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Palma-Alvarez RF, Ortega-Hernández G, Roch-Santed M, Ramos-Quiroga JA, Grau-López L. Long-acting injectable buprenorphine in the real world: case report on dual disorders. J Addict Dis 2024:1-7. [PMID: 38771148 DOI: 10.1080/10550887.2024.2354566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
OBJECTIVES Long-acting injectable buprenorphine (LAIB) has demonstrated a good profile for opioid use disorder (OUD) management. However, there is scarce information on LAIB in OUD patients with comorbid mental disorders (dual disorder patients). METHODS We present a case report on OUD patients with a comorbid mental disorder who have received LAIB for at least 3 months. RESULTS Two women and one man with OUD and another comorbid mental disorder were prescribed with LAIB ranging from three to twelve months. Good adherence and opioid abstinence were observed during the follow-up. Psychopathological issues related to comorbid mental disorders were stabilized. A deep discussion on LAIB in this profile of patients is conducted. CONCLUSIONS LAIB in OUD patients with comorbid mental disorders may be a safe and well tolerated option, similar to OUD patients without comorbid mental disorders. LAIB's impact on psychopathological issues requires further high-quality research to understand the real impact of LAIB on OUD and comorbid mental disorders.
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Affiliation(s)
- Raul Felipe Palma-Alvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Germán Ortega-Hernández
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Maria Roch-Santed
- Pharmacy Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
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2
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Onaemo VN, Chireh B, Fawehinmi TO, D'Arcy C. Comorbid substance use disorder, major depression, and associated disability in a nationally representative sample. J Affect Disord 2024; 348:8-16. [PMID: 38070745 DOI: 10.1016/j.jad.2023.12.016] [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: 05/30/2023] [Revised: 11/14/2023] [Accepted: 12/02/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Major depressive disorders (MDD) and substance use disorders (SUDs) are commonly linked to disability, but there is a lack of research on the risk of disability among individuals who have both SUDs and MD in the general population. This study aimed to investigate the associated risk of disability in people with comorbid SUDs- specifically cannabis use disorder, alcohol use disorder, other drug (except cannabis) use disorder, and a major depressive episode using a nationally representative sample. METHODS The 2012 Canadian Community Health Survey- Mental Health (CCHS-MH) data were analyzed using multilevel logistic regression models. The survey included a nationally representative sample of Canadians aged 15 years and older (n = 25,113) residing in the ten Canadian provinces from January to December 2012. The diagnoses of major depressive episodes (MDE) and the SUDs were derived from the DSM-IV diagnostic criteria using a modified WHO-CIDI instrument, while disability was assessed using the World Health Organization Disability Assessment Score (WHODAS) 2.0. RESULTS The strongest predictor of disability was found to be comorbidity. Individuals diagnosed with both a SUD and MDE were 4 to 9 times more likely to experience disability, depending on the substance used, compared to those without either diagnosis. LIMITATIONS The study's cross-sectional design limits causal inferences. CONCLUSIONS Our research discovered that individuals who have both SUD and MDE are at a significantly higher risk of experiencing disability. This highlights the importance of integrating mental health and addiction services to mitigate the risk of disability and improve overall treatment outcomes.
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Affiliation(s)
- Vivian N Onaemo
- Division of Public Health and Preventive Medicine, Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, Saskatchewan S7N 2Z4, Canada.
| | - Batholomew Chireh
- EPID@Work Research Institute, Lakehead University, 955 Oliver Road, Thunder Bay, ON P7B 5E1, Canada; Department of Health Sciences, Lakehead University, 955 Oliver Road, Thunder Bay, ON P7B 5E1, Canada
| | | | - Carl D'Arcy
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, Saskatchewan S7N 2Z4, Canada; Professor Emeritus (Psychiatry & Public Health), University of Saskatchewan, 103 Hospital Drive, Saskatoon, Saskatchewan S7N 2Z4, Canada
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3
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Holbeck M, DeVries HS, Singal AK. Integrated Multidisciplinary Management of Alcohol-associated Liver Disease. J Clin Transl Hepatol 2023; 11:1404-1412. [PMID: 37719958 PMCID: PMC10500286 DOI: 10.14218/jcth.2023.00002] [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: 01/10/2023] [Revised: 04/12/2023] [Accepted: 04/25/2023] [Indexed: 07/03/2023] Open
Abstract
Alcohol-associated liver disease (ALD) is one of the most common liver diseases and indications for liver transplantation (LT). Alcohol use disorder (AUD), a frequent accompaniment in ALD patients, may also be associated with psychiatric comorbidities such as depression and anxiety. Identification of ALD at an earlier stage, and treatment of AUD may help prevent progression to advanced stage of ALD such as cirrhosis and alcoholic hepatitis. Screening for alcohol use and AUD treatment in ALD patients is often not performed due to several barriers at the level of patients, clinicians, and administrative levels. This review details the integrated multidisciplinary care model especially on the specific role of the hepatologist, psychiatrist, addiction counselor, and social worker in providing complete management for the dual pathology of liver disease and of AUD. Laboratory assessment, pharmacological and behavioral therapies, and recommended assessments for follow-up care by the respective specialists is outlined. We provide perspective along with the literature support, with the goal of providing team based comprehensive care of patients with ALD.
