Search results for: substance use disorder

Authors: Helena Baffoe

Abstract:

The US has developed numerous programs over the past 50 years to enhance the lives of those who suffer from mental health illnesses and substance abuse, as well as the effectiveness of their treatments. Despite these advances over the past 50 years, there hasn't been a corresponding improvement in American public attitudes and beliefs about mental health disorders and substance abuse. Highly publicized acts of violence frequently elicit comments that blame the perpetrator's perceived mental health disorder since such people are thought to be substance abusers. Despite these strong public beliefs and perception about mental disorder and substance abuse, concreate empirical evidence that entail this perception is lacking, and evidence of their effectiveness has not been integrated. A rich data was collected from Substance Abuse and Mental Health Services Administration (SAMHSA) with a hypothesis that people who are diagnosed with a mental health disorder are likely to be diagnosed with substance abuse using logit regression analysis and Instrumental Variable. It was found that depressive, anxiety, and trauma/stressor mental disorders constitute the most common mental disorder in the United States, and the study could not find statistically significant evidence that being diagnosed with these leading mental health disorders in the United States does necessarily imply that such a patient is diagnosed with substances abuse. Thus, the public has a misconception of mental health and substance abuse issues, and social workers' responsibilities are outlined in order to assist ameliorate this attitude and perception.

Keywords: mental health disorder, substance use, empirical evidence, logistic regression

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Authors: Helena Baffoe

Abstract:

The US has developed numerous programs over the past 50 years to enhance the lives of those who suffer from mental health illnesses and substance abuse, as well as the effectiveness of their treatments. Despite these advances over the past 50 years, there hasn't been a corresponding improvement in American public attitudes and beliefs about mental health disorders and substance abuse. Highly publicized acts of violence frequently elicit comments that blame the perpetrator's perceived mental health disorder since such people are thought to be substance abusers. Despite these strong public beliefs and perception about mental disorder and substance abuse, concreate empirical evidence that entail this perception is lacking, and evidence of their effectiveness has not been integrated. A rich data was collected from Substance Abuse and Mental Health Services Administration (SAMHSA) with a hypothesis that people who are diagnosed with a mental health disorder are likely to be diagnosed with substance abuse using logit regression analysis and Instrumental Variable. It was found that depressive, anxiety, and trauma/stressor mental disorders constitute the most common mental disorder in the United States, and the study could not find statistically significant evidence that being diagnosed with these leading mental health disorders in the United States does necessarily imply that such a patient is diagnosed with substances abuse. Thus, the public has a misconception of mental health and substance abuse issues, and social workers' responsibilities are outlined in order to assist ameliorate this attitude and perception.

Keywords: mental health disorder, substance abuse, role of a social worker, evidence based research

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Authors: J. Raub, H. Schillok, L. Kaupe, C. Jung-Sievers, G. Pitschel-Walz, M. Bühner, J. Gensichen, F. D. Pokal-Gruppe

Abstract:

Introduction: In Germany, depression ranks among the top ten diseases with the highest disease burden and often occurs with comorbidities. Collaborative Care (CC), a concept developed in the United States for the primary care management of chronic diseases, has been identified as an efficient model for the treatment of depression in general medicine. A recent meta-analysis highlights research gaps regarding CC in patients with psychiatric multimorbidity. The highest prevalence of psychiatric comorbidities in depression is observed in anxiety disorders, post-traumatic stress disorder (PTSD), and substance use disorders. Methods: We conducted a literature search following the PRISMA guidelines with three components: Collaborative Care, Depression and randomized controlled trial on the common databases. We focused on the examination of psychiatric comorbidities in depression, specifically Posttraumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD). Results: During the screening process, we identified nine relevant articles related to PTSD, the number of articles related to Substance Use Disorder (SUD) was ten. We examined a total of 8,634 individuals. Our literature review did not reveal any overall significant superiority of the Collaborative Care model compared to Usual Care in patients with depression with comorbid Substance Use Disorder (SUD) or Posttraumatic Stress Disorder (PTSD). Discussion: Five studies demonstrate a faster and statistically significant improvement in depression outcomes among patients with Substance Use Disorder (SUD) and Posttraumatic Stress Disorder (PTSD). Currently, several randomized controlled trials on the topic of Collaborative Care in depression with psychiatric comorbidity are ongoing, such as miCare, Claro and COMET.

Keywords: Depression, primary care, collaborative care, PTSD, Substance use Disorder

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Authors: Famurewa Olumide Joseph, Akinsulore Adesanmi

Abstract:

The current study investigated aggressive behaviour and its association with substance use disorder among senior secondary school students in Ilesha, Nigeria. Participants were three hundred and seventy-five (375) comprising (212) females and (163) males of senior secondary school students in Ilesa East and Ilesa West; who were randomly selected among the population of students from the schools. The mean age of the respondents was 14.61 years (S.D = 1.16), with 311 (82.9%) between 14 – 16 years. Female respondents were 212 (56.5%), while male respondents were 163 (43.5%). A cross sectional design was adopted. Three instruments were used for data collection. Buss Perry Aggression Questionnaire, Alcohol Use Disorder Identification Test (AUDIT) and Drug Abuse Screening Test (DAST). It was hypothesized that aggressive behaviour will be associated with substance use disorder among senior secondary school students in Ilesa East and Ilesa West. The result indicated that the overall prevalence of substance use disorder was 16.0%. Chi-Square test exploring the association between aggressive behaviour and substance use disorder shows that there is a significant association between aggressive behaviour and substance use disorder (χ2 =8.55, p =0.014). Results also showed that emotional problem (χ2 (2) =13.0; p = 0.001) was statistically significant while current medications intake (χ2 (2) =2.03; p =0.362) and overall wellbeing (χ2 (4) =2.49; p =0.646) were not statistically significant. There is an inverse association between prosocial behaviour and aggressive behaviour (r= -0.037, p>0.05). This indicates that as the level of prosocial behaviour increases, the level of aggressive behaviour among respondents decreases. However, alcohol use had no correlation with aggressive behaviour (r=0.070, p>0.05). Among the implications stated is that factors such as emotional symptoms, conduct problems, hyperactivity, peer problem and drug use contributed to the prevalence of aggressive behaviour among students. Suggestions for further studies were equally made.

