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substance related disorder [keywords]
- Pain in mental health setting and community: an exploration. [Journal Article]
- Indian J Psychol Med 2014 Jan; 36(1):98-100.
Pain is a commonly experienced complaint in the general population. It aims to determine the occurrence of pain complaints among the general population as well as the clinical group. The sample for the current study was drawn from the ongoing study on development of NIMHANS Screening tool for psychological problems. It includes males and females (119 males and 110 normal and 200 males and 100 clinical subjects) above age 18 years. Subjects were assessed on the question related to frequent experience of body ache and headache in the past one week in an individual setting. Data was analyzed using percentage scores. It indicate that 27% (16% in females and 11% in male) experience pain in the normal group, whereas in clinical categories, 14.5% of anxiety disorder (9.5% in females and 5% in males), 13.9% of depression (8.9% in females and 5% in males), 17.9% of obsessive compulsive disorder (OCD) (8.5% in females and 9.4% in males) and 13.9% of substance users reported pain in last seven days. It implies the need for sensitization among professionals and general population to identify pain complaints.
- Sex Differences in Animal Models of Psychiatric Disorders. [JOURNAL ARTICLE]
- Br J Pharmacol 2014 Apr 4.
Psychiatric disorders are characterized by sex differences in their prevalence, symptomatology and treatment response. Animal models have been widely employed for the investigation of the neurobiology of such disorders and the discovery of new treatments. However, mostly male animals have been used in preclinical pharmacological studies. In this review, we highlight the need for the inclusion of both males and females in experimental studies aiming at gender-oriented prevention, diagnosis and treatment of psychiatric disorders. We present behavioural findings on sex differences from animal models of depression, anxiety, post-traumatic stress disorder, substance related disorders, obsessive-compulsive disorder, schizophrenia, bipolar disorder, and autism. Moreover, when available, we include studies conducted across different stages of the estrous cycle. By inspection of the relevant literature, it is obvious that robust sex differences exist in models of all psychiatric disorders. However, many times results are conflicting and no clear conclusion regarding the direction of sex differences and the effect of the estrous cycle is drawn. Moreover, there is a lack of considerable amount of studies using psychiatric drugs in both males and females, in order to evaluate the differential response between the two sexes. Notably, while in most cases animal models successfully mimic drug response in both sexes, test parameters and treatment-sensitive behavioural indices are not always the same for male and female rodents. Thus, there is an increasing need to validate animal models for both sexes and use standard procedures across different laboratories.
- Prognosis for Emergency Physician with Substance Abuse Recovery: 5-year Outcome Study. [Journal Article]
- West J Emerg Med 2014 Feb; 15(1):20-5.
Introduction: Emergency physicians (EPs) are reported to have a higher rate of substance use disorder (SUD) than most specialties, although little is known about their prognosis. We examined the outcomes of emergency physician compared to other physicians in the treatment of substance use disorders in Physician Health Programs (PHP).
Methods:This study used the dataset from a 5-year, longitudinal, cohort study involving 904 physicians with diagnoses of SUD consecutively admitted to one of 16 state PHPs between 1995 and 2001. We compared 56 EPs to 724 other physicians. Main outcome variables were rates of relapse, successful completion of monitoring, and return to clinical practice.
Results:EPs had a higher than expected rate of SUD (odds ratio [OR] 2.7 confidence interval [CI]: 2.1-3.5, p<0.001). Half of each group (49% of EPs and 50% of the others) enrolled in a PHP due to alcohol-related problems. Over a third of each group (38% of EPs and 34% of the others) enrolled due to opioid use. During monitoring by the PHPs, 13% of EPs had at least one positive drug test compared to 22% of the other physicians; however, this difference was not significant (p=0.13). At the end of the 5-year follow-up period, 71% of EPs and 64% of other physicians had completed their contracts and were no longer required to be monitored (OR 1.4 [CI: 0.8-2.6], p = 0.31). The study found that the proportion of EPs (84%) continuing their medical practice was generally as high as that of other physicians (72%) (OR 2.0 [CI: 1.0-4.1], p = 0.06).
Conclusion:In the study EPs did very well in the PHPs with an 84% success rate in completion and return to clinical practice at 5 years. Of the 3 outcome variables measured, rates of relapse, successful completion of monitoring, and return to clinical practice, EPs had a high rate of success on all variables compared to the other physician cohort. These data support the conclusion that EM physicians do well following treatment of SUD with monitoring in PHPs and generally return to the practice of emergency medicine.
- Doctors criticise UN's approach to global drugs control. [News]
- Lancet 2014 Mar 29; 383(9923):1114.
- Fears over future of opioid substitution therapy in Crimea. [News]
- Lancet 2014 Mar 29; 383(9923):1113.
- CRF1 receptor-deficiency induces anxiety-like vulnerability to cocaine. [JOURNAL ARTICLE]
- Psychopharmacology (Berl) 2014 Apr 1.
The intake of psychostimulant drugs may induce cognitive dysfunction and negative affective-like states, and is associated with increased activity of stress-responsive systems. The corticotropin-releasing factor (CRF) system mediates neuroendocrine, behavioural and autonomic responses to stressors, and might be implicated in substance-related disorders. CRF signalling is mediated by two receptor types, named CRF1 and CRF2.The present study aims to elucidate the role for the CRF1 receptor in cognitive dysfunction and anxiety-like states induced by cocaine.The genetic inactivation of the CRF1 receptor (CRF1+/- and CRF1-/-) does not influence recognition memory in drug-naïve mice, as assessed by the novel object recognition (NOR) test. Moreover, the chronic administration of escalating doses of cocaine (5-20 mg/kg, i.p.) induces NOR deficits, which are unaffected by CRF1 receptor-deficiency. However, the same drug regimen reveals an anxiety-like vulnerability to cocaine in CRF1-/- but not in wild-type or CRF1+/- mice, as assessed by the elevated plus maze test.The present findings indicate dissociation of cognitive dysfunction and anxiety-like states induced by cocaine. Moreover, they unravel a novel mechanism of vulnerability to psychostimulant drugs.
