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Murta JCD, Easpaig BNG, Hazell-Raine K, Byrne MK, Lertwatthanawilat W, Kritkitrat P, Bressington D. Recreational cannabis policy reform-What mental health nurses need to know about minimising harm and contributing to the reform debate. J Psychiatr Ment Health Nurs 2024; 31:270-282. [PMID: 37767750 DOI: 10.1111/jpm.12984] [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: 04/04/2023] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
The recently rapidly evolving legal status of recreational cannabis in various countries has triggered international debate, particularly around measures required to minimise resulting harms. The present article argues that mental health nurses should have a key role in promoting safe and appropriate use of recreational cannabis, and minimising harm based on the extant evidence. The article summarises the factors driving legalisation, outlines the evident medicinal benefits of cannabis, and appraises the evidence on the negative mental health impacts associated with use. We go on to discuss research findings on the potentially deleterious mental health effects resulting from legalising recreational cannabis and strategies to minimise these harms, including directions for future research and evaluation. Further, we consider the importance of the implementation of harm minimisation measures that are context-specific, using Thailand as an example. Finally, we present the key health promotion messages that mental health nurses should aim to convey to people who use or consider using recreational cannabis. Ultimately, we aim to provide a summary of the existing evidence that mental health nurses can draw upon to promote mental health and engage with the policy reform debate.
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Affiliation(s)
| | | | - Karen Hazell-Raine
- Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Mitchell K Byrne
- Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia
| | | | | | - Daniel Bressington
- Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
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Christensen GM, Marcus M, Vanker A, Eick SM, Malcolm-Smith S, Smith ADAC, Dunn EC, Suglia SF, Chang HH, Zar HJ, Stein DJ, Hüls A. Sensitive periods for exposure to indoor air pollutants and psychosocial factors in association with symptoms of psychopathology at school-age in a South African birth cohort. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.08.23293825. [PMID: 37609236 PMCID: PMC10441486 DOI: 10.1101/2023.08.08.23293825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Background Gestation and the first few months of life are important periods for brain development. During these periods, exposure to environmental toxicants and psychosocial stressors are particularly harmful and may impact brain development. Specifically, exposure to indoor air pollutants (IAP) and psychosocial factors (PF) during these sensitive periods has been shown to predict childhood psychopathology. Objectives This study aims to investigate sensitive periods for the individual and joint effects of IAP and PF on childhood psychopathology at 6.5 years. Methods We analyzed data from the Drakenstein Child Health Study (N=599), a South African birth cohort. Exposure to IAP and PF was measured during the second trimester of pregnancy and 4 months postpartum. The outcome of childhood psychopathology was assessed at 6.5 years old using the Childhood Behavior Checklist (CBCL). We investigated individual effects of either pre-or postnatal exposure to IAP and PF on CBCL scores using adjusted linear regression models, and joint effects of these exposures using quantile g-computation and self-organizing maps (SOM). To identify possible sensitive periods, we used a structured life course modeling approach (SLCMA) as well as exposure mixture methods (quantile g-computation and SOM). Results Prenatal exposure to IAP or PFs, as well as the total prenatal mixture assessed using quantile g-computation, were associated with increased psychopathology. SLCMA and SOM models also indicated that the prenatal period is a sensitive period for IAP exposure on childhood psychopathology. Depression and alcohol were associated in both the pre-and postnatal period, while CO was associated with the postnatal period. Discussion Pregnancy may be a sensitive period for the effect of indoor air pollution on childhood psychopathology. Exposure to maternal depression and alcohol in both periods was also associated with psychopathology. Determining sensitive periods of exposure is vital to ensure effective interventions to reduce childhood psychopathology.
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Abstract
AbstractIt is well established that high-dose alcohol consumption during pregnancy increases the risk for a plethora of adverse offspring outcomes. These include neurodevelopmental, cognitive and social deficits, as well as psychiatric illnesses, such as depression and anxiety. However, much less evidence is available on the effects of low- and early-dose alcohol exposure on mental health outcomes, regardless of the accumulating evidence that mental health outcomes should be considered in the context of the Developmental Origins of Health and Disease hypothesis. This review will discuss the evidence that indicates low-dose and early prenatal alcohol exposure can increase the risk of mental illness in offspring and discuss the mechanistic pathways that may be involved.
