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Achury Saldaña DM, Rodríguez Parrado IY, González RA. Cardio SEM: A Novel Approach for a Traffic Light System for Heart Failure Warning Signs. Comput Inform Nurs 2023; 41:673-678. [PMID: 37165833 DOI: 10.1097/cin.0000000000000996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Existing literature on the follow-up of heart failure patients with warning signs shows that it is necessary to increase patients' knowledge and of seeking help in a timely manner. This suggests an opportunity to implement strategies that integrate technology to visualize the risk of decompensation. This article studies the acceptance of Cardio Sem, a traffic light system mobile application for patients with heart failure. A descriptive, observational pilot study was performed with 23 outpatients belonging to a heart failure program. For 4 weeks, patients used Cardio Sem, which allows visualizing the risk of decompensation through a series of questions that patients must answer daily and provides guidance for managing signs and symptoms of decompensation. A technology acceptance questionnaire was applied to all patients, resulting in acceptance of the application, especially in the dimensions that emphasized perceived usefulness (100%), social influence (100%), and behavioral intent (99.8%). Cardio Sem is useful for early detection of symptoms that allow for early response to complications. Acceptance of the application by patients and its ease of use present the possibility to implement it as a complementary tool to promote self-care and effective management of symptoms.
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Affiliation(s)
- Diana Marcela Achury Saldaña
- Author Affiliations : School of Nursing, Pontificia Universidad Javeriana (Ms Achury Saldaña); Clínica Palermo (Ms Parrado); and Engineering Faculty, Pontificia Universidad Javeriana (Dr González), Bogotá, Colombia
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García-Peña ÁA, Achury-Saldaña D, González RA, Mariño A, Aponte L, Bohórquez R. Modelo de aceptación tecnológica de la aplicación móvil de seguimiento ControlVit<sup>®</sup> en pacientes con falla cardiaca. RCCAR 2022. [DOI: 10.24875/rccar.m22000169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Nova NA, González RA. A financial inclusion app and USSD service for farmers in rural Colombia. Information Development 2022. [DOI: 10.1177/02666669221120050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study reports the implementation of a financial inclusion app for farmers in rural Colombia. Stemming from the triple helix initiative, this study aims to make public financing instruments more readily available to farmers. Through a design science research approach, the app was collaboratively conceived, designed, implemented, and evaluated. We provide this reflective design as a case study of how a combination of triple helix collaboration, design science, and agile software development contributes toward the creation of context-oriented artefacts. The app could potentially benefit rural farmers to obtain information regarding the credit access, which is traditionally delivered in face-to-face meetings with bank staff. The findings provided evidence of the benefits and ease of use of the app, including certain affordances and constraints that are perceived by farmers. Moreover, factors such as technology literacy, experience using information and communication technologies (ICT), trust in technology, age of farmers, and mediation suggest that we should consider both material features of technology and social determinants for adoption in case of designing ICTs for rural communities.
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López-Toro E, Wolf CJH, González RA, van den Brink W, Schellekens A, Vélez-Pastrana MC. Network Analysis of DSM Symptoms of Substance Use Disorders and Frequently Co-Occurring Mental Disorders in Patients with Substance Use Disorder Who Seek Treatment. J Clin Med 2022; 11:jcm11102883. [PMID: 35629008 PMCID: PMC9145186 DOI: 10.3390/jcm11102883] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/10/2022] [Accepted: 05/15/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Substance use disorders (SUD) often co-occur with other psychiatric conditions. Research on SUD and comorbid disorders generally flows from a categorical diagnostic or dimensional latent variable perspective, where symptoms are viewed as independent indicators of an underlying disorder. In contrast, the current study took a network analysis perspective to examine the relationships between DSM symptoms of SUD, ADHD, conduct disorder (CD), depression (MDD), and borderline personality disorder (BPD). In addition, we explored possible gender differences in the network structures of these symptoms. Method: In a sample of 722 adult treatment-seeking patients with SUD from the International ADHD in Substance Use Disorders Prevalence Study (IASP) we estimated the network structure for 41 symptoms of SUD, ADHD, CD, MDD, and BPD. We described the structure of symptom networks and their characteristics for the total sample, and we compared the symptom networks for males and females. Results: Network analyses identified seven clusters of symptoms, largely corresponding with the DSM diagnostic categories. There were some connections between clusters, mainly between some hyperactivity symptoms and CD and depressive symptoms. ADHD hyperactivity was most central in the symptom network. Invariance tests revealed no significant gender differences in the structure of symptom networks. Conclusions: The current findings support the categorical DSM classification of mental disorders in treatment-seeking patients with SUD. Future network analyses should include a broader range of symptoms and prospectively explore changes in the symptoms network of patients during treatment.
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Affiliation(s)
- Edith López-Toro
- PhD Program in Clinical Psychology, Universidad Carlos Albizu, P.O. Box 9023711, San Juan, PR 00902-3711, USA;
| | - Casper J. H. Wolf
- Department of Psychiatry, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (C.J.H.W.); (A.S.)
- Department of Cognitive Neuroscience, Donders Institute for Brain Cognition and Behaviour, Radboud University, 6525 EN Nijmegen, The Netherlands
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), 6525 HR Nijmegen, The Netherlands
| | - Rafael A. González
- National Adoption and Fostering Service & National Conduct Problems Team, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK;
- Centre for Psychiatry, Imperial College London, London W12 0NN, UK
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam University Medical Center, Location Academic Medical Center, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands;
| | - Arnt Schellekens
- Department of Psychiatry, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (C.J.H.W.); (A.S.)
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), 6525 HR Nijmegen, The Netherlands
| | - María C. Vélez-Pastrana
- PhD Program in Clinical Psychology, Universidad Carlos Albizu, P.O. Box 9023711, San Juan, PR 00902-3711, USA;
- Correspondence: ; Tel.: +1-787-725-6500
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Özgen H, Spijkerman R, Noack M, Holtmann M, Schellekens ASA, van de Glind G, Banaschewski T, Barta C, Begeman A, Casas M, Crunelle CL, Daigre Blanco C, Dalsgaard S, Demetrovics Z, den Boer J, Dom G, Eapen V, Faraone SV, Franck J, González RA, Grau-López L, Groenman AP, Hemphälä M, Icick R, Johnson B, Kaess M, Kapitány-Fövény M, Kasinathan JG, Kaye SS, Kiefer F, Konstenius M, Levin FR, Luderer M, Martinotti G, Matthys FIA, Meszaros G, Moggi F, Munasur-Naidoo AP, Post M, Rabinovitz S, Ramos-Quiroga JA, Sala R, Shafi A, Slobodin O, Staal WG, Thomasius R, Truter I, van Kernebeek MW, Velez-Pastrana MC, Vollstädt-Klein S, Vorspan F, Young JT, Yule A, van den Brink W, Hendriks V. [International Consensus Statement for the Screening, Diagnosis, and Treatment of Adolescents with Concurrent Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder]. Z Kinder Jugendpsychiatr Psychother 2021; 50:54-67. [PMID: 34397296 DOI: 10.1024/1422-4917/a000828] [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] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
International Consensus Statement for the Screening, Diagnosis, and Treatment of Adolescents with Concurrent Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder Abstract. Background: Childhood attention-deficit/hyperactivity disorder (ADHD) is a risk factor for substance misuse and substance use disorder (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment and is associated with poor treatment outcomes. Research on the effect of treatment of childhood ADHD on the prevention of adolescent SUD is inconclusive, and studies on the diagnosis and treatment of adolescents with ADHD and SUD are scarce. Thus, the available evidence is generally not sufficient to justify robust treatment recommendations. Objective: The aim of the study was to obtain a consensus statement based on a combination of scientific data and clinical experience. Method: A modified Delphi study to reach consensus based upon the combination of scientific data and clinical experience with a multidisciplinary group of 55 experts from 17 countries. The experts were asked to rate a set of statements on the effect of treatment of childhood ADHD on adolescent SUD and on the screening, diagnosis, and treatment of adolescents with comorbid ADHD and SUD. Results: After 3 iterative rounds of rating and adapting 37 statements, consensus was reached on 36 of these statements representing 6 domains: general (n = 4), risk of developing SUD (n = 3), screening and diagnosis (n = 7), psychosocial treatment (n = 5), pharmacological treatment (n = 11), and complementary treatments (n = 7). Routine screening is recommended for ADHD in adolescent patients in substance abuse treatment and for SUD in adolescent patients with ADHD in mental healthcare settings. Long-acting stimulants are recommended as the first-line treatment of ADHD in adolescents with concurrent ADHD and SUD, and pharmacotherapy should preferably be embedded in psychosocial treatment. The only remaining no-consensus statement concerned the requirement of abstinence before starting pharmacological treatment in adolescents with ADHD and concurrent SUD. In contrast to the majority, some experts required full abstinence before starting any pharmacological treatment, some were against the use of stimulants in the treatment of these patients (independent of abstinence), while some were against the alternative use of bupropion. Conclusion: This international consensus statement can be used by clinicians and patients together in a shared decision-making process to select the best interventions and to reach optimal outcomes in adolescent patients with concurrent ADHD and SUD.
