1
|
Hall W, Manthey J, Stjepanović D. Cannabis use and cannabis use disorders and their treatment in the Europe. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01776-1. [PMID: 38489067 DOI: 10.1007/s00406-024-01776-1] [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: 08/07/2023] [Accepted: 02/02/2024] [Indexed: 03/17/2024]
Abstract
This paper introduces the special issue on cannabis use in Europe. It describes data on the prevalence of cannabis use in Europe and the more limited data on the prevalence of cannabis use disorders, one of the most common forms of drug problem treated in many countries in Europe. It summarises what research has indicated about the adverse effects of acute and chronic cannabis use and discusses potential health system responses that may reduce some of these harms. These include public education about the risks of cannabis use; screening and brief interventions in primary medical settings; and specialist treatment for cannabis use disorders. It briefly indicates the special issues that may need to be addressed in dealing with the high rates of comorbidity between cannabis use disorders, other types of drug use disorders, and common mental disorders.
Collapse
Affiliation(s)
- Wayne Hall
- The National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia.
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
| | - Daniel Stjepanović
- The National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
| |
Collapse
|
2
|
Wu JH, Radha Saseendrakumar B, Moghimi S, Sidhu S, Kamalipour A, Weinreb RN, Baxter SL. Epidemiology and factors associated with cannabis use among patients with glaucoma in the All of Us Research Program. Heliyon 2023; 9:e15811. [PMID: 37215923 PMCID: PMC10192773 DOI: 10.1016/j.heliyon.2023.e15811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 04/09/2023] [Accepted: 04/21/2023] [Indexed: 05/24/2023] Open
Abstract
Purpose To examine the epidemiology and factors of cannabis use among open-angle glaucoma (OAG) patients. Methods In this cross-sectional study, OAG participants in the All of Us database were included. Cannabis ever-users were defined based on record of cannabis use. Demographic and socioeconomic data were collected and compared between cannabis ever-users and never-users using Chi-Square tests and logistic regression. Odds ratios (OR) of potential factors associated with cannabis use were examined in univariable and multivariable models. Results Among 3723 OAG participants, 1436 (39%) were cannabis ever-users. The mean (SD) age of never-users and ever-users was 72.9 (10.4) and 69.2 (9.6) years, respectively (P < 0.001). Compared to never-users, Black (34%) and male (55%) participants were better represented in ever-users, while Hispanic or Latino participants (6%) were less represented (P < 0.001). Diversity was also observed in socioeconomic characteristics including marital status, housing security, and income/education levels. A higher percentage of ever-users had a degree ≥12 grades (91%), salaried employment (26%), housing insecurity (12%), and history of cigar smoking (48%), alcohol consumption (96%), and other substance use (47%) (P < 0.001). In the multivariable analysis, Black race (OR [95% CI] = 1.33 [1.06, 1.68]), higher education (OR = 1.19 [1.07, 1.32]), and history of nicotine product smoking (OR: 2.04-2.83), other substance use (OR = 8.14 [6.63, 10.04]), and alcohol consumption (OR = 6.80 [4.45, 10.79]) were significant factors associated with cannabis use. Increased age (OR = 0.96 [0.95, 0.97]), Asian race (OR = 0.18 [0.09, 0.33]), and Hispanic/Latino ethnicity (OR = 0.43 [0.27, 0.68]) were associated with decreased odds of use (P < 0.02). Conclusions This study elucidated the previously uncharacterized epidemiology and factors associated with cannabis use among OAG patients, which may help to identify patients requiring additional outreach on unsupervised marijuana use.
Collapse
Affiliation(s)
- Jo-Hsuan Wu
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Bharanidharan Radha Saseendrakumar
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
- UCSD Health Department of Biomedical Informatics, University of California San Diego, La Jolla, CA, USA
| | - Sasan Moghimi
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Sophia Sidhu
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Alireza Kamalipour
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Robert N. Weinreb
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Sally L. Baxter
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
- UCSD Health Department of Biomedical Informatics, University of California San Diego, La Jolla, CA, USA
| |
Collapse
|
3
|
Keerthy D, Chandan JS, Abramovaite J, Gokhale KM, Bandyopadhyay S, Day E, Marwaha S, Broome MR, Nirantharakumar K, Humpston C. Associations between primary care recorded cannabis use and mental ill health in the UK: a population-based retrospective cohort study using UK primary care data. Psychol Med 2023; 53:2106-2115. [PMID: 34593061 PMCID: PMC10106282 DOI: 10.1017/s003329172100386x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Cannabis use is a global public health issue associated with increased risks of developing mental health disorders, especially in young people. We aimed to investigate the relationships between cannabis exposure and risks of receiving mental illness diagnoses or treatment as outcomes. METHODS A population based, retrospective, open cohort study using patients recorded in 'IQVIA medical research data', a UK primary care database. Read codes were used to confirm patients with recorded exposure to cannabis use who were matched up to two unexposed patients. We examined the risk of developing three categories of mental ill health: depression, anxiety or serious mental illness (SMI). RESULTS At study entry, the exposed cohort had an increased likelihood of having experienced mental ill health [odds ratio (OR) 4.13; 95% confidence interval (CI) 3.99-4.27] and mental ill health-related prescription (OR 2.95; 95% CI 2.86-3.05) compared to the unexposed group. During the study period we found that exposure to cannabis was associated with an increased risk of developing any mental disorder [adjusted hazard ratio (aHR) 2.73; 95% CI 2.59-2.88], also noted when examining by subtype of disorder: anxiety (aHR 2.46; 95% CI 2.29-2.64), depression (aHR 2.34; 95% CI 2.20-2.49) and SMI (aHR 6.41; 95% CI 5.42-7.57). These results remained robust in sensitivity analyses. CONCLUSION These findings point to the potential need for a public health approach to the management of people misusing cannabis. However, there is a gross under-recording of cannabis use in GP records, as seen by the prevalence of recorded cannabis exposure substantially lower than self-reported survey records.
Collapse
Affiliation(s)
- Deepiksana Keerthy
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Joht Singh Chandan
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Juste Abramovaite
- Institute of Global Innovation, University of Birmingham, Birmingham B15 2TT, UK
| | - Krishna Margadhamane Gokhale
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | | | - Ed Day
- Institute for Mental Health, College of Life and Environmental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Steven Marwaha
- Institute for Mental Health, College of Life and Environmental Sciences, University of Birmingham, Birmingham B15 2TT, UK
- Birmingham and Solihull Mental Health NHS Trust, Birmingham B1 3RB, UK
| | - Matthew R. Broome
- Institute for Mental Health, College of Life and Environmental Sciences, University of Birmingham, Birmingham B15 2TT, UK
- Birmingham Women' and Children' NHS Foundation Trust, Birmingham B15 2TG, UK
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Clara Humpston
- Institute for Mental Health, College of Life and Environmental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| |
Collapse
|
4
|
Levit JD, Meyers JL, Georgakopoulos P, Pato MT. Risk for alcohol use problems in severe mental illness: Interactions with sex and racial/ethnic minority status. J Affect Disord 2023; 325:329-336. [PMID: 36587907 PMCID: PMC9942932 DOI: 10.1016/j.jad.2022.12.140] [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] [Received: 05/16/2022] [Revised: 12/22/2022] [Accepted: 12/25/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Alcohol use disorder (AUD) is exceedingly common among individuals with bipolar disorder and schizophrenia. However, studies on alcohol use in psychiatric illness rely largely on population surveys with limited representation of severe mental illness (SMI); schizophrenia and bipolar disorder. METHODS Using data from the Genomic Psychiatry Cohort (GPC) (Pato MT, 2013), associations of bipolar disorder and schizophrenia with alcohol use problems were examined in a diverse US based sample, considering the influence of self-described race (African Ancestry (AA), European Ancestry (EA), or Latinx Ancestry (LA)), sex, and tobacco use. Participants answered alcohol use problem items derived from the CAGE instrument, yielding a summed "probable" alcohol use disorder (pAUD) risk score. RESULTS This study included 1952 individuals with bipolar disorder with psychosis (BDwP), 409 with bipolar disorder without psychosis (BD), 9218 with schizophrenia (SCZ), and 10,416 unaffected individuals. We found that SMI (BDwP, BD, SCZ) was associated with elevated AUD risk scores (B = 0.223, p < 0.001), an association which was strongest in females, particularly those of AA and LA, and in tobacco users. Schizophrenia was associated with the greatest increase in pAUD score (B = 0.141, p < 0.001). pAUD risk scores were increased among participants with bipolar disorder, with greater increases in BDwP (B = 0.125, p < 0.001) than in BD without psychosis (B = 0.027, p < 0.001). LIMITATIONS Limitations include reliance on self-report data, screening items for AUD, voluntary recruitment bias, and differences in race/sex distribution between groups, which were statistically adjusted for in analytic models. CONCLUSIONS SMI is associated with risk for AUD, particularly among females from racial minority groups, smokers, and those with psychotic disorders.
Collapse
Affiliation(s)
- Jeremy D Levit
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - Jacquelyn L Meyers
- Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | | | - Michele T Pato
- Department of Psychiatry, Rutgers University, Piscataway, NJ, USA.
| |
Collapse
|
5
|
Psychiatric Comorbidities of Substance Use Disorders: Does Dual Diagnosis Predict Inpatient Detoxification Treatment Outcomes? Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00821-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
AbstractComorbidity of substance use and psychiatric disorders, particularly depressive disorders, are well established. The impact of comorbidity on treatment outcomes, particularly following short-term inpatient detoxification and medical management units, has yet to be fully explored. This study reviewed 456 records of patients voluntarily presenting for medical management of substance misuse in Sydney, Australia. Documented psychiatric comorbidities and primary substance of misuse were extracted and used to predict length of stay, discharge against medical advice and number of readmissions. Our results showed that psychiatric comorbidity did not significantly predict treatment outcomes, although depression was reported in more than half our cohort, along with elevated rates of Post-traumatic Stress Disorder, anxiety disorders and bipolar affective disorders. Medication non-compliance and primary substance of misuse significantly predicted length of stay and discharge against medical advice. Further research into how specific substances interact and affect specific psychiatric disorders is needed to guide optimal treatment options.
Collapse
|
6
|
Somé NH, Wells S, Felsky D, Hamilton HA, Ali S, Elton-Marshall T, Rehm J. Self-reported mental health during the COVID-19 pandemic and its association with alcohol and cannabis use: a latent class analysis. BMC Psychiatry 2022; 22:306. [PMID: 35490222 PMCID: PMC9055215 DOI: 10.1186/s12888-022-03917-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 04/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Mental health problems and substance use co-morbidities during and after the COVID-19 pandemic are a public health priority. Identifying individuals at high-risk of developing mental health problems and potential sequela can inform mitigating strategies. We aimed to identify distinct groups of individuals (i.e., latent classes) based on patterns of self-reported mental health symptoms and investigate their associations with alcohol and cannabis use. METHODS We used data from six successive waves of a web-based cross-sectional survey of adults aged 18 years and older living in Canada (6,021 participants). We applied latent class analysis to three domains of self-reported mental health most likely linked to effects of the pandemic: anxiety, depression, and loneliness. Logistic regression was used to characterize latent class membership, estimate the association of class membership with alcohol and cannabis use, and perform sex-based analyses. RESULTS We identified two distinct classes: (1) individuals with low scores on all three mental health indicators (no/low-symptoms) and (2) those reporting high scores across the three measures (high-symptoms). Between 73.9 and 77.1% of participants were in the no/low-symptoms class and 22.9-26.1% of participants were in the high-symptom class. We consistently found across all six waves that individuals at greater risk of being in the high-symptom class were more likely to report worrying about getting COVID-19 with adjusted odds ratios (aORs) between 1.72 (95%CI:1.17-2.51) and 3.51 (95%CI:2.20-5.60). Those aged 60 + were less likely to be in this group with aORs (95%CI) between 0.26 (0.15-0.44) and 0.48 (0.29-0.77) across waves. We also found some factors associated with class membership varied at different time points. Individuals in the high-symptom class were more likely to use cannabis at least once a week (aOR = 2.28, 95%CI:1.92-2.70), drink alcohol heavily (aOR = 1.71, 95%CI:1.49-1.96); and increase the use of cannabis (aOR = 3.50, 95%CI:2.80-4.37) and alcohol (aOR = 2.37, 95%CI:2.06-2.74) during the pandemic. Women in the high-symptom class had lower odds of drinking more alcohol during the pandemic than men. CONCLUSIONS We identified the determinants of experiencing high anxiety, depression, and loneliness symptoms and found a significant association with alcohol and cannabis consumption. This suggests that initiatives and supports are needed to address mental health and substance use multi-morbidities.
Collapse
Affiliation(s)
- Nibene Habib Somé
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 100 Collip Circle, Suite 200, ON, N6G 4X8, London, Canada. .,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. .,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. .,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
| | - Samantha Wells
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 100 Collip Circle, Suite 200, ON N6G 4X8 London, Canada ,grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario Canada ,grid.39381.300000 0004 1936 8884Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, Ontario Canada ,grid.1021.20000 0001 0526 7079School of Psychology, Deakin University, Victoria, Australia
| | - Daniel Felsky
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, Ontario Canada ,grid.17063.330000 0001 2157 2938Institute of Medical Science, University of Toronto, Toronto, Ontario Canada ,grid.155956.b0000 0000 8793 5925Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, Ontario Canada
| | - Hayley A. Hamilton
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 100 Collip Circle, Suite 200, ON N6G 4X8 London, Canada ,grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
| | - Shehzad Ali
- grid.39381.300000 0004 1936 8884Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario Canada ,grid.39381.300000 0004 1936 8884Schulich Interfaculty Program in Public Health, Schulich School of Medicine and Dentistry, Western University, London, Canada ,grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK ,grid.1004.50000 0001 2158 5405Department of Psychology, Macquarie University, Sydney, Australia ,grid.418792.10000 0000 9064 3333Bruyere Research Institute, Ottawa, Canada
| | - Tara Elton-Marshall
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 100 Collip Circle, Suite 200, ON N6G 4X8 London, Canada ,grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario Canada ,grid.39381.300000 0004 1936 8884Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada ,grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada ,grid.258900.60000 0001 0687 7127Department of Health Sciences, Lakehead University, Thunder Bay, Ontario Canada
| | - Jürgen Rehm
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 100 Collip Circle, Suite 200, ON N6G 4X8 London, Canada ,grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, Ontario Canada ,grid.17063.330000 0001 2157 2938Institute of Medical Science, University of Toronto, Toronto, Ontario Canada ,grid.4488.00000 0001 2111 7257Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
| |
Collapse
|
7
|
Wang DF, Zhou YN, Liu YH, Hao YZ, Zhang JH, Liu TQ, Ma YJ. Social support and depressive symptoms: exploring stigma and self-efficacy in a moderated mediation model. BMC Psychiatry 2022; 22:117. [PMID: 35168584 PMCID: PMC8845403 DOI: 10.1186/s12888-022-03740-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 01/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although some psychological processes, such as stigma and self-efficacy, affect the complicated relationship between social support and depressive symptoms, few studies explored a similar psychological mechanism among individuals with substance use disorders (SUDs). Hence, this research investigates the mediating effects of stigma and the moderating effects of self-efficacy among the psychological mechanism that social support affects depressive symptoms. METHODS The study included 1040 Chinese participants with SUDs and completed a series of self-report questionnaires. R software was used to organize and clean up data sets and analyze mediation and moderation effects. RESULTS The result showed that stigma partially mediated depressive symptoms, while self-efficacy moderated this relationship. More specifically, less social support increased depression symptoms by bringing about higher stigma. Besides, subjects with higher self-efficacy are less susceptible to stigma and therefore have mild depressive symptoms. Furthermore, clinical and theoretical implications are discussed in our study. CONCLUSIONS Chinese SUDs patients' depressive symptoms were indirectly affected by perceived social support via stigma and less affected by stigma with improved self-efficacy. The theoretical and practical implications of these results are discussed.
