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Scarpa S, Lundgren L, Modeste-James A, John-Langba J. Immigrant background, incarceration history and recidivism among adults assessed for illicit substance use severity: Findings from a Swedish registry study. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 128:104432. [PMID: 38669771 DOI: 10.1016/j.drugpo.2024.104432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 03/18/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND In Sweden, as in other countries, individuals with immigrant backgrounds are disproportionately represented within the incarcerated population. This study examined the association between immigrant background and future incarceration for individuals assessed for illicit substance use severity, while considering their prior incarceration history. METHODS Using data from Swedish Addiction Severity Index (ASI) assessments linked to register data from Statistics Sweden, we employed Zero-Inflated Negative Binomial (ZINB) regression models to analyse differences in incarceration histories within five years before and after ASI assessments based on immigrant backgrounds. Additionally, Cox proportional-hazard models were used to assess the likelihood of post-assessment incarceration among these groups. RESULTS Immigrant background was positively associated with pre- and post-assessment incarceration. First- and second-generation immigrants from the Global South had longer periods of incarceration in the five years before assessments compared to native Swedes. Post-assessment, first-generation immigrants showed longer periods of incarceration. Survival analyses supported these findings, indicating a higher risk of prolonged post-assessment incarceration among all immigrant groups, particularly first-generation immigrants from the Global South. CONCLUSION Among individuals assessed for illicit drug use within Swedish municipalities, those with immigrant backgrounds faced higher incarceration risks, even after controlling for substance use severity and prior incarceration. Tailored interventions and support systems are vital to prevent re-entry into the criminal justice system. Timely actions can break re-offending cycles, redirecting paths away from reoffending and towards legal reintegration, thereby reducing incarceration and recidivism rates.
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Affiliation(s)
- Simone Scarpa
- Department of Social Work, Umeå University, Samhällsvetarhuset, 901 87 Umeå, Sweden.
| | - Lena Lundgren
- Department of Social Work, Umeå University, Samhällsvetarhuset, 901 87 Umeå, Sweden; Cross-National Behavioral Health Laboratory, University of Denver, 2148 S High Street, Denver, CO 80208, United States; Graduate School of Social Work, University of Denver, 2148 S High Street, Denver, CO 80208, United States
| | - Akeem Modeste-James
- Cross-National Behavioral Health Laboratory, University of Denver, 2148 S High Street, Denver, CO 80208, United States; Graduate School of Social Work, University of Denver, 2148 S High Street, Denver, CO 80208, United States
| | - Johannes John-Langba
- School of Applied Human Sciences, University of KwaZulu-Natal, Howard College 238 Mazisi Kunene Road Glenwood, Durban, South Africa
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Lindner SR, Scarpa S, McCarty D, Lundgren L. Addiction severity and re-employment in Sweden among adults with risky alcohol and drug use. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 156:209178. [PMID: 37820868 DOI: 10.1016/j.josat.2023.209178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 04/19/2023] [Accepted: 09/30/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND The Addiction Severity Index (ASI) assesses respondents' biopsychosocial problems in seven addiction-related domains (mental health, family and social relations, employment, alcohol use, drug use, physical health, and legal problems). This study examined the association between the seven ASI composite scores and re-employment in a sample of Swedish adults screened for risky alcohol and drug use who were without employment at assessment. METHODS We conducted a retrospective cohort analysis of employment outcomes among 6502 unemployed adults living in Sweden who completed an ASI assessment for risky alcohol and drug use. The study linked ASI scores to annual tax register data. The primary outcome was employment, defined as having earnings above an administrative threshold. We used Cox proportional hazard models to estimate the association between time to re-employment and ASI composite scores, controlling for demographic characteristics, RESULTS: Approximately three in ten individuals in the sample regained employment within five years. ASI composite scores suggested widespread biopsychosocial problems. Re-employment was associated with lower ASI composite scores for mental health (estimate: 0.775, 95 % confidence interval: 0.629-0.956), employment (estimate: 0.669, confidence interval: 0.532-0.841), drug use (estimate: 0.628, confidence interval: 0.428-0.924), and health (estimate: 0.798, confidence interval: 0.699-0.912). CONCLUSIONS This study suggests that several ASI domains may provide information on the complex factors (i.e., mental health, health, drug use) associated with long-term unemployment for people with risky substance use.
