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Venkatesh U, Aparnavi P, Mogan K, Durga R, Pearson J, Kishore S, Joshi HS, Nair NS, Nisha B, Agrawal R, Vidusha K, Chenkual CV, Nath B, Epari VR, Kumari R, Goyal P, Ahamed F, Baruah M, Anil R, Swami AA, Kamble BD, Sharma GA, Sharma A, Bera OP, Grover A, Verma SK. Determinants of substance use among young people attending primary health centers in India. Glob Ment Health (Camb) 2024; 11:e23. [PMID: 38572250 PMCID: PMC10988150 DOI: 10.1017/gmh.2024.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/14/2023] [Accepted: 01/24/2024] [Indexed: 04/05/2024] Open
Abstract
Background Substance use is a complex condition with multidimensional determinants. The present study aims to find the prevalence and determinants of substance use among young people attending primary healthcare centers in India. Methods A multicentric cross-sectional study was conducted across 15 states in India on 1,630 young people (10-24 years) attending primary health centers. The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was used to capture data on substance use. The degree of substance involvement was assessed and multivariate regression analysis was conducted to determine the risk factors of substance use. Results The prevalence of substance use was 32.8%, with a median substance initiation age of 18 years. Among the substance users, 75.5% began before completing adolescence. Tobacco (26.4%), alcohol (26.1%) and cannabis (9.5%) were commonly consumed. Sociodemographic determinants included higher age, male gender, urban residence, positive family history, northeastern state residence and lower socioeconomic class. Over 80% of users had moderate or high involvement. Conclusions High substance use prevalence among young people in Indian healthcare centers underscores the urgency of targeted intervention. Insights on determinants guide effective prevention strategies for this complex public health issue.
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Affiliation(s)
- U. Venkatesh
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | - P. Aparnavi
- Kovai Medical Center and Hospital Institute of Health Sciences and Research, Coimbatore, India
| | - K.A. Mogan
- South Asia Field Epidemiology and Technology Network, Inc., Metro Manila, Philippines
| | - R. Durga
- Department of Dentistry, All India Institute of Medical Sciences, Gorakhpur, India
| | | | - Surekha Kishore
- All India Institute of Medical Sciences (AIIMS), Gorakhpur, India
| | - Hari Shanker Joshi
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | | | - B. Nisha
- Saveetha Medical College and Hospital, Kuthambakkam, India
| | | | | | | | - Bhola Nath
- All India Institute of Medical Sciences, Raebareli, India
| | | | | | - Pooja Goyal
- Employment State Insurance Corporation Medical College and Hospital, Faridabad, India
| | - Farhad Ahamed
- All India Institute of Medical Sciences, Kalyani, India
| | | | - R. Anil
- PES Institute of Medical Sciences and Research, Beggilipalle, India
| | | | | | | | - Akash Sharma
- Department of Medicine, University at Buffalo – Catholic Health System, Buffalo, NY, USA
| | | | - Ashoo Grover
- Indian Council of Medical Research, New Delhi, India
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Effect of Testosterone on the Extinction Period of Morphine-induced CPP in Male Rats. ARCHIVES OF NEUROSCIENCE 2022. [DOI: 10.5812/ans-127059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Sex-related differences in the incidence, prevalence, symptoms, and side effects of drug use, especially narcotics, have been previously shown in animal models and human studies. Objectives: In the presents study, the effects of different doses of testosterone on morphine extinction period were investigated in a rat model. Methods: Forty mature male Wistar rats were randomly allocated to four categories (10 in each group), including control (received intramuscular injection of vehicle) and testosterone (received intramuscular injection of testosterone at 1, 2.5 and 5 mg/kg) during the extinction period. Conditioned place preference (CPP) test was done to assess the psychological phenomena of drug craving and relapse. The CPP score was calculated in four stages, including the baseline (preconditioning), expression (postconditioning), extinction, and reinstatement. Results: Our results demonstrated that testosterone (1, 2.5 and 5 mg/kg) significantly extended morphine extinction duration compared to the control group. Conclution: It has been shown that dopamine neurotransmission in mesocorticolimbic system is affected by testosterone through androgen receptors in adolescence and alteration in testosterone level could affect drug use vulnerability. It seems that normalization of testosterone levels reduces the symptoms of opioid withdrawal syndrome and have important clinical implication for clinicians to understand the effects of testosterone dysregulation on the extinction and withdrawal periods.
