RESUMO
Substance use disorder is a chronic and relapsing disease that burdens both the individual and the society. In addition to psychosocial treatment approaches, currently there are approved pharmacological treatment options for opioid, alcohol and tobacco use disorders, but only symptomatic treatment can be offered to patients with other substance use disorders. Advances in neuroscience and a better understanding of the addiction process offer an opportunity to create new treatment options. There is a wide range of studies, ranging from the use of drugs with different indications to the development of new pharmacological treatments, and from vaccine studies to neuromodulation techniques. Establishing novel treatment goals in addition to complete abstinence and individualizing treatment by focusing on endophenotypes may increase the treatment alternatives and the efficacy of these treatments for SUD.
RESUMO
Introduction: Synthetic cannabinoid (SC) use, an important public health problem, is becoming increasingly widespread and leads to many medical and psychiatric problems. This study aimed to evaluate the impact of SC use on cognitive and psychomotor functions of patients. Materials and Methods: The participants (30 outpatients with SC use disorder and 33 healthy controls) were administered the Montreal Cognitive Assessment (MOCA) test, the Edinburgh Handedness Inventory (EHI), the Finger-Tapping Test (FTT), and the Adult Memory and Information Processing Battery-B form (AMIPB-B). Results: The SC users scored lower in AMIPB-B, MOCA. and FTT compared to the healthy controls. Conclusion: These findings suggest that SC might impair both cognitive and psychomotor functions. Therefore, outpatients with SC use disorder should be carefully evaluated for cognitive and psychomotor functions since neurological examinations and interventions may also be required in treatment programs for these cases.
RESUMO
The use of synthetic cannabinoid has been increasing throughout the world and has become a major public health problem. The present study aims to investigate the attention, memory, visuospatial and executive functions in individuals with synthetic cannabinoid use disorder and compare the results with findings obtained from individuals with cannabis use disorder and healthy volunteers with no substance use. Fifty-two patients with synthetic cannabinoid use disorder, 45 patients with cannabis use disorder and 48 healthy control group males were included in the study. The neuropsychological test battery was designed to involve ten studies evaluating a large series of cognitive functions. Impairments in attention, memory, executive and visuospatial functions were identified in individuals with synthetic cannabinoid use disorder and these impairments were found to be significantly greater than in individuals with cannabis use disorder and healthy controls. In line with the data obtained from this study; the evaluation of each cognitive function with more comprehensive test batteries and supporting these evaluations with sensitive brain imaging studies are important topics for future research.
Assuntos
Canabinoides/efeitos adversos , Disfunção Cognitiva/induzido quimicamente , Abuso de Maconha/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Medicamentos Sintéticos/efeitos adversos , Adolescente , Adulto , Atenção/efeitos dos fármacos , Estudos de Casos e Controles , Cognição/efeitos dos fármacos , Humanos , Masculino , Memória/efeitos dos fármacos , Testes Neuropsicológicos , Adulto JovemRESUMO
OBJECTIVE: The aim of the present study was to evaluate the relationship of posttraumatic stress disorder (PTSD) with impulsivity dimensions while controlling the effect of anxiety and depression in a sample of inpatients with alcohol use disorder (AUD). METHODS: Participants were 190 male patients admitted to a specialized center for substance use disorders within a six month period. Participants were evaluated with the State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), the Short Form Barratt Impulsiveness Scale (BIS-11-SF), the Traumatic Experiences Checklist, and PTSD Checklist-Civilian version. RESULTS: Age was lower in the group with PTSD (n = 63, 33.2%) than the group without PTSD (n = 127, 66.8%). Duration of education, marital, and employment status did not differ between the groups. STAI, BDI, and BIS-11-SF scores were higher in the group with PTSD. Trait anxiety, depression, and impulsivity predicted high PTSD risk in a logistic regression model. Same variables predicted the severity of PTSD symptoms in a linear regression. Among dimensions of impulsivity attentional component was the only predictor of PTSD symptoms severity, not motor or nonplanning impulsivity. CONCLUSIONS: These findings suggest that the PTSD may be related to impulsivity, particularly attentional impulsivity, even after controlling anxiety and depression among inpatients with AUD.