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Affiliation(s)
- Malia Holbeck
- Addiction Medicine, Avera McKennan University Hospital, University of South Dakota, Sioux Falls, SD, USA
| | - Hannah Statz DeVries
- Psychiatry, Avera McKennan University Hospital, University of South Dakota, Sioux Falls, SD, USA
| | - Ashwani K. Singal
- Transplant Hepatology, Avera McKennan University Hospital, University of South Dakota, Sioux Falls, SD, USA
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Herrera-Imbroda J, Flores-López M, Requena-Ocaña N, Araos P, García-Marchena N, Ropero J, Bordallo A, Suarez J, Pavón-Morón FJ, Serrano A, Mayoral F, Rodríguez de Fonseca F. Antidepressant Medication Does Not Contribute to the Elevated Circulating Concentrations of Acylethanolamides Found in Substance Use Disorder Patients. Int J Mol Sci 2023; 24:14788. [PMID: 37834235 PMCID: PMC10573451 DOI: 10.3390/ijms241914788] [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: 08/16/2023] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Circulating acylethanolamides (NAEs) are bioactive signaling molecules that modulate multiple homeostatic functions including mood and hedonic responses. Variations in their plasma concentrations are associated with substance use disorders (SUD) and recent studies suggest that psychotropic medication might influence its circulating levels, limiting its use as a clinical biomarker of addiction. In addition, they might have a role as mediators of the pharmacological effects of psychotropic drugs. Thus, in mild depression, the response to selective serotonin reuptake inhibitor-type antidepressants (SSRI) is associated with a marked increase in circulating NAEs. To further investigate if antidepressants are able to modify the plasma concentration of NAEs in SUD patients, we analyzed the circulating levels of NAEs in 333 abstinent and 175 healthy controls on the basis of the treatment with SSRI antidepressants. As described previously, SUD patients display higher concentrations of NAEs than those measured in a control population. This increase was not further modified by antidepressant therapy. Only marginal increases in palmitoylethanolamide (PEA), oleoylethanolamide (OEA), or docosatetraenoyl-ethanolamide (DEA) were found, and the net effect was very small. Thus, our study shows that treatment with SSRI-type antidepressants does not modify the clinical utility of monitoring enhanced NAE production as biomarkers of SUD. In addition, the possibility that a blunted NAE response to antidepressant therapy might be related to the loss of efficacy of SSRIs in dual depression emerges as an attractive hypothesis that needs to be addressed in future studies.
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Affiliation(s)
- Jesús Herrera-Imbroda
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain;
- Departamento de Farmacología y Pediatría, Facultad de Medicina, Universidad de Málaga, 29071 Málaga, Spain
| | - María Flores-López
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain;
| | - Nerea Requena-Ocaña
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain;
| | - Pedro Araos
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Departamento de Psicología Básica, Facultad de Psicología, Universidad de Málaga, 29071 Málaga, Spain
| | - Nuria García-Marchena
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Departamento de Psicobiología y Metodología, Facultad de Psicología, Universidad Complutense de Madrid, 28223 Madrid, Spain
| | - Jessica Ropero
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain;
| | - Antonio Bordallo
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain;
| | - Juan Suarez
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Departamento of Anatomía, Medicina Legal e Historia de la Ciencia, Facultad de Medicina, Universidad de Málaga, 29071 Málaga, Spain
| | - Francisco J. Pavón-Morón
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Unidad Clínica Área del Corazón, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Antonia Serrano
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain;
| | - Fermín Mayoral
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain;
| | - Fernando Rodríguez de Fonseca
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Unidad Clínica de Neurología, Hospital Regional Universitario de Málaga, 29010 Malaga, Spain
- Andalusian Network for Clinical and Translational Research in Neurology (NEURO-RECA), 29001 Malaga, Spain
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5
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Torrens M, Adan A. Recent Advances in Dual Disorders (Addiction and Other Mental Disorders). J Clin Med 2023; 12:jcm12093315. [PMID: 37176755 PMCID: PMC10179482 DOI: 10.3390/jcm12093315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 04/15/2023] [Indexed: 05/15/2023] Open
Abstract
In clinical mental health practice, the presence of Dual Disorders (DDs), defined as the comorbidity of at least one Substance Use Disorder (SUD) and another mental disorder in the same person [...].
