Low family support perception: a ‘social marker’ of substance dependence?

Substance use-related factors and psychosocial characteristics among Turkish adults with early- and late-onset substance use disorder

The onset of substance use is a strong predictor of substance use disorders and related problems. This study examined the differences between early- and late-onset substance use in personality and substance use characteristics, traumatic experiences, and social support with a sample of 100 Turkish adults with substance use disorders. Early onset (<18 years) was associated with more traumatic experiences, increased risk of developing posttraumatic stress disorder (PTSD), and higher levels of depressive symptoms compared to late onset (≥18 years). Also, depressive symptoms, living, and working status were predictors of substance use onset. The study addresses the groups at risk of initiating substance use.

Investigating the Associations among Drug Dependents' Family Function and Exercise Attitudes: Marital Status Differences

This paper examines: (1) The demographic characteristics of different marital statuses of drug dependents; (2) differences in exercise attitudes and family function by marital status; and (3) if family function factors correlated with exercise attitudes and if exercise attitude factors correlated with family function. Multivariate analyses of variance (MANOVAs) revealed significant differences in drug dependents’ exercise attitudes between married and single groups (p < 0.05) and the married and “other” groups (p < 0.01). Furthermore, we observed significant differences in drug dependents’ family function between married and single groups (p < 0.01) and married and other groups (p < 0.05). Regression analyses indicated that communication [F_change(1,1791) = 137.819; p < 0.001] was a significant positive predictor for drug dependents’ exercise attitude, accounting for 7.1% of the observed variance. Moreover, 50% of the variance was explained by willingness [F_change(1,1791) = 850.49, p < 0.001] and control [F_change(1,1790) = 141.415, p < 0.001], which were two significant predictors of drug dependents’ family function. Findings of this study were: (1) Exercise attitude and family function of married drug dependents were better than single drug dependents and other marital status addicts; (2) communication was observed as a factor of family function that correlated with exercise attitude; and (3) willingness was related with family function.

The effect of perceived social support on quality of life in Turkish men with alcohol, opiate and cannabis use disorder

OBJECTIVE

The purpose of this study was to investigate the effect of perceived social support on the quality of life of male patients with alcohol, opiate and synthetic cannabinoid use disorders by considering sociodemographic factors and mood, and to compare these three groups in terms of social support and quality of life.

METHOD

One hundred and thirtyone (131) patients who were hospitalized at Addiction Clinic of Istanbul Erenkoy Psychiatric and Neurological Diseases Training and Research Hospital in Turkey and diagnosed as alcohol, opiate and synthetic cannabinoid use disorder were included in the study. Sociodemographic Data Form, Turkish version of the World Health Organization Quality of Life Questionnaire Scale (WHOQOL-BREF-TR), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Multidimensional Scale of Perceived Social Support (MSPSS), API (Addiction Profile Index) were applied to the participants.

RESULTS

A total of 131 male patients were 32 synthetic cannabinoids, 51 opiates and 48 alcohol use disorders diagnosed. The mean age of alcohol users was higher than the other groups. Separation/divorce rate was higher in alcohol users and single rate in opiate users. Alcohol use was higher in living alone and opiate users lived with first degree relatives. The crime history was higher in the cannabis group. Prison experience, probation and self-injury were higher among opiate users. Family history of substance use was higher in opiate users. Crime was found to be less in alcohol users. In the comparison of alcohol and substance (opiate, cannabis) groups, the rate of self-injury (93.8%) was found to be significantly higher in the substance user' group. There was no statistically significant difference between the groups in terms of depression and anxiety scores. When the alcohol and substance (opiate, cannabis) comparisons were made between the groups, the mean depression (21.02 ± 11.6) and anxiety (20.09 ± 17.49) of the alcohol group was significantly higher. The "effect on life" (31.8 ± 6.13) and "motivation" subscales (10.38 ± 2.39) of API was found to be significantly higher in patients with substance use. In the opioid group, physical, environmental and psychological subscales of the WHOQOL-BREF-TR did not show significant correlation with MSPSS, and the family, friend' subscales and total perceived social support were significantly correlated with the social subscale of WHOQOL-BREF-TR. In the alcohol group, the environmental and social subscales of WHOQOL-BREF-TR showed a significant correlation with perceived social support from the family and private person and total perceived support.

CONCLUSION

Addiction is a recurrent and chronic disease and inevitably reduces quality of life. Social support has an important role on the quality of life. Improving the quality of life seems to be one of the main goals during the addiction treatment. For this purpose, it is very important to provide psychosocial support with pharmacological treatment by evaluating the medical, mental and social needs of the dependent patient as a whole.

Highlighting the Role of Cognitive and Brain Reserve in the Substance use Disorder Field

BACKGROUND

Cognitive reserve (CR) refers to the ability of an individual to cope with brain pathology remaining free of cognitive symptoms. This protective factor has been related to compensatory and more efficient brain mechanisms involved in resisting brain damage. For its part, Brain reserve (BR) refers to individual differences in the structural properties of the brain which could also make us more resilient to suffer from neurodegenerative and mental diseases.