Assuntos
Alcoolismo/fisiopatologia , Ansiedade/fisiopatologia , Depressão/fisiopatologia , Comportamento Impulsivo/fisiologia , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Adulto , Alcoolismo/epidemiologia , Ansiedade/epidemiologia , Comorbidade , Depressão/epidemiologia , Diagnóstico Duplo (Psiquiatria) , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Transtornos de Estresse Pós-Traumáticos/epidemiologiaRESUMO
AIM: This study aimed to evaluate the relationship of attention-deficit/hyperactivity disorder (ADHD) symptoms with dissociative experiences, and the mediator role of childhood traumas on this relationship, while controlling the effect of depression in alcohol use disorder (AUD). SETTINGS AND DESIGN: It was a hospital-based, cross-sectional study. MATERIALS AND METHODS: One hundred and ninety inpatients with AUD were evaluated with the Beck Depression Inventory, the Adult ADHD Self-Report Scale (ASRS), Childhood Trauma Qestionnaire, and Dissociative Experiences Scale (DES). STATISTICAL ANALYSIS: One-way ANOVA, Chi-squared test, and hierarchical linear regression model were performed. RESULTS: The ratio of those who receive 10 points or less from DES was 26.8%, those who receive points between 11 and 30 was 45.3%, and those who receive more than 30 points was 27.9%. The latter group that was considered as a group with high risk of dissociative disorder had higher scores from depression, childhood trauma, and ADHD scores than the other groups. Rate of those with high probability of ADHD was higher among this group. ASRS total score and inattentive subscale scores were moderately (r = 0.552 and r = 0.547, respectively) and hyperactive/impulsive subscale was mildly (r = 0.430) correlated with DES score. Severity of ADHD was related with the severity of dissociative symptoms, and physical abuse had partial mediator effect on this relationship, even after controlling the depressive symptoms. CONCLUSIONS: These findings demonstrate that the presence of severe IN symptoms is an important factor related with dissociative tendency in AUD population with a history of physical abuse.
RESUMO
Cannabis and synthetic cannabinoids are widely used illicit substances in Turkey. The Cannabis Use Problems Identification Test (CUPIT) is a brief self-report screening instrument for detection of problematic cannabis use, whereas the Cannabis Problems Questionnaire (CPQ) is a measure for cannabis treatment outcome. The aim of this study was to evaluate the psychometric properties of the CUPIT and CPQ among Turkish male outpatients with cannabis (n = 52) and synthetic cannabinoid (n = 45) use disorder. Participants were evaluated with the CUPIT, the CPQ, and the Cannabis Withdrawal Scale (CWS). Principal Component Analysis (PCA) supported two-factor construct validity for CUPIT. Cronbach's alpha was 0.84 for CUPIT-A factor, 0.83 for CUPIT-B factor, and 0.89 for CUPIT, when considered as a unidimensional scale. Cronbach's alpha was 0.82 for CPQ-A factor, 0.73 for CPQ-B factor, 0.30 for CPQ-C, and 0.87 for CPQ, when considered as a unidimensional scale. The CUPIT and the CPQ were moderately correlated with the CWS (r = 0.63 and r = 0.74, respectively), whereas the CUPIT and the CPQ were strongly correlated with each other (r = 0.76). The Turkish version of the CUPIT and the CPQ can effectively identify substance use problems and treatment outcome, respectively, among outpatients with cannabis or synthetic cannabinoid use disorder.
