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Hagen D, Bambra C, Ompad DC, Goldmann E. Macro-level determinants of gender differences in the prevalence of major depression and alcohol use disorder in the United States and across Europe. J Affect Disord 2024:S0165-0327(24)01779-8. [PMID: 39490672 DOI: 10.1016/j.jad.2024.10.082] [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: 02/22/2024] [Revised: 09/24/2024] [Accepted: 10/20/2024] [Indexed: 11/05/2024]
Abstract
BACKGROUND Major depressive disorder (MDD) and alcohol use disorder (AUD) are leading psychiatric causes of burden of disease. Although research has found pronounced gender differences in these disorders, the magnitude of these differences varies substantially between settings. However, integrated analyses of both disorders are lacking, limiting the comparability of findings. Moreover, few studies conceptualize political and socio-cultural characteristics as separate macro-level determinants of gender differences. This paper analyzes the association between gender differences in the prevalence of both MDD and AUD with social policy expenditures and indicators of gender equality. METHODS Data for adults from the U.S. Behavioral Risk Factor Surveillance System 2006/2008 (n = 234,020) and the European Social Survey 2014 (n = 30,416) were used. Cross-sectional analyses were conducted using modified Poisson regression models adjusted for individual-level and macro-level covariates; multiplicative and additive interaction were evaluated. RESULTS Social policy expenditures and support for gender equality were negatively associated with gender differences in AUD in Europe (p < 0.001), with the male excess prevalence varying between 26.1 % at lowest and 9.4 % at highest observed levels of expenditures, and between 23.3 % at lowest and 6.8 % at highest levels of gender equality. In the U.S., state-level reproductive rights were negatively associated with gender differences in AUD (p = 0.036). No equivalent effects were observed for gender differences in MDD. CONCLUSION The prevalence of AUD among men and women tends to converge in settings with higher levels of social policy generosity and gender equality, respectively. This effect does not seem to apply to gender differences in MDD in either setting.
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Affiliation(s)
- Daniel Hagen
- Department of Epidemiology, School of Global Public Health, New York University, NY, New York, USA.
| | - Clare Bambra
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon-Tyne, UK
| | - Danielle C Ompad
- Department of Epidemiology, School of Global Public Health, New York University, NY, New York, USA
| | - Emily Goldmann
- Department of Epidemiology, School of Global Public Health, New York University, NY, New York, USA
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2
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Burke CW, Lanni S, Hoeppner BB, Ducharme P, Wilens TE. Substance use and psychiatric phenotypes of youth experiencing homelessness: A cluster analysis. Am J Addict 2024. [PMID: 39390664 DOI: 10.1111/ajad.13655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 09/20/2024] [Accepted: 09/28/2024] [Indexed: 10/12/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Due to the complex interactions of psychopathology, psychosocial stressors, and risk behaviors, characterizing high-risk phenotypic groups of transitional-age youth experiencing homelessness (TAY-EH) for targeted interventions remains difficult. We aimed to uncover specific phenotypes of TAY-EH based upon psychiatric and substance use disorder (SUD) diagnoses, and to assess relationships between these phenotypes and negative outcomes including suicidality and high-risk behaviors. METHODS Participants (N = 140; 57% male, 54% Black) were individuals aged 16-25 years accessing support at a psychosocial agency in the U.S. Northeast. Data were gathered via structured assessment. Cluster analysis identified sub-groups of TAY-EH with differing diagnostic patterns. Bivariate analyses examined associations between cluster membership and target outcomes. RESULTS A four-cluster solution was identified. Cluster 1 (Co-occurring; N = 33) was characterized by high levels of comorbidity (i.e., major depressive disorder (MDD), SUD, and notable levels of other diagnoses). Clusters 2 (MDD alone; N = 47) and 3 (SUD alone; N = 18) were characterized by single diagnoses. Cluster 4 (None; N = 42) was characterized by low levels of psychopathology. Clusters differed significantly on several variables including suicidality, adverse childhood experiences, and social connectedness. Comorbid MDD and SUD were most strongly associated with high-risk behaviors and suicidality. DISCUSSION AND CONCLUSIONS These results highlight the importance of diagnosis and targeted interventions for co-occurring MDD and SUD to address the crisis of early mortality and other negative outcomes among TAY-EH. SCIENTIFIC SIGNIFICANCE This study is the first to identify specific high-risk psychiatric and psychosocial phenotypes among the highly complex group of TAY-EH based upon structured diagnostic assessments.
