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Dehghan M, Mirza HK, Alaeifar S, Jazinizadeh M, Iranmanesh MH, Mohammadiakbarabadi F, Salehi M, Ghonchehpour A, Zakeri MA. Quality of Life and Use of Complementary and Alternative Medicines among Narcotics Anonymous Patients: A Cross-Sectional Study in Southeast Iran. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2023; 2023:3003247. [PMID: 37727769 PMCID: PMC10506870 DOI: 10.1155/2023/3003247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 08/11/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023]
Abstract
Background Addiction, a chronic and recurrent disorder, is associated with lasting changes in the brain and can significantly affect the quality of life of people. Complementary and alternative medicine (CAM) along with modern medical treatments can improve the quality of life of individuals. This study aimed to investigate the relationship between the use of complementary and alternative medicines (CAMs) and quality of life in narcotics anonymous patients. Methods This cross-sectional study was performed on 189 narcotics anonymous patients in southeastern Iran. Using questionnaires such as the demographic information, the World Health Organization Quality of Life-BREF (WHOQOL-BREF), CAM, and satisfaction with the use of CAM, the researcher was able to compile a comprehensive picture of the population. Results The mean score of overall quality of life and general health was 64.02 ± 23.32. Overall, 66.1 percent (n = 125) of the participants reported using at least one type of CAM in the previous year. Last year, 25.9% of participants used at least one kind of CAM, 22.8% used two types of CAM, 7.9% used three types of CAM, and 4.8% used four to five types of CAM. Thirty-nine point seven percent of them reported using prayer, 36.5% reported using medicinal herbs, 15.3% of participants reported using massage, 14.3% of participants reported using dietary supplements, 12.2% reported using wet cupping, and 8.5% reported using meditation. There were no significant differences in physical, psychological, environmental, and overall quality of life between CAM users and non-CAM users. The prayer users had significantly higher scores in terms of social relationships, environment, and overall quality of life than nonprayer users. Employed participants and opium users had significantly higher overall quality of life than others. Conclusion Although there was no difference in quality of life between CAM and non-CAM users, the present study showed that prayer and medicinal herbs were the most commonly used methods among narcotics anonymous patients. However, prayer and religious beliefs were successful in improving the quality of life of these individuals. Physicians and other healthcare providers must advise patients with addiction to use different CAMs in order to improve their quality of life and quit narcotics. Future in-depth studies could help these patients use CAMs and improve their quality of life.
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Affiliation(s)
- Mahlagha Dehghan
- Department of Critical Care Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Sobhan Alaeifar
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | | | | | | | - Mina Salehi
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Asma Ghonchehpour
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Ali Zakeri
- Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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BAHADIR YILMAZ E, ATA E. Factors Affecting Adherence to Treatment of Male Inpatients with Alcohol Addiction: an Qualitative Study. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.832339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Quality of life among people who use drugs living in poor urban communities in the Philippines. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 93:103160. [PMID: 33721576 DOI: 10.1016/j.drugpo.2021.103160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/08/2021] [Accepted: 02/03/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND The quality of life (QOL) and mental health of people who use drugs (PWUD) in the Philippines, especially those living in poor urban communities, are highly concerning due to the situations surrounding drug use and the ongoing hard-line antidrug policy. This study aimed to investigate the QOL and mental health status of PWUD, compare them with a comparison group with no history of drug use, and identify factors associated with QOL among Filipino PWUD. METHODS A cross-sectional study was conducted with recruitment from a community-based rehabilitation programme and poor urban communities in Muntinlupa in 2018. QOL was measured using the WHOQOL-BREF, while psychological distress and posttraumatic stress disorder (PTSD) were measured using the Kessler Psychological Distress Scale (K-6) and the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), respectively. Multivariable linear regressions with each WHOQOL-BREF domain as a dependent factor were conducted to establish three predictions: age- and gender-adjusted QOL means, factors associated with QOL among PWUD, and interaction of lifetime drug use with each covariate. RESULTS In total, 272 PWUD and 402 comparison participants were recruited. Most PWUD were current drug users (53%), primarily of methamphetamine (70%). Among PWUD, the prevalence of moderate to severe psychological distress was 70%, and probable PTSD was 28%-both rates higher than those among the comparison group. All four QOL domain scores (physical, psychological, social, and environmental) of PWUD were lower than those of the comparison group. Multivariable regressions showed that psychological distress, current drug use, selling drugs, experiencing discrimination, and being never-married were associated with lower QOL. Higher individual income, household resources, social activity participation, and service use for drug use problems were associated with higher QOL among PWUD. Stratified and interaction analyses revealed that the QOL of PWUD was more sensitive to changes in individual income relative to the QOL of comparison group. CONCLUSION A comprehensive intervention addressing psychological distress reduction, economic empowerment, and social inclusion-complementary to abstinence-oriented programmes-may improve the well-being of Filipino PWUD.
