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ABSTRACT: Food addiction is associated with dysfunctions in the reward circuit, such as hyperresponsiveness during the exposure to high-calorie flavors in overweight and obese individuals. Similar to drug addiction, there is also impaired self-regulatory control supported by deregulation of the frontostriatal circuit. The inclusion of validated measures of food addiction in clinical research, such as the Yale Food Addiction Scale, has increased the understanding of the clinical utility of this concept. Furthermore, food addiction, eating disorders, and obesity are interrelated. Thus, it is important to recognize food addiction among individuals affected by obesity and candidates for bariatric surgery (ie, preoperative and postoperative assessment). In this context, it has been reported that food addiction may impede weight loss and increase the likelihood of regaining weight when associated with personality traits such as neuroticism and impulsiveness, which are also related to mood disorders, anxiety, and addictive behaviors.
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Cirugía Bariátrica , Conducta Adictiva , Adicción a la Comida , Humanos , Adicción a la Comida/epidemiología , Conducta Impulsiva , Conducta Alimentaria , Conducta Adictiva/epidemiología , Obesidad , Encuestas y CuestionariosRESUMEN
BACKGROUND: COVID-19 physical distancing measures can potentially increase the likelihood of mental disorders. It is unknown whether these measures are associated with depression and anxiety. OBJECTIVES: To investigate meta-analytic global levels of depression and anxiety during the COVID-19 pandemic and how the implementation of mitigation strategies (i.e. public transportation closures, stay-at-home orders, etc.) impacted such disorders. DATA SOURCES: PubMed, MEDLINE, Web of Science, BIOSIS Citation Index, Current Content Connect, PsycINFO, CINAHL, medRxiv, and PsyArXiv databases for depression and anxiety prevalences; Oxford Covid-19 Government Response Tracker for the containment and closure policies indexes; Global Burden of Disease Study for previous levels of depression and anxiety. STUDY ELIGIBILITY CRITERIA: Original studies conducted during COVID-19 pandemic, which assessed categorical depression and anxiety, using PHQ-9 and GAD-7 scales (cutoff ⩾10). PARTICIPANTS AND INTERVENTIONS: General population, healthcare providers, students, and patients. National physical distancing measures. STUDY APPRAISAL AND SYNTHESIS METHODS: Meta-analysis and meta-regression. RESULTS: In total, 226 638 individuals were assessed within the 60 included studies. Global prevalence of both depression and anxiety during the COVID-19 pandemic was 24.0% and 21.3%, respectively. There were differences in the prevalence of both anxiety and depression reported across regions and countries. Asia (17.6% and 17.9%), and China (16.2% and 15.5%) especially, had the lowest prevalence of both disorders. Regarding the impact of mitigation strategies on mental health, only public transportation closures increased the prevalence of anxiety, especially in Europe. LIMITATIONS: Country-level data on physical distancing measures and previous anxiety/depression may not necessarily reflect local (i.e. city-specific) contexts. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Mental health concerns should not be viewed only as a delayed consequence of the COVID-19 pandemic, but also as a concurrent epidemic. Our data provide support for policy-makers to consider real-time enhanced mental health services, and increase initiatives to foster positive mental health outcomes.
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Ansiedad/epidemiología , Depresión/epidemiología , Gobierno Federal , Distanciamiento Físico , Asia/epidemiología , COVID-19 , China/epidemiología , Europa (Continente)/epidemiología , Femenino , Humanos , Masculino , Salud Mental , Prevalencia , SARS-CoV-2RESUMEN
Rapid urbanization worldwide is associated to an increase of population in the urban settings and this is leading to new emerging mental health issues. This narrative mini-review is based on a literature search conducted through PubMed and EMBASE. A total of 113 articles published on the issue of urban mental health have been selected, cited, reviewed, and summarized. There are emerging evidences about the association between urbanization and mental health issues. Urbanization affects mental health through social, economic, and environmental factors. It has been shown that common mental syndromes report higher prevalence in the cities. Social disparities, social insecurity, pollution, and the lack of contact with nature are some of recognized factors affecting urban mental health. Further reserach studies and specific guidelines should be encouraged to help policy makers and urban designers to improve mental health and mental health care facilities in the cities; additional strategies to prevent and reduce mental illness in the urban settings should be also adopted globally.
