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Martínez-León MA, Carballo JL, Pérez-Jover V. Prevalence and risk factors for misuse of prescription psychotropic drug in patients with severe mental illness: A systematic review. ACTAS ESPANOLAS DE PSIQUIATRIA 2023; 51:229-240. [PMID: 38117263 PMCID: PMC10803847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 09/01/2023] [Indexed: 12/21/2023]
Abstract
RESUMEN Objective. The misuse of prescription psychotropic drugs is a major health problem.
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Affiliation(s)
- M A Martínez-León
- Departamento de Psicología de la Salud, Universidad Miguel Hernández
| | - J L Carballo
- Departamento de Psicología de la Salud, Universidad Miguel Hernández
| | - V Pérez-Jover
- Departamento de Psicología de la Salud, Universidad Miguel Hernández
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Kassam A, Beder M, Sediqzadah S, Levy M, Ritts M, Maher J, Kirwan N, Law S. Impact of COVID-19 on the lives of people with severe mental illness-front-line community psychiatry workers observation from a provincial survey of assertive community treatment teams in Ontario, Canada. Int J Ment Health Syst 2023; 17:18. [PMID: 37328776 DOI: 10.1186/s13033-023-00585-8] [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: 10/05/2022] [Accepted: 05/23/2023] [Indexed: 06/18/2023] Open
Abstract
Using an online survey distributed to members of the provincial organization that represents the 88 Assertive Community Treatment (ACT) and Flexible ACT teams in Ontario, Canada, this descriptive study relied on the unique vantage points and observations of the front-line community psychiatry workers who maintained contact with patients through outreach and telecommunication during the height of COVID-19. The patients who suffer from serious mental illness (SMI) were uniquely affected by COVID-19 due to the changes, reduction or shut down of many essential clinical and community support services. Thematic and quantitative analyses of the workers' observations highlighted 6 main areas of note, including significant social isolation and loneliness, clinical course deterioration and life disruption, increased hospital and ER use, police and legal contacts, and substance abuse and related deaths. There were also encouraging signs of positive adaptations in terms of independence and resilience. Reflections of these impacts and potential ameliorating approaches are further discussed.
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Affiliation(s)
- Aly Kassam
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Michaela Beder
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Saadia Sediqzadah
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Matthew Levy
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Madeleine Ritts
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - John Maher
- Canadian Mental Health Association, Barrie and Ontario Association of ACT and FACT, Barrie, ON, Canada
| | - Nicole Kirwan
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Samuel Law
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada.
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Petros R, Walker DD, Pierce A, Monroe-DeVita M. Scoping Review of Cannabis-Reduction Psychosocial Interventions and Reasons for Use among Young Adults with Psychosis. J Dual Diagn 2023; 19:124-150. [PMID: 37391686 DOI: 10.1080/15504263.2023.2226024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
Objective: No evidence-based intervention effectively reduces cannabis use in young adults with psychosis (YAP). To generate hypotheses about why, a scoping review was conducted to synthesize evidence about motivations for cannabis use and reduction/cessation for YAP and the psychosocial interventions trialed to identify possible gaps between motivations and interventive strategies. Methods: A systematic literature search was conducted in December, 2022. Reviews of titles and abstracts (N = 3,216) and full-texts (n = 136) resulted in 46 articles. Results: YAP use cannabis for pleasure, to reduce dysphoria, and for social and recreational reasons; motivations for cessation include insight about cannabis-psychosis interactions, incompatibility with goals and social roles, and support from social networks. Interventions with at least minimal evidence of efficacy include motivational interviewing, cognitive-behavioral strategies, and family skills training. Conclusions: Authors recommend additional research on mechanisms of change and motivational enhancement therapy, behavioral activation, and family-based skills interventions matched to YAP motivations for use/cessation.