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Affiliation(s)
- Stephan R Lindner
- Center for Health Systems Effectiveness (CHSE), Oregon Health & Science University, 3030 SW Moody Ave, Portland, OR 97201, United States; OHSU-PSU School of Public Health, 1805 SW Fourth Ave, Portland, OR 97201, United States.
| | - Simone Scarpa
- Department of Social Work, Umeå University, Samhällsvetarhuset, 901 87 Umeå, Sweden.
| | - Dennis McCarty
- OHSU-PSU School of Public Health, 1805 SW Fourth Ave, Portland, OR 97201, United States; Division of General and Internal Medicine, School of Medicine, Oregon Health & Science University, 3266 SW Research Drive, Portland, OR 97239, United States.
| | - Lena Lundgren
- Department of Social Work, Umeå University, Samhällsvetarhuset, 901 87 Umeå, Sweden; Cross-National Behavioral Health Laboratory, University of Denver, 2148 S High Street, Denver, CO 80208, United States.
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Wallace M, Hiam L, Aldridge R. Elevated mortality among the second-generation (children of migrants) in Europe: what is going wrong? A review. Br Med Bull 2023; 148:5-21. [PMID: 37933157 PMCID: PMC10724460 DOI: 10.1093/bmb/ldad027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/21/2023] [Accepted: 09/30/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION The 'second-generation' (i.e. the children of migrants) represent one of the fastest growing subpopulations of the child and young adult populations in Europe today. The research so far appears to indicate that their mortality risk is elevated relative to people with non-migrant backgrounds. SOURCES OF DATA Peer-reviewed publications. AREAS OF AGREEMENT Second-generation status is a clear marker of elevated mortality risk in Europe in early life (including stillbirth, perinatal, neonatal and infant mortality) and adulthood, particularly if the parent(s) were born outside of Europe. Socioeconomic inequality plays an important, albeit rarely defining, role in these elevated risks. AREAS OF CONTROVERSY It remains unclear what causes-of-death are driving these elevated mortality risks. The exact influence of (non-socioeconomic) explanatory factors (e.g. health care, racism & discrimination, and factors related to integration) on the elevated mortality risks of the second-generation also remains unclear. GROWING POINTS The second-generation will continue to grow and diversify in Europe; we must intervene to address these inequalities now. AREAS TIMELY FOR DEVELOPING RESEARCH Place more emphasis on the complexity of migration background, specific causes-of-death, and understanding the roles of explanatory factors beyond socioeconomic background.
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Affiliation(s)
- Matthew Wallace
- Sociology Department, Stockholm University, Frescativägen, Stockholm 114 19, Sweden
| | - Lucinda Hiam
- School of Geography and the Environment, Oxford University Centre for the Environment, University of Oxford, South Parks Road, Oxford, OX1 3QY, UK
| | - Robert Aldridge
- Institute of Health Informatics, University College London, 222 Euston Road London, NW1 2DA, UK
- The Institute for Health Metrics and Evaluation, Hans Rosling Center for Population Health, 3980 15th Ave NE, Seattle WA 98195, United States
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Zahavi E, Lev-Shalem L, Yehoshua I, Adler L. Methylphenidate use and misuse among medical residents in Israel: a cross-sectional study. HUMAN RESOURCES FOR HEALTH 2023; 21:5. [PMID: 36721145 PMCID: PMC9890881 DOI: 10.1186/s12960-023-00792-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Methylphenidate (MPH) and other stimulants may be misused, mainly as cognitive enhancers and recreational drugs. Data regarding misuse among medical residents are scarce. This study aimed to evaluate the prevalence of and main reasons for methylphenidate (MPH) use and misuse among Israeli medical residents. METHODS In this cross-sectional study, we sent an online questionnaire to medical residents who had completed their first residency exam and specialists with up to 2 years of experience. We asked about the use of MPH before and during residency and attitudes toward the use of MPH as a cognitive enhancer. We also added the Adult ADHD Self-Report Scale (ASRS) questionnaire, a validated tool used to screen for the presence of attention deficit hyperactivity disorder (ADHD). Users and misusers were classified based