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Trastornos Mentales/epidemiología , Salud Mental , Urbanización , Humanos , PrevalenciaRESUMEN
OBJECTIVE: To investigate factors associated with violent behavior in a large nationally representative sample of Brazilian adolescents. METHODS: The data were derived from the 2015 National Adolescent School-based Health Survey (Pesquisa Nacional de Saúde do Escolar [PeNSE]). The independent variables of interest included feelings of safety while on the way to and at school. The outcome was violent behavior, including bullying. Logistic regression models were developed to examine the relationship between violent behavior and each independent and control variable. RESULTS: In the adjusted regression model, male sex (aOR: 1.75; 95%CI 1.65-1.86), being assaulted by a family member (aOR: 1.74; 95%CI 1.59-1.90), and being assaulted in the past year (aOR: 1.70; 95%CI 1.57-1.85) all increased the chance of violent behavior. Feeling safe on the way to school (aOR: 0.82; 95%CI 0.74-0.92) and at school (aOR: 0.82; 95%CI 0.73-0.92) reduced the chance of violent behavior. CONCLUSIONS: This study extends the body of literature on violent behavior among adolescents, demonstrating a correlation between school, domestic, family, or community violence and violent behavior. Our research supports the idea that adolescents who experience violence act violently with greater frequency. This finding has significant implications for pediatricians, child psychiatrists and psychologists, other health care professionals, school professionals, and other professionals involved in adolescent health. School professionals must be prepared to identify adolescents with violent behavior due to its potential consequences for their mental and physical health.
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Conducta del Adolescente , Víctimas de Crimen , Niño , Humanos , Masculino , Adolescente , Salud del Adolescente , Brasil , Violencia , Encuestas EpidemiológicasRESUMEN
Climate changes affect planet ecosystems, living beings, humans, including their lives, rights, economy, housing, migration, and both physical and mental health. Geo-psychiatry is a new discipline within the field of psychiatry studying the interface between various geo-political factors including geographical, political, economic, commercial and cultural determinants which affect society and psychiatry: it provides a holistic overview on global issues such as climate changes, poverty, public health and accessibility to health care. It identifies geopolitical factors and their effects at the international and national levels, as well as considers the politics of climate changes and poverty within this context. This paper then introduces the Compassion, Assertive Action, Pragmatism, and Evidence Vulnerability Index (CAPE-VI) as a global foreign policy index: CAPE-VI calculates how foreign aid should be prioritised for countries that are at risk or already considered to be fragile. These countries are characterised by various forms of conflict, disadvantaged by extremes of climate change, poverty, human rights abuses, and suffering from internal warfare or terrorism.
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Cambio Climático , Psiquiatría , Humanos , Salud Mental , Ecosistema , Derechos Humanos , Salud GlobalRESUMEN
OBJECTIVES: To examine drug overdose records in Brazil from 2000 to 2020, analyzing trends over time in overdoses and overall sociodemographic characteristics of the deceased. METHODS: Using data from the Brazilian Mortality Information System (Sistema de Informações sobre Mortalidade), we identified records from 2000-2020 in which the underlying cause-of-death was one of the following codes: X40-X45 (accidental poisoning), X60-X65 (intentional poisoning), or Y10-Y15 (undetermined intentionality poisoning). The Brazilian dataset included 21,410 deaths. We used joinpoint regression analysis to assess changes in trends over time. RESULTS: People who died of drug overdoses in Brazil between 2000 and 2020 had a mean age of 38.91 years; 38.45% were women, and 44.01% were identified as White. Of the overdose deaths, 44.70% were classified as intentional and 32.12% were classified as unintentional. Among the identified drugs, stimulants were the most common class. However, most records did not report which drug was responsible for death. CONCLUSION: Sociodemographic trends in overdose deaths in Brazil must guide country-specific policies. Nevertheless, data collection protocols must be improved, particularly regarding the drug used in overdoses.