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Yüksel BC, Mortan Sevi O. Substance use-related factors and psychosocial characteristics among Turkish adults with early- and late-onset substance use disorder. J Ethn Subst Abuse 2022; 23:128-149. [PMID: 35678296 DOI: 10.1080/15332640.2022.2075514] [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: 10/18/2022]
Abstract
The onset of substance use is a strong predictor of substance use disorders and related problems. This study examined the differences between early- and late-onset substance use in personality and substance use characteristics, traumatic experiences, and social support with a sample of 100 Turkish adults with substance use disorders. Early onset (<18 years) was associated with more traumatic experiences, increased risk of developing posttraumatic stress disorder (PTSD), and higher levels of depressive symptoms compared to late onset (≥18 years). Also, depressive symptoms, living, and working status were predictors of substance use onset. The study addresses the groups at risk of initiating substance use.
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Erci B. Effectiveness of gender and drug avoidance self-efficacy on beliefs and attitudes substance use in adolescence. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1953166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Behice Erci
- Nursing Faculty, İnönü University, Malatya, Turkey
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Erdoğan A, Yalnız Dilcen H, Cinemre B, Kulaksızoğlu B, İnan D, Kuloğlu MM. Sociodemographic and clinical characteristics of patients admitted to an addiction center. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1941352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Ali Erdoğan
- Department of Psychiatry, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Hacer Yalnız Dilcen
- Department of Midwifery, Bartin University Faculty of Health Sciences, Bartın, Turkey
| | - Buket Cinemre
- Department of Psychiatry, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Burak Kulaksızoğlu
- Department of Psychiatry, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Dilara İnan
- Department of Infectious Diseases and Clinical Microbiology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Mehmet Murat Kuloğlu
- Department of Psychiatry, Akdeniz University Faculty of Medicine, Antalya, Turkey
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Sönmez Güngör E, Tunca D, Çelebi C, Gündüz A, Karaer G, Kandemir G, Akvardar Y. Descriptive norms influence alcohol use among high-school students: a social norms study from Istanbul. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1900429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Ekin Sönmez Güngör
- Department of Psychiatry, Erenköy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul, Turkey
| | - Dilay Tunca
- Department of Psychiatry, Bilecik State Hospital, Bilecik, Turkey
| | - Cengiz Çelebi
- Department of Psychiatry, Büyükçekmece Mimar Sinan State Hospital, Istanbul, Turkey
| | - Anıl Gündüz
- Department of Clinical Psychology, Istanbul Kent University, Istanbul, Turkey
| | - Gülhan Karaer
- Department of Psychiatry, Dr Lütfi Kırdar Kartal Training and Research Hospital, Istanbul, Turkey
| | - Güler Kandemir
- Department of Psychiatry, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Yıldız Akvardar
- Department of Psychiatry, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
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Mogan KA, Venkatesh U, Kapoor R, Kumar M. Determinants of substance use among young people attending an urban primary health center in Delhi. Int J Adolesc Med Health 2020; 34:/j/ijamh.ahead-of-print/ijamh-2019-0243/ijamh-2019-0243.xml. [PMID: 32474456 DOI: 10.1515/ijamh-2019-0243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 01/05/2020] [Indexed: 11/15/2022]
Abstract