on self-report of use and formal ADHD diagnosis. Logistic regression analysis was used to evaluate factors associated with MPH misuse. RESULTS From March 2021 to August 2021, 370 physicians responded to our questionnaire (response rate 26.4%). Twenty-eight met the exclusion criteria and were not included. The respondents' average age was 36.5 years. Women comprised 63.5% of the respondents. Of the participants, 16.4% were classified as users and 35.1% as misusers. The prevalence of misusers was 45.6% among surgery and OB/GYN physicians, 39.4% among pediatricians and internists, and 24% among family physicians (P < 0.001). Misusers had a more liberal approach than others to MPH use as a cognitive enhancer. Factors associated with misuse of MPH included not being a native-born Israeli (OR-1.99, 95% CI 1.08, 3.67) and type of residency (OR-2.33, 95% CI 1.22, 4.44 and OR-4.08, 95% CI 2.06, 8.07 for pediatrics and internal medicine and surgery, respectively). CONCLUSION Very high levels of MPH misuse during residency may be related to stress, long working hours, night shifts, and the academic burden of the residency period. We believe that our findings should be considered by healthcare policymakers as they make decisions regarding the conditions of medical residencies. The use of MPH as a cognitive enhancer should be further studied and discussed.
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Affiliation(s)
- Eden Zahavi
- Health Division, Maccabi Healthcare Services, 27 Ha'mered St., Tel Aviv, Israel
- Faculty of Health Sciences, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Liat Lev-Shalem
- Health Division, Maccabi Healthcare Services, 27 Ha'mered St., Tel Aviv, Israel
| | - Ilan Yehoshua
- Health Division, Maccabi Healthcare Services, 27 Ha'mered St., Tel Aviv, Israel
- Faculty of Health Sciences, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Limor Adler
- Health Division, Maccabi Healthcare Services, 27 Ha'mered St., Tel Aviv, Israel.
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv, Israel.
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Marginean V, Sheth P, Varma A, Vessie A. A short review of acculturation and addiction among immigrant and refugee communities in the United States and abroad. J Nurs Scholarsh 2023; 55:584-589. [PMID: 36601971 DOI: 10.1111/jnu.12873] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/05/2022] [Accepted: 12/13/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE To summarize recent evidence of the relationship between acculturation and substance use addiction among foreign-born persons living in the United States (U.S.) and abroad. RECENT FINDINGS Foreign-born populations are increasing in many countries as a result of immigration and global refugee displacement. Acculturation and discrimination toward both populations have been related to the initiation of illicit substance use. The "immigrant paradox" may serve as a protective factor against the initiation and worsening prognosis of substance use disorders. Improving multilingual accessibility and frequency of use of clinical screeners may enhance addiction risk factor identification and potential interventions for foreign-born populations living in countries of emigration, such as the U.S. SUMMARY Foreign-born persons compose a significant proportion of nurse-patient interactions in the U.S. and abroad. The unique sociological phenomenon of the immigrant paradox may serve as a protective factor for foreign-born persons despite the increased risk for adverse childhood events, acculturation, and discrimination. Due to conflicting evidence, future studies should examine longitudinal outcomes of substance use exclusively among foreign-born persons as well as protective and risk factors associated with immigrants and refugees, respectively. CLINICAL RELEVANCE Foreign-born persons may experience unique risk factors associated with addiction. Future studies should focus on foreign-born populations to explore if social constructs surrounding addiction can be extrapolated into other populations, including their second-generation offspring. Differences surrounding migration contexts between immigrants and refugees may be important for clinical researchers to understand when designing research studies centered on these experiences. Nurses can play a significant role in identifying patients at risk for substance use by advocating for inclusive and comprehensive multilingual screeners.
