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Makarenko I, Minoyan N, Bordier Høj S, Udhesister S, Martel-Laferrière V, Jutras-Aswad D, Larney S, Bruneau J. Determinants of psychological distress during the COVID-19 pandemic among people who use drugs in Montreal, Canada. Drug Alcohol Rev 2024. [PMID: 38741361 DOI: 10.1111/dar.13862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 04/22/2024] [Accepted: 04/22/2024] [Indexed: 05/16/2024]
Abstract
INTRODUCTION Limited data exists on psychological impacts of the COVID-19 pandemic among people who use drugs (PWUD). This study aimed to determine the prevalence and correlates of severe psychological distress (PD) among PWUD in Montreal around the beginning of the pandemic. METHODS We conducted a rapid assessment study from May to December 2020 among PWUD recruited via a community-based cohort of people who inject drugs in Montreal (Hepatitis C cohort [HEPCO], N = 128) and community organisations (N = 98). We analysed self-reported data on changes in drug use behaviours and social determinants since the declaration of COVID-19 as a public health emergency, and assessed past-month PD using the Kessler K6 scale. Multivariable logistic regression was conducted to examine correlates of PD distress (score ≥13). RESULTS Of 226 survey participants, a quarter (n = 56) were screened positive for severe PD. In multivariable analyses, age (1-year increment) (adjusted odds ratio = 0.94, 95% confidence interval [0.90, 0.98]) and a decrease in non-injection drug use versus no change (0.26 [0.07, 0.92]) were protective against severe PD, while positive associations were found for any alcohol use in the past 6 months (3.73 [1.42, 9.78]), increased food insecurity (2.88 [1.19, 6.93]) and both moving around between neighbourhoods more (8.71 [2.63, 28.88]) and less (3.03 [1.18, 7.74]) often compared to no change. DISCUSSION AND CONCLUSIONS This study documented a high prevalence of severe PD among PWUD during the COVID-19 pandemic compared with pre-COVID-19 data. Social determinants such as food insecurity and mobility issues, alongside demographic and substance use-related factors, were linked to distress. Evidence-based risk mitigation strategies for this population could reduce negative consequences in future pandemics or disruptions.
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Affiliation(s)
- Iuliia Makarenko
- Department of Family Medicine, McGill University, Montreal, Canada
- Centre de Recherche, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
| | - Nanor Minoyan
- Centre de Recherche, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Canada
| | - Stine Bordier Høj
- Centre de Recherche, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
| | - Sasha Udhesister
- Centre de Recherche, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Canada
| | - Valérie Martel-Laferrière
- Centre de Recherche, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
- Department of Microbiology and Infectiology, Université de Montréal, Montreal, Canada
| | - Didier Jutras-Aswad
- Centre de Recherche, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
- Department of Psychiatry and Addictology, Université de Montréal, Montreal, Canada
| | - Sarah Larney
- Centre de Recherche, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Canada
| | - Julie Bruneau
- Centre de Recherche, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Canada
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Källmen H, Hallgren M. Mental health problems among adolescents during the COVID-19 pandemic: a repeated cross-sectional study from Sweden. Scand J Public Health 2024; 52:329-335. [PMID: 38217316 PMCID: PMC11067385 DOI: 10.1177/14034948231219832] [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: 08/07/2023] [Revised: 11/01/2023] [Accepted: 11/14/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVE Most international studies have concluded that exposure to the COVID-19 pandemic was associated with worse mental health. Sweden implemented lighter restrictions than many other countries. We evaluated the association between changes in exposure of COVID-19 restrictions and changes in mental health problems among Swedish adolescents. METHOD Repeated cross-sectional data were derived from the Stockholm school survey, mandatory for all students in municipal schools and voluntary for students in private schools. Unexposed students were assessed in the year 2020 and exposed were assessed in 2022. Mental health was assessed using items similar to the psychosomatic problem scale. All variables were dichotomised, and a non-parametric logistic regression was used to evaluate associations. RESULTS A significant positive association was found between exposure of COVID-19 restrictions and self-reports of five to seven mental health problems a week for girls (odds ratio (OR) 1.29, 95% confidence interval (CI) 1.18-1.41), but a non-significant association was found for boys (also after controlling for relevant covariates). Among boys and girls (shown), changes in mental health during the pandemic were moderated by social support from parents (OR 2.23, 95% CI 1.98-2.51), bullying victimisation (OR 2.24, 95% CI 2.06-2.66), a sensation-seeking temperament (OR 1.40, 95% CI 1.24-1.58) and school achievement (OR 1.34, 95% CI 1.18-1.51). CONCLUSIONS Compared with boys, adolescent girls self-reported worse mental health following COVID-19 exposure. Girls may have been more affected by social distancing regulations in Sweden during the pandemic than boys and may require additional psychosocial support post-pandemic. Social support from parents may play an important role.
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Affiliation(s)
- Håkan Källmen
- Department of Psychology, Uppsala University, Sweden
| | - Mats Hallgren
- Epidemiology of Psychiatric Conditions, Substance Use and Social Environment (EPiCSS), Karolinska Institutet, Sweden
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Hunduma G, Dessie Y, Geda B, Yadeta TA, Deyessa N. Prevalence and correlates of internalizing and externalizing mental health problems among in-school adolescents in eastern Ethiopia: a cross-sectional study. Sci Rep 2024; 14:3574. [PMID: 38347112 PMCID: PMC10861546 DOI: 10.1038/s41598-024-54145-2] [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: 09/08/2023] [Accepted: 02/08/2024] [Indexed: 02/15/2024] Open
Abstract
Adolescent's mental health issues are a major social burden and a significant public health issue, but they have not received enough attention in Ethiopia. Therefore, this study aimed to determine the prevalence and correlates of internalizing and externalizing mental health problems among in-school adolescents in the Harari region, eastern Ethiopia. A cross-sectional study was conducted among 3227 in-school adolescents. Multistage sampling was used to select schools and eligible students to participate in the study. A guided, self-administered strength and difficulty questionnaire measured mental health problems. Data were double-entered, validated, and cleaned using EpiData 3.1 and analyzed using STATA version 17. Ordinal logistic regression analysis was performed to estimate the adjusted odds ratio between mental health problems and their correlates. Statistical significance was set at p-value < 0.05. The magnitudes of mental health problems among in-school adolescents by subscale was 24.17% (95% CI 22.72; 25.67) for internalizing and 11.93% (95% CI 10.85; 13.09) for externalizing problems. A high internalizing problem score was associated with females, rural residents, alcohol users, attending public schools, those bullied at school, and those in the lowest wealth index. Likewise, the likelihood of a high externalizing problem score was high among alcohol users, adolescents whose fathers are uneducated, rural, and bullied at school. The study suggests that mental health problems are prevalent among in-school adolescents in Ethiopia, especially internalizing problems. The study also identifies several risk factors associated with internalizing and externalizing problems, such as wealth index, school types, alcohol use, bullying, and rural residence. These factors may indicate the need for more mental health awareness and support programs for adolescents in Ethiopia. This highlights that schools and communities should prioritize mental health awareness and support programs for adolescents. These programs should be tailored to address the specific needs of the population, such as rural residents, those in the lowest wealth index, and those who have experienced bullying.
