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1.
Cent Eur J Public Health ; 29(3): 209-216, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34623121

RESUMEN

OBJECTIVES: The aim of this study was to evaluate the relationship between internet addiction, substance use and alexithymia among students of education faculty and medical faculty. METHODS: This cross-sectional analytical study included 1,257 faculty students aged 18 and over, studying at Meram Medical Faculty and Ahmet Kelesoglu Faculty of Education. Young's Internet Addiction Scale, Toronto Alexithymia Scale, Fagerström Tobacco Addiction Test and CAGE alcohol use tests were applied to collect data. RESULTS: The mean age of the participants was 21.12 ± 1.96 years, 71% (n = 893) of them were females and 29% (n = 364) were males, 37.9% (n = 477) were training at medical faculty, 62.1% (n = 780) were training at the faculty of education. Of the students, 1.5% were internet addicts, 15.3% were possible addicts, and 22.8% had alexithymia. Internet addiction was higher in those with higher alexithymia scores (p < 0.001). Internet addiction was significantly higher in male students, the third grade, ones with lower academic success, students who work their lessons less than 2 hours a week. Internet addiction was also significantly higher in smokers and alcohol users (p < 0.001). While there was a low negative correlation between the first internet using age and internet addiction (p < 0.001), there was a moderately significant positive correlation between spending uninterrupted time on the internet and internet addiction (p < 0.001). CONCLUSION: In this study, it was determined that the teacher and doctor candidates, who are studying at the faculties of education and medicine, were at risk of internet addiction. A teacher or a doctor who cannot develop social skills due to excessive internet use will not be a good model to communicate correctly with the target population.


Asunto(s)
Trastorno de Adicción a Internet , Trastornos Relacionados con Sustancias , Adolescente , Adulto , Estudios Transversales , Docentes , Femenino , Humanos , Masculino , Estudiantes , Adulto Joven
2.
Emerg Med Clin North Am ; 39(4): 821-837, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34600640

RESUMEN

There are a variety of gastrointestinal pathologies that may be emergently identified in the patient who chronically uses alcohol or other substances. Patients may present to an Emergency Department with abdominal complaints existing on a spectrum from vague and benign to systemically toxic and potentially life-threatening. This article highlights ethanol, opioids, and other common substances of abuse and how they may contribute to gastrointestinal complaints.


Asunto(s)
Dolor Abdominal/etiología , Trastornos Relacionados con Sustancias/complicaciones , Enfermedades del Sistema Digestivo/complicaciones , Enfermedades del Sistema Digestivo/etiología , Servicio de Urgencia en Hospital , Humanos , Síndrome de Abstinencia a Sustancias/complicaciones
3.
BMC Health Serv Res ; 21(1): 1035, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34598693

RESUMEN

BACKGROUND: Given high rates of mental health and substance challenges among youth and substantial system access barriers, system innovation is required. Integrated youth services (IYS) models aim to transform youth mental health and substance use services by creating integrative, collaborative models of care in youth-friendly settings. This study examines service provider perspectives on the key service components to include in IYS models. METHOD: A discrete choice experiment modeled service provider preferences for the service components of IYSs. The sample includes 388 service provider/agency leader participants (age 18+) from youth-serving organizations in Ontario. Importance scores and utility values were calculated for 12 attributes represented by four levels each. Latent class analysis identified subgroups of participants with different preferences. RESULTS: The majority of participants were direct service providers working in larger organizations in the mental health and/or substance use sectors in large urban centers. Participants strongly endorsed service models that provide rapid access to the widest variety of culturally sensitive service options, with supplementary e-health services, in youth-focused community settings with evening and weekend hours. They prefer caregiver involvement in youth services and treatment decisions and support youth and family engagement. Latent class analyses reveal three segments of service providers: a Youth-Focused Service Accessibility segment representing 62.1% (241/388) of participants, a Service Options segment representing 27.6% (107/388) of participants, and a Caregiver Integration segment representing 10.3% (40/388) of participants. Within these segments, the degree of prioritization of the various service components differ; however, the overall endorsement of the service components remains largely consistent across classes for most attributes. The segments did not differ based on demographic or agency characteristics. CONCLUSIONS: The core characteristics of IYS settings for youth with mental health and substance use challenges, i.e., rapid access to a wide range of youth-oriented services, are strong priorities of service providers and youth-serving agency leaders. These findings confirm that youth-oriented service providers endorse the importance and relevance of IYS models as a whole; strong service provider buy-in to the model is expected to facilitate development, implementation and scaling of IYS models. Hearing stakeholder perspectives, including those of service providers, youth, and caregivers, is essential to developing, effectively implementing, and scaling effective youth services.