Keywords: aggressive behaviour, alcohol, prevalence, students, substance use disorder (SUD)

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Authors: Mohammad Muntasir Maruf, Muhammad Zillur Rahman Khan, Nasim Jahan, Md. Waziul Alam Chowdhury, Satparkash, Md. Nozrul Islam

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Background: Substance use disorders have become a major public health problem in Bangladesh. Objectives: The present study was designed to assess the pattern of substance use and factors related to it among the hospitalized patients. Methods: This was a cross-sectional study. All the patients who were admitted in a private drug de-addiction clinic in the capital city (Dhaka) of Bangladesh during 1 July-31 December, 2013 and diagnosed as a case of substance use disorder by applying Structured Clinical Interview for DSM- Clinician Version were enrolled in the study. Data were collected through face to face interview by a semi-structured questionnaire and the information was complemented by the case-notes. Study subjects were 105 in number. Data analysis was performed using Statistical Package for Social Sciences (SPSS). Results: Most (90.5%) of the respondents were male. The mean age of the respondents was 28.8 (± 8.0) years. Majority (91.4%) were poly-substance users. Most (27.6%) respondents used 3 types of substances. Smoking or inhalation was the route used by most (90.5%) respondents. More than three-fourth (81%) of the respondents used nicotine. Among the other substances, majority (79%) used opiates group, followed by cannabinoids group (55.2%) and alcohol (41%). Curiosity, peer pressure and to have enjoyment or fun were identified as the common reasons for initiating substance use. Conclusions: A high proportion of poly-substance use was found. The study findings would help in management and prevention strategy of substance use in Bangladesh.

Keywords: Bangladesh, de-addiction clinic, poly-substance users, substance use disorder

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Authors: Conchita Martin de Bustamante, Christopher S. Kung, Brianne Lacy, Eunsol Park, Hien Piotrowski, Mustafa Husain, Waseem Ahmed

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Objective: To explore the comorbidity of mental health conditions (major depressive disorder, borderline personality disorder, generalized anxiety disorder, and schizophrenia) with opioid use disorder in people incarcerated at a large urban jail. Background Schizophrenia, depression, bipolar disorder, and anxiety are all serious mental health conditions that are highly prevalent amongst incarcerated patients. However, it is seldom the only disorder these patients are suffering from. According to the US Department of Justice, about half of US prisoners, both at the state and federal level, suffer from substance use disorders. Although the opioid epidemic has been studied greatly in the recent years amongst the general population, little has been explored on how the opioid crisis has affected incarcerated patients in local jails, particularly regarding which of these patients are most susceptible. Method The cohort consisted of 507 people incarcerated at a large county jail who were evaluated by mental health providers in December 2020. A retrospective review was performed to evaluate associations between mental health diagnoses, substance use disorder, and other demographic variables. Results Participants had been diagnosed with various mental health conditions, including MDD (22.6%, n = 115), GAD (33.7%, n = 171), Schizophrenia (15.2%, n = 77) and BPD (27%, n = 137). Preliminary Chi square tests were conducted for these conditions against marijuana, alcohol, cocaine, opioid, methamphetamine, benzodiazepines, and sedative use disorders. The results showed significant associations between Schizophrenia (p = 0.013), GAD (p M 0.001), and MDD (p = 0.029) with opioid use disorders. Conclusions Determining the extent of these comorbid substance use and mental health disorders within an incarcerated population can help influence treatment plans for future incarcerated patients. Many federal and state jail systems lack pharmacological substance use intervention and the prevalence of these co-morbid conditions can shed light on the importance of treating conditions concurrently upon intake.

Keywords: mental health conditions, opioids, substance use disorder, comorbidity

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Authors: Ruhollah Heydari Sheikh Ahmad, Sara Alaie Khoraem

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Introduction: Substance use disorder is conceptualized as a chronic relapsing condition where relapse is usually defined as the return to problematic substance use following treatment. An issue of great importance is the identification of the predictors of relapse and the development of treatments that may help prevent relapse. One of the strongest predictors of relapse is craving. The purpose of the present study was to study the effect of anxiety, anxiety sensitivity, and coping motives on craving. Materials and method: Participants (n=74) were male opiate users recruited from a semi-private clinic providing de-toxification and treatment services for substance users. Anxiety, anxiety sensitivity, coping motives and craving were assessed using relevant questionnaires. The addiction severity index was used to assess addiction severity. Results: All patients were methadone maintained and one year after detoxification, 36 patients (48.64%) relapsed. Stress and anxiety, anxiety sensitivity, addiction severity and coping motives predicted craving and relapse. Anxiety sensitivity specifically predicted early relapse. Conclusion: Substance use is a severe mental disorder, with high relapse rates. Substance users high in anxiety sensitivity are particularly prone to relapse during the first six months of treatment. Addiction severity and coping motives need to be taken into account when providing interventional services for substance users. Findings imply the significance of additional psychological attention to methadone maintained patients to prevent craving and relapse.