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Affiliation(s)
- Gari Hunduma
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Biftu Geda
- School of Nursing and Midwifery, College of Health and Medical Sciences, Madda Walabu University, Shashamene, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Negussie Deyessa
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Connolly S, Govoni TD, Jiang X, Terranella A, Guy GP, Green JL, Mikosz C. Characteristics of Alcohol, Marijuana, and Other Drug Use Among Persons Aged 13-18 Years Being Assessed for Substance Use Disorder Treatment - United States, 2014-2022. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2024; 73:93-98. [PMID: 38329914 PMCID: PMC10861205 DOI: 10.15585/mmwr.mm7305a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Substance use often begins during adolescence, placing youths at risk for fatal overdose and substance use disorders (SUD) in adulthood. Understanding the motivations reported by adolescents for using alcohol, marijuana, and other drugs and the persons with whom they use these substances could guide strategies to prevent or reduce substance use and its related consequences among adolescents. A cross-sectional study was conducted among adolescents being assessed for SUD treatment in the United States during 2014-2022, to examine self-reported motivations for using substances and the persons with whom substances were used. The most commonly reported motivation for substance use was "to feel mellow, calm, or relaxed" (73%), with other stress-related motivations among the top reasons, including "to stop worrying about a problem or to forget bad memories" (44%) and "to help with depression or anxiety" (40%); one half (50%) reported using substances "to have fun or experiment." The majority of adolescents reported using substances with friends (81%) or using alone (50%). These findings suggest that interventions related to reducing stress and addressing mental health concerns might reduce these leading motivations for substance use among adolescents. Education for adolescents about harm reduction strategies, including the danger of using drugs while alone and how to recognize and respond to an overdose, can reduce the risk for fatal overdose.
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Qadhi OA, Mohammed Alasmari M, Nasser Alsulaihim I, Syed W, Al-Rawi MBA. Evaluation of clinical knowledge of drugs causing addiction and associated social determinants among male pharmacy and nursing students in Riyadh, Saudi Arabia - A Cross-Sectional study. Prev Med Rep 2024; 38:102606. [PMID: 38375160 PMCID: PMC10874849 DOI: 10.1016/j.pmedr.2024.102606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 01/09/2024] [Accepted: 01/09/2024] [Indexed: 02/21/2024] Open
Abstract
Drug abuse is a rising psychological concept in many countries, and its use among individuals is increasing. Therefore, this study aimed to assess the Knowledge and demographic factors associated with drug abuse among male pharmacy and nursing students at King Saud University, Riyadh, Saudi Arabia. This study used a cross-sectional design targeting male entry-level pharmacy and nursing students in their first and second years of Bachelor of Nursing and Doctor of Pharmacy courses. Of them, 85.3 % of the pharmacy and 75.3 % of nursing students thought that cocaine causes drug addiction, followed by heroin (pharmacy 80.7 %; nursing students 71 %), and morphine (pharmacy 75.2 %; nursing students 59.1 %). In this study, 52 % (n = 105) claimed low awareness, whereas 48 % (n = 97) indicated good understanding regarding drug addictions. Furthermore, the mean knowledge score among pharmacy students was higher (7.073 ± 2.570) in comparison to nursing (5.806 ± 2.494) (t = 3.540; p = 0. 0001). In addition, the father's occupation was found to be significantly associated with the mean knowledge score of drug addiction (F = 2.667; p = 0.034). According to the findings, 52 % of male students had insufficient knowledge about drugs that cause addiction. Age, course of study, and father's occupation all had a substantial impact on knowledge scores. The knowledge score on the complications of addictive substances was not significantly associated with the characteristics of the students (p = 0.05). As a result, we advocate for the introduction of educational initiatives that educate students about the harmful consequences of drug addiction and how to avoid issues.
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Affiliation(s)
- Omaimah A. Qadhi
- Department of Medical-Surgical College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Moadeyah Mohammed Alasmari
- Department of Maternity and Child Health, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Ibrahim Nasser Alsulaihim
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Wajid Syed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mahmood Basil A. Al-Rawi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Halladay J, Ogrodnik M, Farag Alla J, Sunderland M, Gardner LA, Georgiades K. Playing for more than winning: Exploring sports participation, physical activity, and belongingness and their relationship with patterns of adolescent substance use and mental health. Drug Alcohol Depend 2024; 254:111039. [PMID: 38043225 DOI: 10.1016/j.drugalcdep.2023.111039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Promoting adolescent sports participation and physical activity may be effective low-barrier prevention strategies for co-occurring adolescent substance use (SU) and mental health symptoms (MH). The objectives of this study were to: 1) explore associations between profiles of SU/MH and sports participation; and 2) determine whether physical activity and belongingness account for these associations. METHODS Data came from a representative sample of 11,994 grade 9-12 Ontarian students (ages ~14-18) previously grouped into five SU/MH profiles based on patterns of use and symptoms. A series of multinomial logistic regressions, adjusted for socio-demographics and school clustering, were used to predict the risks of students belonging to SU/MH profiles based on: 1) school sports participation (>=weekly), 2) sports and physical activity (>=60minutes; 0-7 days), and 3) sports, physical activity, and school belongingness. RESULTS Greater school sports participation, physical activity, and belongingness were each associated with reduced risks of belonging to most profiles with elevations in SU and/or MH symptoms relative to the low SU/MH profile (Relative Risk Ratios: sports=0.62-0.87, physical activity=0.78-0.98, belonging=0.75-0.83). Frequency of physical activity accounted for ~32-60% of the associations between sports and SU/MH profiles, while school belongingness accounted for the remaining associations. Physical activity and belongingness remained independently associated with SU/MH profiles. CONCLUSIONS Findings suggest possible indirect associations between school sports participation and SU/MH profiles through physical activity and school belongingness, which may be promising prevention targets that have independent associations over and above sports. School sports participation may be one of a number of ways to achieve these goals.