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Estimulantes del Sistema Nervioso Central , Sobredosis de Droga , Femenino , Humanos , Adulto , Masculino , Brasil/epidemiologíaRESUMEN
BACKGROUND: South America's substance use profile, poverty, income inequality, and cocaine-supplier role make it a unique place for substance use research. This study investigated the burden of disease attributable to amphetamine use disorder, cannabis use disorder (CAD), cocaine use disorder, and opioid use disorder (OUD) in South America from 1990 to 2019, on the basis of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS: GBD 2019 estimated the incidence, prevalence, mortality, years of life lost (YLL), years of life lived with disability (YLD), and disability-adjusted life-years (DALYs) due to substance use disorders in each of the 12 South American countries (Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Guyana, Paraguay, Peru, Suriname, Uruguay, and Venezuela). Data were modelled using standardised tools (ie, the Cause of Death Ensemble model, spatio-temporal Gaussian process regression, and disease modelling meta-regression) to generate estimates of each quantity of interest by sex, location, and year. The analysis included comparisons by sex and country, and against regional and global estimates. FINDINGS: In 2019, the highest amphetamine use disorder burden per 100â000 population in South America was in Peru (66 DALYs). CAD DALY rates per 100â000 in South America were stable between 1990 and 2019, except in Chile and Colombia, which had the highest rates in 2019 (19 DALYs for Chile and 18 DALYs for Colombia). OUD DALYs per 100â000 increased during the period in Brazil and Peru, which in 2019 had the highest rates in South America (82 DALYs for Brazil and 70 DALYs for Peru). In 2019, Brazil had the highest cocaine use disorder DALYs per 100â000 (45 DALYs), nearly double its rate in 1990. DALY rates were higher in males than females for each substance use disorder, except in Paraguay. The overall burden of substance use disorders was higher in males than in females, mainly because of cocaine use disorder and CAD, whereas for amphetamine use disorder, the difference between sexes was minimal, and for OUD there was no difference. For males and females, the highest rate of substance use disorders DALYs per 100â000 was for OUD except in Argentina (in males, 58 DALYs for cocaine use disorder vs 52 DALYs for OUD) and in Paraguay (in females, 77 for amphetamine use disorder vs 50 for OUD). CAD DALY rates were generally the lowest among the substance use disorders for males and females. Amphetamine use disorder YLD rates were reasonably stable throughout the period and were highest in Peru, Paraguay, and Uruguay (>40 YLD per 100â000). For CAD, YLD rates were stable in all countries except Chile and Colombia. Cocaine use disorder YLD rates per 100â000 for the top four countries (Argentina, Uruguay, Chile, and Brazil) increased from 1990 to 2010 (eg, from 19 to 33 in Brazil), but decreased between 2010 and 2019 (eg, from 36 to 31 in Chile). For OUD, YLD rates showed a slight increase in most countries apart from Brazil, which increased from 52 in 1990 to 80 in 2019 and was top among the countries. Amphetamine use disorder YLL rates per 100â000 were highest in Suriname and Peru during the period, although in Suriname it increased from 2·7 in 2010 to 3·2 in 2019, whereas in Peru it decreased from 2·1 to 1·7. The highest YLL rate for cocaine use disorder was in Brazil, which increased from 3·7 in 1990 to 18·1 in 2019. Between 2000 and 2019, Chile and Uruguay showed the highest OUD YLL rates (11·6 for Chile and 10·9 for Uruguay). A high incidence of CAD was found in Chile, Colombia, Guyana, and Suriname. There were high incidences of amphetamine use disorder in Paraguay, cocaine use disorder in Argentina, and OUD in Ecuador. A decrease in annual prevalence for substance use disorders during the period was observed in Venezuela (amphetamine use disorder, CAD, and OUD), Brazil (CAD and amphetamine use disorder), Colombia (amphetamine use disorder and cocaine use disorder), Peru (amphetamine use disorder and cocaine use disorder), Chile and Suriname (amphetamine use disorder), Uruguay (CAD), and Bolivia (OUD). Overall, the cocaine use disorder burden stabilised then decreased. OUD was less prevalent than other substance use disorders but its burden was the highest. INTERPRETATION: The decrease in the burden of cocaine use disorder probably reflects the success of national standardised treatment programmes. Programmes for amphetamine use disorder, CAD, and OUD management should be improved. We did not find an increase in CAD burden in Uruguay, the country with the highest degree of cannabis decriminalisation in the region. Countries in South America should improve monitoring of substance use disorders, including regular surveys to provide more accurate data on which to base policy decisions. FUNDING: The Bill & Melinda Gates Foundation.