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Clark CAC, Massey SH, Wiebe SA, Espy KA, Wakschlag LS. Does early maternal responsiveness buffer prenatal tobacco exposure effects on young children's behavioral disinhibition? Dev Psychopathol 2019; 31:1285-1298. [PMID: 30428950 PMCID: PMC6520205 DOI: 10.1017/s0954579418000706] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Children with prenatal tobacco exposure (PTE) exhibit early self-regulatory impairments, reflecting a life-course persistent propensity toward behavioral disinhibition. Previously, we demonstrated the protective role of parental responsiveness for reducing the risk of exposure-related disruptive behavior in adolescence. Here, we expanded this line of inquiry, examining whether responsiveness moderates the relation of PTE to a broader set of behavioral disinhibition features in early childhood and testing alternative diathesis-stress versus differential susceptibility explanatory models. PTE was assessed prospectively using interviews and bioassays in the Midwestern Infant Development Study (MIDS). Mother-child dyads (N = 276) were re-assessed at approximately 5 years of age in a preschool follow-up. We quantified maternal responsiveness and child behavioral disinhibition using a combination of directly observed activities in the lab and developmentally sensitive questionnaires. Results supported a diathesis-stress pattern. Children with PTE and less responsive mothers showed increased disruptive behavior and lower effortful control compared with children without PTE. In contrast, exposed children with more responsive mothers had self-regulatory profiles similar to their non-exposed peers. We did not observe sex differences. Findings provide greater specification of the protective role of maternal responsiveness for self-regulation in children with PTE and help clarify mechanisms that may underscore trajectories of exposure-related behavioral disinhibition.
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Affiliation(s)
- Caron A C Clark
- Department of Educational Psychology,University of Nebraska-Lincoln,Lincoln, NE,USA
| | - Suena H Massey
- Department of Psychiatry and Behavioral Sciences,Northwestern University Feinberg School of Medicine,Chicago, IL,USA
| | - Sandra A Wiebe
- Department of Psychology,University of Alberta,Edmonton,Alberta,Canada
| | - Kimberly Andrews Espy
- Office of the Provost,University of San Antonio at Texas, San Antonio, TX, USA;Developmental Cognitive Neuroscience Laboratory,University of Nebraska-Lincoln,Lincoln, NE, USA
| | - Lauren S Wakschlag
- Institute for Innovations in Developmental Sciences, Northwestern University,Chicago,IL, USA
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Ruckle D, Keheila M, West B, Baron P, Villicana R, Mattison B, Thomas A, Thomas J, De Vera M, Kore A, Wai P, Baldwin DD. Should donors who have used marijuana be considered candidates for living kidney donation? Clin Kidney J 2019; 12:437-442. [PMID: 31198546 PMCID: PMC6543962 DOI: 10.1093/ckj/sfy107] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The use of marijuana in the USA has been steadily increasing over the last 10 years. This study is the first to investigate the effect of marijuana use by live kidney donors upon outcomes in both donors and recipients. METHODS Living kidney donor transplants performed between January 2000 and May 2016 in a single academic institution were retrospectively reviewed. Donor and recipient groups were each divided into two groups by donor marijuana usage. Outcomes in donor and recipient groups were compared using t-test, Chi-square and mixed linear analysis (P < 0.05 considered significant). RESULTS This was 294 living renal donor medical records were reviewed including 31 marijuana-using donors (MUD) and 263 non-MUDs (NMUD). It was 230 living kidney recipient records were reviewed including 27 marijuana kidney recipients (MKRs) and 203 non-MKRs (NMKR). There was no difference in donor or recipient perioperative characteristics or postoperative outcomes based upon donor marijuana use (P > 0.05 for all comparisons). There was no difference in renal function between NMUD and MUD groups and no long-term difference in kidney allograft function between NMKR and MKR groups. CONCLUSIONS Considering individuals with a history of marijuana use for living kidney donation could increase the donor pool and yield acceptable outcomes.