Introduction Substance abuse remains one of the major challenges in young people, as it is one of the top five causes of disability-adjusted life years (DALY). The present study aims to find the prevalence and determinants of substance use among young people attending an urban primary health center in Delhi. Methodology Systematic random sampling was used to enroll the calculated sample size of 190. Substance use was assessed using ASSIST (an Alcohol Smoking Substance Involvement Screening Tool) and brief intervention was given based on the standard guidelines of ASSIST. The total score among the substance users is calculated and divided into Grades 1, 2 or 3. Log binomial regression was performed to quantify the association between substance use and covariates such as age, sex, education, occupation, family history of substance use, socio-economic status and family type. The association was expressed in odds ratio (OR) with 95 percent confidence interval (CI). Result The mean age of study participants was 18.6 ± 4.1, ranges from 10 to 24 years. Out of 48 substance users, 43.7% were consuming only tobacco, 22.9% were consuming only alcohol and 33.3% were polysubstance users. The history of substance use among family members of participants was found to be 46.3%. Median substance involvement score of tobacco, alcohol and cannabis users was 19 (IQR: 14.5-22), 19 (IQR: 13.5-25) and 22.5 (IQR: 22-23), respectively. Among tobacco users, 2.7% were Grade 1 and 7.2% were Grade 2. Four (16%), 20 (80%) and one (4%) of alcohol users were Grades 1, 2 and 3, respectively. Among the cannabis users, four (100%) were in the Grade 2 category. The median age of initiation of substance use among users was 16 (range 13-21) years. The analysis shows substance use was almost 25 times (adjusted OR = 25.84, 95% CI 5.65-118.09) more common among males and it increase by 2.5 times with a decrease in socio-economic status (adjusted OR = 2.52, 95% CI 1.27-5.02) and the result is significant. The substance use was almost 7 times higher when there is a family history of substance usage (adjusted OR = 7.40, 95% CI 2.15-25.4). Residential and marital status were not significantly associated with substance use. Conclusion Male sex, lower socio-economic status, participants currently not going to school/college, family history of substance use were found to be significant predictors of substance use among the study participants.
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Affiliation(s)
- K A Mogan
- Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - U Venkatesh
- Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Richa Kapoor
- Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Mukesh Kumar
- Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Sui X, Massar K, Kessels LTE, Reddy PS, Ruiter RAC, Sanders-Phillips K. Exposure to violence across multiple contexts and health risk behaviours in South African adolescents: the moderating role of emotion dysregulation. Psychol Health 2019; 35:144-162. [PMID: 31273997 DOI: 10.1080/08870446.2019.1637521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: The association between violence exposure and health risk behaviours in South African adolescents, and the moderating role of emotion dysregulation were investigated. Design: A multi-ethnic sample of adolescents (N = 925: boy: 47.3%, girl: 52.7%, M age = 16 years, SD = 1.54) completed a survey. Main outcome measures: Violence exposure across different contexts (home-, school-, community-, political victimisation), emotion dysregulation (inability to regulate sadness and anger) and a composite measure of health risk behaviours (smoking, substance use, risky sexual behaviour) were examined. Results: Boys reported more risk behaviours than girls, t (844) = 5.25, p < 0.001. Direct community victimisation was a predictor for boys' risk behaviours, B = 0.22, p < 0.001. Indirect school victimisation and direct community victimisation were predictors for girls' risk behaviours, B's = 0.19, p's < 0.01. Girls reported higher emotion dysregulation than boys, t (748) = -2.95, p < 0.01. Only for girls, emotion dysregulation moderated the associations of indirect home victimisation, B = 16, p < 0.01, and direct community victimisation, B = 15, p < 0.05, with risk behaviours. Conclusion: Interventions may target emotion regulation skills, particularly for girls, to enhance resilience to the negative effects of violence on behaviours.