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Cannabis , Trastornos Relacionados con Sustancias , Masculino , Femenino , Humanos , Carga Global de Enfermedades , Años de Vida Ajustados por Calidad de Vida , Brasil , Anfetaminas , Salud GlobalRESUMEN
BACKGROUND: Maintained abstinence during the first 24 h of a quit attempt is a critical predictor of long-term smoking cessation. Little is known about sex differences in the very early abstinence period, particularly in the context of low- and middle-income countries (LMICs) with varying anti-smoking policies and female smoking prevalences. We examined female sex effects on one-day relapse in a cross-national sample from 12 LMICs. METHODS: Data from the Global Adult Tobacco Survey (2008-2012) included nationally representative samples from 12 LMICs restricted to smokers with ≥ 1 quit attempt in the past 12 months (n = 16,576). We ran adjusted logistic regression models for female sex effects on one-day relapse, adjusting for nine individual-level demographics (e.g., age, education, age at smoking initiation) and smoking cessation variables (e.g., exposure to health warnings, receipt of counseling). We then conducted a meta-analysis adjusted for national-level and policy measures through meta-regression (e.g., cigarette consumption per capita, percent of cigarette box covered with warning labels). RESULTS: One-day relapse prevalence varied across countries (2.7-13.6%). The odds of one-day relapse were significantly higher for women than for men in six countries (adjusted for nine individual-level sociodemographic variables), and there were no significant sex differences in the remaining six countries. Result remained significant after meta-regressions for national-level tobacco consumption and policy measures. Sensitivity analyses showed that the odds of one-day relapse for women remained significant when excluding countries with both higher and lower relative rates of female smoking. Larger warning labels on cigarette packs were associated with reduced odds of one-day relapse among women. CONCLUSION: The first day of a quit attempt is more challenging for women than men in LMICs. Tailored interventions incorporating national policies, in addition to counseling and pharmacotherapy, could play an essential role in supporting women during the initial abstinence phase of smoking cessation in LMICs.
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Países en Desarrollo , Cese del Hábito de Fumar , Adulto , Consejo , Femenino , Humanos , Masculino , Pobreza , Uso de TabacoRESUMEN
BACKGROUND: There are remarkably high smoking rates in patients living with mental disorders (PLWMD), and the absence of a specific treatment policy for smoking cessation for these patients worldwide. The present study aimed to (i) investigate the quality of service and commitment to tobacco dependence treatment, and (ii) produce high-quality French versions of the Index of Tobacco Treatment Quality (ITTQ) and Tobacco Treatment Commitment Scale (TTCS). METHODS: ITTQ and TTCS were used to assess French mental health professionals (n = 80). Both scales were translated from their original language following standard procedures (i.e. forward translation). Descriptive analysis for total score, each factor and item were calculated for the entire sample, followed by subgroup analysis by gender, and role of the practitioner. RESULTS: Nurses presented higher levels of both treatment commitment and treatment quality in their mental health care units, compared to psychiatrists, and residents. Overall, counseling offering was low and there was a perception that it is unfair to take tobacco away from PLWMD. In the other hand, there were high levels of smoking assessment and perceptions that nicotine dependence should be included in drug treatment programs. CONCLUSIONS: There is a gap in tobacco treatment implementation for French PLWMD. The present pilot study alerts about the problem, and should stimulate larger studies validating such measures for wide use with French-speaking mental health professionals. French nurses presented higher levels of both treatment commitment and quality, and could be in a leadership position for such implementation. Encouraging the implementation of tobacco counseling within conventional mental health treatment is critical to improve cessation rates among this population. There is a potential for the sustainability of tobacco treatment interventions since the levels of commitment observed here were higher than in previous studies conducted abroad.