Assuntos
Canabinoides/administração & dosagem , Abuso de Maconha/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Inquéritos e Questionários , Adulto , Canabinoides/efeitos adversos , Humanos , Masculino , Pacientes Ambulatoriais , Análise de Componente Principal , Psicometria , Síndrome de Abstinência a Substâncias/diagnóstico , Resultado do Tratamento , Turquia , Adulto JovemRESUMO
PURPOSE: Attention-deficit/hyperactivity disorder (ADHD) has been shown to be related to a higher risk of developing psychiatric problems such as depressive disorders, substance use disorder, and impulsivity. Adults who have comorbid ADHD and alcohol use disorder (AUD) are at greater risk of negative outcomes. Thus, it is important to evaluate the relationship of ADHD symptoms and the severity of alcohol-related problems among patients with AUD. The aim of the present study was to evaluate the effect of ADHD symptoms on severity of alcohol-related problems, while controlling the effects of depression and impulsivity in a sample of inpatients with AUD. PATIENTS AND METHODS: Participants (n=190) were evaluated with the Beck Depression Inventory, the Short Form Barratt Impulsiveness Scale, the Michigan Alcohol Screening Test, and the Adult ADHD Self-Report Scale. RESULTS: Severity of the scale scores was positively correlated with each other. Although severity of depression and impulsivity (particularly non-planning impulsivity) predicted the severity of alcohol-related problems in a linear regression model, when severity of ADHD symptoms was included in the analysis, the inattentive subscale score, in particular, predicted the severity of alcohol-related problems together with non-planning impulsivity, whereas depression was no longer a predictor. CONCLUSION: These findings suggest that, together with non-planning impulsivity, symptoms of ADHD (particularly inattentive factor) are an important factor that predict alcohol-related problems, while controlling the severity of depressive symptoms among inpatients with AUD.
RESUMO
The aim of the present study was to evaluate relationship of PTSD symptom severity with severity of ADHD symptoms while controlling the effect of childhood trauma in a sample of male inpatients with alcohol use disorder (AUD). Participants included 190 male inpatients with AUD. Participants were evaluated with the Childhood Trauma Questionnaire (CTQ-28), the Adult ADHD Self-Report Scale (ASRS) and PTSD Checklist Civilian version (PCL-C). PTSD and ADHD scores were mildly correlated with severity of childhood trauma and types of traumas, the only exception was emotional neglect, which was not correlated with PTSD and ADHD. Severity of ADHD symptoms was associated with the severity of PTSD symptoms, together with the severity of childhood trauma in a linear regression model. In another linear regression model where dimensions of ADHD and childhood trauma were considered as independent variables, emotional abuse and both inattentive and hyperactive/impulsive dimensions of ADHD were associated with the severity of PTSD. These findings suggest that the severity of adult ADHD symptoms is related with the severity of PTSD symptoms, while severity of childhood trauma, particularly emotional abuse may have an mediating role on this relationship among male inpatients with AUD.
Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Transtornos Relacionados ao Uso de Álcool/complicações , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Emoções , Pacientes Internados/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Adulto , Transtornos Relacionados ao Uso de Álcool/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato , Índice de Gravidade de Doença , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e QuestionáriosRESUMO
AIMS: The aim of this study was to determine the effects of life-time tobacco, alcohol, and substance use on psychological and behavioral variables among 10th grade students in Istanbul/Turkey. MATERIALS AND METHODS: This study employed a cross-sectional online self-report survey conducted in 45 schools from the 15 districts in Istanbul. The questionnaire featured a section about use of substances, including tobacco, alcohol, and drugs. The depression, anxiety, anger, assertiveness, sensation seeking and impulsiveness subscales of the Psychological Screening Test for Adolescents (PSTA) were used. The analyses were conducted based on 4957 subjects. RESULTS: Logistic regression analyses were conducted with each school with the related and behavioral variables as the dependent variables. Gender, tobacco, alcohol, and drug use being the independent variables. All four independent variables predicted the dependent variables. Lifetime tobacco and drug use had significant effects on all the subscale score, whereas lifetime alcohol use had significant effects on all the subscale scores other than lack of assertiveness, and male gender was a significant covariant for all the subscale scores. Drug use showed the highest effect on dependent variables. Interaction was found between effects of tobacco and alcohol on anxiety, whereas interactions were found between effects of tobacco and drugs on lack of assertiveness and impulsiveness. CONCLUSION: The findings suggested that male students with lifetime tobacco, alcohol or drug use have particularly high risk of psychological and behavioral problems. The unique effects of substance clusters on these problems may be useful in developing secondary preventive practices for substance use and abuse problems in Istanbul.