OBJECTIVE

This review summarizes how this construct, mainly mediated by educational level, occupational attainment, physical and mental activity, as well as successful social relationships, has gained scientific attention in the last years with regard to diseases, such as neurodegenerative diseases, stroke or traumatic brain injury. Nevertheless, although CR has been studied in a large number of disorders, few researches have addressed the role of this concept in drug addiction.

METHODS

We provide a selective overview of recent literature about the role of CR and BR in preventing substance use onset. Likewise, we will also discuss how variables involved in CR (healthy leisure, social support or job-related activities, among others) could be trained and included as complementary activities of substance use disorder treatments.

RESULTS

Evidence about this topic suggests a preventive role of CR and BR on drug use onset and when drug addiction is established, these factors led to less severe addiction-related problems, as well as better treatment outcomes.

CONCLUSION

CR and BR are variables not taken yet into account in drug addiction. However, they could give us a valuable information about people at risk, as well as patient's prognosis.

Social Support patterns in Primary Health Care: differences between having physical diseases or mental disorders

The social support network is a health protective factor involving physical, mental and psychological aspects, providing a better quality of life, favoring better adaptation to adverse conditions, promoting resilience and mobilizing resources for a more effective coping with negative life events that can lead to illness. We aimed to analyze the association between physical diseases, common mental disorders and the social support network of patients serviced at primary care facilities in the cities of Rio de Janeiro and São Paulo through a cross-sectional study with 1,466 patients in the 18-65 years age group. We used the Social Network Index (SNI) to assess the support network through the categories of isolation and integration. The doctor/nurse completed the questionnaire to evaluate the physical disease diagnosis, while the Hospital Anxiety and Depression Scale was used to detect mental disorders. We found that the pattern of social support was different depending on the presence of physical diseases or mental disorders. Negative associations were found between diabetes and isolation; integration and anxiety; integration and depression. Positive associations were identified between isolation and anxiety and isolation and depression.

Confounding and Statistical Significance of Indirect Effects: Childhood Adversity, Education, Smoking, and Anxious and Depressive Symptomatology

The life course perspective, the risky families model, and stress-and-coping models provide the rationale for assessing the role of smoking as a mediator in the association between childhood adversity and anxious and depressive symptomatology (ADS) in adulthood. However, no previous study has assessed the independent mediating role of smoking in the association between childhood adversity and ADS in adulthood. Moreover, the importance of mediator-response confounding variables has rarely been demonstrated empirically in social and psychiatric epidemiology. The aim of this paper was to (i) assess the mediating role of smoking in adulthood in the association between childhood adversity and ADS in adulthood, and (ii) assess the change in estimates due to different mediator-response confounding factors (education, alcohol intake, and social support). The present analysis used data collected from 1994 to 2008 within the framework of the Tromsø Study (N = 4,530), a representative prospective cohort study of men and women. Seven childhood adversities (low mother's education, low father's education, low financial conditions, exposure to passive smoke, psychological abuse, physical abuse, and substance abuse distress) were used to create a childhood adversity score. Smoking status was measured at a mean age of 54.7 years (Tromsø IV), and ADS in adulthood was measured at a mean age of 61.7 years (Tromsø V). Mediation analysis was used to assess the indirect effect and the proportion of mediated effect (%) of childhood adversity on ADS in adulthood via smoking in adulthood. The test-retest reliability of smoking was good (Kappa: 0.67, 95% CI: 0.63; 0.71) in this sample. Childhood adversity was associated with a 10% increased risk of smoking in adulthood (Relative risk: 1.10, 95% CI: 1.03; 1.18), and both childhood adversity and smoking in adulthood were associated with greater levels of ADS in adulthood (p < 0.001). Smoking in adulthood did not significantly mediate the association between childhood adversity and ADS in adulthood. However, when education was excluded as a mediator-response confounding variable, the indirect effect of childhood adversity on ADS in adulthood was statistically significant (p < 0.05). This study shows that a careful inclusion of potential confounding variables is important when assessing mediation.

Relationship between drug dependence and alcohol users receiving treatment in a community health center specializing in alcohol treatment

The aims of this study were: to identify the therapeutic activities of a psychosocial care center specifically for family members, and to consider whether the care offered provided benefits to the relationship between the family and alcohol users. This was a qualitative research study, and included 15 families of alcohol users from Minas Gerais. The data collection occurred during January and March of 2012. Thematic analysis was used. The analysis identified three themes: 1) relationship: before and after the initiation of treatment in the service; 2) assistance for the family; 3) treatment suggestions. The results showed that the care in the service contributed to improving the family relationship, but families provided some suggestions to improve this care. We concluded that the service was an important provider of social support for improving the family relationship.