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Affiliation(s)
- Colin W Burke
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, USA
| | - Sylvia Lanni
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, USA
| | - Bettina B Hoeppner
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, USA
| | - Peter Ducharme
- Bridge Over Troubled Waters, 47 West Street, Boston, Massachusetts, USA
| | - Timothy E Wilens
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, USA
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3
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Greydanus DE, Nazeer A, Qayyum Z, Patel DR, Rausch R, Hoang LN, Miller C, Chahin S, Apple RW, Saha G, Prasad Rao G, Javed A. Pediatric suicide: Review of a preventable tragedy. Dis Mon 2024; 70:101725. [PMID: 38480023 DOI: 10.1016/j.disamonth.2024.101725] [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] [Indexed: 09/07/2024]
Abstract
Concepts of suicide are explored in this issue with a focus on suicide in children and adolescents. The epidemiology of pediatric suicide in the United States is reviewed; also, risk and protective factors, as well as prevention strategies, are discussed. Suicide in the pediatric athlete and the potential protective effect of exercise are examined. In addition, this analysis addresses the beneficial role of psychological management as well as current research on pharmacologic treatment and brain stimulation procedures as part of comprehensive pediatric suicide prevention. Though death by suicide in pediatric persons has been and remains a tragic phenomenon, there is much that clinicians, other healthcare professionals, and society itself can accomplish in the prevention of pediatric suicide as well as the management of suicidality in our children and adolescents.
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Affiliation(s)
- Donald E Greydanus
- Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States.
| | - Ahsan Nazeer
- Division of Child and Adolescent Psychiatry, Sidra Medicine/Weill Cornell Medicine, Doha, Qatar
| | - Zheala Qayyum
- Harvard Medical School, Boston, Massachusetts, United States
| | - Dilip R Patel
- Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Rebecca Rausch
- Division of Pediatric Psychology, Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Linh-Nhu Hoang
- Western Michigan University, Kalamazoo, MI, United States
| | - Caroline Miller
- Fielding Graduate University, Santa Barbara, CA, United States
| | - Summer Chahin
- Mott Children's Hospital, University of Michigan, Ann Arbor, MI, United States
| | - Roger W Apple
- Division of Pediatric Psychology, Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Gautam Saha
- Immediate Past President of the SAARC (South Asian Association for Regional Cooperation) Psychiatric Federation (SPF), India
| | - G Prasad Rao
- President, Asian Federation of Psychiatric Association (AFPA), India
| | - Afzal Javed
- Chairman Pakistan Psychiatric Research Centre, Immediate Past President of the World Psychiatric Association (WPA), Pakistan
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4
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Choi NG, Marti CN, Choi BY. Mental Health Treatment Use, Perceived Treatment Need, and Reasons for Non-Use Among U.S. Adults with Serious Suicidal Thoughts During the COVID-19 Pandemic. Community Ment Health J 2024; 60:972-984. [PMID: 38372825 DOI: 10.1007/s10597-024-01249-8] [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: 09/22/2023] [Accepted: 02/11/2024] [Indexed: 02/20/2024]
Abstract
Analyzing the 2021 National Survey on Drug Use and Health data with generalized linear models, we examined: (1) COVID pandemic-related and other correlates of mental health treatment use and unmet perceived treatment need among U.S. adults who experienced serious suicidal thoughts (N = 3,177); and (2) correlates of self-reported reasons for not receiving treatment. We found that 61% used any mental health treatment, and 48% of users and 37% of nonusers reported perceived treatment need. Significant correlates of treatment use were demographic factors, insurance, major depressive disorder, and illicit drug use disorder. Significant correlates of perceived treatment need were age 18-34, some college education, and major depressive episode. Perceived negative effect of the COVID pandemic on mental health was a significant factor for both treatment use and perceived need. The most frequent reasons for not getting treatment were the cost of treatment or lack of insurance and stigma-related concerns.
