Mental health screening and increased risk for anxiety and depression among treatment-seeking smokers

Neuroprotective effects of Olea europaea L. fruit extract against cigarette smoke-induced depressive-like behaviors in Sprague-Dawley rats

Depression is broadly acclaimed as a mental health anomaly and despite advancements in the development of antidepressant drugs, they are linked with side effects. Dietary modifications and medicinal plants like olives can be used as effective strategies due to their antioxidant, immune-modulatory, antiinflammatory, and anticonvulsant properties. Considering the compositional alterations in olive fruits during ripening, the antidepressant potential of olive fruits at different degrees of ripeness, that is, un-ripened (green) and ripened (black) was investigated. Rats were randomly divided into five groups: G₀ (Normal diet), G₁ (Normal diet + smoke exposure (SE), G₂ (Normal diet + SE + Citalopram), G₃ (Normal diet + SE + Green olive extract), and G₄ (Normal diet + SE + Black olive extract). Depressive-like behaviors were induced in all groups through cigarette smoke exposure except G₀ . Green and black olive extracts prevented depressive behaviors by reducing the immobility time of rats in forced swim test and tail suspension test while increased the latency to respond in hot plate assay. Moreover, lipid peroxidation in brain tissue was reduced with citalopram, green, and black olive extracts. Additionally, treatments also enhanced the antioxidant pool of brain tissues. Histological examination revealed that olive extracts and citalopram prevented cigarette smoke-induced moderate to severe necrosis and congestion in the brain parenchyma and elucidated antidepressant potential by improving the expression of monoamine oxidase-A, solute carrier family 6 member 4, and brain-derived neurotrophic factor genes. Conclusively, olives may act as a promising antidepressant agent in ameliorating cigarette smoke-induced depressive-like behaviors. PRACTICAL APPLICATIONS: Olive extracts at both ripening stages revealed an antidepressant-like effect almost similar to the standard antidepressant drug and also prevented oxidative damages. Therefore, from the current findings, it can be recommended that food ingredients with antidepressant potential like olives should be incorporated in future interventions to combat depression/psychiatric anomalies and diet therapy should be encouraged to alleviate lifestyle-related disorders.

Analyzing the symptoms in colorectal and breast cancer patients with or without type 2 diabetes using EHR data

This research extracted patient-reported symptoms from free-text EHR notes of colorectal and breast cancer patients and studied the correlation of the symptoms with comorbid type 2 diabetes, race, and smoking status. An NLP framework was developed first to use UMLS MetaMap to extract all symptom terms from the 366,398 EHR clinical notes of 1694 colorectal cancer (CRC) patients and 3458 breast cancer (BC) patients. Semantic analysis and clustering algorithms were then developed to categorize all the relevant symptoms into eight symptom clusters defined by seed terms. After all the relevant symptoms were extracted from the EHR clinical notes, the frequency of the symptoms reported from colorectal cancer (CRC) and breast cancer (BC) patients over three time-periods post-chemotherapy was calculated. Logistic regression (LR) was performed with each symptom cluster as the response variable while controlling for diabetes, race, and smoking status. The results show that the CRC and BC patients with Type 2 Diabetes (T2D) were more likely to report symptoms than CRC and BC without T2D over three time-periods in the cancer trajectory. We also found that current smokers were more likely to report anxiety (CRC, BC), neuropathic symptoms (CRC, BC), anxiety (BC), and depression (BC) than non-smokers.

Variable reduction for past year alcohol and drug use in unmet need for mental health services among US adults

BACKGROUND

No previous study has focused on the inter-relationship among alcohol and drug use variables in the past year. This study aimed to classify the past year alcohol and drug use variables and investigate the selected variables in past year alcohol and drug use with the unmet need for mental health services among US adults.

METHODS

Data came from the 2015 National Survey on Drug Use and Health (NSDUH). Oblique principal component cluster analysis (OPCCA) was used to classify 37 variables on alcohol and drug use in the past year into disjoint clusters. Weighted multiple logistic regression analysis was used to examine the associations of selected variables with the unmet need.