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Affiliation(s)
- David Ruckle
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Mohamed Keheila
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Benjamin West
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Pedro Baron
- Department of Transplant and Transplant Nephrology, Loma Linda University Health, Loma Linda, CA, USA
| | - Rafael Villicana
- Department of Transplant and Transplant Nephrology, Loma Linda University Health, Loma Linda, CA, USA
| | - Braden Mattison
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Alex Thomas
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Jerry Thomas
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Michael De Vera
- Department of Transplant and Transplant Nephrology, Loma Linda University Health, Loma Linda, CA, USA
| | - Arputharaj Kore
- Department of Transplant and Transplant Nephrology, Loma Linda University Health, Loma Linda, CA, USA
| | - Philip Wai
- Department of Transplant and Transplant Nephrology, Loma Linda University Health, Loma Linda, CA, USA
| | - D Duane Baldwin
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
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Römer P, Reinelt T, Petermann F, Teickner C. Alkoholkonsum während der Schwangerschaft. KINDHEIT UND ENTWICKLUNG 2019. [DOI: 10.1026/0942-5403/a000267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Kinder sind bereits im Mutterleib sensitiv für Umwelteinflüsse. Pränataler Alkoholkonsum zählt dabei zu den einflussreichsten Risikofaktoren für die frühkindliche Entwicklung. Das Ziel ist es, einen Überblick über die aktuelle Forschungslage zum Thema Alkoholkonsum während der Schwangerschaft zu geben. Darüber hinaus wird der Forschungsstand zu Belastungen und Folgeschäden für die frühkindliche Entwicklung durch pränatale Alkoholexposition, aber auch zu weiteren Risikofaktoren zusammengefasst. Es wird gezeigt, dass das Wissen um die Prävalenz für Alkoholkonsum während der Schwangerschaft sowohl für die Erforschung der Folgen als auch für das Umsetzen von präventiven Maßnahmen ausschlaggebend ist. Die Prävalenzen unterscheiden sich nicht nur regional, sondern können auch durch andere Faktoren beeinflusst werden. Es wird deutlich, dass der Risikofaktor Alkohol und dessen mögliche Auswirkungen auf die frühkindliche Entwicklung nicht isoliert, sondern in Abhängigkeit von weiteren genetischen und Umweltfaktoren betrachtet werden müssen. Denn auch Folgen von weiteren perinatalen Risikofaktoren machen sich in den ersten beiden Lebensjahren bemerkbar. Beispiele für Entwicklungsstörungen in dieser Entwicklungsspanne sind externalisierendes Verhalten und kognitive Beeinträchtigungen. Inwieweit sich perinatale Risikofaktoren jedoch auf Entwicklungsverläufe von Kindern, die durch pränatalen Alkoholkonsum belastet sind, auswirken, erfasst eine umfassende Diskussion. Diese Lücke gilt es zu schließen um das Zusammenspiel perinataler Risiken genauer zu verstehen und adäquat entgegenwirken zu können.