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Barati M, Bandehelahi K, Nopasandasil T, Jormand H, Keshavarzi A. Quality of life and its related factors in women with substance use disorders referring to substance abuse treatment centers. BMC Womens Health 2021; 21:16. [PMID: 33407363 PMCID: PMC7789253 DOI: 10.1186/s12905-020-01155-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 12/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Substance-Related Disorders are among the most common social problems caused by using legal and illegal substances. Therefore, this study aimed at determining the quality of life (QoL) and its related factors among women with substance use disorders referring to substance abuse treatment centers in Hamadan, west of Iran. METHODS This cross-sectional study was carried out on 120 Iranian female substance users recruited through the census sampling method in 2018. Data collection tools consisted of demographic characteristics and QoL assessment (SF-36). Data were analyzed using SPSS-16 via one-way analysis of variance (ANOVA) and chi-square tests. RESULTS The mean age of the participants was 33.2 ± 12.1 years and the mean score of their total QoL was 35.35 ± 13.5. The results of multiple linear regression analysis indicated that using methamphetamine (β = - 6.62) was the predictor of QoL in women. Moreover, there was a significant association between QoL and age (p < 0.001), educational level (p = 0.011), and age at first use (p < 0.001). CONCLUSION According to the results, the participants' QoL was found to be at an unsatisfactory level. So, it is essential to implement educational help-seeking behavior for treatment and effectiveness educational, as well as holding mental health intervention, school-based substance abuse prevention, and harm reduction programs of substance use. This is especially important in adolescents, young, low-educated, early drug use, and methamphetamine user women, as it may increase the QoL.
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Affiliation(s)
- Majid Barati
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran
| | | | - Tahereh Nopasandasil
- Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran
| | - Hanieh Jormand
- Students Research Committee, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran.
| | - Amir Keshavarzi
- Department of Psychiatry, Research Center for Behavioral Disorders and Substances Abuse, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran
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Wang Y, Zuo J, Hao W, Shen H, Zhang X, Deng Q, Liu M, Zhao Z, Zhang L, Zhou Y, Li M, Liu T, Zhang X. Quality of Life in Patients With Methamphetamine Use Disorder: Relationship to Impulsivity and Drug Use Characteristics. Front Psychiatry 2020; 11:579302. [PMID: 33192720 PMCID: PMC7555609 DOI: 10.3389/fpsyt.2020.579302] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/31/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The quality of life (QOL) of patients with methamphetamine use disorder (MAUD) is increasingly recognized as an important outcome. Previous studies have found that impulsivity is negatively associated with QOL in mental disorders, but this relationship is rarely confirmed in patients with MAUD. We hypothesized that impulsivity is negatively correlated with QOL in patients with MAUD based on previous findings. In addition, a variety of drug use characteristics of patients that may potentially affect their QOL need to be further explored. Therefore, the purpose of this study was to explore the relationship between impulsivity, multiple drug use characteristics, and QOL in patients with MAUD. METHODS A total of 379 patients with MAUD were recruited, and the majority of them were male (85.5%), with an average age of 33.93 ± 7.08 years. Two psychiatrists conducted semi-structured interviews with methamphetamine (MA) users in two compulsory drug rehabilitation centers to obtain their demographics and drug use characteristics. The Barratt Impulsiveness Scale-11 (BIS-11) and Brief WHO Quality of Life Assessment (WHOQOL-BREF) were used to assess patients' impulsivity and QOL, respectively. Correlation and univariate regression analysis were used to explore the relationships between impulsivity, a series of drug use characteristics and patients' QOL in different domains. Further multiple linear regression analysis was used to identify what extent the above clinical variables explained the variations in patients' QOL. RESULTS Age, marital status, employment, and various drug use characteristics were significantly associated with at least one QOL domain. Among them, married and full-time job were positively correlated with QOL, while others were negatively correlated with QOL. The total score of BIS-11 was significantly negatively correlated with all four domains of QOL. Impulsivity, a range of drug use characteristics and certain demographic characteristics collectively explained varying degrees of variation in different domains of QOL. CONCLUSIONS Impulsivity and various drug use characteristics can significantly predict QOL in all fields of MAUD patients. In addition, we have also found differences in the predictors of QOL in different domains. Overall, this study provides clinical guidance for the treatment of MAUD patients, that is, management of impulsivity in patients with MAUD may help improve their QOL and even sustain their drug rehabilitation.
