office, Beijing, China
| | - Xiaona Huang
- Health, Nutrition & WASH Section of UNICEF China Office, Beijing, China
| | - Xiaobo Tian
- Health, Nutrition & WASH Section of UNICEF China Office, Beijing, China
| | - Xi Jin
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lili Mei
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xinyan Xie
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huaiting Gu
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Hou
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lingfei Liu
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiu Luo
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Heng Meng
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, NC, USA
| | - Ranran Song
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Hayati Rezvan P, Rezai R, Comulada WS, Lee SJ, Arnold EM, Swendeman D, Rotheram-Borus MJ, Fernández MI, Adolescent Trials Network Atn Cares Team. Psychiatric hospitalization among youth at high risk for HIV. AIDS Care 2021; 34:1073-1082. [PMID: 34165345 PMCID: PMC8702570 DOI: 10.1080/09540121.2021.1944599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Youth at-risk for HIV are also at-risk for mental health disorders and psychiatric hospitalization. Understanding the association between engagement in HIV prevention, concurrent risk behaviors, and psychiatric hospitalization may lead to improvements in integrated prevention and mental health treatment efforts. Youth at-risk for HIV, aged 14-24 years old, predominantly Black/African American and Latinx (75%) were recruited through youth-serving clinics and community sites in Los Angeles (n = 839) and New Orleans (n = 647). We compared youth with and without histories of psychiatric hospitalization on engagement in HIV prevention, concurrent risk behaviors, and demographic characteristics. We examined predictors of hospitalization using multiple imputations for missing data. Hospitalized youth (30%) were more involved in HIV programs, but were less likely to use PrEP/PEP or condoms than non-hospitalized youth. The odds of hospitalization were higher for transgender/gender nonconforming youth relative to cisgender youth; the OR was increased after adjustment for concurrent risk behaviors. Hospitalization was associated with homelessness, trauma, incarceration, substance use, and involvement in substance abuse treatment programs. There is a continuing need to integrate the diagnosis and treatment of mental health disorders into HIV prevention programs to better address multiple challenges faced by vulnerable youth.
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Affiliation(s)
- Panteha Hayati Rezvan
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Roxana Rezai
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.,Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - W Scott Comulada
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Sung-Jae Lee
- UCLA Nathanson Family Resilience Center, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | | | - Dallas Swendeman
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Mary Jane Rotheram-Borus
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - M Isabel Fernández
- College of Osteopathic Medicine, Nova Southeastern University, Miami, FL, USA
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