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Affiliation(s)
- Pia Römer
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Tilman Reinelt
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Claudia Teickner
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
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Madigan S, Oatley H, Racine N, Fearon RMP, Schumacher L, Akbari E, Cooke JE, Tarabulsy GM. A Meta-Analysis of Maternal Prenatal Depression and Anxiety on Child Socioemotional Development. J Am Acad Child Adolesc Psychiatry 2018; 57:645-657.e8. [PMID: 30196868 DOI: 10.1016/j.jaac.2018.06.012] [Citation(s) in RCA: 243] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 05/23/2018] [Accepted: 06/21/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Observed associations between maternal prenatal stress and children's socioemotional development have varied widely in the literature. The objective of the current study was to provide a synthesis of studies examining maternal prenatal anxiety and depression and the socioemotional development of their children. METHOD Eligible studies through to February 2018 were identified using a comprehensive search strategy. Included studies examined the association between maternal prenatal depression or anxiety and the future development of their children's socioemotional development (eg, difficult temperament, behavioral dysregulation) up to 18 years later. Two independent coders extracted all relevant data. Random-effects meta-analyses were used to derive mean effect sizes and test for potential moderators. RESULTS A total of 71 studies met full inclusion criteria for data analysis. The weighted average effect size for the association between prenatal stress and child socioemotional problems was as follows: odds ratio (OR) = 1.66 (95% CI = 1.54-1.79). Effect sizes were stronger for depression (OR = 1.79; 95% CI = 1.61-1.99) compared to anxiety (OR = 1.50; 95% CI = 1.36-1.64). Moderator analyses indicated that effect sizes were stronger when depression was more severe and when socio-demographic risk was heightened. CONCLUSION Findings suggest that maternal prenatal stress is associated with offspring socioemotional development, with the effect size for prenatal depression being more robust than for anxiety. Mitigating stress and mental health difficulties in mothers during pregnancy may be an effective strategy for reducing offspring behavioral difficulties, especially in groups with social disadvantage and greater severity of mental health difficulties.
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Affiliation(s)
| | - Hannah Oatley
- Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | | | - Emis Akbari
- George Brown College, Toronto, Ontario, Canada
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De Genna NM, Richardson GA, Goldschmidt L, Day NL, Cornelius MD. Prenatal exposures to tobacco and cannabis: Associations with adult electronic cigarette use. Drug Alcohol Depend 2018; 188:209-215. [PMID: 29778775 PMCID: PMC6038701 DOI: 10.1016/j.drugalcdep.2018.03.045] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/26/2018] [Accepted: 03/28/2018] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Prenatal exposures to tobacco and cannabis are associated with combustible cigarette use. This study evaluated pathways from these prenatal exposures to adult electronic cigarette use. We tested whether there were indirect effects of these prenatal exposures via childhood behavior dysregulation, early tobacco use, and adolescent tobacco dependence. METHODS Telephone interviews were conducted with 427 adult offspring (22-33 years old) from 3 prenatal cohorts with trimester-specific data on exposures to tobacco, alcohol, and cannabis. The offspring were 59% Black and 41% White (61% female). Prenatal exposures included quantity/frequency of tobacco, alcohol, and cannabis use by mothers during the first trimester. Using logistic regression and structural equation modeling, we examined the effects of gestational exposures on adult electronic cigarette use via early cigarette use (prior to age 14), controlling for covariates of combustible and electronic cigarette use. RESULTS There were no effects of childhood behavioral dysregulation on electronic cigarette use. However, there was a significant indirect effect of prenatal exposures to tobacco and cannabis on electronic cigarette use via early adolescent combustible cigarette use and adolescent risk for tobacco dependence. CONCLUSIONS One implication of these findings is that the inter-generational risk for tobacco use conferred via gestational exposures to tobacco and cannabis generalizes to novel products such as electronic cigarettes. These results have implications for public health, as more women use cannabis and co-use cigarettes and cannabis during pregnancy.
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Affiliation(s)
- Natacha M De Genna
- University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic (WPIC), 3811 O'Hara Street, Pittsburgh, PA, 15213, USA.
| | - Gale A Richardson
- University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic (WPIC), 3811 O'Hara Street, Pittsburgh, PA, 15213, USA.
| | - Lidush Goldschmidt
- Western Psychiatric Institute and Clinic (WPIC) at University of Pittsburgh Medical Center (UPMC), 3811 O'Hara Street, Pittsburgh, PA, 15213, USA.
| | - Nancy L Day
- University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic (WPIC), 3811 O'Hara Street, Pittsburgh, PA, 15213, USA.
| | - Marie D Cornelius
- University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic (WPIC), 3811 O'Hara Street, Pittsburgh, PA, 15213, USA.
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