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Trastornos Mentales , Cese del Hábito de Fumar , Tabaquismo , Humanos , Tabaquismo/terapia , Proyectos Piloto , Cese del Hábito de Fumar/métodos , Cese del Hábito de Fumar/psicología , Fumar/epidemiología , Fumar/terapia , Trastornos Mentales/terapia , Trastornos Mentales/psicologíaRESUMEN
Background: There is sparse knowledge on overdose deaths resulting from non-benzodiazepines and gabapentinoids usage. We examined overdose death rate across demographics categories and the overdose death trends over time. Methods: Using data from the National Center for Health Statistics (USA), we identified 21,167 persons that died with an overdose ICD code as the underlying cause of death and had a T42.6/T42.7 ICD code, which include gabapentinoids and z-drugs, among their multiple causes of death. The overdose death rate was calculated per 100,000 persons for every year between 2000 and 2018. We used joinpoint regression analyses to assess trends over time. Results: We identified a rise in the proportion of deaths with a T42.6/T42.7 ICD code between 2000 and 2006 (yearly change: +0.06) and between 2006 and 2015 (yearly change: +0.32). From 2000 to 2008, the proportion of deaths with any other T code rose significantly (yearly change: +3.56). Between 2008 and 2018, there was also a significant rise (yearly change: +1.31). From 2000 to 2015, the proportion of deaths with a T42.6/T42.7 ICD code with any other T code rose (yearly change: +2.58). From 2000 to 2015, the proportion of deaths with a T42.6/T42.7 ICD code with a concurrent benzodiazepine T code rose (yearly change: +1.98). From 2000 to 2005, the proportion of alcohol T codes rose non-significantly (yearly change: +0.35). Finally, the proportion of alcohol T codes fell significantly between 2008 and 2018 (yearly change: - 0.74). Interpretation: Deaths due to non-benzodiazepine hypnotics and gabapentinoids increased significantly over the last two decades. Clinicians should not assume that replacing benzodiazepines and opioids with these medications necessarily lowers risk to the patient. Funding: This study was funded by an internal grant from the Columbia University President's Global Innovation Fund (PI: Martins).
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INTRODUCTION: Alcohol and cannabis are commonly involved in motor vehicle crashes and fatalities. This study examines whether simultaneous use of alcohol/cannabis is associated with higher odds of reporting driving under the influence of alcohol and cannabis in the U.S. METHODS: Drivers aged ≥16 years with any past-year alcohol and cannabis use in the 2016-2019 National Survey on Drug Use and Health (N=34,514) reported any past-year driving under the influence of alcohol-only, cannabis-only, both alcohol/cannabis, or not driving under the influence. Survey-weighted associations between simultaneous alcohol/cannabis use and each of the driving under the influence outcomes were computed adjusting for sociodemographics and daily alcohol/cannabis use. Analyses were conducted from November 2020 to September 2021. RESULTS: In 2016-2019, 42% of drivers with past-year alcohol and cannabis use reported driving under the influence (8% alcohol-only, 20% cannabis-only, 14% alcohol/cannabis). Simultaneous alcohol/cannabis use was associated with 2.88-times higher adjusted odds of driving under the influence of cannabis-only (95% CI=2.59, 3.19) and 3.51-times higher adjusted odds of driving under the influence of both alcohol/cannabis (95% CI=3.05, 4.05), compared to not driving under the influence. Associations with driving under the influence of alcohol-only were unexpectedly in the opposite direction (adjusted conditional odds ratio=0.59, 95% CI=0.45, 0.79). CONCLUSIONS: Overall, 2 in 5 drivers who used alcohol and cannabis reported driving under the influence of alcohol and/or cannabis. People reporting simultaneous alcohol/cannabis use were more likely to report cannabis-related driving under the influence. Prevention strategies should target individuals reporting simultaneous alcohol/cannabis use to reduce the occurrence of driving under the influence.
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Conducción de Automóvil , Cannabis , Conducir bajo la Influencia , Accidentes de Tránsito , Consumo de Bebidas Alcohólicas/epidemiología , Analgésicos , Etanol , HumanosRESUMEN
Atopic dermatitis (AD) is a chronic disease of the skin with significant pruritus and phases of exacerbation and remission. The hallmarks of AD are changes in the epithelial barrier and chronic inflammation. This condition is associated with an increased risk of developing mental disorders such as depression, anxiety, and suicidal ideation. It has been proposed that psychological stress may impact on immunological factors with an up-regulation of mediating neuropeptides at the level of central nervous system and secondary involvement of endocrine glands, peripheral nervous system, and immune resident skin cells. This article provides a concise review for dermatologists on the psychodermatology of AD, in order to highlight the putative common pathways between the dermatologic and mental health issues in this illness.