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Affiliation(s)
- Heval Özgen
- Diese Autor_innen haben zu gleichen Teilen zu diesem Beitrag beigetragen.,Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, Den Haag, Niederlande.,Curium, Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, Niederlande
| | - Renske Spijkerman
- Diese Autor_innen haben zu gleichen Teilen zu diesem Beitrag beigetragen.,Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, Den Haag, Niederlande
| | - Moritz Noack
- LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Hamm, Deutschland
| | - Martin Holtmann
- LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Hamm, Deutschland
| | - Arnt S A Schellekens
- Department of Psychiatry, Donders institute, Radboud UMC, Nijmegen, Niederlande.,Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud UMC, Nijmegen, Niederlande
| | - Geurt van de Glind
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud UMC, Nijmegen, Niederlande.,International Collaboration on ADHD and Substance Abuse (ICASA) Foundation, Nijmegen, Niederlande
| | - Tobias Banaschewski
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Zentralinstitut für Seelische Gesundheit, Mannheim, Deutschland
| | - Csaba Barta
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Ungarn.,Institute of Psychology, Faculty of Humanities and Social Sciences, Pázmány Péter Catholic University, Budapest, Ungarn
| | | | - Miguel Casas
- Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, Barcelona, Spanien
| | - Cleo L Crunelle
- Department of Psychiatry, University Hospital Brussels, Brüssel, Belgien
| | - Constanza Daigre Blanco
- Department of Psychiatry, Mental Health and Addictions, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spanien.,Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spanien.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spanien
| | - Søren Dalsgaard
- Department of Economics and Business Economics, Aarhus University, Aarhus, Dänemark
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Ungarn
| | | | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University (UA), Antwerpen, Belgien
| | - Valsamma Eapen
- Academic Unit of Infant, Child, Adolescent Psychiatry South West Sydney, University of New South Wales, Sydney, New South Wales, Australien
| | - Stephen V Faraone
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Johan Franck
- Child- and Adolescent Department, Piteå Hospital, Region Norrbotten, Piteå, Schweden
| | - Rafael A González
- Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, London, Vereinigtes Königreich.,East London NHS Foundation Trust, Child and Adolescent Mental Health Service (CAMHS) - ADHD clinic, London, Vereinigtes Königreich
| | - Lara Grau-López
- Department of Psychiatry, Mental Health and Addictions, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spanien.,Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spanien.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spanien.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spanien
| | - Annabeth P Groenman
- Department of Psychology, University of Amsterdam, Amsterdam, Niederlande.,Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, Niederlande
| | - Malin Hemphälä
- Child- and Adolescent Department, Piteå Hospital, Region Norrbotten, Piteå, Schweden
| | - Romain Icick
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, Frankreich.,INSERM U1144, Paris, Frankreich.,Inserm UMR-S1144, Université de Paris, Paris, Frankreich
| | - Brian Johnson
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Michael Kaess
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Bern, Schweiz.,Klinik für Kinder- und Jugendpsychiatrie, Zentrum für psychosoziale Medizin, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Máté Kapitány-Fövény
- Faculty of Health Sciences, Semmelweis University, Budapest, Ungarn.,Drug Outpatient Centre, Nyírő Gyula National Institute of Psychiatry and Addictions, Budapest, Ungarn
| | - John G Kasinathan
- Adolescent Mental Health, Justice Health and Forensic Mental Health Network, Sydney, New South Wales, Australien
| | - Sharlene S Kaye
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australien
| | - Falk Kiefer
- Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für seelische Gesundheit, Mannheim, Deutschland
| | - Maija Konstenius
- Child- and Adolescent Department, Piteå Hospital, Region Norrbotten, Piteå, Schweden
| | - Frances R Levin
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, New York, USA
| | - Mathias Luderer
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Frankfurt, Goethe Universität, Frankfurt am Main, Deutschland
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging, Clinical Sciences, University "G. d'Annunzio", Chieti-Pescara, Chieti, Italien
| | - Frieda I A Matthys
- Department of Psychiatry, UZ Brussel, Vrije Universiteit Brussel (VUB), Brüssel, Belgien
| | - Gergely Meszaros
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Ungarn
| | - Franz Moggi
- Universitätsklinik für Psychiatrie, Universität Bern, Bern, Schweiz
| | - Ashmita P Munasur-Naidoo
- Department of Pharmacy, Nelson Mandela University, Port Elizabeth, Südafrika.,Cipla Medpro Pharmaceuticals, Durban, Südafrika
| | - Marianne Post
- Brijder Youth Addiction Treatment, Parnassia Psychiatric Institute, Den Haag, Niederlande
| | - Sharon Rabinovitz
- School of Criminology and The Unit for Excellence in Research & Study of Addiction (ERSA), The Center for Rehabilitation Research, University of Haifa, Haifa, Israel
| | - J Antoni Ramos-Quiroga
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spanien.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spanien.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spanien.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spanien
| | - Regina Sala
- Centre for Psychiatry, Wolfson Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, Vereinigtes Königreich
| | - Abu Shafi
- East London NHS Foundation Trust, London, Vereinigtes Königreich
| | - Ortal Slobodin
- Department of Education, Ben-Gurion University, Beer-Sheva, Beer-Sheva, Israel
| | - Wouter G Staal
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, Niederlande.,Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, Niederlande
| | - Rainer Thomasius
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Ilse Truter
- Drug Utilization Research Unit (DURU), Department of Pharmacy, Nelson Mandela University, Port Elizabeth, Südafrika
| | - Michiel W van Kernebeek
- Department of Psychiatry, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brüssel, Belgien
| | | | - Sabine Vollstädt-Klein
- Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für seelische Gesundheit, Mannheim, Deutschland
| | - Florence Vorspan
- INSERM U1144, Paris, Frankreich.,Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Paris, Frankreich.,Faculté de Médecine, Université de Paris, Paris, Frankreich.,FHU NOR-SUD Network of Research in Substance Use Disorders, Paris, Frankreich
| | - Jesse T Young
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australien.,Murdoch Children's Research Institute, Melbourne, Victoria, Australien.,School of Population and Global Health, The University of Western Australia, Perth, Washington, Australien.,National Drug Research Institute, Curtin University, Perth, Washington, Australien
| | - Amy Yule
- Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Wim van den Brink
- International Collaboration on ADHD and Substance Abuse (ICASA) Foundation, Nijmegen, Niederlande.,Amsterdam University Medical Centers, location Academic Medical Center, Amsterdam, Niederlande
| | - Vincent Hendriks
- Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, Den Haag, Niederlande.,Curium, Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, Niederlande
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Young S, González RA, Wolff K, Xenitidis K, Mutch L, Malet-Lambert I, Gudjonsson GH. Substance and Alcohol Misuse, Drug Pathways, and Offending Behaviors in Association With ADHD in Prison Inmates. J Atten Disord 2020; 24:1905-1913. [PMID: 28135882 DOI: 10.1177/1087054716688532] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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] [Indexed: 11/17/2022]
Abstract
Objective: The objective of the study is to quantify the extent of specific polysubstance use, drug transitions to current substances, and describe the association with alcohol use disorders among inmates with ADHD. We also examined health risk behaviors and patterns of offending in relation with ADHD. Method: A total of 387 male British prison inmates were screened and interviewed via the Diagnostic Interview for ADHD in Adults 2.0 (DIVA-2). Results: Male prisoners with ADHD endorse more methadone and amphetamine use. There was a significantly higher linear trend among those with ADHD for the number of substances ever used. ADHD was positively associated with increasing levels of alcohol use disorder severity, and with alcohol dependence. Transition along the pathways of substance misuse and persistence of drug misuse was better explained by the presence of conduct disorder/antisocial personality traits. Conclusion: Higher rates of alcohol dependence and stimulant-cocaine misuse suggest these inmates have maladaptive coping mechanisms, such as self-medication behaviors.
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Affiliation(s)
- Susan Young
- Imperial College London, UK.,West London Mental Health Trust, London, UK
| | - Rafael A González
- Imperial College London, UK.,University of Puerto Rico, San Juan, Puerto Rico
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Coid J, González RA, Kallis C, Zhang Y, Liu Y, Wood J, Quigg Z, Ullrich S. Gang membership and sexual violence: associations with childhood maltreatment and psychiatric morbidity. Br J Psychiatry 2020; 217:583-590. [PMID: 32338230 PMCID: PMC7525108 DOI: 10.1192/bjp.2020.69] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Gang members engage in many high-risk sexual activities that may be associated with psychiatric morbidity. Victim-focused research finds high prevalence of sexual violence towards women affiliated with gangs. AIMS To investigate associations between childhood maltreatment and psychiatric morbidity on coercive and high-risk sexual behaviour among gang members. METHOD Cross-sectional survey of 4665 men 18-34 years in Great Britain using random location sampling. The survey oversampled men from areas with high levels of violence and gang membership. Participants completed questionnaires covering violent and sexual behaviours, experiences of childhood disadvantage and trauma, and psychiatric diagnoses using standardised instruments. RESULTS Antisocial men and gang members had high levels of sexual violence and multiple risk behaviours for sexually transmitted infections, childhood maltreatment and mental disorders, including addictions. Physical, sexual and emotional trauma were strongly associated with adult sexual behaviour and more prevalent among gang members. Other violent behaviour, psychiatric morbidity and addictions accounted for high-risk and compulsive sexual behaviours among gang members but not antisocial men. Gang members showed precursors before age 15 years of adult preference for coercive rather than consenting sexual behaviour. CONCLUSIONS Gang members show inordinately high levels of childhood trauma and disadvantage, sexual and non-sexual violence, and psychiatric disorders, which are interrelated. The public health problem of sexual victimisation of affiliated women is explained by these findings. Healthcare professionals may have difficulties promoting desistance from adverse health-related behaviours among gang members whose multiple high-risk and violent sexual behaviours are associated with psychiatric morbidity, particularly addictions.
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Affiliation(s)
- Jeremy Coid
- Brain Research Center and Mental Health Center, West China Hospital of Sichuan University, China; and Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK,Correspondence: Jeremy Coid.
| | | | - Constantinos Kallis
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK
| | - Yamin Zhang
- Brain Research Center and Mental Health Center, West China Hospital of Sichuan University, China
| | - YuanYuan Liu
- West China School of Public Health, Sichuan University, China
| | - Jane Wood
- School of Psychology, University of Kent, UK
| | - Zara Quigg
- Public Health Institute, Liverpool John Moores University, UK
| | - Simone Ullrich
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK
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Vélez-Pastrana MC, González RA, Ramos-Fernández A, Ramírez Padilla RR, Levin FR, Albizu García C. Attention Deficit Hyperactivity Disorder in Prisoners: Increased Substance Use Disorder Severity and Psychiatric Comorbidity. Eur Addict Res 2020; 26:179-190. [PMID: 32615575 DOI: 10.1159/000508829] [Citation(s) in RCA: 3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/18/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Attention deficit hyperactivity disorder (ADHD) and substance use disorders (SUD) are overrepresented among incarcerated populations. We examined whether ADHD was associated with increased severity of comorbid SUD and with increased psychiatric comorbidity among prisoners. METHODS Cross-sectional study of 500 randomly selected Latino male prisoners in the Puerto Rico Correctional System using validated diagnostic measures to assess Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) ADHD and SUD diagnosis, antisocial personality disorder (ASP) and borderline personality disorder (BPD), major depression, and generalized anxiety disorder (GAD). We defined SUD severity by symptom count and by presence of at least 2 current SUD diagnoses (polysubstance). RESULTS Participants with ADHD had increased risk for lifetime (p < 0.05) and current (p < 0.01) SUDs, all comorbid psychiatric disorders, and suicidality (p < 0.001). They had more severe SUD, both in number of symptoms and number of SUD (polysubstance) diagnoses (p < 0.01). ADHD was associated with increased psychiatric comorbidity, as participants with ADHD were more likely to have a second diagnosis, and a greater number of comorbid disorders (p < 0.001). ASP, BPD, major depression, and GAD, but not ADHD, were significant predictors of SUD severity in adjusted models. CONCLUSIONS Findings highlight the complex mental health needs of incarcerated populations, where SUD, ADHD, and other psychiatric disorders are prevalent and interrelated.
