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1.
Expert Opin Pharmacother ; 21(3): 287-296, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31928246

RESUMO

Introduction: Gambling disorder is classified as an addictive disorder and is associated with significant distress and impairment in personal, social, occupational or other important areas of functioning. Although no pharmacotherapy has a formal indication for gambling disorder, data suggest potential benefits of specific medications.Area covered: This systematic review evaluated findings from 19 randomized controlled trials testing pharmacotherapies for the treatment of gambling disorder.Expert opinion: Few randomized controlled trials have studied pharmacotherapies for gambling disorder. Though results are limited, opioid antagonists like naltrexone showed promise in the pharmacological treatment of gambling disorder. Pharmacotherapy combined with psychotherapy treatments for gambling disorder may provide better rates of patient retention in comparison to pharmacology-only treatments, though further research is needed in this area. Future studies should address gaps relating to considerations of racial, ethnic, gender and other individual differences in clinical studies. Because gambling disorder often co-occurs with other psychiatric disorders, additional research is needed to test treatments for dually diagnosed patients.


Assuntos
Comportamento Aditivo/tratamento farmacológico , Jogo de Azar/tratamento farmacológico , Diagnóstico Duplo (Psiquiatria) , Humanos , Naltrexona/uso terapêutico , Antagonistas de Entorpecentes/uso terapêutico , Psicoterapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico
4.
BMC Health Serv Res ; 19(1): 749, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651302

RESUMO

BACKGROUND: An estimated 8.2 million adults in the United States live with co-occurring mental health and substance use disorders. Although the benefits of integrated treatment services for persons with co-occurring disorders has been well-established, gaps in access to integrated care persist. Implementation research can address this gap. We evaluated if the Network for the Improvement of Addiction Treatment (NIATx) implementation strategy was effective in increasing integrated services capacity among organizations treating persons with co-occurring disorders. METHODS: This study employed a cluster randomized waitlist control group design. Forty-nine addiction treatment organizations from the State of Washington were randomized into one of two study arms: (1) NIATx strategy (active implementation strategy), or (2) waitlist (control). The primary outcome was a standardized organizational measure of integrated service capability: the Dual Diagnosis in Addiction Treatment (DDCAT) Index. Intent-to-treat analyses and per-protocol analyses were conducted to address the following questions: (1) Is NIATx effective in increasing integrated service capacity? and (2) Are there differences in organizations that actually use NIATx per-protocol versus those that do not? RESULTS: From baseline to one-year post active implementation, both the NIATx strategy and waitlist arms demonstrated improvements over time in DDCAT Index total and DDCAT dimension scores. In intent-to-treat analyses, a moderate but statistically significant difference in improvement between study arms was seen only in the Program Milieu dimension (p = 0.020, Cohen's d = 0.54). In per-protocol analyses, moderate-to-large effects in Program Milieu (p = 0.002, Cohen's d = 0.91) and Continuity of Care (p = 0.026, Cohen's d = 0.63) dimensions, and in total DDCAT Index (p = 0.046, Cohen's d = 0.51) were found. CONCLUSIONS: Overall, organizations in both study arms improved DDCAT Index scores over time. Organizations in the NIATx strategy arm with full adherence to the NIATx protocol had significantly greater improvements in the primary outcome measure of integrated service capacity for persons with co-occurring disorders. TRAIL REGISTRATION: ClinicalTrials.gov, NCT03007940 . Retrospectively registered January 2017.