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Affiliation(s)
- Yingying Wang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Institute of Mental Health and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jinsong Zuo
- College of Life Sciences and Chemistry, Hunan University of Technology, Zhuzhou, China
| | - Wei Hao
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Institute of Mental Health and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Hongxian Shen
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Institute of Mental Health and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaojie Zhang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Institute of Mental Health and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qijian Deng
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Institute of Mental Health and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Mengqi Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Institute of Mental Health and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhiqiang Zhao
- Department of Medicine Addiction, Xinjiang Mental Health Center and Urumqi Fourth People's Hospital, Urumqi, China
| | - Lina Zhang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Institute of Mental Health and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yanan Zhou
- Department of Psychiatry, Brains Hospital of Hunan Province, Changsha, China
| | - Manyun Li
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Institute of Mental Health and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Tieqiao Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Institute of Mental Health and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Campêlo SR, Barbosa MA, Dias DR, Caixeta CC, Leles CR, Porto CC. Association between severity of illicit drug dependence and quality of life in a psychosocial care center in BRAZIL: cross-sectional study. Health Qual Life Outcomes 2017; 15:223. [PMID: 29149893 PMCID: PMC5693571 DOI: 10.1186/s12955-017-0795-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 11/02/2017] [Indexed: 11/26/2022] Open
Abstract
Background Quality of life must be one of the main purposes for the treatment of drug users, requiring a better understanding of the association between the quality of life and the severity of dependency. This study aimed to investigate the correlation between severity of substance use in various areas of human functioning and quality of life of illicit drug users in a psychosocial care center for alcohol and drugs. Methods This cross-sectional study included 60 participants – illicit drug users – treated at a psychosocial care center for alcohol and drugs. Participants were evaluated with the short version of World Health Organization Quality of Life (WHOQOL-Bref) instrument to measure the quality of life, the 6th version of Addiction Severity Index (ASI-6) to assess the severity of dependence in several areas and the Mini International Neuropsychiatric Interview (MINI) to identify the presence of psychiatric disorders. Pearson and Spearman correlation tests and linear regression were applied to verify the association between the severity of dependence and the quality of life, and Student’s t-test to compare the mean quality of life between individuals with and without psychiatric comorbidities. Results Negative correlation was found between the severity of dependence on the drugs dimensions: alcohol, psychiatric, medical, legal, family/social support and family/social problems of ASI-6, and the quality of life domains measured by the WHOQOL-Bref. The evidence was strongest in the psychiatric and medical dimensions. There was a significant difference in the quality of life mean among participants presenting or not presenting psychiatric comorbidities, for the psychological domain in anxiety disorders, and for the physical and psychological domains in mood disorders. Conclusion The quality of life decreased as the severity of dependence increased, with different results in the various areas of the participant’s life. This result emphasizes the need for training the professional team which works in the substance use disorders area for more comprehensive diagnostic evaluations and more appropriate therapeutic interventions for each area. The associations were more evident in the medical and psychiatric fields, indicating the need for greater attention to be paid in relation to medical and psychiatric comorbidities. Electronic supplementary material The online version of this article (10.1186/s12955-017-0795-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Selva Rios Campêlo
- Medical School, Federal University of Goiás, Rua B4, Qd 5, Lt 6, Casa 2, Setor Bueno CEP, Goiás, 74210-103, Brazil.