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Affiliation(s)
- María C Vélez-Pastrana
- PhD Program in Clinical Psychology, Universidad Carlos Albizu, San Juan, Puerto Rico, .,Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, Rio Piedras, Puerto Rico, USA,
| | - Rafael A González
- National Adoption and Fostering Service & National Conduct Problems Team, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Centre for Psychiatry, Division of Brain Sciences, Department of Medicine, Imperial College London, London, United Kingdom
| | | | - Rafael R Ramírez Padilla
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, Rio Piedras, Puerto Rico, USA
| | - Frances R Levin
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York, USA
| | - Carmen Albizu García
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, Rio Piedras, Puerto Rico, USA
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Özgen H, Spijkerman R, Noack M, Holtmann M, Schellekens ASA, van de Glind G, Banaschewski T, Barta C, Begeman A, Casas M, Crunelle CL, Daigre Blanco C, Dalsgaard S, Demetrovics Z, den Boer J, Dom G, Eapen V, Faraone SV, Franck J, González RA, Grau-López L, Groenman AP, Hemphälä M, Icick R, Johnson B, Kaess M, Kapitány-Fövény M, Kasinathan JG, Kaye SS, Kiefer F, Konstenius M, Levin FR, Luderer M, Martinotti G, Matthys FIA, Meszaros G, Moggi F, Munasur-Naidoo AP, Post M, Rabinovitz S, Ramos-Quiroga JA, Sala R, Shafi A, Slobodin O, Staal WG, Thomasius R, Truter I, van Kernebeek MW, Velez-Pastrana MC, Vollstädt-Klein S, Vorspan F, Young JT, Yule A, van den Brink W, Hendriks V. International Consensus Statement for the Screening, Diagnosis, and Treatment of Adolescents with Concurrent Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder. Eur Addict Res 2020; 26:223-232. [PMID: 32634814 DOI: 10.1159/000508385] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 04/08/2020] [Accepted: 05/04/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Childhood attention-deficit/hyperactivity disorder (ADHD) is a risk factor for substance misuse and substance use disorder (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment and is associated with poor treatment outcomes. Research on the effect of treatment of childhood ADHD on the prevention of adolescent SUD is inconclusive, and studies on the diagnosis and treatment of adolescents with ADHD and SUD are scarce. Thus, the available evidence is generally not sufficient to justify robust treatment recommendations. OBJECTIVE The aim of the study was to obtain a consensus statement based on a combination of scientific data and clinical experience. METHOD A modified Delphi study to reach consensus based upon the combination of scientific data and clinical experience with a multidisciplinary group of 55 experts from 17 countries. The experts were asked to rate a set of statements on the effect of treatment of childhood ADHD on adolescent SUD and on the screening, diagnosis, and treatment of adolescents with comorbid ADHD and SUD. RESULTS After 3 iterative rounds of rating and adapting 37 statements, consensus was reached on 36 of these statements representing 6 domains: general (n = 4), risk of developing SUD (n = 3), screening and diagnosis (n = 7), psychosocial treatment (n = 5), pharmacological treatment (n = 11), and complementary treatments (n = 7). Routine screening is recommended for ADHD in adolescent patients in substance abuse treatment and for SUD in adolescent patients with ADHD in mental healthcare settings. Long-acting stimulants are recommended as the first-line treatment of ADHD in adolescents with concurrent ADHD and SUD, and pharmacotherapy should preferably be embedded in psychosocial treatment. The only remaining no-consensus statement concerned the requirement of abstinence before starting pharmacological treatment in adolescents with ADHD and concurrent SUD. In contrast to the majority, some experts required full abstinence before starting any pharmacological treatment, some were against the use of stimulants in the treatment of these patients (independent of abstinence), while some were against the alternative use of bupropion. CONCLUSION This international consensus statement can be used by clinicians and patients together in a shared decision-making process to select the best interventions and to reach optimal outcomes in adolescent patients with concurrent ADHD and SUD.
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Affiliation(s)
- Heval Özgen
- Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, The Hague, The Netherlands, .,Curium, Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands,
| | - Renske Spijkerman
- Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Moritz Noack
- Department of Child and Adolescent Psychiatry, LWL-University Hospital, Ruhr-University Bochum, Hamm, Germany
| | - Martin Holtmann
- Department of Child and Adolescent Psychiatry, LWL-University Hospital, Ruhr-University Bochum, Hamm, Germany
| | - Arnt S A Schellekens
- Department of Psychiatry, Donders institute, RadboudUMC, Nijmegen, The Netherlands.,Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), RadboudUMC, Nijmegen, The Netherlands
| | - Geurt van de Glind
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), RadboudUMC, Nijmegen, The Netherlands.,International Collaboration on ADHD and Substance Abuse (ICASA) Foundation, Nijmegen, The Netherlands
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry, Central Institute of Mental Health Mannheim (CIMH), Heidelberg University, Mannheim, Germany
| | - Csaba Barta
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary.,Institute of Psychology, Faculty of Humanities and Social Sciences, Pázmány Péter Catholic University, Budapest, Hungary
| | | | - Miguel Casas
- Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Cleo L Crunelle
- Department of Psychiatry, University Hospital Brussels, Brussels, Belgium
| | - Constanza Daigre Blanco
- Department of Psychiatry, Mental Health and Addictions, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Søren Dalsgaard
- Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | | | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University (UA), Antwerp, Belgium
| | - Valsamma Eapen
- Academic Unit of Infant, Child, Adolescent Psychiatry South West Sydney, University of New South Wales, Sydney, New South Wales, Australia
| | - Stephen V Faraone
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Johan Franck
- Child- and Adolescent Department, Piteå Hospital, Region Norrbotten, Piteå, Sweden
| | - Rafael A González
- Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, London, United Kingdom.,East London NHS Foundation Trust, Child and Adolescent Mental Health Service (CAMHS) - ADHD clinic, London, United Kingdom
| | - Lara Grau-López
- Department of Psychiatry, Mental Health and Addictions, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Annabeth P Groenman
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.,Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Malin Hemphälä
- Child- and Adolescent Department, Piteå Hospital, Region Norrbotten, Piteå, Sweden
| | - Romain Icick
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, Paris, France.,Inserm UMR-S1144, Université de Paris, Paris, France
| | - Brian Johnson
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Máté Kapitány-Fövény
- Faculty of Health Sciences, Semmelweis University, Budapest, Hungary.,Drug Outpatient Centre, Nyírő Gyula National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - John G Kasinathan
- Adolescent Mental Health, Justice Health and Forensic Mental Health Network, Sydney, New South Wales, Australia
| | - Sharlene S Kaye
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Falk Kiefer
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - Maija Konstenius
- Child- and Adolescent Department, Piteå Hospital, Region Norrbotten, Piteå, Sweden
| | - Frances R Levin
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, New York, USA
| | - Mathias Luderer
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging, Clinical Sciences, University "G.d'Annunzio", Chieti-Pescara, Chieti, Italy
| | - Frieda I A Matthys
- Department of Psychiatry, UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Gergely Meszaros
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Franz Moggi
- University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Ashmita P Munasur-Naidoo
- Department of Pharmacy, Nelson Mandela University, Port Elizabeth, South Africa.,Cipla Medpro Pharmaceuticals, Durban, South Africa
| | - Marianne Post
- Brijder Youth Addiction Treatment, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Sharon Rabinovitz
- School of Criminology and The Unit for Excellence in Research & Study of Addiction (ERSA), The Center for Rehabilitation Research, University of Haifa, Haifa, Israel
| | - J Antoni Ramos-Quiroga
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Regina Sala
- Centre for Psychiatry, Wolfson Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom
| | - Abu Shafi
- East London NHS Foundation Trust, London, United Kingdom
| | - Ortal Slobodin
- Department of Education, Ben-Gurion University, Beer-Sheva, Beer-Sheva, Israel
| | - Wouter G Staal
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands.,Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Rainer Thomasius
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Ilse Truter
- Drug Utilization Research Unit (DURU), Department of Pharmacy, Nelson Mandela University, Port Elizabeth, South Africa
| | - Michiel W van Kernebeek
- Department of Psychiatry, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | | | - Sabine Vollstädt-Klein
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - Florence Vorspan
- INSERM U1144, Paris, France.,Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Paris, France.,Faculté de Médecine, Université de Paris, Paris, France.,FHU NOR-SUD Network of Research in Substance Use Disorders, Paris, France
| | - Jesse T Young
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,School of Population and Global Health, The University of Western Australia, Perth, Washington, Australia.,National Drug Research Institute, Curtin University, Perth, Washington, Australia
| | - Amy Yule
- Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Wim van den Brink
- International Collaboration on ADHD and Substance Abuse (ICASA) Foundation, Nijmegen, The Netherlands.,Amsterdam University Medical Centers, location Academic Medical Center, Amsterdam, The Netherlands
| | - Vincent Hendriks
- Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, The Hague, The Netherlands.,Curium, Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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10
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González RA, Vélez-Pastrana MC, Blankers M, Bäcker A, Konstenius M, Holtmann M, Levin FR, Noack M, Kaye S, Demetrovics Z, van de Glind G, van den Brink W, Schellekens A. Onset and Severity of Early Disruptive Behavioral Disorders in Treatment-Seeking Substance Use Disorder Patients with and without Attention-Deficit/Hyperactivity Disorder. Eur Addict Res 2020; 26:211-222. [PMID: 32594079 DOI: 10.1159/000508653] [Citation(s) in RCA: 3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/13/2020] [Indexed: 11/19/2022]
Abstract
AIMS This study addressed the age of onset of conduct disorder (CD) and oppositional defiant disorder (ODD) in treatment-seeking substance use disorder (SUD) patients with and without adult attention-deficit/hyperactivity disorder (ADHD) and its association with early onset of SUD. METHODS We examined data from the 2nd International ADHD in Substance Use Disorders Prevalence Study, including 400 adults in SUD treatment from Puerto Rico, Hungary, and Australia. ADHD, SUD, and CD/ODD were assessed with the Conners Adult ADHD Diagnostic Interview for DSM-IV, the MINI International Neuropsychiatric Interview, and the K-SADS, respectively. Cox regression analyses modeled time to emergence of CD/ODD separately for SUD patients with and without adult ADHD. Linear regression models examined associations between age of onset of SUD and presence of ADHD and adjusted for sex, age, and country. To assess the mediating role of CD/ODD on the association of ADHD with onset of SUD, adjusted regression models were estimated. RESULTS Treatment-seeking SUD patients with ADHD presented an earlier onset of CD/ODD compared with those without ADHD. CD/ODD symptom loads were higher among the SUD and ADHD group. Age of first substance use and SUD were significantly earlier in SUD patients with ADHD, and these findings remained significant after adjustment for demographics and coexisting CD/ODD. CONCLUSIONS ADHD is associated with earlier onset of SUD as well as with an earlier onset of more frequent and more severe disruptive behavioral disorders. These findings may inform preventive interventions to mitigate adverse consequences of ADHD.