Assuntos
Prestação Integrada de Cuidados de Saúde/organização & administração , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Comportamento Aditivo , Análise por Conglomerados , Diagnóstico Duplo (Psiquiatria) , Feminino , Humanos , Masculino , Transtornos Mentais/complicações , Saúde Mental , Serviços de Saúde Mental/estatística & dados numéricos , Estudos Retrospectivos , Transtornos Relacionados ao Uso de Substâncias/complicações , Washington
5.
Lancet Psychiatry ; 6(12): 1068-1080, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31630984

RESUMO

Alcohol use disorder is a major contributor to the morbidity and mortality burden worldwide. It often coexists with other psychiatric disorders; however, the nature of this comorbidity is still a matter of debate. In this Series paper, we examine the main psychiatric disorders associated with alcohol use disorder, including the prevalence of co-occurring disorders, the temporal nature of the relationship, and mechanisms that might explain comorbidity across the lifespan. Overall, this disorder co-occurs with a wide range of other psychiatric disorders, especially those disorders involving substance use and violent or aggressive behaviour. The causal pathways between alcohol use disorder and other psychiatric disorders are heterogeneous. Hypotheses explaining these relationships include reciprocal direct causal associations, shared genetic and environmental causes, and shared psychopathological characteristics of broader diagnostic entities (eg, externalising disorders). Efforts to untangle the associations between alcohol use disorder and other disorders across the lifespan remain a crucial avenue of research.


Assuntos
Transtornos Relacionados ao Uso de Álcool/epidemiologia , Comorbidade , Diagnóstico Duplo (Psiquiatria) , Transtornos Mentais/epidemiologia , Transtornos Relacionados ao Uso de Álcool/psicologia , Humanos , Transtornos Mentais/psicologia , Prevalência , Escalas de Graduação Psiquiátrica , Violência/psicologia
6.
Tijdschr Psychiatr ; 61(9): 635-643, 2019.
Artigo em Holandês | MEDLINE | ID: mdl-31560783

RESUMO

BACKGROUND: Antidepressants remain controversial, partly due to allegations that disappointing results were buried and because of their modest average efficacy.
AIM: To investigate bias in the antidepressant literature and the possibilities for predicting which patients with depression or anxiety do receive significant benefits from antidepressants.
METHOD: We investigated bias by comparing information from the US Food and Drug Administration with the published literature. To predict response, we used patient data from randomized trials.
RESULTS: Of all studies on depression or anxiety, 50% and 72% were positive, compared to 95% and 96% of all published studies. Safety outcomes were poorly reported in published articles and unpublished studies were often 'bundled' into pooled-trials publications with positive conclusions. We found an association between severity and antidepressant efficacy for some, but not all, anxiety disorders; previous research has found inconsistent evidence for this association for depression. Furthermore, patients with depression that showed early improvement were more likely to attain a good response, irrespective of which symptoms improved.
CONCLUSION: These results demonstrate the severe impact of bias on the antidepressant literature. Severity and early improvement predicted a good response, but more information is needed to improve predictions. The increased accessibility of individual patient data will hopefully soon enable further progress in this area.


Assuntos
Antidepressivos/uso terapêutico , Transtornos de Ansiedade/tratamento farmacológico , Transtorno Depressivo/tratamento farmacológico , Transtornos de Ansiedade/complicações , Transtorno Depressivo/complicações , Diagnóstico Duplo (Psiquiatria) , Medicina Baseada em Evidências , Humanos , Resultado do Tratamento
8.
J Shoulder Elbow Surg ; 28(11): 2225-2231, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31279718

RESUMO

BACKGROUND: Understanding risk factors associated with prolonged opioid use to help mitigate abuse and develop presurgical screening programs to identify at-risk patients is paramount. The purpose of this study was to develop and validate a clinical risk assessment tool to preoperatively predict prolonged opioid use after shoulder surgery. METHODS: A total of 561 patients who underwent shoulder surgery within a tertiary health care system were identified, and opioid prescription data were retrospectively collected from the Connecticut Prescription Monitoring and Reporting System. The inclusion criteria were patients aged 18 years or older, and the exclusion criteria were patients not registered in the Connecticut Prescription Monitoring and Reporting System. Quantities of opioids prescribed were documented. Demographic characteristics, surgery type, medications, and medical comorbidities were identified by chart abstraction. Logistic regression was used to calculate odds ratios of patients using opioids longer than 6 weeks, and multivariate analysis was performed on 10 identified patient factors. A concordance index was used to calculate the discriminatory ability of a nomogram to predict prolonged opioid use. RESULTS: Multivariate analysis demonstrated that opioid use prior to surgery, insurance type, procedure type, body mass index, smoking status, and psychiatric disorders were responsible for prolonged opioid use. The prediction accuracy of this model was good, with a calculated concordance index of 0.766 (95% confidence interval, 0.736-0.820). CONCLUSIONS: We present a preoperative predictive calculator to help identify at-risk patients and quantify their risk of prolonged opioid use after shoulder surgery. This is a valuable clinical decision-making tool to identify patients benefitting from referral to pain management specialists and to possibly reduce the risk of opioid abuse and addiction.