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Affiliation(s)
- Ryan Petros
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Denise D Walker
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Adam Pierce
- Mental Health and Neurosciences Division, VA Portland Health Care System, Portland, Oregon, USA
| | - Maria Monroe-DeVita
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
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Tadese M, Tessema SD, Mihretie A, Wake GE, Teshome HN, Mulu GB, Habtewold TD. Perceived stress and its associated factors among people living in post-war Districts of Northern Ethiopia: A cross-sectional study. PLoS One 2022; 17:e0279571. [PMID: 36576931 PMCID: PMC9797080 DOI: 10.1371/journal.pone.0279571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 12/11/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND War and conflict environments result in long-term physical and psychological consequences. Sexual violence, displacement, malnutrition, death, illness, injury, torture, and disability are some of the physical effects, whereas stress, depression, aggressive behaviors, and anxiety are some of the emotional complications of war. Hence, evidence-based interventions are required particularly to monitor mental health disorders. Thus, we aimed to investigate the prevalence of perceived stress and its associated factors among people living in post-war situations, Northern Ethiopia. METHOD A community-based cross-sectional study design was employed among 812 samples from April 1 to May 15, 2022. The study participants were selected using a multistage sampling technique. The data was collected through face-to-face interviews using a structured and pre-tested tool. Data were cleaned and entered into Epi-Data version 4.6 and transferred to SPSS version 25 for analysis. Binary logistic regression analysis was performed to identify determinants of perceived stress. The Hosmer-Lemeshow goodness-of-fit was applied to test for model fitness and a p-value of <0.05 was considered statistically significant. RESULT The prevalence of perceived stress was 76.1%, 95% CI (72.9-78.8). Age above 45 years (AOR (CI) = 2.45 (1.07-5.62), poor educational level (AOR (CI) = 5.92 (2.36-14.8), large family size (AOR (CI) = 0.48 (0.31-0.74), alcohol consumption (AOR (CI) = 0.63 (0.42-0.94), smoking (AOR (CI) = 0.17 (0.06-0.56), and exposure to multiple traumatic events (AOR (CI) = 2.38 (1.23-4.62) have shown a statistically significant association with perceived stress. CONCLUSION This study revealed that more than three-fourths of participants living in post-war settings were found to have perceived stress. Older age, poor level of education, large family size, alcohol consumption, smoking, and the number of traumatic events were significant associates of perceived stress. Psychotherapy that can effectively address the medical, social, and psychological well-being of the community is important to reduce the burden of perceived stress.
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Affiliation(s)
- Mesfin Tadese
- Department of Midwifery, School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
- * E-mail:
| | - Saba Desta Tessema
- Department of Midwifery, School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Abebe Mihretie
- Department of Midwifery, School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Getu Engida Wake
- Department of Midwifery, School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Hana Nigussie Teshome
- Department of Nursing, School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Getaneh Baye Mulu
- Department of Nursing, School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Tesfa Dejenie Habtewold
- Branch of Epidemiology, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, United States of America
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
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Prevalence and Demographic Correlates of Substance Use among Adults with Mental Illness in Eastern Cape, South Africa: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105428. [PMID: 34069572 PMCID: PMC8161045 DOI: 10.3390/ijerph18105428] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/28/2021] [Accepted: 03/29/2021] [Indexed: 11/21/2022]
Abstract
This study reports on the prevalence and demographic correlates of substance use among individuals with mental illness in the Eastern Cape, South Africa. This cross-sectional study was conducted in the Outpatient Clinic of a large hospital in the Eastern Cape, South Africa. A pre-validated tool on alcohol and psychoactive drug use was administered to 390 individuals with mental illness. Multivariable logistic regression models were fitted to explore the demographic correlates of alcohol and psychoactive drug use. Of the total participants (N = 390), 64.4% and 33.3% reported lifetime (ever used) and past-year use of alcohol, respectively, but the prevalence of risky alcohol use was 18.5%. After adjusting for relevant covariates, only male sex, younger age, and rural residence remained significantly associated with risky alcohol use. The prevalence of ever-use and past-year use of psychoactive substances was 39.7% and 17.4%, respectively. The most common substance ever used was cannabis (37.4%). Male sex, younger age, owning a business, and being unemployed were significantly associated with higher odds of lifetime and past-year use of psychoactive substances. Findings highlight the need for dedicated infrastructure and staff training in the management of these dual diagnoses in the region.
