Use of medicines to alleviate negative emotional states among adolescents attending Special Education Centres.

Introduction: Substantial research evidence indicates that adolescents commonly use a variety of pharmaceuticals. Studies in this area carried out so far in Poland have focused on youth attending mainstream schools. However, there is a lack of research covering adolescents residing in special education centres (SEC). The purpose of the study was to assess the prevalence of medicine use for negative emotional states (nervousness, difficulties in falling asleep, and depressive mood), and to identify factors associated with the use of the aforementioned medications by SEC youth. Materials and methods: The study was conducted in 2018 on a random nationwide sample of SEC adolescents aged 12-19 (N = 1730). The logistic regression analyses included sociodemographic variables, as well as factors related to the participant's individual characteristics and to their social environment. Results: Medicine use for negative emotional states was confirmed by about 24%-30% of respondents. The prevalence of these medicine use among SEC youth was significantly higher than among adolescents from mainstream schools. The individual risk factors associated with medicine use were gender (female), current mental and somatic health problems, past suicide attempts and psychoactive substances use while self-control turned out to be protective factor. Among factors related to the respondents' social environment, positive relationships with peers were significant protective factor. Conclusions: Preventive measures aimed at SEC youth should be focused on improving positive relationships with peers and developing self-control. Educational programs for youth, their parents and SEC staff to develop knowledge and skills regarding safe medicines intake would also be useful.

Prevalence and determinants of psychotropic medication use in Poland. / Rozpowszechnienie i wybrane uwarunkowania stosowania leków psychotropowych wsród mieszkanców Polski.

OBJECTIVES: The aim of the study was to assess the prevalence of psychotropic medication use among adult population in Poland in past 12 months, and to analyse the relationship between psychotropic medication use and sociodemographic factors as well as mental health disorders experienced by respondents. METHODS: Composite International Diagnostic Instrument (WHO CIDI 3.0) was used in Polish survey of general population aged 18-64. Respondents were randomly selected from the population register. Ten thousand interviews were completed with a response rate of 50,4%. RESULTS: In the general population, psychotropic medicines were used by almost 5% of the respondents in the past 12 months. These medicines were used more often by women, respondents from the oldest age group, with low level of education, retirees, unemployed, singles and residents of small and large cities. Among those experiencing mental health problems in the past 12 months, psychotropic medications were taken by up to 17% of the respondents. Pharmacological treatment was most often endorsed by over 40% of persons with symptoms of major depression and any mood disorders, while approximately 25% of respondents with major depression confirmed antidepressant use. Gender differences were small and mostly insignificant. CONCLUSIONS: The results indicate the need to improve access to mental health treatment and to educate better general practitioners (GPs) for appropriate diagnosing and treatment of mental health disorders.

Mental health of Warsaw middle school students. Mokotow Study 2004-2016. / Zdrowie psychiczne warszawskich gimnazjalistów. Badania mokotowskie 2004­2016.

OBJECTIVES: The aim of the study was to estimate the prevalence of mental health problems in subpopulation of Warsaw adolescents and to identify trends in 2004-2016. METHODS: The cross-sectional study, conducted every four years, covered the third grade Warsaw middle school students from three Warsaw districts: Mokotów, Ursynów and Wilanów. Sample was randomly selected with the adjustment for cluster selection. The self-administered questionnaire had been completed during school lessons. Indicators were related to following problems: (1) internalizing (symptoms of depression measured by the shortened CES-D scale and other emotional problems, based on subjective assessment); (2) externalizing - coexistence of two out of three types of behaviors (psychoactive substances abuse, being perpetrator of violence and delinquent behavior); (3) mixed. RESULTS: In 2016, 42% of youth exhibited symptoms of mental health disorders. These problems more often affected girls (48%) than boys (36%). Between 2008 and 2016, the percentage of young people experiencing internalizing problems increased significantly. This was due to the increase in the prevalence of depressive symptoms. At the same time, there was a significant decrease in the percentage of young people demonstrating externalizing problems. The last result was a consequence of the decrease in substance abuse and violence. CONCLUSIONS: Growing prevalence of internalizing problems, depressive symptoms and other emotional problems among teenagers indicates an urgent need to develop or adapt effective prevention programs and to improve the access to psychological and psychiatric support.

Drinking and alcohol-related problems among at-risk adolescents: The role of protective behavioral strategies.