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Dermatitis Atópica , Ansiedad/etiología , Dermatitis Atópica/etiología , Dermatólogos , Humanos , Prurito/complicaciones , Ideación SuicidaRESUMEN
BACKGROUND: Although Alcohol Use Disorder (AUD) is highly prevalent worldwide, treating this condition remains challenging. Further, potential treatments for AUD do not fully address alcohol-induced neuroadaptive changes. Understanding the effects of pharmacotherapies for AUD on the human brain may lead to tailored, more effective treatments, and improved individual clinical outcomes. OBJECTIVES: We systematically reviewed the literature for studies investigating pharmacotherapies for AUD that included neuroimaging-based treatment outcomes. We searched the PubMed, Scielo, and PsycINFO databases up to January 2021. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS: Eligible studies included those investigating pharmacotherapies for AUD and employing functional magnetic resonance imaging (fMRI), positron emission tomography (PET), single-photon emission computed tomography (SPECT), and/or proton magnetic resonance spectroscopy (H-MRS). STUDY APPRAISAL AND SYNTHESIS METHODS: Two independent reviewers screened studies' titles and abstracts for inclusion. Data extraction forms were shared among all the authors to standardize data collection. We gathered information on the following variables: sample size; mean age; sociodemographic and clinical characteristics; alcohol use status; study design and methodology; main neuroimaging findings and brain-regions of interest (i.e., brain areas activated by alcohol use and possible pharmacological interactions); and limitations of each study. RESULTS: Out of 177 studies selected, 20 studies provided relevant data for the research topic. Findings indicate that: (1) Acamprosate and gabapentin may selectively modulate limbic regions and the anterior cingulate cortex; (2) Naltrexone and disulfiram effects may involve prefrontal, premotor, and cerebellar regions; (3) Pharmacotherapies acting on glutamate and GABA neurotransmission involve primarily areas underpinning reward and negative affective states, and; (4) Pharmacotherapies acting on opioid and dopamine systems may affect areas responsible for the cognitive and motor factors of AUD. LIMITATIONS: Most of the studies were focused on naltrexone. A small number of studies investigated the action of disulfiram and gabapentin, and no neuroimaging studies investigated topiramate. In addition, the time between medication and neuroimaging scans varied widely across studies. CONCLUSIONS: We identified key-brain regions modulated by treatments available for AUD. Some of the regions modulated by naltrexone are not specific to the brain reward system, such as the parahippocampal gyrus (temporal lobe), parietal and occipital lobes. Other treatments also modulate not specific regions of the reward system, but play a role in the addictive behaviors, including the insula and dorsolateral prefrontal cortex. The role of these brain regions in mediating the AUD pharmacotherapy response warrants investigation in future research studies.
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OBJECTIVE: We examined the prevalence of risky alcohol and cannabis use among Brazilian varsity college athletes and whether this group had a greater likelihood of risky use than non-athletes. METHODS: In 2009, Brazilian college students (n=12,711) were recruited for a national stratified random survey. Their sociodemographic characteristics, mental health, substance use, and participation in varsity sports were assessed. Binary logistic regression models were used to examine the association between varsity athlete status and moderate to high-risk alcohol and cannabis use. RESULTS: Among varsity athletes, 67.6 and 10.7% reported risky alcohol and cannabis use, respectively. Varsity athletes had greater odds of risky alcohol consumption than non-athletes (aOR = 2.02, 95%CI 1.08-3.78). Varsity athletes also had greater odds of risky cannabis use than non-athletes in unadjusted analyses (OR = 2.57, 95%CI 1.05-6.28), although this relationship was attenuated after covariate adjustment. CONCLUSIONS: Among college students in Brazil, varsity athletes had a higher prevalence of risky alcohol and cannabis use than non-athletes. The rates were considerably higher than those observed among samples of U.S. college athletes. Future research should examine the use of these substances among varsity college athletes in other middle-income countries since these findings will likely guide prevention and treatment efforts.