Asunto(s)
Servicios de Salud del Adolescente , Servicios de Salud Mental , Trastornos Relacionados con Sustancias , Adolescente , Humanos , Salud Mental , Ontario , Trastornos Relacionados con Sustancias/terapia
4.
Sci Total Environ ; 799: 150013, 2021 Dec 10.
Artículo en Inglés | MEDLINE | ID: mdl-34602307

RESUMEN

Wastewater analysis was used to investigate drug prevalence in primary and secondary schools and institutes of higher education located in urban and non-urban areas of six municipalities in Slovenia. Seven-hour composite raw wastewater samples from 44 educational institutions, including 19 primary schools (6-15 yrs.), ten secondary schools (15-19 yrs.), nine higher education institutions (19+ yrs.) and six mixed secondary and higher education institutions (15+ yrs.), were collected at the end of the 2018/2019 academic year. Metabolic residues of licit drugs (nicotine and alcohol), medications of abuse (morphine, codeine and methadone) and illicit drugs (cannabis, cocaine, amphetamine, methamphetamine, ecstasy and heroin) were targeted in the study. The analysis was carried out using solid-phase extraction and direct injection combined ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Biomarkers of nicotine, alcohol and cannabis intake were the most frequently detected, indicating a high prevalence of these drugs. Morphine and codeine were also detected, while among the stimulants, benzoylecgonine had the highest detection frequency. Drug differences were found between different levels of educational institution, geographic location (inter-municipality comparison) and degree of urbanization. However, t-distributed stochastic neighbour embedding (t-SNE) revealed that the level of educational institution was the main factor influencing the differences in drug prevalence. Although a good agreement between data from this study and other studies implementing wastewater analysis was observed, there was a discrepancy with Slovenian epidemiological survey data. Finally, despite certain drawbacks of the method, its application to detect drug residues in educational institutions provides a non-invasive insight into drug use trends.


Asunto(s)
Drogas Ilícitas , Trastornos Relacionados con Sustancias , Contaminantes Químicos del Agua , Cromatografía Liquida , Humanos , Instituciones Académicas , Detección de Abuso de Sustancias , Trastornos Relacionados con Sustancias/epidemiología , Espectrometría de Masas en Tándem , Aguas Residuales/análisis , Contaminantes Químicos del Agua/análisis
5.
Trials ; 22(1): 705, 2021 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-34654464

RESUMEN

BACKGROUND: Employment is associated with better outcomes of substance use treatment and protects against relapse after treatment completion. Unemployment rates are high for people with substance use disorders (SUD) who undergo treatment, with Norwegian estimates ranging from 81 to 91%. Evidence-based vocational models are lacking for patients in SUD treatment but exist for patients with psychosis in terms of Individual Placement and Support (IPS). The aim of the IPS for substance use disorders (IPS-SUD) trial is to investigate the effect of IPS in a SUD population. METHODS/DESIGN: The IPS-SUD trial is a randomized controlled trial (RCT) comparing IPS to an enhanced control intervention. The study is a seven-site, two-arm, pragmatic, parallel-group, superiority RCT. Participants are randomly assigned (1:1) to receive either IPS plus treatment as usual (TAU) or to receive a self-help guide book and 12-h workshop plus 1-h individual vocational guidance plus TAU. Aiming to recruit 200 participants, we will be able to detect a 20% difference in the main outcome of employment with 90% power. We will make assessments at inclusion and at 6- and 12-month follow-ups and obtain outcome data on employment from national mandatory registries. The primary outcome will be at least 1 day of competitive employment during the 18-month follow-up period. Secondary employment outcomes will capture the pattern and extent of employment in terms of total time worked (days/hours), time to first employment, number of different jobs, duration of the longest employment, and sustained employment. Secondary non-employment outcomes will be substance use, mental distress, and quality of life measured by validated instruments at 6, 12, and 18 months follow-up assessments. To be eligible, participants must be between 18 and 65 years, currently unemployed and in treatment for SUD. DISCUSSION: The IPS-SUD trial will provide evidence for the use of IPS in a SUD population. Findings from the study will have implications for service delivery. TRIAL REGISTRATION: ClinicalTrials.gov NCT04289415 . Registered on February 28, 2020.