INTRODUCTION: Protective Behavioral Strategies (PBS) are an alcohol-specific cognitive-behavioral strategies that may be employed before, during and/or after drinking, in order to reduce alcohol consumption and related consequences, particularly in the at-risk populations. Previous research on PBS was limited to North American college students. The purpose of this study was to examine the role of PBS use in a sample of Polish adolescents attending Special Educational Centers (SEC). METHOD: Data were collected from a nationwide sample of 12-19 year-old (Mean = 15.8; SD = 1.22) students attending SEC in Poland (N = 1585; about 33% female). The self-administered anonymous questionnaires were completed on-site in the SEC. PBS were measured by the authors adaptation of the PBSS-20. Alcohol-related problems were assessed by the Polish adaptation of the measures used in the MINI-KID tool. Alcohol use was measured by a single question on drinking frequency. These two latter variables were measured in the past year timeframe. Hierarchical regression models were used to test the main and interaction effects of employing PBS (total and subscales scores) on alcohol-related problems, after adjusting for demographics (gender, family composition and type of SEC) and alcohol use. RESULTS: The majority (about 94%) of study participants reported employment of some PBS. Regression analyses indicated that PBS use was associated with reduced risk of alcohol use and alcohol-related problems. We found that PBS significantly moderated the relationship between alcohol use and alcohol-related problems, for PBS total scale (F-change (1,1555) = 15.96, p < .001) and one of the PBS subscale: Limiting/Stopping Drinking (F-change (1,1555) = 4.80, p < .029). Findings were discussed within the results of PBS literature and resilience theory framework. CONCLUSION: The use of PBS helps to reduce alcohol-related problems among adolescents attending SEC. Implementation of tailored interventions that teach PBS among vulnerable adolescents may be an effective way to strengthen adolescent self-protection, reduce risky alcohol use and related negative consequences.

Novel psychoactive substances (NPS) - knowledge and expe riences of drug users from Hungary, Poland, the UK and the USA.

BACKGROUND: The recent decade witnessed growing prevalence of novel psychoactive substances (NPS) among young people in Europe and elsewhere. The study, conducted in 2011 as part of the EU-funded ReDNet project, aimed at better understanding of motives behind the demand for NPS among youth as well as at their information needs in this regard. In addition to historical values, the lessons learned during the legal status of NPS may contribute to a more general understanding of use of new drugs and to current drug policies. METHOD: A self-administered anonymous questionnaire on NPS was completed via internet among young people from Hungary, Poland, the United Kingdom and the United States (N=1353) when NPS in general still enjoyed legal status. RESULTS: The majority of respondents (82%) used NPS in the last 12 months and approximately half of them experienced adverse effects from these substances. The most frequent motives behind NSP use were willingness to experiment with new substances. However, sense of security and confidence in their composition as legal products were also important drivers of their consumption. Desired psychoactive effects and risks associated with their use were rated as the two most vital pieces of information to improve their knowledge about NPS. CONCLUSIONS: There were some differences between participants representing different countries, however, the study also revealed many similarities, suggesting emergence of global youth consumption cultures, including NPS use. Provision of information on NPS, including their positive and negative effects, should play an important role in drug policies. Since the time of the study some qualities of NPS (such as confidence in their composition as well as quality and sense of security) may have deteriorated after delegalisation. On the other hand, opinions of NPS users suggest that delegalisation may have a deterrent effect for one third of their consumers while would not affect majority of them.

Alcohol and Cigarette Use Among Warsaw Adolescents: Factors Associated With Risk and Resilience.

BACKGROUND: Youth in Poland are at notable risk for substance use. Guided by resiliency theory, we examine if developmental risk and promotive factors are associated with substance abuse risk. OBJECTIVES: We examined the association between adolescent cigarette and alcohol use and related risk and promotive factors including maternal support, neighbors' informal social control, friends' acceptance of substance use, and alcohol and cigarette use by nonparental adults. METHOD: Data were collected from a random sample of 13- to 14-year-old students attending Warsaw middle schools (N = 3029). We used hierarchical regression models and examined compensatory and protective models of resilience, controlling for sociodemograhic factors. RESULTS: Our results indicated that friends' acceptance of substance use and perceived drug use among nonparental adults was associated with increased risk cigarette and alcohol use among youth. We found that maternal support moderated the relationship between friends' acceptance of substance use and cigarette use (protective model of resilience). Thus, mother support buffered the negative effects of friends' acceptance of substance use on youths' cigarette use. Neighbor's informal social control and maternal support were associated with reduced risk of alcohol use (compensatory model of resilience). CONCLUSION: Collectively, results of the study support compensatory and protective models of resilience in a large representative sample of Warsaw adolescents.