RESULTS

37 alcohol and drug use variables were divided into 7 clusters. The variable with the lowest 1-R² ratio (R² is the squared correlation) from each cluster was selected as follows: tobacco use, pain reliever use, tranquilizer use, stimulant use, zolpidem products use, illicit drug and alcohol use, and benzodiazepine tranquilizers misuse. Multiple logistic regression analysis showed that pain reliever use (OR = 1.33, 95% CI = 1.17-1.50), tranquilizer use (OR = 2.49, 95% CI = 2.16-2.86), stimulant use (OR = 1.22, 95% CI = 1.01-1.47), and illicit drug and alcohol use (OR = 1.54, 95% CI = 1.34-1.77) revealed positive associations with the unmet need for mental health services.

CONCLUSION

This is the first study using OPCCA to reduce the dominations of alcohol and drug use; several alcohol and drug use variables in the past year were associated with unmet need of mental health services.

Factors related to the probability of suffering mental health problems in emergency care professionals

OBJECTIVES

to evaluate the influence of burnout and coping strategies used by health professionals of the hospital emergency service on their mental health status and to determine sociodemographic and labor characteristics.

METHOD

descriptive cross-sectional study in a sample of 235 nursing professionals and physicians who worked in four hospital emergency services. The Maslach Burnout Inventory, the General Health Questionnaire and the Inventario Breve de Afrontamiento-cope 28 were used as data collection instruments and specific and original questionnaires of sociodemographic and labor variables. Descriptive, quantitative and multivariate statistics were applied.

RESULTS

the dimension of depersonalization, avoidance-centered coping and being a physician were related to the presence of somatic symptoms, anxiety, social dysfunction and depression. Increased professional experience was associated with greater social dysfunction among health personnel and increased number of patients was related to depressive symptoms among health professionals.

CONCLUSIONS

the dimensions of emotional exhaustion and depersonalization, avoidance-centered coping, being a physician and a daily smoker increase the risk of a psychiatric case. The practice of daily physical exercise is a protective factor.

Associations of health insurance coverage, mental health problems, and drug use with mental health service use in US adults: an analysis of 2013 National Survey on Drug Use and Health

OBJECTIVE

To estimate the prevalence of mental health service use among US adults, examine the associations of mental health service use with health insurance coverage, mental health problems and drug use, and detect health disparities.

METHODS

This was a cross-sectional study with 5,434 adults receiving mental health service out of 37,424 adult respondents from the 2013 National Survey on Drug Use and Health. Weighted univariate and multiple logistic regression analyses were used to estimate the associations of potential factors with mental health service use.

RESULTS

The overall prevalence of mental health services use was 14.7%. Our results showed that being female, aging, having a major depressive episode, serious psychological distress, and illicit drug or alcohol abuse/dependence were positively associated with mental health service use; whereas being African American, Asian or Hispanic ethnicity, married, and having any form of insurance were negatively associated with mental health service use . Stratified analysis by insurance types showed that Medicaid/CHIP, CHAMPUS, and other insurance were positively associated with mental health service use.

CONCLUSIONS

Health insurance coverage, mental health problems, and drug abuse or dependence were associated with mental health service use in US adults. Furthermore, adults with different insurances had disparities in access of mental health service.

Symptoms of anxiety and depression and use of anxiolytic-hypnotics and antidepressants in current and former smokers with and without COPD - A cross sectional analysis of the COPDGene cohort

OBJECTIVES

To compare the frequency of anxiety/depressive symptoms and use of anxiolytic-hypnotics/antidepressants in smokers with and without COPD and to identify characteristics associated with having unmedicated symptoms.