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Affiliation(s)
- J Halladay
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Australia.
| | - M Ogrodnik
- Department of Kinesiology and Health Sciences, University of Waterloo, Canada
| | - J Farag Alla
- Offord Centre for Child Studies, McMaster University, Canada
| | - M Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Australia
| | - L A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Australia
| | - K Georgiades
- Offord Centre for Child Studies, McMaster University, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
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Rajab D, Fujioka JK, Walker M, Bartels SA, MacKenzie M, Purkey E. Emergency department care experiences among people who use substances: a qualitative study. Int J Equity Health 2023; 22:248. [PMID: 38049838 PMCID: PMC10696685 DOI: 10.1186/s12939-023-02050-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/02/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND People who use substances (PWUS) encounter significant barriers to accessing care for their complex health needs. As a result, emergency departments (EDs) often become the first point of healthcare access for many PWUS and are a crucial setting for the study of health inequities. This study aimed to understand the ED healthcare experiences of PWUS with the intent of informing ways of improving the delivery of equitable care. METHODS This qualitative study was part of a larger cross-sectional, mixed-methods study that examined ED experiences among diverse underserved and equity-deserving groups (EDGs) within Kingston, Ontario, Canada. Participants shared and self-interpreted a story about a memorable ED or UCC visit within the preceding 24 months. Data from participants who self-identified as having substance use experiences was analyzed through inductive thematic analysis. RESULTS Of the 1973 unique participants who completed the survey, 246 participants self-identified as PWUS and were included in the analysis. Most participants were < 45 years of age (61%), male (53%), and white/European (57%). 45% identified as a person with a disability and 39% frequently struggled to make ends meet. Themes were determined at the patient, provider, and system levels. PATIENT history of substance use and experience of intersectionality negatively influenced participants' anticipation and perception of care. Provider: negative experiences were linked to assumption making, feelings of stigma and discrimination, and negative perceptions of provider care. Whereas positive experiences were linked to positive perceptions of provider care. System: timeliness of care and the perception of inadequate mental health resources negatively impacted participants' care experience. Overall, these themes shaped participants' trust of ED staff, their desire to seek care, and their perception of the care quality received. CONCLUSIONS PWUS face significant challenges when seeking care in the ED. Given that EDs are a main site of healthcare utilization, there is an urgent need to better support staff in the ED to improve care experiences among PWUS. Based on the findings, three recommendations are proposed: (1) Integration of an equity-oriented approach into the ED, (2) Widespread training on substance use, and (3) Investment in expert resources and services to support PWUS.
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Affiliation(s)
- Dana Rajab
- Department of Medicine, Queen's University, Kingston, ON, Canada.
| | - Jamie K Fujioka
- Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Melanie Walker
- Department of Medicine, Queen's University, Kingston, ON, Canada
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Susan A Bartels
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Meredith MacKenzie
- Department of Family Medicine, Queen's University, Kingston, ON, Canada
- Street Health Centre, Kingston Community Health Centres, Kingston, ON, Canada
| | - Eva Purkey
- Department of Family Medicine, Queen's University, Kingston, ON, Canada
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
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Kosonen J, Kuusisto K. Treatment for problematic substance use in Nordic youth: a narrative review from the viewpoint of social services. Subst Abuse Treat Prev Policy 2023; 18:70. [PMID: 38001531 PMCID: PMC10675907 DOI: 10.1186/s13011-023-00580-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Youth mortality from drugs is worryingly increasing in Europe. Little is so far known about what substance use services are available to young people. An out-of-home care placement is often used but does not suffice alone as an intervention in problematic substance use among youth. Additional interventions are needed. OBJECTIVE This narrative review investigated what has been done, what works, and what is needed in treating youth substance use in the Nordic countries from the viewpoint of social services. This study brought together previous Nordic studies on this topic and presented responses to youth substance use in Nordic social welfare system to the wider international audience. METHODS A search of the ProQuest and EBSCOhost databases revealed seven interventions reported in 17 papers. Narrative synthesis was used. RESULTS Interventions included the Cannabis Cessation Program (CCP), the Icelandic version of the Motivation to Change Inventory for Adolescents, the Norwegian multisystemic therapy program (MST), the Structured Interview Manual UngDOK implemented in the Swedish Maria clinics, the Finnish ADSUME-based intervention in school health care, and the Swedish Comet 12-18 and ParentStep 13-17 programs. Many interventions had originated in the US rather than in the Nordic countries and most of them were adapted from adult interventions when youth specificity was lacking. Parental involvement was deemed important, but ineffective without involving the adolescent themself. Interventions and ways for dealing with young offenders required reconsideration from the perspective of the best interests of the child. The current research focuses on universal prevention while more knowledge about selective and indicative prevention was called for. CONCLUSIONS Not enough is known about the cessation of problematic youth substance use and subsequent rehabilitation in social services. We would encourage further research on the multi-producer system, subscriber-provider-cooperation in youth substance use services, non-medical youth-specific substance use interventions in social services, and rehabilitative juvenile drug offense practices.