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Chang S, Jeyagurunathan A, Lau JH, Shafie S, Samari E, Cetty L, Mok YM, Verma S, Subramaniam M. Problematic Drug Use Among Outpatients With Schizophrenia and Related Psychoses. Front Psychiatry 2021; 12:762988. [PMID: 34744843 PMCID: PMC8569375 DOI: 10.3389/fpsyt.2021.762988] [Citation(s) in RCA: 2] [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] [Received: 08/23/2021] [Accepted: 09/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Problematic drug use is common among psychiatric patients and is linked with poorer course and outcomes of illness. The aim of this study is to assess the prevalence of problematic drug use, and to explore its sociodemographic correlates and associations with health behaviors and outcomes among outpatients with schizophrenia and related psychoses in Singapore. Methods: Data from 397 individuals who were aged 21-65 years and were seeking treatment for schizophrenia and related psychoses in the outpatient clinics of a tertiary psychiatric hospital were analyzed. The Drug Abuse Screening Test (DAST-10) was used to assess problematic drug use. Information on sociodemographics, smoking status, alcohol use, symptoms severity and quality of life were collected. Multivariable logistic regressions were conducted to explore correlates and associations of problematic drug use. Results: The prevalence of problematic drug use was 5.8% (n = 23) in the sample, and 10.6% (n = 42) of the participants reported having problematic drug use and/or problematic alcohol use. More males than females reported having problematic drug use (p = 0.021), and also problematic drug and/or alcohol use (p = 0.004). Significant associations were observed between problematic drug use and smokers with nicotine dependence, and with physical health domain of quality of life. Individuals with greater symptom severity were approximately twice as likely to have problematic drug use and/or alcohol use. Conclusion: While the prevalence of problematic drug use in this sample population is relatively lower compared to other countries, there is a considerable number who might be at risk. Routine screening and close monitoring of drug use is recommended as part of psychiatric assessment, particularly among males and patients with nicotine dependence.
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Affiliation(s)
- Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Jue Hua Lau
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Ellaisha Samari
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Laxman Cetty
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Yee Ming Mok
- Department of Mood and Anxiety, Institute of Mental Health, Singapore, Singapore
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
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Hamada K, Fan X. The impact of COVID-19 on individuals living with serious mental illness. Schizophr Res 2020; 222:3-5. [PMID: 32473931 PMCID: PMC7250778 DOI: 10.1016/j.schres.2020.05.054] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/23/2020] [Accepted: 05/25/2020] [Indexed: 11/19/2022]
Affiliation(s)
| | - Xiaoduo Fan
- UMass Memorial Health Care/University of Massachusetts Medical School, Worcester, MA 01605, United States of America.
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Broman CL, Wright MK, Broman MJ, Bista S. Self-Medication -and Substance Use: A Test of the Hypothesis. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2020. [DOI: 10.1080/1067828x.2020.1789526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Arranz S, Mané A, Bergé D, Monserrat C, Cabezas A, Vilella E, Sanchez-Gistau V. The impact of sex and cannabis on clinical features in first-admitted patients with psychosis. Eur Neuropsychopharmacol 2020; 36:235-243. [PMID: 32291209 DOI: 10.1016/j.euroneuro.2020.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 02/26/2020] [Accepted: 03/06/2020] [Indexed: 12/22/2022]
Abstract
There is a scarcity of studies investigating the effect of sex on the clinical and treatment characteristics of first-admitted patients with first-episode psychosis (FEP). The reasons for using cannabis and the effect of cannabis on clinical features have not received enough attention either. We aim therefore, to investigate sex differences in the reasons for cannabis use and to determine the effects of sex, cannabis use and their interaction on clinical variables at admission and at discharge from the inpatient unit. 204 first-admitted FEPs in two inpatient units in Spain were included. The reasons for using cannabis were determined using the Dixon questionnaire. Clinical variables were compared between sexes and between cannabis users and non-users. Cannabis use was more frequent in males, but females were more likely to smoke cannabis to "feel relaxed". There was a main effect of sex on positive psychotic symptoms and antipsychotics dose and an interaction effect of cannabis and sex on global functioning at discharge .Our findings show sex differences in the reasons for cannabis use and in some clinical and treatment characteristics among FEP patients. More studies focusing on gender perspectives are needed to develop more individualized treatments.