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Affiliation(s)
- Rafael A González
- National Adoption and Fostering Service & National Conduct Problems Team, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom, .,Centre for Psychiatry, Imperial College London, London, United Kingdom,
| | - María C Vélez-Pastrana
- PhD Program in Clinical Psychology, Universidad Carlos Albizu, San Juan, Puerto Rico, USA
| | - Matthijs Blankers
- Arkin Mental Health Care, Department of Research, Amsterdam, The Netherlands.,Trimbos institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.,Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Amanda Bäcker
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Maija Konstenius
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Martin Holtmann
- LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Frances R Levin
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York, USA
| | - Moritz Noack
- LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Sharlene Kaye
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Geurt van de Glind
- Radboudumc, Donders Centre for Medical Neuroscience, Department of Psychiatry, Nijmegen, The Netherlands.,Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Arnt Schellekens
- Radboudumc, Donders Centre for Medical Neuroscience, Department of Psychiatry, Nijmegen, The Netherlands.,Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands
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11
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Sánchez-García NC, González RA, Ramos-Quiroga JA, van den Brink W, Luderer M, Blankers M, Grau-Lopez L, Levin FR, Kaye S, Demetrovics Z, van de Glind G, Schellekens A, Vélez-Pastrana MC. Attention Deficit Hyperactivity Disorder Increases Nicotine Addiction Severity in Adults Seeking Treatment for Substance Use Disorders: The Role of Personality Disorders. Eur Addict Res 2020; 26:191-200. [PMID: 32564016 DOI: 10.1159/000508545] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 02/27/2020] [Accepted: 05/07/2020] [Indexed: 11/19/2022]
Abstract
AIMS To examine the role of attention deficit/hyperactivity disorder (ADHD) and impulsive personality disorders in nicotine addiction severity among treatment-seeking substance use disorder (SUD) patients. METHODS In a cross-sectional study, we examined data from the second International ADHD in Substance Use Disorders Prevalence Study (IASP-2) on 402 adults in SUD treatment from Puerto Rico, Hungary, and Australia using diagnostic interviews for ADHD, antisocial (ASP) and borderline (BPD) personality disorders, and the self-report Fagerström Test of Nicotine Dependence (FTND). We compared SUD patients with and without ADHD on nicotine addiction severity. We tested direct and indirect pathways from ADHD to nicotine addiction and mediation through ASP and BPD. RESULTS Overall, 81.4% of SUD patients reported current cigarette smoking. SUD patients with ADHD had higher FTND scores and smoked more cigarettes than those without ADHD, with an earlier onset and more years of smoking. ASP mediated the effect of ADHD on all aspects of nicotine addiction severity, whereas BPD did so only on some aspects of nicotine addiction severity. CONCLUSIONS SUD patients with comorbid ADHD show more severe nicotine addiction than those without, which is largely explained by comorbid impulsive personality disorders. In SUD patients, it is important to screen for adult ADHD and other psychiatric disorders, especially those with impulse control deficits such as ASP and BPD.
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Affiliation(s)
| | - Rafael A González
- National Adoption and Fostering Service & National Conduct Problems Team, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, London, United Kingdom
| | - Josep A Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Wim van den Brink
- Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Mathias Luderer
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
| | - Matthijs Blankers
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands.,Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.,Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lara Grau-Lopez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Frances R Levin
- Department of Psychiatry, Columbia University Medical Center, New York, New York, USA.,CUMC/Herbert Pardes Building, New York State Psychiatric Institute, New York, New York, USA
| | - Sharlene Kaye
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, New South Wales, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Zsolt Demetrovics
- Department of Clinical Psychology and Addictions, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Geurt van de Glind
- Department of Psychiatry, Donders Centre for Medical Neuroscience, Radboudumc, Nijmegen, The Netherlands.,Department of Psychiatry, Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands
| | - Arnt Schellekens
- Department of Psychiatry, Donders Centre for Medical Neuroscience, Radboudumc, Nijmegen, The Netherlands.,Department of Psychiatry, Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands
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12
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Agudelo-Londoño S, Gorbanev I, Delgadillo V, Muñoz Ó, Cortes A, González RA, Pomares-Quimbaya A. Development and Evaluation of a Serious Game for Teaching ICD-10 Diagnosis Coding to Medical Students. Games Health J 2019; 8:349-356. [PMID: 31166817 DOI: 10.1089/g4h.2018.0101] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: Assessment of the pedagogical effect and technological acceptance of the serious game, CODIFICO, which has been designed to train medical students in ICD-10 diagnosis coding. Materials and Methods: We designed the serious game, CODIFICO, as an alternative way to teach ICD-10 diagnosis coding to undergraduate medical students. To assess the pedagogical effect of the game, we used the quasiexperimental pretest-posttest design. The participants began by completing a knowledge pretest on Blackboard. After the pretest, the teacher presented the game to the students and invited them to play it for 1 week. Then, the students completed the posttest on Blackboard. We applied the Wilcoxon test to establish the difference between the pretest and posttest. We designed a questionnaire to evaluate the participants' technology acceptance toward the game. Results: Sixty-one undergraduate medical students from a large Colombian private university took part. There was no statistically significant difference between the pretest and the posttest. However, the game had some positive effects on knowledge. The game was well accepted among the participants. Conclusion: The game, CODIFICO, was useful to teach diagnosis determination, not diagnostic coding. Some of the reasons that caused this situation were insufficient attention to the pedagogical theory, excessive reliance on clinical aspects of the medical training, limited resources, and lack of experience at the medical school to design gamification strategies.
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Affiliation(s)
| | - Iouri Gorbanev
- Economics and Management School, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
| | - Vivian Delgadillo
- Medicine School, Pontificia Universidad Javeriana; and Hospital Universitario San Ignacio, Bogotá D.C., Colombia
| | - Óscar Muñoz
- Medicine School, Pontificia Universidad Javeriana; and Hospital Universitario San Ignacio, Bogotá D.C., Colombia
| | - Ariel Cortes
- Economics and Management School, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
| | - Rafael A González
- Engineering School, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
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13
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González RA, Vélez-Pastrana MC, McCrory E, Kallis C, Aguila J, Canino G, Bird H. Evidence of concurrent and prospective associations between early maltreatment and ADHD through childhood and adolescence. Soc Psychiatry Psychiatr Epidemiol 2019; 54:671-682. [PMID: 30903235 DOI: 10.1007/s00127-019-01659-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 07/19/2018] [Accepted: 01/17/2019] [Indexed: 01/04/2023]
Abstract
PURPOSE An emerging body of work suggests a link between childhood maltreatment and attention-deficit hyperactivity disorder (ADHD). However, research examining the role of maltreatment in the early course of the disorder lacks robust evidence from longitudinal studies. Our aim was to examine concurrent and prospective associations between maltreatment experiences and ADHD diagnosis and sex differences, and to estimate the association between repetitive maltreatment exposure and ADHD through childhood and adolescence. METHODS Data were obtained from the Boricua Youth Study, a longitudinal study of 2480 children and adolescents of Puerto Rican background. Neglect, physical, emotional and sexual abuse, and foster placement were regressed on ADHD diagnosis measured at each of three waves using the Diagnostic Interview Schedule for Children-IV. Multilevel regressions estimated the effects of exposure on ADHD, adjusted by age, sex, income, household education, parental psychopathology, comorbidity and ADHD medication status. RESULTS Emotional abuse and foster placement had robust associations with ADHD diagnosis. For girls, physical abuse had a threefold increase in the odds of having ADHD diagnosis; for boys, associations were observed only for emotional abuse. Prospective models examining the risk of ADHD following maltreatment provided initial evidence for the effects of physical abuse on ADHD, and a linear trend for repetitive exposure suggested increased probability for disorder persistence. CONCLUSIONS Associations between early maltreatment and ADHD were robust. Different categories of maltreatment increase the likelihood of ADHD for girls and boys. Increased exposure to maltreatment may predict symptom persistence. Interventions addressing ADHD must consider the effects of both sex and family environment.
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Affiliation(s)
- Rafael A González
- Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, 7th floor Commonwealth Building, Du Cane Road, London, W12 0NN, UK. .,Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, San Juan, PR, USA.
| | - María C Vélez-Pastrana
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, San Juan, PR, USA.,Ph.D. Program in Clinical Psychology, Carlos Albizu University, San Juan, PR, USA
| | - Eamon McCrory
- Division of Psychology and Language Sciences, University College London, London, UK
| | | | - Jivelisse Aguila
- Ph.D. Program in Clinical Psychology, Carlos Albizu University, San Juan, PR, USA
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico School of Medicine, San Juan, PR, USA
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14
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Gorbanev I, Agudelo-Londoño S, González RA, Cortes A, Pomares A, Delgadillo V, Yepes FJ, Muñoz Ó. A systematic review of serious games in medical education: quality of evidence and pedagogical strategy. Med Educ Online 2018; 23:1438718. [PMID: 29457760 PMCID: PMC5827764 DOI: 10.1080/10872981.2018.1438718] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 02/02/2018] [Indexed: 05/23/2023]
Abstract
INTRODUCTION The literature shows an optimistic landscape for the effectiveness of games in medical education. Nevertheless, games are not considered mainstream material in medical teaching. Two research questions that arise are the following: What pedagogical strategies do developers use when creating games for medical education? And what is the quality of the evidence on the effectiveness of games? METHODS A systematic review was made by a multi-disciplinary team of researchers following the Cochrane Collaboration Guidelines. We included peer-reviewed journal articles which described or assessed the use of serious games or gamified apps in medical education. We used the Medical Education Research Study Quality Instrument (MERSQI) to assess the quality of evidence in the use of games. We also evaluated the pedagogical perspectives of such articles. RESULTS Even though game developers claim that games are useful pedagogical tools, the evidence on their effectiveness is moderate, as assessed by the MERSQI score. Behaviourism and cognitivism continue to be the predominant pedagogical strategies, and games are complementary devices that do not replace traditional medical teaching tools. Medical educators prefer simulations and quizzes focused on knowledge retention and skill development through repetition and do not demand the use of sophisticated games in their classrooms. Moreover, public access to medical games is limited. DISCUSSION Our aim was to put the pedagogical strategy into dialogue with the evidence on the effectiveness of the use of medical games. This makes sense since the practical use of games depends on the quality of the evidence about their effectiveness. Moreover, recognition of said pedagogical strategy would allow game developers to design more robust games which would greatly contribute to the learning process.