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Affiliation(s)
- Janika Kosonen
- Unit of Welfare Sciences, Tampere University, Kalevantie 5, 33100, Tampere, Finland.
| | - Katja Kuusisto
- Unit of Welfare Sciences, Tampere University, Kalevantie 5, 33100, Tampere, Finland
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Jaguga F, Kwobah EK, Giusto A, Apondi E, Barasa J, Korir M, Rono W, Kosgei G, Puffer E, Ott M. Feasibility and acceptability of a peer provider delivered substance use screening and brief intervention program for youth in Kenya. BMC Public Health 2023; 23:2254. [PMID: 37974158 PMCID: PMC10652467 DOI: 10.1186/s12889-023-17146-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Youth in sub-Saharan Africa are at high risk of substance use yet lack access to substance use interventions. The goal of this project was to evaluate the feasibility and acceptability of a peer-delivered, single-session substance use screening and brief intervention program for youth in Kenya. METHODS This was a convergent parallel mixed methods study utilizing both quantitative and qualitative approaches. Two trained peer providers administered the screening and brief intervention program to 100 youth aged 15-24 years. To evaluate the implementation of the intervention, we collected quantitative and qualitative data. Feasibility and acceptability were quantitatively assessed using the Dissemination and Implementation Measures. Fidelity was assessed by rating all 100 audio-recorded sessions using a checklist. To obtain qualitative feedback on the intervention, we conducted five focus group discussions with 25 youths and six semi-structured interviews with two peer providers and four clinic leaders. The semi-structured interviews were guided by the Consolidated Framework for Implementation Research. Quantitative data was analyzed via descriptive statistics using STATA. Qualitative data was analyzed using thematic analysis with NVIVO. RESULTS The lifetime prevalence of any substance use was 50%. The mean level of acceptability of the intervention from the perspective of the youth was 3.53 (SD 0.15), meaning that the youth found the intervention to be acceptable "a lot" of the time. Mean levels of implementation outcomes (acceptability, adoption, Acceptability, Appropriateness, Feasibility, Reach/access, Organizational climate, General leadership skills, and Sustainability) as rated by peer providers and clinic staff ranged between 2.61 ("a moderate amount") and 4.0 ("a lot"). In qualitative data, youth reported that the intervention was helpful and useful in enabling them to stop or reduce substance use. The peer providers felt that the intervention was easy to implement, while the clinic leaders felt that available resources were adequate, and that the intervention aligned well with the goals of the clinic. CONCLUSION Our findings suggest that the peer-delivered screening and brief intervention program was perceived as acceptable to the youth and feasible to implement. TRIAL REGISTRATION NCT04998045 Registration date: 10/08/2021.
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Affiliation(s)
- Florence Jaguga
- Moi Teaching & Referral Hospital Department of Mental Health, PO BOX 3-30100, Eldoret, Kenya.
| | - Edith Kamaru Kwobah
- Moi Teaching & Referral Hospital Department of Mental Health, PO BOX 3-30100, Eldoret, Kenya
| | - Ali Giusto
- Columbia University Medical Center/New York State Psychiatric Institute, New York City, NY, USA
| | - Edith Apondi
- Moi Teaching & Referral Hospital Department of Child Health and Pediatrics, PO BOX 3-30100, Eldoret, Kenya
| | - Julius Barasa
- Academic Model Providing Access to Healthcare, Eldoret, Kenya
| | - Mercy Korir
- Academic Model Providing Access to Healthcare, Eldoret, Kenya
| | - Wilter Rono
- Academic Model Providing Access to Healthcare, Eldoret, Kenya
| | - Gilliane Kosgei
- Academic Model Providing Access to Healthcare, Eldoret, Kenya
| | - Eve Puffer
- Department of Psychology & Neuroscience, Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Mary Ott
- Division of Adolescent Medicine, Department of Pediatrics, Indiana University, Indianapolis, IN, USA
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Arve K. "You get stuck in it": Young people's accounts of attempting to quit non-medical tramadol use. NORDIC STUDIES ON ALCOHOL AND DRUGS 2023; 40:355-370. [PMID: 37663056 PMCID: PMC10472933 DOI: 10.1177/14550725231160330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/13/2023] [Indexed: 09/05/2023] Open
Abstract
Aim: Non-medical use of tramadol and other prescription opioid use has become a great concern in many countries, including Sweden. This study examines key components in young people's accounts of attempting to quit drugs, focusing on non-medical use of tramadol. Methods: Repeated qualitative interviews were conducted with 12 individuals aged 19-24 years with experiences of problems related to non-medical tramadol use. The analysis used the concepts of autonomy, competence, and relatedness from self-determination theory. Results: Three themes emerged from the young people's accounts: (1) quitting initiated by parents and professionals; (2) being willing, but unable; and (3) between ambivalence and determination. These themes demonstrate conflicting emotions towards drug use along with a significant external pressure to quit, but also difficulties in quitting due to experiences of dependence, withdrawal symptoms, and mental health issues. For most participants, however, an increasing autonomous will and ability to abstain from drugs gradually developed, with the support from trusted relationships with professionals, family, and friends playing a crucial role. Conclusion: The process of trying to quit non-medical tramadol use can be challenging and involve a complex interaction between willingness and capability, where external influence can be either facilitating or hindering. This study highlights the importance of taking into account young people's own perspectives in treatment efforts, where trust is a key component.