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Affiliation(s)
- Sara Arranz
- Parc Sanitari Sant Joan de Dèu, Sant Boi de Llobregat, Barcelona, Spain; Hospital Universitari Institut Pere Mata of Reus, Medical Research Institute Pere Virgili (IISPV), and Rovira i Virgili University of Tarragona, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Spain
| | - Anna Mané
- Hospital del Mar Medical Research Institute (IMIM) of Barcelona, Autonomous University of Barcelona, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Spain
| | - Dani Bergé
- Hospital del Mar Medical Research Institute (IMIM) of Barcelona, Autonomous University of Barcelona, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Spain
| | - Clara Monserrat
- Hospital del Mar Medical Research Institute (IMIM) of Barcelona, Autonomous University of Barcelona, Spain
| | - Angel Cabezas
- Hospital del Mar Medical Research Institute (IMIM) of Barcelona, Autonomous University of Barcelona, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Spain
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata of Reus, Medical Research Institute Pere Virgili (IISPV), and Rovira i Virgili University of Tarragona, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Spain
| | - Vanessa Sanchez-Gistau
- Hospital Universitari Institut Pere Mata of Reus, Medical Research Institute Pere Virgili (IISPV), and Rovira i Virgili University of Tarragona, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Spain.
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Abstract
Mixed affective states occur in approximately 40% of patients with mood disorders and are burdened with a significant rate of comorbidities, including addictive disorders (AD). The co-occurrence of mixed features and AD represents a challenge for clinicians because the reciprocal, negative influence of these conditions leads to a worse course of illness, treatment resistance, unfavorable outcome, and higher suicide risk. This article discusses clinical presentation, possible common pathogenetic pathways, and treatment options. Further investigations are required to clarify the determinants and the implications of this co-occurrence, and to detect suitable approaches in clinical management.
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Flores-García L, Lensing MB, Bjerke TN, Kvalnes M, Eisemann M. Positive and negative aspects of substance use and treatment goals among substance use disorder patients with and without attention deficit hyperactivity disorder: A qualitative study. COGENT PSYCHOLOGY 2019. [DOI: 10.1080/23311908.2019.1682765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Lizbett Flores-García
- Division of Mental Health and Substance Abuse, unit ReStart, University Hospital of Northern Norway, NO. Postboks 6124, 9291, Tromsø, Norway
- Department of Psychology, The Arctic University of Norway, NO. N-9037, Tromsø, Norway
| | - Michael B. Lensing
- Division of Paediatric and Adolescent Medicine, NevSom- Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias, Oslo University Hospital, NO. Postboks 4956 Nydalen, Oslo 0424, Norway
| | - Trond N. Bjerke
- Department of Development, Research and Education. University Hospital of Northern Norway, NO. Postboks 6124, Tromsø 9291, Norway
| | - Martin Kvalnes
- Division of Mental Health and Substance Abuse, unit ReStart, University Hospital of Northern Norway, NO. Postboks 6124, 9291, Tromsø, Norway
| | - Martin Eisemann
- Department of Psychology, The Arctic University of Norway, NO. N-9037, Tromsø, Norway
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Milano G, Vergani HM, Cattedra S, Carrozzino R, Mattioli F, Robbiano L, Martelli A. Co-Occurring Psychiatric and Substance Use Disorders: Clinical Survey Among a Rural Cohort of Italian Patients. Neuropsychiatr Dis Treat 2019; 15:3453-3459. [PMID: 31908460 PMCID: PMC6927221 DOI: 10.2147/ndt.s222567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/23/2019] [Indexed: 01/15/2023] Open
Abstract
PURPOSE Dual diagnosis (DD) is the co-occurrence of both a mental illness and a substance use disorder (SUD). Lots of studies have analysed the integrated clinical approach, which involves both psychiatry and toxicology medical experts. The purpose of this study is to analyse the socio-demographic characteristics and treatment strategies of patients with DD in a rural area of Italy. PATIENTS AND METHODS Clinical data of 750 patients were collected in 2016 through the analysis of health plan records. RESULTS The rate of co-occurring disorders is highly variable among people with SUD. In the considered area, patients with DD are 24%, of these only 46.1% have been treated with an integrated clinical program. Moreover, this percentage is further reduced (35.8%) if only patients with heroin use disorder are considered. CONCLUSION A comprehensive revision of DD treatment is needed, especially for people suffering from heroin use disorder and living in remote areas. Meticulous data analysis from other addiction health services of rural areas could be necessary to identify a science-based clinical intervention.
