PURPOSE OF REVIEW:

To introduce the existing research conducted into gambling problems among young people in the Asian region.

RECENT FINDINGS:

The prevalence rates of gambling-related problems of young people ranged from 32 to 60% for participation, from 1.5 to 5.0% for problem gambling and from 0.07 to 2.66% for pathological gambling in Asia; social gambling and lottery were the most popular gambling types. Psychiatric comorbidity is common among pathological gamblers, but the causal mechanisms are unclear. The psychological theories on youth gambling in Asia included diathesis, motivation, stress, coping, cognitive and positive youth development. The Positive Adolescent Training through Holistic Social Programmers has been developed; this aims to intervene and help those young people experiencing gambling problems in Hong Kong.

SUMMARY:

Published gambling studies on young people in Asia are limited and have different definitions, research tools and diagnostic criteria. Therefore, the results vary and are incomparable. More work needs to be done in the near future, on comorbidity mechanisms, the neuropsychological and neurobiological mechanisms of youth gambling and, importantly, an increase in early intervention programmes.

PURPOSE OF REVIEW:

This article reviews recent findings regarding neurobehavioral factors which may be associated with risk for alcohol misuse, as well as those which may occur as a result of alcohol misuse during adolescence and emerging adulthood.

RECENT FINDINGS:

Current research extends previous findings by engaging multiple assessment methods and integrating behavioral and imaging technologies. These efforts reinforce previous findings regarding alcohol-related changes in macrostructure while demonstrating alterations in brain connectivity previously underappreciated. Longitudinal work now being reported suggests problem use during adolescence may be associated with persistent neurobehavioral aberrations.

SUMMARY:

For many years, little attention was directed to the neurobehavioral consequences of alcohol use across adolescence and emerging adulthood or to the neurobehavioral factors which might predispose youth to alcohol misuse. Recent work provides critical insights regarding the underpinnings of the deficits in executive function often observed in those at risk for alcohol dependence and those who develop alcohol use disorders. These studies suggest that, even when behavioral deficits are not evident, changes in brain connectivity and microstructure may be observed. Programmatic, longitudinal research must be conducted to determine the relevance of these alterations to use trajectories and long-term adaptation.

PURPOSE OF REVIEW:

Adolescence is a developmental period characterized by relatively high rates of substance use and substance use disorders. Precise assessment and classification of adolescent drug use behaviors are essential in gaining an accurate understanding of the nature and extent of adolescent drug use, and possible intervention or treatment needs. There has been a select group of recently published research reports and manuscripts that address critical and emerging issues pertaining to the classification and assessment of alcohol and other drug use behaviors among adolescents. An overview of these publications is provided and their clinical relevance is discussed.

RECENT FINDINGS:

The paper will focus on recent research, most from the United States, that addresses four main issues. One is the application of the new DSM-5 criteria to adolescents, including the advantages and disadvantages of the new criteria for substance use disorders. The second issue pertains to advances in instrumentation that provide new tools for researchers and clinicians in assessing substance use in adolescents. A significant public health issue is addressed as the third theme in the paper - screening for alcohol abuse in college settings. Finally, the paper reviews how the emerging science of brain development can inform the assessment process.

SUMMARY:

Recent advances in the adolescent drug abuse assessment field continue to inform clinical service and research. As a whole, these advances have strengthened the field, but continued research is needed to further refine assessment practices and standards and to better understand how to define a substance use disorder in youth.

PURPOSE OF REVIEW:

Mentally ill homeless persons are among the most neglected or marginalized patient groups. Their needs for mental healthcare are widely unmet. The current economic crisis probably accelerates the social decline and deterioration of physical and mental health in high-risk groups worldwide and increases the need for appropriate treatments, services, and prevention strategies.

RECENT FINDINGS:

Research on service provision for mentally disordered homeless people (from 2010 to 2012) covers the following issues: epidemiology of mental ill health among homeless persons, service delivery and healthcare utilization, specific treatments, specific high-risk groups among homeless persons, and subjective experience with mental health service provision.

SUMMARY:

The number of studies published on these issues between 2010 and 2012 may suggest an awareness for the need for adequate service provision of this marginalized clientele. Research evidence is still not sufficient. The majority of studies are from the United States. The methodological quality of the studies is still moderate, being descriptive in nature or applying qualitative approaches to small samples. Included are usually easy to access patients from inner-city regions. There is an encouraging trend to focus on younger age groups that supports the focus on primary or secondary prevention strategies for homelessness and mental disorders.

PURPOSE OF REVIEW:

In many regions of the world, wives of alcohol and drug-using men are at an increased risk for HIV/AIDS because of their husbands' high-risk behaviours. These women also tend to be poor, illiterate and dependent on their husbands. Few interventions are designed exclusively for these women. Furthermore, these interventions have had to obtain permission from the husbands to recruit the wives. This article discusses the ethical concerns in obtaining husbands' permission to recruit their wives, with examples taken from India and other countries in Asia and Africa.

RECENT FINDINGS:

Studies indicate that married women are recruited for interventions only with their husbands' consent. Researchers reported that this strategy was acceptable to the local culture, increased acceptance of the research by family and community and improved the participation rate of married women. However, this strategy conflicts with the ethical principles of individual autonomy and voluntariness.

SUMMARY:

Designing research processes according to the local cultural norms is important. However, it is a researcher's ethical duty to ensure that every individual of the society, irrespective of sex, race or marital status, gets equal opportunities to make health-related decisions. This article suggests alternate strategies to directly approach and recruit monogamous wives of alcohol and drug-using men; further research is required to test the feasibility of suggested strategies.

