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West R, Cox S, Notley CJ, Du Plessis G, Hastings J. Achieving consensus, coherence, clarity and consistency when talking about addiction. Addiction 2024; 119:796-798. [PMID: 37985001 DOI: 10.1111/add.16393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023]
Affiliation(s)
- Robert West
- Department of Behavioural Science and Health, University College London, London, UK
| | - Sharon Cox
- Department of Behavioural Science and Health, University College London, London, UK
| | | | - Guy Du Plessis
- I-System Institute for Transdisciplinary Studies, Utah State University, Logan, Utah, USA
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Cao Z, McCabe M, Callas P, Cupertino RB, Ottino-González J, Murphy A, Pancholi D, Schwab N, Catherine O, Hutchison K, Cousijn J, Dagher A, Foxe JJ, Goudriaan AE, Hester R, Li CSR, Thompson WK, Morales AM, London ED, Lorenzetti V, Luijten M, Martin-Santos R, Momenan R, Paulus MP, Schmaal L, Sinha R, Solowij N, Stein DJ, Stein EA, Uhlmann A, van Holst RJ, Veltman DJ, Wiers RW, Yücel M, Zhang S, Conrod P, Mackey S, Garavan H. Recalibrating single-study effect sizes using hierarchical Bayesian models. Front Neuroimaging 2023; 2:1138193. [PMID: 38179200 PMCID: PMC10764546 DOI: 10.3389/fnimg.2023.1138193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024]
Abstract
Introduction There are growing concerns about commonly inflated effect sizes in small neuroimaging studies, yet no study has addressed recalibrating effect size estimates for small samples. To tackle this issue, we propose a hierarchical Bayesian model to adjust the magnitude of single-study effect sizes while incorporating a tailored estimation of sampling variance. Methods We estimated the effect sizes of case-control differences on brain structural features between individuals who were dependent on alcohol, nicotine, cocaine, methamphetamine, or cannabis and non-dependent participants for 21 individual studies (Total cases: 903; Total controls: 996). Then, the study-specific effect sizes were modeled using a hierarchical Bayesian approach in which the parameters of the study-specific effect size distributions were sampled from a higher-order overarching distribution. The posterior distribution of the overarching and study-specific parameters was approximated using the Gibbs sampling method. Results The results showed shrinkage of the posterior distribution of the study-specific estimates toward the overarching estimates given the original effect sizes observed in individual studies. Differences between the original effect sizes (i.e., Cohen's d) and the point estimate of the posterior distribution ranged from 0 to 0.97. The magnitude of adjustment was negatively correlated with the sample size (r = -0.27, p < 0.001) and positively correlated with empirically estimated sampling variance (r = 0.40, p < 0.001), suggesting studies with smaller samples and larger sampling variance tended to have greater adjustments. Discussion Our findings demonstrate the utility of the hierarchical Bayesian model in recalibrating single-study effect sizes using information from similar studies. This suggests that Bayesian utilization of existing knowledge can be an effective alternative approach to improve the effect size estimation in individual studies, particularly for those with smaller samples.
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Affiliation(s)
- Zhipeng Cao
- Shanghai Xuhui Mental Health Center, Shanghai, China
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, United States
| | - Matthew McCabe
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, United States
| | - Peter Callas
- Department of Mathematics and Statistics, University of Vermont College of Engineering and Mathematical Sciences, Burlington, VT, United States
| | - Renata B. Cupertino
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, United States
| | - Jonatan Ottino-González
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, United States
| | - Alistair Murphy
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, United States
| | - Devarshi Pancholi
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, United States
| | - Nathan Schwab
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, United States
| | - Orr Catherine
- Department of Psychological Sciences, School of Health Sciences, Swinburne University, Melbourne, VIC, Australia
| | - Kent Hutchison
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Janna Cousijn
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Alain Dagher
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - John J. Foxe
- Department of Neuroscience, The Ernest J. Del Monte Institute for Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Anna E. Goudriaan
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Robert Hester
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Chiang-Shan R. Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | | | - Angelica M. Morales
- Department of Psychiatry at Oregon Health and Science University, Portland, OR, United States
| | - Edythe D. London
- David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, United States
| | - Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural & Health Sciences, Faculty of Health Sciences, Australian Catholic University, Australia
| | - Maartje Luijten
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Rocio Martin-Santos
- Department of Psychiatry and Psychology, University of Barcelona, Barcelona, Spain
| | - Reza Momenan
- Clinical NeuroImaging Research Core, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| | - Martin P. Paulus
- Laureate Institute for Brain Research, Tulsa, OK, United States
- VA San Diego Healthcare System and Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Lianne Schmaal
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Rajita Sinha
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Dan J. Stein
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Elliot A. Stein
- Neuroimaging Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, United States
| | - Anne Uhlmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Ruth J. van Holst
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Dick J. Veltman
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Reinout W. Wiers
- Addiction Development and Psychopathology (ADAPT)-Lab, Department of Psychology and Center for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging Facility, Monash University, Melbourne, VIC, Australia
| | - Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Patricia Conrod
- Department of Psychiatry, Université de Montreal, CHU Ste Justine Hospital, Montreal, QC, Canada
| | - Scott Mackey
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, United States
| | - Hugh Garavan
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, United States
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3
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Wang L, Volkow ND, Berger NA, Davis PB, Kaelber DC, Xu R. Cardiac and mortality outcome differences between methadone, buprenorphine and naltrexone prescriptions in patients with an opioid use disorder. J Clin Psychol 2023; 79:2869-2883. [PMID: 37584532 DOI: 10.1002/jclp.23582] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 07/01/2023] [Accepted: 08/08/2023] [Indexed: 08/17/2023]
Abstract
IMPORTANCE More than 109,000 Americans died of drug overdose in 2022, with 81,231 overdose deaths involving opioids. Methadone, buprenorphine and naltrexone are the most widely used medications for opioid use disorders (MOUD) and the most effective intervention for preventing overdose deaths. However, there is a concern that methadone results in long QT syndrome, which increases the risk for fatal cardiac arrythmias. Currently few studies have systematically evaluated both the short-term and long-term differences in cardiac and mortality outcomes between MOUD. OBJECTIVES To compare the risks of cardiac arrythmias, long QT syndrome and overall mortality between patients with opioid use disorders (OUD) who were prescribed methadone, buprenorphine or naltrexone. DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort study based on a multicenter and nationwide database of electronic health records (EHRs) in the United States. The study population was comprised of 144,141 patients who had medical encounters for OUD in 2016-2022, were prescribed MOUD within 1 month following a medical encounter for OUD diagnosis and had no diagnosis of cardiac arrythmias or long QT syndrome before any MOUD prescription. The study population was divided into three cohorts: (1) Methadone cohort (n = 40,938)-who were only prescribed methadone. (2) Buprenorphine cohort (n = 80,055)-who were only prescribed buprenorphine. (3) Naltrexone cohort (n = 5,738)-who were only prescribed naltrexone. EXPOSURES methadone, buprenorphine, or naltrexone. MAIN OUTCOMES AND MEASURES Cardiac arrythmias, long QT syndrome, and death. Hazard ratio (HR) and 95% confidence interval (CI) of outcomes at six different follow-up time frames (1-month, 3-month, 6-month, 1-year, 3-year, and 5-year) by comparing propensity-score matched cohorts using Kaplan-Meier survival analysis. RESULTS Patients with OUD who were prescribed methadone had significantly higher risks of cardiac arrhythmias, long QT syndrome and death compared with propensity-score matched patients with OUD who were prescribed buprenorphine or naltrexone. For the 1-month follow-up, the overall risk for cardiac arrythmias was 1.03% in the Methadone cohort, higher than the 0.87% in the matched Buprenorphine cohort (HR: 1.20, 95% CI: 1.04-1.39); The overall risk for long QT syndrome was 0.35% in the Methadone cohort, higher than the 0.15% in the matched Buprenorphine cohort (HR: 2.40, 95% CI: 1.75-3.28); The overall mortality was 0.59% in the Methadone cohort, higher than the 0.41% in the matched Buprenorphine cohort (HR: 1.48, 95% CI: 1.21-1.81). The increased risk persisted for 5 years: cardiac arrhythmias (HR: 1.31, 95% CI: 1.23-1.38), long QT syndrome (HR: 3.14, 95% CI: 2.76-3.58), death (HR: 1.50, 95% CI: 1.41-1.59). CONCLUSIONS AND RELEVANCE Methadone was associated with a significantly higher risk for cardiac and mortality outcomes than buprenorphine and naltrexone. These findings are relevant to the development of guidelines for medication selection when initiating MOUD treatment and inform future medication development for OUD that minimizes risks while maximizing benefits.
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Affiliation(s)
- Lindsey Wang
- Center for Science, Health, and Society, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Nora D Volkow
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, USA
| | - Nathan A Berger
- Center for Science, Health, and Society, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Pamela B Davis
- Center for Community Health Integration, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - David C Kaelber
- The Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland, Ohio, USA
| | - Rong Xu
- Center for Artificial Intelligence in Drug Discovery, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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Zuccon M, Topino E, Musetti A, Gori A. Psychodynamic Therapies for the Treatment of Substance Addictions: A PRISMA Meta-Analysis. J Pers Med 2023; 13:1469. [PMID: 37888080 PMCID: PMC10608724 DOI: 10.3390/jpm13101469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/28/2023] Open
Abstract
The aim of this meta-analysis was to compare psychodynamic with other treatments in studies of substance addiction. The literature search was conducted using the PubMed, Web of Science, Cohcrane library, SCOPUS, and Onesearch databases. All studies comparing psychodynamic therapy with other types of psychological interventions for Substance Use Disorder were eligible. Three outcomes were considered to compare intervention performance: substance use, participation in treatment and other symptomatic conditions (OSCs). Hedges' G was used to measure effect size. The Revised Cochrane Risk of Bias tool for randomized trials was used to assess quality of evidence and possible bias, Egger regression analyses for publication bias, and Q and I-square statistics were used to assess heterogeneity. The alcohol group showed no differences between treatments on the three outcomes. The cocaine group showed no significant differences in the two outcomes, while for OSCs, available data was insufficient. The opioids group showed small but significant differences regarding participation in favor of non-psychodynamic interventions and no significant results for other outcomes. Based on the three measures of recovery considered in this meta-analysis, psychodynamic interventions were shown to be as effective as other psychological treatments in treating substance dependence and proved to be an empirically-supported treatment for the above addictions.
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Affiliation(s)
- Marco Zuccon
- Department of Health Sciences, University of Florence, Via di San Salvi 12, Pad. 26, 50135 Florence, Italy;
| | - Eleonora Topino
- Department of Human Sciences, LUMSA University of Rome, Via della Traspontina 21, 00193 Rome, Italy;
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy;
| | - Alessio Gori
- Department of Health Sciences, University of Florence, Via di San Salvi 12, Pad. 26, 50135 Florence, Italy;
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Schifano N, Chiappini S, Mosca A, Miuli A, Santovito MC, Pettorruso M, Capogrosso P, Dehò F, Martinotti G, Schifano F. Recreational Drug Misuse and Its Potential Contribution to Male Fertility Levels' Decline: A Narrative Review. Brain Sci 2022; 12:1582. [PMID: 36421906 PMCID: PMC9688450 DOI: 10.3390/brainsci12111582] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 10/14/2023] Open
Abstract
Recreational drug intake may be associated with a range of medical untoward consequences, including male infertility. However, as the related evidence is still limited, the main outcome of this review is to provide a better understanding of the existence of any association between recreational drug misuse and male fertility levels' decline. Whilst searching the MEDLINE/PubMed, a comprehensive overview of the literature regarding male infertility and substances of abuse (e.g., phytocannabinoids, opiates/opioids, stimulants, 'herbal highs', psychedelics, and 'novel psychoactive substances) was here undertaken. Due to the paucity of robust, high-quality, empirical, human studies, a narrative strategy was here preferred over a systematic approach. Relevant data are qualitatively analyzed and presented in a table. Although most available evidence is in support of a detrimental role of cannabis on human spermatogenesis, a few remaining studies failed to document any effect of this drug on seminal quality, and it is not clear to which extent this drug impacts fertility rates/time to pregnancy. The current understanding of the impact of opiate-, cocaine- and amphetamine/stimulant-misuse on human reproduction is widely unknown, and most studies dealing with this matter represent only an extrapolation of data derived from specific clinical circumstances. Although the message of 'no smoking, no alcohol and no street drugs' should always be offered as good health advice to all patients seeking medical help for fertility issues, robust scientific clinical evidence in support of a direct detrimental impact of recreational drugs on spermatogenesis is scant to date.
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Affiliation(s)
- Nicolò Schifano
- Department of Urology, ASST Sette Laghi–Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy
| | - Stefania Chiappini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy
| | - Alessio Mosca
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy
| | - Andrea Miuli
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy
| | - Maria Chiara Santovito
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy
| | - Paolo Capogrosso
- Department of Urology, ASST Sette Laghi–Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy
| | - Federico Dehò
- Department of Urology, ASST Sette Laghi–Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK
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Connolly DJ, Davies E, Lynskey M, Maier LJ, Ferris JA, Barratt MJ, Winstock AR, Gilchrist G. Differences in Alcohol and Other Drug Use and Dependence Between Transgender and Cisgender Participants from the 2018 Global Drug Survey. LGBT Health 2022; 9:534-542. [PMID: 35878065 DOI: 10.1089/lgbt.2021.0242] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Purpose: The purpose of this study was to compare five gender groups (cisgender women, cisgender men, transgender women, transgender men, people with nonbinary/other identities) on measures of use of and dependence on seven substances. Methods: A two-stage approach to assessing gender allowed 126,648 participants from the 2018 Global Drug Survey (GDS) to be classified to one of these five gender groups. Participants were asked to disclose use of each substance in the preceding 12 months. The Alcohol Use Disorders Identification Test and the Severity of Dependence Scale were used to assess dependence. Multivariable logistic regression generated odds ratios (ORs) to measure the association between gender and each substance use/dependence outcome, with cisgender women as the reference group. Results: The sample comprised 43,331 cisgender women, 81,607 cisgender men, 215 transgender women, 254 transgender men, and 1241 people with nonbinary/other identities. Relative to cisgender women, nonbinary/other participants reported greater odds of last 12-month use of all substances (adjusted odds ratio [AOR] = 1.66-2.30), except alcohol (lower odds; AOR = 0.42), and greater odds of dependence on cannabis (AOR = 2.39), 3,4-methylenedioxymethamphetamine (AOR = 1.64) and alcohol (AOR = 3.28), adjusting only for age (all p < 0.05). Conclusion: Transgender 2018 GDS respondents, particularly those with nonbinary/other identities, had greater odds of reporting most substance use outcomes than cisgender women. These findings suggest that a nuanced approach to gender reporting in surveys and treatment centers is required to understand the needs of transgender people who use substances.