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Affiliation(s)
- Kristin Arve
- Lund University School of Social Work, Lund, Sweden
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11
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Vold JH, Halmøy A, Chalabianloo F, Pierron MC, Løberg EM, Johansson KA, Fadnes LT. Attention-deficit/hyperactivity disorder (ADHD) symptoms and their relation to diagnosed ADHD, sociodemographic characteristics, and substance use among patients receiving opioid agonist therapy: a Norwegian cohort study. BMC Psychiatry 2023; 23:479. [PMID: 37386438 PMCID: PMC10308780 DOI: 10.1186/s12888-023-04980-w] [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: 12/04/2022] [Accepted: 06/22/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) symptoms may challenge sufficient treatment of substance use and mental disorders. The literature on the extent of such symptoms among patients receiving opioid agonist therapy (OAT) is scarce. This study examined ADHD symptoms using the ADHD self-report scale (ASRS) and the association between the 'ASRS-memory' and 'ASRS-attention' scores and substance use and sociodemographic characteristics among patients receiving OAT. METHODS We used data from assessment visits of a cohort of patients in Norway. In total, 701 patients were included from May 2017 to March 2022. All patients responded at least once to two ASRS questions assessing memory and attention, respectively. Ordinal regression analyses were performed to investigate whether the two obtained scores were associated with age, sex, frequent substance use, injecting use, housing status, and educational attainment at baseline, i.e., the first assessment, and over time. The results are presented as odds ratios (OR) with 95% confidence intervals (CI). Additionally, a subsample of 225 patients completed an extended interview, including the ASRS-screener and collection of registered mental disorder diagnoses from the medical records. Standard cutoffs were used to define the presence of each ASRS symptom or a positive ASRS-screener ('ASRS-positive'). RESULTS At baseline, 428 (61%) and 307 (53%) patients scored over the cutoffs on the 'ASRS-memory' and 'ASRS-attention,' respectively. Frequent cannabis use was associated with higher 'ASRS-memory' (OR: 1.7, 95% CI: 1.1-2.6) and 'ASRS-attention' (1.7, 1.1-2.5) scores compared with less or no use at baseline, though reduced score on the 'ASRS-memory' over time (0.7, 0.6-1.0). At baseline, frequent stimulant use (1.8, 1.0-3.2) and low educational attainment (0.1, 0.0-0.8) were associated with higher 'ASRS-memory' scores. In the subsample fulfilling the ASRS-screener, 45% of the patients were 'ASRS-positive,' of whom 13% with a registered ADHD diagnosis. CONCLUSIONS Our findings illustrate a relationship between the ASRS-memory and -attention scores and frequent cannabis and stimulant use. Furthermore, nearly half of the subsample was 'ASRS-positive.' Patients receiving OAT might benefit from being further assessed for ADHD, but improved diagnostic methods are required.
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Affiliation(s)
- Jørn Henrik Vold
- Department of Addiction Medicine, Haukeland University Hospital, Jonas Lies Vei 65, N-5021 Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Anne Halmøy
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Fatemeh Chalabianloo
- Department of Addiction Medicine, Haukeland University Hospital, Jonas Lies Vei 65, N-5021 Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Marianne Cook Pierron
- Department of Addiction Medicine, Haukeland University Hospital, Jonas Lies Vei 65, N-5021 Bergen, Norway
| | - Else-Marie Løberg
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Kjell Arne Johansson
- Department of Addiction Medicine, Haukeland University Hospital, Jonas Lies Vei 65, N-5021 Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Lars Thore Fadnes
- Department of Addiction Medicine, Haukeland University Hospital, Jonas Lies Vei 65, N-5021 Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Amini M, Abdolahpur MA, Bach B, Darharaj M, Hamraz I, Javaheri A, Lotfi M. The Relationship between Traumatic Life Events and Polysubstance Use: Examining the Mediating Role of DSM-5 Level of Personality Functioning and Maladaptive Personality Traits. THE JOURNAL OF PSYCHOLOGY 2023; 157:227-241. [PMID: 36919464 DOI: 10.1080/00223980.2023.2182265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
The experience of traumatic events in childhood is an important risk factor for the initiation and continuation of polysubstance use. This study aimed to examine the mediating role of DSM-5 level of personality functioning and maladaptive personality traits in the relationship between traumatic life events and polysubstance use. We used a mixed sample (N = 290; Mage = 40; SDage = 12.26; 75.2% males) of patients with substance use disorder (SUD; including 90 mono-drug users and 113 polysubstance users) and non-users (including 87 university students) recruited using convenience sampling method from harm reduction-oriented drug treatment centers and universities respectively in Tehran, Iran. Participants completed the Level of Personality Functioning Scale-Brief Form, the Personality Inventory for DSM 5-Brief Form, and the Life Events Checklist-Revised. The results of structural equation modeling showed that DSM-5 level of personality functioning and maladaptive personality traits partially mediated the relationship between traumatic life events and polysubstance use. Experiencing traumatic events may contribute to the risk of polysubstance use through the effect of global personality dysfunction and specific personality traits. This proposed mediational model must be replicated using a longitudinal design across different populations.
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Affiliation(s)
| | | | - Bo Bach
- Center for Personality Disorder Research, Psychiatric Research Unit
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13
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Otlhapile OE, Gitau CW, Kuria MW. The prevalence of substance use disorders and associated patterns among patients admitted to a psychiatric hospital in Botswana. Int J Psychiatry Med 2023:912174231156027. [PMID: 36752226 DOI: 10.1177/00912174231156027] [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] [Indexed: 02/09/2023]
Abstract
OBJECTIVE Substance use disorders (SUDs) have risen substantially, especially in developing nations, and has become one of the world's most significant public health and socioeconomic challenge. This study aimed to determine the prevalence and patterns of substance use disorders among patients admitted at the main psychiatric hospital, Sbrana Psychiatric Hospital in Botswana. METHOD The study design was descriptive cross-sectional, involving patients admitted to a psychiatric hospital. SUDs were assessed using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) v13.0. Bivariate analysis was conducted to determine the association between socio-demographic characteristics and SUDs. Multivariate logistic regression was performed to rule out the effect of confounders. RESULTS The final analysis involved one hundred and one (101) participants. Participants ages ranged from 18-60 years with over half (59.4%) being male. Majority of participants (85.1%) had ever used studied substances; with 63.4% found to have substance use disorders. The most frequently used substances were tobacco, cannabis, alcohol and cocaine at 58.4%, 42.6%, 34.7% and 12.8% respectively. SUDs were more common among participants who were male, younger age of 18-35 years, single, tertiary education and unemployed. CONCLUSIONS There is a high prevalence of substance use and SUDs among psychiatric patients in Botswana. Structured screening and interventions to manage substance use disorders should be part of routine care at the psychiatric health care facilities in Botswana. Consideration should be given to screening all patients admitted to psychiatric hospitals in Botswana for SUDs using the ASSIST.