Assuntos
Analgésicos Opioides/uso terapêutico , Prescrições de Medicamentos/estatística & dados numéricos , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Dor Pós-Operatória/tratamento farmacológico , Ombro/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Estudos de Casos e Controles , Diagnóstico Duplo (Psiquiatria) , Feminino , Humanos , Seguro Saúde , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/etiologia , Período Pré-Operatório , Estudos Retrospectivos , Medição de Risco/métodos , Fatores de Risco , Fumar/epidemiologia , Fatores de Tempo , Adulto Jovem
9.
Ann Ist Super Sanita ; 55(2): 131-142, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31264636

RESUMO

AIM: In this study, we investigated in people suffering from alcohol use disorder (AUD) with or without dual diagnosis (concomitant psychiatric disability) how they feel their dependence condition. We predicted that AUD people with a dual diagnosis could feel potentiated their addiction. METHODS: Alcohol habits and psychiatric conditions of 183 AUD men and 62 AUD women were measured by using the DSM-5, the severity of alcohol dependence questionnaire (SADQ), the alcohol anamnesis and psychiatric examination by the symptom check list 90-R (SCL-90-R). RESULTS: We have shown that alcohol drinking does not correlate with both psychiatric examination and self-reported psychopathology. SADQ shows that severe alcohol dependence correlates with highest psychiatric symptoms and with the levels of alcohol consumption. CONCLUSIONS: This finding suggests that high SADQ scores may represent a tool to early disclose only patients with dual diagnosis. SADQ may provide information to address pharmacological interventions because revealing aspects of the dark side of addiction potentiated by AUD associated psychopathology.


Assuntos
Alcoolismo/psicologia , Diagnóstico Duplo (Psiquiatria)/psicologia , Índice de Gravidade de Doença , Adulto , Alcoolismo/epidemiologia , Transtornos de Ansiedade/epidemiologia , Transtorno Bipolar/epidemiologia , Lista de Checagem , Comorbidade , Escolaridade , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Transtornos da Personalidade/epidemiologia , Autorrelato , Fumar/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Avaliação de Sintomas
10.
Eur Addict Res ; 25(5): 238-247, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31163437