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Affiliation(s)
- Iouri Gorbanev
- Economics and Management School, Pontificia Universidad Javeriana, Bogotá, Colombia
- CONTACT Iouri Gorbanev Economics and Management School, Pontificia Universidad Javeriana, Bogotá, D.C, Colombia
| | | | | | - Ariel Cortes
- Economics and Management Sciences School, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Alexandra Pomares
- Engineering School, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Francisco J. Yepes
- Public Health Institute, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Óscar Muñoz
- Medicine School, Pontificia Universidad Javeriana, Bogotá, Colombia
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Pérez-Pedrogo C, Martínez-Taboas A, González RA, Caraballo JN, Albizu-García CE. Sex differences in traumatic events and psychiatric morbidity associated to probable posttraumatic stress disorder among Latino prisoners. Psychiatry Res 2018; 265:208-214. [PMID: 29738944 PMCID: PMC6016368 DOI: 10.1016/j.psychres.2018.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 05/01/2017] [Revised: 03/01/2018] [Accepted: 04/05/2018] [Indexed: 10/17/2022]
Abstract
Latinos comprised 17.1% of the U.S. population and 33.1% of US prisoners, yet they are underrepresented in the psychopathology literature. Despite higher rates of trauma among incarcerated individuals than in the general population, most of the previous research in this area focused primarily on women samples, and very few studies examined sex differences in PTSD and traumatic experiences. In addition, there is a need for research assessing traumatic experiences and probable PTSD in men and women Latino inmates to inform culturally competent care and sex sensitive care for this vulnerable and underserved population. Our study examined whether men and women Latino inmates with probable Posttraumatic Stress Disorder (PTSD), based on the cut off 40 or more symptoms on the Davidson Trauma Scale (DTS), differed significantly by the number of event types experienced, the type of potentially traumatizing event, and in co-occurring psychiatric conditions. A multi-stage sample design was used to select a probabilistic sample of 1,331 inmates from 26 penal institutions in PR of which 1179 participated in the study. Bivariate associations were calculated for each type of traumatic event and probable PTSD. Mean number of types of potentially traumatizing event experienced was comparable for both sexes (F = 3.83, M = 3.74) yet sex differences were found in the nature of the event. Women with probable PTSD had higher rates of experiencing rape and sexual abuse. Men had higher rates of experiencing combat in war, a life-threatening accident, of witnessing violence, and being threatened with a weapon. Men with significant ADHD symptoms in childhood and with Generalized Anxiety Disorder (GAD) during adulthood were almost 5 and 7 times as likely to score above threshold on the DTS whereas women were >3 times as likely in the presence of ADHD symptoms in childhood or depression during adulthood. This study underscores the need to improve understanding of the clinical manifestations of trauma and co-occurring psychiatric conditions for appropriate sex sensitive interventions targeting Latinos living in prisons.
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Affiliation(s)
- Coralee Pérez-Pedrogo
- University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico; Carlos Albizu University, San Juan Campus, San Juan, Puerto Rico.
| | | | - Rafael A González
- East London NHS Foundation Trust, Child and Adolescent Mental Health Service (CAMHS), London, UK; Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College, London, UK
| | - José N Caraballo
- University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
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Young S, González RA, Fridman M, Hodgkins P, Kim K, Gudjonsson GH. The economic consequences of attention-deficit hyperactivity disorder in the Scottish prison system. BMC Psychiatry 2018; 18:210. [PMID: 29940897 PMCID: PMC6019793 DOI: 10.1186/s12888-018-1792-x] [Citation(s) in RCA: 14] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 06/13/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) is highly prevalent amongst prison inmates and the criminal justice system (CJS) likely bears considerable costs for offenders with ADHD. We aimed to examine the relationship between ADHD and health-related quality of life (HRQoL) and quality-adjusted life years (QALY) amongst imprisoned adults; and to estimate the annual expenditure associated with ADHD status in prison. METHODS An observational study was performed in 2011-2013, at Porterfield Prison, Inverness, United Kingdom (UK). The all male sample included 390 adult prison inmates with capacity to consent and no history of moderate or severe intellectual disability. Participants were interviewed using the Diagnostic Interview for ADHD in Adults 2.0. The Health Utilities Index Mark 3 (HUI3) was used to measure health status, and to calculate attribute specific HRQoL scores and QALY. Health service utilisation was obtained through inspection of medical prison records. Inmates with ADHD were compared with inmates without ADHD. RESULTS Inmates with ADHD had significantly lower QALYs, with a clinically significant adjusted difference of 0.13. Psychiatric co-morbidity accounted for the variation of ADHD on the HUI3 emotion domain only. Medical costs for inmates with ADHD were significantly higher; and behaviour-related prison costs were similar to prisoners without ADHD, reflecting a low frequency of recorded critical incidents. CONCLUSIONS ADHD may directly contribute to adverse health and quality of life through cognitive and executive function deficits, and co-morbid disorders. The extrapolation of conservative cost estimates suggests that the financial burden of medical and behavior-related prison care for inmates with ADHD in the UK is approximately £11.7 million annually. The reported cost estimates are conservative as there is great variability in recorded critical incidents in prisons. In turn, for some prison establishments the prison care costs associated with prisoners with ADHD may be considerably greater.
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Affiliation(s)
- Susan Young
- Psychology Services Limited, PO Box 1735, Croydon, CR97AE, UK. .,Reykjavik University, Reykjavik, Iceland.
| | - Rafael A. González
- 0000 0004 0426 7183grid.450709.fEast London NHS Foundation Trust, London, UK
| | | | - Paul Hodgkins
- 0000 0004 5913 664Xgrid.476678.cSage Therapeutics, Cambridge, MA USA
| | - Keira Kim
- Indedpendent Medical Writer, San Diego, CA USA
| | - Gisli H. Gudjonsson
- 0000 0004 0643 5232grid.9580.4Reykjavik University, Reykjavik, Iceland ,0000 0001 2322 6764grid.13097.3cInstitute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Young S, González RA, Fridman M, Hodgkins P, Kim K, Gudjonsson GH. Health-related quality of life in prisoners with attention-deficit hyperactivity disorder and head injury. BMC Psychiatry 2018; 18:209. [PMID: 29929487 PMCID: PMC6013883 DOI: 10.1186/s12888-018-1785-9] [Citation(s) in RCA: 9] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 06/12/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) and head injury (including traumatic brain injury (TBI)) manifest in high levels across prison samples and guidance from the National Institute for Health and Care Excellence notes that people with acquired brain injury may have increased prevalence of ADHD. We aimed to examine the association of ADHD with TBI and the impact of the association upon health-related quality of life (HRQoL) and service use among imprisoned adults. METHODS An observational study was performed in 2011-2013, at Porterfield Prison, Inverness, United Kingdom (UK). The all male sample included 390 adult prison inmates with capacity to consent and no history of moderate or severe intellectual disability. Head injury was measured with a series of self-reported questions, addressing history of hits to the head: frequency, severity, loss of consciousness (LOC), and sequelae. Participants were interviewed using the Diagnostic Interview for ADHD in Adults 2.0. The Health Utilities Index Mark 3 was used to measure health status, and to calculate attribute specific HRQoL and Quality-Adjusted Life Year (QALY) scores. RESULTS 72% of prisoners sampled reported at least one head injury in their lifetime. Among those, 70% of head injuries occurred before age 16 and 70% experienced LOC. Prisoners with ADHD were nearly twice more likely to have TBI. Prisoners with ADHD-only and ADHD with co-morbid TBI had significantly lower scores in several HRQoL attributes, compared with TBI only or the absence of either condition. Adjusted logistic regression models indicated an average reduction of 0.20 QALYs in inmates with ADHD-only and 0.30 QALY loss in those with ADHD with co-morbid TBI compared with inmates with neither condition. CONCLUSIONS There is a robust association between ADHD and TBI, and ADHD with co-morbid TBI confers significantly greater impairment in terms of HRQoL. Managing the short and long-term consequences of TBI is essential to improving care for prisoners and to addressing the criminogenic factors related to them.
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Affiliation(s)
- Susan Young
- Psychology Services Limited, PO Box 1735, Croydon, CR97AE, UK. .,Reykjavik University, Reykjavik, Iceland.
| | - Rafael A. González
- 0000 0004 0426 7183grid.450709.fEast London NHS Foundation Trust, East London, UK
| | | | - Paul Hodgkins
- 0000 0004 5913 664Xgrid.476678.cSage Therapeutics, Cambridge, MA USA
| | - Keira Kim
- Independent Medical Writer, San Diego, CA USA
| | - Gisli H. Gudjonsson
- 0000 0004 0643 5232grid.9580.4Reykjavik University, Reykjavik, Iceland ,0000 0001 2322 6764grid.13097.3cInstitute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Young S, González RA, Mullens H, Mutch L, Malet-Lambert I, Gudjonsson GH. Neurodevelopmental disorders in prison inmates: comorbidity and combined associations with psychiatric symptoms and behavioural disturbance. Psychiatry Res 2018; 261:109-115. [PMID: 29291476 DOI: 10.1016/j.psychres.2017.12.036] [Citation(s) in RCA: 26] [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: 11/17/2016] [Revised: 12/04/2017] [Accepted: 12/14/2017] [Indexed: 11/17/2022]
Abstract
The identification and management of inmates with neurodevelopmental disorders (ND) has been insufficiently addressed in the literature. We estimated the proportion of cases with Attention deficit/hyperactivity disorder (ADHD), Autism spectrum disorder (ASD) and Intellectual disability (ID) in prison, their comorbidity, and associations with disruptive behaviours and with psychiatric symptoms. Further, we examined the role of coexisting ND on psychiatric symptoms and attitudes toward violence. All 390 male inmates underwent an assessment that included the Diagnostic Interview for ADHD in Adults 2.0, the Autism Quotient, the Learning Disability Screening Questionnaire, the Brief Symptom Inventory (BSI), and measures of disruptive behaviours and attitudes towards violence. The percentage of cases with ADHD, ASD and ID were 25%, 9% and 9%. Inmates with ADHD and those with ID had significantly higher levels of disruptive behaviours. The combined ADHD/ASD group had significantly higher scores on global severity symptoms than either ADHD or ASD only. Meanwhile, the combined ADHD/ID group had significantly higher scores of behavioural disturbance than the ADHD-only group. Our findings show the extent of ND in prison, their inter-relations and associations with further mental health problems. Vulnerabilities conferred by ND within the criminal justice system should be addressed via interventions and preventative strategies.
