The Role of Transdiagnostic Variables Within Gender Differences in Adolescents' Self Reports of Suicidal Ideation and Suicide Attempts.

BACKGROUND: The incidence of suicide attempts peaks during adolescence, with adolescent girls having a higher rate of attempts than boys. Depression is one of the main risk factors of suicidal behaviour and yet not all adolescents with suicidal ideation or attempting suicide have a diagnosable depressive disorder. The present study examined the unique contributions to suicidal ideation and attempting suicide of cognitive processes known to be associated with depression and anxiety, but which are also transdiagnostic: anomalous perception of reality, intolerance of uncertainty, and rumination. METHOD: 605 adolescents (M= 13.22, SD= 1.03, 47% girls) were evaluated in a cross-sectional study. RESULTS: Multiple linear regression showed that the anomalous perception of reality and intolerance of uncertainty were uniquely associated with the severity of suicidal ideation, even when accounting for symptoms of depression and anxiety, but only amongst girls. In a logistic regression, self-reported depression symptoms, and not underlying cognitive processes, predicted the likelihood of a person having attempted suicide versus not having done so. CONCLUSIONS: In adolescent girls, less frequently evaluated transdiagnostic variables may have an important impact on suicidal ideation. However, depression symptoms, and not these transdiagnostic variables, seem to be the greatest contributor to attempting suicide.

Cannabis use among early adolescents and transdiagnostic mental health risk factors.

INTRODUCTION: Cannabis is the most widely used psychoactive substance among adolescents worldwide, and the age at which consumption begins to decrease. Cannabis use in adolescents is associated with a wide range of adverse consequences in adulthood including increased vulnerability to psychosis and other mental disorders, as well as suicidal ideation and attempt. The aim of this study is to extend understanding of the link between cannabis use and mental illness by examining whether cannabis use at early ages predicts transdiagnostic variables that are precursors to severe clinical diagnoses. METHODS: A descriptive cross-sectional study was conducted. The sample was made up of 605 adolescents from 7th to 9th grades, with a mean age of 13.2 years (SD = 1.0, 47% girls). The variables evaluated were: anomalous perception of reality, intolerance of uncertainty, rumination, suicide attempt, hopelessness, and symptoms of depression and anxiety. The administration of the questionnaires was carried out in groups of 20 participants under the supervision of a researcher in a unique session of 1 hour. RESULTS: Adolescent cannabis users scored higher on all variables assessed: anomalous perception of reality (Cohen's d = .60), rumination (d = .48), intolerance of uncertainty (d = .11), suicidal attempt (affirmative answer: 25.9% of users vs 7.7% of non-users), hopelessness (d = .85), symptoms of depression (d = .80), and anxiety (d = .39). A binary logistic regression showed that the only variable uniquely related to cannabis use was hopelessness (Wald = 4.560, OR: 1.159, p = .033). CONCLUSIONS: Among some mental health risk factors, hopelessness appears uniquely related to cannabis use. Adolescents may use cannabis as a coping strategy for negative thoughts and emotions, or it may be a consequence of cannabis use. Future prevention programs should focus on preventing/treating modifiable factors such as hopelessness, and delaying cannabis use in specific subgroups of adolescents who experience pathologies such as depression or suicide attempts.

Methadone for the treatment of Prescription Opioids Dependence. A retrospective chart review. / Metadona para el tratamiento de la dependencia de opioides de prescripción médica. Una revisión retrospectiva de historias clínicas.

Prescription opioids (PO) addiction is increasing to an epidemic level. Few studies exist regarding its treatment. Although buprenorphine has been the mainstay so far, other treatment options might be considered, such as methadone. We conducted a retrospective assessment of all patients admitted to a psychiatry ward for PO detoxification using methadone between 2010 and 2013. The assessment and description was carried out during a 3-month follow-up period after their discharge. Although this is a retrospective chart review, our exploration included sociodemographic and treatment variables in addition to the abstinence rates for the whole sample. Eleven patients were included, mostly women (81.8%), with a median age of 50 years. The median duration of dependence was 8 years. Dependence on other substances and psychiatric comorbidities were high. Eight patients were monitored during three months. Of these, 7 (87.5%) were abstinent after that period. The results suggest that methadone deserves further exploration as a potentially efficacious treatment option for PO dependence.

La adicción a opioides de prescripción médica (OPM) está ahasta la fecha sobre su tratamiento se basan principalmente en el uso de buprenorfina. Sin embargo, la metadona puede considerarse como otra opción. El objetivo de nuestro estudio fue revisar las historias clínicas de todos los pacientes ingresados en una unidad de psiquiatría para la desintoxicación de OPM usando metadona entre el 2010 y el 2013. El periodo de evaluación finaliza a los 3 meses desde el alta médico. Pese a ser una revisión de historia clínicas, se evaluaron las características sociodemográficas de la muestra, así como las variables relacionadas con el tratamiento y la tasa de abstinencia durante el estudio. Se incluyeron 11 pacientes, mayoritariamente mujeres (81,8%), con una mediana de edad de 50 años. La mediana de duración de la dependencia fue de 8 años. Hubo una alta prevalencia de adicción a otras sustancias así como de comorbilidades psiquiátricas. Ocho pacientes fueron seguidos durante al menos 3 meses. De estos, 7 (87,5%) estuvieron abstinentes hasta el final del periodo evaluado por el estudio. Los resultados sugieren la necesidad de estudios de mayor rigor metodológico para la correcta evaluación de la metadona como un tratamiento potencialmente eficaz para la dependencia de los OPM.