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Affiliation(s)
- Namkee G Choi
- Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX, 78712, USA.
| | - C Nathan Marti
- Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX, 78712, USA
| | - Bryan Y Choi
- Department of Emergency Medicine, Philadelphia College of Osteopathic Medicine and BayHealth, Philadelphia, USA
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Vilar-Ribó L, Cabana-Domínguez J, Alemany S, Llonga N, Arribas L, Grau-López L, Daigre C, Cormand B, Fernàndez-Castillo N, Ramos-Quiroga JA, Soler Artigas M, Ribasés M. Disentangling heterogeneity in substance use disorder: Insights from genome-wide polygenic scores. Transl Psychiatry 2024; 14:221. [PMID: 38811559 PMCID: PMC11137038 DOI: 10.1038/s41398-024-02923-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/31/2024] Open
Abstract
Substance use disorder (SUD) is a global health problem with a significant impact on individuals and society. The presentation of SUD is diverse, involving various substances, ages at onset, comorbid conditions, and disease trajectories. Current treatments for SUD struggle to address this heterogeneity, resulting in high relapse rates. SUD often co-occurs with other psychiatric and mental health-related conditions that contribute to the heterogeneity of the disorder and predispose to adverse disease trajectories. Family and genetic studies highlight the role of genetic and environmental factors in the course of SUD, and point to a shared genetic liability between SUDs and comorbid psychopathology. In this study, we aimed to disentangle SUD heterogeneity using a deeply phenotyped SUD cohort and polygenic scores (PGSs) for psychiatric disorders and related traits. We explored associations between PGSs and various SUD-related phenotypes, as well as PGS-environment interactions using information on lifetime emotional, physical, and/or sexual abuse. Our results identify clusters of individuals who exhibit differences in their phenotypic profile and reveal different patterns of associations between SUD-related phenotypes and the genetic liability for mental health-related traits, which may help explain part of the heterogeneity observed in SUD. In our SUD sample, we found associations linking the genetic liability for attention-deficit hyperactivity disorder (ADHD) with lower educational attainment, the genetic liability for post-traumatic stress disorder (PTSD) with higher rates of unemployment, the genetic liability for educational attainment with lower rates of criminal records and unemployment, and the genetic liability for well-being with lower rates of outpatient treatments and fewer problems related to family and social relationships. We also found evidence of PGS-environment interactions showing that genetic liability for suicide attempts worsened the psychiatric status in SUD individuals with a history of emotional physical and/or sexual abuse. Collectively, these data contribute to a better understanding of the role of genetic liability for mental health-related conditions and adverse life experiences in SUD heterogeneity.
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Grants
- Instituto de Salud Carlos III: CP22/00128 Ministry of Science, Innovation and Universities: IJC2018-035346-I
- Instituto de Salud Carlos III: FI18/00285
- Ministry of Science, Innovation and Universities: RYC2021-031324-I Network Center for Biomedical Research (CIBER)
- Instituto de Salud Carlos III: CP22/00026
- Ministry of Science, Innovation and Universities: PID2021-1277760B-I100
- Ministry of Science, Innovation and Universities: PID2021-1277760B-I100 Ministry of Health, Social Services and Equality:PNSD-2020I042
- Agència de Gestió d’Ajuts Universitaris i de Recerca (AGAUR, 2017SGR-1461, 2021SGR-00840 and 2021-SGR-01093)., European Regional Development Fund (ERDF), the European Union H2020 Programme (H2020/2014-2020) under grant agreements no. 848228 (DISCOvERIE) and no. 2020604 (TIMESPAN), the ECNP Network ‘ADHD across the Lifespan’,“La Marató de TV3” (202228-30 and 202228-31) and ICREA Academia 2021
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Affiliation(s)
- Laura Vilar-Ribó
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Judit Cabana-Domínguez
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Silvia Alemany
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Natalia Llonga
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Lorena Arribas
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Lara Grau-López
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Constanza Daigre
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Bru Cormand
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Catalonia, Spain
- Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain
| | - Noèlia Fernàndez-Castillo
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Catalonia, Spain
- Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain
| | - Josep Antoni Ramos-Quiroga
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - María Soler Artigas
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.
- Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Catalonia, Spain.
| | - Marta Ribasés
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.
- Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Catalonia, Spain.