| | | | | | | | | | - Celmo Celeno Porto
- Medical School, Federal University of Goiás, Rua B4, Qd 5, Lt 6, Casa 2, Setor Bueno CEP, Goiás, 74210-103, Brazil
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Juel A, Kristiansen CB, Madsen NJ, Munk-Jørgensen P, Hjorth P. Interventions to improve lifestyle and quality-of-life in patients with concurrent mental illness and substance use. Nord J Psychiatry 2017; 71:197-204. [PMID: 27834103 DOI: 10.1080/08039488.2016.1251610] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Patients with co-existence of psychiatric disorders and substance use have an increased risk of premature death. This is attributable to a higher prevalence of physical comorbidities and a lifestyle related to substance use. Furthermore, they experience low quality-of-life (QoL). Studies addressing lifestyle interventions for these patients are warranted. AIMS To investigate the physical health and QoL in patients with co-existence of psychiatric disorders and substance use, and to analyse for changes in their (a) health, (b) substance use, and (c) QoL after a 24-month health-promotion programme. Further aims were to investigate associations between (a) QoL and number of interventions, (b) QoL and patient characteristics, and (c) QoL and length of participation in the intervention. METHODS In this naturalistic cohort study, 64 non-selected patients were engaged in health-promoting interventions added to contemporary treatments. QoL and clinical variables were measured at the beginning of and continuously during the programme by means of the WHOQoL-Bref questionnaire. RESULTS At enrolment, the patients' intake of cannabis and alcohol was high. During follow-up, patients consumed significantly fewer caffeinated beverages (p = .038) and fast-food meals (p = .018), and slept significantly less (p = .032). The average dose of antipsychotic medication increased significantly (p = .015). QoL was low at enrolment, but improved significantly overall (p = .009) and in the psychological (p = .020) and environmental domains (p = .012) at follow-up. The difference in total QoL was positively associated with the number of interventions attended. CONCLUSION This programme shows promise in addressing health promotion for these patients and can easily be integrated into contemporary treatments.
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Affiliation(s)
- Anette Juel
- a Department of Affective Disorders, Aarhus University Hospital , Risskov , Denmark
| | | | | | - Povl Munk-Jørgensen
- d Department of Psychiatry Odense , University Function, Southern University of Denmark , Odense , Denmark
| | - Peter Hjorth
- e Mental health Center, Psychiatric Hospital , Randers , Denmark
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Harm Reduction and Tensions in Trust and Distrust in a Mental Health Service: A Qualitative Approach. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2017; 12:12. [PMID: 28270218 PMCID: PMC5341417 DOI: 10.1186/s13011-017-0098-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 03/01/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND People seeking care for substance use (PSCSU) experience deep social and health inequities. Harm reduction can be a moral imperative to approach these persons. The purpose of this study was to explore relationships among users, health care providers, relatives, and society regarding harm reduction in mental health care, using a trust approach rooted in feminist ethics. METHODS A qualitative study was conducted in a mental health service for PSCSU, and included fifteen participants who were health care providers, users, and their relatives. Individual in-depth and group interviews, participant observation, and a review of patients' records and service reports were conducted. RESULTS Three nested levels of (dis)trust were identified: (dis)trust in the treatment, (dis)trust in the user, and self-(dis)trust of the user, revealing the interconnections among different layers of trust. (Dis)trust at each level can amplify or decrease the potential for a positive therapeutic response in users, their relatives' support, and how professionals act and build innovations in care. Distrust was more abundant than trust in participants' reports, revealing the fragility of trust and the focus on abstinence within this setting. CONCLUSION The mismatch between wants and needs of users and the expectations and requirements of a society and mental health care system based on a logic of "fixing" has contributed to distrust and stigma. Therefore, we recommend policies that increase the investment in harm reduction education and practice that target service providers, PSCSU, and society to change the context of distrust identified.