Asunto(s)
Empleos Subvencionados , Trastornos Mentales , Trastornos Psicóticos , Trastornos Relacionados con Sustancias , Empleo , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Rehabilitación Vocacional , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/terapia , Desempleo
6.
JAMA ; 326(13): 1299-1309, 2021 Oct 05.
Artículo en Inglés | MEDLINE | ID: mdl-34609453

RESUMEN

Importance: Assessing the scope of acute medication harms to patients should include both therapeutic and nontherapeutic medication use. Objective: To describe the characteristics of emergency department (ED) visits for acute harms from both therapeutic and nontherapeutic medication use in the US. Design, Setting, and Participants: Active, nationally representative, public health surveillance based on patient visits to 60 EDs in the US participating in the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance Project from 2017 through 2019. Exposures: Medications implicated in ED visits, with visits attributed to medication harms (adverse events) based on the clinicians' diagnoses and supporting data documented in the medical record. Main Outcomes and Measures: Nationally weighted estimates of ED visits and subsequent hospitalizations for medication harms. Results: Based on 96 925 cases (mean patient age, 49 years; 55% female), there were an estimated 6.1 (95% CI, 4.8-7.5) ED visits for medication harms per 1000 population annually and 38.6% (95% CI, 35.2%-41.9%) resulted in hospitalization. Population rates of ED visits for medication harms were higher for patients aged 65 years or older than for those younger than 65 years (12.1 vs 5.0 [95% CI, 7.4-16.8 vs 4.1-5.8] per 1000 population). Overall, an estimated 69.1% (95% CI, 63.6%-74.7%) of ED visits for medication harms involved therapeutic medication use, but among patients younger than 45 years, an estimated 52.5% (95% CI, 48.1%-56.8%) of visits for medication harms involved nontherapeutic use. The proportions of ED visits for medication harms involving therapeutic use were lowest for barbiturates (6.3%), benzodiazepines (11.1%), nonopioid analgesics (15.7%), and antihistamines (21.8%). By age group, the most frequent medication types and intents of use associated with ED visits for medication harms were therapeutic use of anticoagulants (4.5 [95% CI, 2.3-6.7] per 1000 population) and diabetes agents (1.8 [95% CI, 1.3-2.3] per 1000 population) for patients aged 65 years and older; therapeutic use of diabetes agents (0.8 [95% CI, 0.5-1.0] per 1000 population) for patients aged 45 to 64 years; nontherapeutic use of benzodiazepines (1.0 [95% CI, 0.7-1.3] per 1000 population) for patients aged 25 to 44 years; and unsupervised medication exposures (2.2 [95% CI, 1.8-2.7] per 1000 population) and therapeutic use of antibiotics (1.4 [95% CI, 1.0-1.8] per 1000 population) for children younger than 5 years. Conclusions and Relevance: According to data from 60 nationally representative US emergency departments, visits attributed to medication harms in 2017-2019 were frequent, with variation in products and intent of use by age.


Asunto(s)
Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Enfermedad Aguda , Adolescente , Adulto , Distribución por Edad , Factores de Edad , Anciano , Analgésicos no Narcóticos/efectos adversos , Antibacterianos/efectos adversos , Anticoagulantes/efectos adversos , Barbitúricos/efectos adversos , Benzodiazepinas/efectos adversos , Niño , Preescolar , Intervalos de Confianza , Femenino , Antagonistas de los Receptores Histamínicos/efectos adversos , Hospitalización/estadística & datos numéricos , Humanos , Hipoglucemiantes/efectos adversos , Masculino , Persona de Mediana Edad , Medicamentos sin Prescripción/efectos adversos , Vigilancia en Salud Pública , Distribución por Sexo , Factores de Tiempo , Estados Unidos/epidemiología , Adulto Joven
7.
J Addict Nurs ; 32(3): 180-187, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34473447