Assuntos
Comportamento do Adolescente/psicologia , Consumo de Bebidas Alcoólicas/efeitos adversos , Comportamento Problema/psicologia , Fumar/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/complicações , Adolescente , Comportamento do Adolescente/efeitos dos fármacos , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Análise de Variância , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Prevalência , Assunção de Riscos , Autorrelato , Distribuição por Sexo , Fumar/epidemiologia , Classe Social , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários , Tempo , Turquia/epidemiologiaRESUMO
BACKGROUND: Tropicamide is an antimuscarinic ophthalmic solution used to produce short-acting mydriasis and cycloplegia. Topical abuse of ophthalmic solutions has been reported, but intravenous (IV) abuse of tropicamide seems to be a new phenomenon. CASES: The authors present 2 patients with concomitant IV tropicamide abuse and opioid use disorder. Patients were hospitalized and started on buprenorphine/naloxone treatment for opioid withdrawal. Patients' reports about tropicamide effects are remarkable, as they claimed that tropicamide increased the efficacy of heroin while decreasing and delaying the withdrawal symptoms. DISCUSSION: Although anticholinergics have been known to be abused for their euphoric effects, these cases' motivation to use tropicamide seemed to extend beyond its euphoric effect and was also based on its interaction with heroin. It is feared that tropicamide abuse may become more frequent. Health professionals should be aware of this trend so that symptoms of misuse and intoxication can be recognized, and ophthalmologists should consider the abuse potential of anticholinergic eye drops when prescribing them.
Assuntos
Transtornos Relacionados ao Uso de Opioides/complicações , Abuso de Substâncias por Via Intravenosa/complicações , Tropicamida/administração & dosagem , Tropicamida/efeitos adversos , Adulto , Combinação Buprenorfina e Naloxona/uso terapêutico , Humanos , Masculino , Antagonistas Muscarínicos/efeitos adversos , Síndrome de Abstinência a Substâncias/tratamento farmacológicoRESUMO
The aim of this study was to evaluate psychometric properties of the Drug Use Disorders Identification Test (DUDIT) and the Drug Abuse Screening Test (DAST-10) in prisoners with (n = 124) or without (n = 78) drug use disorder. Participants were evaluated with the DUDIT, the DAST-10, and the Addiction Profile Index-Short (API-S). The DUDIT and the DAST-10 were found to be psychometrically sound drug abuse screening measures with high convergent validity when compared with each other (r = 0.86), and API-S (r = 0.88 and r = 0.84, respectively), and to have a Cronbach's α of 0.93 and 0.87, respectively. In addition, a single component accounted for 58.28% of total variance for DUDIT, whereas this was 47.10% for DAST-10. The DUDIT had sensitivity and specificity scores of 0.95 and 0.79, respectively, when using the optimal cut-off score of 10, whereas these scores were 0.88 and 0.74 for the DAST-10 when using the optimal cut-off score of 4. Additionally, both the DUDIT and the DAST-10 showed good discriminant validity as they differentiated prisoners with drug use disorder from those without. Findings support the Turkish versions of both the DUDIT and the DAST-10 as reliable and valid drug abuse screening instruments that measure unidimensional constructs.