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Affiliation(s)
- Dean J Connolly
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Early Intervention Service, Newham Centre for Mental Health, East London NHS Foundation Trust, London, United Kingdom
| | - Emma Davies
- Department of Psychology, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Michael Lynskey
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Larissa J Maier
- Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, California, USA.,Early Postdoc Mobility Grantee (P2ZHP1_174812), Swiss National Science Foundation, Bern, Switzerland
| | - Jason A Ferris
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Monica J Barratt
- Social and Global Studies Centre and Digital Ethnography Research Centre, RMIT University, Melbourne, Australia.,National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Adam R Winstock
- Institute of Epidemiology and Health Care, University College London, London, United Kingdom.,Global Drug Survey, London, United Kingdom
| | - Gail Gilchrist
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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7
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Hosseini J, Shojaeefar E, Pooladgar P, Aliakbari F, Ganji M, Hamdieh M, Kheradmand A, Fashami MA. Prevalence of substance use among Iranian male adolescents: Systematic review and meta-analysis. Health Sci Rep 2022; 5:e885. [PMID: 36304760 PMCID: PMC9595342 DOI: 10.1002/hsr2.885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 07/08/2022] [Accepted: 09/20/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND AIMS Substance use among adolescents is one of the most challenging behavioral disorders with direct consequences. It is of the essence (that) the prevalence of substance use is investigated among Iranian male adolescents. METHODS The present study is a systematic review and meta-analysis. All published articles titled "prevalence of substance use among Iranian adolescents" authored in Persian and English from 2004 to 2020 on Pub Med, Scopus, SID, and Google Scholar, a top list of academic research databases, were reviewed. Thirty-three out of 805 articles, hinge on the inclusion and exclusion criteria, were eligible. Statistical analysis carried out in STATA 14.0.Q index, I2 index, and χ 2 test were applied. RESULTS Overall prevalence reported with (95% confidence interval) for substance use 7% (4%-11%), methamphetamine 4% (3%-6%), tobacco 10% (3%-19%), and any addictive substances 4% (2%-7%) among male adolescents respectively. Besides, overall prevalence of alcohol consumption reported 10% (8%-11%). CONCLUSION The prevalence of substance use among male adolescents is high, so it is indispensable for researchers to pay special attention to this issue.
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Affiliation(s)
- Jalil Hosseini
- Men's Health and Reproductive Health Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Ehsan Shojaeefar
- Immunology Board for Transplantation and Advanced Cellular Therapeutics (ImmunoTACT)Universal Scientific and Education Network (USERN)TehranIran
| | - Parham Pooladgar
- School of MedicineShahid Beheshti University of Medical ScienceTehranIran
| | - Fereshteh Aliakbari
- Men's Health and Reproductive Health Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Maryam Ganji
- Men's Health and Reproductive Health Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Mostafa Hamdieh
- Men's Health and Reproductive Health Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Ali Kheradmand
- Department of Psychiatry, Taleghani Hospital Research Development Committee, School of MedicineShahid Beheshti University of Medical SciencesTehranIran
| | - Mahta Abbasi Fashami
- School of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehranIran
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Jones AA, Gicas KM, Mostafavi S, Woodward ML, Leonova O, Vila-Rodriguez F, Procyshyn RM, Cheng A, Buchanan T, Lang DJ, MacEwan GW, Panenka WJ, Barr AM, Thornton AE, Honer WG. Dynamic networks of psychotic symptoms in adults living in precarious housing or homelessness. Psychol Med 2022; 52:2559-2569. [PMID: 33455593 DOI: 10.1017/s0033291720004444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND People living in precarious housing or homelessness have higher than expected rates of psychotic disorders, persistent psychotic symptoms, and premature mortality. Psychotic symptoms can be modeled as a complex dynamic system, allowing assessment of roles for risk factors in symptom development, persistence, and contribution to premature mortality. METHOD The severity of delusions, conceptual disorganization, hallucinations, suspiciousness, and unusual thought content was rated monthly over 5 years in a community sample of precariously housed/homeless adults (n = 375) in Vancouver, Canada. Multilevel vector auto-regression analysis was used to construct temporal, contemporaneous, and between-person symptom networks. Network measures were compared between participants with (n = 219) or without (n = 156) history of psychotic disorder using bootstrap and permutation analyses. Relationships between network connectivity and risk factors including homelessness, trauma, and substance dependence were estimated by multiple linear regression. The contribution of network measures to premature mortality was estimated by Cox proportional hazard models. RESULTS Delusions and unusual thought content were central symptoms in the multilevel network. Each psychotic symptom was positively reinforcing over time, an effect most pronounced in participants with a history of psychotic disorder. Global connectivity was similar between those with and without such a history. Greater connectivity between symptoms was associated with methamphetamine dependence and past trauma exposure. Auto-regressive connectivity was associated with premature mortality in participants under age 55. CONCLUSIONS Past and current experiences contribute to the severity and dynamic relationships between psychotic symptoms. Interrupting the self-perpetuating severity of psychotic symptoms in a vulnerable group of people could contribute to reducing premature mortality.
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Affiliation(s)
- Andrea A Jones
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kristina M Gicas
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Sara Mostafavi
- Department of Statistics, University of British Columbia, Vancouver, Canada
- Department of Medical Genetics, University of British Columbia, Vancouver, Canada
| | - Melissa L Woodward
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Olga Leonova
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Fidel Vila-Rodriguez
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ric M Procyshyn
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alex Cheng
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tari Buchanan
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Donna J Lang
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - G William MacEwan
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - William J Panenka
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alasdair M Barr
- Department of Anesthesia, Pharmacology & Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Allen E Thornton
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - William G Honer
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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Al-Qurayshi Z, Rossi-Meyer M, Shama MA, Williams AM, Bayon R, Kandil E. Presentation and Outcomes of Otolaryngologic Surgeries in Patients With Mental Illness History. Ann Otol Rhinol Laryngol 2022; 132:614-621. [PMID: 35766624 DOI: 10.1177/00034894221105975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Describe the epidemiology and characteristics of patients with a history of mental illness undergoing otolaryngologic procedures. METHODS A retrospective cross-sectional analysis utilizing the Nationwide Readmissions Database, 2010 to 2015. The study sample included adult (≥18 years) patients undergoing otolaryngologic procedures. RESULTS A total of 146 182 patients were included, 18.3% with mental illness history. The prevalence of patients who required otolaryngologic surgeries with history of mental illness increased significantly from 14.9% in 2010 to 25.0% in 2015 (P < .001). Mental illness diagnoses included: depression (6.9%), anxiety (5.8%), alcohol dependence (4.2%), substance dependence (2.9%), bipolar disorder (1.4%), memory disorders (1.2%), delusional disorders (0.6%), self-harm (0.1%). Patients with a history of mental illness were more likely to be <65 years, female, and have multiple comorbidities (P < .05 each). Patients with history of mental illness had a higher risk of complications [OR:1.59, 95% CI:1.50,1.69, P < .001]. CONCLUSIONS Patients with a history of mental illness are increasingly encountered in otolaryngology service. This study provides an epidemiological perspective that warrants increasing clinical investigation of this subpopulation.
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Affiliation(s)
- Zaid Al-Qurayshi
- Department of Otolaryngology - Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Monica Rossi-Meyer
- Department of Otolaryngology - Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Mohamed A Shama
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - Amy M Williams
- Department of Otolaryngology - Head & Neck Surgery, Henry Ford Health System, Detroit, MI, USA
| | - Rodrigo Bayon
- Department of Otolaryngology - Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Emad Kandil
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
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10
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Huang W, Liu T, Chen H, Fu Q, Fu L, Xu X, Liu L, Guo Y, Balasubramanian PS, Chen F. Mapping white matter structural and network alterations in betel quid-dependent chewers using high angular resolution diffusion imaging. Front Psychiatry 2022; 13:1036728. [PMID: 36545042 PMCID: PMC9760978 DOI: 10.3389/fpsyt.2022.1036728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To evaluate brain white matter diffusion characteristics and anatomical network alterations in betel quid dependence (BQD) chewers using high angular resolution diffusion imaging (HARDI). METHODS The current study recruited 53 BQD chewers and 37 healthy controls (HC) in two groups. We explored regional diffusion metrics alternations in the BQD group compared with the HC group using automated fiber quantification (AFQ). We further employed the white matter (WM) anatomical network of HARDI to explore connectivity alterations in BQD chewers using graph theory. RESULTS BQD chewers presented significantly lower FA values in the left and right cingulum cingulate, the left and right thalamic radiation, and the right uncinate. The BQD has a significantly higher RD value in the right uncinate fasciculus than the HC group. At the global WM anatomical network level, global network efficiency (p = 0.008) was poorer and Lp (p = 0.016) was greater in the BQD group. At the nodal WM anatomical network level, nodal efficiency (p < 0.05) was lower in the BQD group. CONCLUSION Our findings provide novel morphometric evidence that brain structural changes in BQD are characterized by white matter diffusivity and anatomical network connectivity among regions of the brain, potentially leading to the enhanced reward system and impaired inhibitory control.
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Affiliation(s)
- Weiyuan Huang
- Department of Radiology, Hainan General Hospital, Hainan, China
| | - Tao Liu
- Department of Geriatric Center, Hainan General Hospital, Hainan, China
| | - Huijuan Chen
- Department of Radiology, Hainan General Hospital, Hainan, China
| | - Qingqing Fu
- Department of Radiology, Hainan General Hospital, Hainan, China
| | - Lili Fu
- Department of Radiology, Hainan General Hospital, Hainan, China
| | - Xiaolin Xu
- Department of Radiology, Hainan General Hospital, Hainan, China
| | - Liting Liu
- Department of Radiology, Yueyang Central Hospital, Shanghai, China
| | - Yihao Guo
- Department of Radiology, Hainan General Hospital, Hainan, China
| | - Priya S Balasubramanian
- Department of Electrical and Computer Engineering, Cornell University, Ithaca, NY, United States
| | - Feng Chen
- Department of Radiology, Hainan General Hospital, Hainan, China
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11
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Degan TJ, Kelly PJ, Robinson LD, Deane FP, Smith AM. Health literacy of people living with mental illness or substance use disorders: A systematic review. Early Interv Psychiatry 2021; 15:1454-1469. [PMID: 33254279 DOI: 10.1111/eip.13090] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 09/22/2020] [Accepted: 11/14/2020] [Indexed: 02/07/2023]
Abstract
AIM Health literacy is one's ability to use cognitive and social skills to access, understand and appraise health information. Despite poor health outcomes of people living with mental illness there is limited research assessing their health literacy. This systematic review aims to synthesise research on health literacy rates, conceptualizations, and outcomes of people living with mental illness, including substance use disorders. This will provide insights into how health literacy might be targeted to reduce these health inequities. METHODS A search of published literature in multiple databases up until February 2019 was conducted. One reviewer screened the titles, abstracts and keywords of identified publications and the eligibility of all full-text publications were assessed for inclusion along with a second reviewer. Both reviewers independently rated the quality of the included studies. RESULTS Fourteen studies were included in the review. Rates and measures of health literacy varied. Low health literacy and health literacy weaknesses were identified. There is a lack of research on the relationship between health literacy and other outcomes, particularly health service engagement. CONCLUSION The review highlights the high rates of low health literacy within this population compared with general populations. Most studies used a functional health literacy measure, despite its limitations, with only a few using multidimensional measures. Overall, there is limited research examining the impact that this populations health literacy has on their recovery and how it affects them over time. The review emphasizes the importance of practitioners assessing and targeting health literacy needs when working with this population.
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Affiliation(s)
- Tayla J Degan
- School of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Peter J Kelly
- School of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Laura D Robinson
- School of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Frank P Deane
- School of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Anna M Smith
- School of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
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12
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Kumar A, Goyal E, Singh VP, Chaudhury S, Puria A. Psychiatric morbidity in individuals with permanent orthopedic disability. Ind Psychiatry J 2021; 30:S97-S102. [PMID: 34908673 PMCID: PMC8611563 DOI: 10.4103/0972-6748.328796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/02/2021] [Accepted: 08/03/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Individuals with permanent orthopedic disability present with a number of physical and mental health issues. Psychiatric illnesses have been seen more frequently among people with disabilities as compared to normal population. AIM To study psychiatric morbidity among people with permanent orthopedic disability. MATERIALS AND METHODS This cross-sectional, observational, hospital-based study was conducted at the department of psychiatry of a tertiary care hospital attached to a medical college during January 01, 2018, to December 31, 2018. The study included subjects over the age of 18 years comprising two groups: Group A (n = 50) including consecutive subjects with orthopedic disability and Group B (n = 50) including normal age- and sex-matched controls. Permission was obtained from the institutional ethics committee before the start of the study. Prior informed consent was obtained from all subjects. Sociodemographic variables were recorded, and psychiatric morbidity was screened on Mini International Neuropsychiatric Interview. RESULTS 62% (n = 31) of subjects in Group A had psychiatric morbidity as compared to Group B (22%, n = 11). Maximum psychiatric morbidity noted among subjects with disability was generalized anxiety disorder (22%, n = 11), followed by major depressive disorder (20%, n = 10) and alcohol dependence (18%, n = 9). Substance dependence was more in Group A (34%, n = 17) as compared to Group B (18%, n = 9). The most common substance dependence was for alcohol (18%, n = 9), followed by opioids (8%, n = 4) and tobacco (6%, n = 3). CONCLUSION Psychiatric morbidity including substance dependence is more common among people with orthopedic disability as compared to normal control subjects.