RESUMO

BACKGROUND: The specialized literature provides solid evidence that substance use disorders (SUD) and personality disorders (PD) are interrelated. Given the relative novelty of the Alternative Model for PD, there are still few studies that have analyzed the relationship between the different facets, substance use disorder, and the various consumption profiles. OBJECTIVE: This paper analyzes the relationship between the facets of the Alternative Model for PD and different substance use disorder profiles, using the facet scores obtained in a sample of substance use disorder patients and comparing these with normative scores. A comparison is also conducted between types of patients. METHOD: The Personality Inventory for DSM-5-SF was administered to a sample of 289 patients diagnosed with SUD who began treatment for alcohol (ALC), cannabis (CAN), cocaine (COC), or heroin (HER) use disorder. A latent class analysis was conducted and scores obtained for each of the classes were compared with normative scores. Logistic regression analyzes were carried out to determine which facets and domains show the greatest explanatory capacity of belonging to each latent class. RESULTS: Four patient profiles were identified on the basis of their SUD: polydrug use (POLY), COC-HER, ALC, and CAN. When comparing the groups with the normative population, POLY presented higher scores on all the domains, COC-HER and ALC on all domains except antagonism, and CAN showed higher scores on detachment and psychoticism. The CAN cluster presented lower scores than the other 3 groups in different domains. No statistically significant differences were observed on any domain between the groups POLY and COC - HER, while differences were found between the classes POLY and ALC for the detachment domain. CONCLUSIONS: The results help to identify the personality profiles associated with various SUD profiles. In particular, patients from the groups POLY, COC-HER, and ALC present high scores on pathological facets related to borderline PD and schizotypal PD (all 3), and antisocial PD (POLY), while the CAN cluster is more normalized and its pathological facets are related to the schizotypal PD. Patients with POLY have a greater tendency toward pathological personality, with the involvement of a large number of facets, while COC-HER and ALC show a slightly less severe profile, and CAN users are characterized by lower scores, but high detachment and psychoticism.


Assuntos
Diagnóstico Duplo (Psiquiatria) , Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos da Personalidade/fisiopatologia , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Adulto , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Reprodutibilidade dos Testes , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
11.
Actas Esp Psiquiatr ; 47(3): 88-96, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31233207

RESUMO

OBJECTIVES: To compare alcohol and other drugs abuse, state impulsivity, craving and the relationship between craving and impulsivity in alcohol-dependent patients with or without dual disorder attending to an alcohol treatment center in Cadiz town. METHOD: An observational, descriptive and transversal study performed on 112 alcohol dependent patient sample who were seeking treatment in ARCA outpatient treatment center in Cadiz. The sample was divided in two groups, according to present dual diagnosis or not. The sample was assessed with an AdHoc sociodemographic and clinical questionnaire and specific scales and interviews that included: 5.0 Mini International Neuropsychiatric Interview results (MINI), State Impulsivity Scale (SIS), and Multidimensional Alcohol Craving Scale (MACS). RESULTS: The prevalence of dual diagnosis was 50%, being the most prevalent disorders: Current and recurrent Major Depressive Episode Mood Disorder, Current Dysthymic Mood Disorder, Panic Disorder and Anxiety Disorder. 52,7% of the total sample had a positive result on the State Impulsivity Scale. No statistically significant results were found on the Craving Scale (neither in the score or in the sub-sections). A relationship between craving and impulsivity were found for all groups and researched items. CONCLUSIONS: As a relationship between craving and impulsivity was observed, these aspects should be considered as main factors for the treatment and evolution of alcohol- dependent patients.


Assuntos
Transtornos Relacionados ao Uso de Álcool/epidemiologia , Fissura/efeitos dos fármacos , Transtorno Depressivo Maior/epidemiologia , Comportamento Impulsivo/efeitos dos fármacos , Pacientes Ambulatoriais/estatística & dados numéricos , Estudos Transversais , Diagnóstico Duplo (Psiquiatria) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Escalas de Graduação Psiquiátrica , Espanha/epidemiologia
12.
Actas esp. psiquiatr ; 47(3): 88-96, mayo-jun. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-185158