Collapse
Affiliation(s)
- Dong-Fang Wang
- grid.6936.a0000000123222966Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Ya-Nan Zhou
- grid.216417.70000 0001 0379 7164Department of Psychiatry, The Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, Chinese National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, No. 139, Middle Renmin Road, Changsha, Hunan 410011 P.R. China
| | - Yue-Heng Liu
- grid.216417.70000 0001 0379 7164Department of Psychiatry, The Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, Chinese National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, No. 139, Middle Renmin Road, Changsha, Hunan 410011 P.R. China
| | - Yu-Zhu Hao
- grid.216417.70000 0001 0379 7164Department of Psychiatry, The Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, Chinese National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, No. 139, Middle Renmin Road, Changsha, Hunan 410011 P.R. China
| | - Jun-Hong Zhang
- grid.216417.70000 0001 0379 7164Department of Psychiatry, The Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, Chinese National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, No. 139, Middle Renmin Road, Changsha, Hunan 410011 P.R. China
| | - Tie-Qiao Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, Chinese National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, No. 139, Middle Renmin Road, Changsha, Hunan, 410011, P.R. China.
| | - Yue-Jiao Ma
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, Chinese National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, No. 139, Middle Renmin Road, Changsha, Hunan, 410011, P.R. China. .,Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany.
| |
Collapse
|
8
|
Examining the Use of Antidepressants for Adolescents with Depression/Anxiety Who Regularly Use Cannabis: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010523. [PMID: 35010782 PMCID: PMC8744706 DOI: 10.3390/ijerph19010523] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 11/21/2022]
Abstract
Depression and anxiety disorders are two of the most common and growing mental health concerns in adolescents. Consequently, antidepressant medication (AD) use has increased widely during the last decades. Several classes of antidepressants are used mainly to treat depression, anxiety, and obsessive-compulsive disorders by targeting relevant brain neurochemical pathways. Almost all randomized clinical trials of antidepressants examined patients with no concomitant medications or drugs. This does not address the expected course of therapy and outcome in cannabis users. Cannabis is the most commonly used illicit substance globally. Substantial changes in its regulation are recently taking place. Many countries and US states are becoming more permissive towards its medical and recreational use. The psychological and physiological effects of cannabis (mainly of its major components, tetrahydrocannabinol (THC) and cannabidiol (CBD)) have been extensively characterized. Cannabis use can be a risk factor for depressive and anxiety symptoms, but some constituents or mixtures may have antidepressant and/or anxiolytic potential. The aim of this literature review is to explore whether simultaneous use of AD and cannabis in adolescence can affect AD treatment outcomes. Based on the current literature, it is reasonable to assume that antidepressants are less effective for adolescents with depression/anxiety who frequently use cannabis. The mechanisms of action of antidepressants and cannabis point to several similarities and conjunctions that merit future investigation regarding the potential effectiveness of antidepressants among adolescents who consume cannabis regularly.
Collapse
|
9
|
Van Baelen L, Gremeaux L, Antoine J, Bruggeman H, Gisle L, Plettinckx E, De Ridder K. COVID-19 and people who use drugs: Impact of the pandemic on general anxiety and depressive disorders among adults in Belgium. J Affect Disord 2021; 295:946-953. [PMID: 34706467 PMCID: PMC8441094 DOI: 10.1016/j.jad.2021.08.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 07/31/2021] [Accepted: 08/25/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND During previous pandemics people who use drugs (PWUD) were categorized among the most vulnerable. In the current study, firstly, we wanted to evaluate the impact of the COVID-19 crisis on the prevalence of anxiety and depressive disorders among PWUD. Furthermore, we wanted to compare the prevalence of these disorders with that of members from the general population who did not use drugs. METHODS We used a matched cohort design based on two separate repeated cross-sectional online surveys (April and November 2020) among PWUD and the general population. Results of GAD-7 and PHQ-9 were used as outcome variables. We calculated absolute and relative risks for matched pairs for both affective disorders, and logistic regression to compare affective disorders over both waves for PWUD. RESULTS In April, the prevalence of affective disorders was similar for PWUD and the general population. In November, the risks for anxiety disorders increased with 64% for PWUD compared to non-PWUD (RR = 1.64, 95%CI 1.42-1.88), whereas the risks for depressive disorders more than doubled (RR = 2.29, 95%CI 1.97-2.67). Having a job and being male were protective factors for PWUD for both anxiety and depressive disorders. LIMITATIONS As this study used self-reported data, GAD-7 and PHQ-9 give an indication of the presence of anxiety and depression which might differ from a clinician's judgement. CONCLUSIONS PWUD might be disproportionally affected by COVID-19. Health care providers should be attentive to substance use as an indicator for increased risk of mental health problems.
Collapse
Affiliation(s)
- Luk Van Baelen
- Department of Epdemiology and public health, Sciensano, Rue Juliette Wytsmanstraat, 14, Brussels 1050, Belgium.
| | | | | | | | | | | | | |
Collapse
|
10
|
Abstract
Nicotine is one of the most abused substances worldwide. Just as in adolescence and adulthood, tobacco use is also problematic in the elderly. Older people are more vulnerable to smoking consequences because of the additive effects of smoke. Cardiovascular diseases are the most common health problems associated with smoking; however, other systems are also affected, including the respiratory, nervous, integumentary, and many other systems. Smoking cessation is a difficult task especially in the elderly; therefore, physicians should encourage older patients to quit with every patient-physician encounter by offering counseling and replacement therapy.
Collapse
Affiliation(s)
- Nazem K Bassil
- Geriatric Medicine, Palliative Care, Balamand University, Saint George Hospital University Medical Center, Beirut, Lebanon.
| | - Marie Lena K Ohanian
- Family Medicine, Balamand University, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Theodora G Bou Saba
- Family Medicine, Balamand University, Saint George Hospital University Medical Center, Beirut, Lebanon
| |
Collapse
|
11
|
Drennan ML, Karoly HC, Bryan AD, Hutchison KE, Bidwell LC. Acute objective and subjective intoxication effects of legal-market high potency THC-dominant versus CBD-dominant cannabis concentrates. Sci Rep 2021; 11:21744. [PMID: 34741088 PMCID: PMC8571303 DOI: 10.1038/s41598-021-01128-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/20/2021] [Indexed: 02/01/2023] Open
Abstract
As the market for cannabis concentrate products grows, the lack of research regarding the effects of concentrated THC and CBD becomes more glaring. The present study analyzes cannabinoid blood levels and subjective outcomes of physical sensation and affective state after ad libitum use of legal-market concentrate products. Recreational cannabis users were randomly assigned to THC- or CBD-dominant concentrate products, completing a baseline session, and an experimental mobile laboratory session consisting of timepoints before, immediately after, and one-hour after concentrate use. THC-dominant concentrates induced higher intoxication, and higher ratings of drug effect and drug liking than the CBD-dominant concentrate. Both products induced immediate feelings of elation, diminishing over the subsequent hour. Subjective outcomes in the CBD-dominant group revealed immediate decreases in tension and anxiety relative to pre-use, while the THC-dominant group only saw significant decreases in anxiety after one hour. Paranoia spiked immediately post-use in THC-dominant concentrate users, returning to baseline within an hour. Overall, the CBD-dominant concentrate invoked positive mood effects, lower intoxication and an absence of undesirable effects experienced with the THC-dominant concentrate, potentially mitigating negative effects when combined. Results support the need for further investigation into harm-reduction potential of concentrated CBD when used alone and with THC.
Collapse
Affiliation(s)
- M L Drennan
- Department of Psychology, Colorado State University, Fort Collins, CO, 80525, USA.
| | - H C Karoly
- Department of Psychology, Colorado State University, Fort Collins, CO, 80525, USA
- Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - A D Bryan
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - K E Hutchison
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - L C Bidwell
- Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO, 80309, USA
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, 80309, USA
| |
Collapse
|
12
|
Walter Z, Quinn CA, Dingle G, Pocuca N, Baker AL, Beck A, De Andrade D, Toombs M, Hides L. FullFix: a randomised controlled trial of a telephone delivered transdiagnostic intervention for comorbid substance and mental health problems in young people. BMJ Open 2021; 11:e045607. [PMID: 34635511 PMCID: PMC8506879 DOI: 10.1136/bmjopen-2020-045607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 09/15/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Transdiagnostic cognitive-behavioural therapy (CBT) targets common psychological factors that underlie multiple disorders. While transdiagnostic interventions are a promising new approach, limited research has evaluated these treatments within the alcohol and other drug (AOD) sector for young people with comorbid mental health symptoms. This project will examine the feasibility and preliminary efficacy of FullFix-a new risk-targeted transdiagnostic CBT telehealth programme for comorbid AOD and depression/anxiety disorders in young people. Secondary aims are to identify moderators and mediators of treatment outcomes, to determine how and why treatment is effective and who is most likely to benefit. METHODS/DESIGN Participants will be 130 young people (aged 16-35) accessing AOD services in Queensland, Australia, with comorbid mental health symptoms. They will be randomised to receive either the FullFix intervention plus standard AOD care or standard AOD care alone. Primary outcomes on AOD use and mental health symptoms will be reassessed at 6 weeks, 3 months, 6 months and 12 months, along with secondary outcomes of emotion regulation, social connectedness, perceived self-efficacy, coping skills and quality of life. The trial commenced on October 2018 and expected completion date is September 2021. ETHICS AND DISSEMINATION Ethical approval for this trial was provided by the University of Queensland (#2018001185). The results of the trial will be disseminated through publication in a peer-reviewed scientific journal, scientific presentations at conferences and distributed via a report and presentations to the partner organisation. TRIAL REGISTRATION NUMBER ACTRN12618001563257.
Collapse
Affiliation(s)
- Zoe Walter
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Catherine A Quinn
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Genevieve Dingle
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Nina Pocuca
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Alison Beck
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Dominique De Andrade
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Maree Toombs
- Rural Clinical School, The University of Queensland, Toowoomba, Queensland, Australia
| | - Leanne Hides
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
13
|
Gibson LP, Gust CJ, Ellingson JM, YorkWilliams SL, Sempio C, Klawitter J, Bryan AD, Hutchison KE, Bidwell LC. Investigating sex differences in acute intoxication and verbal memory errors after ad libitum cannabis concentrate use. Drug Alcohol Depend 2021; 223:108718. [PMID: 33866072 PMCID: PMC9357512 DOI: 10.1016/j.drugalcdep.2021.108718] [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: 10/16/2020] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND An innovative naturalistic at-home administration procedure was used to investigate sex differences in subjective drug effects and verbal memory errors after ad libitum use of high potency state legal market Δ9-tetrahydrocannabinol (THC) concentrate. METHODS Regular concentrate users were randomly assigned to ad libitum administration of one of two cannabis concentrate products (70 % or 90 % THC) that they purchased from a dispensary. 65 participants (N = 34 men, N = 31 women) were assessed in a mobile pharmacology lab before, immediately after, and 1 -h after ad libitum concentrate use. Plasma cannabinoids (THC, 11-OH-THC, CBD), subjective drug effects, and verbal memory errors were assessed at all three time points. RESULTS Although men and women exhibited similar plasma 11-OH-THC levels across time (p = .10), sex differences were found in plasma THC and CBD after legal market concentrate use, with men displaying significantly higher levels of plasma THC and CBD immediately after cannabis concentrate use (plasma THC [ng/mL]: Mmen = 489.88, Mwomen = 135.08, p < .001; plasma CBD [ng/mL]: Mmen = 1.14, Mwomen = 0.53, p = .04). Despite this, sex differences in subjective effects and verbal memory errors did not emerge, although women reported a steeper decrease in drug liking after use (p = .04). CONCLUSION These data provide the first look at sex differences after acute naturalistic cannabis concentrate use, and suggest much higher THC exposure in men versus women, but similar acute drug and impairment effects across the sexes. Further studies are needed to determine the mechanisms (e.g. tolerance, cannabinoid metabolism, smoking topography) behind these findings.