Keywords: anxiety sensitivity, coping motives, relapse, substance use craving

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Authors: Jayme R. Swanke

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This study examined the benefits of maintaining public blogs about substance use disorder recovery. The data analyzed for this study included statements about the benefits derived by individuals who blogged about their recovery. The researcher developed classifications of statements that expressed what these individuals gained from blogging into common themes and developed an emerging theory based on these patterns. The findings indicate that these individuals in recovery benefit from blogging by developing connections, processing emotions, remaining accountable, as well as enjoying.

Keywords: substance use disorder recovery, connection, blogging, accountability, processing emotions

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Authors: Helena Baffoe

Abstract:

Context: In the United States, there have been significant advancements in programs aimed at improving the lives of individuals with mental health disorders and substance abuse problems. However, public attitudes and beliefs regarding these issues have not improved correspondingly. This study aims to explore the perceptions and beliefs surrounding mental health disorders and substance abuse in the context of data analytics in the field of social work. Research Aim: The aim of this research is to provide empirical evidence on the beliefs and perceptions regarding mental health disorders and substance abuse. Specifically, the study seeks to answer the question of whether being diagnosed with a mental disorder implies a diagnosis of substance abuse. Additionally, the research aims to analyze the specific roles that social workers can play in addressing individuals with mental disorders. Methodology: This research adopts a data-driven methodology, acquiring comprehensive data from the Substance Abuse and Mental Health Services Administration (SAMHSA). A noteworthy causal connection between mental disorders and substance abuse exists, a relationship that current literature tends to overlook critically. To address this gap, we applied logistic regression with an Instrumental Variable approach, effectively mitigating potential endogeneity issues in the analysis in order to ensure robust and unbiased results. This methodology allows for a rigorous examination of the relationship between mental disorders and substance abuse. Empirical Findings: The analysis of the data reveals that depressive, anxiety, and trauma/stressor mental disorders are the most common in the United States. However, the study does not find statistically significant evidence to support the notion that being diagnosed with these mental disorders necessarily implies a diagnosis of substance abuse. This suggests that there is a misconception among the public regarding the relationship between mental health disorders and substance abuse. Theoretical Importance: The research contributes to the existing body of literature by providing empirical evidence to challenge prevailing beliefs and perceptions regarding mental health disorders and substance abuse. By using a novel methodological approach and analyzing new US data, the study sheds light on the cultural and social factors that influence these attitudes.

Keywords: mental health disorder, substance abuse, empirical evidence, logistic regression with IV

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Authors: Ipek Sensu

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Comorbid Axis I disorders are highly common for suicidal borderline personality disorder (BPD) patients, especially substance use disorder and anxiety disorders. Since interpersonal dysfunction is one of the core symptoms in BPD, the purpose of the current study is to examine perceived criticism and anxiety disorders and also substance abuse disorders (SUD) for women with borderline personality disorder (BPD) who attempt suicide at least once in their lifetime. In the current study, it was suggested that the perceived criticism from others and being upset by criticism differ between suicidal women with BPD with comorbidity of anxiety disorders and SUD (separately) and suicidal women with BPD without anxiety disorders and without SUD (separately). The participants in this study included ninety-nine women who have already been diagnosed with borderline personality disorder and also have had at least two episodes of deliberate self-harm, in other words, suicide attempts and/or non-suicidal self-injury (NSSI) in the last five years and at least one episode in the 8-week period before joining the research study and at least one suicide attempt in the previous year. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) and Social History Interview (SHI) were conducted to determine the comorbid axis I disorders and level of perceived criticism. As a result of the independent sample t-tests, the first hypothesis was rejected, in other words, women with BPD and a comorbid anxiety disorder did not show significantly higher levels of ‘criticized by others’, compared to women with BPD alone. However, the levels of ‘upset at criticism’ were significantly different between suicidal women with BPD with or without any anxiety disorders, which is the second hypothesis. In addition, the third hypothesis was also accepted; this means, women with BPD who had any substance use dependence would show significantly higher levels of 'criticized by others' compared to women with BPD alone. Finally, the fourth hypothesis was partly accepted: that is, women with BPD with alcohol dependence had significantly higher levels of ‘how upset when they expose to criticism’, compared to those without alcohol dependence. Limitations, implications, and directions for future research are discussed.