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Tamburin S, Federico A, Faccini M, Casari R, Morbioli L, Sartore V, Mirijello A, Addolorato G, Lugoboni F. Determinants of Quality of Life in High-Dose Benzodiazepine Misusers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14010038. [PMID: 28054975 PMCID: PMC5295289 DOI: 10.3390/ijerph14010038] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 12/20/2016] [Accepted: 12/29/2016] [Indexed: 02/04/2023]
Abstract
Benzodiazepines (BZDs) are among the most widely prescribed drugs in developed countries, but they have a high potential for tolerance, dependence and misuse. High-dose BZD misuse represents an emerging addiction phenomenon, but data on quality of life (QoL) in high-dose BZD misusers are scant. This study aimed to explore QoL in high-dose BZD misuse. We recruited 267 high-dose BZD misusers, compared the QoL scores in those who took BZD only to poly-drug misusers, and explored the role of demographic and clinical covariates through multivariable analysis. Our data confirmed worse QoL in high-dose BZD misusers and showed that (a) QoL scores were not negatively influenced by the misuse of alcohol or other drugs, or by coexisting psychiatric disorders; (b) demographic variables turned out to be the most significant predictors of QoL scores; (c) BZD intake significantly and negatively influenced QoL. Physical and psychological dimensions of QoL are significantly lower in high-dose BZD misusers with no significant effect of comorbidities. Our data suggest that the main reason for poor QoL in these patients is high-dose BZD intake per se. QoL should be considered among outcome measures in these patients.
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Affiliation(s)
- Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, Verona 37134, Italy.
| | - Angela Federico
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, Verona 37134, Italy.
| | - Marco Faccini
- Department of Internal Medicine, Addiction Unit, Verona University Hospital, Piazzale Scuro 10, Verona 37134, Italy.
| | - Rebecca Casari
- Department of Internal Medicine, Addiction Unit, Verona University Hospital, Piazzale Scuro 10, Verona 37134, Italy.
| | - Laura Morbioli
- Department of Internal Medicine, Addiction Unit, Verona University Hospital, Piazzale Scuro 10, Verona 37134, Italy.
| | - Valentina Sartore
- Department of Internal Medicine, Addiction Unit, Verona University Hospital, Piazzale Scuro 10, Verona 37134, Italy.
| | - Antonio Mirijello
- Alcohol Use Disorders Unit, Department of Internal Medicine, Gastroenterology and Hepatology, Catholic University of Rome, Rome 00168, Italy.
| | - Giovanni Addolorato
- Alcohol Use Disorders Unit, Department of Internal Medicine, Gastroenterology and Hepatology, Catholic University of Rome, Rome 00168, Italy.
| | - Fabio Lugoboni
- Department of Internal Medicine, Addiction Unit, Verona University Hospital, Piazzale Scuro 10, Verona 37134, Italy.
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Li J, Gu J, Lau JTF, Chen H, Mo PKH, Tang M. Prevalence of depressive symptoms and associated factors among people who inject drugs in China. Drug Alcohol Depend 2015; 151:228-35. [PMID: 25920800 DOI: 10.1016/j.drugalcdep.2015.03.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 03/25/2015] [Accepted: 03/25/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND People who inject drugs (PWID) have a high prevalence of mental health problems (e.g., depression) which compromise the effects of HIV prevention. We investigated the prevalence of depression and associated factors among PWID in Dazhou, China. METHODS Anonymous face-to-face interviews were administered to eligible participants by well-trained doctors. The Center of Epidemiological Studies Depression Scale (CES-D) was used to measure depression, using hierarchical linear regression models. RESULTS Among the 257 participants, 7.0%, 11.3%, and 75.1% were probable cases of mild (16 ≤ CES-D < 21), moderate (21 ≤ CES-D < 25), and severe (CES-D ≥ 25) depression, respectively. Hopefulness (standardized β = -0.34, p < 0.001) and emotional family support (β = -0.21, p < 0.001) were negatively associated, whereas severity of drug dependence (β = 0.12, p = 0.034) and unmet service needs (β = 0.20, p < 0.001) were positively associated, respectively, with CES-D scores. The adjusted analysis showed that resilience was negatively associated with CES-D, but it was not selected by the stepwise model containing hopefulness and emotional family support. Protective factors (i.e., hopefulness and emotional family support) and risk factors (i.e., severity of drug dependence and unmet service needs) remained significant in the same regression model. CONCLUSION Protective and risk factors were independently associated with depressive symptoms. Integrated interventions covering basic and psychosocial needs for PWID are warranted. Such interventions should strengthen emotional family support and cultivate positive factors such as hopefulness.