Collapse
Affiliation(s)
- Laurel P. Gibson
- Department of Psychology and Neuroscience, University of Colorado, 345 UCB, Boulder, CO, 80309-0345, USA,Corresponding author at: Department of Psychology and Neuroscience, 345 UCB, Boulder, CO, 80309-0345, USA. (L.P. Gibson)
| | - Charleen J. Gust
- Department of Psychology and Neuroscience, University of Colorado, 345 UCB, Boulder, CO, 80309-0345, USA
| | - Jarrod M. Ellingson
- Division of Substance Dependence, Department of Psychiatry, University of Colorado Anschutz Medical Campus, 13001 E. 17th Place, Mail Stop F570, Aurora, CO, 80045, USA
| | - Sophie L. YorkWilliams
- Department of Psychology and Neuroscience, University of Colorado, 345 UCB, Boulder, CO, 80309-0345, USA
| | - Cristina Sempio
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, 12705 East Montview Blvd, Suite 200, Aurora, CO, 80045, USA
| | - Jost Klawitter
- Division of Substance Dependence, Department of Psychiatry, University of Colorado Anschutz Medical Campus, 13001 E. 17th Place, Mail Stop F570, Aurora, CO, 80045, USA,Department of Anesthesiology, University of Colorado Anschutz Medical Campus, 12705 East Montview Blvd, Suite 200, Aurora, CO, 80045, USA
| | - Angela D. Bryan
- Department of Psychology and Neuroscience, University of Colorado, 345 UCB, Boulder, CO, 80309-0345, USA,Institute of Cognitive Science, University of Colorado, 344 UCB, Boulder, CO, 80309-0344, USA
| | - Kent E. Hutchison
- Department of Psychology and Neuroscience, University of Colorado, 345 UCB, Boulder, CO, 80309-0345, USA,Institute of Cognitive Science, University of Colorado, 344 UCB, Boulder, CO, 80309-0344, USA
| | - L. Cinnamon Bidwell
- Department of Psychology and Neuroscience, University of Colorado, 345 UCB, Boulder, CO, 80309-0345, USA,Institute of Cognitive Science, University of Colorado, 344 UCB, Boulder, CO, 80309-0344, USA
| |
Collapse
|
14
|
Chang S, Jeyagurunathan A, Lau JH, Shafie S, Samari E, Cetty L, Mok YM, Verma S, Subramaniam M. Problematic Drug Use Among Outpatients With Schizophrenia and Related Psychoses. Front Psychiatry 2021; 12:762988. [PMID: 34744843 PMCID: PMC8569375 DOI: 10.3389/fpsyt.2021.762988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 09/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Problematic drug use is common among psychiatric patients and is linked with poorer course and outcomes of illness. The aim of this study is to assess the prevalence of problematic drug use, and to explore its sociodemographic correlates and associations with health behaviors and outcomes among outpatients with schizophrenia and related psychoses in Singapore. Methods: Data from 397 individuals who were aged 21-65 years and were seeking treatment for schizophrenia and related psychoses in the outpatient clinics of a tertiary psychiatric hospital were analyzed. The Drug Abuse Screening Test (DAST-10) was used to assess problematic drug use. Information on sociodemographics, smoking status, alcohol use, symptoms severity and quality of life were collected. Multivariable logistic regressions were conducted to explore correlates and associations of problematic drug use. Results: The prevalence of problematic drug use was 5.8% (n = 23) in the sample, and 10.6% (n = 42) of the participants reported having problematic drug use and/or problematic alcohol use. More males than females reported having problematic drug use (p = 0.021), and also problematic drug and/or alcohol use (p = 0.004). Significant associations were observed between problematic drug use and smokers with nicotine dependence, and with physical health domain of quality of life. Individuals with greater symptom severity were approximately twice as likely to have problematic drug use and/or alcohol use. Conclusion: While the prevalence of problematic drug use in this sample population is relatively lower compared to other countries, there is a considerable number who might be at risk. Routine screening and close monitoring of drug use is recommended as part of psychiatric assessment, particularly among males and patients with nicotine dependence.
Collapse
Affiliation(s)
- Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Jue Hua Lau
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Ellaisha Samari
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Laxman Cetty
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Yee Ming Mok
- Department of Mood and Anxiety, Institute of Mental Health, Singapore, Singapore
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | | |
Collapse
|
15
|
Malischnig D, Baumgartner C, Schaub MP. CANreduce 2.0: Reduzierung des Cannabiskonsums unter Berücksichtigung von psychischen Komorbiditäten wie der Generalisierten Angststörung – Zwei Fliegen auf einen Schlag? SUCHTTHERAPIE 2020. [DOI: 10.1055/a-1257-9681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Zusammenfassung
Ziel der Studie Zahlreiche Studien weisen auf ein breites Spektrum häufig gleichzeitig auftretender psychischer Störungen wie jene der Generalisierten Angststörung bei der Behandlung von Personen mit Cannabiskonsumstörungen hin (GAD). Bisherige Internet-basierte Studien konnten zwar vereinzelt die Reduktion von Cannabiskonsum zeigen, berücksichtigten aber keine komorbide Störungen. Ziel des E-Coach gestützten Online-Selbsthilfeprogramm CANreduce 2.0 ist die Reduzierung des Cannabiskonsums und der gegebenenfalls vorhandenen GAD.
Methodik Sekundäranalyse der in der Allgemeinbevölkerung rekrutierten Cannabiskonsumierenden der CANreduce 2.0 Studie der beiden aktiven Interventionsgruppen (N=367). Für die Analysen wurden diese Teilnehmende aufgrund ihres erreichten Symptomatik-Wertes der General Anxiety Disorder Scale (GAD-7) in 4 Gruppen eingeteilt: Minimale (GAD-7 Werte: 0–4; N=102), Milde (5–9; N=151), Moderate (10–14; N=78) und Schwere (15–21; N=36) Angststörung und anschliessend ihre Behandlungsverläufe mittels Intention-to-Treat Analysen bezüglich ihrer Cannabiskonsumtage und ihrer Werte auf dem Cannabis Use Disorder Identification Test (CUDIT), der Severity of Dependence Scale (SDS), der GAD-7, der Center of Epidemiologic Studies of Depression Scale (CES-D) sowie bezüglich ihrer Adhärenz verglichen.
Ergebnisse Alle 4 Gruppen reduzierten unabhängig von ihrer GAD-Symptomatik die Anzahl ihrer Cannabiskonsumtage, ihren CUDIT und SDS Score sowohl 6 Wochen als auch 3 Monate nach der Baselineerhebung. Weiter haben mit Ausnahme von der minimalen GAD-7-Gruppe alle Gruppen eine Reduktion der Angstsymptomatik nach 3 Monaten aufgewiesen. Analog zeigten mit Ausnahme der minimalen GAD-7-Gruppe alle GAD-7-Gruppen eine deutliche Reduktion in der depressiven Symptomatik. Bezüglich der gemessenen Adhärenz zeigten sich keine Unterschiede zwischen den GAD-7-Gruppen.
Schlussfolgerungen CANreduce 2.0 scheint sowohl den Cannabiskonsum, die Ausprägung der Cannabiskonsumstörung bzw. die Cannabisabhängigkeit wie auch eine gegebenenfalls vorhandene GAD-Symptomatik zu reduzieren.
Collapse
Affiliation(s)
- Doris Malischnig
- Institut für Suchtprävention der Sucht- und Drogenkoordination Wien, Austria
| | | | | |
Collapse
|
16
|
Chye Y, Mackey S, Gutman BA, Ching CR, Batalla A, Blaine S, Brooks S, Caparelli EC, Cousijn J, Dagher A, Foxe JJ, Goudriaan AE, Hester R, Hutchison K, Jahanshad N, Kaag AM, Korucuoglu O, Li CR, London ED, Lorenzetti V, Luijten M, Martin‐Santos R, Meda SA, Momenan R, Morales A, Orr C, Paulus MP, Pearlson G, Reneman L, Schmaal L, Sinha R, Solowij N, Stein DJ, Stein EA, Tang D, Uhlmann A, Holst R, Veltman DJ, Verdejo‐Garcia A, Wiers RW, Yücel M, Thompson PM, Conrod P, Garavan H. Subcortical surface morphometry in substance dependence: An ENIGMA addiction working group study. Addict Biol 2020; 25:e12830. [PMID: 31746534 DOI: 10.1111/adb.12830] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/25/2019] [Accepted: 08/26/2019] [Indexed: 11/27/2022]
Abstract
While imaging studies have demonstrated volumetric differences in subcortical structures associated with dependence on various abused substances, findings to date have not been wholly consistent. Moreover, most studies have not compared brain morphology across those dependent on different substances of abuse to identify substance-specific and substance-general dependence effects. By pooling large multinational datasets from 33 imaging sites, this study examined subcortical surface morphology in 1628 nondependent controls and 2277 individuals with dependence on alcohol, nicotine, cocaine, methamphetamine, and/or cannabis. Subcortical structures were defined by FreeSurfer segmentation and converted to a mesh surface to extract two vertex-level metrics-the radial distance (RD) of the structure surface from a medial curve and the log of the Jacobian determinant (JD)-that, respectively, describe local thickness and surface area dilation/contraction. Mega-analyses were performed on measures of RD and JD to test for the main effect of substance dependence, controlling for age, sex, intracranial volume, and imaging site. Widespread differences between dependent users and nondependent controls were found across subcortical structures, driven primarily by users dependent on alcohol. Alcohol dependence was associated with localized lower RD and JD across most structures, with the strongest effects in the hippocampus, thalamus, putamen, and amygdala. Meanwhile, nicotine use was associated with greater RD and JD relative to nonsmokers in multiple regions, with the strongest effects in the bilateral hippocampus and right nucleus accumbens. By demonstrating subcortical morphological differences unique to alcohol and nicotine use, rather than dependence across all substances, results suggest substance-specific relationships with subcortical brain structures.
Collapse
Affiliation(s)
- Yann Chye
- Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University Clayton Victoria Australia
| | - Scott Mackey
- Departments of Psychiatry University of Vermont Burlington VT USA
| | - Boris A. Gutman
- Biomedical Engineering Illinois Institute of Technology Chicago IL USA
| | - Christopher R.K. Ching
- Department of Neurology, Keck School of Medicine, Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute University of Southern California Los Angeles CA USA
| | - Albert Batalla
- Department of Psychiatry University Medical Centre Utrecht Brain Center, Utrecht University Utrecht The Netherlands
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM, Institute of Neuroscience University of Barcelona Barcelona Spain
| | - Sara Blaine
- Departments of Psychiatry and Neuroscience Yale University School of Medicine CT USA
| | - Samantha Brooks
- Faculty of Health, School of Psychology Liverpool John Moores University L3 3AF Liverpool UK
- Department of Neuroscience, Section of Functional Pharmacology Uppsala University 75240 Sweden
| | - Elisabeth C. Caparelli
- Neuroimaging Research Branch, Intramural Research Program National Institute of Drug Abuse Baltimore MD USA
| | - Janna Cousijn
- Department of Developmental Psychology University of Amsterdam The Netherlands
| | - Alain Dagher
- McConnell Brain Imaging Center, Montreal Neurological Institute McGill University Montreal Quebec Canada
| | - John J. Foxe
- Department of Neuroscience & The Ernest J. Del Monte Institute for Neuroscience University of Rochester School of Medicine and Dentistry Rochester NY USA
| | - Anna E. Goudriaan
- Amsterdam UMC, Department of Psychiatry, Amsterdam Institute for Addiction Research University of Amsterdam Amsterdam The Netherlands
- Department of Research and Quality of Care Arkin Mental Health Care Amsterdam The Netherlands
| | - Robert Hester
- Melbourne School of Psychological Sciences University of Melbourne Melbourne Victoria Australia
| | - Kent Hutchison
- Department of Psychology and Neuroscience University of Colorado Boulder Boulder CO USA
| | - Neda Jahanshad
- Department of Neurology, Keck School of Medicine, Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute University of Southern California Los Angeles CA USA
| | - Anne M. Kaag
- Department of Developmental Psychology University of Amsterdam The Netherlands
| | - Ozlem Korucuoglu
- Department of Psychiatry Washington University School of Medicine Saint Louis MO USA
| | - Chiang‐Shan R. Li
- Departments of Psychiatry and Neuroscience Yale University School of Medicine CT USA
| | - Edythe D. London
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine Universityof California at Los Angeles Los Angeles CA USA
| | - Valentina Lorenzetti
- Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University Clayton Victoria Australia
- School of Psychology, Faculty of Health Sciences Australian Catholic University Melbourne Victoria Australia
| | - Maartje Luijten
- Behavioural Science Institute Radboud University Nijmegen The Netherlands
| | - Rocio Martin‐Santos
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM, Institute of Neuroscience University of Barcelona Barcelona Spain
| | - Shashwath A. Meda
- Olin Neuropsychiatry Research Center Hartford Hospital/IOL Hartford CT USA
| | - Reza Momenan
- Clinical NeuroImaging Research Core, Division of Intramural Clinical and BiologicalResearch National Institute of Alcohol Abuse and Alcoholism Bethesda MD USA
| | - Angelica Morales
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine Universityof California at Los Angeles Los Angeles CA USA
| | - Catherine Orr
- Departments of Psychiatry University of Vermont Burlington VT USA
| | - Martin P. Paulus
- VA San Diego Healthcare System and Department of Psychiatry University of California San Diego CA USA
- Laureate Institute for Brain Research Tulsa OK USA
| | - Godfrey Pearlson
- Departments of Psychiatry and Neuroscience Yale University School of Medicine CT USA
| | - Liesbeth Reneman
- Department of Radiology and Nuclear Medicine Amsterdam UMC, location AMC Amsterdam The Netherlands
| | - Lianne Schmaal
- Orygen The National Centre of Excellence in Youth Mental Health Parkville Australia
- Centre for Youth Mental Health The University of Melbourne Parkville Australia
| | - Rajita Sinha
- Departments of Psychiatry and Neuroscience Yale University School of Medicine CT USA
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute University of Wollongong Wollongong New South Wales Australia
- The Australian Centre for Cannabinoid Clinical and Research Excellence (ACRE) New Lambton Heights New South Wales Australia
| | - Dan J. Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute University of Cape Town Cape Town South Africa
| | - Elliot A. Stein
- Neuroimaging Research Branch, Intramural Research Program National Institute of Drug Abuse Baltimore MD USA
| | - Deborah Tang
- McConnell Brain Imaging Center, Montreal Neurological Institute McGill University Montreal Quebec Canada
| | - Anne Uhlmann
- Department of Psychiatry and Mental Health Faculty of Health Sciences University of Cape Town South Africa
| | - Ruth Holst
- Department of Psychiatry University of Amsterdam Amsterdam The Netherlands
| | - Dick J. Veltman
- Department of Psychiatry VU University Medical Center Amsterdam The Netherlands
| | - Antonio Verdejo‐Garcia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University Clayton Victoria Australia
| | - Reinout W. Wiers
- Addiction Development and Psychopathology (ADAPT) Lab University of Amsterdam Amsterdam The Netherlands
| | - Murat Yücel
- Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University Clayton Victoria Australia
| | - Paul M. Thompson
- Department of Neurology, Keck School of Medicine, Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute University of Southern California Los Angeles CA USA
| | - Patricia Conrod
- Department of Psychiatry Université de Montreal, CHU Ste Justine Hospital Canada
| | - Hugh Garavan
- Departments of Psychiatry University of Vermont Burlington VT USA
| |
Collapse
|
17
|
Stefanovics EA, Potenza MN, Pietrzak RH. Smoking, obesity, and their co-occurrence in the U.S. military veterans: results from the national health and resilience in veterans study. J Affect Disord 2020; 274:354-362. [PMID: 32469827 DOI: 10.1016/j.jad.2020.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 01/24/2020] [Accepted: 04/09/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Smoking and obesity are major public health concerns, though little is known about the mental and physical health burden of co-occurring obesity and smoking. METHODS Using a nationally representative sample of U.S. military veterans, we examined the prevalence of mental and physical co-morbidities, physical and mental functioning, and quality of life between obese only; smoking only; and obese smokers. RESULTS Among current smokers, 31.7% were obese; among obese veterans, 16.4% were current smokers; and in the total sample, 5.4% were obese and current smokers. Relative to the obese-only group, obese smokers were more likely to be younger, male, non-white, non-married, unemployed and VA-served, and have lower household incomes. These also reported higher levels of perceived stress and trauma and were more likely to endorsed current suicidal ideation and lifetime suicide attempts (odds ratio [OR]=2.0), medical (2.3<=OR<=3.9) and psychiatric (1.5<=OR<=2.9) comorbidities, and lower overall health status and quality of life. Compared to the smoking-only group, obese smokers were more likely to endorse current suicidal ideation (OR=2.0) and nicotine dependence (OR=1.5), and reported poorer physical health and overall quality of life. Analyses were adjusted for sociodemographic and military characteristics. LIMITATIONS The cross-sectional study design precludes causal inference. CONCLUSIONS These findings suggest that co-occurring obesity and smoking is associated with substantial mental and physical health burden in U.S. veterans. Collectively, they underscore the importance of multicomponent interventions targeting, obesity, smoking, and co-occurring issues, such as trauma and internalizing disorders, in this population.