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Affiliation(s)
- Ajay Kumar
- Department of Psychiatry, Government Medical College and Rajindra Hospital, Patiala, Punjab, India
| | - Ekram Goyal
- Department of Psychiatry, Government Medical College and Rajindra Hospital, Patiala, Punjab, India
| | | | - Suprakash Chaudhury
- Department of Psychiatry Dr D Y Patil Medical College, Pune, Maharashtra, India
| | - Alka Puria
- Department of Biochemistry, DMCH, Darbhanga, Bihar, India
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13
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Somohano VC, Shank T, Manuel J, Mallik D, Rehder K, Bowen S. The Role of Pretreatment Expectancy on Substance Use Outcomes in Women Mandated to Mindfulness-Based Relapse Prevention. J Altern Complement Med 2021; 27:1147-1155. [PMID: 34516782 DOI: 10.1089/acm.2021.0123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: More than one-third of justice-involved individuals meet the criteria for substance use disorder (SUD). Many studies show that treatment expectancy predicts longitudinal SUD outcomes; however, results are inconsistent, and the role of treatment expectancy on SUD outcomes for individuals mandated to a mindfulness-based intervention (MBI) is unknown. Mindfulness-based relapse prevention (MBRP) has shown efficacy with justice-involved populations; however, enrollment in MBRP is typically voluntary. The current study assessed whether pretreatment expectancy predicted SUD- and affect-related outcomes in a sample of women (n = 54) mandated to MBRP as part of their residential SUD programming. Method: The authors employed a quasiexperimental design and administered measures at pre-, mid-, and postcourse. Results: Following mandatory participation in MBRP, significant reductions in craving and substance use were observed. However, contrary to hypotheses, higher pretreatment expectancy predicted greater substance dependence at postcourse. Conclusions: Positive treatment expectancy within the context of an MBI was not related to favorable posttreatment outcomes; in fact, it was related to higher postcourse substance dependence. This suggests that MBIs may be suitable for mandated individuals who may not have voluntarily chosen to participate in such an intervention, and thus may have lower expectancy for the treatment. This finding needs to be replicated in a larger sample to warrant a firmer conclusion.
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Affiliation(s)
| | - Taylor Shank
- School of Graduate Psychology, Pacific University, Hillsboro, OR, USA
| | - Jacob Manuel
- School of Graduate Psychology, Pacific University, Hillsboro, OR, USA
| | - Debesh Mallik
- School of Graduate Psychology, Pacific University, Hillsboro, OR, USA
| | - Kristoffer Rehder
- VA Portland Health Care System, Portland, OR, USA.,School of Graduate Psychology, Pacific University, Hillsboro, OR, USA
| | - Sarah Bowen
- School of Graduate Psychology, Pacific University, Hillsboro, OR, USA
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14
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Cao Z, Ottino‐Gonzalez J, Cupertino RB, Schwab N, Hoke C, Catherine O, Cousijn J, Dagher A, Foxe JJ, Goudriaan AE, Hester R, Hutchison K, Li CR, London ED, Lorenzetti V, Luijten M, Martin‐Santos R, Momenan R, Paulus MP, Schmaal L, Sinha R, Sjoerds Z, Solowij N, Stein DJ, Stein EA, Uhlmann A, Holst RJ, Veltman DJ, Wiers RW, Yücel M, Zhang S, Jahanshad N, Thompson PM, Conrod P, Mackey S, Garavan H. Mapping cortical and subcortical asymmetries in substance dependence: Findings from the ENIGMA Addiction Working Group. Addict Biol 2021; 26:e13010. [PMID: 33508888 DOI: 10.1111/adb.13010] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/21/2020] [Accepted: 01/14/2021] [Indexed: 02/03/2023]
Abstract
Brain asymmetry reflects left-right hemispheric differentiation, which is a quantitative brain phenotype that develops with age and can vary with psychiatric diagnoses. Previous studies have shown that substance dependence is associated with altered brain structure and function. However, it is unknown whether structural brain asymmetries are different in individuals with substance dependence compared with nondependent participants. Here, a mega-analysis was performed using a collection of 22 structural brain MRI datasets from the ENIGMA Addiction Working Group. Structural asymmetries of cortical and subcortical regions were compared between individuals who were dependent on alcohol, nicotine, cocaine, methamphetamine, or cannabis (n = 1,796) and nondependent participants (n = 996). Substance-general and substance-specific effects on structural asymmetry were examined using separate models. We found that substance dependence was significantly associated with differences in volume asymmetry of the nucleus accumbens (NAcc; less rightward; Cohen's d = 0.15). This effect was driven by differences from controls in individuals with alcohol dependence (less rightward; Cohen's d = 0.10) and nicotine dependence (less rightward; Cohen's d = 0.11). These findings suggest that disrupted structural asymmetry in the NAcc may be a characteristic of substance dependence.
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Affiliation(s)
- Zhipeng Cao
- Department of Psychiatry University of Vermont College of Medicine Burlington Vermont USA
| | | | - Renata B. Cupertino
- Department of Psychiatry University of Vermont College of Medicine Burlington Vermont USA
| | - Nathan Schwab
- Department of Psychiatry University of Vermont College of Medicine Burlington Vermont USA
| | - Colin Hoke
- Department of Psychiatry University of Vermont College of Medicine Burlington Vermont USA
| | - Orr Catherine
- Department of Psychological Sciences, School of Health Sciences Swinburne University Melbourne Australia
| | - Janna Cousijn
- Departments of Psychology University of Amsterdam Amsterdam Netherlands
| | - Alain Dagher
- Department of Neurology and Neurosurgery, Montreal Neurological Institute McGill University Montreal Quebec Canada
| | - John J. Foxe
- Department of Neuroscience and The Ernest J. Del Monte Institute for Neuroscience University of Rochester School of Medicine and Dentistry Rochester New York USA
| | - Anna E. Goudriaan
- Department of Psychiatry, Amsterdam UMC, Location AMC University of Amsterdam Amsterdam Netherlands
| | - Robert Hester
- Melbourne School of Psychological Sciences University of Melbourne Melbourne Australia
| | - Kent Hutchison
- Department of Psychology and Neuroscience University of Colorado Boulder Boulder Colorado USA
| | - Chiang‐Shan R. Li
- Department of Psychiatry Yale University School of Medicine New Haven Connecticut USA
| | - Edythe D. London
- David Geffen School of Medicine University of California at Los Angeles Los Angeles California USA
| | - Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences Australian Catholic University Sydney Australia
| | - Maartje Luijten
- Behavioural Science Institute Radboud University Nijmegen Netherlands
| | - Rocio Martin‐Santos
- Department of Psychiatry and Psychology University of Barcelona Barcelona Spain
| | - Reza Momenan
- Clinical NeuroImaging Research Core, Division of Intramural Clinical and Biological Research National Institute on Alcohol Abuse and Alcoholism Bethesda Maryland USA
| | - Martin P. Paulus
- VA San Diego Healthcare System and Department of Psychiatry University of California San Diego La Jolla California USA
- Laureate Institute for Brain Research Tulsa Oklahoma USA
| | - Lianne Schmaal
- Orygen Parkville Australia
- Centre for Youth Mental Health University of Melbourne Melbourne Australia
| | - Rajita Sinha
- Department of Psychiatry Yale University School of Medicine New Haven Connecticut USA
| | - Zsuzsika Sjoerds
- Institute of Psychology and Leiden Institute for Brain and Cognition Leiden University Leiden Netherlands
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute University of Wollongong Wollongong Australia
| | - Dan J. Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute University of Cape Town Cape Town South Africa
| | - Elliot A. Stein
- Neuroimaging Research Branch, Intramural Research Program National Institute on Drug Abuse Baltimore Maryland USA
| | - Anne Uhlmann
- Department of Child and Adolescent Psychiatry and Psychotherapy Technische Universität Dresden Dresden Germany
| | - Ruth J. Holst
- Department of Psychiatry, Amsterdam UMC, Location AMC University of Amsterdam Amsterdam Netherlands
| | - Dick J. Veltman
- Department of Psychiatry, Amsterdam UMC, Location AMC University of Amsterdam Amsterdam Netherlands
| | - Reinout W. Wiers
- Addiction Development and Psychopathology (ADAPT)‐lab, Department of Psychology and Center for Urban Mental Health University of Amsterdam Amsterdam Netherlands
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging Facility Monash University Melbourne Victoria Australia
| | - Sheng Zhang
- Department of Psychiatry Yale University School of Medicine New Haven Connecticut USA
| | - Neda Jahanshad
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC University of Southern California Marina del Rey California USA
| | - Paul M. Thompson
- Imaging Genetics Center, Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine University of Southern California Marina del Rey Californis USA
| | - Patricia Conrod
- Department of Psychiatry Université de Montreal, CHU Ste Justine Hospital Montreal Quebec Canada
| | - Scott Mackey
- Department of Psychiatry University of Vermont College of Medicine Burlington Vermont USA
| | - Hugh Garavan
- Department of Psychiatry University of Vermont College of Medicine Burlington Vermont USA
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15
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Ingram I, Kelly PJ, Carradus LJ, Deane FP, Baker AL, Byrne G, McKay JR, Osborne B, Meyer JM, Nunes JL, Robinson LD, Lunn J. Continuing care following residential alcohol and other drug treatment: Continuing care worker perceptions. Drug Alcohol Rev 2021; 41:88-95. [PMID: 34134173 DOI: 10.1111/dar.13337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/20/2021] [Accepted: 05/10/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Little is known about the experiences of continuing care workers (CCW) in the implementation of continuing care programs. The current study sought to understand CCWs and supervisor perceptions of the successes and challenges of implementing a telephone-based continuing care intervention following residential alcohol and other drug treatment services. It also aimed to provide recommendations for treatment providers wishing to integrate continuing care into their treatment model, including the resources, training and supervision needs of CCWs. METHODS The participants were eight CCWs and two independent supervisors who completed semi-structured interviews. Interview coding and analysis was guided by Iterative Categorisation procedures and an implementation framework. The Consolidated Framework for Implementation Research was used. RESULTS Telephone delivery was advantageous, but even more enhanced, when there was a face-to-face session first to build rapport. Other key successes included CCWs who were confident and competent, as well as a match between the organisation's values and the philosophy of the continuing care program. Key challenges faced by CCWs related to a perceived lack of support from managers, difficulties accessing quiet office spaces and participant disengagement. DISCUSSION AND CONCLUSIONS Interviews revealed several factors that may influence successful delivery of continuing care as part of alcohol and other drug treatment. These included features of the intervention (e.g. telephone delivery, evidence-based content), characteristics of the individual CCWs (e.g. flexibility in delivery of the intervention while maintaining fidelity), organisational culture (e.g. alignment of organisational values with continuing care) and resources (e.g. office space, flexible work schedules).
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Affiliation(s)
- Isabella Ingram
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Peter J Kelly
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Lenna J Carradus
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Frank P Deane
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Gerard Byrne
- The Salvation Army, Sydney, Australia.,We Help Ourselves, Sydney, Australia
| | - James R McKay
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Briony Osborne
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Johanna M Meyer
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Jason L Nunes
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Laura D Robinson
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
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16
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Fletcher K. A Systematic Review of the Relationship between Child Sexual Abuse and Substance Use Issues. J Child Sex Abus 2021; 30:258-277. [PMID: 33017264 DOI: 10.1080/10538712.2020.1801937] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 06/05/2020] [Accepted: 06/28/2020] [Indexed: 06/11/2023]
Abstract
Child sexual abuse (CSA) and substance use issues later in life have been well documented in the literature. This systematic review from 2009 to 2019 provides an update on what is known about the relationship between CSA and substance use. While the review confirms a clear relationship between CSA and substance use, it also highlights some potential gaps in our current practices, including an acknowledgment of the other risk factors associated with CSA and substance use issues, as well as the need to develop treatment that specifically screens for and addresses CSA in the context of substance use.
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Affiliation(s)
- Kara Fletcher
- Faculty of Social Work, University of Regina, Saskatoon, Canada
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17
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Eriksson L, Bryant S, McPhedran S, Mazerolle P, Wortley R. Alcohol and drug problems among Australian homicide offenders. Addiction 2021; 116:618-631. [PMID: 32562295 DOI: 10.1111/add.15169] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/05/2020] [Accepted: 06/13/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Most homicide studies focus upon 'acute' situational intoxication as opposed to 'chronic' substance misuse. The aims of the study were to: (1) determine the extent of homicide offenders' alcohol and drug use in the year preceding the homicide; (2) compare the individual characteristics of homicide offenders across levels of problematic substance use; and (3) compare homicide incident characteristics across levels of problematic substance use. DESIGN AND SETTING Observational study using data collected through face-to-face interviews in custodial and community correctional settings across Australia. Participants were recruited through an opt-in process. PARTICIPANTS The data consist of 302 individuals convicted of murder or manslaughter. MEASUREMENTS We used the Alcohol Use Disorder Identification Test and Drug Abuse Screening Test to determine problematic alcohol or drug use. We also used a range of self-report measures to ascertain offender characteristics [socio-demographics, developmental experiences, criminal history, personality] and incident characteristics (who was killed, and situational intoxication). FINDINGS Of the sample, 38.8% displayed high levels of alcohol problems and 30.8% displayed high levels of drug problems. Those displaying high levels of alcohol and/or drug problems were more likely than those without high levels of alcohol and/or drug problems to report adverse developmental experiences, low education, financial difficulties, extensive criminal histories and high levels of trait anger, impulsivity and risk-seeking. In addition, offenders with problematic substance use were more likely to have killed non-family and to have used substances at the time of the homicide. CONCLUSIONS High proportions of homicide offenders in Australia appear to have problematic substance use in the year preceding the homicide offence, and such use appears to be associated with a range of other challenging factors, including adverse childhoods, criminal involvement, low socio-economic factors and low self-regulation.
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Affiliation(s)
- Li Eriksson
- Griffith Criminology Institute, Griffith University, Mt Gravatt, QLD, Australia
| | - Sarah Bryant
- Centre for Youth Substance Abuse Research, University of Queensland, St Lucia, QLD, Australia
| | - Samara McPhedran
- Pro-Vice Chancellor's (Arts, Education, Law) Office, Griffith University, Mt Gravatt, QLD, Australia
| | - Paul Mazerolle
- Vice-Chancellor's Office, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Richard Wortley
- Jill Dando Institute for Security and Crime Science, University College London, London, UK
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18
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Goh MCW, Kelly PJ, Deane FP, Raftery DK, Ingram I. Communication of health risk in substance-dependent populations: A systematic review of randomised controlled trials. Drug Alcohol Rev 2021; 40:920-936. [PMID: 33565172 DOI: 10.1111/dar.13249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/29/2020] [Accepted: 12/15/2020] [Indexed: 11/28/2022]
Abstract
ISSUES Individuals with substance use problems are at greater risk of chronic diseases due to their unhealthy lifestyle behaviours (e.g. alcohol use, smoking, physical inactivity, poor nutrition). There is increasing evidence that health risk communication is crucial in improving risk perception and knowledge of chronic diseases, and both factors are associated with health behaviour change. The aim of this systematic review is to provide a comprehensive overview of the current state of evidence on health risk communication on people with substance use problems. APPROACH A systematic search identified peer reviewed studies from the databases MEDLINE, PsycINFO, CINAHL and Scopus. Data were extracted from the included studies and a narrative synthesis of the results was conducted. KEY FINDINGS Eight articles, representing five unique studies, were included in the review. The overall risk of bias of the included studies was considered to be low. The studies evaluated the use of message framing and personalised/customised recommendations across smoking cessation and patient engagement with methadone maintenance treatment. Results revealed that message framing, specifically gain-framed messages, had a positive impact on smoking cessation. Risk perception, sex and level of nicotine dependence were also found to be associated with smoking cessation. IMPLICATIONS AND CONCLUSIONS The limited number of studies provides preliminary evidence that health risk communication promotes smoking cessation. However, studies included in the review were characterised by heterogeneous methods and measures. Further investigation of health risk communication using adequately powered randomised controlled trial is warranted.