[Effectiveness of alcohol prevention program for pre-adolescents]. / Skutecznosc programu profilaktyki alkoholowej dla dzieci na progu dojrzewania.

AIM: The aim of this research was to assess the delayed effects of a two-year alcohol prevention program implemented in Polish primary schools. METHOD: The program comprised two curricula implemented the school and in family houses: Program Domowych Detektywów and Fantastyczne Mozliwosci. Both curricula were the Polish versions of two American school-based prevention programs which belonged to Project Northland. The initial study sample (N = 802) comprised 10 to 11 years old pupils (fourth and fifth-grade) from eight primary schools in Warsaw. Schools were randomly assigned to the intervention (n = 421) and the reference group (n = 381). A self-completion questionnaire was administered to students four times: at the baseline, seven, fifteen and twenty seven months after. RESULTS: The program had an expected influence on the students' attitudes, knowledge and resistance skills towards alcohol. The effects on the participants' initiation of drunkenness and their first experience in alcohol use with their peers have also been reported. Most of the positive effects remained significant over time. CONCLUSIONS: The effectiveness of the program, as shown by the outcome evaluation, supports an argument for its wide implementation in Polish schools. Further progress in the field of alcohol and drug prevention in Poland depends on overcoming the existing barriers in this area of public health.

Promoting innovation and excellence to face the rapid diffusion of novel psychoactive substances in the EU: the outcomes of the ReDNet project.

OBJECTIVES: The recent emergence of new psychoactive compounds (novel psychoactive substances (NPS)) has raised prominent challenges in the fields of drug policy, substance use research, public health and service provision. The Recreational Drugs European Network project, funded by the European Commission, was implemented to improve the information stream to young people and professionals about effects/risks of NPS by identifying online products and disseminating relevant information through technological tools. METHODS: Regular multilingual qualitative assessments of websites, drugs fora and other online resources were carried out using the Google search engine in eight languages from collaborating countries. These included the following: the UK, Norway, Belgium, Germany, Hungary, Poland, Italy and Spain. Products were tested and prevention messages were developed and disseminated via technological tools such as interactive websites, SMS alert, social networking (Facebook, Twitter), Multimedia (You Tube), Smartphone applications (iPhone) and virtual learning environments (Second Life). RESULTS: The Recreational Drugs European Network project established itself as the first Europe-wide prevention programme designed for NPS based on the efficacy of novel information and communication technology-based forms of intervention. More than 650 NPS products and combinations were identified; relevant information was disseminated to target population and advice was given to both European Union/international agencies and national policy makers. CONCLUSIONS: Web-monitoring activities are essential for mapping the diffusion of NPS and the use of technological tools can be successfully incorporated in specific prevention programmes. Furthermore, the involvement of multi-disciplinary international partnerships was and continues to be fundamental for responding to such a prominent challenge.

Phenomenon of new drugs on the Internet: the case of ketamine derivative methoxetamine.

On the basis of the material available both in the scientific literature and on the web, this paper aims to provide a pharmacological, chemical and behavioural overview of the novel compound methoxetamine. This is a dissociative drug related to ketamine, with a much longer duration of action and intensity of effects. A critical discussion of the availability of information on the web of methoxetamine as a new recreational trend is here provided. Those methodological limitations, which are intrinsically associated with the analysis of online, non-peer reviewed, material, are here discussed as well. It is concluded that the online availability of information on novel psychoactive drugs, such as methoxethanine, may constitute a pressing public health challenge. Better international collaboration levels and novel forms of intervention are necessary to tackle this fast-growing phenomenon.

[Neighbourhood characteristic as risk-protective factor related to substance use by youth Review of the contemporary research.] / Wlasciwosci srodowiska sasiedzkiego jako czynnik chroniacy/ryzyka uzywania przez mlodziez substancji psychoaktywnych. Przeglad badan