Keywords: anxiety disorders, borderline personality disorders, perceived criticism, substance use disorders

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Authors: Kay-Anne Haykal, Issack Biyong

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The post-traumatic stress disorder (PTSD) rises from exposure to a traumatic event and appears by a persistent experience of this event. Several psychiatric co-morbidities are associated with PTSD and include mood disorders, anxiety disorders, and substance abuse. The main objective was to compare the criteria for PTSD according to the literature to those used to diagnose a patient in a francophone hospital and to check the correspondence of these two criteria. 700 medical charts of admitted patients on the medicine or psychiatric unit at the Montfort Hospital were identified with the following diagnoses: major depressive disorder, bipolar disorder, anxiety disorder, substance abuse, and PTSD for the period of time between April 2005 and March 2006. Multiple demographic criteria were assembled. Also, for every chart analyzed, the PTSD criteria, according to the Manual of Mental Disorders (DSM) IV were found, identified, and grouped according to pre-established codes. An analysis using the receiver operating characteristic (ROC) method was elaborated for the study of data. A sample of 57 women and 50 men was studied. Age was varying between 18 and 88 years with a median age of 48. According to the PTSD criteria in the DSM IV, 12 patients should have the diagnosis of PTSD in opposition to only two identified in the medical charts. The ROC method establishes that with the combination of data from PTSD and depression, the sensitivity varies between 0,127 and 0,282, and the specificity varies between 0,889 and 0,917. Otherwise, if we examine the PTSD data alone, the sensibility jumps to 0.50, and the specificity varies between 0,781 and 0,895. This study confirms the presence of an underdiagnosed and treated PTSD that causes severe perturbations for the affected individual.

Keywords: post-traumatic stress disorder, co-morbidities, diagnosis, mental health disorders

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Authors: Mahadzirah Mohamad, Morliyati Mohammad, Nor Azman Mat Ali, Zainudin Awang

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Globally, youth substance abuse has been identified as the problem that causes substantial damage not only to individuals, but also to families and communities. In addition, substance abuse youths have become unproductive resources that would play lesser roles in the nation’s development. The increasing trend of substance abuse among youths has raised a lot of concern among various quarters in Malaysia. It has also been reported that Malay youths are the majority group involved in substance abuse. However, it was noted that life satisfaction had been found to be an important mitigating factor that addressed substance abuse. The objectives of the study were twofold: firstly, to ascertain the effect of life satisfaction on substance abuse among Malay youth. Secondly, to identify the role of delinquency on the relationship between life satisfaction and substance abuse. This study adopted a cross-sectional research design. Self-administered questionnaires were distributed to 500 Malay youths at the youth programmes using a two-step sampling technique: area sampling and systematic sampling. The research hypotheses were tested using Structural Equation Modelling. The findings of the study revealed that there is no significance relationship between life satisfaction and substance abuse. There is a significant inverse relationship between life satisfaction and delinquency. Moreover, delinquency has a positive significant influence on substance abuse. The use of Bootstrapping analysis proved that delinquency plays a full mediating role in the relationship between life satisfaction and substance abuse. This study suggested that life satisfaction has no effect on youth substance abuse. In order to reduce substance abuse, efforts should be undertaken to reduce delinquency behaviour by increasing youth life satisfaction.

Keywords: delinquency, life satisfaction, substance abuse, youth

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Authors: Ellen McClure

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It is generally well-known that a number of inmates suffer from some form of substance or alcohol use disorder. This study identifies, analyses, classifies and codifies the most recent Canadian criminal judgments involving an accused diagnosed with an alcohol use disorder specifically. From this research, patterns in judicial discourse and sentencing norms can be established, and these findings can be juxtaposed with existing relevant academic literature, particular attention will be given to this discussion at the sentencing stage, and the subsequent incarceration of those with alcohol use disorders. This topic will be explored with an overarching emphasis on the effects that a lack of conversation regarding a possible correlation between alcohol consumption and crime may have. Although comparisons may be made in order to clarify or highlight certain issues, particular attention will be paid to jurisdictions within Canada. This paper explores the existing judicial discourse in sentencing regarding the relationship between alcohol and crime, and how this might explain the higher incarceration rates of those suffering from alcohol use disorders in Canada. The research questions are as follows: (1) What are the existing judicial discourses in sentencing around the relationship between alcohol and crime? (2) To what extent has the current discourse on alcohol addiction among judges and legal academics contributed to the incarceration of alcoholics?The major findings of this research indicate a strong correlation between a lack of judicial discussion regarding the accused’s alcohol use disorder and an increased tendency to consider an alcohol use disorder as an aggravating factor. Furthermore, it was found that an 82% of judges who discussed the alcohol use disorder meaningfully referred to the disorder as a mitigating factor. This can be compared with 6.7% of judges who referred to the alcohol use disorder as a mitigating factor in cases where the disorder was not meaningfully discussed.

Keywords: alcohol use disorder, addiction, criminal justice, judicial discourse

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Authors: Sahra Setorg

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The purpose of this study was to determine the effect of meta-cognitive therapy on meta-cognitive defects and emotional regulation in industrial substance dependence patients. This quasi-experimental research was conducted with post-test and two-month follow-up design with control and experimental groups. The statistical population consisted of all industrial Substance dependence patients refer to addictive withdrawal clinics in Esfahan city, in Iran in 2013. 45 patients were selected from three clinics through the convenience sampling method and were randomly divided into two experimental groups (15 crack dependences, 15 amphetamine dependences) and one control group (n=15). The meta-cognitive questionnaire (MCQ) and difficulties in emotional regulation questionnaire (DERS) were used as pre-test measures and the experimental groups (crack and amphetamine) received 8 MC therapy sessions in groups. The data were analyzed via multivariate covariance statistic method by spss-18. The results showed that MCT had a significant effect in improving the meta-cognitive defects in crack and amphetamine dependences. Also, this therapy can increase the emotional regulation in both groups (p<0/05).The effect of this therapy is confirmed in two months followup. According to these findings, met-cognitive is as an interface and important variable in prevention, control, and treatment of the new industrial substance dependences.