RESUMEN

BACKGROUND: Substance abuse represents a foremost national concern for adolescents and adults; investigators have implemented a variety of interventions, delivered with both in-person and mobile-based apps' modalities. The electronic techniques could be more effective because they avoid the cost, privacy, and accessibility issues associated with in-person intervention. To address this issue, a systematic review of the scientific evidence relative to the efficacy of app-based interventions delivered by mobile devices (smartphones) to reduce substance abuse in adolescents and adults was carried out. METHODS: To identify relevant studies published from 2005 to 2019, a comprehensive search was conducted. Databases that were searched include CINAHL, Cochrane CENTRAL, Embase, PsycINFO, PubMed, and Web of Science. Keywords and relevant controlled vocabulary terms related to substance abuse and technology were included. Studies were included if they had examined reductions in substance abuse and problem behaviors as a primary outcome with app-based interventions delivered to adolescents and adults. RESULTS: The initial search yielded 21,641 articles, duplicates were removed, and 14,797 citations remained; title/abstract screening yielded 190 full-text articles. One hundred seventy-three were excluded because they did not meet the inclusion criteria, leaving 17 final articles to be analyzed in this review. Use of app-based interventions showed some evidence of effectiveness in reducing substance abuse in the adolescent adult population. CONCLUSION: Most intervention studies analyzed focused on alcohol reduction. Further research is needed on diverse substance abuse utilizing larger sample sizes, longitudinal studies, and theoretical foundations on the practice of delivering interventions using mobile-based apps.


Asunto(s)
Aplicaciones Móviles , Trastornos Relacionados con Sustancias , Telemedicina , Adolescente , Adulto , Humanos , Teléfono Inteligente , Trastornos Relacionados con Sustancias/prevención & control
8.
Lancet ; 398(10303): 920-930, 2021 09 04.
Artículo en Inglés | MEDLINE | ID: mdl-34481571

RESUMEN

The COVID-19 pandemic has heightened interest in how physician mental health can be protected and optimised, but uncertainty and misinformation remain about some key issues. In this Review, we discuss the current literature, which shows that despite what might be inferred during training, physicians are not immune to mental illness, with between a quarter and a third reporting increased symptoms of mental ill health. Physicians, particularly female physicians, are at an increased risk of suicide. An emerging consensus exists that some aspects of physician training, working conditions, and organisational support are unacceptable. Changes in medical training and health systems, and the additional strain of working through a pandemic, might have amplified these problems. A new evidence-informed framework for how individual and organisational interventions can be used in an integrated manner in medical schools, in health-care settings, and by professional colleagues is proposed. New initiatives are required at each of these levels, with an urgent need for organisational-level interventions, to better protect the mental health and wellbeing of physicians.


Asunto(s)
Trastornos Mentales/epidemiología , Médicos/psicología , Suicidio/estadística & datos numéricos , Agotamiento Profesional , COVID-19/epidemiología , Femenino , Humanos , Masculino , Trastornos Mentales/prevención & control , Pandemias , Médicos Mujeres/psicología , Factores de Riesgo , SARS-CoV-2 , Trastornos Relacionados con Sustancias/epidemiología , Suicidio/prevención & control , Tolerancia al Trabajo Programado
9.
BMC Psychol ; 9(1): 138, 2021 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-34511136

RESUMEN

BACKGROUND: Patients with Substance use disorder have distinct personality traits, they were high score in novelty seeking (NS) and sensation seeking and lower in Self-directedness and higher in Self-transcendence, so we aim to investigate the relationships of temperament and characteristics with related some variables such as substance of choice. DESIGN AND SETTING: A case-control study enrolling 70 Substance use disorder patients and 70 controls was conducted at Mashhad University of medical sciences. METHODS: Using a case-control design, a group of 70 Substance use disorder patients and 70 controls was conducted at Mashhad university of medical sciences. All participation completed the 240 questions of Temperament and Character Inventory-Revised (TCI-R). Multivariate analysis of covariance (MANCOVA) was employed to compare the relationship between temperament and character traits and patterns of substance use. RESULTS: The scores of reward dependence, persistence, self-directedness, cooperativeness, and self-transcendence were significantly lower in the case group compared to healthy individuals (P < 0.05). In contrast, the score of novel seeking was significantly higher in the case group (P < 0.05). On the other hand, harm avoidance was not significantly different between the two studied groups (P = 0.637). CONCLUSIONS: Higher NS in patients with substance use disorder is common and different traits, and temperaments would choose different substance combinations.