Collapse
Affiliation(s)
- Elina A Stefanovics
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.; U.S. Department of Veteran Affairs New England Mental Illness Research and Education Clinical Center (MIRECC), Connecticut Healthcare System, West Haven, CT, USA..
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.; Department of Neuroscience and Child Study Center, Yale University School of Medicine, New Haven, CT, USA.; Connecticut Council on Problem Gambling, Connecticut Council on Problem Gambling, Wethersfield, CT, USA.; Connecticut Mental Health Center, New Haven, CT, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| |
Collapse
|
18
|
Akbari M, Hasani J, Seydavi M. Negative affect among daily smokers: A systematic review and meta-analysis. J Affect Disord 2020; 274:553-567. [PMID: 32663988 DOI: 10.1016/j.jad.2020.05.063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/02/2020] [Accepted: 05/13/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Negative Affect (NA), as a personality trait is a tendency towards experiencing a more negative emotion. The body of research suggests that NA encourages smoking relapse and smoking as a reason for NA reduction, though. The likelihood of this connection does not seem to be bright yet. The present study critically reviews researches to synthesize the existing literature to determine the strength of this linkage. METHODS Key-word related research was systematically searched in PubMed, PsychINFO, Science Direct and Google Scholar for studies conducted from 1980 to 2019, followed by, the assessment and selection of retrieved studies based on defined inclusion criteria. A random-effects meta-analysis model was used to examine the prospective relationship between NA and smoking. Meta-regression was also used to dig for possible explanations of heterogeneity. Furthermore a multi-moderators model and sub-group analyses examined the moderating factors. RESULTS Forty effect-sizes comprising 12 cross-sectional studies, 28 longitudinal studies and 24,913 participants were included in the meta-analysis. The forest plot of the pooled correlation effect size in the random model indicates a significant effect size of the relationship between NA and smoking (r = 0.11; 95%CI 0.071-0.15, P = 0.001) in the meta-analysis with high heterogeneity (Q = 473.916; df=39; P = 0.001; I2=91.77%). Also, the pooled effect size was obtained as 0.143 (95%CI 0.071-0.214) for light-to-moderate and 0.112 (95%CI 0.057-0.166) for moderate-to-heavy smokers, with the effect size ranging from 0.061 to 0.195 which was significant among all subtypes, though this trend seem higher among adolescents, males, and longitudinal studies than in adults, females, and cross-sectional studies. LIMITATIONS The review was limited to English articles, and the heterogeneity of the studies were high. CONCLUSION These results support the notion that NA was positively and weakly linked to smoking and this linkage is stronger in light-to-moderate smokers, males, and adolescents. Theoretical and clinical implications are discussed with the aim of extending future directions on NA and smoking.
Collapse
Affiliation(s)
- Mehdi Akbari
- Clinical Psychology, Faculty of Psychology and Education, Department of Clinical Psychology, Kharazmi University, Tehran, Iran.
| | | | | |
Collapse
|
19
|
Rogers CJ, Forster M, Valente TW, Unger JB. Associations between network-level acculturation, individual-level acculturation, and substance use among Hispanic adolescents. J Ethn Subst Abuse 2020; 21:439-456. [PMID: 32539637 DOI: 10.1080/15332640.2020.1777610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Acculturation is associated with substance use behaviors in Hispanic adolescents. However, there is limited research determining whether the individual's friends' acculturation patterns also influence substance use. Tenth-grade students (N = 970) participated in Project RED, a study of substance use and social networks among Hispanic youth in Southern California. Acculturation and substance use data from both the respondent and their nominated friends were regressed on lifetime cigarette use, marijuana use, and alcohol use controlling for sibling substance use, sex, depressive symptoms, and network measures. Respondent's Hispanic orientation was significantly associated with lower odds of both cigarette and marijuana use, whereas respondent's friends' US orientation was associated with higher odds of cigarette use. When controlling for network-level acculturation, individual-level U.S. orientation was not associated with substance use. Participants who nominated more friends had lower odds of cigarette use. Among this sample of Hispanic adolescents, affiliating with U.S.-oriented friends was associated with a higher risk for smoking. Substance use prevention efforts should consider encouraging Hispanic youth to maintain their cultural heritage and foster friendship groups that support abstinence and promote Hispanic and bicultural identity.
Collapse
Affiliation(s)
| | - Myriam Forster
- California State University, Northridge, Northridge, California
| | - Thomas W. Valente
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Jennifer B. Unger
- Keck School of Medicine, University of Southern California, Los Angeles, California
| |
Collapse
|
20
|
Liu F, Cui J, Liu X, Chen KW, Chen X, Li R. The effect of tai chi and Qigong exercise on depression and anxiety of individuals with substance use disorders: a systematic review and meta-analysis. BMC Complement Med Ther 2020; 20:161. [PMID: 32471415 PMCID: PMC7260819 DOI: 10.1186/s12906-020-02967-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 05/19/2020] [Indexed: 12/16/2022] Open
Abstract
Background Previous studies have acknowledged Tai Chi and Qigong exercise could be potential effective treatments for reducing depression and anxiety in both healthy and clinical populations. However, there is a scarcity of systematic reviews summarizing the clinical evidence conducted among individuals with substance use disorders. This study tries to fill up this gap. Methods A systematic search using Medline, EMbase, PsychINFO, Eric, SPORTDiscus, CINAHL, the Cochrane Central Register of Controlled Trials (CENTRAL), the Chinese National Knowledge Infrastructure (CNKI), Wanfang, and the Chinese Scientific Journal (VIP) databases was initiated to identify randomized controlled trials (RCTs) and non-randomized comparison studies (NRS) assessing the effect of Tai Chi and Qigong versus various comparison groups on depression and anxiety related outcomes. Study quality was evaluated using a Checklist to Evaluate a Report of a Nonpharmacological Trial (CLEAR-NPT) designed for nonpharmacological trial. Results One RCT and six NRS with a total of 772 participants were identified. Some of them were meta-analyzed to examine the pooled effects based on different types of intervention and controls. The results of meta-analyses suggested the effect of Tai Chi was comparable to treatment as usual (TAU) on depression (standardized mean difference (SMD) = − 0.17[− 0.52, 0.17]). Qigong exercise appears to result in improvement on anxiety compared to that of medication (SMD = -1.12[− 1.47, − 0.78]), and no treatment control (SMD = -0.52[− 0.77, − 0.27]). Conclusion The findings suggest potentially beneficial effect of Qigong exercise on symptoms of anxiety among individuals with drug abuse. Considering the small number and overall methodological weakness of included studies and lack of RCTs, results should be interpreted with caution and future rigorously designed RCTs are warranted to provide more reliable evidence.
Collapse
Affiliation(s)
- Fang Liu
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China
| | - Jiabao Cui
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China
| | - Xuan Liu
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China
| | - Kevin W Chen
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China.,Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, USA
| | - Xiaorong Chen
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China
| | - Ru Li
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China.
| |
Collapse
|
21
|
Hendryx M, Dinh P, Chow A, Kroenke CH, Hingle M, Shadyab AH, Garcia L, Howard BV, Luo J. Lifestyle and Psychosocial Patterns and Diabetes Incidence Among Women with and Without Obesity: a Prospective Latent Class Analysis. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 21:850-860. [PMID: 32405807 DOI: 10.1007/s11121-020-01130-6] [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: 11/30/2022]
Abstract
We conducted latent class analyses to identify women with homogeneous combinations of lifestyle and behavioral variables and tested whether latent classes were prospectively associated with diabetes incidence for women with or without baseline obesity. A total of 64,710 postmenopausal women aged 50-79 years without prevalent diabetes at baseline (years 1993-1998) were followed until 2018 with a mean follow-up of 14.6 years (sd = 6.4). Lifestyle variables included smoking, diet quality, physical activity, and sleep quality. Psychosocial variables included social support, depression, and optimism. Multivariable Cox proportional hazards regression models tested associations between latent classes and diabetes incidence controlling for age, race/ethnicity, and education. During follow-up, 8076 (12.4%) women developed diabetes. For women without baseline obesity, five latent classes were identified. Compared with a lower risk referent, diabetes incidence was higher in classes characterized by high probability of multiple lifestyle and psychosocial risks (HR = 1.45; 95% CI 1.28, 1.64), poor diet and exercise (HR = 1.23; 95% CI 1.13, 1.33), and psychosocial risks alone (HR = 1.20; 95% CI 1.12, 1.29). For women with baseline obesity, four latent classes were identified. Compared with a lower risk referent, diabetes incidence was higher for women with obesity in classes characterized by high probability of multiple lifestyle and psychosocial risks (HR = 1.48; 95% CI 1.32, 1.66), poor diet and exercise (HR = 1.32; 95% CI 1.19, 1.47), and intermediate probabilities of multiple risks (HR = 1.17; 95% CI 1.05, 1.30). Diabetes prevention efforts that focus on diet and exercise may benefit from attention to how lifestyle behaviors interact with psychosocial variables to increase diabetes risks, and conversely, how psychological or social resources may be leveraged with lifestyle changes to reduce the risk for women with and without obesity.
Collapse
Affiliation(s)
- Michael Hendryx
- Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, IN, 47405, USA.
| | - Paul Dinh
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Angela Chow
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Candyce H Kroenke
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Melanie Hingle
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
| | - Aladdin H Shadyab
- Department of Family Medicine and Public Health, University of California San Diego School of Medicine, San Diego, CA, USA
| | - Lorena Garcia
- Department of Public Health Sciences, University of California Davis School of Medicine, Davis, CA, USA
| | | | - Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, USA
| |
Collapse
|
22
|
Hides L, Quinn C, Stoyanov S, Kavanagh D, Baker A. Psychological interventions for co-occurring depression and substance use disorders. Cochrane Database Syst Rev 2019; 2019:CD009501. [PMID: 31769015 PMCID: PMC6953216 DOI: 10.1002/14651858.cd009501.pub2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Comorbid depression and substance use disorders are common and have poorer outcomes than either disorder alone. While effective psychological treatments for depression or substance use disorders are available, relatively few randomised controlled trials (RCTs) have examined the efficacy of these treatments in people with these comorbid disorders. OBJECTIVES To assess the efficacy of psychological interventions delivered alone or in combination with pharmacotherapy for people diagnosed with comorbid depression and substance use disorders. SEARCH METHODS We searched the following databases up to February 2019: Cochrane Central Register of Controlled Trials, PubMed, Embase, CINAHL, Google Scholar and clinical trials registers. All systematic reviews identified, were handsearched for relevant articles. SELECTION CRITERIA The review includes data from RCTs of psychological treatments for people diagnosed with comorbid depression and substance use disorders, using structured clinical interviews. Studies were included if some of the sample were experiencing another mental health disorder (e.g. anxiety); however, studies which required a third disorder as part of their inclusion criteria were not included. Studies were included if psychological interventions (with or without pharmacotherapy) were compared with no treatment, delayed treatment, treatment as usual or other psychological treatments. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS Seven RCTs of psychological treatments with a total of 608 participants met inclusion criteria. All studies were published in the USA and predominately consisted of Caucasian samples. All studies compared different types of psychological treatments. Two studies compared Integrated Cognitive Behavioural Therapy (ICBT) with Twelve Step Facilitation (TSF), another two studies compared Interpersonal Psychotherapy for Depression (IPT-D) with other treatment (Brief Supportive Therapy (BST) or Psychoeducation). The other three studies compared different types or combinations of psychological treatments. No studies compared psychological interventions with no treatment or treatment as usual control conditions. The studies included a diverse range of participants (e.g. veterans, prisoners, community adults and adolescents). All studies were at high risk of performance bias, other main sources were selection, outcome detection and attrition bias. Due to heterogeneity between studies only two meta-analyses were conducted. The first meta-analysis focused on two studies (296 participants) comparing ICBT to TSF. Very low-quality evidence revealed that while the TSF group had lower depression scores than the ICBT group at post-treatment (mean difference (MD) 4.05, 95% confidence interval (CI) 1.43 to 6.66; 212 participants), there was no difference between groups in depression symptoms (MD 1.53, 95% CI -1.73 to 4.79; 181 participants) at six- to 12-month follow-up. At post-treatment there was no difference between groups in proportion of days abstinent (MD -2.84, 95% CI -8.04 to 2.35; 220 participants), however, the ICBT group had a greater proportion of days abstinent than the TSF group at the six- to 12-month follow-up (MD 10.76, 95% CI 3.10 to 18.42; 189 participants). There were no differences between the groups in treatment attendance (MD -1.27, 95% CI -6.10 to 3.56; 270 participants) or treatment retention (RR 0.95, 95% CI 0.72 to 1.25; 296 participants). The second meta-analysis was conducted with two studies (64 participants) comparing IPT-D with other treatment (Brief Supportive Psychotherapy/Psychoeducation). Very low-quality evidence indicated IPT-D resulted in significantly lower depressive symptoms at post-treatment (MD -0.54, 95% CI -1.04 to -0.04; 64 participants), but this effect was not maintained at three-month follow-up (MD 3.80, 95% CI -3.83 to 11.43) in the one study reporting follow-up outcomes (38 participants; IPT-D versus Psychoeducation). Substance use was examined separately in each study, due to heterogeneity in outcomes. Both studies found very low-quality evidence of no significant differences in substance use outcomes at post-treatment (percentage of days abstinent, IPD versus Brief Supportive Psychotherapy; MD -2.70, 95% CI -28.74 to 23.34; 26 participants) or at three-month follow-up (relative risk of relapse, IPT-D versus Psychoeducation; RR 0.67, 95% CI 0.30 to 1.50; 38 participants). There was also very low-quality evidence for no significant differences between groups in treatment retention (RR 1.00, 95% CI 0.81 to 1.23; 64 participants). No adverse events were reported in any study. AUTHORS' CONCLUSIONS The conclusions of this review are limited due to the low number and very poor quality of included studies. No conclusions can be made about the efficacy of psychological interventions (delivered alone or in combination with pharmacotherapy) for the treatment of comorbid depression and substance use disorders, as they are yet to be compared with no treatment or treatment as usual in this population. In terms of differences between psychotherapies, although some significant effects were found, the effects were too inconsistent and small, and the evidence of too poor quality, to be of relevance to practice.
