RESUMEN
Few studies have explored sexual orientation disparities in mental health and substance use outcomes among racial minorities. This study examined sexual orientation disparities in depression, suicidality and substance use among Black American young people in the USA, and the mediating role of cyber and bias-based victimisation in accounting for these disparities. Secondary analyses were performed on data from a probability sample of young people (N = 1,129) collected in a school district in the south-eastern USA. Participants reported socio-demographics, depressive symptoms, suicidality, substance use and experiences of bias-based and cyber victimisation. With some exceptions, Black participants who were lesbian, gay, bisexual or mostly heterosexual reported higher rates of depression, suicidal ideation, suicide planning and substance use than Black heterosexual participants. Black lesbian, gay, bisexual and mostly heterosexual participants reported more cyber and bias-based victimisation than Black heterosexual participants. Sexual orientation disparities in mental health and, to some extent, substance use were partially explained by both forms of victimisation. Further research is needed to address the role of bias-based and cyber victimisation in disparities in mental health and substance use among Black sexual minority young people. The present study carries implications for prevention and treatment efforts for racially diverse sexual minorities.
Asunto(s)
Negro o Afroamericano/estadística & datos numéricos , Víctimas de Crimen , Ciberacoso , Disparidades en el Estado de Salud , Salud Mental , Conducta Sexual/estadística & datos numéricos , Trastornos Relacionados con Sustancias/etnología , Adolescente , Niño , Víctimas de Crimen/psicología , Estudios Transversales , Femenino , Heterosexualidad/estadística & datos numéricos , Humanos , Masculino , Minorías Sexuales y de Género/estadística & datos numéricos , Ideación Suicida , Encuestas y Cuestionarios , Estados UnidosRESUMEN
Gamma-aminobutyric acid (GABA), the main inhibitory neurotransmitter in the nervous system, plays an important role in biobehavioral processes that regulate alcohol seeking, food intake, and stress response. The metabotropic GABA-B receptor has been investigated as a potential therapeutic target for alcohol use disorder, by using orthosteric agonists (e.g., baclofen) and positive allosteric modulators. Whether and how pharmacological manipulation of the GABA-B receptor, in combination with alcohol intake, may affect feeding- and stress-related neuroendocrine pathways remains unknown. In the present randomized, double-blind, placebo-controlled study, thirty-four alcohol-dependent individuals received baclofen (30â¯mg/day) or placebo in a naturalistic outpatient setting for one week, and then performed a controlled laboratory experiment which included alcohol cue-reactivity, fixed-dose priming, and self-administration procedures. Blood samples were collected, and the following neuroendocrine markers were measured: ghrelin, leptin, amylin, glucagon-like peptide-1 (GLP-1), insulin, prolactin, thyroid-stimulating hormone, growth hormone, cortisol, and adrenocorticotropic hormone (ACTH). During the outpatient phase, baclofen significantly increased blood concentrations of acyl-ghrelin (pâ¯=â¯0.01), leptin (pâ¯=â¯0.01), amylin (pâ¯=â¯0.004), and GLP-1 (pâ¯=â¯0.02). Significant drugâ¯×â¯time-point interaction effects for amylin (pâ¯=â¯0.001) and insulin (pâ¯=â¯0.03), and trend-level interaction effects for GLP-1 (pâ¯=â¯0.06) and ACTH (pâ¯=â¯0.10) were found during the laboratory experiment. Baclofen, compared to placebo, had no effect on alcohol drinking in this study (p'sâ¯≥â¯0.05). Together with previous studies, these findings shed light on the role of the GABAergic system and GABA-B receptors in the shared neurobiology of alcohol-, feeding-, and stress-related behaviors.
Asunto(s)
Disuasivos de Alcohol/uso terapéutico , Alcoholismo/sangre , Alcoholismo/tratamiento farmacológico , Baclofeno/uso terapéutico , Agonistas de Receptores GABA-B/uso terapéutico , Sistemas Neurosecretores/efectos de los fármacos , Adulto , Atención Ambulatoria , Biomarcadores/sangre , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pacientes Ambulatorios , Receptores de GABA-B/metabolismo , Resultado del TratamientoRESUMEN
BACKGROUND: Food intake and use of drugs of abuse like cocaine share common central and peripheral physiological pathways. Appetitive hormones play a major role in regulating food intake; however, little is known about the effects of acute cocaine administration on the blood concentrations of these hormones in cocaine users. METHODS: We evaluated serum concentrations of six appetitive hormones: ghrelin (total and acyl-ghrelin), amylin, glucagon-like peptide-1 (GLP-1), insulin, leptin and peptide YY (PYY), as well as acute cardiorespiratory and subjective responses of 8 experienced cocaine users who received 25mg intravenous (IV) cocaine. RESULTS: Serum concentrations of GLP-1 (p=0.014) and PYY (p=0.036) were significantly decreased one hour following IV cocaine administration; there was a trend towards a decrease for insulin (p=0.055) and amylin (p=0.063) concentrations, while no significant IV cocaine effect was observed for ghrelin (total or acyl-ghrelin) or leptin concentrations (p'sâ«>0.5). We also observed associations between hormone concentrations acutely affected by IV cocaine (GLP-1, PYY, insulin, amylin) and some cocaine-related cardiorespiratory and subjective responses (e.g., increased heart and respiratory rates; feeling high and anxious). DISCUSSION: These findings show a significant effect of acute IV cocaine administration on some appetitive hormones and suggest potential associations between these hormones and cocaine-related cardiorespiratory and subjective responses. Additional research is needed to further investigate the potential mechanisms underlining these associations.