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Affiliation(s)
- Susan Young
- Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, UK; Reykjavik University, Iceland.
| | - Rafael A González
- Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, UK; Child and Family Consultation Service, East London NHS Foundation Trust, UK
| | | | - Laura Mutch
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | | | - Gisli H Gudjonsson
- Reykjavik University, Iceland; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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Román-Ithier JC, González RA, Vélez-Pastrana MC, González-Tejera GM, Albizu-García C. Attention deficit hyperactivity disorder symptoms, type of offending and recidivism in a prison population: The role of substance dependence. Crim Behav Ment Health 2017; 27:443-456. [PMID: 27455899 PMCID: PMC5269538 DOI: 10.1002/cbm.2009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 02/14/2016] [Accepted: 06/07/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND It is unclear whether adult offenders with a history of attention deficit hyperactivity disorder (ADHD) are more likely to re-offend, and if so, in any specific offences. AIM This study aimed to examine correlates of childhood ADHD symptoms among prisoners. METHODS A randomly selected sample of 1179 participants from the adult sentenced population of Puerto Rico (USA) reported their history of violent and non-violent offences, age of first arrest and re-offending. Participants completed retrospective measures of ADHD and a diagnostic interview for substance use disorders. RESULTS Self-reported ADHD was associated with age of first arrest, a number of violent and non-violent offences and re-offending. The association with any non-violent offending was explained statistically by substance use disorders and other psychosocial covariates. ADHD was independently associated with being under 15 years of age at first arrest and with re-offending. CONCLUSIONS Although some associations between ADHD and offending may be accounted for by co-morbidity with substance use disorders, early onset of offending and repeated violent offending appear to be directly related to ADHD. Criminal justice policies should, therefore, incorporate ADHD screening accompanied by appropriate rehabilitation programmes when such neurodevelopmental disorder is identified. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
| | - Rafael A. González
- Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, UK
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico
| | - María C. Vélez-Pastrana
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico
- Clinical Psychology PhD Program, Carlos Albizu University, San Juan, PR
| | | | - Carmen Albizu-García
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico
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Young S, González RA, Wolff K, Mutch L, Malet-Lambert I, Gudjonsson GH. Transitions and Motivations for Substance Misuse in Prison Inmates With ADHD and Conduct Disorder: Validation of a New Instrument. J Dual Diagn 2017; 13:91-100. [PMID: 28418789 DOI: 10.1080/15504263.2017.1290859] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 01/23/2023]
Abstract
OBJECTIVE There is a reasonable theoretical base for understanding the possible causes and motivations behind substance misuse and its dependency. There is a need for a reliable and valid measure that delineates the markers of substance use from its initiation and identifies different motivations for drug use transitioning, maintenance, and dependency. We addressed this gap in the United Kingdom by examining and validating the Substance Transitions in Addiction Rating Scale (STARS). METHODS For this review, 390 male prisoners were screened for conduct disorder and assessed with a clinical diagnostic interview for attention deficit/hyperactivity disorder (ADHD). They completed the four STARS subscales regarding their substance use. Exploratory structural equation modeling was performed to assess the STARS structure and to derive factors to assess validity against ADHD and conduct disorder diagnostic categories. RESULTS Each of the subscales produced meaningful and reliable factors that supported the self-medication and behavioral disinhibition hypotheses of substance use motivation. The findings robustly show that ADHD is significantly associated with the need for coping as a way of managing primary and comorbid symptoms, but not conduct disorder. The findings were strongest for the combined ADHD type. DISCUSSION STARS has a great potential to further the understanding of the motivation behind substance use and its dependency in different populations.
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Affiliation(s)
- Susan Young
- a Centre for Mental Health, Division of Brain Sciences, Department of Medicine , Imperial College London , London , United Kingdom.,b Broadmoor Hospital , West London Mental Health Trust , London , United Kingdom
| | - Rafael A González
- a Centre for Mental Health, Division of Brain Sciences, Department of Medicine , Imperial College London , London , United Kingdom.,c Center for Evaluation and Sociomedical Research, Graduate School of Public Health , University of Puerto Rico , San Juan , Puerto Rico
| | - Kim Wolff
- d Institute of Pharmaceutical Science, Faculty of Life Sciences and Medicine, King's College London , London , United Kingdom
| | - Laura Mutch
- e Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience , King's College London , United Kingdom
| | - Isabella Malet-Lambert
- e Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience , King's College London , United Kingdom
| | - Gisli H Gudjonsson
- e Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience , King's College London , United Kingdom
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Muñoz-Yáñez C, Pérez-Morales R, Moreno-Macías H, Calleros-Rincón E, Ballesteros G, González RA, Espinosa J. Polymorphisms FTO rs9939609, PPARG rs1801282 and ADIPOQ rs4632532 and rs182052 but not lifestyle are associated with obesity related-traits in Mexican children. Genet Mol Biol 2016; 39:547-553. [PMID: 27560839 PMCID: PMC5127146 DOI: 10.1590/1678-4685-gmb-2015-0267] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 02/29/2016] [Indexed: 11/26/2022] Open
Abstract
Concerning the genetic factors of obesity, no consistent association between populations has been reported, which may be due to the frequency of polymorphisms, the lifestyle of studied populations and its interaction with other factors. We studied a possible association of polymorphisms FTO rs9939609, PPARG rs1801282, and ADIPOQ rs4632532 and rs182052 with obesity phenotypes in 215 Mexican children. Glucose, triglycerides, cholesterol, HDL and LDL were measured. In addition, weight, height, waist circumference and triceps skin thickness were recorded. High-energy diets and sedentary behavior were evaluated with a validated questionnaire. In contrast with other reports, only FTO rs9939609 was associated with obesity related-traits, including BMI (p = 0.03), waist circumference (p = 0.02), triceps skinfold (p = 0.03) and waist/height ratio (p = 0.01), and also with cholesterol levels (p = 0.02) and LDL (p = 0.009). Lower levels of triglycerides (p=0.04) were related with presence of PPARG rs1801282, while ADIPOQ rs4632532 showed an effect on HDL (p = 0.03) levels. On the other hand, diet, physical activity and screen time were not related with obesity. In summary, only FTO rs9939609 was associated with obesity related-traits, while PPARG2 rs1801282 and ADIPOQ rs4632532 were involved in lipid metabolism.
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Affiliation(s)
- C Muñoz-Yáñez
- Departamento de Investigación, Facultad de Medicina, Universidad Juárez del Estado de Durango, Durango, México
| | - R Pérez-Morales
- Departamento de Biología Molecular, Facultad de Ciencias Químicas, Universidad Juárez del Estado de Durango, Durango, México
| | - H Moreno-Macías
- Departamento de Economía, División CSH de la Universidad Autónoma Metropolitana, Unidad Iztapalapa, D.F. México, México
| | - E Calleros-Rincón
- Departamento de Biología Molecular, Facultad de Ciencias Químicas, Universidad Juárez del Estado de Durango, Durango, México
| | - G Ballesteros
- Facultad de Ciencias, Universidad Autónoma del Estado de Morelos, Cuernavaca, Morelos, México
| | - R A González
- Facultad de Ciencias, Universidad Autónoma del Estado de Morelos, Cuernavaca, Morelos, México
| | - J Espinosa
- Departamento de Investigación, Facultad de Medicina, Universidad Juárez del Estado de Durango, Durango, México
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González RA, Igoumenou A, Kallis C, Coid JW. Borderline personality disorder and violence in the UK population: categorical and dimensional trait assessment. BMC Psychiatry 2016; 16:180. [PMID: 27255770 PMCID: PMC4891918 DOI: 10.1186/s12888-016-0885-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 05/24/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Borderline personality disorder (BPD) is characterised by difficulties with impulse control and affective dysregulation. It is unclear whether BPD contributes to the perpetration of violence or whether this is explained by comorbidity. We explored independent associations between categorical and dimensional representations of BPD and violence in the general population, and differential associations from individual BPD criteria. METHODS We used a representative combined sample of 14,753 men and women from two British national surveys of adults (≥16 years). BPD was assessed using the Structured Clinical Interview II- Questionnaire. We measured self-reported violent behaviour in the past 5 years, including severity, victims and locations of incidents. Associations for binary, dimensional and trait-level exposures were performed using weighted logistic regression, adjusted for demography and comorbid psychopathology. RESULTS Categorical diagnosis of BPD was associated only with intimate partner violence (IPV). Associations with serious violence leading to injuries and repetitive violence were better explained by comorbid substance misuse, anxiety and antisocial personality disorder (ASPD). However, anger and impulsivity BPD items were independently associated with most violent outcomes including severity, repetition and injury; suicidal behaviours and affective instability were not associated with violence. Both trait-level and severity-dimensional analyses showed that BPD symptoms might impact males and females differently in terms of violence. CONCLUSIONS For individuals diagnosed BPD, violence is better explained by comorbidity. However, BPD individual traits show different pathways to violence at the population level. Gender differences in BPD traits and their severity indicate distinct, underlying mechanisms towards violence. BPD and traits should be evaluated in perpetrators of IPV.