Collapse
Affiliation(s)
- Leanne Hides
- The University of QueenslandSchool of PsychologySt Lucia, BrisbaneQueenslandAustralia4072
| | - Catherine Quinn
- Queensland University of TechnologySchool of Psychology and Counselling, Institute of Health and Biomedical Innovation60 Musk AvenueKelvin GroveBrisbaneQueenslandAustralia4059
| | - Stoyan Stoyanov
- Queensland University of TechnologySchool of Psychology and Counselling, Institute of Health and Biomedical Innovation60 Musk AvenueKelvin GroveBrisbaneQueenslandAustralia4059
| | - David Kavanagh
- Queensland University of TechnologySchool of Psychology and Counselling, Institute of Health and Biomedical Innovation60 Musk AvenueKelvin GroveBrisbaneQueenslandAustralia4059
| | - Amanda Baker
- University of Newcastle, CallaghanCentre for Brain and Mental Health ResearchNewcomen Street, James Fletcher HospitalNewcastleNew South WalesAustralia2300
| | | |
Collapse
|
23
|
Determining Risks for Cannabis Use Disorder in the Face of Changing Legal Policies. CURRENT ADDICTION REPORTS 2019; 6:466-477. [PMID: 33312839 DOI: 10.1007/s40429-019-00288-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose of review This review aims to summarize and critically evaluate the current literature on the associations between individual and socio-cultural factors that increase risk for cannabis use disorder (CUD), and policy change. Recent findings Epidemiological studies show that areas with permissive legal cannabis climates are associated with greater individual risk factors for CUD. This includes: (1) higher rates of edible consumption and vaping, (2) higher delta-9-tetrahydrocannabinol (THC) potency and lower cannabidiol (CBD) levels, and, (3) younger age of initiation of use. Summary A change in the socio-cultural level, such as shifts in the legalization of cannabis, could interact with individual-level factors in their associations with CUD. There is currently a lack of empirical studies that evaluate this interaction. We propose that future research consider a bioecological framework for CUD to allow for a comprehensive understanding of the effects of legal climate that could inform policy and clinical practice.
Collapse
|
24
|
Associations of major depressive disorder with chronic physical conditions, obesity and medication use: Results from the PISMA-ep study. Eur Psychiatry 2019; 60:20-27. [PMID: 31100609 DOI: 10.1016/j.eurpsy.2019.04.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/24/2019] [Accepted: 04/26/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Life expectancy of people with depression is on average 15 years less than that of the general population. This excess of mortality is largely attributed to a deteriorated physical health. Evidence about the association between major depressive disorder (MDD) and physical health is still lacking in some areas. The aim of this study was to explore the association between MDD and physical health-related variables in southern Spain. METHODS The PISMA-ep is a cross-sectional study based on community-dwelling adult population. Our main outcome was current prevalence of MDD. Independent variables explored were: lifetime prevalence of twenty-one chronic physical conditions (CPCs), anthropometric measures (height, weight, body max index, and hip and waist circumferences), general health status, and medication use. RESULTS MDD was significantly associated with any CPC (OR = 2.60; 95% CI: 2.01-3.35; p < 0.001). Increases in BMI were associated with MDD in women (OR=1.08; 95% CI: 1.05-1.11; p < 0.001), but not in men (OR=0.99; 95% CI: 0.95-1.05; p = 0.916). Variables associated with MDD in the multivariate model were: female gender, obesity, general health status, cancer, peptic ulcer, tinnitus and vertigo. 21.4% of participants with MDD received antidepressant treatment. CONCLUSIONS MDD is associated with CPCs, obesity, and increased use of medication. The high rates of comorbidity between MDD and CPCs call for a more holistic management of patients in the clinical practice. The low rate of antidepressant use may be indicating underdiagnosis. Anthropometric variables were differently associated with MDD depending on gender, suggesting a strong influence of psychosocial factors.
Collapse
|
25
|
Kotlaja MM, Carson JV. Cannabis Prevalence and National Drug Policy in 27 Countries: An Analysis of Adolescent Substance Use. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2019; 63:1082-1099. [PMID: 30477367 DOI: 10.1177/0306624x18814184] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Prior research that assesses the relationship between cannabis policy and prevalence rates has yielded mixed results, perhaps due to the varying rigor of these investigations. Addressing some of these issues in rigor and informed by a rational choice theory (RCT), we hypothesize that those policies on the more punitive end of McDonald and colleagues' classification will be most effective. Examining legislation in 27 countries utilizing the Second International Self-Report Delinquency Study (ISRD-2) through hierarchical linear modeling (HLM) models with both individual- and country-level controls, we find little support for these hypotheses. Instead, results from our analysis largely indicate that the variation in country prevalence rates from 2005 to 2007 was not significantly related to cannabis control policy. We comment on possible policy implications for these preliminary results.
Collapse
|
26
|
Rodriguez T, Ward JT, Tillyer MS, Ray JV. The Influence of Delinquent Peer Affiliation on Substance Use: The Moderating Effects of Anxiety and Depression. JOURNAL OF DRUG ISSUES 2019. [DOI: 10.1177/0022042619832019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
27
|
Otterstatter MC, Crabtree A, Dobrer S, Kinniburgh B, Klar S, Leamon A, May-Hadford J, Mill C, Park M, Tu AW, Zheng L. Patterns of health care utilization among people who overdosed from illegal drugs: a descriptive analysis using the BC Provincial Overdose Cohort. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2019; 38:328-333. [PMID: 30226726 DOI: 10.24095/hpcdp.38.9.04] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION British Columbia (BC) declared a public health emergency in April 2016 in response to a rapid rise in overdose deaths. Further understanding of health care utilization is needed to inform prevention strategies for individuals who overdose from illegal drugs. METHODS The Provincial Overdose Cohort includes linked administrative data on health care utilization by individuals who experienced an illegal drug overdose event in BC between 1 January 2015 and 30 November 2016. Overdose cases were identified using data from ambulance services, coroners' investigations, poison control centre calls and hospital, emergency department and physician administrative records. In total, 10 455 overdose cases were identified and compared with 52 275 controls matched on age, sex and area of residence for a descriptive analysis of health care utilization. RESULTS Two-thirds (66%) of overdose cases were male and about half (49%) were 20-39 years old. Over half of the cases (54%) visited the emergency department and about one-quarter (26%) were admitted to hospital in the year before the overdose event, compared with 17% and 9% of controls, respectively. Nevertheless, nearly onefifth (19%) of cases were recorded leaving the emergency department without being seen or against medical advice. High proportions of both cases (75%) and controls (72%) visited community-based physicians. Substance use and mental health-related concerns were the most common diagnoses among people who went on to overdose. CONCLUSION People who overdosed frequently accessed the health care system in the year before the overdose event. In light of the high rates of health care use, there may be opportunities to identify at-risk individuals before they overdose and connect them with targeted programs and evidence-based interventions. Further work using the BC Provincial Overdose Cohort will focus on identifying risk factors for overdose events and death by overdose.
Collapse
Affiliation(s)
- Michael C Otterstatter
- BC Centre for Disease Control, Vancouver, British Columbia, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alexis Crabtree
- BC Centre for Disease Control, Vancouver, British Columbia, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sabina Dobrer
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | | | - Salman Klar
- Fraser Health Authority, Surrey, British Columbia, Canada
| | - Anthony Leamon
- Island Health Authority, Victoria, British Columbia, Canada.,BC Observatory for Population and Public Health, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Jennifer May-Hadford
- First Nations Health Authority, Vancouver, British Columbia, Canada.,Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Christopher Mill
- BC Centre for Disease Control, Vancouver, British Columbia, Canada.,Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Mina Park
- BC Centre for Disease Control, Vancouver, British Columbia, Canada.,BC Observatory for Population and Public Health, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Andrew W Tu
- BC Coroners Service, Burnaby, British Columbia, Canada
| | - Lu Zheng
- BC Emergency Health Services, Victoria, British Columbia, Canada
| |
Collapse
|
28
|
Zartaloudi E, Polemikou A. Functional hemispheric asymmetry and nicotine dependency as variables mediating neurobiological vulnerability to schizotypy in a non-clinical population of college students. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2018.09.003] [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: 10/28/2022]
|
29
|
Eguchi H, Tsutsumi A, Inoue A, Hikichi H, Kawachi I. Association of workplace social capital with psychological distress: results from a longitudinal multilevel analysis of the J-HOPE Study. BMJ Open 2018; 8:e022569. [PMID: 30580264 PMCID: PMC6318521 DOI: 10.1136/bmjopen-2018-022569] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Workplace social capital (WSC) is increasingly recognised as a social contextual determinant of workers' mental health, but longitudinal data are sparse. We aimed to evaluate the impact of changes in unit-level WSC on psychological distress among Japanese employees using a prospective multilevel repeated-measures design. PARTICIPANTS AND STUDY DESIGN We conducted a 2-year prospective cohort study with 1,944 men and 786 women aged 18-65 years. Participants worked at two manufacturing worksites in Japan and were free from mental illness from the first to third study waves. We used a three-level multilevel regression design to evaluate the prospective association of unit-level WSC with individual-level psychological distress. WSC was measured using a validated six-item instrument and individual-level psychological distress with the Kessler Psychological Distress Scale (K6). RESULTS The null model indicated a significant degree of between-work unit variation in psychological distress (intraclass correlation=0.1%, p<0.001). In the full model, each SD increase in unit-level WSC was associated with 0.69 point improvement in K6 scores (95% CI -1.12 to -0.26). CONCLUSIONS This prospective study builds on existing knowledge by showing an association between unit-level WSC and modest improvements in mental health among employees in Japan. We recommend that WSC is considered alongside other contextual influences when assessing employees' mental health risks.
Collapse
Affiliation(s)
- Hisashi Eguchi
- Takemi Program in International Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Akiomi Inoue
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Hiroyuki Hikichi
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| |
Collapse
|
30
|
Substance-related disorders: A review of prevalence and correlates among patients with chronic pain. Prog Neuropsychopharmacol Biol Psychiatry 2018; 87:245-254. [PMID: 28669582 DOI: 10.1016/j.pnpbp.2017.06.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/26/2017] [Accepted: 06/27/2017] [Indexed: 01/25/2023]
Abstract
Over the past few decades, research has revealed high rates of substance-related disorders among patients with chronic pain. In addition to their potentially deleterious health consequences, substance-related disorders have consistently been associated with negative pain-related outcomes among patients with chronic pain. The goal of this narrative review was to provide an overview of studies that have examined the prevalence and correlates of substance-related disorders among patients with chronic pain. A particular focus was placed on opioids, sedatives/hypnotics, cannabis, tobacco, and alcohol given that these substances have received the bulk of research attention among patients with pain. Research conducted to date suggests that a host of biological and psychological factors are likely to contribute to the elevated rates of substance-related disorders among patients with chronic pain. In this review, in addition to reviewing the prevalence and correlates of substance-related disorders among patients with pain, we briefly discussed the changes that were recently made from the DSM-4 to the DSM-5 in the diagnostic criteria for substance-related disorders, and the implications of these changes for the assessment of patients with chronic pain. We also provided a brief overview of instruments that can be used for the assessment of these disorders in clinical and research settings.
Collapse
|
31
|
Hunt GE, Large MM, Cleary M, Lai HMX, Saunders JB. Prevalence of comorbid substance use in schizophrenia spectrum disorders in community and clinical settings, 1990-2017: Systematic review and meta-analysis. Drug Alcohol Depend 2018; 191:234-258. [PMID: 30153606 DOI: 10.1016/j.drugalcdep.2018.07.011] [Citation(s) in RCA: 236] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 07/02/2018] [Accepted: 07/09/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Comorbidity is highly prevalent between substance use disorders (SUDs) and schizophrenia. This systematic review and meta-analysis estimated prevalence rates of SUDs in epidemiological and treatment-seeking patients diagnosed with schizophrenia or first episode psychosis. METHODS A literature search of Medline, EMBASE, PsycINFO and CINAHL databases was conducted from 1990 to 2017 inclusive. Prevalence of co-morbid SUDs and schizophrenia were extracted and odds ratios (ORs) were calculated using random effects meta-analysis. Combining like studies was dictated how authors reported substance use. RESULTS There were 123 included articles with a total sample size of 165,811 subjects that yielded six epidemiological studies, 11 national or state case-registry studies, 20 large cohort studies and 86 clinical studies using in- or out-patient samples. The prevalence of any SUD was 41.7%, followed by illicit drugs (27.5%), cannabis (26.2%), alcohol (24.3%) and stimulant use (7.3%). Meta-analysis showed the pooled variance of any SUD in males was 48% which was significantly higher than that for females with schizophrenia (22.1%, OR 3.43, 95% CI 3.01, 3.92). Patients with SUD had an earlier age of onset of schizophrenia. Meta-regression showed prevalence increased over time for illicit drugs but not for other substances, including alcohol. CONCLUSIONS The meta-analysis revealed that SUDs in schizophrenia is highly prevalent and rates have not changed over time. This indicates SUD are difficult to treat in this patient population and there is an urgent need for more informative studies to help develop better prevention, detection and treatment of SUDs in persons with schizophrenia and co-morbid disorders.