Przedmiotem artykulu jest przeglad prac badawczych dotyczacych zwiazku miedzy cechami srodowiska sasiedzkiego a uzywaniem przez mlodziez substancji psychoaktywnych. W pierwszej czesci pracy opisano sposoby definiowania obszaru srodowiska sasiedzkiego, w drugiej scharakteryzowano podstawy teoretyczne badan, w trzeciej - metody pomiaru cech srodowiska sasiedzkiego, a w czwartej przedstawiono wynik badan. Najczesciej przywolywanymi w badaniach teoriami, wyjasniajacymi zwiazek miedzy srodowiskiem sasiedzkim a zachowaniem mlodziezy byly teoria spolecznej dezorganizacji oraz teoria kapitalu spolecznego. Odwolywano sie ponadto do mechanizmów wplywu srodowiska sasiedzkiego na mlodziez, takich jak: mechanizm norm i kolektywnej skutecznosci, mechanizm zasobów instytucjonalnych, mechanizm relacji rodzinnych, mechanizm poczucia wspólnoty ze spolecznosci lokalna oraz model kolektywnego stylu zycia. Najpowszechniej wykorzystywanym zródlem informacji o cechach srodowiska byly dane ze spisu powszechnego dotyczace spolecznej i demograficznej charakterystyki mieszkanców. Stosowano równiez takie metody pomiaru, jak obserwacje w terenie, analiza dokumentacji oraz ankiety i wywiady z osobami badanymi, mlodzieza i rodzicami mlodych ludzi. Wyniki badan potwierdzily, ze cechy srodowiska sasiedzkiego maja bezposredni i posredni wplyw na sieganie przez mlodziez po papierosy, alkohol i narkotyki. Stwierdzono, ze znaczacym czynnikiem ryzyka jest charakterystyczna dla niekorzystnych srodowisk latwa dostepnosc substancji psychoaktywnych. Czynnikami chroniacymi sa bezpieczenstwo w sasiedztwie, kontrola spoleczna oraz dostepnosc zasobów instytucjonalnych. Zaproponowane przez badaczy modele teoretyczne, odnoszace sie do wplywu srodowiska sasiedzkiego na zachowanie mlodziezy, wyznaczaja obiecujace obszary badan. Zebrane dotychczas wyniki wskazuja, ze w dzialaniach profilaktycznych i interwencyjnych istotne znaczenie ma ksztaltowanie indywidualnych czynników chroniacych mlodziez przed negatywnym wplywem srodowiska sasiedzkiego, poprawa dostepnosci do zasobów materialnych oraz wzmacnianie kapitalu spolecznego mlodych ludzi.

[Some problems in the cross-cultural adaptation of programs for primary prevention of alcohol abuse]. / Wybrane problemy zwiazane z adaptacja kulturowa programy profilaktycznego.

The subject of this article is a presentation of chosen problems connected with cross-cultural adaptation of school-based prevention programmes. These problems are described according to an example of the two first parts of the American Northland Project. The aim of this project is to delay the onset of alcohol use among young adolescents. As the first step, the adaptation required an expert opinion on the goals and theoretical background of the Northland Project. The second was adjustment of the programme to Polish cultural conditions - however, these changes could not modify the prevention strategies, which were used in the programme and which determined its effectiveness. The goal of the adaptation was creation of the Polish version, which will be accepted by students, their parents and teachers. The final step of adaptation, was evaluation of the effectiveness of the Polish version of the programme.

[Evaluation of a school-based intervention method for drug using students]. / Ocena przydatnosci i funkcjonowania metody interwencji profilaktycznej w szkole.

The article presents the study results concerning the feasibility of an intervention method for drug using students in the school environment. The representatives of 11 schools from three towns took part in focus group interviews. They shared their experiences related to the use of this method in practice. During the research period 34 interventions were conducted. Most of them were held according to the basic assumptions of the intervention method. In the opinion of the respondents, 15 of the undertaken interventions finished successfully. This means, that persistent change in student behaviour was achieved or there was no evidence of further breaking school rules by the student. The outcome of the study indicates, that the probability of achieving desired effects was going up with the increase in the number of implemented components of the intervention method. The gathered information allows to conclude that this school-based intervention method can be useful for the school staff and that for most part, it fits their potential skills.

[Introduction of a school-based intervention method targeted for drug using students. Barriers related to the co-operation between parents and teachers]. / Wprowadzenie do szkól metody interwencji wobec ucznia siegajacego po srodki psychoaktywne -- bariery we wspólpracy z rodzicami i ich pokonywanie.

The aim of the study was to analyse the process of implementing a school-based intervention method, for drug using students and barriers, related to the parent-school co-operation, impeding this process. Data were collected during the qualitative evaluation of the intervention implementation into 11 schools representing various educational levels and local communities. Results indicate that in 6 schools at least some of proposed system modifications were implemented and in 7 schools teachers used key elements of the intervention method while solving problems related to students' conduct or drug use. The teachers' attitude and expectations related to the idea of family-school co-operation were important from the very beginning of the programme implementation - at the stage of establishing a sense of urgency of the change. In proceeding stages, good communication and openness in parent-school contacts were crucial for the programme effectiveness. These were also a source of positive reinforcement for the people involved.