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Affiliation(s)
- Valentina Marginean
- Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Pankti Sheth
- Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Ashima Varma
- Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Arden Vessie
- Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
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Scarpa S, Grahn R, Lundgren LM. Compulsory care of individuals with severe substance use disorders and alcohol- and drug-related mortality: A Swedish registry study. Front Psychiatry 2023; 14:1106509. [PMID: 36741106 PMCID: PMC9889928 DOI: 10.3389/fpsyt.2023.1106509] [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: 11/23/2022] [Accepted: 01/02/2023] [Indexed: 01/20/2023] Open
Abstract
AIM This study used 17 year of Swedish registry data (2003-2019) for 25,125 adults assessed for their severity of substance use to identify the baseline factors predicting the risk of being court-ordered into compulsory care and examine the association between admission to compulsory care and mortality risks due to alcohol- or drug-related causes. METHODS AND MATERIALS Addiction Severity Index (ASI) assessment data were linked to register data on demographic characteristics, compulsory care, and alcohol- and drug-related mortality. Cox regression models were used to identify baseline factors predictive of post-assessment admission to compulsory care in the 5 years post-substance use assessment. Discrete-time random-effect logistic regression models were used to examine the association between compulsory care duration and alcohol or drug-related mortality risks. Propensity score matching was used for validation. RESULTS The first models identified that younger age, female gender, and ASI composite scores for drug use, mental health and employment were significantly associated with the risk of placement in compulsory care for drugs other than alcohol. Female gender and ASI composite scores for alcohol, drug use and employment were significantly associated with compulsory care treatment for alcohol use. The second models showed that older individuals and men were more likely to die due to alcohol-related causes, while younger individuals and men were more likely to die due to drug-related causes. Length of stay in compulsory care institutions significantly increased the likelihood of dying due to substance use-related causes. Propensity scores analyses confirmed the results. CONCLUSION In Sweden, a significant concern is the higher likelihood of women and young individuals to be court-ordered to compulsory care. Although compulsory care is often advocated as a life-saving intervention, our findings do not provide strong support for this claim. On the contrary, our findings show that admission to compulsory care is associated with a higher risk of substance use-related mortality. Factors such as compulsory care often not including any medical or psychological therapy, together with relapse and overdose after discharge, may be possible contributing factors to these findings.
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Affiliation(s)
- Simone Scarpa
- Department of Social Work, Umeå University, Umeå, Sweden
| | - Robert Grahn
- Department of Social Work, Umeå University, Umeå, Sweden
| | - Lena M Lundgren
- Department of Social Work, Umeå University, Umeå, Sweden.,Graduate School of Social Work, University of Denver, Denver, CO, United States
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Lundgren L, Padyab M, Sandlund M, McCarty D. Frequency and recency of non-medical opioid use and death due to overdose or suicide among individuals assessed for risky substance use: A national registry study in Sweden. J Subst Abuse Treat 2021; 134:108567. [PMID: 34340844 DOI: 10.1016/j.jsat.2021.108567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 07/06/2021] [Accepted: 07/06/2021] [Indexed: 01/04/2023]
Abstract
Sweden and many other countries have experienced increases in suicide and accidental overdose deaths. An analysis examined the associations between recency of non-medical opioid misuse and frequency of use of non-medical opioids with death due to either suicide or accidental overdose within a sample of 15,000 Swedish adults who completed an Addiction Severity Index (ASI) assessment for risky substance use or a substance use disorder. METHODS AND MATERIALS Suicide (n = 136) and death due to overdose (n = 405) were identified in the official Cause of Death Registry from the Swedish National Board of Health and Welfare. Control variables included demographic characteristics and risks associated with either overdose or suicide. Cox regression analyses controlled for variables statistically significantly at the bivariate level. RESULTS At the multivariable level: a) a higher (modified) ASI Composite Score for mental health; b) history of suicide attempt; c) having used non-medical opioids for 1-2 times per week for at least a year; d) history of injection drug use; and, e) early onset of drug use, were all significantly and positively associated with death due to suicide. At the multivariable level: a) a higher the revised ASI Composite Score for mental health; b) recency of use of non-medical opioids; c) frequency of non-medical opioid use; d) being a male; and e) being of ages 18-24 years compared to ages 43-51 years were all positively and significantly associated with death due to accidental overdose. CONCLUSION These findings underscore the need to integrate mental health and substance use disorder treatment and provide suicide and overdose prevention interventions for individuals with an opioid use disorder. Recency and frequency of non-medical opioids were only associated with death due to overdose and not suicide. However, other drug use related variables (using opioids 1-2 times per week for at least a year, early onset of drug use and drug injection) were significantly associated with death due to suicide.
