Do Individuals with Alcohol Dependence Show Higher Unfairness Sensitivity? The Relationship Between Impulsivity and Unfairness Sensitivity in Alcohol-Dependent Adults.

BACKGROUND: Alcohol-dependent patients are known to be generally more unfairness sensitive. The ultimatum game (UG) is an experimental task designed to provoke feelings of perceived unfairness. A previous study using the UG has reported more unfairness sensitivity in patients with alcohol dependence than in a nondependent control group; it has been speculated that this increased sensitivity might be due to a difficulty in impulse control. However, the mechanism of this relationship has not been clarified. Therefore, the relationship between unfairness sensitivity in interpersonal relationships and impulsivity was investigated using UG and delay discounting (DD) paradigms. METHODS: Subjects were 32 individuals with alcohol dependency and 36 healthy control individuals; both groups performed UG and DD tasks. RESULTS: Participants with alcohol dependence rejected monetary offers deemed unfair at a significantly higher rate than did control participants. Moreover, the proportion of accepting unfairness was negatively correlated with impulsivity in patients with alcohol dependence. CONCLUSIONS: Perceived unfairness is related to impulsivity in patients with alcohol dependence. These results provide insights concerning the psychopathology of alcohol dependence.

Sex differences in risk factors for suicidality among Japanese substance use disorder patients: association with age, types of abused substances, and depression.

AIM: The aim of this study was to identify risk factors for suicide in Japanese substance use disorder (SUD) patients, adjusting for age and sex, and to examine sex differences in suicide risk among these patients. METHODS: A self-reporting questionnaire on age, sex, types of abused substances, current depression, and suicidality was administered to 1420 SUD patients who consecutively visited seven hospitals specializing in SUD treatment during the month of December 2009. Unadjusted/adjusted odds ratios of factors associated with suicidality were calculated for each sex. RESULTS: The multivariate analysis using the total sample identified younger age, female sex, and current depression as risk factors for severe suicidality in SUD patients. The multivariate analysis by each sex demonstrated that younger age and current depression were associated with severe suicidality in male SUD patients. Only current depression was associated with severe suicidality in female patients. CONCLUSION: Current depression is a risk factor for suicide in SUD patients common in both Western countries and Japan, although in Japanese SUD patients both younger age and female sex were more closely associated with severe suicidality than aspects of SUD. Additionally, young male SUD patients are speculated to have psychosocial features associated with suicidality in common with female SUD patients.

Depression and suicide risk of outpatients at specialized hospitals for substance use disorder: comparison with depressive disorder patients at general psychiatric clinics.

The present study used a self-reporting questionnaire to compare suicide risk in outpatients being treated for substance use disorder at specialized hospitals to suicide risk in outpatients being treated for depressive disorder at general psychiatric clinics. Although patients in both groups exhibited an equal severity of depression, the patients with drug use disorder had a higher suicide risk than those with depressive disorder. These findings indicate that drug-abusing patients at specialized hospitals may have a severe risk of committing suicide, suggesting that carefully assessing the comorbidity of depression with drug abuse may be required for preventing suicide in drug-abusing patients.

[A study on differences of suicide risk in substance use disorder patients by types of an abused substance: a comparison among alcohol, amphetamine, and sedative, hypnotic or anxiolytic use disorder patients].

BACKGROUND AND PURPOSE: Substance use disorder is one of the important mental health problems related to suicide, nearly equal with depressive disorder. However, it is unclear how differences of abused substances influence the suicide risk of individuals with substance use disorder in Japan. The purpose of the present study is to compare an estimated suicide risk among patients with alcohol, amphetamine, and sedative, hypnotic or anxiolytic use disorders. METHODS: Subjects were 1082 outpatients with alcohol use disorder (AUD), 191 with amphetamine-like use disorder (AMUD), and 63 with sedative, hypnotic or anxiolytic use disorder (SUD), all of whom consecutively had consulted seven medical facilities specialized for treatment of substance use disorder during a month of December 2009. A self-reporting questionnaire including the items of Kessler 10 (K10) and the Mini International Neuropsychiatric Interview (M.I.N.I.) was administered, and scores of the K10 and M.I.N.I., and the other clinical information were compared among the patients with AUD, AMUD, and SUD. RESULTS: Patients with AMUD and SUD showed significantly higher score on the M.I.N.I. than those with AUD, while those with SUD showed highest score on the K10, followed by those with AMUD. In either of patients with AUD, AMUD, or SUD, approximately 60% of the subjects who attempted suicide within a month reported to take any psychoactive substance in the attempted suicide. Additionally, a remarkable difference was found in histories of general psychiatric treatment before consulting medical facilities specialized for treatment of substance use disorder between these three groups. Most of outpatients with SUD reported such histories. CONCLUSIONS: Outpatients with SUD appeared to involve the highest risk for suicide of all patients with substance use disorder, probably because of the comorbid-severe depression. In our speculation, SUD which our subjects suffered from might be induced or accelerated by pharmacotherapy performed in general psychiatric facilities. Education on dependency of prescribed psychotropic drugs to general psychiatrists is required.

Simple segmental hair analysis for α-pyrrolidinophenone-type designer drugs by MonoSpin extraction for evaluation of abuse history.

For detection of a history of drug abused, we developed a simple method for extracting pyrrolidinophenone-type designer drugs in human hair by using a MonoSpin(®) C18 column. Target drugs were extracted from a single alkaline-digested hair segment (length, 10mm; weight, ca 0.1mg). The analytes extracted were then analyzed by high-performance liquid chromatography-mass spectrometry without evaporation of the eluent after MonoSpin extraction. Linearity from 0.5 to 500ng/mg was observed for all the tested drugs using an internal standard method (correlation coefficients >0.998) and the limit of detection was 0.2ng/mg. The recoveries were between 0.7 and 11.1%. The coefficients for intraday and interday variations at 4, 40, 200, and 400ng/mg in hair were between 0.7 and 11.1%. This method was successfully applied to the identification of these designer drugs in segmented human hair from drug abusers and indicated their history of drug abuse. The results were consistent with the patients' statements, indicating that this rapid method can be used to detect a history of drug abuse.