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Affiliation(s)
| | - Catherine W Gitau
- Department of Medicine, Aga Khan University Hospital, Nairobi, Kenya
| | - Mary W Kuria
- Department of Psychiatry, 107854Univeristy of Nairobi, Nairobi, Kenya
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Alageel MK, Alwassel AA, Almohsen HA. Presentations of active substance use in the emergency department: A single center's perspective study in Riyadh, Saudi Arabia. Saudi Med J 2023; 44:187-193. [PMID: 36773976 PMCID: PMC9987698 DOI: 10.15537/smj.2023.44.2.20220753] [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: 11/10/2022] [Accepted: 01/10/2023] [Indexed: 02/13/2023] Open
Abstract
OBJECTIVES To explore the most common clinical presentations of active substance users in our institution's Emergency Department (ED). METHODS This was a retrospective chart review of all patients that were brought to the ED of King Saud University Medical City in Riyadh, Saudi Arabia thought to be actively using illicit substances, between January 2019 and December 2021. Those with incomplete data were excluded. RESULTS A total of 582 patients were included in the study, 532 (91.4%) males, the majority were in the age group 21-30 years old (53.1%). Most patients were fully alert (n=405, 69.6%). Overall, cannabis was used by 349 (60%) of patients. Seventy-four patients presented to the ED because of motor vehicle collisions, the majority were males (98.6%), 35 (47.3%) were the driver of the vehicle and 40 (54.1%) were on cannabis. Males had 5.5 times more medical illness presentations and 10.8 times traumatic illness presentations when compared to females predominantly presenting with psychological illness presentations. CONCLUSION Among Saudi users of illicit substances, the majority were young men with medical illness presentations. The rate of traumatic injuries / vehicular and road traffic accidents is at 15.3%, and cannabis and amphetamine were the most used substances. Screening for active substance use should be conducted using both patient histories and laboratory testing for all high-risk presentations and not solely based on clinical assessment.
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Affiliation(s)
- Mohammed K. Alageel
- From the Department of Emergency Medicinem (Alageel, Alwassel, Almohsen), College of Medicine, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia; and from the Department of Emergency Medicine (Alageel), University of British Columbia,Vancouver, Canada.
- Address correspondence and reprint request to: Dr. Mohammed Khalid Alageel, Department of Emergency Medicine, College of Medicine, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail: ORCID ID: https://orcid.org/0000-0002-1215-6825
| | - Alshamoos A. Alwassel
- From the Department of Emergency Medicinem (Alageel, Alwassel, Almohsen), College of Medicine, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia; and from the Department of Emergency Medicine (Alageel), University of British Columbia,Vancouver, Canada.
| | - Hamad A. Almohsen
- From the Department of Emergency Medicinem (Alageel, Alwassel, Almohsen), College of Medicine, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia; and from the Department of Emergency Medicine (Alageel), University of British Columbia,Vancouver, Canada.
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Amini Z, HeidariFarsani E. Investigating the effect of zinc supplementation on probability of relapse and mental health in patients with opioid use disorder undergoing methadone maintenance treatment. Subst Abuse Treat Prev Policy 2023; 18:1. [PMID: 36609286 PMCID: PMC9817328 DOI: 10.1186/s13011-023-00514-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 01/02/2023] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Considering different factors, such as high withdrawal rates in methadone maintenance treatment (MMT) programs alongside mental health (MH) problems appearing in patients with opioid use disorder and the lack of prior research on the effect of zinc supplementation in this respect, the present study aimed to investigate the effect of zinc supplementation on the probability of relapse (PoR) and MH problems in patients with opioid use disorder undergoing MMT. METHODS For this purpose, a randomized controlled trial with a clinical basis was fulfilled on a total of 68 patients with opioid use disorder receiving MMT, allocated to two groups, viz. intervention, and control (each one consisting of 34 individuals). Then, the participants in the intervention group were given zinc supplements combined with methadone for three months, and the controls only took methadone, according to the treatment plan. The data were collected using the Relapse Prediction Scale (RPS) and the Depression, Anxiety, and Stress Scale 21 (DASS-21) before, one month after, and at the end of the intervention program. FINDINGS Compared to the control group, the likelihood of drug use (p = 0.01), drug craving (p = 0.002), and the RPS total score (p = 0.002) in the intervention group was significantly lower. Moreover, the results revealed a significant decreasing trend in depression (p = 0.01), anxiety (p < 0.001), stress (p = 0.001), and the DASS-21 total score (p = 0.001) in the intervention. Compared to the control group, the DASS-21 total score (p < 0.001) in the intervention group was significantly lower. CONCLUSION Accordingly, it was concluded that zinc supplementation could reduce the PoR and improve MH problems in patients with opioid use disorder experiencing MMT. However, further research is recommended to fill the gaps. TRIAL REGISTRATION The research protocol has also been listed on the Iranian Registry of Clinical Trials (IRCT) with code no. IRCT2020050904736N1.
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Affiliation(s)
- Zahra Amini
- grid.411036.10000 0001 1498 685XDepartment of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib Street, Isfahan, 8174673461 Isfahan Province Iran ,grid.411036.10000 0001 1498 685XDepartment of Community Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ebrahim HeidariFarsani
- Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Hezar Jerib Street, Isfahan, 8174673461, Isfahan Province, Iran. .,Department of Community Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
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Karle A, Agardh A, Larsson M, Arunda MO. Risky sexual behavior and self-rated mental health among young adults in Skåne, Sweden - a cross-sectional study. BMC Public Health 2023; 23:9. [PMID: 36597068 PMCID: PMC9808998 DOI: 10.1186/s12889-022-14823-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/07/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Risky sexual behavior is a public health challenge that significantly affects young people's health and well-being in Sweden and throughout the world. Moreover, poor mental health, anxiety and depression among adolescents and young adults have increased in recent years. However, although hypothesized, the associations between general mental health and risky sexual behavior among young adults are less established. Thus, this study aimed to examine the association between self-rated mental health and risky sexual behavior among young adults in southern Sweden. METHODS Population-based, cross-sectional survey data from 2968 participants aged 18-30 years old residing in southern Sweden was used (response rate 42%). The survey included questions on sexual behavior, alcohol habits, sociodemographic background, and mental health. Logistic regression was used to examine the associations between mental health, depression, anxiety, and risky sexual behavior, stratified by sex (gender). Indicators for risky sexual behavior included not using a condom, non-condom use with casual partner, and multiple (≥2) sexual partners during the last year. RESULTS Generally, male participants rated their depression and anxiety levels considerably lower than their female counterparts. Poor mental health, high depression, and high anxiety scores (levels) were significantly associated with having multiple sexual partners among among female participants; adjusted odds ratios (aOR) was 1.3 (95% CI 1.01 to 1.71). However, findings among males were not statistically significant. Furthermore, overall results indicated that higher depression and anxiety scores were associated with 1.4 and 1.6 higher odds, respectively, of not using condom with a casual partner in the most recent sexual encounter. Similarly, higher anxiety scores were associated with non-condom use in the latest sexual encounter, aOR 1.4 (1.1-1.7), but no significant gender-specific associations were found. CONCLUSION The associations found between poor mental health factors and multiple sex partners among females warrant consideration in future public health interventions. Further research to increase the understanding of the causal mechanisms that link mental health factors and risky sexual behavior, especially multiple sex partners, among young adult females is needed to support evidence-based interventions.