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Affiliation(s)
- Giulia Milano
- Department of Internal Medicine, Clinical Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy
| | - Hayley M Vergani
- Department of Internal Medicine, Clinical Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy
| | - Simone Cattedra
- Department of Internal Medicine, Clinical Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy
| | | | - Francesca Mattioli
- Department of Internal Medicine, Clinical Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy
| | - Luigi Robbiano
- Department of Internal Medicine, Clinical Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy
| | - Antonietta Martelli
- Department of Internal Medicine, Clinical Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy
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Guimarães FJ, Mariano MR, Pagliuca LMF. Psychoactive Substance Use and Disabled People: An Integrative Review. Health (London) 2016. [DOI: 10.4236/health.2016.814142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Borçoi AR, Patti CL, Zanin KA, Hollais AW, Santos-Baldaia R, Ceccon LMB, Berro LF, Wuo-Silva R, Grapiglia SB, Ribeiro LTC, Lopes-Silva LB, Frussa-Filho R. Effects of prenatal immune activation on amphetamine-induced addictive behaviors: Contributions from animal models. Prog Neuropsychopharmacol Biol Psychiatry 2015; 63:63-9. [PMID: 26051209 DOI: 10.1016/j.pnpbp.2015.05.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 05/30/2015] [Accepted: 05/31/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Prenatal environmental adversities may affect brain development and are associated with increased risk for schizophrenia, an illness with 50% comorbidity with addiction. Maternal immune activation by poly-inosinic-citidilic acid (Poly(I:C)) exposure can promote behavioral alterations consistent with schizophrenia symptoms in rodents. OBJECTIVES Considering the vulnerability to addiction in patients with schizophrenia, we evaluated the interactions between prenatal Poly(I:C) administration and addiction in two animal models (behavioral sensitization and conditioned place preference - CPP) in mice repeatedly treated with amphetamine (AMP). Additionally, stereotyped behavior and cross-sensitization with cocaine (COC) were also investigated. METHODS Swiss male mice offspring were submitted to prenatal administration of 5mg/kg Poly(I:C) in the 9(th) day of pregnancy. At the age of 90days, mice were treated with 2.5mg/kg AMP for 9days to evaluate behavioral sensitization or stereotyped behavior. Cross-sensitization with 10mg/kg COC was evaluated 24h after the last treatment day. For AMP-induced CPP evaluation, mice were treated during 8 consecutive days. RESULTS Prenatal Poly(I:C) administration potentiated both AMP-induced behavioral sensitization and CPP. Furthermore, Poly(I:C) increased cross-sensitization with COC. CONCLUSIONS Prenatal administration of Poly(I:C) is able to potentiate vulnerability to addiction in two animal models, without however modulating stereotyped behavior.
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Affiliation(s)
- Aline R Borçoi
- Departamento de Farmacologia, Universidade Federal de São Paulo, R. Botucatu, 862, Ed. Leal Prado, 1° andar, 04023062 São Paulo, SP, Brazil
| | - Camilla L Patti
- Departamento de Farmacologia, Universidade Federal de São Paulo, R. Botucatu, 862, Ed. Leal Prado, 1° andar, 04023062 São Paulo, SP, Brazil.