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Cannabis , Atletas , Brasil/epidemiología , Humanos , Estudiantes , UniversidadesRESUMEN
There are some concerns regarding alcohol use behaviors during the COVID-19 pandemic. The mixed findings of the first alcohol use studies during this pandemic may reflect the lack of differentiation between on-premise and home consumption. Most of the countries adopted severe restrictions on drinking place functioning. Alcohol retail store sales temporal data were used to examine alcohol sales changes in the United States (U.S.) throughout the COVID-19 pandemic as a proxy indicator of at-home drinking. Data were sourced from the Monthly Retail Trade Survey, which has provided U.S. representative estimates of sales at retail and food services stores since 1951. In the present study, we analyzed data from seasonally adjusted beer, wine, and liquor store (BWLS) sales from January 1992 to September 2020. Poisson cubic spline models were used to assess nonlinearity in such sales during the period. These models were adjusted to the consumer price index for alcoholic beverages. There was a significant increase in retail alcohol sales during the beginning of the pandemic, reaching a plateau in the third quarter of 2020. During the COVID-19 period (March 2020 to September 2020), there were 41.9 billion dollars in BWLS sales, representing an increase of 20% compared to the same period in 2019. On the other hand, food and drinking place retail sales decreased by 27% during the same period in the same survey. These results may indicate an increase in home drinking during the period, which could potentially lead to higher alcohol consumption and alcohol-related adverse health outcomes. More aggressive efforts should be made to warn the population about the risks associated with increased home alcohol consumption during the pandemic. Additionally, tracking individual alcohol consumption and releasing real-time data at different levels are needed to better assess the effects of increased alcohol consumption during the pandemic.
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COVID-19 , Pandemias , Consumo de Bebidas Alcohólicas/epidemiología , Bebidas Alcohólicas , Humanos , SARS-CoV-2 , Estados Unidos/epidemiologíaRESUMEN
BACKGROUND: It remains unclear whether COVID-19 is associated with psychiatric symptoms during or after the acute illness phase. Being affected by the disease exposes the individual to an uncertain prognosis and a state of quarantine. These factors can predispose individuals to the development of mental symptoms during or after the acute phase of the disease. There is a need for prospective studies assessing psychiatric symptoms in COVID-19 patients in the post-infection period. METHODS: In this prospective cohort study, nasopharyngeal swabs for COVID-19 tests were collected at patients' homes under the supervision of trained healthcare personnel. Patients who tested positive for COVID-19 and were classified as mild cases (N = 895) at treatment intake were further assessed for the presence of psychiatric symptoms (on average, 56.6 days after the intake). We investigated the association between the number of COVID-19 symptoms at intake and depressive, anxiety and post-traumatic symptoms approximately two months later, adjusting for previous mental health status, time between baseline and outcome, and other confounders. Multivariate logistic regression and generalized linear models were employed for categorical and continuous outcomes, respectively. RESULTS: A clinically significant level of depressive, anxiety and post-traumatic stress symptoms were reported by 26.2% (N = 235), 22.4% (N = 201), and 17.3% (N = 155) of the sample. Reporting an increased number of COVID-related symptoms was associated with the presence of clinically significant levels of depressive (aOR = 1.059;95%CI = 1.002-1.119), anxiety (aOR = 1.072;95%CI = 1.012-1.134), and post-traumatic stress (aOR = 1.092;95%CI = 1.024-1.166) symptoms. Sensitivity analyses supported findings for both continuous and categorical measures. CONCLUSION: Exposure to an increased number of COVID-19 symptoms may be associated with depressive, anxiety and post-traumatic symptoms after the acute phase of the disease. These patients should be monitored for the development of psychiatric symptoms after COVID-19 treatment discharge. Early interventions, such as brief interventions of psychoeducation on coping strategies, could benefit these individuals.
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Ansiedad/psicología , COVID-19/psicología , Depresión/psicología , Trastornos por Estrés Postraumático/psicología , Adulto , COVID-19/diagnóstico , Femenino , Humanos , Masculino , Estudios Prospectivos , Índice de Severidad de la EnfermedadRESUMEN
Background: The efficacy of naltrexone in the treatment of alcohol use disorder (AUD) has been associated with a set of variables not directly related with the expression of opioid receptors. All the variables have been found to be highly associated with AUD itself or more severe clinical levels of AUD. Objectives: Given the high association between alcohol metabolizing enzymes (AME) and the outcome of AUD, the present study aims to investigate the role of AME genotype variants in the treatment of AUD with naltrexone. Methods: We carried out a 12-week longitudinal clinical trial based on the treatment of AUD patients with naltrexone (N = 101), stratified by different alcohol metabolization genotypes. Genotyping was performed after the inclusion of the patients in the study, based on the individual presence of single nucleotide polymorphisms (SNPs) in the ADH (alcohol dehydrogenase)1B (ADH1B*2 and ADH1B*3), ADH1C (ADHC*1) and ALDH (aldehyde dehydrogenase) 2 (ALDH2*2) genes. The outcome of alcohol use has been monitored employing the timeline follow-back during the treatment. Results: The ADH1C*1 (Ile350Val, rs698) and ALDH2*2 (Glu504Lys, rs671) polymorphisms were associated with a better response to naltrexone treatment, whereas the ADH1B*3 (Arg370Cys, rs2066702) allelic variant showed a negative outcome. Conclusions: The present study explores a genomic setting for the treatment of AUD with naltrexone. According to our findings, the association between ADH1C*1 and ALDH2*2 variants and better outcomes suggests a successful treatment, whereas the ADH1B*3 mutated allele might lead to an unsuccessful treatment. Further studies should be performed to investigate the relationship between alcohol metabolizing genotypes, the family history of alcohol use disorders and the effect of naltrexone on the outcomes. Genotyping may be a valuable tool for precision-medicine and individualized approach, especially in the context of alcohol use disorders. The small number of subjects was the main limitation of the present study.