Asunto(s)
Trastornos Relacionados con Sustancias , Temperamento , Estudios de Casos y Controles , Humanos , Irán , Inventario de Personalidad , Trastornos Relacionados con Sustancias/epidemiología
10.
Rev Esc Enferm USP ; 55: e20210138, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-34516604

RESUMEN

OBJECTIVE: To compare the consequences of psychoactive substance use among users of mental health services in Brazil and Portugal. METHOD: Cross-sectional, comparative, quantitative study, carried out with 362 users of two specialized treatment services in the cities of São Paulo (n = 200) and Lisbon (n = 162). Data collected in 2019 through the application of the Substance Addiction Consequences scale. A descriptive analysis and ordinary least squares and logistic regressions were performed. RESULTS: All dimensions assessed by the scale were more severe for Brazilian users, with a difference for the physical domain and cognitive skills (p < 0.01). Brazilian participants were more likely to consume cocaine (p < 0.01) and have psychosis (p = 0.02) and Portuguese participants to have hepatitis (p < 0.01), personality disorders (p < 0.01), use benzodiazepines (p < 0.01) and tobacco (p < 0.01), and receive pharmacological support (p < 0.01). CONCLUSION: It was found that Brazilian users have more serious consequences related to substance use, and Portuguese users have more comorbidities and exposure to risky consumption. It emerges that Portuguese responses minimize the consequences severity.


Asunto(s)
Trastornos Relacionados con Sustancias , Brasil/epidemiología , Ciudades , Estudios Transversales , Humanos , Portugal/epidemiología , Trastornos Relacionados con Sustancias/epidemiología
11.
BMC Psychiatry ; 21(1): 442, 2021 09 07.
Artículo en Inglés | MEDLINE | ID: mdl-34493253

RESUMEN

BACKGROUND: Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) have high comorbidity. Although prior research indicated that PTSD can effectively be treated with Prolonged Exposure (PE) in these patients, reported effects are small and treatment dropout rates high. Eye Movement Desensitization and Reprocessing (EMDR) and Imagery Rescripting (ImRs) are other promising treatment options for PTSD, that have not yet been examined in this patient group. Furthermore, it is unclear whether PTSD treatment is most effective when offered simultaneous to or after SUD treatment. METHODS: In this article, the Treatment Of PTSD and Addiction (TOPA) study is described: a Dutch randomized controlled trial (RCT) that studies the effectiveness of PTSD treatment as an add-on to regular SUD treatment in patients with SUD and co-occurring PTSD. Effects of PE, EMDR, ImRs, and a 3-month SUD treatment only condition will be compared, as well as simultaneous SUD/PTSD treatment to sequential SUD/PTSD treatment. The primary outcome measure is PTSD symptoms. Secondary outcomes are: treatment completion, psychological distress, substance use, interpersonal problems, emotion dysregulation, and trauma-related emotions guilt, shame, and anger. DISCUSSION: This study is the first to compare effects of PE, EMDR, and ImRs in one study and to compare simultaneous SUD/PTSD treatment to sequential SUD/PTSD treatment as well. This RCT will provide more knowledge about the effectiveness of different treatment strategies for PTSD in patients with co-occurring SUD and will ultimately improve treatment outcomes for patients with this common co-morbidity worldwide. TRIAL REGISTRATION: Netherlands Trial Register (NTR), Identifier: NL7885 . Registered 22 July 2019.