Collapse
Affiliation(s)
- Glenn E Hunt
- Discipline of Psychiatry and Addiction Medicine, Concord Clinical School, University of Sydney, Hospital Rd, Concord, NSW, 2139, Australia.
| | - Matthew M Large
- School of Psychiatry, University of New South Wales, Kensington, NSW, 2052, Australia.
| | - Michelle Cleary
- School of Health Sciences, University of Tasmania, Lilyfield, NSW, 2040, Australia.
| | - Harry Man Xiong Lai
- Discipline of Psychiatry, University of Sydney, Hospital Rd, Concord, NSW, 2139, Australia.
| | - John B Saunders
- Discipline of Psychiatry and Addiction Medicine, Concord Clinical School, University of Sydney, Hospital Rd, Concord, NSW, 2139, Australia.
| |
Collapse
|
32
|
Reeves LE, Gaudiano BA, Metrik J, Guzman Holst C, Morena A, Sydnor VJ, Weinstock LM, Epstein-Lubow G. Comorbid Cannabis and Tobacco Use Disorders in Hospitalized Patients with Psychotic-Spectrum Disorders. J Dual Diagn 2018; 14:171-180. [PMID: 30265850 DOI: 10.1080/15504263.2018.1470359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Individuals with psychotic-spectrum disorders use tobacco and cannabis at higher rates than the general population and individuals with other psychiatric disorders, which may contribute to increased rates of medical problems and mortality. The present study examined whether individuals with psychosis and comorbid tobacco and/or cannabis use disorders exhibit differing clinical characteristics in terms of their sociodemographic, mental health, substance use, physical health, and medication use patterns. Elucidation of these profiles, and determining their relative severity, has important implications for treatment, including offering more targeted interventions based on type of comorbidity pattern. METHODS We examined the electronic medical records of 829 patients with psychotic-spectrum disorders admitted to a psychiatric hospital and categorized them as having: (1) cannabis use disorder (CUD); (2) tobacco use disorder (TUD); (3) comorbid cannabis and tobacco use disorders (CUD + TUD); or (4) neither disorder (no CUD/TUD). Multinomial logistic regression was used to compare the aforementioned groups on multiple variables controlling for age and sex. RESULTS Alcohol and stimulant use disorder diagnoses were each related to higher odds of having a CUD and CUD + TUD, relative to no CUD/TUD. Stimulant and polysubstance use disorder diagnoses were each related to higher odds of having a TUD compared to no CUD/TUD. Greater number of prescribed psychotropic medications was related to higher odds of a TUD compared to no CUD/TUD. CONCLUSIONS Although several differences between groups were accounted for by age of cannabis versus tobacco users, findings point to the importance of considering comorbid alcohol and substance use disorders among those with psychosis and CUD/TUD, as these comorbidities have important implications for screening and treatment selection during and following acute hospitalization.
Collapse
Affiliation(s)
- Lauren E Reeves
- a Butler Hospital, Psychosocial Research Program, Providence , Rhode Island , USA.,b Warren Alpert Medical School of Brown University , Department of Psychiatry and Human Behavior , Providence , Rhode Island , USA
| | - Brandon A Gaudiano
- a Butler Hospital, Psychosocial Research Program, Providence , Rhode Island , USA.,b Warren Alpert Medical School of Brown University , Department of Psychiatry and Human Behavior , Providence , Rhode Island , USA
| | - Jane Metrik
- c Providence Veterans Administration Medical Center , Providence , Rhode Island , USA.,d Center for Alcohol and Addiction Studies , Brown University, School of Public Health , Providence , Rhode Island , USA
| | - Carolina Guzman Holst
- a Butler Hospital, Psychosocial Research Program, Providence , Rhode Island , USA.,b Warren Alpert Medical School of Brown University , Department of Psychiatry and Human Behavior , Providence , Rhode Island , USA
| | - Alexandra Morena
- a Butler Hospital, Psychosocial Research Program, Providence , Rhode Island , USA
| | - Valerie J Sydnor
- a Butler Hospital, Psychosocial Research Program, Providence , Rhode Island , USA.,b Warren Alpert Medical School of Brown University , Department of Psychiatry and Human Behavior , Providence , Rhode Island , USA
| | - Lauren M Weinstock
- a Butler Hospital, Psychosocial Research Program, Providence , Rhode Island , USA.,b Warren Alpert Medical School of Brown University , Department of Psychiatry and Human Behavior , Providence , Rhode Island , USA
| | - Gary Epstein-Lubow
- a Butler Hospital, Psychosocial Research Program, Providence , Rhode Island , USA.,b Warren Alpert Medical School of Brown University , Department of Psychiatry and Human Behavior , Providence , Rhode Island , USA
| |
Collapse
|
33
|
Moody RL, Starks TJ, Grov C, Parsons JT. Internalized Homophobia and Drug Use in a National Cohort of Gay and Bisexual Men: Examining Depression, Sexual Anxiety, and Gay Community Attachment as Mediating Factors. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1133-1144. [PMID: 28608294 PMCID: PMC5726951 DOI: 10.1007/s10508-017-1009-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 05/17/2017] [Accepted: 05/24/2017] [Indexed: 05/04/2023]
Abstract
The minority stress process of internalized homophobia (IH) has been associated with a range of adverse health outcomes among gay and bisexual men (GBM). However, evidence is mixed regarding the effect of IH on drug use, suggesting the potential role of multiple mediated pathways. Researchers have linked depression, sexual anxiety, and gay community attachment with IH. Depression, sexual anxiety, and gay community attachment have also been linked with drug use and drug-related problems suggesting potential mediating roles. A U.S. national sample of 1071 HIV-negative GBM completed at-home surveys, including measures of sociodemographic characteristics, IH, depression, sexual anxiety, gay community attachment, and drug use and associated problems. Adjusting for sociodemographic characteristics, depression mediated the association between IH and recent drug use. IH was positively associated with depression, and depression was positively associated with recent drug use. Gay community attachment partially mediated drug-related problems. IH had a positive direct association with drug-related problems and a negative direct association with gay community attachment. Gay community attachment had a positive association with drug-related problems. IH was positively associated with sexual anxiety, but sexual anxiety was not associated with either drug outcome. Efforts to reduce IH among HIV-negative GBM are likely to have a positive impact on mental health problems, as well as reduce risk for drug use and drug-related problems. Gay communities could provide the social support necessary for reducing IH; however, emphasis on community level interventions that address factors that increase risk for drug-related problems remains important.
Collapse
Affiliation(s)
- Raymond L. Moody
- Center for HIV/AIDS Educational Studies & Training, Hunter College of the City University of New York (CUNY), New York, NY;
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY
| | - Tyrel J. Starks
- Center for HIV/AIDS Educational Studies & Training, Hunter College of the City University of New York (CUNY), New York, NY;
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY
| | - Christian Grov
- Center for HIV/AIDS Educational Studies & Training, Hunter College of the City University of New York (CUNY), New York, NY;
- CUNY School of Public Health, New York, NY
| | - Jeffrey T. Parsons
- Center for HIV/AIDS Educational Studies & Training, Hunter College of the City University of New York (CUNY), New York, NY;
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY
- CUNY School of Public Health, New York, NY
| |
Collapse
|
34
|
Lovell ME, Bruno R, Johnston J, Matthews A, McGregor I, Allsop DJ, Lintzeris N. Cognitive, physical, and mental health outcomes between long-term cannabis and tobacco users. Addict Behav 2018; 79:178-188. [PMID: 29291509 DOI: 10.1016/j.addbeh.2017.12.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/17/2017] [Accepted: 12/07/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Cannabis intoxication adversely affects health, yet persistent effects following short-term abstinence in long-term cannabis users are unclear. This matched-subjects, cross-sectional study compared health outcomes of long-term cannabis and long-term tobacco-only users, relative to population norms. METHODS Nineteen long-term (mean 32.3years of use, mean age 55.7years), abstinent (mean 15h) cannabis users and 16 long-term tobacco users (mean 37.1years of use, mean age 52.9years), matched for age, educational attainment, and lifetime tobacco consumption, were compared on measures of learning and memory, response inhibition, information-processing, sustained attention, executive control, and mental and physical health. RESULTS Cannabis users exhibited poorer overall learning and delayed recall and greater interference and forgetting than tobacco users, and exhibited poorer recall than norms. Inhibition and executive control were similar between groups, but cannabis users had slower reaction times during information processing and sustained attention tasks. Cannabis users had superior health satisfaction and psychological, somatic, and general health than tobacco users and had similar mental and physical health to norms whilst tobacco users had greater stress, role limitations from emotional problems, and poorer health satisfaction. CONCLUSIONS Long-term cannabis users may exhibit deficits in some cognitive domains despite short-term abstinence and may therefore benefit from interventions to improve cognitive performance. Tobacco alone may contribute to adverse mental and physical health outcomes, which requires appropriate control in future studies.
Collapse
Affiliation(s)
- M E Lovell
- School of Medicine (Psychology), University of Tasmania, Hobart, Tasmania 7000, Australia.
| | - R Bruno
- School of Medicine (Psychology), University of Tasmania, Hobart, Tasmania 7000, Australia
| | - J Johnston
- University Centre for Rural Health - North Coast, University of Sydney, Lismore, New South Wales 2480, Australia
| | - A Matthews
- School of Medicine (Psychology), University of Tasmania, Hobart, Tasmania 7000, Australia
| | - I McGregor
- Lambert Initiative for Cannabinoid Therapeutics, School of Psychology, Brain and Mind Centre, University of Sydney, New South Wales 2006, Australia
| | - D J Allsop
- Lambert Initiative for Cannabinoid Therapeutics, School of Psychology, Brain and Mind Centre, University of Sydney, New South Wales 2006, Australia
| | - N Lintzeris
- Discipline of Addictive Medicine, Sydney Medical School, University of Sydney, Sydney, New South Wales 2006, Australia; The Langton Centre, South East Sydney Local Health District (SESLHD), Drug and Alcohol Services, 2010, Australia
| |
Collapse
|
35
|
Iszáj F, Kapitány-Fövény M, Farkas J, Kökönyei G, Urbán R, Griffiths MD, Demetrovics Z. Substance Use and Psychological Disorders Among Art and Non-art University Students: an Empirical Self-Report Survey. Int J Ment Health Addict 2018; 16:125-135. [PMID: 29491769 PMCID: PMC5814514 DOI: 10.1007/s11469-017-9812-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Media stories often suggest that those working in the creative arts appear to use and abuse psychoactive substances. The aim of the present study was to analyze the relationship between the use of psychoactive substances and the presence of psychological disorders among art and non-art students. Questionnaires related to these two areas were completed by 182 art students in higher education and a control group of 704 non-art university students. To assess psychoactive substance use, a structured questionnaire including the Cannabis Abuse Screening Test (CAST) and the Alcohol Use Disorders Identification Test (AUDIT) was administered to participants. Psychological disorders were assessed using the Hungarian version of the Brief Symptom Inventory (BSI) and the Global Severity Index (GSI). After analyzing the data, significant differences were found between the two groups regarding their first use of psychoactive substances. Art students' current substance use was found to be significantly more frequent compared to the control group. In relation to psychological disorders, art students scored significantly higher on three scales of the BSI (i.e., psychoticism, hostility, and phobic anxiety). Overall, a significantly higher proportion of artists were labeled as "problematic" using the GSI. The results suggest that artists have a higher risk of both substance use and experiencing psychological disorders.
Collapse
Affiliation(s)
- Fruzsina Iszáj
- 1Department of Clinical Psychology and Addiction, Institute of Psychology, ELTE Eötvös Loránd University, Izabella utca 46, Budapest, 1064 Hungary
| | - Máté Kapitány-Fövény
- 1Department of Clinical Psychology and Addiction, Institute of Psychology, ELTE Eötvös Loránd University, Izabella utca 46, Budapest, 1064 Hungary.,2Department of Addictology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary.,Nyírő Gyula Hospital, National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Judit Farkas
- 1Department of Clinical Psychology and Addiction, Institute of Psychology, ELTE Eötvös Loránd University, Izabella utca 46, Budapest, 1064 Hungary.,Nyírő Gyula Hospital, National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Gyöngyi Kökönyei
- 1Department of Clinical Psychology and Addiction, Institute of Psychology, ELTE Eötvös Loránd University, Izabella utca 46, Budapest, 1064 Hungary
| | - Róbert Urbán
- 4Department of Personality and Clinical Psychology, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Mark D Griffiths
- 5Psychology Department, International Gaming Research Unit, Nottingham Trent University, 50 Shakespeare Street, Nottingham, UK
| | - Zsolt Demetrovics
- 1Department of Clinical Psychology and Addiction, Institute of Psychology, ELTE Eötvös Loránd University, Izabella utca 46, Budapest, 1064 Hungary
| |
Collapse
|
36
|
Duperrouzel J, Hawes SW, Lopez-Quintero C, Pacheco-Colón I, Comer J, Gonzalez R. The association between adolescent cannabis use and anxiety: A parallel process analysis. Addict Behav 2018; 78:107-113. [PMID: 29149635 DOI: 10.1016/j.addbeh.2017.11.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 11/01/2017] [Accepted: 11/03/2017] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Associations between anxiety symptoms and cannabis use have been previously explored, yet the directionality of these associations remains highly debatable. The present study aims to prospectively examine patterns of cannabis use and anxiety during adolescence focusing on their co-development and bidirectional influences. METHODS Adolescents (n=250) of predominantly Hispanic ethnicity, aged 14-17 at baseline, exposed to drugs, alcohol, or cigarettes completed three (bi-annual) assessments across a 1-year period. Latent growth curve modeling (LGCM) and parallel process growth curves were conducted to examine potential associations in the joint development of anxiety and cannabis use. RESULTS Our results suggest that, during adolescence, early cannabis use has a greater influence on prospective reports of anxiety, than vice versa. Specifically, adolescents exhibiting higher initial levels of cannabis use displayed more persisting self-reported anxiety across time, as compared to those with less frequent use (b=0.28, p=0.024). In contrast, early levels of anxiety were not found to influence rates of change in cannabis use. These analyses considered concurrent depression, alcohol, and nicotine use. CONCLUSIONS Our findings suggest that prevention and targeted intervention programs for cannabis use in adolescence would benefit from anxiety management strategies; in order to reduce subsequent anxiety associated with cannabis use. Future studies should continue to employ longitudinal designs across larger time periods and aim to replicate these findings with more diverse samples.