- Time to relapse following treatment for methamphetamine use: A long-term perspective on patterns and predictors. [JOURNAL ARTICLE]
- Drug Alcohol Depend 2014 Mar 12.
This paper describes methamphetamine (MA) use patterns, specifically the duration of continuing abstinence ("time to relapse") for periods averaging 5 years post-discharge from treatment for MA use, and the relationship with selected user and treatment characteristics.A sample of 350 treatment admissions from a large county substance use disorder (SUD) treatment system was randomly selected (within gender, race/ethnicity, treatment modality strata). Retrospective self-report data are from natural history interviews (NHI) conducted approximately 3 years after treatment and a follow-up of 2-3 years later. Relapse is defined as any use of MA with time as the number of months of continuous MA abstinence after treatment discharge until relapse. This outcome was constructed from a monthly MA use timeline using NHI data. A Cox model was used to examine time to relapse and predictors.Sixty-one percent of the sample relapsed to MA use within 1 year after treatment discharge and 14% during years 2-5. Significant protective factors predicting longer time to relapse included having experienced serious MA-related psychiatric/behavioral problems (hazard ratio [HR]=0.75, p=0.027), longer duration of the index treatment episode (HR=0.93, p=0.001), and participating in self-help or other treatment during the post-treatment abstinence period (HR=0.29, p<0.001); risk factors for shorter time to relapse included having a parent with alcohol and/or drug use problems (HR=1.35, p=0.020) and involvement in MA sales (HR=1.48, p=0.002).Results contribute a long-term perspective on patterns of MA use following treatment and support a need for early post-treatment and long-term continuing care and relapse-prevention services.
- Socioeconomic Inequalities in Risk of Hospitalization for Community-Acquired Bacteremia: A Danish Population-Based Case-Control Study. [JOURNAL ARTICLE]
- Am J Epidemiol 2014 Mar 28.
In a Danish population-based case-control study, we examined the association between socioeconomic status (SES) and risk of community-acquired bacteremia, as well as the contribution of chronic diseases and substance abuse to differences in bacteremia risk. Analyses were based on 4,117 patients aged 30-65 years who were hospitalized with first-time community-acquired bacteremia during 2000-2008 and 41,170 population controls matched by sex, age, and region of residence. Individual-level information on SES (education and income), chronic diseases, and substance abuse was retrieved from public and medical registries. Conditional logistic regression was used to compute odds ratios for bacteremia. Persons of low SES had a substantially higher risk of bacteremia than those of high SES (for short duration of education vs. long duration, odds ratio = 2.30 (95% confidence interval: 2.10, 2.52); for low income vs. high income, odds ratio = 2.77 (95% confidence interval: 2.54, 3.02)). A higher prevalence of chronic diseases and substance abuse in low-SES individuals versus high-SES individuals explained 43%-48% of the socioeconomic differences in bacteremia risk. In a country with a universal welfare system, differences in the burden of chronic diseases and substance abuse seem to have major importance in explaining inequalities in bacteremia risk.
- Abuse and diversion of buprenorphine sublingual tablets and film. [JOURNAL ARTICLE]
- J Subst Abuse Treat 2014 Mar 3.
Buprenorphine abuse is common worldwide. Rates of abuse and diversion of three sublingual buprenorphine formulations (single ingredient tablets; naloxone combination tablets and film) were compared. Data were obtained from the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS(®)) System Poison Center, Drug Diversion, Opioid Treatment (OTP), Survey of Key Informants' Patients (SKIP), and College Survey Programs through December 2012. To control for drug availability, event ratios (rates) were calculated quarterly, based on the number of patients filling prescriptions for each formulation ("unique recipients of a dispensed drug," URDD) and averaged and compared using negative binomial regression. Abuse rates in the OTP, SKIP, and College Survey Programs were greatest for single ingredient tablets, and abuse rates in the Poison Center Program and illicit diversion rates were greatest for the combination tablets. Combination film rates were significantly less than rates for either tablet formulation in all programs. No geographic pattern could be discerned.
- Mafia and psychopathy. [JOURNAL ARTICLE]
- Crim Behav Ment Health 2014 Feb 12.
In popular culture, Mafia members are often portrayed as ruthless, callous and remorseless, but there is no empirical research on their personality traits.The goal of this research was to examine levels of psychopathic traits among Mafia members who have been convicted of a criminal offence.The Psychopathy Checklist-Revised (PCL-R) rated 30 Italian adult male prisoners who had been convicted for Mafia-related crimes (86% resident in one 6-month period) and 39 next adjacent convicted men who were not enrolled in any criminal organisation.Mafia members obtained lower PCL-R total scores, interpersonal and affective (PCL-R factor 1) scores and lifestyle scores (factor 2) than the other offenders. Logistic regression analysis showed that lower PCL-R factor 1 scores with higher factor 2 scores in the absence of a history of substance misuse disorder distinguished Mafia from non-Mafia offenders. A probability curve confirmed an exponential growth in the probability of classification as a Mafia member in relation to lower PCL-R factor 1 scores.Our findings bring new hope for resocialisation of convicted Mafia members, because they showed significant antisocial traits but they maintained a capacity for emotional connection and greater likelihood of engaging with training and resocialisation programmes than other imprisoned offenders in Italy. Copyright © 2014 John Wiley & Sons, Ltd.