Keywords: meta-cognitive therapy, meta-cognitive defects, emotional regulation, substance dependence disorder

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Authors: Dalia Elleuch

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Narcissistic Personality Disorder (NPD) manifests as a personality disorder marked by inflated self-importance, heightened sensitivity to criticism, a lack of empathy, a preoccupation with appearance over substance, and features such as arrogance, grandiosity, a constant need for admiration, a tendency to exploit others, and an inclination towards demanding special treatment due to a sense of excessive entitlement (APA, 2013). This interdisciplinary study delves into NPD through the systematic synthesis of psycholinguistic analysis and neuroscientific correlates. The cognitive and emotional dimensions of NPD reveal linguistic patterns, including grandiosity, entitlement, and manipulative communication. Neuroscientific investigations reveal structural brain differences and alterations in functional connectivity, further explaining the neural underpinnings of social cognition deficits observed in individuals with NPD. Genetic predispositions and neurotransmitter imbalances add a layer of complexity to the understanding of NPD. The necessity for linguistic intervention in diagnosing and treating Narcissistic Personality Disorder is underscored by an interdisciplinary study that intricately synthesizes psycholinguistic analysis and neuroscientific correlates, offering a comprehensive understanding of NPD’s cognitive, emotional, and neural dimensions and paving the way for future practical, theoretical, and pedagogical approaches to address the complexities of this personality disorder.

Keywords: Narcissistic Personality Disorder (NPD), psycholinguistic analysis, neuroscientific correlates, interpersonal dysfunction, cognitive empathy

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Authors: Nicolas Meylan, Eric Tardif

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Many studies have highlighted the links between substance use and school difficulties. However, most of these studies address only the consumption in terms of frequency without considering the different types of behavior (use, abuse, dependence). Moreover, little is known about the associations between substance use and variables such as school engagement and school burnout recently described as a positive state of mind and an exhaustion syndrome related to school, respectively. Through this study, we wish to describe and compare school-related variables in adolescents with different type of substance use. Our study focuses on 402 Swiss adolescents, aged between 14 and 19 years old. They responded collectively and anonymously to a set of scales assessing substance use and several school variables (social support, stress, burnout, engagement and school climate). First, results on frequency and severity of substance use are relatively close to those observed in other studies. Second, it also appears that certain dimensions of stress, burnout, engagement and school climate are associated with the frequency of alcohol and cannabis consumption. Finally, adolescents’ substance abusers show particularly high scores of burnout, cynicism and stress related to workload, which can be understand as self-medication behavior. Additional analyzes are underway to clarify these associations. Results are discussed in terms of implications for research and clinical practice in academic burnout.

Keywords: school burnout, school engagement, adolescence, substance use, self-medication

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Authors: Gaironeesa Hendricks, Shazly Savahl, Maria Florence

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The aim of the study is to determine whether peer pressure and leisure boredom influence substance use among adolescents in low-income communities in Cape Town. Non-probability sampling was used to select 296 adolescents between the ages of 16–18 from schools located in two low-income communities. The measurement tools included the Drug Use Disorders Identification Test, the Resistance to Peer Influence and Leisure Boredom Scales. Multiple regression revealed that the combined influence of peer pressure and leisure boredom predicted substance use, while peer pressure emerged as a stronger predictor than leisure boredom on substance use among adolescents.

Keywords: substance use, peer pressure, leisure boredom, adolescents, multiple regression

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Authors: Silsila Sherzad, Hazrat Ali Khan, Tabasum Sherzad, Hazratullah, Sanaullah

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Objective: To study the prevalence of common Mental health disorders among forcibly displaced people and to compare with the common mental health disorders among host community members. Study design: Analytical Study. Place of study: Balochistan institute of psychiatry and behavioral sciences, Quetta, Baluchistan, Pakistan. Methodology: Data from the Outpatient department were analyzed to numerate both the host community and refugees. Out of 4120, 354 refugee patients were identified using their proof registration (POR) card and for 3776 of the host community using their computerized national identity card (CNIC), data was analyzed for the prevalence of mental health disorders among them. Results: This study states that Afghan Refugees presented to OPD services of Balochistan institute of psychiatry and behavioral sciences, 47% were diagnosed as Major depressive disorder with/without psychosis, 19% with Generalized anxiety disorder, 5% were diagnosed as Bipolar Affective disorder, 5% With schizophrenia, 4% as Post-traumatic stress disorder, 3% as migraine, 3% conversion disorder, 2% Obsessive-compulsive disorder, 1% somatoform disorder and 10% of them presented with other psychiatric disorders, while in host community 21% were diagnosed as Major depressive disorder with/without psychosis, 24% as Generalized anxiety disorder, 12% as somatoform disorder, 10% as Obsessive-compulsive disorder, 8% as migraine, 7% as conversion disorder, 4% as Bipolar Affective disorder, 3% as schizophrenia, 3% as Mental and behavioral disorder due to substance misuse and rest of 7% presented with other psychiatric disorders. Conclusion: The conclusion of this study states that mental health disorders are more common among refugees than in other populations. The result of this study shows that there is a big difference in the prevalence of mental health disorders among displaced people and the rest of the population. Some Mental health disorders are present in a higher percentage among displaced people rather than among the host community, while some other disorders are present in a lower percentage among displaced people rather than among the host community. This study also highlights that further studies are needed to determine risk and protective factors within the host community.