Collapse
|
37
|
Abstract
Depression, as a heterogeneous collection of disorders, is likely to include subgroups that are more genetic in origin. In common with other neuropsychiatric disorders such as schizophrenia, Alzheimer's disease and Huntington's disease, earlier age at onset in depression is associated with higher genetic loading and poorer long-term outcome. Adolescents and young adults with depression are also at high risk of developing a bipolar illness. This article reviews depressive illnesses that occur for the first time in adolescence and young adulthood. Case studies are used to discuss atypical presentations and the evolving concept of bipolar-spectrum disorders.
Collapse
|
38
|
Cheng HG, Phillips MR, Li X, Zhang J, Shi Q, Xu G, Song Z, Ding Z, Pang S. Co-occurrence of DSM-IV mental disorders and alcohol use disorder among adult Chinese males. Psychol Med 2017; 47:2811-2822. [PMID: 28552086 DOI: 10.1017/s0033291717001337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Studies from high-income countries report moderate-to-strong positive associations between alcohol use disorder (AUD) and other mental disorders, but there is little evidence about the comorbidity of AUD from low-and-middle-income countries. METHODS A sample of 74 752 adults from five provinces that account for >12% of China's adult population was screened using the General Health Questionnaire, and the Structured Clinical Interview for DSM-IV was administered by psychiatrists to a subsample of 9619 males. The associations between AUD and other mental disorders at each site and the characteristics of men with AUD with and without comorbid mental disorders were estimated using logistic regression and summarized across sites using meta-analysis. Generalized estimation equations estimated the associations between the clinical features of alcohol dependence and comorbidity. RESULTS Robust inverse associations were found between current AUD and any mood disorder (adjusted OR = 0.6, 95% CI = 0.4-0.8) and any anxiety disorder (OR = 0.5, 95% CI = 0.3-1.0). Compared with men without AUD, men with AUD without comorbid disorders were more likely to be middle-aged, to be currently married, and to have higher family incomes. Men with comorbid AUD and other disorders were more likely to have the clinical features of alcohol dependence than men with AUD without comorbid disorders. CONCLUSIONS Inverse associations between AUD and other mental disorders and the higher social status of men with AUD than men without AUD found in this large, representative sample of community-dwelling Chinese males highlight the importance of considering the local substance-use culture when designing clinical or preventive interventions for addictive conditions.
Collapse
Affiliation(s)
- H G Cheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine,China
| | - M R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine,China
| | - X Li
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing Hui Long Guan Hospital,Beijing,China
| | - J Zhang
- Shandong Provincial Mental Health Center,Jinan City,Shandong Province,China
| | - Q Shi
- Tong De Hospital of Zhejiang Province,Hangzhou City,Zhejiang Province,China
| | - G Xu
- Tianjin Mental Health Center,Tianjin,China
| | - Z Song
- The 3rd People's Hospital of Qinghai Province,Xining City,Qinghai Province,China
| | - Z Ding
- Tianshui City Mental Hospital,Tianshui City,Gansu Province,China
| | - S Pang
- Qingdao Mental Health Centre,Qingdao City,Shandong Province,China
| |
Collapse
|
39
|
Erevik EK, Torsheim T, Andreassen CS, Vedaa Ø, Pallesen S. Recurrent cannabis use among Norwegian students: Prevalence, characteristics, and polysubstance use. NORDIC STUDIES ON ALCOHOL AND DRUGS 2017; 34:497-510. [PMID: 32934508 PMCID: PMC7450846 DOI: 10.1177/1455072517743427] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 10/17/2017] [Indexed: 11/15/2022] Open
Abstract
Background: Research on cannabis has focused on lifetime use or regular/heavy use (i.e., daily or almost daily). Regular, albeit not necessarily daily, cannabis use has received less scientific attention. Objectives: This study aims to identify demographic and personality factors associated with recurrent cannabis use (i.e., cannabis usage 5 to 50 times in the last six months) and to investigate the relationship between cannabis use and use of other substances. Methods: Public and private university students (N = 11,236) in Bergen, Norway, participated in an online survey during autumn 2015. Binary logistic regression was run to identify individual characteristics related to recurrent cannabis use. Chi-square tests were conducted to investigate differences in substance use (alcohol, nicotine, and illicit drugs) between recurrent cannabis users and cannabis abstainers/low-frequency users. Results: A total of 4.0% of the students reported recurrent cannabis use. Students born in North America, non-Christians (compared to non-religious students), and men were more likely to be recurrent users. Recurrent cannabis users scored higher on extroversion and intellect/imagination compared to abstainers/low-frequency users. Male and female recurrent cannabis users had somewhat different characteristics (e.g., agreeableness scores were negatively associated with recurrent use among females but not among males). Recurrent cannabis use was overall strongly associated with polysubstance use. Conclusions: The prevalence of recurrent cannabis use among Norwegian students is low. Recurrent cannabis use seems more prevalent among individuals marked by extroversion and intellect/imagination, which supports the notion of cannabis use as a social activity for individuals identifying themselves as outgoing and unconventional. Cannabis use among students seems strongly associated with use of other substances, suggesting that cannabis should not be considered a replacement drug.
Collapse
Affiliation(s)
| | | | | | - Øystein Vedaa
- University of Bergen, Norway Norwegian Institute of Public Health, Norway
| | | |
Collapse
|
40
|
Goodwin RD, Pacek LR, Copeland J, Moeller SJ, Dierker L, Weinberger A, Gbedemah M, Zvolensky MJ, Wall MM, Hasin DS. Trends in Daily Cannabis Use Among Cigarette Smokers: United States, 2002-2014. Am J Public Health 2017; 108:137-142. [PMID: 29161058 DOI: 10.2105/ajph.2017.304050] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To estimate changes in the prevalence of daily cannabis use among current, former, and never cigarette smokers from 2002 to 2014 in the United States. METHODS The National Survey on Drug Use and Health is a nationally representative cross-sectional study conducted annually among persons aged 12 years and older in the United States. RESULTS Daily cannabis use occurs nearly exclusively among nondaily and daily cigarette smokers compared with former and never smokers (8.03%, 9.01%, 2.79%, 1.05%, respectively). Daily cannabis use increased over the past decade among both nondaily (8.03% [2014] vs 2.85% [2002]; linear trend P < .001) and daily smokers (9.01% [2014]; 4.92% [2002]; linear trend P < .001). Daily cannabis use increased most rapidly among former cigarette smokers (2.79% [2014] vs 0.98% [2002]; linear trend P < .001). CONCLUSIONS Daily cannabis use occurs predominantly among cigarette smokers in the United States. Daily cannabis use increased among current, former, and never smokers over the past decade, with particularly rapid increases among youth and female cigarette smokers. Future research is needed to monitor the observed increase in daily cannabis use, especially among youths and adults who smoke cigarettes.
Collapse
Affiliation(s)
- Renee D Goodwin
- Renee D. Goodwin is with the Institute for Implementation Science in Population Health, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY. Lauren R. Pacek is with the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC. Jan Copeland is with the University of New South Wales Medicine, Sydney, New South Wales, Australia. Scott J. Moeller is with the Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY. Lisa Dierker is with the Department of Psychology, Wesleyan University, Middletown, CT. Andrea Weinberger is with the Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY. Michael J. Zvolensky is with the Department of Psychology, University of Houston, Houston, TX. Melanie M. Wall is with the Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY. Deborah S. Hasin is with the Department of Epidemiology, Mailman School of Public Health
| | - Lauren R Pacek
- Renee D. Goodwin is with the Institute for Implementation Science in Population Health, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY. Lauren R. Pacek is with the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC. Jan Copeland is with the University of New South Wales Medicine, Sydney, New South Wales, Australia. Scott J. Moeller is with the Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY. Lisa Dierker is with the Department of Psychology, Wesleyan University, Middletown, CT. Andrea Weinberger is with the Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY. Michael J. Zvolensky is with the Department of Psychology, University of Houston, Houston, TX. Melanie M. Wall is with the Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY. Deborah S. Hasin is with the Department of Epidemiology, Mailman School of Public Health
| | - Jan Copeland
- Renee D. Goodwin is with the Institute for Implementation Science in Population Health, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY. Lauren R. Pacek is with the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC. Jan Copeland is with the University of New South Wales Medicine, Sydney, New South Wales, Australia. Scott J. Moeller is with the Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY. Lisa Dierker is with the Department of Psychology, Wesleyan University, Middletown, CT. Andrea Weinberger is with the Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY. Michael J. Zvolensky is with the Department of Psychology, University of Houston, Houston, TX. Melanie M. Wall is with the Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY. Deborah S. Hasin is with the Department of Epidemiology, Mailman School of Public Health
| | - Scott J Moeller
- Renee D. Goodwin is with the Institute for Implementation Science in Population Health, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY. Lauren R. Pacek is with the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC. Jan Copeland is with the University of New South Wales Medicine, Sydney, New South Wales, Australia. Scott J. Moeller is with the Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY. Lisa Dierker is with the Department of Psychology, Wesleyan University, Middletown, CT. Andrea Weinberger is with the Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY. Michael J. Zvolensky is with the Department of Psychology, University of Houston, Houston, TX. Melanie M. Wall is with the Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY. Deborah S. Hasin is with the Department of Epidemiology, Mailman School of Public Health
| | - Lisa Dierker
- Renee D. Goodwin is with the Institute for Implementation Science in Population Health, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY. Lauren R. Pacek is with the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC. Jan Copeland is with the University of New South Wales Medicine, Sydney, New South Wales, Australia. Scott J. Moeller is with the Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY. Lisa Dierker is with the Department of Psychology, Wesleyan University, Middletown, CT. Andrea Weinberger is with the Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY. Michael J. Zvolensky is with the Department of Psychology, University of Houston, Houston, TX. Melanie M. Wall is with the Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY. Deborah S. Hasin is with the Department of Epidemiology, Mailman School of Public Health
| | - Andrea Weinberger
- Renee D. Goodwin is with the Institute for Implementation Science in Population Health, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY. Lauren R. Pacek is with the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC. Jan Copeland is with the University of New South Wales Medicine, Sydney, New South Wales, Australia. Scott J. Moeller is with the Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY. Lisa Dierker is with the Department of Psychology, Wesleyan University, Middletown, CT. Andrea Weinberger is with the Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY. Michael J. Zvolensky is with the Department of Psychology, University of Houston, Houston, TX. Melanie M. Wall is with the Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY. Deborah S. Hasin is with the Department of Epidemiology, Mailman School of Public Health
| | - Misato Gbedemah
- Renee D. Goodwin is with the Institute for Implementation Science in Population Health, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY. Lauren R. Pacek is with the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC. Jan Copeland is with the University of New South Wales Medicine, Sydney, New South Wales, Australia. Scott J. Moeller is with the Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY. Lisa Dierker is with the Department of Psychology, Wesleyan University, Middletown, CT. Andrea Weinberger is with the Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY. Michael J. Zvolensky is with the Department of Psychology, University of Houston, Houston, TX. Melanie M. Wall is with the Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY. Deborah S. Hasin is with the Department of Epidemiology, Mailman School of Public Health
| | - Michael J Zvolensky
- Renee D. Goodwin is with the Institute for Implementation Science in Population Health, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY. Lauren R. Pacek is with the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC. Jan Copeland is with the University of New South Wales Medicine, Sydney, New South Wales, Australia. Scott J. Moeller is with the Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY. Lisa Dierker is with the Department of Psychology, Wesleyan University, Middletown, CT. Andrea Weinberger is with the Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY. Michael J. Zvolensky is with the Department of Psychology, University of Houston, Houston, TX. Melanie M. Wall is with the Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY. Deborah S. Hasin is with the Department of Epidemiology, Mailman School of Public Health
| | - Melanie M Wall
- Renee D. Goodwin is with the Institute for Implementation Science in Population Health, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY. Lauren R. Pacek is with the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC. Jan Copeland is with the University of New South Wales Medicine, Sydney, New South Wales, Australia. Scott J. Moeller is with the Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY. Lisa Dierker is with the Department of Psychology, Wesleyan University, Middletown, CT. Andrea Weinberger is with the Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY. Michael J. Zvolensky is with the Department of Psychology, University of Houston, Houston, TX. Melanie M. Wall is with the Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY. Deborah S. Hasin is with the Department of Epidemiology, Mailman School of Public Health
| | - Deborah S Hasin
- Renee D. Goodwin is with the Institute for Implementation Science in Population Health, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY. Lauren R. Pacek is with the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC. Jan Copeland is with the University of New South Wales Medicine, Sydney, New South Wales, Australia. Scott J. Moeller is with the Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY. Lisa Dierker is with the Department of Psychology, Wesleyan University, Middletown, CT. Andrea Weinberger is with the Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY. Michael J. Zvolensky is with the Department of Psychology, University of Houston, Houston, TX. Melanie M. Wall is with the Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY. Deborah S. Hasin is with the Department of Epidemiology, Mailman School of Public Health
| |
Collapse
|
41
|
Hamilton I. Cannabis, psychosis and schizophrenia: unravelling a complex interaction. Addiction 2017; 112:1653-1657. [PMID: 28419656 DOI: 10.1111/add.13826] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 02/21/2017] [Accepted: 03/13/2017] [Indexed: 01/14/2023]
Abstract
The relationship between cannabis and psychosis and schizophrenia has tested the field of addiction for decades, and in some ways serves as measure of our ability to provide a credible contribution to public health. As cannabis is used widely, many people are interested in the risks the drug poses to mental health. This paper focuses upon a seminal study examining this, the trajectory of subsequent research findings and what this has meant for understanding and communicating risk factor information. These studies provided evidence of a dose-response relationship between cannabis and psychosis, and that for those individuals with schizophrenia cannabis exacerbated their symptoms. The findings fit with a multi-causal model in which vulnerability interacts with a precipitating agent to produce a disease outcome. Even though this is a common model in epidemiology, it has proved difficult to communicate it in this case. This may be because at a population level the increased risk is weak and the vulnerabilities relatively rare. It may also be because people bring strongly held preconceptions to interpreting a complex multi-causal phenomenon.