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6
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Onaemo VN, Chireh B, Fawehinmi TO, D'Arcy C. Comorbid substance use disorder, major depression, and associated disability in a nationally representative sample. J Affect Disord 2024; 348:8-16. [PMID: 38070745 DOI: 10.1016/j.jad.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/14/2023] [Accepted: 12/02/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Major depressive disorders (MDD) and substance use disorders (SUDs) are commonly linked to disability, but there is a lack of research on the risk of disability among individuals who have both SUDs and MD in the general population. This study aimed to investigate the associated risk of disability in people with comorbid SUDs- specifically cannabis use disorder, alcohol use disorder, other drug (except cannabis) use disorder, and a major depressive episode using a nationally representative sample. METHODS The 2012 Canadian Community Health Survey- Mental Health (CCHS-MH) data were analyzed using multilevel logistic regression models. The survey included a nationally representative sample of Canadians aged 15 years and older (n = 25,113) residing in the ten Canadian provinces from January to December 2012. The diagnoses of major depressive episodes (MDE) and the SUDs were derived from the DSM-IV diagnostic criteria using a modified WHO-CIDI instrument, while disability was assessed using the World Health Organization Disability Assessment Score (WHODAS) 2.0. RESULTS The strongest predictor of disability was found to be comorbidity. Individuals diagnosed with both a SUD and MDE were 4 to 9 times more likely to experience disability, depending on the substance used, compared to those without either diagnosis. LIMITATIONS The study's cross-sectional design limits causal inferences. CONCLUSIONS Our research discovered that individuals who have both SUD and MDE are at a significantly higher risk of experiencing disability. This highlights the importance of integrating mental health and addiction services to mitigate the risk of disability and improve overall treatment outcomes.
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Affiliation(s)
- Vivian N Onaemo
- Division of Public Health and Preventive Medicine, Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, Saskatchewan S7N 2Z4, Canada.
| | - Batholomew Chireh
- EPID@Work Research Institute, Lakehead University, 955 Oliver Road, Thunder Bay, ON P7B 5E1, Canada; Department of Health Sciences, Lakehead University, 955 Oliver Road, Thunder Bay, ON P7B 5E1, Canada
| | | | - Carl D'Arcy
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, Saskatchewan S7N 2Z4, Canada; Professor Emeritus (Psychiatry & Public Health), University of Saskatchewan, 103 Hospital Drive, Saskatoon, Saskatchewan S7N 2Z4, Canada
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7
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Sajid S, Lawrence RE, Galfalvy HC, Keilp JG, Moitra VK, Mann JJ, Grunebaum MF. Intramuscular ketamine vs. midazolam for rapid risk-reduction in suicidal, depressed emergency patients: Clinical trial design and rationale. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2024; 15:100690. [PMID: 38283689 PMCID: PMC10812090 DOI: 10.1016/j.jadr.2023.100690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024] Open
Abstract
Emergency department (ED) visits for suicidal ideation or behavior have been increasing in all age groups, particularly younger adults. A rapid-acting treatment to reduce suicidal thinking, adapted for ED use, is needed. Previous studies have shown a single dose of ketamine can improve depression and suicidal ideation within hours. However, most studies used 40 min intravenous infusions which can be impractical in a psychiatric ED. The ER-Ketamine study we describe here is a randomized midazolam-controlled clinical trial (RCT; NCT04640636) testing intramuscular (IM) ketamine's feasibility, safety, and effectiveness to rapidly reduce suicidal ideation and depression in a psychiatric ED. A pre-injection phase involves screening, informed consent, eligibility confirmation, and baseline assessment of suicidal ideation, depression, and comorbidities. The randomized double-blind IM injection is administered in the ED under research staff supervision, vital sign monitoring, pharmacokinetic blood sampling, and clinical assessments. The post-injection phase occurs on a psychiatric inpatient unit with follow-up research assessments through four weeks post-discharge. Outcome measures are feasibility, safety, and effects on suicidal ideation and depression at 24 h post-injection, and through follow-up. The target sample is N = 90 adults in a major depressive episode, assessed by ED clinicians as warranting hospitalization for suicide risk. Here we report design, rationale, and preliminary feasibility and safety for this ongoing study. Demographics of the 53 participants (ages 18 to 65 years) randomized to date suggest a diverse sample tending towards younger adults.