Keywords: forced displacement, mental health, Afghan refugees, depression

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Authors: Imaneh Abbasi, Ladan Fata, Majid Sadeghi, Sara Banihashemi, Abolfazl Mohammadee

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Background: Dimensional and transdiagnostic approaches as a result of high comorbidity among mental disorders have captured researchers and clinicians interests for exploring the latent factors of development and maintenance of some psychological disorders. The goal of present study is to compare some of these common factors between generalized anxiety disorder and unipolar mood disorder. Methods: 27 patients with generalized anxiety disorder, 29 patients with depression disorder were recruited using SCID-I and 69 non-clinical population were selected using GHQ cut off point. MANCOVA was used for analyzing data. Results: The results show that worry, rumination, intolerance of uncertainty, maladaptive metacognitive beliefs, and experiential avoidance were all significantly different between GAD and unipolar mood disorder groups. However, there were not any significant differences in difficulties in emotion regulation and neuroticism between GAD and unipolar mood disorder groups. Discussion: Results indicate that although there are some transdiagnostic and common factors in GAD and unipolar mood disorder, there may be some specific vulnerability factors for each disorder. Further study is needed for answering these questions.

Keywords: transdiagnostic, depression, generalized anxiety disorder, emotion regulation

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Authors: Siphesihle Hlongwane

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Background: Globally, alcohol consumption, smoking, and the use of illicit drugs kill more than 11.8 million people each year. In sub-Saharan Africa, substance abuse is responsible for more than 6.4% of all deaths recorded and about 4.7% of all Disability Adjusted Life Years (DALYs), with numbers still expected to grow if no drastic measures are taken to curb and address drug use. In a setting where substance use is rife, understanding contextual factors that influence an individual’s perceived eligibility to seek rehabilitation is paramount. Using the candidacy framework, we unpack how situational factors influence an individual’s perceived eligibility for healthcare uptake in adolescents and youth with substance use disorder (SUD). Methods: The candidacy framework is concerned with how people consider their eligibility for accessing a health service. The study collected and analyzed primary qualitative data to answer the research question. Data were collected between January and July 2022 on participants aged between 18 and 35 for drug users and 18 to 60 for family members. Participants include 20 previous and current drug users and 20 family members that experience the effects of addiction. A pre-drafted semi-structured interview guide was administered to a conveniently sampled population supplemented with a referral sampling method. Data were thematically analyzed using the NVivo 12pro software to manage the data. Findings: Our findings show that people with substance use disorders are aware of their drug use habits and acknowledge their candidacy for health services. Candidacy for health services is also acknowledged by those around them, such as family members and peers, and as such, information on the navigation of health services for drug users is shared by those who have attended health services, those affected by drug use, and this includes health service research by family members to identify accessible health services. While participants reported willingness to quit drug use if assistance is provided, the permeability of health care services is hindered by both individual determinations to quit drug use from long-time use and the availability of health services for drug users, such as rehabilitation centers. Our findings also show that drug users are conscious and can articulate their ailments; however, the hunt for the next dose of drugs and long waiting cues for health service acquisition overshadows their claim to health services. Participants reported a mixture of treatments prescribed, with some more gruesome than others prescribed, thus serving as both a facilitator and barrier for health service uptake. Despite some unorthodox forms of treatments prescribed in health care, the majority of those who enter treatment complete the process of treatment, although some are met with setbacks and sometimes relapse after treatment has finished. Conclusion: Drug users are able to ascertain their candidacy for health services; however, individual and environmental characteristics relating to drug use hinder the use of health services. Drug use interventions need to entice health service uptake as a way to improve candidacy for health use.

Keywords: substance use disorder, rehabilitation, drug use, relapse, South Africa, candidacy framework

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Authors: Mutshinye Manguvhewa, Maria Florence, Mansoo Yu, Elize Koch, Kamal Kamaloodien

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Substance use among pregnant women is a perennial problem in the Western Cape Province of South Africa. There are many influential factors are associated with substance use among women of childbearing age. The study explored factors associated with substance use among pregnant women using a qualitative research design and the bio-ecological theoretical framework to explore and guide the researcher throughout the study. Participants were selected using purposive sampling. Only participants accessed from the Department of Social Development meeting the inclusion criteria of the study were interviewed using semi structured interviews. Immediate referral for psychological intervention during the interview was available for participants who needed it. Braun and Clarke's six phases of thematic analysis were utilised to analyse the data. The study adheres to ethical guidelines for the participants' protection. Participants were informed about the study before the initiation of the interviews and the details of their voluntary participation were explained. The key findings from this study illustrate that socio-cultural factors, personal factors, emotional response and intimate relationships are the major contributing factors to substance use among pregnant women in this sample. The results outline the preventative measures that pregnant women implement. Lastly, the study reveals the positive and negative perceptions of substance use programmes that participants share. Some of the study findings are similar to the existing literature and some of the findings differed. Recommendations emanating from the study include that the stakeholders, rehabilitation centres, Department of Health and future researchers should act proactively against substance use during pregnancy.

Keywords: substance addiction, antenatal care, pregnancy, substance use

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Authors: Merve Cebi, Turker Tekin Erguzel, Gokben Hizli Sayar

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Understanding the biological mechanisms of dissociation in patients with bipolar disorder is important for developing new treatment approaches for the disorder as well as using the appropriate treatment strategies. In this study, we compared EEG power and coherence values for alpha, theta and beta frequency bands between patients having bipolar disorder with dissociation as compared to the bipolar patients without dissociation. Accordingly, we did not find any statistically significant difference in either the absolute or the relative power between the groups. Coherence values were not found to be statistically different, as well. Therefore, our results demonstrated that the existence of dissociation did not influence electrophysiological correlates in bipolar disorder.