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Affiliation(s)
- Xincheng Sui
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Karlijn Massar
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Loes T E Kessels
- Education office, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Priscilla S Reddy
- Population Health, Health Systems and Innovations, Human Sciences Research Council, Cape Town, South Africa
| | - Robert A C Ruiter
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
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Chaves JJF, Khenti A. KNOWLEDGE OF THE CONSEQUENCES AND USE OF DRUGS FOR COSTA RICA UNIVERSITY STUDENTS. TEXTO & CONTEXTO ENFERMAGEM 2019. [DOI: 10.1590/1980-265x-tce-cicad-4-16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to determine the relationship between knowledge of consequences and drug use in undergraduate students of a university in San José, Costa Rica. Method: the cross-sectional study examines the demographic profile of the sample and the relationship between knowledge of consequences, drug use and academic performance. The study focuses on three types of drugs: alcohol, marijuana and cocaine. Three variables will be analyzed: demographic data, knowledge of consequences and use of drugs. Results: the relationship between knowledge of consequences and use of drugs was made using of the T-test. The sample had 272 students, 28.2% (n=77) of them were men and 71.4% were women (n=195). They were selected from the areas of social sciences (n=137, 50.2%), and from the area of health sciences (n=136; 49.8%). Alcohol was the most used drug (n=217, 79.8%), followed by marijuana (n=72, 26.6%) and finally cocaine (n=3, 1.1%) in the last 12 months. Conclusion: the results shown indicate that there is no significant relationship between such variables. The findings are important at the level of drug policies to support the development of new preventive strategies for drug use.
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Affiliation(s)
| | - Akwatu Khenti
- University of Toronto, Canada; Centre for Addiction and Mental Health, Canada
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Breet E, Goldstone D, Bantjes J. Substance use and suicidal ideation and behaviour in low- and middle-income countries: a systematic review. BMC Public Health 2018; 18:549. [PMID: 29699529 PMCID: PMC5921303 DOI: 10.1186/s12889-018-5425-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 04/10/2018] [Indexed: 12/15/2022] Open
Abstract
Background Understanding relationships between substance use and suicidal ideation and behaviour (SIB) has important public health implications for suicide prevention in low- and middle-income countries (LMICs), where 75% of suicides occur. This systematic review explored the associations between substance use and SIB in LMICs. Methods We searched five databases using a combination of keywords for substance use, SIB and LMICs to identify English-written quantitative studies published between January 2006 and February 2016. Data were extracted to provide an overview of what is known about the topic, highlight gaps in the literature, and explore the implications of current knowledge for suicide prevention. Studies included in the review were assessed for methodological quality using the Scottish Intercollegiate Guidelines Network checklist. Results Analysis of included studies (N = 108) demonstrated a consistent positive association between substance use and SIB across all substances (i.e. alcohol, tobacco, cannabis, illicit drugs, non-medical use of prescription drugs), all substance use dimensions (i.e. intoxication, use, and pathological use) and all SIB dimensions (i.e. suicidal ideation, non-fatal suicidal behaviour, and suicide). Most of the available research evidence comes from upper-middle-income countries, only 22% comes from lower-middle-income and low-income countries. Most studies focused on alcohol and tobacco, while neglecting substances such as cannabis, opioids, sedatives, stimulants, misuse of prescription medication, inhalants, and hallucinogens. Most of the studies employed a cross-sectional design, were conducted within a risk-factor paradigm, and provided little information about the potential interaction between variables. Conclusions Public health suicide prevention policy and research in LMICs should take account of the fact that: substance use is a potentially modifiable risk factor; assessment and management of substance use is integral to the care of at-risk patients; reducing consumption and hazardous use of substances in LMICs is important for suicide prevention; and research needs to be expanded to include more theory driven research that focuses on all substance use dimensions and SIB dimensions, while employing more sophisticated statistical methods. Electronic supplementary material The online version of this article (10.1186/s12889-018-5425-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elsie Breet
- Department of Psychology, Stellenbosch University, Private Bag X1 Matieland, Stellenbosch, 7602, South Africa.