Asunto(s)
Desensibilización y Reprocesamiento del Movimiento Ocular , Trastornos por Estrés Postraumático , Trastornos Relacionados con Sustancias , Comorbilidad , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Trastornos por Estrés Postraumático/complicaciones , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/terapia , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/terapia , Resultado del Tratamiento
12.
JNMA J Nepal Med Assoc ; 59(234): 184-187, 2021 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-34506452

RESUMEN

INTRODUCTION: Personality disorders is comprised of deeply ingrained and enduring behavioral patterns, manifesting themselves as inflexible responses to a broad range of personal and social situations." Personality Disorders are frequently occurring among patients with substance use disorders. Co-occurrence of substance use disorders and personality disorder is associated with a greater functional impairment affecting treatment adherence. This study's objective was to find out the prevalence of personality disorders among substance use disorders from the Department of Psychiatry and Mental Health, of a tertiary care center of Nepal. METHODS: A descriptive cross-sectional study was done at the Department of Psychiatry and Mental Health of Shree Birendra Hospital, Chhauni, Kathmandu, Nepal. The ethical approval was approved by the Institutional Review Committee prior to the study. The International Personality Disorder Examination ICD-10 module interview schedule was used to determine personality disorders. There were 100 patients, 86 males and 14 females of age ranging between 18-59 years, from different education levels, socioeconomic statuses, and ethnicities. RESULTS: Of the total 100 patients, 63% of the patients with substance use disorders were found to have either single 24 (24%) or multiple 39 (39%) personality disorders. The most frequently identified disorders were Emotionally Unstable Borderline Type 34 (34%), Anxious Personality Disorder 27 (27%), Emotionally Unstable Impulsive Type 27 (27%). CONCLUSIONS: Present study indicates that personality disorders were highly comorbid with patients of substance use disorders with either single or multiple personality disorders. Personality disorders mostly found in substance use disorders are Emotional Unstable Borderline Type, Anxious Personality Disorder, and Emotional Unstable impulsive Type.


Asunto(s)
Trastornos Mentales , Trastornos Relacionados con Sustancias , Adolescente , Adulto , Comorbilidad , Estudios Transversales , Femenino , Humanos , Masculino , Trastornos Mentales/epidemiología , Persona de Mediana Edad , Nepal/epidemiología , Trastornos de la Personalidad/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Centros de Atención Terciaria , Adulto Joven
13.
JNMA J Nepal Med Assoc ; 59(238): 571-576, 2021 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-34508402

RESUMEN

INTRODUCTION: Psychoactive substance use among medical students is common. This may not only pose a threat to their health and academic performance but may have medico-legal and ethical ramifications. The aim of this study was to find out the prevalence of six psychoactive substances (alcohol, tobacco, cannabis, cocaine, benzodiazepines, opioids) among second year and third year medical students. METHODS: A descriptive cross-sectional study was done in a medical college. Whole sampling was done and ethical approval was taken from the Institutional Review Committee (Reference Number: 54-074/075). The study was conducted from May 2018 to June 2018. A semi-structured self-administered questionnaire modified and adapted from World Health Organization's guidelines for student substance use survey was used to collect data from second year and third year medical students. Statistical Package for Social Sciences version 16.0 was used for analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Out of 226 total respondents, 95 (42.0%) (35.55- 48.45 at 95% Confidence Interval) reported current use of one or more psychoactive substances. Most frequently used substance was alcohol with current use prevalence of 87 (38.5%), followed by smoking 39 (17.3%) and cannabis 27 (11.9%). Cocaine, benzodiazepines and opioids were the least consumed substances with current use prevalence of 2 (0.9%) each. CONCLUSIONS: Almost half of the students were currently using one or more psychoactive substances which is concerning, and therefore strategies must be adopted to alleviate such use.


Asunto(s)
Estudiantes de Medicina , Trastornos Relacionados con Sustancias , Estudios Transversales , Humanos , Prevalencia , Trastornos Relacionados con Sustancias/epidemiología , Universidades
14.
BMC Psychiatry ; 21(1): 444, 2021 09 08.
Artículo en Inglés | MEDLINE | ID: mdl-34496834