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Affiliation(s)
- Marta Torrens
- Addiction Research Group (GRAd), Neuroscience Research Program, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
- School of Medicine, Universitat de Vic-Central de Catalunya, 08500 Vic, Spain
- Psychiatry Department, School of Medicine, Universitat Autònoma de Barcelona (UAB), 08093 Cerdanyola del Vallès, Spain
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebrón 171, 08035 Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, 08035 Barcelona, Spain
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Szerman N, Basurte-Villamor I, Vega P, Mesías B, Martínez-Raga J, Ferre F, Arango C. Is there such a thing as gambling dual disorder? Preliminary evidence and clinical profiles. Eur Neuropsychopharmacol 2023; 66:78-91. [PMID: 36516511 DOI: 10.1016/j.euroneuro.2022.11.010] [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: 06/28/2022] [Revised: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 12/14/2022]
Abstract
Patients with gambling disorder (GD) frequently present other mental disorders, such as substance use disorder (SUDs), attention deficit/hyperactivity disorder (ADHD), mood disorders, and impulse-control disorders. We propose that GD should not be conceptualized as a single nosological entity, but rather as a gambling dual disorder (GDD). This study aims to provide further evidence of the co-occurrence of GD and other mental disorders in routine clinical practice and to identify different clinical profiles of severity. This descriptive, cross-sectional, and observational study included 116 patients with GD who were undergoing treatment in a specialized center. The MULTICAGE-CAD 4 and South Oaks gambling screen questionnaires confirmed the presence of GD in 97.4% and 100% of the patients, respectively. Other addictive behaviors such as compulsive spending, Internet, video games, or SUD (59.5%, 27.6%, 11.2%, and 13.8%, respectively) were also identified. The most used substances were tobacco (42.2%) and alcohol (5.2%). Half of the patients suffered from ADHD, 30.2% showed moderate or severe depression, and 17.2% suffered from a social anxiety problem. The majority (76.7%) also presented a phenotype with high impulsiveness. The cluster analysis identified two different clinical profiles of severity in patients with GDD. One profile showed higher severity of other mental disorders (ADHD, depression, anxiety, SUD, or insomnia), impulsivity, general psychopathological burden, and disability. In conclusion, our study provides further evidence on the co-occurrence of GD and other mental disorders supporting the GDD existence, shows impulsiveness as a vulnerability factor for GD, and identifies two clinical severity profiles.
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Affiliation(s)
- Néstor Szerman
- WADD and WPA Section Dual Disorders, Mental Health and Psychiatric Institute, Gregorio Marañon University Hospital, Madrid, Spain.
| | - Ignacio Basurte-Villamor
- Department of Psychiatry and Behavioral Health, Clínica López Ibor, Madrid, Spain; School of Medicine, Universidad Europea de Madrid, Spain.
| | - Pablo Vega
- Institute for Addictions, Madrid Salud, Madrid City Council, Madrid, Spain
| | - Beatriz Mesías
- Institute for Addictions, Madrid Salud, Madrid City Council, Madrid, Spain
| | - José Martínez-Raga
- Department of Psychiatry and Clinical Psychology, Hospital Universitario Doctor Peset & University of Valencia
| | - Francisco Ferre
- Institute of Psychiatry and Mental Health, Gregorio Marañón University Hospital, Madrid, School of Medicine, Universidad Complutense de Madrid, CIBERSAM, Spain
| | - Celso Arango
- Institute of Psychiatry and Mental Health, Gregorio Marañón University Hospital, Madrid, School of Medicine, Universidad Complutense de Madrid, CIBERSAM, Spain
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