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Affiliation(s)
- Rafael A González
- Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College, London, UK
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, Puerto Rico, USA
| | - Artemis Igoumenou
- Violence Prevention Research Unit, Queen Mary University of London, London, UK.
| | - Constantinos Kallis
- Violence Prevention Research Unit, Queen Mary University of London, London, UK
| | - Jeremy W Coid
- Violence Prevention Research Unit, Queen Mary University of London, London, UK
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Vélez-Pastrana MC, González RA, Cardona JR, Baerga PP, Rodríguez ÁA, Levin FR. Psychometric properties of the Barkley Deficits in Executive Functioning Scale: A Spanish-Language Version in a community sample of puerto rican adults. Psychol Assess 2016; 28:483-98. [PMID: 26302104 PMCID: PMC4766062 DOI: 10.1037/pas0000171] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 11/08/2022]
Abstract
Performance-based measures have shown some limitation in the assessment of executive functioning (EF) and rating scales have been proposed as an alternative. Our aim was to conduct a comprehensive psychometric evaluation of the Barkley Deficits in Executive Functioning Scale (BDEFS), as administered in 452 Latino community adults (65.5% female). The BDEFS was back-translated into Spanish. We performed exploratory factor analysis (EFA) to assess the structure of the translated BDEFS and to compare it with the original five-factor structure based on the English-language version. Confirmatory factor analysis (CFA) was performed to test the original language structure of the instrument, and also a modified version with items that loaded equally in both versions. The Adult Self-Report Scale was used to screen for ADHD symptoms. We assessed invariance on the latent factor's mean by age and gender, and to estimate associations with ADHD symptom dimensions. The five-factor structure of the BDEFS was partially supported by EFA/CFA, in which 78 out of 89 items loaded similar to the original English-language structure. Factor scores were significantly associated with ADHD symptom dimensions. Model-based contrasts revealed that inattention was primarily associated with disorganization, time-management and motivational aspects of EF; hyperactivity was predominantly related to self-restraint and self-regulation factors. The BDEFS seemingly assesses similar dimensions of the EF construct in English and in the present Spanish-language versions. Factor scores were differentially associated with ADHD subtypes. Replication and confirmation of the Spanish-language BDEFS in a larger sample is advised. (PsycINFO Database Record
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Affiliation(s)
- María C. Vélez-Pastrana
- Carlos Albizu University, San Juan, PR
- University of Puerto Rico Graduate School of Public Health
| | - Rafael A. González
- University of Puerto Rico Graduate School of Public Health
- Imperial College London, UK
| | | | | | - Ángel Alicea Rodríguez
- Carlos Albizu University, San Juan, PR
- University of Puerto Rico Graduate School of Public Health
| | - Frances R. Levin
- Columbia University, New York, NY, USA
- New York State Psychiatric Institute, USA
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Young S, González RA, Mutch L, Mallet-Lambert I, O'Rourke L, Hickey N, Asherson P, Gudjonsson GH. Diagnostic accuracy of a brief screening tool for attention deficit hyperactivity disorder in UK prison inmates. Psychol Med 2016; 46:1449-1458. [PMID: 26867860 DOI: 10.1017/s0033291716000039] [Citation(s) in RCA: 18] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is overrepresented in prison, making it imperative to identify a screening tool that can be quickly applied to efficiently detect the disorder. We explored the discrimination ability of a widely used ADHD screen, the Barkley Adult ADHD Rating Scale (BAARS-IV), against a clinical diagnostic interview. A brief version of the screen was then developed in order to simplify its use in the prison context, and maximize its diagnostic properties. METHOD A cross-sectional study of 390 male prison inmates was performed in the UK, all participants were screened and interviewed via the Diagnostic Interview for ADHD in Adults 2.0 (DIVA-2). RESULTS A total of 47 (12.1%) inmates screened positive for ADHD using the full BAARS-IV, and 96 (24.6%) were clinically diagnosed, for a sensitivity of 37.9 and a specificity of 96.3. Our models identified the six items that most predicted ADHD diagnosis, with adjusted odds ratios ranging from 2.66 to 4.58. Sensitivity, specificity and accuracy were 0.82, 0.84 and 0.84, respectively, for the developed brief scale, and 0.71, 0.85 and 0.81 for its validation. Weighted probability scores produced an area under the curve of 0.89 for development, and 0.82 for validation of the brief scale. CONCLUSIONS The original BAARS-IV performed poorly at identifying prison inmates with ADHD. Our developed brief scale substantially improved diagnostic accuracy. The brief screening instrument has great potential to be used as an accurate and resource-effective tool to screen young people and adults for likely ADHD in the criminal justice system.
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Affiliation(s)
- S Young
- Division of Brain Sciences,Department of Medicine,Centre for Mental Health,Imperial College,London,UK
| | - R A González
- Division of Brain Sciences,Department of Medicine,Centre for Mental Health,Imperial College,London,UK
| | - L Mutch
- Institute of Psychiatry,Psychology and Neuroscience,King's College London,UK
| | - I Mallet-Lambert
- Institute of Psychiatry,Psychology and Neuroscience,King's College London,UK
| | - L O'Rourke
- Institute of Psychiatry,Psychology and Neuroscience,King's College London,UK
| | - N Hickey
- Division of Brain Sciences,Department of Medicine,Centre for Mental Health,Imperial College,London,UK
| | - P Asherson
- Institute of Psychiatry,Psychology and Neuroscience,King's College London,UK
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Abstract
OBJECTIVE The aim of this study was to examine the role of emotional distress as well as ADHD symptomatology in explaining (a) recidivism, (b) behavioral disturbances in prison, and (c) violent and nonviolent offending. METHOD In all, 196 male prisoners from Aberdeen prison completed the Symptom Checklist-90, which examines various clinical symptoms and emotional distress. Current adult symptoms were assessed by the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria for ADHD. RESULTS Emotional distress and ADHD explained the variance in prison records of behavioral disturbance above and beyond antisocial personality (ASP) traits; however, much of the effect of emotional distress was mediated by ADHD symptoms. Only ADHD symptoms were significantly associated to history of violent offending, whereas ASP and age mostly explained nonviolent offenses and overall recidivism. CONCLUSION Our results provide support for the conceptual association between ADHD and its related emotional dimension with behavioral disturbance in prison, suggesting a link to reactive violence.
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González RA, Kallis C, Ullrich S, Barnicot K, Keers R, Coid JW. Childhood maltreatment and violence: mediation through psychiatric morbidity. Child Abuse Negl 2016; 52:70-84. [PMID: 26803688 DOI: 10.1016/j.chiabu.2016.01.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 12/16/2015] [Accepted: 01/01/2016] [Indexed: 06/05/2023]
Abstract
Childhood maltreatment is associated with multiple adverse outcomes in adulthood including poor mental health and violence. We investigated direct and indirect pathways from childhood maltreatment to adult violence perpetration and the explanatory role of psychiatric morbidity. Analyses were based on a population survey of 2,928 young men 21-34 years in Great Britain in 2011, with boost surveys of black and minority ethnic groups and lower social grades. Respondents completed questionnaires measuring psychiatric diagnoses using standardized screening instruments, including antisocial personality disorder (ASPD), drug and alcohol dependence and psychosis. Maltreatment exposures included childhood physical abuse, neglect, witnessing domestic violence and being bullied. Adult violence outcomes included: any violence, violence toward strangers and intimate partners (IPV), victim injury and minor violence. Witnessing domestic violence showed the strongest risk for adult violence (AOR 2.70, 95% CI 2.00, 3.65) through a direct pathway, with psychotic symptoms and ASPD as partial mediators. Childhood physical abuse was associated with IPV (AOR 2.33, 95% CI 1.25, 4.35), mediated by ASPD and alcohol dependence. Neglect was associated with violence toward strangers (AOR 1.73, 95% CI 1.03, 2.91), mediated by ASPD. Prevention of violence in adulthood following childhood physical abuse and neglect requires treatment interventions for associated alcohol dependence, psychosis, and ASPD. However, witnessing family violence in childhood had strongest and direct effects on the pathway to adult violence, with important implications for primary prevention. In this context, prevention strategies should prioritize and focus on early childhood exposure to violence in the family home.
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Affiliation(s)
- Rafael A González
- Department of Medicine, Division of Brain Sciences, Centre for Mental Health, Imperial College London, Du Cane Road, London W12 0NN, England, UK; Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, PR, USA
| | - Constantinos Kallis
- Violence Prevention Research Unit, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Garrod Building, Turner Street, London E1 2AD, England, UK
| | - Simone Ullrich
- Violence Prevention Research Unit, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Garrod Building, Turner Street, London E1 2AD, England, UK
| | - Kirsten Barnicot
- Department of Medicine, Division of Brain Sciences, Centre for Mental Health, Imperial College London, Du Cane Road, London W12 0NN, England, UK
| | - Robert Keers
- Social, Genetic and Developmental Psychiatry, King's College London, Institute of Psychology, Psychiatry and Neuroscience, England, UK
| | - Jeremy W Coid
- Violence Prevention Research Unit, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Garrod Building, Turner Street, London E1 2AD, England, UK
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González RA, Vélez-Pastrana MC, Ruiz Varcárcel JJ, Levin FR, Albizu-García CE. Childhood ADHD symptoms are associated with lifetime and current illicit substance-use disorders and in-site health risk behaviors in a representative sample of Latino prison inmates. J Atten Disord 2015; 19:301-12. [PMID: 23212598 PMCID: PMC3641170 DOI: 10.1177/1087054712461690] [Citation(s) in RCA: 21] [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] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aimed to explore retrospective childhood ADHD symptomatology, psychiatric comorbidity, rates of substance-use disorders (SUD), as well as their association with high-risk health behaviors in prison and adverse health outcomes. METHOD A randomly selected representative sample of inmates in the Puerto Rico correctional system (N = 1,179) was assessed with the Spanish-language Wender Utah Rating Scale (WURS); the Composite International Diagnostic Interview (CIDI) modules for lifetime/current major depression disorder (MDD), generalized anxiety disorder (GAD), and SUD; the Davidson Trauma Scale (DTS; posttraumatic stress disorder [PTSD]); and self-reports of in-site high-risk behaviors. RESULTS Wald χ(2) tests revealed significant associations of ADHD with MDD and PTSD, as well as increased risk for overdosing and intravenous drug use in prison. A logistic regression model adjusted for mood and anxiety comorbidity predicted lifetime SUD diagnosis (odds ratio = 2.38; 95% confidence interval = [1.15, 4.94]). CONCLUSION Our results provide further evidence on the association of drug dependence and ADHD symptoms, and their overrepresentation among prison inmates.