METHODS

Cross-sectional analysis of ambulatory, current/former smokers ≥10 pack years enrolled in the COPDGene study. We measured anxiety/depressive symptoms using the Hospital Anxiety and Depression Scale (subscales ≥8), recorded anxiolytic-hypnotic/antidepressant use, and defined unmedicated symptoms as elevated anxiety/depressive symptoms and not on medications. Regression analysis identified characteristics associated with having unmedicated symptoms.

KEY RESULTS

Of 5331 current/former smokers (45% with and 55% without COPD), 1332 (25.0%) had anxiety/depressive symptoms. Anxiety symptoms were similar in frequency in smokers with and without COPD (19.7% overall), while depressive symptoms were most frequent in severe-very severe COPD at 20.7% (13.1% overall). In the entire cohort, 1135 (21.2%) were on medications. Anxiolytic-hypnotic use was highest in severe-very severe COPD (range 7.6%-12.0%), while antidepressant use showed no significant variation in smokers with and without COPD (range 14.7%-17.1%). Overall, 881 (66% of those with symptoms) had unmedicated symptoms, which was associated with African American race (adjusted OR 2.95, 95% CI 2.25-3.87), male gender (adjusted OR 1.93, 95% CI 1.57-2.36), no health insurance (adjusted OR 2.38, 95% CI 1.30-4.35), severe-very severe COPD (adjusted OR 1.48, 95% CI 1.04-2.11), and higher respiratory symptoms/exacerbation history (adjusted OR 2.21, 95% CI 1.62-3.02).

CONCLUSIONS

Significant unmet mental health care needs exist in current and former smokers with and without COPD. One in five have unmedicated symptoms, identified by key demographic and clinical characteristics.

PRIMARY FUNDING SOURCE

National Institutes of Health and The COPD Foundation.

Smoking, alcohol consumption and mental health: Data from the Brazilian study of Cardiovascular Risks in Adolescents (ERICA)

Introduction

Previous researches have indicated a strong association of alcohol and tobacco use with psychiatric disorders, but the relationship with depression and anxiety symptoms is still uncertain. We investigated the association of psychological distress and alcohol consumption, tobacco use and exposure to secondhand smoke (SHS) among adolescents in a developing country.

Methods

The authors evaluated 73,399 individuals (12–17 years) who participated in the Cardiovascular Risks Study in Adolescents (ERICA), a cross-sectional, national and school-based study, carried out in 124 Brazilian municipalities. The variables considered were alcoholic beverages (experimentation, consumption in the previous month and frequency of use) and smoking (experimentation, current smoking habits, frequent smoking and SHS exposure). Psychological distress was defined as a score ≥ 3 points in GHQ-12. Analyses included multiple logistic regression modeling.

Results

The frequency of individuals with psychological distress was higher in the group who smoked for at least 7 consecutive days (53.3% vs 31.2%; OR: 2.17; 95%CI: 1.65–2.86), were exposed to SHS indoors (37.8% vs 29.8%; OR:1.30; 95%CI: 1.14–1.48), and outdoors (37.7% vs 26.6%; OR: 1.49; 95%CI: 1.28–1.74), and among young people who consumed at least 1 drink of alcohol in the previous 30 days (42.4% vs 28.6%; OR: 1.70; 95%CI: 1.46–1.97), when compared to adolescents not exposed.

Conclusions

Smoking (passively and actively) and the consumption of alcoholic beverages are associated to psychological distress in the adolescent population. Avoiding smoking and the use of alcohol may have beneficial effects on the mental health. Our data reinforce the urgent necessity to prevent effectively underage access to legal drugs in Brazil.

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The chance of psychological distress was 70% higher in the group of adolescents who consumed alcohol in the last month.

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Prevalence of psychological distress was twice as high among adolescents who smoked for seven consecutive days.