| | - Daniel Goldstone
- Department of Psychology, Stellenbosch University, Private Bag X1 Matieland, Stellenbosch, 7602, South Africa
| | - Jason Bantjes
- Department of Psychology, Stellenbosch University, Private Bag X1 Matieland, Stellenbosch, 7602, South Africa
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Evaluation of Risk Factors Affecting Substance Use among Tenth-Grade Students. BIOMED RESEARCH INTERNATIONAL 2018; 2018:1407649. [PMID: 29736390 PMCID: PMC5874976 DOI: 10.1155/2018/1407649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 01/02/2018] [Indexed: 11/21/2022]
Abstract
Aim The aim of this study is to detect the prevalence of substance use among tenth-grade students; their thoughts, attitudes, behaviors, and tendencies towards substance use; and risk factors of substance use in tenth-grade students in general. Methods This study is descriptive and cross-sectional conducted between April and May 2016. Research population consists of tenth-grade students in 2015-2016 school year in the city of Ordu. Since the study involved all tenth-grade students, no sampling was done. Questions on substance use were prepared by Ordu Public Health Directorate and the authors by making use of European School Survey Project on Alcohol and Other Drugs (ESPAD) study questions, AMATEM's “Drugs and Addiction Youth Survey” study conducted on May 1996, and scientific studies conducted previously on similar subjects. Results 9825 tenth-grade students in 88 schools from 19 counties in the city of Ordu were included in the study. 8714 of the students participated in the survey. Being male, being over the age of 15, mother and father being separated, living with relatives, being in low income, negative feelings about school, perception of being unsuccessful in school, failing a year, absenteeism, and not being content with life are the risk factors for substance use. Conclusions The tendency of illegal substance use becoming more and more prevalent especially among youth requires the development of new treatment strategies.
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Lise Öğrencileri Arasında Sigara, Alkol Kullanım Sıklığı Ve Etkileyen Faktörler. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2017. [DOI: 10.21673/anadoluklin.245632] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Tanidir C, Ciftci AD, Doksat NG, Gunes H, Toz HI, Erdogan A. Trends and Gender Differences in Substance Use Among Children and Adolescents Admitted to an Addiction Treatment Center in Turkey: Years 2011–2013. ACTA ACUST UNITED AC 2016. [DOI: 10.5455/bcp.20150210030606] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Canan Tanidir
- Department of Child and Adolescent Psychiatry, Bakirkoy State and Research Hospital for Mental Health and Neurologic Disorders, Istanbul-Turkey
| | - Arzu Demirci Ciftci
- Department of Psychiatry, Bakirkoy State and Research Hospital for Mental Health and Neurologic Disorders, Istanbul-Turkey
| | | | - Hatice Gunes
- Department of Child and Adolescent Psychiatry, Bakirkoy State and Research Hospital for Mental Health and Neurologic Disorders, Istanbul-Turkey
| | - Hamiyet Ipek Toz
- Department of Child and Adolescent Psychiatry, Bakirkoy State and Research Hospital for Mental Health and Neurologic Disorders, Istanbul-Turkey
| | - Ayten Erdogan
- Department of Child and Adolescent Psychiatry, Bakirkoy State and Research Hospital for Mental Health and Neurologic Disorders, Istanbul-Turkey
- Duzce University, Medical Faculty, Department of Child and Adolescent Psychiatry, Duzce-Turkey
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Çiftçi Demirci A, Erdoğan A, Yalçın Ö, Yıldızhan E, Koyuncu Z, Eseroğlu T, Önder A, Evren C. Sociodemographic characteristics and drug abuse patterns of adolescents admitted for substance use disorder treatment in Istanbul. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2014; 41:212-9. [DOI: 10.3109/00952990.2014.973961] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
| | - Ayten Erdoğan
- Department of Child and Adolescent Psychiatry, Bakirköy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul,
- Child and Adolescent Psychiatry, Düzce University, Düzce, and
| | - Özhan Yalçın
- Department of Child and Adolescent Psychiatry, Bakirköy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul,
| | - Eren Yıldızhan
- Department of Psychiatry, Niksar State Hospital, Tokat, Turkey
| | - Zehra Koyuncu
- Department of Child and Adolescent Psychiatry, Bakirköy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul,
| | - Tuğba Eseroğlu
- Department of Child and Adolescent Psychiatry, Bakirköy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul,
| | - Arif Önder
- Department of Child and Adolescent Psychiatry, Bakirköy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul,
| | - Cuneyt Evren
- Alcohol and Drug Research, Treatment and Training Center,
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