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Affiliation(s)
- Anna Karle
- grid.4514.40000 0001 0930 2361Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
| | - Anette Agardh
- grid.4514.40000 0001 0930 2361Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
| | - Markus Larsson
- grid.4514.40000 0001 0930 2361Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
| | - Malachi Ochieng Arunda
- grid.4514.40000 0001 0930 2361Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
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Obadeji A, Kumolalo F, Adegoke B. Substance use trends among undergraduate students and its association with sociodemographics and self-esteem. TAIWANESE JOURNAL OF PSYCHIATRY 2023. [DOI: 10.4103/tpsy.tpsy_5_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
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18
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Hutchesson MJ, Whatnall MC, Yazin N, Fenton S, Duncan MJ, Kay-Lambkin FJ, Burrows TL. Health behavior interventions for university students measuring mental health outcomes: A scoping review. Front Public Health 2022; 10:1063429. [PMID: 36568797 PMCID: PMC9771454 DOI: 10.3389/fpubh.2022.1063429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/04/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Many university students have poor mental health, and co-occurring health risk behaviors. Targeting health behavior change in this population may improve mental health outcomes. This scoping review describes the extent and range of randomized controlled trials (RCT) evaluating interventions targeting health risk behaviors and measuring a mental health outcome, among university students. Methods Six electronic databases were searched for RCTs published until the 18th May 2021. Eligible RCTs included university students, evaluated interventions that promoted health behavior change (i.e., dietary intake, physical activity, sedentary behavior, alcohol and drug use, smoking, and sleep), and measured a mental health-related outcome. Results Fifty-nine RCTs met the inclusion criteria that were published from 2000 to 2021, and over half (n = 33) were conducted in the United States. Interventions evaluated within the RCTs (n = 92) predominantly targeted changes to dietary intake (n = 41 interventions), physical activity (n = 39), or alcohol intake (n = 35). Most interventions targeted one (n = 51) or two (n = 27) health behaviors only. Included RCTs considered mental ill health outcomes (n = 24), psychological wellbeing outcomes (n = 20), or both (n = 15). Discussion This scoping review identified a moderate volume of experimental research investigating the impact of health behavior interventions on university students' mental health. There is scope for further research examining health behavior interventions targeting university students, particularly interventions taking a multi-behavioral approach.
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Affiliation(s)
- Melinda J. Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia,*Correspondence: Melinda J. Hutchesson
| | - Megan C. Whatnall
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Nazish Yazin
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Sasha Fenton
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Mitch J. Duncan
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Frances J. Kay-Lambkin
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Tracy L. Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
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Gerdner A, Håkansson A. Prevalence and comorbidity in a Swedish adolescent community sample - gambling, gaming, substance use, and other psychiatric disorders. BMC Psychiatry 2022; 22:594. [PMID: 36068500 PMCID: PMC9450242 DOI: 10.1186/s12888-022-04218-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study investigates a broad spectrum of psychiatric disorders, substance use disorders, gambling, and internet gaming disorders in Swedish 18-year-old boys and girls with the aim of estimating the prevalence of disorders and comorbidity. METHODS We used a two-phase design with screening to detect candidates for clinical interviews. Screening included 949 adolescents (55.6% girls), out of which 758 adolescents (57.0% girls) were selected for interview with at least one of four instruments: M.I.N.I., ADDIS, NODS and IGDS. Of these, 387 (61.2% girls) were interviewed. Gender separated prevalence was estimated on the assumption that those selected but not interviewed had the same distribution as those interviewed based on similar outcomes above screening cut-offs. Comorbidity between types of disorders was estimated on similar assumptions. In addition, comorbidity between dyads of the ten most common specified disorders was calculated based on recorded data without these assumptions. RESULTS We estimated that 14.6% met the criteria of a substance use disorder (SUD), mostly concerning alcohol and more frequent in girls than in boys. Those meeting the criteria lifetime of at least one of 16 other psychiatric disorders were 26.7%, more than twice as frequent in girls compared to boys, and with depression being the most common disorder. Gambling and gaming disorders were found almost exclusively in boys, of which 5.8% met the criteria for gambling, and 2.3% for gaming disorders. Of girls with a SUD, 40% also had a psychiatric disorder, while on the other hand more than 28% of girls with a psychiatric disorder also had a SUD. In boys with a SUD, 22% had another psychiatric disorder, while 15% of those with a psychiatric disorder also had a SUD. CONCLUSIONS Psychiatric comorbidity is common in SUDs in adolescents, which calls for screening and diagnostic efforts in young patients presenting with symptoms of SUDs. Girls with SUDs are at higher risk of also suffering from psychiatric conditions. Gambling and gaming disorders appear in a substantial minority of adolescents and warrant further study of their comorbidity. Since prevalences and comorbidity were estimated on the assumptions mentioned, some caution in interpreting the results is needed.