PURPOSE OF REVIEW:

The aim of this review was to examine current trends in cannabis use and cannabis use disorder (CUD) among youth, and to investigate recent findings concerning the relationship between cannabis use and mental health concerns, with a focus on how use during adolescence may interact with related mental health disorders.

RECENT FINDINGS:

Current data indicate that cannabis use among adolescents has shown both marginal increases and decreases, depending on global location; however, the profile of cannabinoids in cannabis may now be biased toward those that promote psychotogenic and memory-impairing effects. CUD has been found most prevalent among youth. After controlling for multiple confounders, longitudinal research suggests that cannabis use predicts the development of anxiety disorders, depression, suicidal ideation, certain personality disorders, and interpersonal violence. Further, associations have been found stronger in adolescents relative to adults, and younger age of initiation increases the risk of developing mental health disorders.

SUMMARY:

Cannabis use among youth remains prevalent, and recent studies are consolidating previous findings that adolescents are especially vulnerable to mental health disorders associated with cannabis. This suggests that cannabis involvement requires increased prominence in research, prevention initiatives, routine screening, and interventions to improve adolescent mental health.

PURPOSE OF REVIEW:

The focus of this review is to examine service utilization, treatment effectiveness, and future directions for adolescents who misuse substances.

RECENT FINDINGS:

Although the effectiveness of treatments has improved in the last two decades, young people's utilization of services has remained relatively stable. This is disconcerting because early intervention improves outcomes and deterioration is associated with physical, psychological, and social problems. The requirement for coordinated service provision across a wide range of treatment agencies cannot be emphasized enough, because young substance misusers come to services with a variety of symptoms and problems. It is encouraging that, to date, treatment studies indicate that adolescents in almost all types of treatment reduce their use of substances. The greatest reductions are shown for family therapy, followed by cognitive behavior therapy (CBT), motivational enhancement therapy (MET)/CBT, MET behavior therapy, and pharmacological treatment. Despite the developing treatment literature, important methodological limitations restrict comparability between studies.

SUMMARY:

The requirement for holistic, systematic assessments should include adolescents' social contexts, trauma, and psychiatric and physical illnesses because they are the cornerstones to understanding engagement and retention. Our review shows the importance of coordinating primary healthcare, mental health, and substance abuse treatment facilities, and highlights networking between other providers as integral to providing an optimal response to this unpredictable, often marginalized, group.

PURPOSE OF REVIEW:

The Global Burden of Disease study 2010 (GBD 2010) estimated regional and global burden of 291 diseases and 67 risk factors. Here, we provide an overview of the methodological approach taken to this work, as well as the challenges and limitations encountered in deriving the burden of mental and drug use disorders.

RECENT FINDINGS:

GBD 2010 estimated the burden of 11 mental disorders and four drug use disorders for 21 regions. This involved a systematic literature search for epidemiological data; setting lay case definitions; synthesizing available epidemiological data into an internally consistent disease model; and quantifying the associated disability and health outcomes, to derive region, sex, year and age-specific burden estimates. Notable challenges included the difficulty in deriving culturally comparable case definitions for mental and drug use disorders, the paucity of epidemiological data and the difficulty in capturing disability associated with mental and drug use disorders.

SUMMARY:

GBD 2010 findings demonstrated the major public health importance of mental and drug use disorders. The methodology used to estimate burden was more sophisticated than previous GBD studies, with some restrictions required in order to achieve defensible numerical measures of burden for mental and drug use disorders.

PURPOSE OF REVIEW:

Despite an increasing awareness of support needs of families affected by parental mental illness, there is a lack of adequate mental healthcare provision for parents. As contemporary mental health services are both user-focused and evidence based, the present review focuses on knowledge regarding the subjective perspective on parenting issues among affected parents and the evidence base for parenting programs.

RECENT FINDINGS:

There has been a shift in the research focus from adverse effects of parental mental illness on children toward inclusion and the subjective perspective in affected mothers and, more recently, fathers with mental health problems. Parents report on role conflicts, parenting difficulties, and stigma. Despite a broad spectrum of parental needs, many parents are reluctant to use services. There is an increasing evidence base for intervention programs.

SUMMARY:

Adequate care for parents affected by mental illness requires sensitivity for parents' subjective perspective, interagency collaboration, standard intake practice, high level of professional knowledge and skills, provision of family-friendly environments, evidence-based parenting programs comprising both individual and group approaches and peer support. There is a lack of research on other parenting needs such as desire for children, coping with custody loss, and childlessness related to mental illness.

PURPOSE OF REVIEW:

Alcohol and drug abuse among older adults is a topic of growing public health concern. The authors review the recent epidemiological surveys of this emerging trend and outline some public health challenges for the coming future.

RECENT FINDINGS:

Relevant studies showed that prevalence of substance use disorders is increasing among American and European elders. Although treatment admissions involving use of alcohol have slightly decreased, rates involving misuse of prescription medications and illicit drugs have increased. As older adults were less likely than younger adults to recognize substance use as problematic or to use treatment services, elders were as likely to benefit from treatment as younger people. Healthcare settings should be prepared to treat this population.

SUMMARY:

There is robust epidemiological evidence showing that alcohol and drug abuse among the elderly are current health problems in developed regions. The number of older adults will increase in less developed regions in the next decades, but it is unclear whether this population subgroup will also seek treatment for substance use to a greater extent. Investigations of the sexual difference and cross-cultural variation can help tailor effective interventions. Routine screening programmes to address the needs of the ageing substance-using population are recommended.