RESUMO

Introducción: Comparar el consumo de alcohol y otras drogas, la impulsividad estado, el craving y la relación entre estos últimos en pacientes con dependencia alcohólica con o sin patología dual que acuden a un centro de tratamiento específico de alcoholismo en la ciudad de Cádiz. Metodología. Estudio observacional, descriptivo y transversal de una muestra de 112 pacientes con dependencia alcohólica que acuden para solicitar tratamiento al Centro de Tratamiento Ambulatorio ARCA, de Cádiz. Se divide a los pacientes en dos grupos, según padezcan o no patología dual, mediante la entrevista MINI 5.0. Se evalúa la impulsividad mediante la Escala de Impulsividad de Estado (EIE) y el craving mediante la Escala Multidimensional de Craving de Alcohol (EMCA) y se rellena un cuestionario de información adicional que recoge datos sociobiográficos, educativos, económicos y relativos al consumo de alcohol y otras drogas. Resultados. La prevalencia de patología dual es del 50%, las patologías más prevalentes son: Episodio Depre-sivo Mayor actual y recurrente, Trastorno Distímico actual, Trastorno de Angustia y Trastorno de Ansiedad. El 52,7% de la muestra global presenta un resultado positivo en la escala EIE. No existen diferencias de puntuación significativas, tanto en la valoración global como en los subapartados de la escala de craving. Existe una asociación entre el craving y la impulsividad en todos los subgrupos de población y en todas las categorías. Conclusiones. Existe una relación entre craving e impulsividad, lo que debe ser tenido en cuenta en el momento e planificar el tratamiento y diseñar estrategias de prevención de recaídas


Objectives: To compare alcohol and other drugs abuse, state impulsivity, craving and the relationship between craving and impulsivity in alcohol-dependent patients with or without dual disorder attending to an alcohol treatment center in Cadiz town. Method. An observational, descriptive and transversal study performed on 112 alcohol dependent patient sample who were seeking treatment in ARCA outpatient treatment center in Cadiz. The sample was divided in two groups, ac-cording to present dual diagnosis or not. The sample was assessed with an AdHoc sociodemographic and clinical questionnaire and specific scales and interviews that included: 5.0 Mini International Neuropsychiatric Interview results (MINI), State Impulsivity Scale (SIS), and Multidimensional Alcohol Craving Scale (MACS). Results. The prevalence of dual diagnosis was 50%, be-ing the most prevalent disorders: Current and recurrent Ma-jor Depressive Episode Mood Disorder, Current Dysthymic Mood Disorder, Panic Disorder and Anxiety Disorder. 52,7% of the total sample had a positive result on the State Impulsivity Scale. No statistically significant results were found on the Craving Scale (neither in the score or in the subsecions). A relationship between craving and impulsivity were found for all groups and researched items. Conclusions. As a relationship between craving and impulsivity was observed, these aspects should be considered as main factors for the treatment and evolution of alcohol-dependent patients


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Fissura/efeitos dos fármacos , Transtorno Depressivo Maior/epidemiologia , Comportamento Impulsivo/efeitos dos fármacos , Pacientes Ambulatoriais/estatística & dados numéricos , Estudos Transversais , Diagnóstico Duplo (Psiquiatria) , Espanha/epidemiologia , Escalas de Graduação Psiquiátrica , Prevalência
13.
Int J Ment Health Nurs ; 28(4): 997-1007, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31120591

RESUMO

The experiences of mothers of adult offspring with a dual diagnosis have rarely been discussed in the literature, despite growing involvement and responsibility of mothers for daily care of their children. Interpretive phenomenological analysis of in-depth interviews was used to examine the mothering experience of 12 mothers of adult offspring with dual diagnosis. The analysis revealed that the mothers' experiences were intensive, abusive, and isolating, and simultaneously rendered them invisible, undervalued, or ignored by professionals, community, and family. Furthermore, the analysis indicated that this experience of 'intensive-invisible' mothering was promoted or prevented by three intersecting mechanisms, identified here as discursive, institutional, and spatial. The research contributes to the fields of knowledge regarding family members of people with mental health problems, by adding a theoretical layer that takes into account how public discourses of motherhood mould women's accounts of their mothering experience. Practical implications of these findings for professionals working with these mothers are discussed. Specifically, therapeutic intervention that focuses on identifying and modifying the underlying psychological and social processes associated with the 'intensive-invisible' mothering experience could be useful.