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Affiliation(s)
- Sumra Sajid
- Columbia University Irving Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States
| | - Ryan E. Lawrence
- Columbia University Irving Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States
| | - Hanga C. Galfalvy
- Columbia University Irving Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States
| | - John G. Keilp
- Columbia University Irving Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States
| | | | - J. John Mann
- Columbia University Irving Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States
| | - Michael F. Grunebaum
- Columbia University Irving Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States
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8
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Irmak-Yazicioglu MB, Arslan A. Navigating the Intersection of Technology and Depression Precision Medicine. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1456:401-426. [PMID: 39261440 DOI: 10.1007/978-981-97-4402-2_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2024]
Abstract
This chapter primarily focuses on the progress in depression precision medicine with specific emphasis on the integrative approaches that include artificial intelligence and other data, tools, and technologies. After the description of the concept of precision medicine and a comparative introduction to depression precision medicine with cancer and epilepsy, new avenues of depression precision medicine derived from integrated artificial intelligence and other sources will be presented. Additionally, less advanced areas, such as comorbidity between depression and cancer, will be examined.
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Affiliation(s)
| | - Ayla Arslan
- Department of Molecular Biology and Genetics, Üsküdar University, İstanbul, Türkiye.
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9
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El-Ammari A, El Malki H, Moutawakkil SG, El Hilaly J, El Houari F, El Gnaoui S, Ragala MEA, El Rhazi K, Zarrouq B. Validation of the Center for Epidemiologic Studies Depression Scale (CES-D) in a Moroccan sample with substance use disorder. BMC Psychiatry 2023; 23:723. [PMID: 37803359 PMCID: PMC10557308 DOI: 10.1186/s12888-023-05245-2] [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: 06/14/2023] [Accepted: 10/01/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Transcultural validation studies of depression scales are rare in Morocco. The Center for Epidemiologic Studies Depression Scale (CES-D) is commonly one of the most common and frequently used screening instruments for depressive symptoms, but the scale has not, up to date, been validated in dialect of Arabic in Moroccan contexts. Given the importance of assessing and preventing depressive symptoms in our Moroccan context, this study aims to validate the CES-D, translated, and adapted to the dialect of Arabic and Moroccan culture, in a sample with substance use disorder. METHODS The data were analyzed in two successive phases. First, exploratory factor analysis (EFA) was used to assess the factor structure in the pilot sample (N = 140). Then, this structure was confirmed in the validation sample (N = 205) using confirmatory factor analysis (CFA). RESULTS Exploratory factor analysis extracted three factors different from the four factors in the original version. Confirmatory factor analysis confirmed the structure of three factors. The fit indices level showed acceptable to good performance of the measurement model. The instrument showed sufficient reliability and convergent validity, as demonstrated by acceptable values of composite reliability (CR = 0.89-0.93) and average variance extracted (AVE = 0.64-0.66), respectively. The square roots of AVE were higher than factor-factor pairs correlations, and the Heterotrait-Monotrait ratio (HTMT) of correlations values was less than 0.85, indicating acceptable discriminant validity. CONCLUSIONS Overall reliability and both convergent and discriminant validity tests indicated that the Moroccan dialectal Arabic version of the CES-D had a good performance and may serve as a valid tool for measuring the severity of depression in people with substance use disorder.
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Affiliation(s)
- Abdelfettah El-Ammari
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
| | - Hicham El Malki
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Salma Ghofrane Moutawakkil
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Jaouad El Hilaly
- R.N.E Laboratory, Multidisciplinary Faculty of Taza, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Laboratory of Pedagogical and Didactic Engineering of Sciences and Mathematics, Regional Center of Education and Training (CRMEF) of Fez, Fez, Morocco
| | | | | | - Mohammed El Amine Ragala
- Department of Biology-Geology, Teachers Training College (Ecole Normale Superieure), Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Karima El Rhazi
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Btissame Zarrouq
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
- Department of Biology-Geology, Teachers Training College (Ecole Normale Superieure), Sidi Mohamed Ben Abdellah University, Fez, Morocco.
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Flórez G, Espandian A, Llorens N, Seoane-Pillado T, Saiz P. Suicide deaths and substance use in the Galician provinces between 2006 and 2020. Front Psychiatry 2023; 14:1242069. [PMID: 37645637 PMCID: PMC10461002 DOI: 10.3389/fpsyt.2023.1242069] [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: 06/18/2023] [Accepted: 07/28/2023] [Indexed: 08/31/2023] Open
Abstract
Background Suicide is a serious public health problem that affects our entire country, including the Galician provinces. The aim of this research was to study the variation in completed suicide rates, between 2006 and 2020, in the different Galician provinces and their relationship with the consumption of addictive substances. Methods Completed suicide data from the Spanish Office for National Statistics and the Institute of Legal Medicine of Galicia were analyzed with a Joinpoint regression model to determine time trends. The relationship between the variation in completed suicide rates with sociodemographic variables obtained from the Spanish Office for National Statistics and variables related to the consumption of substances obtained from the survey on alcohol and other drugs in Spain (EDADES) of the Government Delegation for the National Plan on Drugs was also analyzed. Results The Joinpoint regression model did not reveal any point of significant change in the period studied for any Galician province. The following variables correlated positively with the variation in completed suicide rates in the Galician provinces: masculinity ratio, average age, daily alcohol consumption and daily illegal substance consumption. Conclusion Applying preventive strategies on the daily consumption of alcohol and illegal substances would help reduce the rates of completed suicide in the Galician provinces.