| | - Karina A Zanin
- Departamento de Farmacologia, Universidade Federal de São Paulo, R. Botucatu, 862, Ed. Leal Prado, 1° andar, 04023062 São Paulo, SP, Brazil; Departamento de Psicobiologia, Universidade Federal de São Paulo, R. Napoleão de Barros, 925, 04021002 São Paulo, SP, Brazil
| | - André W Hollais
- Departamento de Farmacologia, Universidade Federal de São Paulo, R. Botucatu, 862, Ed. Leal Prado, 1° andar, 04023062 São Paulo, SP, Brazil
| | - Renan Santos-Baldaia
- Departamento de Farmacologia, Universidade Federal de São Paulo, R. Botucatu, 862, Ed. Leal Prado, 1° andar, 04023062 São Paulo, SP, Brazil
| | - Liliane M B Ceccon
- Departamento de Farmacologia, Universidade Federal de São Paulo, R. Botucatu, 862, Ed. Leal Prado, 1° andar, 04023062 São Paulo, SP, Brazil
| | - Laís F Berro
- Departamento de Farmacologia, Universidade Federal de São Paulo, R. Botucatu, 862, Ed. Leal Prado, 1° andar, 04023062 São Paulo, SP, Brazil; Departamento de Psicobiologia, Universidade Federal de São Paulo, R. Napoleão de Barros, 925, 04021002 São Paulo, SP, Brazil
| | - Raphael Wuo-Silva
- Departamento de Farmacologia, Universidade Federal de São Paulo, R. Botucatu, 862, Ed. Leal Prado, 1° andar, 04023062 São Paulo, SP, Brazil
| | - Stephanie B Grapiglia
- Departamento de Farmacologia, Universidade Federal de São Paulo, R. Botucatu, 862, Ed. Leal Prado, 1° andar, 04023062 São Paulo, SP, Brazil
| | - Luciana T C Ribeiro
- Departamento de Farmacologia, Universidade Federal de São Paulo, R. Botucatu, 862, Ed. Leal Prado, 1° andar, 04023062 São Paulo, SP, Brazil
| | - Leonardo B Lopes-Silva
- Departamento de Farmacologia, Universidade Federal de São Paulo, R. Botucatu, 862, Ed. Leal Prado, 1° andar, 04023062 São Paulo, SP, Brazil; Departamento de Psicobiologia, Universidade Federal de São Paulo, R. Napoleão de Barros, 925, 04021002 São Paulo, SP, Brazil
| | - Roberto Frussa-Filho
- Departamento de Farmacologia, Universidade Federal de São Paulo, R. Botucatu, 862, Ed. Leal Prado, 1° andar, 04023062 São Paulo, SP, Brazil
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Stahlman S, Javanbakht M, Cochran S, Hamilton AB, Shoptaw S, Gorbach PM. Mental Health and Substance Use Factors Associated With Unwanted Sexual Contact Among U.S. Active Duty Service Women. J Trauma Stress 2015; 28:167-73. [PMID: 25976935 PMCID: PMC4522288 DOI: 10.1002/jts.22009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Many U.S. military women are exposed to unwanted sexual contact during military service, which can have important implications for mental health. Using data from the 2008 Department of Defense Survey of Health Related Behaviors, we employed multiple logistic regression methods to examine whether unwanted sexual contact was associated with stress, screening positive for mental disorders, or substance use, among active duty service women. The sample included 7,415 female military personnel, of whom 13.4% reported unwanted sexual contact (including any touching of genitals) since entering the military. After adjusting for potentially confounding variables, factors independently associated with unwanted sexual contact included military-related stress (adjusted odds ratio [AOR] = 2.44), family/personal life-related stress (AOR = 1.78), and gender-related stress (AOR = 1.98) in the past 12 months. In addition, screening positive for depression, anxiety, posttraumatic stress disorder, or psychological distress, and suicidal ideation or attempt were associated with unwanted sexual contact (AOR = 1.57-2.11). For drug/alcohol use, only misuse of tranquilizers/muscle relaxers (past 12 months) was associated with report of unwanted sexual contact (AOR = 1.35). Given the prevalence of unwanted sexual contact and corresponding adverse health outcomes in this sample of active duty women, strategies to create military structural/cultural changes and reduce gender-related stress and sexism are needed.