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Affiliation(s)
- Arne Gerdner
- School of Health and Welfare, Department of Social Work, Jönköping University, Box 1026, 551 11, Jönköping, Sweden.
| | - Anders Håkansson
- grid.4514.40000 0001 0930 2361Department of Medical Sciences Lund, Lund University, Psychiatry, Lund, Sweden
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Lima-Smit B, Nel K, Setwaba M. Cultural knowledge and perceptions of students towards mental illness in South Africa. JOURNAL OF PSYCHOLOGY IN AFRICA 2022. [DOI: 10.1080/14330237.2022.2066367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Bianca Lima-Smit
- Department of Psychology, University of Limpopo, Polokwane, South Africa
| | - Kathryn Nel
- Research Administration and Development, University of Limpopo, Polokwane, South Africa
| | - Mokgadi Setwaba
- Department of Psychology, University of Limpopo, Polokwane, South Africa
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Campisi SC, Krause KR, Chan BWC, Courtney DB, Bennett K, Korczak DJ, Szatmari P. Eating, sleeping and moving recommendations in clinical practice guidelines for paediatric depression: umbrella review. BJPsych Open 2021; 7:e185. [PMID: 34607616 PMCID: PMC8503910 DOI: 10.1192/bjo.2021.1020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Current first-line treatments for paediatric depression demonstrate mild-to-moderate effectiveness. This has spurred a growing body of literature on lifestyle recommendations pertaining to nutrition, sleep and exercise for treating paediatric depression. AIMS Paediatric depression clinical practice guidelines (CPGs) were reviewed for quality and to catalogue recommendations on nutrition, sleep and exercise made by higher-quality CPGs. METHOD Searches were conducted in Medline, EMBASE, PsycINFO, Web of Science and CINAHL, and grey literature CPGs databases for relevant CPGs. Eligible CPGs with a minimum or high-quality level, as determined by the Appraisal of Guidelines for Research and Evaluation, Second Edition instrument, were included if they were (a) paediatric; (b) CPGs, practice parameter or consensus or expert committee recommendations; (c) for depression; (d) the latest version and (e) lifestyle recommendations for nutrition, sleep or exercise. Key information extracted included author(s), language, year of publication, country, the institutional body issuing the CPG, target disorder, age group, lifestyle recommendation and the methods used to determine CPG lifestyle recommendations. RESULTS Ten paediatric CPGs for depression with a minimum or high-quality level contained recommendations on nutrition, sleep or exercise. Lifestyle recommendations were predominately qualitative, with quantitative details only outlined in two CPGs for exercise. Most recommendations were brief general statements, with 50% lacking supporting evidence from the literature. CONCLUSIONS Interest in lifestyle interventions for treatment in child and youth depression is growing. However, current CPG lifestyle recommendations for nutrition, sleep or exercise are based on expert opinion rather than clinical trials.
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Affiliation(s)
- Susan C Campisi
- Department of Psychiatry, Hospital for Sick Children, Canada
| | - Karolin R Krause
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Canada; Evidence-Based Practice Unit, University College London, UK; and Evidence-Based Practice Unit, Anna Freud National Centre for Children and Families, UK
| | | | - Darren B Courtney
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Canada; and Department of Psychiatry, University of Toronto, Canada
| | - Kathryn Bennett
- Department of Health Research Methods, Evidence and Impact, McMaster University, Canada
| | - Daphne J Korczak
- Department of Psychiatry, Hospital for Sick Children, Canada; and Department of Psychiatry, University of Toronto, Canada
| | - Peter Szatmari
- Department of Psychiatry, Hospital for Sick Children, Canada; Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Canada; and Department of Psychiatry, University of Toronto, Canada
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Aas CF, Vold JH, Gjestad R, Skurtveit S, Lim AG, Gjerde KV, Løberg EM, Johansson KA, Fadnes LT. Substance use and symptoms of mental health disorders: a prospective cohort of patients with severe substance use disorders in Norway. Subst Abuse Treat Prev Policy 2021; 16:20. [PMID: 33639969 PMCID: PMC7912462 DOI: 10.1186/s13011-021-00354-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND There is high co-occurrence of substance use disorders (SUD) and mental health disorders. We aimed to assess impact of substance use patterns and sociodemographic factors on mental health distress using the ten-item Hopkins Symptom Checklist (SCL-10) over time. METHODS Nested prospective cohort study of 707 participants with severe SUD across nine opioid-agonist-therapy outpatient clinics and low-threshold municipality clinics in Norway, during 2017-2020. Descriptive statistics were derived at baseline and reported by means and standard deviation (SD). A linear mixed model analysis was used to assess the impact of substance use patterns and sociodemographic factors on SCL-10 sum score with beta coefficients with 95% confidence intervals (CI). RESULTS Mean (SD) SCL-10 score was 2.2 (0.8) at baseline with large variations across patients. We observed more symptoms of mental health disorders among people with frequent use of benzodiazepines (beta 3.6, CI:2.4;4.8), cannabis (1.3, CI:0.2;2.5), opioids (2.7, CI:1.1;4.2), and less symptoms among people using frequent stimulant use (- 2.7, CI:-4.1;-1.4) compared to no or less frequent use. Females (1.8, CI:0.7;3.0) and participants with debt worries (2.2, CI:1.1;3.3) and unstable living conditions (1.7, CI:0.0;3.3) had also higher burden of mental health symptoms. There were large individual variations in SCL-10 score from baseline to follow-up, but no consistent time trends indicating change over time for the whole group. 65% of the cohort had a mean score > 1.85, the standard reference score. CONCLUSIONS People with SUD have a considerable burden of mental health symptoms. We found no association between substance use patterns and change in mental health symptoms over time. This could suggest that the differences observed were indicating flattening of effects or self-medication to a larger degree than medication-related decline in mental health. This call for better individualized mental health assessment and patient care.
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Affiliation(s)
- Christer Frode Aas
- Bergen Addiction Research group, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
| | - Jørn Henrik Vold
- Bergen Addiction Research group, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Rolf Gjestad
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Svetlana Skurtveit
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Aaron Guanliang Lim
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Else-Marie Løberg
- Bergen Addiction Research group, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Kjell Arne Johansson
- Bergen Addiction Research group, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Lars Thore Fadnes
- Bergen Addiction Research group, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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