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Affiliation(s)
- Melvin C W Goh
- School of Psychology, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Peter J Kelly
- School of Psychology, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Frank P Deane
- School of Psychology, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Dayle K Raftery
- School of Psychology, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Isabella Ingram
- School of Psychology, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
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Kvam PD, Romeu RJ, Turner BM, Vassileva J, Busemeyer JR. Testing the factor structure underlying behavior using joint cognitive models: Impulsivity in delay discounting and Cambridge gambling tasks. Psychol Methods 2021; 26:18-37. [PMID: 32134313 PMCID: PMC7483167 DOI: 10.1037/met0000264] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Neurocognitive tasks are frequently used to assess disordered decision making, and cognitive models of these tasks can quantify performance in terms related to decision makers' underlying cognitive processes. In many cases, multiple cognitive models purport to describe similar processes, but it is difficult to evaluate whether they measure the same latent traits or processes. In this article, we develop methods for modeling behavior across multiple tasks by connecting cognitive model parameters to common latent constructs. This approach can be used to assess whether 2 tasks measure the same dimensions of cognition, or actually improve the estimates of cognitive models when there are overlapping cognitive processes between 2 related tasks. The approach is then applied to connecting decision data on 2 behavioral tasks that evaluate clinically relevant deficits, the delay discounting task and Cambridge gambling task, to determine whether they both measure the same dimension of impulsivity. We find that the discounting rate parameters in the models of each task are not closely related, although substance users exhibit more impulsive behavior on both tasks. Instead, temporal discounting on the delay discounting task as quantified by the model is more closely related to externalizing psychopathology like aggression, while temporal discounting on the Cambridge gambling task is related more to response inhibition failures. The methods we develop thus provide a new way to connect behavior across tasks and grant new insights onto the different dimensions of impulsivity and their relation to substance use. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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20
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Abstract
BACKGROUND Previous literature has extensively investigated the brain activity during response inhibition in adults with addiction. Inconsistent results including both hyper- and hypo-activities in the fronto-parietal network (FPN) and the ventral attention network (VAN) have been found in adults with addictions, compared with healthy controls (HCs). METHODS Voxel-wise meta-analyses of abnormal task-evoked regional activity were conducted for adults with substance dependence (SD) and behavioral addiction during response inhibition tasks to solve previous inconsistencies. Twenty-three functional magnetic resonance imaging studies including 479 substance users, 38 individuals with behavioral addiction and 494 HCs were identified. RESULTS Compared with HCs, all addictions showed hypo-activities in regions within FPN (inferior frontal gyrus and supramarginal gyrus) and VAN (inferior frontal gyrus, middle temporal gyrus, temporal pole and insula), and hyper-activities in the cerebellum during response inhibition. SD subgroup showed almost the same activity patterns, with an additional hypoactivation of the precentral gyrus, compared with HCs. Stronger activation of the cerebellum was associated with longer addiction duration for adults with SD. We could not conduct meta-analytic investigations into the behavioral addiction subgroup due to the small number of datasets. CONCLUSION This meta-analysis revealed altered activation of FPN, VAN and the cerebellum in adults with addiction during response inhibition tasks using non-addiction-related stimuli. Although FPN and VAN showed lower activity, the cerebellum exhibited stronger activity. These results may help to understand the neural pathology of response inhibition in addiction.
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Affiliation(s)
- Zeguo Qiu
- Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou510006, China
- School of Psychology, The University of Queensland, Brisbane4072, Australia
| | - Junjing Wang
- Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou510006, China
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21
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Huang X, Wu Z, Liu Z, Liu D, Huang D, Long Y. Acute Effect of Betel Quid Chewing on Brain Network Dynamics: A Resting-State Functional Magnetic Resonance Imaging Study. Front Psychiatry 2021; 12:701420. [PMID: 34504445 PMCID: PMC8421637 DOI: 10.3389/fpsyt.2021.701420] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/02/2021] [Indexed: 12/12/2022] Open
Abstract
Betel quid (BQ) is one of the most popular addictive substances in the world. However, the neurophysiological mechanism underlying BQ addiction remains unclear. This study aimed to investigate whether and how BQ chewing would affect brain function in the framework of a dynamic brain network model. Resting-state functional magnetic resonance imaging scans were collected from 24 male BQ-dependent individuals and 26 male non-addictive healthy individuals before and promptly after chewing BQ. Switching rate, a measure of temporal stability of functional brain networks, was calculated at both global and local levels for each scan. The results showed that BQ-dependent and healthy groups did not significantly differ on switching rate before BQ chewing (F = 0.784, p = 0.381, analysis of covariance controlling for age, education, and head motion). After chewing BQ, both BQ-dependent (t = 2.674, p = 0.014, paired t-test) and healthy (t = 2.313, p = 0.029, paired t-test) individuals showed a significantly increased global switching rate compared to those before chewing BQ. Significant corresponding local-level effects were observed within the occipital areas for both groups, and within the cingulo-opercular, fronto-parietal, and cerebellum regions for BQ-dependent individuals. Moreover, in BQ-dependent individuals, switching rate was significantly correlated with the severity of BQ addiction assessed by the Betel Quid Dependence Scale scores (Spearman's rho = 0.471, p = 0.020) before BQ chewing. Our study provides preliminary evidence for the acute effects of BQ chewing on brain functional dynamism. These findings may provide insights into the neural mechanisms of substance addictions.
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Affiliation(s)
- Xiaojun Huang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Clinical Psychology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Zhipeng Wu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhening Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Dayi Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Danqing Huang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yicheng Long
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
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22
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Chye Y, Mackey S, Gutman BA, Ching CR, Batalla A, Blaine S, Brooks S, Caparelli EC, Cousijn J, Dagher A, Foxe JJ, Goudriaan AE, Hester R, Hutchison K, Jahanshad N, Kaag AM, Korucuoglu O, Li CR, London ED, Lorenzetti V, Luijten M, Martin‐Santos R, Meda SA, Momenan R, Morales A, Orr C, Paulus MP, Pearlson G, Reneman L, Schmaal L, Sinha R, Solowij N, Stein DJ, Stein EA, Tang D, Uhlmann A, Holst R, Veltman DJ, Verdejo‐Garcia A, Wiers RW, Yücel M, Thompson PM, Conrod P, Garavan H. Subcortical surface morphometry in substance dependence: An ENIGMA addiction working group study. Addict Biol 2020; 25:e12830. [PMID: 31746534 DOI: 10.1111/adb.12830] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/25/2019] [Accepted: 08/26/2019] [Indexed: 11/27/2022]
Abstract
While imaging studies have demonstrated volumetric differences in subcortical structures associated with dependence on various abused substances, findings to date have not been wholly consistent. Moreover, most studies have not compared brain morphology across those dependent on different substances of abuse to identify substance-specific and substance-general dependence effects. By pooling large multinational datasets from 33 imaging sites, this study examined subcortical surface morphology in 1628 nondependent controls and 2277 individuals with dependence on alcohol, nicotine, cocaine, methamphetamine, and/or cannabis. Subcortical structures were defined by FreeSurfer segmentation and converted to a mesh surface to extract two vertex-level metrics-the radial distance (RD) of the structure surface from a medial curve and the log of the Jacobian determinant (JD)-that, respectively, describe local thickness and surface area dilation/contraction. Mega-analyses were performed on measures of RD and JD to test for the main effect of substance dependence, controlling for age, sex, intracranial volume, and imaging site. Widespread differences between dependent users and nondependent controls were found across subcortical structures, driven primarily by users dependent on alcohol. Alcohol dependence was associated with localized lower RD and JD across most structures, with the strongest effects in the hippocampus, thalamus, putamen, and amygdala. Meanwhile, nicotine use was associated with greater RD and JD relative to nonsmokers in multiple regions, with the strongest effects in the bilateral hippocampus and right nucleus accumbens. By demonstrating subcortical morphological differences unique to alcohol and nicotine use, rather than dependence across all substances, results suggest substance-specific relationships with subcortical brain structures.
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Affiliation(s)
- Yann Chye
- Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University Clayton Victoria Australia
| | - Scott Mackey
- Departments of Psychiatry University of Vermont Burlington VT USA
| | - Boris A. Gutman
- Biomedical Engineering Illinois Institute of Technology Chicago IL USA
| | - Christopher R.K. Ching
- Department of Neurology, Keck School of Medicine, Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute University of Southern California Los Angeles CA USA
| | - Albert Batalla
- Department of Psychiatry University Medical Centre Utrecht Brain Center, Utrecht University Utrecht The Netherlands
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM, Institute of Neuroscience University of Barcelona Barcelona Spain
| | - Sara Blaine
- Departments of Psychiatry and Neuroscience Yale University School of Medicine CT USA
| | - Samantha Brooks
- Faculty of Health, School of Psychology Liverpool John Moores University L3 3AF Liverpool UK
- Department of Neuroscience, Section of Functional Pharmacology Uppsala University 75240 Sweden
| | - Elisabeth C. Caparelli
- Neuroimaging Research Branch, Intramural Research Program National Institute of Drug Abuse Baltimore MD USA
| | - Janna Cousijn
- Department of Developmental Psychology University of Amsterdam The Netherlands
| | - Alain Dagher
- McConnell Brain Imaging Center, Montreal Neurological Institute McGill University Montreal Quebec Canada
| | - John J. Foxe
- Department of Neuroscience & The Ernest J. Del Monte Institute for Neuroscience University of Rochester School of Medicine and Dentistry Rochester NY USA
| | - Anna E. Goudriaan
- Amsterdam UMC, Department of Psychiatry, Amsterdam Institute for Addiction Research University of Amsterdam Amsterdam The Netherlands
- Department of Research and Quality of Care Arkin Mental Health Care Amsterdam The Netherlands
| | - Robert Hester
- Melbourne School of Psychological Sciences University of Melbourne Melbourne Victoria Australia
| | - Kent Hutchison
- Department of Psychology and Neuroscience University of Colorado Boulder Boulder CO USA
| | - Neda Jahanshad
- Department of Neurology, Keck School of Medicine, Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute University of Southern California Los Angeles CA USA
| | - Anne M. Kaag
- Department of Developmental Psychology University of Amsterdam The Netherlands
| | - Ozlem Korucuoglu
- Department of Psychiatry Washington University School of Medicine Saint Louis MO USA
| | - Chiang‐Shan R. Li
- Departments of Psychiatry and Neuroscience Yale University School of Medicine CT USA
| | - Edythe D. London
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine Universityof California at Los Angeles Los Angeles CA USA
| | - Valentina Lorenzetti
- Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University Clayton Victoria Australia
- School of Psychology, Faculty of Health Sciences Australian Catholic University Melbourne Victoria Australia
| | - Maartje Luijten
- Behavioural Science Institute Radboud University Nijmegen The Netherlands
| | - Rocio Martin‐Santos
- Department of Psychiatry and Psychology, Hospital Clinic, IDIBAPS, CIBERSAM, Institute of Neuroscience University of Barcelona Barcelona Spain
| | - Shashwath A. Meda
- Olin Neuropsychiatry Research Center Hartford Hospital/IOL Hartford CT USA
| | - Reza Momenan
- Clinical NeuroImaging Research Core, Division of Intramural Clinical and BiologicalResearch National Institute of Alcohol Abuse and Alcoholism Bethesda MD USA
| | - Angelica Morales
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine Universityof California at Los Angeles Los Angeles CA USA
| | - Catherine Orr
- Departments of Psychiatry University of Vermont Burlington VT USA
| | - Martin P. Paulus
- VA San Diego Healthcare System and Department of Psychiatry University of California San Diego CA USA
- Laureate Institute for Brain Research Tulsa OK USA
| | - Godfrey Pearlson
- Departments of Psychiatry and Neuroscience Yale University School of Medicine CT USA
| | - Liesbeth Reneman
- Department of Radiology and Nuclear Medicine Amsterdam UMC, location AMC Amsterdam The Netherlands
| | - Lianne Schmaal
- Orygen The National Centre of Excellence in Youth Mental Health Parkville Australia
- Centre for Youth Mental Health The University of Melbourne Parkville Australia
| | - Rajita Sinha
- Departments of Psychiatry and Neuroscience Yale University School of Medicine CT USA
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute University of Wollongong Wollongong New South Wales Australia
- The Australian Centre for Cannabinoid Clinical and Research Excellence (ACRE) New Lambton Heights New South Wales Australia
| | - Dan J. Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute University of Cape Town Cape Town South Africa
| | - Elliot A. Stein
- Neuroimaging Research Branch, Intramural Research Program National Institute of Drug Abuse Baltimore MD USA
| | - Deborah Tang
- McConnell Brain Imaging Center, Montreal Neurological Institute McGill University Montreal Quebec Canada
| | - Anne Uhlmann
- Department of Psychiatry and Mental Health Faculty of Health Sciences University of Cape Town South Africa
| | - Ruth Holst
- Department of Psychiatry University of Amsterdam Amsterdam The Netherlands
| | - Dick J. Veltman
- Department of Psychiatry VU University Medical Center Amsterdam The Netherlands
| | - Antonio Verdejo‐Garcia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University Clayton Victoria Australia
| | - Reinout W. Wiers
- Addiction Development and Psychopathology (ADAPT) Lab University of Amsterdam Amsterdam The Netherlands
| | - Murat Yücel
- Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University Clayton Victoria Australia
| | - Paul M. Thompson
- Department of Neurology, Keck School of Medicine, Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute University of Southern California Los Angeles CA USA
| | - Patricia Conrod
- Department of Psychiatry Université de Montreal, CHU Ste Justine Hospital Canada
| | - Hugh Garavan
- Departments of Psychiatry University of Vermont Burlington VT USA
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23
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Rodríguez-Míguez E, Casal B, Rivera B. Measuring health-related quality of life in patients treated for substance dependence: differences among instruments and methods of eliciting preferences. Expert Rev Pharmacoecon Outcomes Res 2020; 21:683-690. [PMID: 32744467 DOI: 10.1080/14737167.2020.1804872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Measuring the health-related quality of life is an essential estimation in cost-utility studies. In this research, we provide new evidence about comparing utility scores - in the field of substance dependence. Although the main objective is to compare the EQ-5D-5L and SF-6D with paired gamble, evidence about the SF-6D with standard gamble is also provided. METHODS Ninety-four patients with substance dependence were recruited; the SF-6D and the EQ-5D-5L were administered at the beginning of treatment and 6 months thereafter. Differences in treatment effect were estimated by comparing utility gains. All analyses were reproduced for two subgroups of severity. RESULTS Both the baseline scores and the treatment effect are sensitive to the instrument used. For severe states, the SF-6D with paired gamble (SF-6D with standard gamble) estimates the lowest (highest) utility. With regard to the impact of treatment, the EQ-5D-5L and SF-6D with paired gamble estimate strongly similar effects for severe states (and both estimate greater effects than does the SF-6D with standard gamble). CONCLUSIONS These findings have implications for cost-utility analyses. The incremental cost-utility ratio of treatments intended for severe states is barely sensitive to the choice of EQ-5D-5L or SF-6D with paired gamble.