Keywords: bipolar disorder, dissociation, absolute power, coherence

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Authors: Cheyenne Johnson, Samantha Robinson, Christina Chant, Ann M. Mitchell, Carol Price, Carmel Clancy, Adam Searby, Deborah S. Finnell

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Introduction: Substance use along the continuum from at-risk use to a substance use disorder (SUD) contributes substantially to the burden of disease and related harms worldwide. There is a growing body of literature that highlights the lack of substance use related content in nursing curricula. Furthermore, there is also a lack of consensus on key competencies necessary for entry-level nurses. Globally, there is a lack of established nursing competencies related to prevention, health promotion, harm reduction and treatment of at-risk substance use and SUDs. At a critical time in public health, this gap in nursing curricula contributes to a lack of preparation for entry-level nurses to support people along the continuum of substance use. Thus, in practice, early opportunities for screening, support, and interventions may be missed. To address this gap, an international committee was convened to develop international entry-level nursing competencies specifying the knowledge, skills, and abilities that all nurses should possess in order to address the continuum of substance use. Methodology: An international steering committee, including representation from Canada, United States, United Kingdom, and Australia was established to lead this work over a one-year time period. The steering committee conducted a scoping review, undertaken to examine nursing competency frameworks, and to inform a competency structure that would guide this work. The next steps were to outline key competency areas and establish leaders for working groups to develop the competencies. In addition, a larger international committee was gathered to contribute to competency working groups, review the collective work and concur on the final document. Findings: A comprehensive framework was developed with competencies covering a wide spectrum of substance use across the lifespan and in the context of prevention, health promotion, harm reduction and treatment, including special populations. The development of this competency-based framework meets an identified need to provide guidance for universities, health authorities, policy makers, nursing regulators and other organizations that provide and support nursing education which focuses on care for patients and families with at-risk substance use and SUDs. Conclusion: Utilizing these global competencies as expected outcomes of an educational and skill building curricula for entry-level nurses holds great promise for incorporating evidence-informed training in the care and management of people across the continuum of substance use.

Keywords: addiction nursing, addiction nursing curriculum, competencies, substance use

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Authors: Elizabeth Latham

Abstract:

Aristotle’s definition of substance from Metaphysics is relevant to the Catholic transubstantiation of the Eucharist, the idea that the actual substance of bread and wine is replaced by the substance of the body and blood of Christ. Assuming the physiological nature of the subjects do not change, the Aristotelian view on the nature of substance seems to be incompatible with this belief, since bread and wine have essential qualities different from those of flesh and blood. However, based on a theological view of the essence of the body and blood of Christ as salvation along with the essence of Eucharist, transubstantiation can fit within Aristotle’s brackets. This is one step further than theologians like Aquinas have gone in their similar discussions. Using his work as a method by which to understand the apparently impossible act of transforming food to flesh provides a logical angle on a question of faith.

Keywords: aristotle, catholicism, eucharist, metaphysics transubstantiation

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Authors: Usha Barahmand, Ali Khazaee, Goudarz Sadeghi Hashjin

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The purpose of this study is to assess the relative mediating effects of impulsivity and internalizing problems in the relationship between childhood neglect and motives for opiate use. Seventy-two adolescent opiate users were recruited for the study. Participants completed assessments of childhood abuse history, distress, impulsiveness and motives for substance use as well as a socio-demographic information sheet. Findings from bootstrap mediator analyses indicated that distress, but not impulsiveness, mediated the relationship between childhood emotional abuse and expansion and enhancement motives for substance use. The current study provides preliminary evidence that internalizing problems may function as a mechanism linking prior childhood experiences of emotional neglect to subsequent motives for substance use. Clinical implications of these findings suggest that targeting emotion dysregulation problems may be an effective adjunct in the treatment of adolescents with a history of childhood maltreatment that are at risk for substance use.

Keywords: childhood neglect, impulsiveness, internalizing problems, substance use motives

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Authors: Quervin Zacary M. Roldan, Gwyneth Gabrielle M. Fajardo, Carmela M. Maciar

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Alcohol in the Philippines is regarded as a part of their culture however, it is also stigmatized, as alcohol addiction is prevalent among Filipino Males leading them to develop Alcohol Use Disorder. With this, Discourses of alcohol consumption from Individuals recovering from AUD from different rehabilitation centers in the Philippines were analyzed in the study to explore how they ‘talk’ about their alcohol consumption. By utilizing the Foucauldian Discourse Analysis following the six steps by Carla Willig, four (4) major discourses were major construed by the recovering individuals of AUD which are: (1) Being alcohol-free was a dream, (2) Drinking alcohol turns you into a demon that will destroy your life, (3) Drinking alcohol as ‘doing’ drugs and (4) Alcohol is a temporary solution. These discourses construct alcohol consumption as something that is being referred to as a 'bad' substance which is both normalized and stigmatized in Philippine society.