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Affiliation(s)
- Jinghua Li
- Division of Behavioral Health and Health Promotion, Faculty of Medicine, The School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jing Gu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Joseph T F Lau
- Division of Behavioral Health and Health Promotion, Faculty of Medicine, The School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China; Centre for Medical Anthropology and Behavioral Health, Sun Yat-sen University, Guangzhou, China.
| | - Hongyao Chen
- Dazhou Center for Disease Control and Prevention, Sichuan, China
| | - Phoenix K H Mo
- Division of Behavioral Health and Health Promotion, Faculty of Medicine, The School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Mei Tang
- Dazhou Center for Disease Control and Prevention, Sichuan, China
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Marques TCN, Sarracini KLM, Cortellazzi KL, Mialhe FL, de Castro Meneghim M, Pereira AC, Ambrosano GMB. The impact of oral health conditions, socioeconomic status and use of specific substances on quality of life of addicted persons. BMC Oral Health 2015; 15:38. [PMID: 25887243 PMCID: PMC4382833 DOI: 10.1186/s12903-015-0016-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 02/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this cross-sectional study was to evaluate the impact of oral health conditions, socioeconomic status and use of specific substances on quality of life of alcohol and drug addicted persons, receiving care at outpatient treatment facilities in Brazil. METHODS A random sample of 262 participants, mean age 37 years, from Psychosocial Care Centers for Alcohol and Drugs (CAPS AD) located in three cities in the state of São Paulo, Brazil, were clinically examined for caries experience (DMFT index) by a calibrated examiner. They were asked to complete a series of questionnaires, including the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), socioeconomic characteristics, and the World Health Organization Quality of Life assessment (WHOQOL), which were considered the outcome variables of the study. Associations between oral health status, socioeconomic characteristics, substance involvement with WHOQOL were investigated by means of the chi-square test and multiple logistic regression analysis with a level of significance α < 0.05. RESULTS The mean DMF index of the group was 13.0. Subjects with DMFT >14 (OR = 2.25; CI 95% = 1.30-3.89); low-income (OR = 2.41; CI 95% = 1.22-4.77) and users of cocaine/crack (OR = 2.02; CI 95% = 1.15-3.59) were more likely to have poor general quality of life. CONCLUSION This study demonstrated that the general quality of life of addicted persons was associated with caries experience, low income and cocaine/crack use.
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Affiliation(s)
- Tais Cristina Nascimento Marques
- Department of Community Dentistry, University of Campinas, Piracicaba Dental School, P.O. BOX 52, 13414-903, Piracicaba, SP, Brazil.
| | - Karin Luciana Migliato Sarracini
- Department of Community Dentistry, University of Campinas, Piracicaba Dental School, P.O. BOX 52, 13414-903, Piracicaba, SP, Brazil.
| | - Karine Laura Cortellazzi
- Department of Community Dentistry, University of Campinas, Piracicaba Dental School, P.O. BOX 52, 13414-903, Piracicaba, SP, Brazil.
| | - Fábio Luiz Mialhe
- Department of Community Dentistry, University of Campinas, Piracicaba Dental School, P.O. BOX 52, 13414-903, Piracicaba, SP, Brazil.
| | - Marcelo de Castro Meneghim
- Department of Community Dentistry, University of Campinas, Piracicaba Dental School, P.O. BOX 52, 13414-903, Piracicaba, SP, Brazil.
| | - Antonio Carlos Pereira
- Department of Community Dentistry, University of Campinas, Piracicaba Dental School, P.O. BOX 52, 13414-903, Piracicaba, SP, Brazil.
| | - Glaucia Maria Bovi Ambrosano
- Department of Community Dentistry, University of Campinas, Piracicaba Dental School, P.O. BOX 52, 13414-903, Piracicaba, SP, Brazil.