Collapse
Affiliation(s)
- Ian Hamilton
- Department of Health Sciences, University of York, Heslington, York, UK
| |
Collapse
|
42
|
The galanin-3 receptor antagonist, SNAP 37889, suppresses alcohol drinking and morphine self-administration in mice. Neuropharmacology 2017; 118:1-12. [DOI: 10.1016/j.neuropharm.2017.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 02/17/2017] [Accepted: 03/02/2017] [Indexed: 02/07/2023]
|
43
|
Abstract
The paper utilizes data collected at three time points in a longitudinal study of perinatally HIV-infected (PHIV+) and a comparison group of perinatally exposed but HIV-uninfected (PHEU) youths in the United States (N = 325). Using growth curve modeling, the paper examines changes in substance use symptoms among PHIV+ and PHEU youths as they transition through adolescence, and assesses the individual and contextual factors associated with the rate of change in substance use symptoms. Findings indicate that substance use symptoms increased over time among PHIV+ youths, but not among PHEU youths. The rate of change in these symptoms was positively associated with an increasing number of negative life events. Study findings underscore the need for early, targeted interventions for PHIV+ youths, and interventions to reduce adversities and their deleterious effects in vulnerable populations.
Collapse
|
44
|
Havemann-Reinecke U, Hoch E, Preuss UW, Kiefer F, Batra A, Gerlinger G, Hauth I. [On the legalization debate of non-medical cannabis consumption : Position paper of the German Association for Psychiatry, Psychotherapy and Psychosomatics]. DER NERVENARZT 2016; 88:291-298. [PMID: 27981374 DOI: 10.1007/s00115-016-0248-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Calls are increasing for the legalization of cannabis. Some legal experts, various politicians, political parties and associations are demanding a change in drug policy. The legalization debate is lively and receiving wide coverage in the media. The German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) comments on the most important questions from a medical scientific perspective: can cannabis consumption trigger mental illnesses, what consequences would legalization have for the healthcare system and where is more research needed?
Collapse
Affiliation(s)
- U Havemann-Reinecke
- Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen, Georg-August-Universität, Göttingen, Deutschland. .,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland.
| | - E Hoch
- Abt. Psychotherapie & Psychosomatik, Klinik und Poliklinik für Psychiatrie und Psychotherapie, LMU München, München, Deutschland.,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland
| | - U W Preuss
- Vitos Klinik für Psychiatrie und Psychotherapie Herborn, Herborn, Deutschland.,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland
| | - F Kiefer
- Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland.,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland
| | - A Batra
- Universitätsklinik für Psychiatrie und Psychotherapie, Eberhard-Karls-Universität Tübingen, Tübingen, Deutschland.,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland
| | - G Gerlinger
- Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland
| | - I Hauth
- Zentrum für Neurologie, Psychiatrie, Psychotherapie und Psychosomatik, Alexianer St. Joseph Krankenhaus, Berlin, Deutschland.,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland
| |
Collapse
|
45
|
Twyman L, Bonevski B, Paul C, Kay-Lambkin FJ, Bryant J, Oldmeadow C, Palazzi K, Guillaumier A. The association between cannabis use and motivation and intentions to quit tobacco within a sample of Australian socioeconomically disadvantaged smokers. HEALTH EDUCATION RESEARCH 2016; 31:771-781. [PMID: 27923866 DOI: 10.1093/her/cyw049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 09/23/2016] [Indexed: 06/06/2023]
Abstract
This study aimed to (i) describe concurrent and simultaneous tobacco and cannabis use and (ii) investigate the association between cannabis use and motivation and intentions to quit tobacco in a sample of socioeconomically disadvantaged smokers. A cross-sectional survey was conducted in 2013 and 2014 with current tobacco smokers receiving aid from two community service organizations in New South Wales, Australia. At least weekly cannabis use for the month prior to survey, motivation to quit tobacco and intentions to quit tobacco were measured in 369 participants (77% consent rate). Regressions were carried out to investigate associations between weekly cannabis use and motivation and intentions to quit tobacco.Concurrent tobacco and cannabis use was reported by 19% (n = 71) of the sample and of these users, 100% reported simultaneous use. Although regular cannabis use was significantly associated with lower motivation to quit tobacco, it was not significantly associated with intentions to quit tobacco in the next 30 days. Concurrent cannabis use is common in disadvantaged smokers and may play a role in decreased motivation to quit tobacco; however, it does not appear to be associated with intentions to quit in a sample of disadvantaged smokers.
Collapse
Affiliation(s)
- Laura Twyman
- School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Christine Paul
- Priority Research Centre for Health Behaviour and Health Behaviour Research Group, University of Newcastle & Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Frances J Kay-Lambkin
- School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW 2308, Australia
- NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2000, Australia
| | - Jamie Bryant
- Priority Research Centre for Health Behaviour and Health Behaviour Research Group, University of Newcastle & Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - C Oldmeadow
- School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW 2308, Australia
- Clinical Research Design, IT and Statistical Support, Hunter Medical Research Institute, Newcastle, NSW 2308, Australia
| | - K Palazzi
- Clinical Research Design, IT and Statistical Support, Hunter Medical Research Institute, Newcastle, NSW 2308, Australia
| | - A Guillaumier
- School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW 2308, Australia
| |
Collapse
|
46
|
Brook JS, Zhang C, Rubenstone E, Primack BA, Brook DW. Comorbid trajectories of substance use as predictors of Antisocial Personality Disorder, Major Depressive Episode, and Generalized Anxiety Disorder. Addict Behav 2016; 62:114-21. [PMID: 27344118 DOI: 10.1016/j.addbeh.2016.06.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 05/16/2016] [Accepted: 06/06/2016] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To determine longitudinal associations between patterns of comorbid cigarette, alcohol, and marijuana use and Antisocial Personality Disorder (ASPD), Major Depressive Episode (MDE), and Generalized Anxiety Disorder (GAD) in adulthood. METHOD A random community-based sample [X̅ age=36.6 (SD=2.8)] from the Children and Adults in the Community Study, an on-going investigation of substance use and psychiatric disorders. Data were collected at six time waves. Conjoint trajectories of cigarette, alcohol, and marijuana use spanning adolescence to adulthood were determined; multivariable logistic regression analyses assessed associations between trajectory group membership and having ASPD, MDE, or GAD in adulthood. RESULTS Five conjoint trajectory groups were obtained: HHH (chronic cigarette, alcohol, and marijuana use), DDD (delayed/late-starting cigarette, alcohol, and marijuana use), LML (low/no smoking, moderate alcohol use, occasional marijuana use), HMN (chronic smoking, moderate alcohol use, no marijuana use), and NON (occasional alcohol use only). Compared with members of the NON group, those in the HHH group had significantly greater odds for having ASPD (Adjusted Odds Ratio [AOR]=28.52, 95% Confidence Interval [CI]=9.44-86.17), MDE (AOR=2.67, 95% CI=1.14-6.26), and GAD (AOR=6.39, 95% CI=2.62-15.56). Members of the DDD, LML, and HMN groups had weaker and less consistent associations with the three psychiatric outcomes. CONCLUSIONS In a large, community-based sample, long-term concurrent use of more than one substance was associated with both externalizing and internalizing psychiatric disorders in adulthood. Prevention and treatment programs might target individuals in the community and general clinical populations with comorbid substance use, even if they haven't been identified as having a substance use disorder.
Collapse
Affiliation(s)
- Judith S Brook
- New York University School of Medicine, Department of Psychiatry, 215 Lexington Ave., 15th Floor, New York, NY 10016, USA.
| | - Chenshu Zhang
- New York University School of Medicine, Department of Psychiatry, 215 Lexington Ave., 15th Floor, New York, NY 10016, USA
| | - Elizabeth Rubenstone
- New York University School of Medicine, Department of Psychiatry, 215 Lexington Ave., 15th Floor, New York, NY 10016, USA
| | - Brian A Primack
- University of Pittsburgh School of Medicine, Department of Medicine, Division of General Internal Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA 15213-2582, USA
| | - David W Brook
- New York University School of Medicine, Department of Psychiatry, 215 Lexington Ave., 15th Floor, New York, NY 10016, USA
| |
Collapse
|
47
|
Wang JB, Ramo DE, Lisha NE, Cataldo JK. Medical marijuana legalization and cigarette and marijuana co-use in adolescents and adults. Drug Alcohol Depend 2016; 166:32-8. [PMID: 27460859 PMCID: PMC4983542 DOI: 10.1016/j.drugalcdep.2016.06.016] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 06/10/2016] [Accepted: 06/11/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Medical marijuana legalization is associated with a higher prevalence of marijuana use which may affect cigarette use and nicotine dependence in co-users. In the present study, we examined relationships between statewide legalization of medical marijuana and prevalence of cigarette and marijuana co-use and nicotine dependence in co-using adolescents and adults. METHODS Data were analyzed from the 2013 National Survey on Drug Use and Health. We compared cigarette and marijuana co-use in the past 30days across age categories (12-64 years) by statewide medical marijuana legalization. Logistic regression models were used to estimate the odds of having nicotine dependence among current cigarette smokers who also reported past 30-day marijuana use and "ever but not current" marijuana use (vs. "never" use) adjusting for covariates including statewide legalization of medical marijuana. RESULTS Overall, 5.1% of the sample reported past 30-day cigarette and marijuana co-use and a higher proportion of co-users resided in states where medical marijuana was legal compared to illegal (5.8% vs. 4.8%; p=0.0011). Co-use was associated with greater odds of having nicotine dependence compared to cigarette-only use across age categories. Odds were highest and up to 3-times higher in adolescents aged 12-17 years (OR=3.54; 95%CI: 1.81-6.92) and adults aged 50-64 years (OR=3.08; CI: 1.45-6.55). CONCLUSION Marijuana policy could inadvertently affect cigarette and marijuana co-use and pose challenges to tobacco cessation.
Collapse
Affiliation(s)
- Julie B Wang
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco, 530 Parnassus Avenue, San Francisco, CA 94143, USA.
| | - Danielle E Ramo
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco, 530 Parnassus Avenue, San Francisco, CA 94143, USA; Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, 401 Parnassus Avenue, Box RAM 0984, San Francisco, CA 94143, USA
| | - Nadra E Lisha
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco, 530 Parnassus Avenue, San Francisco, CA 94143, USA
| | - Janine K Cataldo
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco, 530 Parnassus Avenue, San Francisco, CA 94143, USA; Department of Physiological Nursing, University of San Francisco, 2 Koret Way, Box 0610, San Francisco, CA 94143, USA
| |
Collapse
|
48
|
Visser M, Routledge LA. Substance Abuse and Psychological Well-being of South African Adolescents. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2016. [DOI: 10.1177/008124630703700313] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This research aimed at identifying patterns of substance abuse among South African adolescents and exploring the relationship between psychological well-being and substance abuse. Psychological well-being was assessed with selected items of the Bar-On EQ-I and Diener's Life Satisfaction scale. Self-reported substance abuse patterns of 1 918 learners between the ages of 12 and 19 from 13 schools in Tshwane were recorded. Schools were selected to represent the population composition of the area. It was found that substance abuse (current alcohol use, excessive alcohol use, and use of illicit drugs) increased with age and that nearly twice as many males as females abused substances. Language group was found to be a determining factor with regard to current and excessive use of alcohol; however, it was not found to influence drug use. An analysis of variance showed that adolescents who used drugs had significantly lower levels of psychological well-being and life satisfaction. The same was not found for excessive use of alcohol. The results can contribute to a better understanding of substance use behaviour and to identifying adolescents who may be at risk of abuse.
Collapse
Affiliation(s)
- Maretha Visser
- Department of Psychology, University of Pretoria, Brooklyn, 0002, South Africa
| | | |
Collapse
|
49
|
Kolena B, Petrovičová I, Trnovec T, Pilka T, Bičanová G. Marijuana: Views on Its Medical Use Recorded at the Slovak Social Network. JOURNAL OF DRUG EDUCATION 2016; 46:3-14. [PMID: 27282988 DOI: 10.1177/0047237916646442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We describe opinions on medical use of Cannabis sativa L under conditions of Slovakia (n = 717). Personal experience with marijuana was detected in 77.42% (n = 553) in age categories younger than 20 years (n = 96) and in 77.06% (n = 457) of adults. Almost 86% of respondents (n = 618) agreed with legal use of marijuana for medical purposes. Furthermore, respondents' views on legal usage of marijuana for medical purposes could be affected by availability of information (r = .12) and personal experience (r = .23). Negative impact of substance abuse in younger age-groups was recognized as threat (r = .47), but knowledge about harmful effect of marijuana use did not affect personal opinion for decriminalization (r = .38).
Collapse
Affiliation(s)
| | | | | | - Tomáš Pilka
- Constantine the Philosopher University in Nitra, Slovakia
| | | |
Collapse
|
50
|
Ketcherside A, Jeon-Slaughter H, Baine JL, Filbey FM. Discriminability of personality profiles in isolated and Co-morbid marijuana and nicotine users. Psychiatry Res 2016; 238:356-362. [PMID: 27086256 PMCID: PMC4834927 DOI: 10.1016/j.psychres.2016.02.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 01/14/2016] [Accepted: 02/15/2016] [Indexed: 01/05/2023]
Abstract
Specific personality traits have been linked with substance use disorders (SUDs), genetic mechanisms, and brain systems. Thus, determining the specificity of personality traits to types of SUD can advance the field towards defining SUD endophenotypes as well as understanding the brain systems involved for the development of novel treatments. Disentangling these factors is particularly important in highly co morbid SUDs, such as marijuana and nicotine use, so treatment can occur effectively for both. This study evaluated personality traits that distinguish isolated and co-morbid use of marijuana and nicotine. To that end, we collected the NEO Five Factor Inventory in participants who used marijuana-only (n=59), nicotine-only (n=27), both marijuana and nicotine (n=28), and in non-using controls (n=28). We used factor analyses to identify personality profiles, which are linear combinations of the five NEO Factors. We then conducted Receiver Operating Characteristics (ROC) curve analysis to test accuracy of the personality factors in discriminating isolated and co-morbid marijuana and nicotine users from each other. ROC curve analysis distinguished the four groups based on their NEO personality patterns. Results showed that NEO Factor 2 (openness, extraversion, agreeableness) discriminated marijuana and marijuana+nicotine users from controls and nicotine-only users with high predictability. Additional ANOVA results showed that the openness dimension discriminated marijuana users from nicotine users. These findings suggest that personality dimensions distinguish marijuana users from nicotine users and should be considered in prevention strategies.
Collapse
Affiliation(s)
- Ariel Ketcherside
- Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX, USA
| | | | - Jessica L. Baine
- Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX, USA
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX, USA.
| |
Collapse
|