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Affiliation(s)
- Eva Rodríguez-Míguez
- Department of Applied Economics,Group of Research in Empirical Economics (GRiEE), ECOBAS, University of Vigo, Vigo, Spain.,South Galicia Biomedical Foundation, University Hospital of Vigo, Vigo, Spain
| | - Bruno Casal
- Department of Economics, University of A Coruña, A Coruña, Spain
| | - Berta Rivera
- Department of Economics, University of A Coruña, A Coruña, Spain
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24
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Ingram I, Kelly PJ, Deane FP, Baker AL, Dingle GA. Perceptions of loneliness among people accessing treatment for substance use disorders. Drug Alcohol Rev 2020; 39:484-494. [PMID: 32657495 DOI: 10.1111/dar.13120] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/22/2020] [Accepted: 05/31/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION AND AIMS Guided by cognitive theory of loneliness, this study sought to explore the experience of loneliness among people accessing treatment for substance use disorders. Specifically, contributors to, consequences and alleviators of loneliness were explored. DESIGN AND METHODS Individual semi-structured interviews were conducted with 20 participants. Interviews were conducted onsite at two residential treatment facilities in New South Wales, Australia. Interviews were audio recorded and transcribed and an iterative categorisation approach was used to guide data analysis and reporting. RESULTS Four key themes emerged as contributors to and consequences of loneliness: cognitions (mistrust, perceived support from others, low self-worth and fear of negative evaluation), quality and authenticity of relationships, unhelpful interpersonal behaviours and the role of substance use. Participants indicated that overcoming the cognitive and behavioural perpetuators helped to alleviate loneliness and also described the utility of support groups, pursuit of authentic relationships and activities that provide a sense of purpose as helpful. DISCUSSION AND CONCLUSIONS Cognitions related to mistrust, lack of perceived support, low self-worth, fear of negative evaluation and identification and pursuit of meaningful relationships supportive of recovery should be key treatment targets for this population.
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Affiliation(s)
- Isabella Ingram
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Peter J Kelly
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Frank P Deane
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
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25
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Chen J, Qin J, He Q, Zou Z. A Meta-Analysis of Transcranial Direct Current Stimulation on Substance and Food Craving: What Effect Do Modulators Have? Front Psychiatry 2020; 11:598. [PMID: 32670118 PMCID: PMC7332543 DOI: 10.3389/fpsyt.2020.00598] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/09/2020] [Indexed: 12/22/2022] Open
Abstract
Substance addiction and food addiction are significant social problems worldwide. In previous studies of substance addiction, transcranial direct current stimulation (tDCS) has been used to influence craving of substance or food. However, the reported effects are not always consistent due to inconsistent experimental settings. The way modulators influence the effect of tDCS on substance addiction is worth exploring. This meta-analysis was conducted to estimate the effect size of tDCS on substance and food craving and to investigate the influence of potential modulators. We systemically identified and reviewed studies on substance/food craving using tDCS that were published between January 2008 to January 2020. A total of 32 eligible studies were identified. Hedges' g was computed as an indicator of the effect of tDCS and some potential moderators (substance type, stimulation sites, current intensities, number of sessions, duration of stimulation, and study design) were examined using subgroup analysis. Random effects analysis revealed a total medium effect size [Hedges' g = 0.536, 95% confidence interval (CI): 0.389-0.683, after adjusting Hedges' g = 0.416, 95% CI: 0.262-0.570] preferring active over sham stimulation to reduce craving. A significant difference was observed between the number of sessions (repeated stimulation was better than single stimulation). The duration of stimulation may have a positive influence on the effects of tDCS. No other significant differences were found in other subgroups analysis. In conclusion, our results provided evidence that tDCS can be an effective way to reduce craving of substance or food, and longer multiple stimulus durations in all can more effectively reduce craving; however, the influences of modulators still need be to be examined in depth in future.
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Affiliation(s)
| | | | | | - Zhiling Zou
- Faculty of Psychology, Southwest University, Chongqing, China
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26
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Abstract
BACKGROUND A primary response to the alarming rise in overdose and mortality due to nonmedical prescription opioid (PO) use has been to restrict opioid prescribing; however, little is known about the relationship between obtaining opioids from a physician and overdose risk among people who use POs nonmedically and illicit street drugs. Objectives: Investigate the relationship between non-fatal overdose and acquiring POs exclusively from physicians for the purposes of engaging in nonmedical PO use. Methods: Data were collected between 2013 and 2016 among participants in two harmonized prospective cohort studies of people who use drugs in Vancouver: the At-Risk Youth Study (ARYS) and the Vancouver Injection Drug Users Study (VIDUS). Analyses were restricted to participants who engaged in nonmedical PO use and used generalized estimating equations. Results: Among 599 participants who used POs nonmedically, 82 (14%) individuals reported acquiring POs exclusively from a physician and 197 (33%) experienced a non-fatal overdose at some point over the study period. Acquiring POs exclusively from physicians was significantly and negatively associated with non-fatal overdose in the bivariate analysis (Odds Ratio = 0.60, 95% Confidence Interval (CI): 0.39-0.94) but not the final multivariate analysis (Adjusted Odds Ratio =0.87, 95% CI: 0.53-1.44). Conclusions: Compared to individuals who acquired POs from friends or the streets, participants who acquired POs exclusively from a physician were not at an increased risk of non-fatal overdose. Although responsible opioid prescribing is an important priority, additional strategies to address nonmedical PO use are urgently needed to reduce overdose and related morbidity and mortality.
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Affiliation(s)
- Tessa Cheng
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300, 8888 University Drive, Burnaby, BC, Canada, V5A 1S6
- British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC Canada, V6Z 2A9
| | - Will Small
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300, 8888 University Drive, Burnaby, BC, Canada, V5A 1S6
- British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC Canada, V6Z 2A9
- Centre for Applied Research in Mental Health and Addiction, SFU Faculty of Health Sciences, 515 W. Hastings Street, Vancouver, BC, Canada, V6B 5K3
| | - Ekaterina Nosova
- British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC Canada, V6Z 2A9
- Faculty of Medicine, University of British Columbia, 317 – 2194 Health Sciences Mall, Vancouver, BC, Canada, V6T 1Z3
| | - Robert Hogg
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300, 8888 University Drive, Burnaby, BC, Canada, V5A 1S6
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, B.C., Canada, V6Z 1Y6
| | - Kanna Hayashi
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300, 8888 University Drive, Burnaby, BC, Canada, V5A 1S6
- British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC Canada, V6Z 2A9
| | - Thomas Kerr
- British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC Canada, V6Z 2A9
- Faculty of Medicine, University of British Columbia, 317 – 2194 Health Sciences Mall, Vancouver, BC, Canada, V6T 1Z3
| | - Kora DeBeck
- British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC Canada, V6Z 2A9
- School of Public Policy, Simon Fraser University, 515 West Hastings Street, Suite 3271, Vancouver, BC, Canada, V6B 5K3
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27
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Kaplan V, Çuhadar D. The levels of anger and aggression in street children with substance dependence. J Child Adolesc Psychiatr Nurs 2020; 33:239-247. [PMID: 32314474 DOI: 10.1111/jcap.12275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/07/2020] [Accepted: 04/12/2020] [Indexed: 11/29/2022]
Abstract
PROBLEM This is a descriptive study to determine the levels of anger and aggression in street children with substance dependence. METHODS The study was conducted between October 2013 and March 2014 with 103 street children who use substances. Personal Information Form, Aggression Scale (AS), and Trait Anger and Anger Expression Styles Scale (STAXI) were used as data collection tools. FINDINGS The rate of the children reported that they lived on the streets due to the conflicts with the family was 67% and 35% of participants reported that they were exposed to violence on the street. The total score of AS was 146.78 ± 25.91, the mean score of the anger subscale of the STAXI was 31.05 ± 9.00 while the scores of the anger-in subscale and the anger-out subscale scores were 19.02 ± 4.55 and 23.04 ± 6.19, respectively. The total scores of AS had a significant positive correlation with both the trait anger and "anger-in" subscale scores. The results show that substance use negatively affected anger control in street children. CONCLUSION The data demonstrated that the presence of continuous anger and turning the anger against oneself correlated with increased levels of aggression. Increasing the duration of living on the street, working on the street and being exposed to stressful situations in the street increased the "anger-in" scores.
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Affiliation(s)
- Veysel Kaplan
- Nursing Department, Faculty of Health Sciences, Harran University, Şanlıurfa, Turkey
| | - Döndü Çuhadar
- Nursing Department, Faculty of Health Sciences, Gaziantep University, Gaziantep, Turkey
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28
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Baer MM, Tull MT, Forbes CN, Richmond JR, Gratz KL. Methods Matter: Nonsuicidal Self-Injury in the Form of Cutting is Uniquely Associated with Suicide Attempt Severity in Patients with Substance Use Disorders. Suicide Life Threat Behav 2020; 50:397-407. [PMID: 31621951 PMCID: PMC7148192 DOI: 10.1111/sltb.12596] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 08/30/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Despite the robust relation between nonsuicidal self-injury (NSSI) and suicidal behaviors, there is considerable heterogeneity in NSSI characteristics that may have implications for the strength of the NSSI-suicide attempt relation. Past research highlights the relevance of both more severe NSSI methods and NSSI in the form of cutting in particular to suicide attempts. To further explore the relations of specific NSSI methods to suicide attempts, this study examined relations between different NSSI methods (i.e., those involving cutting, burning, blunt force, or resulting in minor tissue damage) and both overall suicide attempts and two indicators of suicide attempt severity (attempts requiring medical attention and nonambivalent attempts) in 203 substance-dependent patients in residential treatment. METHOD Participants were administered questionnaires and semistructured interviews assessing the variables of interest. RESULTS Cutting was the only NSSI method to demonstrate significant relations with overall suicide attempts, nonambivalent suicide attempts, and suicide attempts requiring medical attention. Results remained when considering relevant covariates. CONCLUSION Results highlight an important link between NSSI methods involving cutting and suicide attempts among patients with substance use disorders. Findings also highlight the importance of more fine-grained characterizations of NSSI subgroups.
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Affiliation(s)
| | - Matthew T. Tull
- Department of Psychology, University of Toledo, Toledo, OH, USA,Address correspondence to: Matthew T. Tull, Ph.D., Department of Psychology, Mail Stop 948, University of Toledo, 2801 West Bancroft Street, Toledo, Ohio 43606; Telephone: 419-530-4392; Fax: 419-530-8479;
| | | | | | - Kim L. Gratz
- Department of Psychology, University of Toledo, Toledo, OH, USA
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Lappan SN, Brown AW, Hendricks PS. Dropout rates of in-person psychosocial substance use disorder treatments: a systematic review and meta-analysis. Addiction 2020; 115:201-217. [PMID: 31454123 DOI: 10.1111/add.14793] [Citation(s) in RCA: 133] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 06/15/2019] [Accepted: 08/01/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND AIMS Relapse rates for psychosocial substance use disorder (SUD) treatments are high, and dropout is a robust predictor of relapse. This study aimed to estimate average dropout rates of in-person psychosocial SUD treatments and to assess predictors of dropout. DESIGN A comprehensive meta-analysis of dropout rates of studies of in-person psychosocial SUD treatment. Studies included randomized controlled trials (RCTs) and cohort studies. SETTING Studies conducted anywhere in the world that examined SUD treatment and were published from 1965 to 2016, inclusive. PARTICIPANTS/CASES One hundred and fifty-one studies, 338 study arms and 299 dropout rates including 26 243 participants. MEASUREMENTS Databases were searched for studies of SUD treatment that included an in-person psychosocial component. Meta-analyses and meta-regressions were conducted to estimate dropout rates and identify predictors of dropout, including participant characteristics, facilitator characteristics and treatment characteristics. Pooled estimates were calculated with random-effects analyses accounting for the hierarchical structure of study arms nested within studies. FINDINGS The average dropout rate across all studies and study arms was 30.4% [95% confidence interval (CI) = 27.2-33.8 and 95% prediction interval (PI) = 6.25-74.15], with substantial heterogeneity (I2 = 93.7%, P < 0.0001). Studies including a higher percentage of African Americans and lower-income individuals were associated with higher dropout rates. At intake, more cigarettes/day and a greater percentage of heroin use days were associated with lower dropout rates, whereas heavier cocaine use was associated with higher dropout rates. Dropout rates were highest for studies targeting cocaine, methamphetamines and major stimulants (broadly defined) and lowest for studies targeting alcohol, tobacco and heroin, although there were few studies on methamphetamines, major stimulants and heroin. Programs characterized by more treatment sessions and greater average session length were associated with higher dropout rates. Facilitator characteristics were not significantly associated with dropout. CONCLUSIONS On average, approximately 30% of participants drop out of in-person psychosocial SUD treatment studies, but there is wide variability. Drop-out rates vary with the treated population, the substance being targeted, and the characteristics of the treatment.