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Giorgi I, Ottonello M, Vittadini G, Bertolotti G. Psychological changes in alcohol-dependent patients during a residential rehabilitation program. Neuropsychiatr Dis Treat 2015; 11:2989-96. [PMID: 26673839 PMCID: PMC4676624 DOI: 10.2147/ndt.s93520] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Alcohol-dependent patients usually experience negative affects under the influence of alcohol, and these affective symptoms have been shown to decrease as a result of alcohol-withdrawal treatment. A recent cognitive-affective model suggests an interaction between drug motivation and affective symptoms. The aim of this multicenter study was to evaluate the psychological changes in subjects undergoing a residential rehabilitation program specifically designed for alcohol addiction, and to identify at discharge patients with greater affective symptoms and therefore more at risk of relapse. MATERIALS AND METHODS The sample included 560 subjects (mean age 46.91±10.2 years) who completed 28-day rehabilitation programs for alcohol addiction, following a tailored routine characterized by short duration and high intensity of medical and psychotherapeutic treatment. The psychological clinical profiles of anxiety, depression, psychological distress, psychological well-being, and self-perception of a positive change were assessed using the Cognitive Behavioral Assessment - Outcome Evaluation questionnaire at the beginning and at the end of the program. The changes in the psychological variables of the questionnaire were identified and considered as outcome evaluation of the residential intervention. Moreover, differences in the psychological functioning between patients with different characteristics were investigated. RESULTS The score measured by the Cognitive Behavioral Assessment - Outcome Evaluation showed significant improvements in all the psychological characteristics assessed, and the profile at discharge was within the normal scores. Some significant differences were found in relation to specific characteristics of the sample, such as age, sex, level of education, type of intervention, and polysubstance use. CONCLUSION This study shows the changes in psychological profile in subjects undergoing residential rehabilitation from alcohol and how this profile may permit identification of subjects requiring more psychosocial support after discharge.
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Affiliation(s)
- Ines Giorgi
- Psychology Unit, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Pavia, Italy
| | - Marcella Ottonello
- Department of Physical & Rehabilitation Medicine, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Genoa, Italy ; Department of Medicine, PhD Program in Advanced Sciences and Technologies in Rehabilitation Medicine and Sport, Università di Tor Vergata, Rome, Italy
| | - Giovanni Vittadini
- Alcohol Rehabilitation Unit, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Pavia, Italy
| | - Giorgio Bertolotti
- Psychology Unit, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Tradate, Italy
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Lugoboni F, Mirijello A, Faccini M, Casari R, Cossari A, Musi G, Bissoli G, Quaglio G, Addolorato G. Quality of life in a cohort of high-dose benzodiazepine dependent patients. Drug Alcohol Depend 2014; 142:105-9. [PMID: 25001277 DOI: 10.1016/j.drugalcdep.2014.06.020] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 06/03/2014] [Accepted: 06/04/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND Benzodiazepines (BZD) are among the most widely prescribed drugs in developed countries. Since BZD can produce tolerance and dependence even in a short time, their use is recommended for a very limited time. However, these recommendations have been largely disregarded. The chronic use of BZD causes a number of serious side effects, i.e., cognitive impairment, falls, traffic accidents, dependence and tolerance. The aim of the present study was to evaluate quality of life (QoL) in a cohort of 62 consecutive high-dose BZD-dependent patients seeking a BZD detoxification. METHODS Patients seeking BZD detoxification were evaluated using the General Health Questionnaire (GHQ-12) and the short form-36 questionnaire (SF-36). RESULTS Patients showed a significant reduction of QoL as measured by either SF-36 or GHQ-12. In particular, the greater impairment was observed in the items exploring physical and emotional status. Physical functioning was the item more influenced by the length of BZD abuse. Female patients showed a greater reduction of QoL compared to male, at least in some of the explored items. Social functioning scores were greatly reduced. CONCLUSIONS The present study shows for the first time that high-doses BZD dependent patients have a reduced QoL and a reduced social functioning, along with high levels of psychological distress.
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Affiliation(s)
- Fabio Lugoboni
- Addiction Unit, Department of Medicine, Verona University Hospital, Verona, Italy
| | - Antonio Mirijello
- Alcohol Addiction Unit, Department of Internal Medicine, Catholic University of Rome, Rome, Italy
| | - Marco Faccini
- Addiction Unit, Department of Medicine, Verona University Hospital, Verona, Italy
| | - Rebecca Casari
- Addiction Unit, Department of Medicine, Verona University Hospital, Verona, Italy
| | - Anthony Cossari
- Department of Economics, Statistics and Finance, University of Calabria, Rende, Italy
| | - Gessica Musi
- Addiction Unit, Department of Medicine, Verona University Hospital, Verona, Italy
| | - Giorgia Bissoli
- Addiction Unit, Department of Medicine, Verona University Hospital, Verona, Italy
| | - Gianluca Quaglio
- Addiction Unit, Department of Medicine, Verona University Hospital, Verona, Italy
| | - Giovanni Addolorato
- Alcohol Addiction Unit, Department of Internal Medicine, Catholic University of Rome, Rome, Italy.
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