Principal component analysis of early alcohol, drug and tobacco use with major depressive disorder in US adults

Early alcohol, tobacco and drug use prior to 18 years old are comorbid and correlated. This study included 6239 adults with major depressive disorder (MDD) in the past year and 72,010 controls from the combined data of 2013 and 2014 National Survey on Drug Use and Health (NSDUH). To deal with multicollinearity existing among 17 variables related to early alcohol, tobacco and drug use prior to 18 years old, we used principal component analysis (PCA) to infer PC scores and then use weighted multiple logistic regression analyses to estimate the associations of potential factors and PC scores with MDD. The odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. The overall prevalence of MDD was 6.7%. The first four PCs could explain 57% of the total variance. Weighted multiple logistic regression showed that PC1 (a measure of psychotherapeutic drugs and illicit drugs other than marijuana use), PC2 (a measure of cocaine and hallucinogens), PC3 (a measure of early alcohol, cigarettes, and marijuana use), and PC4 (a measure of cigar, smokeless tobacco use and illicit drugs use) revealed significant associations with MDD (OR = 1.12, 95% CI = 1.08-1.16, OR = 1.08, 95% CI = 1.04-1.12, OR = 1.13, 95% CI = 1.07-1.18, and OR = 1.15, 95% CI = 1.09-1.21, respectively). In conclusion, PCA can be used to reduce the indicators in complex survey data. Early alcohol, tobacco and drug use prior to 18 years old were found to be associated with increased odds of adult MDD.

Tobacco-related morbidity and nicotine dependence: An experience in an urban slum of Burdwan district, West Bengal, India

Tobacco use causes many diseases irrespective of age and sex. More the addiction, more is the occurrence of morbidity in terms of frequency and severity. This community-based study was conducted to find out any relationship between the morbidity associated with tobacco use and nicotine dependence. In an urban slum - Alamganj, district Burdwan, West Bengal, India, from January to October 2012 among 128 current adult tobacco users using Fagerström test for nicotine dependence (FTND) questionnaire. Tobacco users were maximally suffering from chronic obstructive pulmonary disease (COPD) (27.27%), gastritis (25.45%), and leukoplakia (25.45%). For individual diseases, the difference in FTND score was significantly high in cases of gastritis, hypertension, and COPDs. All types of morbidity were more common in the group of high nicotine dependence. FTND score can be suitably used to assess nicotine dependence of the tobacco users, who can be counseled accordingly to reduce the tobacco-related morbidity and mortality.

Success rates in smoking cessation: Psychological preparation plays a critical role and interacts with other factors such as psychoactive substances

INTRODUCTION

The aim of this study was to identify factors associated with the results of smoking cessation attempts.

METHODS

Data were collected in Clermont-Ferrand from a smoking cessation clinic between 1999 and 2009 (1,361 patients). Smoking cessation was considered a success when patients were abstinent 6 months after the beginning of cessation. Multivariate logistic regression was used to investigate the association between abstinence and different factors.

RESULTS

The significant factors were a history of depression (ORadjusted = 0.57, p = 0.003), state of depression at the initial consultation (ORa = 0.64, p = 0.005), other psychoactive substances (ORa = 0.52, p<0.0001), heart, lung and Ear-Nose-Throat diseases (ORa = 0.65, p = 0.005), age (ORa = 1.04, p<0.0001), the Richmond test (p<0.0001; when the patient's motivation went from insufficient to moderate, the frequency of abstinence was twice as high) and the Prochaska algorithm (p<0.0001; when the patient went from the 'pre-contemplation' to the 'contemplation' level, the frequency of success was four times higher). A high score in the Richmond test had a greater impact on success with increasing age (significant interaction: p = 0.01). In exclusive smokers, the contemplation level in the Prochaska algorithm was enough to obtain a satisfactory abstinence rate (65.5%) whereas among consumers of other psychoactive substances, it was necessary to reach the preparation level in the Prochaska algorithm to achieve a success rate greater than 50% (significant interaction: p = 0.02).

CONCLUSION

The psychological preparation of the smoker plays a critical role. The management of smoking cessation must be personalized, especially for consumers of other psychoactive substances and/or smokers with a history of depression.