Keywords: alcohol, alcohol consumption, alcohol-based beverages, psychological effects, discourse, alcohol use disorder, stigma

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Authors: Ilaria Manca, Ilaria Manca, Francesca Pettinau, Ignazia Mocci, Elisabetta M. Usai, Barbara Pittau

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Lamotrigine is a phenyltriazine used in the treatment of epilepsy and bipolar disorder type I. The purpose of this study was to test and compare various solid forms of immediate release (IR) lamotrigine products, at different strenghts, in order to study their disaggregation and dissolution behavior. IR products are designed to release their active substance promptly after administration. Concentration of hydrochloric acid in gastric juice is about 0.1-0.001 M, so FDA (Food and Drug Administration) recommends, for lamotrigine regular tablets, dissolution tests in HCl 0.1 M.Toinvestigate the pH dependency of drug release in the entire gastrointestinal tract, we worked at two additional media with different pH values (4.5 and 6.8), that reflect conditions in it. To afford acceptable dissolution rates, tablets must disintegrate. Disaggregation of constituent particles increases the surface area and substantially increases the dissolution rate. For this reason availability of an active substance from tablets depends on its ability to disintegrate fast in dissolution media. pH of gastrointestinal fluid affects drug absorption by conditioning its solubility and dissolution, but also tablet disintegration may be influenced by it. To obtain information about the quantitative relationship between different mixture components, Nuclear Magnetic Resonance (NMR) spectroscopy was used. We also investigate tablet hardness. The investigation carried out confirms pH 1.2 as the ideal environment for the immediate availability of the active substance.

Keywords: dissolution, disaggregation, Lamotrigine, bioequivalence

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Authors: Beatrice Wamuyu Muchiri, Monika M. L. Dos Santos

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An increasingly recognised prevention approach for substance use entails reduction in risk factors and enhancement of promotive or protective factors in individuals and the environment surrounding them during their growth and development. However, in order to enhance the effectiveness of this approach, continuous study of risk aspects targeting different cultures, social groups and mixture of society has been recommended. This study evaluated the impact of potential risk and protective factors associated with family management and relations on adolescent substance abuse in South Africa. Exploratory analysis and cumulative odds ordinal logistic regression modelling was performed on the data while controlling for demographic and socio-economic characteristics on adolescent substance use. The most intensely used substances were tobacco, cannabis, cocaine, heroin and alcohol in decreasing order of use intensity. The specific protective or risk impact of family management or relations factors varied from substance to substance. Risk factors associated with demographic and socio-economic factors included being male, younger age, being in lower education grades, coloured ethnicity, adolescents from divorced parents and unemployed or fully employed mothers. Significant family relations risk and protective factors against substance use were classified as either family functioning and conflict or family bonding and support. Several family management factors, categorised as parental monitoring, discipline, behavioural control and rewards, demonstrated either risk or protective effect on adolescent substance use. Some factors had either interactive risk or protective impact on substance use or lost significance when analysed jointly with other factors such as controlled variables. Interaction amongst risk or protective factors as well as the type of substance should be considered when further considering interventions based on these risk or protective factors. Studies in other geographical regions, institutions and with better gender balance are recommended to improve upon the representativeness of the results. Several other considerations to be made when formulating interventions, the shortcomings of this study and possible improvements as well as future studies are also suggested.

Keywords: risk factors, protective factors, substance use, adolescents

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Authors: Megan E. Davies

Abstract:

As substance use become an increasing prevalent occurrence amongst young people, prevention programs designed specifically for children and adolescents are required to protect against associated cognitive, psychological, and behavioural issues. Further, young people from marginalized backgrounds would highly benefit from culturally adapted substance use prevention programs. The first and second phase of the Life Skills Training (LST) program, the Maskwacis Life Skills Training (MLST) program, the Bii-Zin-Da-De-Da (BZDDD; “Listening to One Another”), and a culturally sensitive smoking prevention program, all of which have been adapted to Canadian Indigenous cultures and are applied within the school and family settings, are discussed. Additionally, comorbid disorders, at-risk personality types, and motivating factors associated with substance use amongst Canadian children and adolescents, specifically Indigenous youth, are explored through the application of a biopsychosocial model. Requital efforts being made in Canada towards Indigenous communities are described within a historical context, and substance use prevention programs targeting Indigenous children and adolescents are compared. Through this lens, suggestions are presented for future research on preventative interventions directed towards substance use within minority groups.

Keywords: early intervention, cultural appropriateness, life skills training, smoking prevention, drug and alcohol prevention

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Authors: Frederick Monyepao

Abstract:

Crack cocaine first appeared on the scene in the form of cocaine freebasing in the late 1970s. Stockbrokers, investment bankers, rock stars, Hollywood elites, and a few pro athletes were regular users of the substance. As criminogenic factors associated with substance abuse began to surface, congress passed new legislation. The laws led to the increase of health coverage insurances and the expansion of hospitals. By the mid-1980s, crack use spread into America's inner cities among impoverished African Americans and Latinos. While substance abuse increased among minority communities, legislation pertaining to substance abuse evolved. The prison industry also expanded the number of cells available. A qualitative approach was taken, drawing from a range secondary sources for contextual analysis. This paper traces out the continued marginalisation and racist undertones towards minorities as perpetuated by certain drug policies. It was discovered that the new legislation on crack was instrumental in the largest incarcerations the United States ever faced. Drug offenders increased in prisons eightfold from 1986 to 2000. The paper concludes that American drug control policies are consistently irrational and ineffective when measured by levels of substance use and abuse. On the contrary, these policies have been successful as agents of social control in maintaining the stratification patterns of racial/ethnic minorities and women. To move beyond prohibition, radical law and policy reform may require a change in narratives on substance use.

Keywords: crack, drug policy, minorities, racism, substance abuse

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