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Affiliation(s)
- Sara N Lappan
- Department of Health Behavior, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Andrew W Brown
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Peter S Hendricks
- Department of Health Behavior, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
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Zhang JJQ, Fong KNK, Ouyang RG, Siu AMH, Kranz GS. Effects of repetitive transcranial magnetic stimulation (rTMS) on craving and substance consumption in patients with substance dependence: a systematic review and meta-analysis. Addiction 2019; 114:2137-2149. [PMID: 31328353 DOI: 10.1111/add.14753] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 04/10/2019] [Accepted: 07/16/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND AIMS Repetitive transcranial magnetic stimulation (rTMS) is increasingly used as an intervention for treating substance dependence. We aimed to assess evidence of the anti-craving and consumption-reducing effects of rTMS in patients with alcohol, nicotine and illicit drug dependence. METHODS A systematic review and meta-analysis of 26 randomized controlled trials (RCTs) published from January 2000 to October 2018 that investigated the effects of rTMS on craving and substance consumption in patients with nicotine, alcohol and illicit drug dependence (n = 748). Craving, measured using self-reported questionnaires or visual analog scale, and substance consumption, measured using self-report substance intake or number of addiction relapse cases, were considered as primary and secondary outcomes, respectively. Substance type, study design and rTMS parameters were used as the independent factors in the meta-regression. RESULTS Results showed that excitatory rTMS of the left dorsolateral pre-frontal cortex (DLPFC) significantly reduced craving [Hedges' g = -0.62; 95% confidence interval (CI) = -0.89 to -0.35; P < 0.0001], compared with sham stimulation. Moreover, meta-regression revealed a significant positive association between the total number of stimulation pulses and effect size among studies using excitatory left DLPFC stimulation (P = 0.01). Effects of other rTMS protocols on craving were not significant. However, when examining substance consumption, excitatory rTMS of the left DLPFC and excitatory deep TMS (dTMS) of the bilateral DLPFC and insula revealed significant consumption-reducing effects, compared with sham stimulation. CONCLUSION Excitatory repetitive transcranial magnetic stimulation of the dorsolateral pre-frontal cortex appears to have an acute effect on reducing craving and substance consumption in patients with substance dependence. The anti-craving effect may be associated with stimulation dose.
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Affiliation(s)
- Jack J Q Zhang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR
| | - Kenneth N K Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR
| | - Rang-Ge Ouyang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR
| | - Andrew M H Siu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR
| | - Georg S Kranz
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR.,Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
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Morley G, Chumbley GM, Briggs EV. 'You wouldn't do that to an animal, would you?' Ethical issues in managing pain in patients with substance dependence. Br J Pain 2019; 14:195-205. [PMID: 32922781 DOI: 10.1177/2049463719888551] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In this article, we present a secondary analysis of a descriptive phenomenological study that we conducted in the United Kingdom exploring nurses' experiences of working with patients with substance dependence and pain. Our aim was to focus upon the ethical issues that emerged in the empirical data and so we used the Four Principles of Biomedical Ethics plus attention to scope to guide and inform our analysis. We present six key themes: trust, paternalism, coercion, failure to respect autonomy, advocacy and withholding. We discuss how these themes intersect with the four principles plus scope to illuminate practice and the ethical issues that emerge when managing this patient population's pain. We recommend that clinicians adopt a collaborative approach to managing pain for patients with substance dependence that they remain aware of the power differentials inherent within the clinical setting and ensure that communication and teamwork remain at the forefront of decisions. Clinicians need access to ethical guidance to inform their practice decisions and clinical ethics support services could provide one solution.
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Affiliation(s)
| | | | - Emma V Briggs
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
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Abstract
OBJECTIVES Substance use disorders (SUDs), including those for alcohol, stimulants, tobacco, opioids and cannabis, in patients with bipolar disorder are a major clinical and public health problem, and are present in the majority of these patients. Nonetheless, the development of effective pharmacological treatments for co-occurring SUDs in bipolar illness have not been well-developed and may be an important practical reason for the reduced effectiveness of these medications in community practice. METHODS We conducted a systematic review of the literature (PubMed, Medline, Google Scholar), and identified N = 29 clinical studies, which evaluated both mental health and SUD outcomes in patients with co-occurring bipolar disorders and SUDs. RESULTS Our findings suggest the potential of valproate sodium and lamotrigine as preferred pharmacological agents for the treatment of co-occurring psychiatric and substance use outcomes in these patients. However, many of the reviewed studies are of open-label designs and of modest sample sizes. CONCLUSIONS Thus, given the gaps in our knowledge, recommendations for treatment of this common and important co-morbidity are preliminary. Accordingly, the conduct of larger, randomized controlled trials for this co-morbidity is clearly needed.
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Affiliation(s)
- Alexandria S Coles
- Addictions Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Julia Sasiadek
- Addictions Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Tony P George
- Addictions Division, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Division of Brain and Therapeutics, Department of Psychiatry, Institute of Medical Sciences (IMS), University of Toronto, Toronto, ON, Canada
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Borelli JL, Sohn L, Wang BA, Hong K, DeCoste C, Suchman NE. Therapist-Client Language Matching: Initial Promise as a Measure of Therapist-Client Relationship Quality. ACTA ACUST UNITED AC 2019; 36:9-18. [PMID: 31564767 DOI: 10.1037/pap0000177] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
While research suggests that the therapeutic alliance is important in predicting outcomes of psychotherapy, relatively little is known about the development of the alliance or the moment-to-moment components of the relationship and how they combine to create an alliance, which may represent a serious limitation in existing methods of measurement. Language style matching (LSM), or the degree to which unconscious aspects of an interactional partner's language mimic that of the other partner, is a promising, unobtrusive measure of interaction quality that could provide novel insight into the therapist-client alliance. In this article, we present a theoretical argument regarding the trajectory of therapist-client LSM across therapy sessions, as well as potential precursors and consequences of LSM. We then report on a pilot test of our hypotheses that examined how LSM, clients' relational histories, and clients' symptoms were associated within a therapeutic context. Using a small sample of substance dependent mothers (N = 7, 100% Caucasian women) enrolled in a randomized controlled trial of psychodynamic psychotherapy lasting 12 sessions, we examined client and therapist LSM across 4 of the 12 sessions. We found that, on average, LSM decreases over the course of treatment. Furthermore, greater client interpersonal problems prospectively predict lower early LSM in therapist-client dyads, which in turn predicts greater posttreatment psychiatric distress. Results generate questions for future research and support further investigations of LSM as one index of the quality of interactions between therapist and client.
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Affiliation(s)
- Jessica L Borelli
- Department of Psychology and Social Behavior, University of California, Irvine
| | - Lucas Sohn
- Department of Psychology, Pomona College
| | | | - Kajung Hong
- Department of Psychology and Social Behavior, University of California, Irvine
| | - Cindy DeCoste
- Department of Psychiatry, Yale University School of Medicine
| | - Nancy E Suchman
- Department of Psychiatry, Yale University School of Medicine
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Bradley KA, Caldeiro RM, Hallgren KA, Kivlahan DR. Making measurement-based care for addictions a reality in primary care. Addiction 2019; 114:1355-1356. [PMID: 31037777 PMCID: PMC7837283 DOI: 10.1111/add.14605] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 03/06/2019] [Indexed: 11/30/2022]
Abstract
Three factors are important to consider when integrating measurement-based care for opioid use disorders into primary care: integration with other behavioral health and substance use disorders care, the availability of a brief, valid measure that is responsive to change, and implementation in a manner that fosters accurate reporting.
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Affiliation(s)
- Katharine A. Bradley
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101,Departments of Medicine and Health Services, University of Washington, Seattle USA, 1730 Minor Ave, Suite 1600, Seattle, WA 98101,VA Puget Sound, Health Services Research and Development Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA USA, 1730 Minor Ave, Suite 1600, Seattle, WA 98101
| | - Ryan M. Caldeiro
- Kaiser Permanente Washington, Behavioral Health Service, 1730 Minor Ave, Suite 1600, Seattle, WA 98101
| | - Kevin A. Hallgren
- Department of Psychiatry and Behavioral Sciences, University of Washington Medical Center, 1959 NE Pacific St, Seattle, WA 98195
| | - Daniel R. Kivlahan
- Department of Psychiatry and Behavioral Sciences, University of Washington Medical Center, 1959 NE Pacific St, Seattle, WA 98195
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Abstract
The leaves from the tree Mitragyna speciosa, commonly known as Kratom, in the coffee plant family (Rubiaceae) are commonly used in their native habitat of Southeast Asia as a stimulant to sustain energy during hard day labor and as an opioid-like analgesic and sedative. Traditional and modern uses overlap based on the effects of the leaf extract which has also gained popularity in the United States and Europe in the last two decades. Kratom has and is being used for the mitigation of opioid withdrawal symptoms and as a harm reduction agent with a minority of users subsequently developing a dependence on the extract. The respective demographic use patterns of Kratom differ between Southeast Asia and the Western world. While pure Kratom is primarily used by day laborers and misused in conjunction with cough medicine by youth in Southeast Asia, a majority of users in the United States is middle-aged, has at least middle income, private health insurance, and completed some college. Deaths attributed to the use of Kratom have been reported in Europe and the United States but not in Southeast Asia. Although Kratom was detected as the alkaloid mitragynine in the blood of the decedents, causality could not be established in almost all cases because of poly-drug exposures. It is notable that Kratom can cause herb–drug interactions, especially with other central nervous system -active substances. Given the mostly unregulated market for Kratom products in Western countries, consumers may be exposed to adulterated or contaminated products, especially if purchased through websites or the darknet. A number of countries have scheduled Kratom because of its stimulant- and opioid-like effects and the established interaction of the alkaloid mitragynine with opioid receptors.
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Affiliation(s)
- Charles Veltri
- Department of Pharmaceutical Sciences, College of Pharmacy, Midwestern University, Glendale, AZ 85308, USA
| | - Oliver Grundmann
- Department of Pharmaceutical Sciences, College of Pharmacy, Midwestern University, Glendale, AZ 85308, USA.,Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, 32611, USA
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Abstract
BACKGROUND A substance-dependent person affects almost all aspects of family life, for example, interpersonal and social relationships, leisure time activities, and finances. Substance dependence invariably increases conflicts, negatively affects family members, and burdens the families. AIMS AND OBJECTIVES To assess family burden perceived by primary caretakers (PCTs) of individuals with substance dependence and relevant clinico-socio-demographic profile of individuals as well as PCTs. MATERIALS AND METHODS Individuals and primary caretakers (n = 150) attending psychiatry OPD and emergency were included in the study. Individuals were selected by convenient sampling. The individuals and PCTs were administered psychiatric thesis/interview pro forma and drug abuse schedule. PCTs were administered "family burden interview schedule." RESULTS Majority of caretakers had moderate objective burden (65.3%) and severe subjective burden (74%). Objective burden was more in areas of "financial burden" and "disruption of routine activities." Objective burden had correlation (P < 0.05) with monthly family income, monthly expenses on substance, number and type of substances, treatment history, sex and type of caretaker. Subjective burden was dependent on sex and type of caretaker and treatment history of the patient. CONCLUSION Our study concluded that substance dependence is associated with substantial burden for family members, more for subjective and objective burden in families with low income and with patients who are dependent on more number of substances and had taken treatment in the past. Higher proportion of severe burden was reported by female caretakers. These findings suggest directions for future research in this area.
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Affiliation(s)
- Anita Sharma
- Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Arvind Sharma
- Department of Psychiatry, Guru Gobind Singh Medical College, Faridkot, Punjab, India
| | - Sanjay Gupta
- Department of Community Medicine, Guru Gobind Singh Medical College, Faridkot, Punjab, India
| | - Satish Thapar
- Department of Psychiatry, Guru Gobind Singh Medical College, Faridkot, Punjab, India
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Abstract
Comorbidity of personality disorders (PDs) and substance use disorders (SUDs) is common in clinical practice. Borderline PD and antisocial PD are particularly found to be associated with SUDs. Our review suggests that the overall prevalence of PD ranges from 10% to 14.8% in the normal population and from 34.8% to 73.0% in patients treated for addictions. Even though the types of PD seen in patients with drug and alcohol use disorder are similar, the prevalence of any PD is higher among patients with drug use disorder than alcohol use disorder. The higher comorbidity between these two conditions has been explained by a primary personality pathology followed by a secondary development of a SUD. The comorbidity with PD positively correlates with the severity of the SUD. Comorbid PD among patients with SUDs is a predictor of poor prognosis in terms of poorer treatment response and outcome. Psychotherapy is the mainstay of treatment in comorbid condition with dialectical behavioral therapy, dynamic deconstructive psychotherapy, and dual-focused schema therapy having the most evidence base. Pharmacotherapy is primarily indicated for the acute crisis management or for the treatment of other comorbid conditions such as psychosis and depression. However, the evidence is insufficient as of now to suggest one treatment over the other. Further research is required to identify more efficacious treatment approaches for this comorbidity.
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Affiliation(s)
- Arpit Parmar
- Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India
| | - Gaurishanker Kaloiya
- Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India
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Ingram I, Kelly PJ, Deane FP, Baker AL, Raftery DK. Loneliness in Treatment-Seeking Substance-Dependent Populations: Validation of the Social and Emotional Loneliness Scale for Adults-Short Version. J Dual Diagn 2018; 14:211-219. [PMID: 30265826 DOI: 10.1080/15504263.2018.1498565] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Loneliness is a distressing emotional experience that is likely to be prevalent among people accessing treatment for substance dependence problems. The first aim of the current study was to report on the validity of the Social and Emotional Loneliness Scale for Adults-Short Version (SELSA-S), a multidimensional measure of loneliness, for use in substance-dependent treatment populations. In order to further the understanding of loneliness among this population, loneliness was examined in relation to demographic, physical, and mental health variables. METHODS Participants were attending Australian residential substance dependence treatment services provided by two nongovernmental organizations (The Salvation Army and We Help Ourselves). Participants completed cross-sectional surveys (N = 316) consisting of measures of demographics, substance use, loneliness, and physical and mental health. RESULTS Confirmatory factor analysis revealed high factor loadings and a moderate degree of concurrent and discriminant validity and internal consistency for the SELSA-S; however, model fit indices did not meet prespecified cutoff criteria. Loneliness was deemed to be a serious problem for 69% of respondents, and 79% reported feeling lonely at least once per month. CONCLUSIONS Findings of this study suggest the need for further research into the validity of the SELSA-S for use with substance-dependent populations. In addition, it may be beneficial to test a range of loneliness measures in order to determine whether other measures of loneliness may be more favorable for use across this population.