Assuntos
Usuários de Drogas/psicologia , Prisioneiros/psicologia , Psicometria , Detecção do Abuso de Substâncias , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Adulto , Análise Discriminante , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Transtornos Relacionados ao Uso de Substâncias/psicologia , TurquiaRESUMO
Aim of this study was to determine prevalence of cigarette smoking and hookah use among 10th grade students in Istanbul, Turkey, and to compare sociodemographic, psychological and behavioral variables according to frequency of tobacco use. Cross-sectional online self-report survey conducted in 45 schools from the 15 districts in Istanbul/Turkey. The questionnaire included sections about demographic data, family characteristics, school life, psychological symptoms and use of substances including tobacco, hookah, alcohol, marijuana, volatiles, heroin, cocaine, non-prescribed legal tranquillizers (benzodiazepines, alprazolam etc.) and illegal tranquillizers (flunitrazepam). The analyses were conducted based on the 4957 subjects. Trial at least once in life is observed as 45.4% for hookah use and as 24.4% for cigarette use. Risk of hookah and cigarette use was significantly higher in male students than in female students. Frequency of tobacco use is related with various sociodemographic, psychological and behavioral variables. Our data also shows that using tobacco and alcohol increases the risk of all the other substances use and these effects are interrelated. The data suggest that there is a link between tobacco use and substance use, psychological, behavioral and social factors. There is also a strong association between tobacco use and suicidal behavior as well as self-mutilative, impulsive, hyperactive, delinquent, aggressive and behavioral problems. The illumination of these relationships may be relevant in prevention and management of tobacco use as well as important problems, such as substance use, impulsivity, hyperactivity, delinquent, aggressive self-mutilative and suicidal behavior among 10th grade students in Istanbul.
Assuntos
Fumar/epidemiologia , Estudantes/estatística & dados numéricos , Uso de Tabaco/epidemiologia , Adolescente , Comportamento do Adolescente/psicologia , Estudos Transversais , Família , Feminino , Humanos , Masculino , Saúde Mental , Prevalência , Fatores de Risco , Assunção de Riscos , Fumar/psicologia , Estudantes/psicologia , Inquéritos e Questionários , Uso de Tabaco/psicologia , Turquia/epidemiologiaRESUMO
BACKGROUND: Non-suicidal self-harm behavior (SHB), which is a pervasive and dangerous problem, is frequent among adolescents and it is important to evaluate the associated psychological and social factors to better understand its nature and to plan treatment programs. AIMS: Aim of the present study is to determine the prevalence of SHB and the associated variables such as substance use, psychological, behavioral and social factors among 10th-grade students in Istanbul/Turkey. METHODS: Cross-sectional online self-report survey conducted in 45 schools from the 15 districts in Istanbul/Turkey. A representative sample of 4957 10th-grade students was studied between October 2012 and December 2012. RESULTS: SHB within the previous year were reported by 14.4% of the students (n = 713). Lifetime suicidal thoughts or behavior, tobacco, alcohol and/or drug use, symptoms of depression, anxiety and impulsive, delinquent and aggressive behaviors were also associated with SHB in Turkish 10th-grade students. CONCLUSIONS: The findings of the present study may be relevant in prevention and management of SHB as well as important problems among students, such as substance use, impulsive, delinquent, aggressive and suicidal behavior.