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Affiliation(s)
- Lena Lundgren
- University of Denver Graduate School of Social Work, USA; Department of Social Work, Umeå University, Sweden
| | - Mojgan Padyab
- Department of Social Work, Umeå University, Sweden; Centre for Demography and Ageing Research (CEDAR), Umeå University, Sweden.
| | - Mikael Sandlund
- Department of Clinical Science, Psychiatry, Umeå University, Sweden
| | - Dennis McCarty
- OHSU-PSU School of Public Health, Oregon Health & Science University, USA
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Grahn R, Padyab M. The predictability of the Addiction Severity Index criminal justice assessment instrument and future imprisonment: A Swedish registry study with a national sample of adults with risky substance use. Drug Alcohol Depend 2020; 217:108396. [PMID: 33234300 DOI: 10.1016/j.drugalcdep.2020.108396] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE In Sweden, social workers uses the Addiction Severity Index (ASI) as their main assessment tool when assessing individuals with risky substance use (RSU) or substance use disorder. The aim of this study is to identify among individuals with RSU, the associations of ASI Composite Scores (CSs) with future imprisonment controlling for age, education level and gender. METHOD Baseline ASI-data was merged with national registry data on prison sentences (2003-2016). Cox regression was used to estimate the associations between CSs for alcohol, drugs other than alcohol, legal, family and social relationships, employment, mental- and physical health and future imprisonment for adults (n = 14,914) assessed for RSU. RESULTS The regression showed that all ASI CSs, age, education level and gender were significantly associated with imprisonment post ASI base-line assessment. The variables with the strongest association with imprisonment were ASI legal CS, followed by ASI drugs other than alcohol CS, ASI employment CS and being a male. ASI legal score showed the strongest association with imprisonment, with a 6 time increase in likelihood of imprisonment. DISCUSSION Given the findings in this study, the strong significant association between ASI legal CS and future imprisonment, it seems as that the ASI-assessment instrument is a reliable and trustworthy assessment tool to use in clinical work. This should motivate social workers and other clinical health professionals to use and rely on the ASI assessment in their intervention planning for clients with RSU, to hopefully reduce future imprisonment and improve their social situation.
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Affiliation(s)
- Robert Grahn
- Department of Social Work, Umeå University, Sweden.
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Brennecke G, Stoeber FS, Kettner M, Keil J, White L, Vasilache A, von Klitzing K, Radeloff D. Suicide among immigrants in Germany. J Affect Disord 2020; 274:435-443. [PMID: 32663973 DOI: 10.1016/j.jad.2020.05.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 03/29/2020] [Accepted: 05/10/2020] [Indexed: 01/23/2023]
Abstract
AIMS The identification of high-risk groups is crucial in public health suicide prevention approaches. This study aims to compare suicide risks of Germans with nine of the largest immigrant populations living in Germany. METHODS Based on a German national database of mortality statistics, the number of suicides in Germans and immigrants was available for the study period (2000 - 2017), stratified for gender and age groups. Standard mortality ratios (SMR) for suicide were computed since age distributions differed between populations. Moreover, SMR of immigrant populations were correlated with potential risk and resilience factors. RESULTS The analysed dataset covers a period of 18 years, which translates to over 1.47 billion life years (LY) and 206,056 recorded suicides. 134,971,779 LY (10.1%) and 8,936 (4.3%) suicides were assigned to non-German citizens. SMR, calculated for nine of the largest immigrant populations, were lower compared with the German reference population ranging from 0.24 (Greek nationality) to 0.86 (Russian nationality). SMR in immigrants was highest in adolescents and declined with age. SMR was associated with country of origin (CO) suicide rates as well as with socio-economic factors of immigrant groups in Germany. With the global financial crisis, suicide risk of immigrants from the most affected countries decreased more strongly compared to immigrants from other CO. CONCLUSIONS The suicide risk strongly differs between the individual immigrant groups and is associated with risk factors of the respective CO. Therefore, future suicide prevention approaches in immigrants should take CO-specific vulnerabilities into account as well as age-related risk factors.