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Affiliation(s)
- Shauna Stahlman
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles; Los Angeles, California, USA
| | - Marjan Javanbakht
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles; Los Angeles, California, USA
| | - Susan Cochran
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles; Los Angeles, California, USA
| | - Alison B. Hamilton
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles; Los Angeles California, USA,VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Steven Shoptaw
- Department of Family Medicine, University of California, Los Angeles; Los Angeles California, USA
| | - Pamina M. Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles; Los Angeles, California, USA
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Engagement in assertive community treatment as experienced by recovering clients with severe mental illness and concurrent substance use. Int J Ment Health Syst 2014; 8:40. [PMID: 25389446 PMCID: PMC4226907 DOI: 10.1186/1752-4458-8-40] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 10/12/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clients with severe mental illness (SMI) who use substances are less engaged in treatment than those who do not use substances, and assertive community treatment (ACT) engages and retains clients with SMI and concurrent substance use at a higher rate compared with traditional treatment. This qualitative study aimed to explore the experiences of being recruited to, and remaining in, ACT among recovering clients diagnosed with SMI and concurrent substance use. METHODS Twenty semi-structured interviews were undertaken among 11 clients with SMI and concurrent substance use who were included in ACT teams. The inclusion criteria were SMI and concurrent substance use and improvement after a minimum of 12 months in treatment regarding one or several of the following parameters: quality of life, general functioning and substance use. Systematic text condensation was applied in the analyses. RESULTS The experiences of building trust through enduring involvement and receiving benefits were most important for the acceptance of ACT by clients. A feeling of exclusiveness, perceiving ACT as a safety net and the clients' own personal responsibility for taking part in the treatment were stated as the most important factors for remaining in treatment. CONCLUSIONS The implications of the results of the present study are that service providers have to prove that they can be trusted in the initial phase of the clients' contact with the team. The feeling by clients with SMI and concurrent substance use that service providers in ACT believe they can improve their client's quality of life, is of importance for feeling exclusive, having hope for the future and remaining in treatment.
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Pettorruso M, De Risio L, Di Nicola M, Martinotti G, Conte G, Janiri L. Allostasis as a conceptual framework linking bipolar disorder and addiction. Front Psychiatry 2014; 5:173. [PMID: 25520673 PMCID: PMC4253530 DOI: 10.3389/fpsyt.2014.00173] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 11/16/2014] [Indexed: 12/28/2022] Open
Abstract
Bipolar disorders (BDs) and addictions constitute reciprocal risk factors and are best considered under a unitary perspective. The concepts of allostasis and allostatic load (AL) may contribute to the understanding of the complex relationships between BD and addictive behaviors. Allostasis entails the safeguarding of reward function stability by recruitment of changes in the reward and stress system neurocircuitry and it may help to elucidate neurobiological underpinnings of vulnerability to addiction in BD patients. Conceptualizing BD as an illness involving the cumulative build-up of allostatic states, we hypothesize a progressive dysregulation of reward circuits clinically expressed as negative affective states (i.e., anhedonia). Such negative affective states may render BD patients more vulnerable to drug addiction, fostering a very rapid transition from occasional drug use to addiction, through mechanisms of negative reinforcement. The resulting addictive behavior-related ALs, in turn, may contribute to illness progression. This framework could have a heuristic value to enhance research on pathophysiology and treatment of BD and addiction comorbidity.
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Affiliation(s)
- Mauro Pettorruso
- Department of Neuroscience, Institute of Psychiatry and Clinical Psychology, Catholic University of Sacred Heart , Rome , Italy
| | - Luisa De Risio
- Department of Neuroscience, Institute of Psychiatry and Clinical Psychology, Catholic University of Sacred Heart , Rome , Italy
| | - Marco Di Nicola
- Department of Neuroscience, Institute of Psychiatry and Clinical Psychology, Catholic University of Sacred Heart , Rome , Italy
| | - Giovanni Martinotti
- Department of Neuroscience and Imaging, Institute of Psychiatry, "G. d'Annunzio" University of Chieti-Pescara , Chieti , Italy
| | - Gianluigi Conte
- Department of Neuroscience, Institute of Psychiatry and Clinical Psychology, Catholic University of Sacred Heart , Rome , Italy
| | - Luigi Janiri
- Department of Neuroscience, Institute of Psychiatry and Clinical Psychology, Catholic University of Sacred Heart , Rome , Italy
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