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Alcoholismo/tratamiento farmacológico , Alcoholismo/genética , Etanol/metabolismo , Naltrexona/uso terapéutico , Femenino , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple/genética , Resultado del TratamientoRESUMEN
[This corrects the article DOI: 10.3389/fpubh.2021.634396.].
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Background: There is a need for prospective studies investigating substance use variations in mild COVID-19 patients. These individuals represent the majority of patients affected by the disease and are routinely treated at home, facing periods of quarantine. Methods: This was a retrospective cohort study. All people who tested positive for COVID-19 and classified as mild cases (i.e., no alarm sign/symptom, no need for in-person consultation) during the treatment in the public health system of a Brazilian city with around 160,000 inhabitants were monitored by phone for all the COVID-19 symptoms listed by the Centers for Disease Control and Prevention (CDC) during the active phase of the disease (i.e., no longer experiencing symptoms, up to 14 days in mild cases). After this phase (median = 108 days after intake, IQR = 76-137), we asked these patients who were classified as experiencing mild COVID-19 (n = 993) about last-month substance use in three time-points: pre-COVID, just after COVID-19 acute phase (post-COVID acute phase) and in the period before survey (post-COVID follow-up phase). Results: The number of COVID-19 symptoms was not associated with pre- or post-infection substance use. Pre-COVID alcohol and non-medical benzodiazepine use were associated with specific COVID-19 symptoms. However, sensitivity analyses showed that such associations could be explained by previous psychiatric and medical profiles. Alcohol and tobacco use decreased and non-medical analgesics increased in the post-COVID acute phase. However, just alcohol use remained lower in the post-COVID follow-up period. Higher pre-COVID levels of tobacco and alcohol were associated with post-COVID follow-up cannabis and non-medical analgesic use, respectively. Non-medical benzodiazepine use had positive and negative bi-directional associations with cannabis and non-medical analgesic use, respectively. Conclusion: We were not able to find specific associations between substance use and COVID-19 symptomatology in the present study. Patients with mild COVID-19 should be monitored for substance use in the post-COVID-19 period, and preventive interventions for non-medical analgesic use should be implemented. Focused preventive interventions increasing the perceived risks of cannabis and non-medical benzodiazepine and analgesic use among people experiencing mild COVID-19 that reported previous substance use could be useful.
Asunto(s)
Consumo de Bebidas Alcohólicas , COVID-19/epidemiología , Cannabis , Trastornos Relacionados con Sustancias/epidemiología , Uso de Tabaco , Adulto , Benzodiazepinas , Brasil/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuarentena , Estudios Retrospectivos , Factores de TiempoRESUMEN
Although smoking rates have declined in most of the countries in the world, there are population groups within these countries whose smoking rates remain significantly higher than the general population. These "forgotten groups" who have not been receiving the needed attention in tobacco control policies and tobacco cessation efforts include people with serious mental illness, substance use disorders, tuberculosis, people living with human immunodeficiency virus (HIV), lesbian-gay-bisexual-transgender-queer people, and pregnant women. A number of steps are needed at the national level in countries where these disparities exist, including modifications to national smoking cessation treatment guidelines that address the special needs of these populations, as well as targeted smoking cessation research, since these populations are often not included in clinical trials. Because of the higher smoking prevalence in these populations, as well as their lower smoking cessation treatment success rates than the general population, more resources are needed if we are to reduce health disparities in these vulnerable populations. Additionally, we believe that more effort should be focused on integrating smoking cessation treatment in the specialized care settings frequented by these subpopulations.