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Affiliation(s)
- G Brennecke
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Liebigstraße 20a, 04103 , Leipzig, Germany
| | - F S Stoeber
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Liebigstraße 20a, 04103 , Leipzig, Germany
| | - M Kettner
- Institute of Forensic Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - J Keil
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Liebigstraße 20a, 04103 , Leipzig, Germany
| | - L White
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Liebigstraße 20a, 04103 , Leipzig, Germany
| | - A Vasilache
- Center for German and European Studies (CGES), Faculty of Sociology, Bielefeld University, Bielefeld, Germany
| | - K von Klitzing
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Liebigstraße 20a, 04103 , Leipzig, Germany
| | - D Radeloff
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Liebigstraße 20a, 04103 , Leipzig, Germany.
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He AS, Padyab M, Sedivy JA, Lundgren L. A Swedish national study: Immigrant-country of birth status and child welfare compulsory care among a sample of parents with risky substance use. CHILD ABUSE & NEGLECT 2020; 101:104316. [PMID: 31862510 DOI: 10.1016/j.chiabu.2019.104316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 07/05/2019] [Accepted: 12/05/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Sweden has a high percentage of foreign-born residents (18.5 %) and one of the highest overdose death rates in Europe. For immigrant parents with risky substance use (RSU), risk factors associated with immigration status (e.g., economic strain and psychological stress) potentially heightening the risk of involvement with the child welfare system (CWS). Using Swedish registry national data, this study explored the relationship between immigration-country of birth status, psychosocial risk factors, and child compulsory care for parents with RSU. METHODS Study sample consisted of 5932 parents from 65 Swedish municipalities assessed for psychosocial problems (including alcohol and drug use) using the Addiction Severity Index (2007-2017). Stepwise multinomial logistic regression models examined the relationship between immigration-country of birth status (Swedish born, Nordic-born, and non-Nordic born), psychosocial problems, and compulsory care in the CWS. RESULTS Compared to Swedish-born parents, parents not born in Sweden, Norway, Denmark or Finland (non-Nordic born parents) had a lower probability of children living in compulsory care (family homes or institutions). However, after accounting for psychosocial problems, immigration status was no longer significantly associated with children's living arrangements. CONCLUSIONS Study findings indicate that parental immigrant status (even among parents dealing with RSU) in itself is not a risk factor for compulsory care in the CWS. Moreover, parental employment and health problems posed greater risk for children being in compulsory care. Receipt of targeted services for employment and health problems may help to maintain stable child living arrangements for immigrant parents dealing with RSU.
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Affiliation(s)
- Amy S He
- Graduate School of Social Work, University of Denver, Denver, CO, USA.
| | - Mojgan Padyab
- Department of Social Work, Umeå University, SE-901 87 Umeå, Sweden; Centre for Demography and Ageing Research (CEDAR), Umeå University, SE-901 87 Umeå, Sweden
| | - Jennifer A Sedivy
- Graduate School of Social Work, University of Denver, Denver, CO, USA
| | - Lena Lundgren
- Graduate School of Social Work, University of Denver, Denver, CO, USA; Department of Social Work, Umeå University, SE-901 87 Umeå, Sweden
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Sexual Abuse and Future Mental Health Hospitalization in a Swedish National Sample of Men Who Use Opioids. J Addict Med 2019; 14:e24-e28. [PMID: 31651560 PMCID: PMC7413673 DOI: 10.1097/adm.0000000000000578] [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] [Indexed: 11/26/2022]
Abstract
Experiences of trauma, specifically sexual abuse, have been linked to both mental health and substance use disorders. This study used 14 years of Swedish health registry data to select a sample of adult men who reported frequent opioid use and assessed if those with a self-reported history of sexual abuse had a higher likelihood of hospitalization for a mental health disorder.
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