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Affiliation(s)
- Isabella Ingram
- a Illawarra Institute for Mental Health, School of Psychology , University of Wollongong , Wollongong , NSW , Australia
| | - Peter J Kelly
- a Illawarra Institute for Mental Health, School of Psychology , University of Wollongong , Wollongong , NSW , Australia
| | - Frank P Deane
- a Illawarra Institute for Mental Health, School of Psychology , University of Wollongong , Wollongong , NSW , Australia
| | - Amanda L Baker
- b School of Medicine and Public Health , University of Newcastle , Callaghan , NSW , Australia
| | - Dayle K Raftery
- a Illawarra Institute for Mental Health, School of Psychology , University of Wollongong , Wollongong , NSW , Australia
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Peacock A, Leung J, Larney S, Colledge S, Hickman M, Rehm J, Giovino GA, West R, Hall W, Griffiths P, Ali R, Gowing L, Marsden J, Ferrari AJ, Grebely J, Farrell M, Degenhardt L. Global statistics on alcohol, tobacco and illicit drug use: 2017 status report. Addiction 2018; 113:1905-1926. [PMID: 29749059 DOI: 10.1111/add.14234] [Citation(s) in RCA: 548] [Impact Index Per Article: 91.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 03/12/2018] [Accepted: 04/04/2018] [Indexed: 12/15/2022]
Abstract
AIMS This review provides an up-to-date curated source of information on alcohol, tobacco and illicit drug use and their associated mortality and burden of disease. Limitations in the data are also discussed, including how these can be addressed in the future. METHODS Online data sources were identified through expert review. Data were obtained mainly from the World Health Organization, United Nations Office on Drugs and Crime and Institute for Health Metrics and Evaluation. RESULTS In 2015, the estimated prevalence among the adult population was 18.4% for heavy episodic alcohol use (in the past 30 days); 15.2% for daily tobacco smoking; and 3.8, 0.77, 0.37 and 0.35% for past-year cannabis, amphetamine, opioid and cocaine use, respectively. European regions had the highest prevalence of heavy episodic alcohol use and daily tobacco use. The age-standardized prevalence of alcohol dependence was 843.2 per 100 000 people; for cannabis, opioids, amphetamines and cocaine dependence it was 259.3, 220.4, 86.0 and 52.5 per 100 000 people, respectively. High-income North America region had among the highest rates of cannabis, opioid and cocaine dependence. Attributable disability-adjusted life-years (DALYs) were highest for tobacco smoking (170.9 million DALYs), followed by alcohol (85.0 million) and illicit drugs (27.8 million). Substance-attributable mortality rates were highest for tobacco smoking (110.7 deaths per 100 000 people), followed by alcohol and illicit drugs (33.0 and 6.9 deaths per 100 000 people, respectively). Attributable age-standardized mortality rates and DALYs for alcohol and illicit drugs were highest in eastern Europe; attributable age-standardized tobacco mortality rates and DALYs were highest in Oceania. CONCLUSIONS In 2015 alcohol use and tobacco smoking use between them cost the human population more than a quarter of a billion disability-adjusted life years, with illicit drugs costing further tens of millions. Europeans suffered proportionately more, but in absolute terms the mortality rate was greatest in low- and middle-income countries with large populations and where the quality of data was more limited. Better standardized and rigorous methods for data collection, collation and reporting are needed to assess more accurately the geographical and temporal trends in substance use and its disease burden.
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Affiliation(s)
- Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
- School of Medicine (Psychology), University of Tasmania, Hobart, Tasmania, Australia
| | - Janni Leung
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
- School of Public Health, Faculty of Medicine, University of Queensland, Queensland, Australia
- Centre for Youth Substance Abuse Research, The University of Queensland, St Lucia, Queensland, Australia
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
| | - Sarah Larney
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
- Alpert Medical School, Brown University, Providence, RI, USA
| | - Samantha Colledge
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Medical Science (IMS), University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Psychology and Psychotherapy, Dresden, Germany
| | - Gary A Giovino
- Department of Community Health and Health Behavior, University at Buffalo, New York, NY, USA
| | - Robert West
- Department of Behavioural Science and Health, University College London, London, UK
| | - Wayne Hall
- Centre for Youth Substance Abuse Research, The University of Queensland, St Lucia, Queensland, Australia
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paul Griffiths
- European Monitoring Centre on Drugs and Drug Addiction, Lisbon, Portugal
| | - Robert Ali
- University of Adelaide, Adelaide, South Australia, Australia
| | - Linda Gowing
- University of Adelaide, Adelaide, South Australia, Australia
| | - John Marsden
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alize J Ferrari
- School of Public Health, Faculty of Medicine, University of Queensland, Queensland, Australia
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
| | - Jason Grebely
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Global Health, School of Public Health, University of Washington, WA, USA
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Aldemir E, Berk G, Coşkunol H. The Effects of the Addiction Programme of Probation on Treatment Motivation, Abstinence and Quality of Life: a Comparative Study with Motivational Interviewing and Individual Intervention. ACTA ACUST UNITED AC 2018; 55:261-270. [PMID: 30224874 DOI: 10.5152/npa.2017.19440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 06/12/2017] [Indexed: 11/22/2022]
Abstract
Introduction The aim of this study is to evaluate the effectiveness of Addiction Programme of Probation (APP) created by the Substance Abuse Treatment Commission of Ministry of Health. Methods The sample was consisted of probationers who were referred to Ege University by probation offices in February 2010. Literate probationers aged above 18, who fulfilled the SCID-I criteria for substance dependence, or had positive urine sample for illegal drugs were included. The probationers were allocated respectively to three treatment groups: APP (n=28); Motivational Interviewing (MI; n=30); Individual Intervention (II; n=30). The effectiveness of the treatment modalities was assessed by the State Anxiety Inventory; the WHO Quality of Life-Brief form; the Treatment Motivation Questionnaire. Visual analogue and Likert-type scales were used to assess the sense of the importance and the readiness of quitting drugs also the levels of craving. Urine toxicological analyses were performed fortnightly. Results The APP increased the readiness of quitting drugs. The MI increased both the sense of importance and readiness of quitting drugs, decreased the frequency and severity of craving. The II improved the mental and physical health, increased the confidence in treatment also readiness of quitting drugs. Additionally, II decreased the level of anxiety, the severity, frequency and duration of craving. There was a significant decrease in positive urine samples of all groups. Conclusion Because of changing only "the level of being ready to quit substance abuse", APP is considered as an inadequate program compared with MI and II.
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Affiliation(s)
- Ebru Aldemir
- Ege University Institute on Drug Abuse, Toxicology and Pharmaceutical Science, İzmir, Turkey
| | - Güneş Berk
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridgeshire, England
| | - Hakan Coşkunol
- Department of Psychiatry, Ege University Faculty of Medicine, İzmir, Turkey
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Denomme WJ, Simard I, Shane MS. Neuroimaging Metrics of Drug and Food Processing in Cocaine-Dependence, as a Function of Psychopathic Traits and Substance Use Severity. Front Hum Neurosci 2018; 12:350. [PMID: 30233344 PMCID: PMC6132024 DOI: 10.3389/fnhum.2018.00350] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 08/15/2018] [Indexed: 12/13/2022] Open
Abstract
Previous studies suggest that psychopathic traits commonly present as comorbid with substance use disorders. Moreover, neuroimaging and psychometric findings suggest that psychopathic traits may predispose individuals to a sensitized reward response to drugs. Given that substance use disorders are characterized by a neurocognitive bias toward drug-reward relative to non-drug reward, it is possible that heightened psychopathic characteristics may further predispose to this processing bias. To evaluate this possibility, we assessed psychopathic traits (measured using the PCL-R; Hare, 2003) in 105 probationers/parolees and evaluated the relationship between PCL-R scores, lifetime duration of drug use, and biases in neural response to drug- compared to food-related videos. Psychopathic traits (potentially driven by interpersonal/affective traits) were positively correlated with drug > food reactivity within the right insula and left amygdala. In addition, psychopathic traits modulated the relationship between drug use and drug > food reactivity within the left dorsomedial prefrontal cortex, right insula, and left caudate nucleus. Specifically, lifetime duration of drug use correlated positively with drug > food reactivity in participants with lower levels of psychopathic traits and correlated negatively with drug > food reactivity in individuals with higher levels of psychopathic traits. These results help reconcile prior studies on psychopathy and drug-stimulus processing and provide neurocognitive support for the notion that psychopathic traits serve as an underlying risk factor for substance use disorders. These results suggest that different treatment regimens for substance abuse for individuals with higher or lower levels of psychopathy may be beneficial and suggest that reduction of neurocognitive biases to drug-related stimuli may offer useful targets for future treatment protocols.
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Affiliation(s)
- William J. Denomme
- The Clinical Affective Neuroscience Laboratory for Discovery and Innovation, Faculty of Social Science and Humanities, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Isabelle Simard
- The Clinical Affective Neuroscience Laboratory for Discovery and Innovation, Faculty of Social Science and Humanities, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Matthew S. Shane
- The Clinical Affective Neuroscience Laboratory for Discovery and Innovation, Faculty of Social Science and Humanities, University of Ontario Institute of Technology, Oshawa, ON, Canada
- The Mind Research Network, The University of New Mexico, Albuquerque, NM, United States
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Aldemir E, Berk G, Coşkunol H. The Effects of the Addiction Programme of Probation on Treatment Motivation, Abstinence and Quality of Life: a Comparative Study with Motivational Interviewing and Individual Intervention. Noro Psikiyatr Ars 2018. [PMID: 30224874 DOI: 10.5152/npa.2017.19440)] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION The aim of this study is to evaluate the effectiveness of Addiction Programme of Probation (APP) created by the Substance Abuse Treatment Commission of Ministry of Health. METHODS The sample was consisted of probationers who were referred to Ege University by probation offices in February 2010. Literate probationers aged above 18, who fulfilled the SCID-I criteria for substance dependence, or had positive urine sample for illegal drugs were included. The probationers were allocated respectively to three treatment groups: APP (n=28); Motivational Interviewing (MI; n=30); Individual Intervention (II; n=30). The effectiveness of the treatment modalities was assessed by the State Anxiety Inventory; the WHO Quality of Life-Brief form; the Treatment Motivation Questionnaire. Visual analogue and Likert-type scales were used to assess the sense of the importance and the readiness of quitting drugs also the levels of craving. Urine toxicological analyses were performed fortnightly. RESULTS The APP increased the readiness of quitting drugs. The MI increased both the sense of importance and readiness of quitting drugs, decreased the frequency and severity of craving. The II improved the mental and physical health, increased the confidence in treatment also readiness of quitting drugs. Additionally, II decreased the level of anxiety, the severity, frequency and duration of craving. There was a significant decrease in positive urine samples of all groups. CONCLUSION Because of changing only "the level of being ready to quit substance abuse", APP is considered as an inadequate program compared with MI and II.
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Affiliation(s)
- Ebru Aldemir
- Ege University Institute on Drug Abuse, Toxicology and Pharmaceutical Science, İzmir, Turkey
| | - Güneş Berk
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridgeshire, England
| | - Hakan Coşkunol
- Department of Psychiatry, Ege University Faculty of Medicine, İzmir, Turkey
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Gurriarán X, Rodríguez-López J, Flórez G, Pereiro C, Fernández JM, Fariñas E, Estévez V, Arrojo M, Costas J. Relationships between substance abuse/dependence and psychiatric disorders based on polygenic scores. Genes Brain Behav 2018; 18:e12504. [PMID: 29974660 DOI: 10.1111/gbb.12504] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 06/20/2018] [Accepted: 07/02/2018] [Indexed: 12/25/2022]
Abstract
Genetic susceptibility to substance use disorders (SUDs) is partially shared between substances. Heritability of any substance dependence, estimated as 54%, is partly explained by additive effects of common variants. Comorbidity between SUDs and other psychiatric disorders is frequent. The present study aims to analyze the additive role of common variants in this comorbidity using polygenic scores (PGSs) based on genome-wide association study discovery samples of schizophrenia (SCZ), bipolar disorder, attention-deficit/hyperactivity disorder, autism spectrum disorder, major depressive disorder and anxiety disorders, available from large consortia. PGSs were calculated for 534 patients meeting DSM-IV criteria for dependence of a substance and abuse/dependence of another substance between alcohol, tobacco, cannabis, cocaine, opiates, hypnotics, stimulants, hallucinogens and solvents; and 587 blood donors from the same population, Iberians from Galicia, as controls. Significance of the PGS and percentage of variance explained were calculated by logistic regression. Using discovery samples of similar size, significant associations with SUDs were detected for SCZ PGS. SCZ PGS explained more variance in SUDs than in most psychiatric disorders. Cross-disorder PGS based on five psychiatric disorders was significant after adjustment for the effect of SCZ PGS. SCZ PGS was significantly higher in women than in men abusing alcohol. Our findings indicate that SUDs share genetic susceptibility with SCZ to a greater extent than with other psychiatric disorders, including externalizing disorders such as attention-deficit/hyperactivity disorder. Women have lower probability to develop substance abuse/dependence than men at similar PGS probably because of a higher social pressure against excessive drug use in women.
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Affiliation(s)
- Xaquín Gurriarán
- Instituto de Investigación Sanitaria (IDIS) de Santiago de Compostela, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Galicia, Spain
| | - Julio Rodríguez-López
- Instituto de Investigación Sanitaria (IDIS) de Santiago de Compostela, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Galicia, Spain
| | - Gerardo Flórez
- Unidade de Conductas Adictivas, Servizo de Psiquiatría, Complexo Hospitalario Universitario de Ourense (CHUO), Servizo Galego de Saúde (SERGAS), Ourense, Galicia, Spain
| | - César Pereiro
- Unidade Asistencial de Drogodependencias (ACLAD), A Coruña, Galicia, Spain
| | - José M Fernández
- Unidade Asistencial de Drogodependencias, Ribeira, Galicia, Spain
| | - Emilio Fariñas
- Unidade Municipal de Atención a Drogodependientes (UMAD), Santiago de Compostela, Galicia, Spain
| | - Valentín Estévez
- Unidade de Conductas Adictivas, Servizo de Psiquiatría, Complexo Hospitalario Universitario de Ourense (CHUO), Servizo Galego de Saúde (SERGAS), Ourense, Galicia, Spain
| | - Manuel Arrojo
- Instituto de Investigación Sanitaria (IDIS) de Santiago de Compostela, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Galicia, Spain.,Servizo de Psiquiatría, Complexo Hospitalario Universitario de Santiago de Compostela, Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Galicia, Spain
| | - Javier Costas
- Instituto de Investigación Sanitaria (IDIS) de Santiago de Compostela, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Galicia, Spain
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Abstract
BACKGROUND Substance use disorder can increase the risk of suicide attempt. However, the relationship between substance use disorder and suicide attempt has yet to be explored among people who report compromised health, even though sick people are more likely to make an attempt. OBJECTIVES Among people who report fair or poor health on the National Survey of Drug Use and Health (2006-2014; N = 502,467), I examined whether people with commonly occurring substance use disorders are more likely to attempt suicide than people without substance use disorders. METHODS Logistic regression was used to predict suicide attempt from presence versus absence of substance use disorder. RESULTS Among individuals reporting compromised health, those who had DSM-IV alcohol use disorders were 2.72 times (CI = 1.81-4.09, p <.001) as likely as people without SUD to attempt suicide, and people with prescription painkiller use disorders were 2.25 times (CI = 1.04-4.90, p <.05) as likely. Individuals with both alcohol and marijuana use disorders were 2.38 times (CI = 1.25-4.54, p <.01) as likely as people without substance use disorder to make an attempt, and people with both alcohol and cocaine use disorders were 3.15 times (CI = 1.16-8.60, p <.05) as likely. Conclusions/Importance: In order to help prevent suicide attempt among people who report compromised health, treatment programs that specialize in health, mental health, or substance abuse could address the drug-specific disorders that are most highly associated with the likelihood of suicide attempt. More research is needed that may underscore risk associated with other drug-specific disorders, or that substantiate the findings reported herein.