RESUMEN

BACKGROUND: Little data exists regarding depression and its associated factors in medical residents and doctors in Sub-Saharan Africa. Residents are at high risk of developing depression owing to the stressful nature of their medical practice and academic training. Depression in medical residents leads to decreased clinical efficiency, and poor academic performance; it can also lead to substance abuse and suicide. Our primary aim was to measure depression prevalence among medical residents in Kenya's largest national teaching and referral hospital. Secondary aims were to describe how depression was associated with perceived stress, perceived social support, substance use, and educational environment. METHODS: We sampled 338 residents belonging to 8 different specialties using self administered questionnaires in this cross-sectional survey between October 2019 and February 2020. Questionnaires included: sociodemographics, the Centres for Epidemiology Depression Scale - Revised, Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, Alcohol, Smoking and Substance Involvement Screening Test, and Postgraduate Hospital Educational Environment Measure. Bivariate and multivariate linear regression were used to assess for risk factors for depression. RESULTS: Mean participant age was 31.8 years and 53.4% were males. Most residents (70.4%) reported no to mild depressive symptoms, 12.7% had moderate, and 16.9% had severe depressive symptoms. Most residents had high social support (71.8%) and moderate stress (61.6%). The educational environment was rated as more positive than negative by 46.3% of residents. Bivariate analyses revealed significant correlations between depressive symptoms, perceived stress, substance use, perceived social support, and educational environment. Multivariate analysis showed that depression was strongly associated with: fewer hours of sleep (ß = - 0.683, p = 0.002), high perceived stress (ß = 0.709, p < 0.001) and low perceived social support (ß = - 2.19, p < 0.001). CONCLUSIONS: Only 30% of medical residents in our study had moderate and severe depressive symptoms. Most residents in our study reported high levels of social support, and moderate levels of stress. Though their overall appraisal of medical residency experience was positive, mental health support and self-care skills in the training of medical professionals needs prioritization.


Asunto(s)
Internado y Residencia , Trastornos Relacionados con Sustancias , Adulto , Estudios Transversales , Depresión/epidemiología , Humanos , Kenia/epidemiología , Masculino , Factores de Riesgo , Facultades de Medicina , Apoyo Social , Estrés Psicológico/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Encuestas y Cuestionarios
15.
Front Public Health ; 9: 709410, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34497792

RESUMEN

People can increase their use of psychoactive substances in response to stressful situations as a maladaptive mechanism for reducing negative affective states. It is therefore necessary to examine changes in the use of such substances and their relationship to mental health in light of the COVID-19 pandemic. Objective: Evaluate the relationship between psychoactive substances and stress, emotional state, and symptomatology during the COVID-19 lockdown in Mexico. Method: A national survey was conducted, using the free Google Forms platform, of residents of Mexico aged 18 and older. The survey was disseminated through social media. Results: The sample comprised 4,122 individuals, mostly women (71.8%), with an age range of 18-81 years (M = 37.08, SD = 12.689), of which 46.8% were single, and 42.9% married. In general, there was a reduction in substance use during the first 2 months of the quarantine; the most commonly used substances were alcohol, tobacco, and tranquilizers. Respondents who described having greater use than before the pandemic presented greater stress, depressive symptomatology, and perceived threat than those who did not use substances. Conclusions: Respondents who did not use substances reported lower levels of stress, depressive symptomatology, impact of the coronavirus pandemic, and perception of its threat. Women reported greater stress, depressive symptomatology, and emotional intensity than men.


Asunto(s)
COVID-19 , Distrés Psicológico , Trastornos Relacionados con Sustancias , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Control de Enfermedades Transmisibles , Femenino , Humanos , Masculino , Salud Mental , México/epidemiología , Persona de Mediana Edad , Pandemias , SARS-CoV-2 , Trastornos Relacionados con Sustancias/epidemiología , Adulto Joven
17.
Front Public Health ; 9: 645980, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34490174

RESUMEN

Background: Khat (Catha edulis) is a traditionally used substance in African and Arab countries that contains the amphetamine-like alkaloid cathinone. Khat use among Ethiopian students is a growing concern. This study aims to describe khat use, psychological problems, and motivation to change and to determine associated factors of khat use among students from Jimma University seeking psychological assistance. Methods: In a cross-sectional study, a sample of 717 students from Jimma University, southwestern Ethiopia, who seek assistance to reduce khat use were recruited. The study used Amharic and Afaan Oromoo language versions of common psychological instruments and employed them as part of a comprehensive tablet computer-delivered self-report assessment battery, comprising the SRQ-20, the PCL-5, the LEC-5, the AUDIT, and the SOCRATES-khat. In addition, socio-demographic, economic variables, and functioning problems due to severe mental disorders were assessed. The analysis relied on the data of the 575 included participants and used clinical cut-off values to describe this treatment-seeking sample and hierarchical regression models to determine variables associated with khat use. Results: The sample showed high khat use in the past month (M = 31.55 bundles, SD = 28.53, on M = 15.11 days, SD = 8.54); 17.0% showed highly problematic use. The sample was extremely burdened with comorbid psychiatric problems: 21.6% reported functioning problems due to past mental disorders, 60.2% scored above the cut-off for current common mental disorders, 37.9% screened positive for PTSD, and 47.1% reported hazardous alcohol use. Small to medium intercorrelations between variables were detected, and in hierarchical regression models, higher motivation to change khat use was associated with higher use of the substance. Conclusions: This study clearly shows the need to develop research instruments, screening methods, and assistance services for khat-using students at Jimma University. Study participants' high mental health burden shows the need for targeted intervention programs that go beyond brief interventions for khat use. Furthermore, the study highlights challenges for implementing such services: the barriers to utilization for females and khat users without comorbid mental health problems.