Assuntos
Comportamento do Adolescente/psicologia , Comportamento Autodestrutivo/epidemiologia , Adolescente , Agressão/psicologia , Ansiedade/epidemiologia , Ansiedade/psicologia , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Diagnóstico Duplo (Psiquiatria)/psicologia , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Autorrelato , Comportamento Autodestrutivo/etiologia , Comportamento Autodestrutivo/psicologia , Estudantes/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Ideação Suicida , Turquia/epidemiologiaRESUMO
BACKGROUND: Impulsivity is closely related to substance use and abuse, both as a contributor to use and as a consequence of use. Particular dimensions of temperament and character were reported to be associated with trait impulsivity in different populations. AIM: The aim of the present study was to evaluate the relationship of personality dimensions with impulsivity among men with alcohol dependence. Also we wanted to control the effect of depression and anxiety symptoms on this relationship. METHODS: Participants were consecutively admitted male alcohol-dependent inpatients (n = 94) and healthy controls (n = 63). Patients were investigated with the Barratt Impulsiveness Scale, version 11 (BIS-11), the Temperament and Character Inventory (TCI) and the Symptom Checklist-Revised (SCL-90-R). RESULTS: Severity of impulsivity and dimensions of impulsivity were higher in alcohol-dependent inpatients than in healthy controls. Impulsivity was negatively correlated with reward dependence, persistence, self-directedness and cooperativeness, but positively correlated with novelty seeking, harm avoidance, depression and anxiety. Although high depression and temperament dimensions (high novelty seeking, harm avoidance and low reward dependence) predicted impulsivity, combinations of personality dimensions that predict dimensions of impulsivity differed. CONCLUSIONS: RESULTS may suggest that together with depression when impulsivity is the problem, both dimensions of impulsivity and personality must be evaluated and the treatment should be shaped accordingly for alcohol-dependent inpatients.
Assuntos
Alcoolismo/psicologia , Comportamento Impulsivo/psicologia , Adulto , Ansiedade/psicologia , Comportamento Cooperativo , Depressão/psicologia , Redução do Dano , Humanos , Pacientes Internados/psicologia , Masculino , Pessoa de Meia-Idade , Personalidade , Transtornos da Personalidade/psicologia , Inventário de Personalidade , Recompensa , Adulto JovemRESUMO
The previous studies have found a relationship between IA and both impulsivity and psychopathology when they were considered separately. The aim of this study was to investigate the relationship of Internet addiction (IA) with impulsivity and severity of psychopathology among Turkish university students. We also wanted to control the effect of impulsivity dimensions on the relationship between IA and psychopathology. A total of 319 university students from two universities in Ankara participated to the study. Students were assessed through the Internet Addiction Scale (IAS), the Symptom Checklist-Revised (SCL-90-R) and the Barratt Impulsiveness Scale-11 (BIS-11). Correlational analyses revealed that severity of IA was related to both SCL-90-R and BIS-11 scores. Among SCL-90-R subscales, severity of obsessive-compulsive symptoms (OCS) was the only predictor for IAS score. Hierarchical regression analysis indicated that interpersonal sensitivity, additional to attentional and motor impulsiveness, was the predictor of IAS score. Although severity of IA is associated with wide range of psychopathology, particularly OCS, interpersonal sensitivity seems to be the main dimension that predict severity of IAS additional to impulsiveness (attentional and motor). Impulsivity seems to be an important construct when considering IA and its treatment among Turkish university students.
Assuntos
Comportamento Aditivo/psicologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/psicologia , Comportamento Impulsivo , Internet , Estudantes/psicologia , Adulto , Comportamento Aditivo/diagnóstico , Comportamento Aditivo/etnologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/diagnóstico , Transtornos Disruptivos, de Controle do Impulso e da Conduta/etnologia , Feminino , Humanos , Relações Interpessoais , Masculino , Inventário de Personalidade , Psicopatologia , Índice de Gravidade de Doença , Inquéritos e Questionários , Turquia/epidemiologia , Universidades , Adulto JovemRESUMO
This work examined the presence of MHC class II molecules expressing mast cells in oviduct, uterus and vaginal tissues in cows. The tissue samples of five cows were collected from a local slaughterhouse. Toluidine blue pH 0.5 (TB) and avidin-biotin peroxidase complex (ABC) staining procedures applied to adjacent sections from tissue samples. It was determined that some TB + cells were also gave positive reaction with strept ABC staining for MHC II molecules. To our knowledge this is the first evidence indicating the presence of MHC class II molecules expressing mast cells in the cow.