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Affiliation(s)
- Jonathan Prince
- a City University of New York System , Silberman School of Social Work at Hunter College , New York , USA
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45
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Wilson MJ, Vassileva J. Decision-Making Under Risk, but Not Under Ambiguity, Predicts Pathological Gambling in Discrete Types of Abstinent Substance Users. Front Psychiatry 2018; 9:239. [PMID: 29922190 PMCID: PMC5996080 DOI: 10.3389/fpsyt.2018.00239] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 05/15/2018] [Indexed: 11/13/2022] Open
Abstract
This study explored how different forms of reward-based decision-making are associated with pathological gambling (PG) among abstinent individuals with prior dependence on different classes of drugs. Participants had lifetime histories of either "pure" heroin dependence (n = 64), "pure" amphetamine dependence (n = 51), or polysubstance dependence (n = 89), or had no history of substance dependence (n = 133). Decision-making was assessed via two neurocognitive tasks: (1) the Iowa Gambling Task (IGT), a measure of decision-making under ambiguity (i.e., uncertain risk contingencies); and (2) the Cambridge Gambling task (CGT), a measure of decision-making under risk (i.e., explicit risk contingencies). The main effects of neurocognitive performance and drug class on PG (defined as ≥3 DSM-IV PG symptoms) as well as their interactional effects were assessed via multiple linear regression. Two CGT indices of decision-making under risk demonstrated positive main effects on PG. Interaction effects indicated that the effects of decision-making under risk on PG were largely consistent across participant groups. Notably, a linear relationship between greater CGT Risk-Taking and PG symptoms was not observed among amphetamine users, whereas IGT performance was selectively and positively associated with PG in polysubstance users. Overall, results indicate that reward-based decision-making under risk may represent a risk factor for PG across substance users, with some variations in these relationships influenced by specific class of substance of abuse.
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Affiliation(s)
- Michael J Wilson
- Neuropsychology Section, VA Maryland Health Care System, Mental Health Service Line, Baltimore, MD, United States
| | - Jasmin Vassileva
- Department of Psychiatry, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, United States
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46
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Maremmani AGI, Bacciardi S, Somers JM, Nikoo M, Schütz C, Jang KL, Krausz M. Substance Dependence Among Bipolar, Unipolar Depression and Psychotic Homeless: A Canadian National Study. Front Psychiatry 2018; 9:701. [PMID: 30618874 PMCID: PMC6305348 DOI: 10.3389/fpsyt.2018.00701] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 12/03/2018] [Indexed: 12/30/2022] Open
Abstract
Introduction: Homeless individuals are often mischaracterized as members of a homogeneous population that suffers from a wide mental health and addiction issues, with little consideration of potentially important differences within or between samples. The aim of the present study was to investigate the comorbidy of alcohol and/or substance dependence (ASD) and major psychiatric diagnoses (bipolar disorder, unipolar depression, and psychotic disorder) in a large Canadian sample of homeless individuals, and to examine potential sources of variability including location and ethnicity. Materials and Methods: A sample of 1,585 homeless individuals were assessed for alcohol and/or substance dependence and bipolar disorder, unipolar depression and psychotic disorder with the Mini-International Neuropsychiatric Interview (version 6.0). Regional and ethnic differences in major psychiatric diagnoses between homeless with and without ASD were examined using univariate (i.e., chi-square) and multivariate (i.e., logistic regression) statistics. Results: Members of the sample with ASD were found to be younger, Aboriginal, less well-educated, and born in the Americas. They were more significantly more prevalent in Western Canada and less prevalent in Central and Eastern Canada. The odds of having ASD were higher among people affected by bipolar disorder and (to a less extent) unipolar depression. Limitations: Data collected were self-reported and no urinalyses were performed. We considered diagnosis of ASD according to the previous 12 months only. Conclusions: Homeless people with major mental illness are at high risk for concurrent ASD, however the prevalence of ASD varies significantly between cities, and based on ethnicity and specific psychiatric diagnosis (with greater prevalence in individuals affected by bipolar disorder and, to a less extent, unipolar depression). Clinicians, administrators and policy makers should develop and deliver services based on careful assessment of the local population.
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Affiliation(s)
- Angelo G I Maremmani
- Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), Pietrasanta, Lucca, Italy.,Local Health Unit (Versilia Zone), Department of Psychiatry, North-Western Tuscany Region, Viareggio, Italy
| | - Silvia Bacciardi
- "Vincent P. Dole" Dual Diagnosis Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Julian M Somers
- Somers Research Group, Faculty of Health Science, Simon Fraser University, Barnaby, BC, Canada
| | - Mohammadali Nikoo
- Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, BC, Canada
| | - Christian Schütz
- Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, BC, Canada
| | - Kerry L Jang
- Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, BC, Canada
| | - Michael Krausz
- Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, BC, Canada.,Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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47
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Carrà G, Nicolini G, Lax A, Bartoli F, Castellano F, Chiorazzi A, Gamba G, Bava M, Crocamo C, Papagno C. Facial emotion recognition in schizophrenia: An exploratory study on the role of comorbid alcohol and substance use disorders and COMT Val158Met. Hum Psychopharmacol 2017; 32. [PMID: 28913946 DOI: 10.1002/hup.2630] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 07/04/2017] [Accepted: 08/01/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To explore whether facial emotion recognition (FER), impaired in both schizophrenia and alcohol and substance use disorders (AUDs/SUDs), is additionally compromised among comorbid subjects, also considering the role of catechol-O-methyltransferase (COMT) Val158Met. METHODS We conducted a cross-sectional study, randomly recruiting 67 subjects with a DSM-IV-TR diagnosis of schizophrenia, and rigorously assessing AUDs/SUDs and COMT Val158Met polymorphism. FER was assessed using the Ekman 60 Faces Test- EK-60F. RESULTS As a whole, the sample scored significantly lower than normative data on EK-60F. However, subjects with comorbid AUDs/SUDs did not perform worse on EK-60F than those without, who had a better performance on EK-60F if they carried the COMT Val/Met variant. CONCLUSIONS This study is the first to date examining the impact of AUDs/SUDs and COMT variants on FER in an epidemiologically representative sample of subjects with schizophrenia. Our findings do not suggest an additional impairment from comorbid AUDs/SUDs on FER among subjects with schizophrenia, whilst COMT Val158Met, though based on a limited sample, might have a role just among those without AUDs/SUDs. Based on our results, additional research is needed also exploring differential roles of various substances.
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Affiliation(s)
- Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.,Division of Psychiatry, University College London, London, UK
| | - Gabriella Nicolini
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Annamaria Lax
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Francesco Bartoli
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Filippo Castellano
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Alessia Chiorazzi
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Giulia Gamba
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Mattia Bava
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Costanza Papagno
- Department of Psychology, University of Milano Bicocca, Milan, Italy
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McHugh RK, Gratz KL, Tull MT. The role of anxiety sensitivity in reactivity to trauma cues in treatment-seeking adults with substance use disorders. Compr Psychiatry 2017; 78:107-14. [PMID: 28822277 DOI: 10.1016/j.comppsych.2017.07.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 07/05/2017] [Accepted: 07/25/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Exposure to traumatic events and posttraumatic stress disorder (PTSD) are common among individuals with substance use disorders (SUDs). Although the presence of trauma exposure and/or PTSD among those with SUDs is associated with a range of negative outcomes, much remains to be understood about the factors contributing to these outcomes. Anxiety sensitivity (the tendency to respond fearfully to the signs and symptoms of anxiety) has been linked to greater PTSD symptoms and the use of substances to cope with PTSD symptoms, and is a promising factor for understanding the negative outcomes associated with co-occurring PTSD and SUDs. METHODS This study examined the association between anxiety sensitivity and trauma cue reactivity among 194 trauma-exposed patients with SUDs (27.3% met criteria for current PTSD). Participants completed ratings of negative affect and substance cravings prior to and after exposure to a personally-relevant trauma cue. RESULTS Results indicated that anxiety sensitivity was associated with greater emotional reactivity (but not craving reactivity) to the trauma cue; neither PTSD symptom severity nor PTSD diagnosis moderated these associations. PTSD symptom severity was associated with greater emotional and craving reactivity to the trauma cue. CONCLUSIONS Results highlight the potential utility of targeting anxiety sensitivity in treatments for trauma-exposed patients with SUDs with and without PTSD.
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Carrà G, Nicolini G, Crocamo C, Lax A, Amidani F, Bartoli F, Castellano F, Chiorazzi A, Gamba G, Papagno C, Clerici M. Executive control in schizophrenia: a preliminary study on the moderating role of COMT Val158Met for comorbid alcohol and substance use disorders. Nord J Psychiatry 2017. [PMID: 28635556 DOI: 10.1080/08039488.2017.1286385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND A functional polymorphism in the catechol-O-methyltransferase (COMT) gene (Val158Met) appears to influence cognition in people with alcohol/substance use disorders (AUD/SUD) and in those with psychosis. METHODS To explore the potential moderating effect of these factors, a cross-sectional study was conducted, randomly recruiting subjects with DSM-IV diagnosis of schizophrenia. AUD/SUD was rigorously assessed, as well as COMT Val158Met polymorphism. Executive control functioning was measured using the Intra-Extra Dimensional Set Shift (IED). The effect of a possible interaction between comorbid AUD/SUD and COMT Val158Met polymorphism on IED scores was explored. RESULTS Subjects with schizophrenia, comorbid AUD/SUD, and MetMet carriers for SNP rs4680 of the COMT gene showed worse performance on IED completed stages scores, as compared with individuals with ValVal genotype. However, among subjects without AUD/SUD, those with the MetMet variant performed better than people carrying ValVal genotype. CONCLUSIONS This study is the first to date examining the impact of COMT on cognition in a highly representative sample of people with schizophrenia and comorbid AUD/SUD. Differential moderating effects of COMT Val/Met genotype variations may similarly influence executive functions in people with schizophrenia and comorbid AUD/SUD.
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Affiliation(s)
- Giuseppe Carrà
- a Department of Medicine and Surgery , University of Milano Bicocca , Monza , Italy
| | - Gabriella Nicolini
- a Department of Medicine and Surgery , University of Milano Bicocca , Monza , Italy
| | - Cristina Crocamo
- a Department of Medicine and Surgery , University of Milano Bicocca , Monza , Italy
| | - Annamaria Lax
- a Department of Medicine and Surgery , University of Milano Bicocca , Monza , Italy
| | - Francesca Amidani
- a Department of Medicine and Surgery , University of Milano Bicocca , Monza , Italy
| | - Francesco Bartoli
- a Department of Medicine and Surgery , University of Milano Bicocca , Monza , Italy
| | - Filippo Castellano
- a Department of Medicine and Surgery , University of Milano Bicocca , Monza , Italy
| | - Alessia Chiorazzi
- a Department of Medicine and Surgery , University of Milano Bicocca , Monza , Italy
| | - Giulia Gamba
- a Department of Medicine and Surgery , University of Milano Bicocca , Monza , Italy
| | - Costanza Papagno
- b Department of Psychology , University of Milano Bicocca , Milano , Italy
| | - Massimo Clerici
- a Department of Medicine and Surgery , University of Milano Bicocca , Monza , Italy
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Cheah ALS, Pandey R, Daglish M, Ford PJ, Patterson S. A qualitative study of patients' knowledge and views of about oral health and acceptability of related intervention in an Australian inpatient alcohol and drug treatment facility. Health Soc Care Community 2017; 25:1209-1217. [PMID: 28105790 DOI: 10.1111/hsc.12423] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/14/2016] [Indexed: 06/06/2023]
Abstract
Social factors, health behaviours and the direct effects of substances contribute to the poor oral health and restricted access to dental services experienced by people who are dependent on drugs and/or alcohol. Admission for inpatient withdrawal management provides an opportunity for intervention to promote oral health but to be effective it must be acceptable to patients. To support intervention design, we examined patients' views about oral health, practices and treatment access, and appropriateness of health-promoting intervention in this context. Given paucity of knowledge in the area we employed a qualitative approach, data were collected in semi-structured interviews with inpatients of a public specialist alcohol and drug unit in Australia in September 2014. Analysis employed the framework approach. All 14 participants wanted 'good teeth' but few diligently attended to oral healthcare; most sought assistance only in emergencies. Participants' knowledge of services was limited and practical and affective barriers hindered access. With none recalling attention to oral health during admission, support was strong for incorporation of oral health in inpatient assessments. Participants wanted information about the impact of substances on oral health and oral hygiene practices provided in various formats, and facilitated referral to non-judgemental, affordable treatment. Patients regarded promotion of oral health in the inpatient context as important, relevant and acceptable. Support should respect the different knowledge, practices and motivations for oral health and recovery, of patients. Addressing practical and affective barriers to dental services will require collaboration between drug and alcohol and dental services, and this should be the focus of further research.
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Affiliation(s)
- Alison Li Sun Cheah
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - Ram Pandey
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - Mark Daglish
- FRANZCP Royal Brisbane & Women's Hospital, Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - Pauline J Ford
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - Sue Patterson
- Metro North Mental Health, Metro North Hospital and Health Service and Griffith University, Herston, Queensland, Australia
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