Asunto(s)
Catha , Trastornos Relacionados con Sustancias , Catha/efectos adversos , Estudios Transversales , Etiopía/epidemiología , Humanos , Lenguaje , Prevalencia , Estudiantes , Trastornos Relacionados con Sustancias/epidemiología , Universidades
18.
Zhonghua Yi Xue Za Zhi ; 101(35): 2745-2747, 2021 Sep 21.
Artículo en Chino | MEDLINE | ID: mdl-34551489

RESUMEN

Benzodiazepines have been on the market for more than half a century and are widely used in clinical practice. Their use in many countries has been limited in recent decades due to drug dependence and dose tolerance in some patients. Currently, benzodiazepines are still effective in treating many mental disorders, but some patients and doctors refuse to use them for fear of drug dependence and dementia caused by long-term use. The author suggests that benzodiazepines should be objectively evaluatedand rationally used.


Asunto(s)
Ansiolíticos , Trastornos Relacionados con Sustancias , Ansiolíticos/uso terapéutico , Benzodiazepinas , Tolerancia a Medicamentos , Miedo , Humanos , Trastornos Relacionados con Sustancias/tratamiento farmacológico
19.
Front Public Health ; 9: 493884, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34527648

RESUMEN

Most local communities lack the capacity to conduct behavioral health needs assessments. The purpose of this paper is to describe a mixed-methods approach to estimate the behavioral health needs in St. Louis, MO. Data were drawn from multiple sources including local and state government prevalence estimates, medical records, and key informant interviews. The most prevalent behavioral conditions were depression, alcohol, and drug abuse. Priority populations were residents with co-occurring disorders, youth transitioning into the adult behavioral system, and homeless individuals with behavioral health needs. Treatment rates for behavioral health conditions were low, relative to identified needs. There are significant provider shortages and high staff turnover, which extend wait times, diminish the quality of care, and contribute to the use of emergency departments for behavioral health care. The data and methods described in this paper could be helpful to other municipalities that are looking to conduct behavioral health needs assessments.


Asunto(s)
Personas sin Hogar , Psiquiatría , Trastornos Relacionados con Sustancias , Adolescente , Adulto , Servicio de Urgencia en Hospital , Humanos , Trastornos Relacionados con Sustancias/epidemiología
20.
R I Med J (2013) ; 104(8): 39-42, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34582515

RESUMEN

Residential treatment for substance use disorder (SUD) is a structured model of care centered on individual and group therapy, peer support, and psychiatric services. However, there is rarely a standardized system for integration of primary care. Consistent access to primary care is important for women with SUD given the myriad healthcare needs of this population, including chronic disease, substance-related infections, sexual and reproductive health, preventive care, and psychiatric conditions. Access to primary care can minimize the morbidity associated with substance-use related medical complications, provide longitudinal support for recovery, and reduce emergency department visits and hospitalizations. This paper explores a program of coordinated medical care at a residential treatment facility for women with histories of SUD located in Pawtucket, RI. We conclude that residential treatment is an ideal time to forge a connection to primary care services to address the multiple medical and psychiatric comorbidities that exist among patients with SUD.


Asunto(s)
Tratamiento Domiciliario , Trastornos Relacionados con Sustancias , Comorbilidad , Servicio de Urgencia en Hospital , Femenino , Humanos , Atención Primaria de Salud , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/terapia
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