Assuntos
Diagnóstico Duplo (Psiquiatria)/psicologia , Mães/psicologia , Adulto , Crianças Adultas/psicologia , Humanos , Relações Mãe-Filho
14.
An. psicol ; 35(2): 233-241, mayo 2019. graf, tab
Artigo em Inglês | IBECS | ID: ibc-181693

RESUMO

Dual patients are usually treated in drug users services, mental health units, or both. However, each patient can choose the service to receive the health care. The aim of this study is to analyze the similarities and differences of the patient profiles that are treated in each one of these centers. The sample consists of 170 patients diagnosed with dual pathology treated at Servicio Provincial de Drogodependencias de Huelva (SPDH) and Unidades de Salud Mental Comunitaria (USMC) in the province of Huelva. In SPDH, higher prevalence of patients with cocaine and heroin dependence profile was observed (35.9% vs 2% in MH and 16.4% in coordinated). In USMC there is higher prevalence of patients with cannabis dependence profile (41.2% vs 9.4% in the DU and 16.4% in the coordinated service). The odds ratio for patients with hypomanic episodes was 2,879 (p <0.05) in SPDH compared to other services. Odds ratio observed for manic episodes was 0.483 (p <0.05) in SPDH. Patients with comorbid psychotic disorders are more prevalent in USMC compared to SPDH services (66% vs 37.5%). The differences observed in the profiles should be considered in the care planning of these centers


La atención médica y psicológica de pacientes con patología dual es realizada por servicios de salud mental, adicciones, o coordinada. No obstante, es elección de los pacientes acudir a uno u otro servicio. Este trabajo tiene como objetivo analizar las semejanzas y diferencias de pacientes con patología dual que acuden a estos centros. El estudio se ha realizado con170 pacientes diagnosticados de patología dual atendidos en el Servicio Provincial de Drogodependencias de Huelva (SPDH) y Unidades de Salud Mental Comunitaria (USMC) de la provincia de Huelva. En el SPDH la prevalencia de pacientes con dependencia a heroína y cocaína es mayor (35.9% vs 2% en USMC y 16.4% en coordinado). En las USMC se observa una mayor prevalencia de pacientes con dependencia a cannabis (41.2% vs 9.4% en el CTA y 16.4% en coordinado). La odds ratio para pacientes con episodios hipomaníacos fue de 2.879 (p<0.05) en el SPDH, y de 0.483 (p<0.05) para episodios maníacos. Hay una mayor prevalencia de pacientes con trastornos psicóticos en las USMC en comparación con el SPDH (66% vs 37.5%). Las diferencias detectadas en los perfiles deben ser consideradas en la planificación asistencial de los centros que atienden a estos pacientes


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Diagnóstico Duplo (Psiquiatria)/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Mentais/complicações , Centros Comunitários de Saúde Mental/estatística & dados numéricos , Centros de Tratamento de Abuso de Substâncias/estatística & dados numéricos
17.
Ir J Psychol Med ; 36(1): 19-22, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30931876

RESUMO

OBJECTIVES: Homelessness causes huge distress to a vulnerable population and great concern to wider society. The aim of this study was to reflect the prevalence of mental disorder within a subset of the homeless population in Dublin. METHOD: Long-term rough sleepers in Dublin were identified by the relevant non-statutory agency (Dublin Simon Community's Rough Sleepers Team). The authors attempted to assess all the identified individuals employing traditional clinical methods. RESULTS: We managed to assess 16 of the 22 identified individuals. We detected no formal disorder in ~30%, severe mental illness in ~30% and either alcohol or substance misuse in another ~30%. We detected dual diagnosis (co-occurrence of severe mental illness and alcohol or substance misuse) in 10%. CONCLUSION: Most but not all long-term rough sleepers in Dublin had a formal mental disorder identified. Just under one-third had a severe mental illness. This suggests that individualised patient centred health and social care will be required on a case by case basis in the long-term rough sleeping population.