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Affiliation(s)
- Rafael A. González
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, San Juan, PR,Corresponding author. 26 Troy Court, High Street Kensington, London, UK, W8RD7 Tel.: +1 (787) 758 2525 ext. 4218, Fax: +1 (787) 767 4146, (R. González)
| | | | - José J. Ruiz Varcárcel
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, San Juan, PR
| | - Frances R. Levin
- Department of Psychiatry, Columbia University College of Physicians and Surgeons/New York State Psychiatric Institute, New York, NY, USA
| | - Carmen E. Albizu-García
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, San Juan, PR
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Quimbaya AP, González RA, Bohórquez WR, Muñoz O, García OM, Londoño D. A Systemic, Participative Design of Decision Support Services for Clinical Research. International Journal of Information Technologies and Systems Approach 2014. [DOI: 10.4018/ijitsa.2014070102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Development of IT-based services to support decision-making in healthcare should be guided by the following considerations: rigor, relevance, user-centered participation and inclusion of the best practices for IT-based service systems. In this paper, the balance between rigor and relevance is achieved by following the design science research methodology; user-centered participation is tackled from the socio-technical tradition in information systems; best practices considered in the planning, design and implementation of the services are informed by the MOF framework. Moreover, and considering the premise that these pillars should holistically converge, this research has been approached from a systemic stance where iterative, participative, socio-technical activities have allowed the effective collaboration between information systems researchers, clinical researchers, medical staff and administrative hospital personnel. This paper argues for a move towards enhancing systemic, participative, design-centered service systems engineering by reporting a case which applies these concepts for providing decision-support services, enabled by data and text mining techniques, to contribute to clinical research and administration by being able to search electronic health records where narrative text hides meaningful information that would otherwise require a time-consuming human revision of these records.
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Affiliation(s)
| | | | - Wilson Ricardo Bohórquez
- Pontificia Universidad Javeriana, Bogotá, Colombia and Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Oscar Muñoz
- Pontificia Universidad Javeriana, Bogotá, Colombia and Hospital Universitario San Ignacio, Bogotá, Colombia
| | | | - Dario Londoño
- Pontificia Universidad Javeriana, Bogotá, Colombia and Hospital Universitario San Ignacio, Bogotá, Colombia
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González RA, Kallis C, Ullrich S, Zhang T, Coid JW. The protective role of higher intellectual functioning on violence in the household population of Great Britain. Personality and Individual Differences 2014. [DOI: 10.1016/j.paid.2014.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Quimbaya AP, Muñoz O, Londoño D, Bohórquez R, García OM, González RA, Amortegui MP, Rodriguez S, Bustamante A. An Executable Knowledge Base for Clinical Practice Guideline Rules. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.protcy.2014.10.164] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Depersonalization experiences have been studied in the United States and Europe, but there is a dearth of investigations with Latino populations. In the current study we examined the psychometric properties of the Spanish version of the Cambridge Depersonalization Scale (CDS) in 300 adult individuals from the community and compared the results with those reported previously with non-Latino clinical populations. Discrepant findings have been reported with respect to the factor structure of the CDS. We performed exploratory and confirmatory factor analyses on the CDS items and compared our results with published analyses on other populations. Results revealed that the psychometric properties of the CDS, such as reliability, seem adequate, although the factor structure of the CDS seems to be inconsistent across studies. We selected a 4-factor solution that was most parsimonious and best fit our data. Furthermore, we obtained a moderate, statistically significant relationship (r = .64, p = .001) between the CDS and the Dissociative Experiences Scale. Our results, utilizing a nonclinical sample of Puerto Rican adults, suggest that depersonalization experiences can be reliably measured in a Latino and Spanish-speaking population.
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González RA, Espinosa R, Romero P, López S, Arias CF. Relative localization of viroplasmic and endoplasmic reticulum-resident rotavirus proteins in infected cells. Arch Virol 2001; 145:1963-73. [PMID: 11043954 DOI: 10.1007/s007050070069] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Replication of rotaviruses, whose capsid is constituted by three concentric layers of proteins, occurs in large cytoplasmic inclusions, termed viroplasms. Subviral, double-layered particles bud from viroplasms to the adjacent endoplasmic reticulum (ER), where the outermost protein layer, formed by VP4 and VP7, is assembled. To better understand the morphogenetic process of the virus, we analyzed the relative distribution of viroplasmic and ER-resident viral proteins. Using double immunostaining and confocal microscopy we observed an extensive co-localization between the ER proteins NSP4 and VP7, and the cytoplasmic protein VP4. These three proteins were found to be organized mostly as ring-like or semicircular structures in close association with viroplasms, except for VP4 which displayed in addition, a filamentous distribution. The observations reported in this study underscore the highly organized nature of rotavirus morphogenesis.
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Affiliation(s)
- R A González
- Departamento de Genética y Fisiología Molecular, Instituto de Biotechnología, Universidad Nacional Autónoma de México, Cuernavaca, Morelos
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Torres-Vega MA, González RA, Duarte M, Poncet D, López S, Arias CF. The C-terminal domain of rotavirus NSP5 is essential for its multimerization, hyperphosphorylation and interaction with NSP6. J Gen Virol 2000; 81:821-30. [PMID: 10675420 DOI: 10.1099/0022-1317-81-3-821] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Rotavirus NSP5 is a non-structural phosphoprotein with putative autocatalytic kinase activity, and is present in infected cells as various isoforms having molecular masses of 26, 28 and 30-34 kDa. We have previously shown that NSP5 forms oligomers and interacts with NSP6 in yeast cells. Here we have mapped the domains of NSP5 responsible for these associations. Deletion mutants of the rotavirus YM NSP5 were constructed and assayed for their ability to interact with full-length NSP5 and NSP6 using the yeast two-hybrid assay. The homomultimerization domain was mapped to the 20 C-terminal aa of the protein, which have a predicted alpha-helical structure. A deletion mutant lacking the 10 C-terminal aa (DeltaC10) failed to multimerize both in yeast cells and in an in vitro affinity assay. When transiently expressed in MA104 cells, NSP5 became hyperphosphorylated (30-34 kDa isoforms). In contrast, the DeltaC10 mutant produced forms equivalent to the 26 and 28 kDa species, but was poorly hyperphosphorylated, suggesting that multimerization is important for this proposed activity of the protein. The interaction domain with NSP6 was found to be present in the 35 C-terminal aa of NSP5, overlapping the multimerization domain of the protein, and suggesting that NSP6 might have a regulatory role in the self-association of NSP5. NSP6 was also found to interact with wild-type NSP5, but not with its mutant DeltaC10, in cells transiently transfected with plasmids encoding these proteins, confirming the relevance of the 10 C-terminal aa for the formation of the heterocomplex.
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Affiliation(s)
- M A Torres-Vega
- Departamento de Genética y Fisiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Apartado Postal 510-3, Cuernavaca, Morelos 62250, Mexico
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Aguilar OM, López MV, Riccillo PM, González RA, Pagano M, Grasso DH, Pühler A, Favelukes G. Prevalence of the Rhizobium etli-like allele in genes coding for 16S rRNA among the indigenous rhizobial populations found associated with wild beans from the Southern Andes in Argentina. Appl Environ Microbiol 1998; 64:3520-4. [PMID: 9726909 PMCID: PMC106759 DOI: 10.1128/aem.64.9.3520-3524.1998] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A collection of rhizobial isolates from nodules of wild beans, Phaseolus vulgaris var. aborigineus, found growing in virgin lands in 17 geographically separate sites in northwest Argentina was characterized on the basis of host range, growth, hybridization to a nifH probe, analysis of genes coding for 16S rRNA (16S rDNA), DNA fingerprinting, and plasmid profiles. Nodules in field-collected wild bean plants were largely dominated by rhizobia carrying the 16S rDNA allele of Rhizobium etli. A similar prevalence of the R. etli allele was observed among rhizobia trapped from nearby soil. Intragroup diversity of wild bean isolates with either R. etli-like or Rhizobium leguminosarum bv. phaseoli-like alleles was generally found across northwest Argentina. The predominance of the R. etli allele suggests that in this center of origin of P. vulgaris the coevolution of Rhizobium spp. and primitive beans has resulted in this preferential symbiotic association.
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Affiliation(s)
- O M Aguilar
- Instituto de Bioquímica y Biología Molecular, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, 1900 La Plata, Argentina.
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Abstract
The rotavirus genome encodes six nonstructural (NS) proteins, five of which (NSP1, NSP2, NSP3, NSP5, and NSP6) have been suggested to be involved in a variety of events, such as genome replication, regulation of gene expression, and gene assortment. These NS proteins have been found to be associated with replication complexes that are precursors of the viral core, however, little information is available about the intermolecular interactions that may exist among them. Using the yeast two-hybrid system, which allows the detection of protein-protein interactions in vivo, all possible combinations among the rotavirus NS proteins were tested, and several interactions were observed. NSP1 interacted with the other four proteins tested; NSP3 associated with itself; and NSP5 was found to form homodimers and to interact with NSP6. Co-immunoprecipitation of proteins from rotavirus-infected cells, using hyperimmune sera monospecific for the NS proteins, showed the same interactions for NSP1 as those observed in yeast. Immunofluorescence co-localization analysis of virus-infected epithelial cells revealed that the intracellular distribution of proteins that were seen to interact in yeast had patterns of distribution that would allow such intermolecular interactions to occur. These findings should contribute to the understanding of the role these proteins play in different aspects of the virus replication cycle.
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Affiliation(s)
- R A González
- Departamento de Genética y Fisiología Molecular, Universidad Nacional Autónoma de México, Cuernavaca, Morelos, Mexico
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González RA, Sánchez J, Holmgren J, López S, Arias CF. Immunological characterization of a rotavirus-neutralizing epitope fused to the cholera toxin B subunit. Gene X 1993; 133:227-32. [PMID: 7693553 DOI: 10.1016/0378-1119(93)90643-h] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
A highly conserved neutralizing epitope from the surface protein VP4 (amino acids 296-313) of human rotaviruses was genetically fused to the B subunit of cholera toxin (CTB). Synthetic oligodeoxyribonucleotides encoding the VP4 peptide were inserted between the 3' end of the DNA that codes for the leader peptide, and the 5' end of the gene encoding mature CTB. The hybrid protein synthesized in Escherichia coli was found to maintain the ability of CTB to pentamerize, and to adhere to its cell receptor, the GM1 ganglioside. The chimera was efficiently recognized by a monoclonal antibody (mAb) directed at CTB and by a virus-neutralizing mAb against the VP4 peptide. The hybrid polypeptide was shown to induce high titers of serum antibodies (Ab) against CTB and the synthetic VP4 peptide following subcutaneous immunization; paradoxically, however, the Ab obtained did not recognize the virus by an enzyme-linked immunosorbent assay method, nor had detectable neutralizing activity. Potential implications of these results for future design and evaluation of fusion proteins as immunogens are discussed.
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Affiliation(s)
- R A González
- Departamento de Biología Molecular, Universidad Nacional Autónoma de México, Cuernavaca, Mexico
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