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Affiliation(s)
- Gerardo Flórez
- Addictive Treatment Unit, Ourense University Hospital, Ourense, Spain
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
| | | | - Noelia Llorens
- Spanish Observatory of Drugs and Addictions, Government Delegation for the National Plan on Drugs, Spanish Ministry of Health, Madrid, Spain
| | - Teresa Seoane-Pillado
- Area of Preventive Medicine and Public Health, Department of Health Sciences, University of A Coruña – INIBIC, A Coruña, Spain
| | - Pilar Saiz
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Asturias, Spain
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Olsavsky AK, Chirico I, Ali D, Christensen H, Boggs B, Svete L, Ketcham K, Hutchison K, Zeanah C, Tottenham N, Riggs P, Epperson CN. Maternal Childhood Maltreatment, Internal Working Models, and Perinatal Substance Use: Is There a Role for Hyperkatifeia? A Systematic Review. Subst Abuse 2023; 17:11782218231186371. [PMID: 37476500 PMCID: PMC10354827 DOI: 10.1177/11782218231186371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/16/2023] [Indexed: 07/22/2023]
Abstract
The parent-infant relationship is critical for socioemotional development and is adversely impacted by perinatal substance use. This systematic review posits that the mechanisms underlying these risks to mother-infant relationships center on 3 primary processes: (1) mothers' childhood maltreatment experiences; (2) attachment styles and consequent internal working models of interpersonal relationships; and (3) perinatal substance use. Further, the review considers the role of hyperkatifeia, or hypersensitivity to negative affect which occurs when people with substance use disorders are not using substances, and which drives the negative reinforcement in addiction. The authors performed a systematic review of articles (published 2000-2022) related to these constructs and their impact on mother-infant relationships and offspring outcomes, including original clinical research articles addressing relationships between these constructs, and excluding case studies, reviews, non-human animal studies, intervention studies, studies with fewer than 30% female-sex participants, clinical guidelines, studies limited to obstetric outcomes, mechanistic/biological studies, and studies with methodological issues precluding interpretation. Overall 1844 articles were screened, 377 were selected for full text review, and data were extracted from 157 articles. Results revealed strong relationships between mothers' childhood maltreatment experiences, less optimal internal working models, and increased risk for perinatal substance use, and importantly, all of these predictors interacted with hyperkatifeia and exerted a marked impact on mother-infant relationships with less data available on offspring outcomes. These data strongly support the need for future studies addressing the additive impact of maternal childhood maltreatment experiences, suboptimal internal working models, and perinatal substance use, with hyperkatifeia as a potential moderator, and their interacting effects on mother-infant socioemotional outcomes.
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Affiliation(s)
- Aviva K. Olsavsky
- University of Colorado School of Medicine, Aurora, CO, USA
- Children’s Hospital Colorado, Aurora, CO, USA
| | - Isabella Chirico
- SUNY Downstate Health Sciences University College of Medicine, Brooklyn, NY, USA
| | - Diab Ali
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Hannah Christensen
- University of Colorado School of Medicine, Aurora, CO, USA
- Children’s Hospital Colorado, Aurora, CO, USA
| | - Brianna Boggs
- University of Colorado School of Medicine, Aurora, CO, USA
- Children’s Hospital Colorado, Aurora, CO, USA
| | - Lillian Svete
- University of Colorado School of Medicine, Aurora, CO, USA
- University of Kentucky College of Medicine, Louisville, KY, USA
| | | | - Kent Hutchison
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Charles Zeanah
- Tulane University School of Medicine, New Orleans, LA, USA
| | | | - Paula Riggs
- University of Colorado School of Medicine, Aurora, CO, USA
- Children’s Hospital Colorado, Aurora, CO, USA
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