Assuntos
Diagnóstico Duplo (Psiquiatria) , Pessoas em Situação de Rua/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Populações Vulneráveis , Irlanda/epidemiologia , Transtornos Psicóticos , Transtornos Relacionados ao Uso de Substâncias
18.
Biol Psychol ; 144: 46-53, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30928622

RESUMO

One of the most prominent issues in psychopathy is the inability to adequately monitor one's performance and learn from one's mistakes. We investigated the relationship between psychopathic traits, as measured with the Youth Psychopathy Inventory - Short Version, and both early and late error-related brain activity in an at-risk sample of male young adults. These multi-problem young adults (age 18-27) are severely dysfunctional in society and suffer from multiple problems including financial problems, delinquency, psychological problems, and drug use. Our final sample consisted of 115 multi-problem young adults and 26 controls. Participants performed an Eriksen-Flanker task during EEG measurements. We used the difference wave of the error-related negativity (ΔERN) as a measure of early error processing and the error positivity (Pe) as a measure of late error processing. Multi-problem young adults showed reduced ERN amplitudes compared to controls, but did not differ in Pe amplitude. We found no statistically significant relation between psychopathic traits and ERN and Pe amplitudes within the multi-problem group. Thus, we found evidence for dysfunctional error-processing in multi-problem young adults compared to controls. However, within the multi-problem sample we did not find evidence for a relationship between psychopathic traits and dysfunctional error-processing. One explanation may be that this is due to the specific developmental stage of our young adult participants in which a transition between error-processing deficits, as present in adolescents high in psychopathic traits, and error-processing overcompensation, as present in adults high in psychopathic traits, may occur.


Assuntos
Transtorno da Personalidade Antissocial/psicologia , Eletroencefalografia/métodos , Potenciais Evocados/fisiologia , Transtornos Mentais/psicologia , Análise e Desempenho de Tarefas , Adolescente , Adulto , Encéfalo/fisiopatologia , Diagnóstico Duplo (Psiquiatria)/psicologia , Humanos , Masculino , Psicopatologia , Adulto Jovem
20.
Cyberpsychol Behav Soc Netw ; 22(5): 349-354, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30896977

RESUMO

Problematic Internet use (PIU) is a growing clinical concern to clinicians working in adolescent mental health, with significant potential comorbidities like depression and substance use. No prior study has examined associations between PIU, high-risk behavior, and psychiatric diagnoses specifically in psychiatrically hospitalized adolescents. Here, we analyzed how PIU severity correlated with preadmission Internet habits, psychiatric symptoms, and high-risk behavior in this unique population. We hypothesized that as the severity of PIU increased, so would endorsement of mood symptoms, engagement in risky behaviors, and chances of having comorbid mood and aggression-related diagnoses. We performed a cross-sectional survey on an adolescent psychiatric inpatient unit in an urban community hospital in Massachusetts. Participants were 12-20 years old (n = 205), 62.0 percent female, and of diverse racial/ethnic backgrounds. Relationships between PIU, high-risk symptoms, diagnoses, and behaviors were performed both using chi-square tests and determining Pearson correlation coefficients. Two hundred five adolescents participated in the study. PIU severity was associated with being female (p < 0.005), sexting (p < 0.05), cyberbullying (p < 0.005), and increased suicidality within the last year (p < 0.05). Adolescents with aggressive and developmental disorders, but not depressive disorders, also had significantly higher PIU scores (p ≤ 0.05). In our sample of psychiatrically hospitalized adolescents, PIU severity was significantly associated with both serious psychiatric symptoms and high-risk behaviors, including those related to suicide. Our findings may improve safety assessments in this vulnerable adolescent population by identifying comorbid risks associated with problematic digital media use.


Assuntos
Comportamento do Adolescente/psicologia , Adolescente Institucionalizado/psicologia , Transtorno Depressivo/psicologia , Internet/estatística & dados numéricos , Assunção de Riscos , Adolescente , Adolescente Institucionalizado/estatística & dados numéricos , Criança , Estudos Transversais , Diagnóstico Duplo (Psiquiatria)/psicologia , Feminino , Humanos , Masculino , Suicídio , Inquéritos e Questionários , Adulto Jovem
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