Is post-traumatic stress disorder a risk factor for development of opioid use disorder among individuals with chronic non-cancer pain? A systematic review.

Introduction: There is emerging evidence that posttraumatic-stress disorder may have mediating effects in development of chronic-non-cancer-pain and opioid-use-disorder independently, but its impact on the development of opioid-use-disorder in people with chronic-non-cancer pain is still unclear. Objectives: (i) Estimate the risk of opioid-use-disorder among individuals with chronic-non-cancer-pain and posttraumatic-stress disorder, relative to those with chronic-non-cancer-pain only, and (ii) identify potential correlates of opioid-use-disorder among people with chronic-non-cancer-pain and posttraumatic-stress disorder. Methods: This systematic review was conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Longitudinal, epidemiological, cohort, follow-up, retrospective, prospective and cross-sectional studies reporting measures of variance on the likelihood of developing opioid-use-disorder with posttraumatic-stress disorder among individuals with chronic-non-cancer-pain were identified from six-electronic databases (Medline, Embase, Evidence-based Medicine reviews, PsycINFO, Scopus and Web of Science) until December 2022. Results: Three out of the four studies, which met the selection criteria for this analysis reported statistically significant positive association between risk of developing opioid-use-disorder with posttraumatic-stress disorder among chronic-non-cancer-pain cohort (unadjusted Relative-Risk range: 1.51-5.27) but this association was not evident in the fourth study (adjusted Relative-Risk: 0.96; statistically non-significant), when adjusted for sociodemographic variables. The increased risk was noted particularly with females and chronic musculoskeletal pain conditions. Conclusions: Posttraumatic-stress disorder can increase the risk of development of opioid-use-disorder among people with chronic-non-cancer-pain and a better understanding of this relationship will help to predict and prevent the development of opioid-use-disorder and may also help in reducing the disability and burden associated with chronic-non-cancer-pain. Perspective: This review quantifies the risk of developing opioid-use-disorder in the context of posttraumatic-stress disorder among individuals with chronic-non-cancer-pain. Awareness and subsequent practice change will reduce the increasing global burden associated with the chronic-non-cancer-pain.

Synthetic cannabinoid use in an acute psychiatric inpatient unit.

In the present study, we explored the prevalence of new psychoactive substance use by people admitted into an Australian acute public mental health facility specializing in comorbid mental health and substance use. These substances have since been banned from retail outlets, but the pattern of uptake and reasons people use them is informative in terms of motivations and the management of substance use more generally. A cross-sectional study to explore the use of synthetic cannabis by people admitted to an acute adult mental health unit was undertaken. Associations with diagnostic, service use, and demographic profiles were explored. Fifty-six percent of people reported having used at least one type of new psychoactive substance, including 53.5% who reported using synthetic cannabis alone, and 18.8% who reported using both synthetic cannabis and other new psychoactive substances. Synthetic cannabis use was not associated with any demographic or diagnostic groups. Legality and availability (43% combined) were common reasons for use, along with the feeling of intoxication (20%). The high prevalence of new psychoactive substance use adds weight to the recommendation that clinicians should routinely screen for substances from the time of admission. Accurate information about these substances is required in order to provide accurate guidance and appropriate interventions to people in their care.

Profile of adult patients attending a marriage and sex clinic in India.

BACKGROUND: Sexual disorders, which are usually influenced by multiple factors, are very prevalent across the globe but there are few studies which provide the pattern of help-seeking behavior in the Indian population. AIMS: The study aims to present the pattern of sexual dysfunction in the patients attending a marriage and sex clinic from 1979 to 2005. METHOD: Details are obtained from the records of the patients who attended the clinic. In accordance with the change in diagnostic classification, the data are presented: ICD-IX (for period 1979-1992) and ICD-X (for period 1993-2005). RESULTS: Out of a total of 1,242 patients, 566 patients attended the clinic during 1979 to 1992, and 676 patients during 1993 to 2005. More than half of the clinic population during the period was aged 20-29 years. Premature ejaculation is the most common complaint and the most commonly diagnosed clinical entity, followed by male erectile problems and culturally induced sexual behaviors such as dhat syndrome. CONCLUSION: Being more educated, married and from an urban background promotes help-seeking in tertiary care clinics but these findings may be due to selection bias. Sexual activity continues to be strongly influenced by culturally held beliefs. This influence is more troublesome for young and unmarried persons who have not changed over the period.

Major depressive disorder, obsessive-compulsive disorder, and generalized anxiety disorder: do the sexual dysfunctions differ?

OBJECTIVES: Major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and generalized anxiety disorder (GAD) are known to have significant impact on sexual functioning. They have been studied individually. Therefore, this study was planned to compare the sexual dysfunction between MDD, OCD, and GAD with healthy subjects as controls. METHOD: Four groups (MDD, OCD, GAD, and healthy subjects), matched for age, gender, marital status, and education status were identified by using the Psychiatric Diagnostic Screening Questionnaire. Subjects in these groups were assessed for absence of any major physical and psychiatric disorders. MDD, OCD, and GAD were rated for severity of illness by using the Hamilton Rating Scale for Depression, Yale-Brown Obsessive Compulsive Scale, and Hamilton Rating Scale for Anxiety, respectively. Subjects were evaluated with the Arizona Sexual Experiences Scale for sexual dysfunction, which was defined as either a score of ≥ 5 on any item or a total score of ≥ 17. Suitable statistical analysis was used to interpret the results. The study was conducted from May 2006 through July 2007. RESULTS: Fifty patients in each group were selected. The rate of sexual dysfunction was 30% in healthy controls, 76% in MDD subjects, 50% in OCD subjects, and 64% in GAD subjects. Low desire was the most commonly reported dysfunction among all the categories (p < .001). No particular dysfunction was associated with the 4 categories under study. Severity of illness did not correlate with the severity of sexual dysfunction. CONCLUSION: Persons with MDD have more sexual dysfunction than those with OCD and GAD. These disorders had a pervasive affect on sexual functioning of the individuals.

Depression among women in the South-Asian region: the underlying issues.

BACKGROUND: The condition of women in third-world countries continues to be dismal. They are constantly exposed to such circumstances which make them prone to sufferings. These sufferings bear an irreparable brunt upon the mental health condition of females which are presented as greater psychological problems in terms of depressive disorders. The impact, in turn is felt by the society as a whole which lags behind due to the huge burden. This study is presented to highlight the various factors affecting the presentation of women in the region. METHODS: This is a review of studies in which various issues pertaining to presentation, course, and outcome of depression among women in South-Asian region are discussed. The studies were chosen from Internet-based search. RESULTS: The various factors affecting the problems can be grouped into: social milieu, reproductive health factors, and biological milieu. LIMITATIONS: This study incorporates various studies which were undertaken at different time durations; hence, its finding cannot be reproduced in an exact sense. It is worth mentioning that these factors need to be studied comprehensively for better health care. CONCLUSION: This study gives an indication of specific health care needs of women in the region which are to be customized as per local needs and cultural sanctions.