Abuse Screening Research Articles

Psychometric properties of CAST for early detection of problematic cannabis use in Spanish adolescents

The high prevalence rates of cannabis use in adolescents and its early onset constitutes a major public health problem, raising the need for its early detection. The availability of validated tools to analyze early cannabis use is essential to detect problematic use at an early age. The Cannabis Abuse Screening Test (CAST) (Legleye et al., 2007) is widely applied in Europe; however, the CAST cut-off scores vary according to the setting, the screening objective, and the correction version (CAST-f or CAST-b), creating therefore confusion in its application. Moreover, the psychometric properties of the CAST as a tool for detecting problematic cannabis use are understudied. To fill this gap, such psychometric properties have been analyzed in a sample of Spanish adolescents while using different cut-off scores for CAST-f and CAST-b. Based on our findings, the optimal cut-off scores are 2 points for CAST-b and 4 points for CAST-f. The internal reliability of CAST-f (α = 0.83) and CAST-b (KR-20 = 0.80) are satisfactory. Factorial analysis suggested the assumption of a one-dimension model. The CAST seems to be a valid and reliable tool for early screening of problematic cannabis use in Spanish adolescents.

Where is the 'C' in antenatal care and postnatal care: A multi-country survey of availability of antenatal and postnatal care in low- and middle-income settings.

ObjectiveAntenatal (ANC) and postnatal care (PNC) are logical entry points for prevention and treatment of pregnancy‐related illness and to reduce perinatal mortality. We developed signal functions and assessed availability of the essential components of care.DesignCross‐sectional survey.SettingAfghanistan, Chad, Ghana, Tanzania, Togo.SampleThree hundred and twenty‐one healthcare facilities.MethodsFifteen essential components or signal functions of ANC and PNC were identified. Healthcare facility assessment for availability of each component, human resources, equipment, drugs and consumables required to provide each component.Main outcome measureAvailability of ANC PNC components.ResultsAcross all countries, healthcare providers are available (median number per facility: 8; interquartile range [IQR] 3–17) with a ratio of 3:1 for secondary versus primary care. Significantly more women attend for ANC than PNC (1668 versus 300 per facility/year). None of the healthcare facilities was able to provide all 15 essential components of ANC and PNC. The majority (>75%) could provide five components: diagnosis and management of syphilis, vaccination to prevent tetanus, BMI assessment, gestational diabetes screening, monitoring newborn growth. In Sub‐Saharan countries, interventions for malaria and HIV (including prevention of mother to child transmission [PMTCT]) were available in 11.7–86.5% of facilities. Prevention and management of TB; assessment of pre‐ or post‐term birth, fetal wellbeing, detection of multiple pregnancy, abnormal lie and presentation; screening and support for mental health and domestic abuse were provided in <25% of facilities.ConclusionsEssential components of ANC and PNC are not in place. Focused attention on content is required if perinatal mortality and maternal morbidity during and after pregnancy are to be reduced.Tweetable abstractANC and PNC are essential care bundles. We identified 15 core components. These are not in place in the majority of LMIC settings.

Effects of COVID-19 on Patients in Adult Ambulatory Psychiatry: Using Patient-Rated Outcome Measures and Telemedicine.

Introduction:To examine the effects of coronavirus disease 2019 (COVID-19) on patients in an academic psychiatric ambulatory clinic, data from a measurement-based care (MBC) system were analyzed to evaluate impacts on psychiatric functioning in patients using telemedicine. Psychiatric functioning was evaluated for psychological distress (brief adjustment scale [BASE]-6), depression (patient health questionnaire [PHQ]-9), and anxiety (generalized anxiety disorder [GAD]-7), including initial alcohol (U.S. alcohol use disorders identification test) and substance use (drug abuse screening test-10) screening.Methods:This observational study included MBC data collected from November 2019 to March 2021. Patient-Reported Outcome Measures (PROMs) were examined to determine changes in symptomatology over the course of treatment, as well as symptom changes resulting from the pandemic. Patients were included in analyses if they completed at least one PROM in the MBC system.Results:A total of 2,145 patients actively participated in the MBC system completing at least one PROM, with engagement ranging from 35.07% to 83.50% depending on demographic factors, where completion rates were significantly different for age, payor status, and diagnostic group. Average baseline scores for new patients varied for the GAD-7, PHQ-9, and BASE-6. Within-person improvements in mental health before and after the pandemic were statistically significant for anxiety, depression, and psychological adjustment.Discussion:MBC is a helpful tool in determining treatment progress for patients engaging in telemedicine. This study showed that patients who engaged in psychiatric services incorporating PROMs had improvements in mental health during the COVID-19 pandemic. Additional research is needed exploring whether PROMs might serve as a protective or facilitative factor for those with mental illness during a crisis when in-person visits are not possible.

The contribution of psychopathic traits and substance use in the prediction of recidivism of sexual offenders

Substance use and dependence may play an essential role in the risk of reoffending by sex offenders. Research examining the influence of substance use and dependence on the criminal behaviour of psychopathic sex offenders is limited. Alcohol and drug use have been identified as factors which promote criminal behaviour and are suspected to contribute, at least partially, to the probability of reoffending. For instance, previous research showed that elevated scores on the Michigan Alcohol Screening Test (MAST) contribute to the predictability of the Hare Psychopathy Checklist – Revised (PCL-R) on recidivism. The current study retrospectively evaluated a database of incarcerated high-risk offenders registered in the Regional Treatment Center, Sex Offender Treatment Program (RTCSOTP); in order to assess the contribution of self-disclosed histories of alcohol and substance use and dependency have, in concert with measures of psychopathic characteristics, on the predictability of recidivism. Results of the retrospective data identified PCL-R and DAST (Drug Abuse Screening Test) scores as significant predictors of sexual and violent recidivism of male inmates undergoing treatment in RTCSOTP within 5 years of their release. MAST scores, however, did not significantly contribute to the predictability of sexual and violent recidivism in this population. We conclude, drug use should be considered as an important factor when addressing recidivism in sexual offenders who demonstrate psychopathic characteristics.

Cannabis and schizophrenia: characterisation of a risk factor in a sample of Moroccan patients hospitalised for psychosis

BackgroundIn addition to the biological plausibility widely described through a very large number of studies, the causal link between cannabis uses and schizophrenia disorders has become illicit internationally and given the scarcity of similar studies in Morocco. Our study consists of a prospective descriptive study in the psychiatric department of the Moulay ben Abdallah Hospital in Essaouira. The sample consisted of 95 patients diagnosed with schizophrenia according to the DSM5 criteria. The diagnostic assessment included the Positive and Negative Syndrome Scale to assess the severity of positive and negative symptoms of schizophrenia as well as the patient’s general psychopathology, the Clinician-Rated Dimensions of Psychosis Symptom Severity to assess the symptom severity of the psychotic dimensions according, and the Cannabis Abuse Screening Test to assess the extent of cannabis use.ResultsThe mean age of the patients recruited in the study was 33.7 ± 9.37 years with a clear male predominance (p < 0.0001). Cannabis users compared to non-users were younger and comprised only men. Cannabis users also have a lower educational and economic level than non-users. Furthermore, a clear dose effect of cannabis uses on the onset of positive and negative symptoms of schizophrenia. The temporality criterion is clear in our study, since the predictivity of the parameter: “age of onset of cannabis use” is highly significant (p = 0.000). These results suggest that cannabis use can be considered as the most illicit risk factor for the development and/or onset of schizophrenia.ConclusionsThese results suggest that there is a causal relationship between cannabis use and/or dependence (problematic use) and the onset and/or worsening of schizophrenic disorder. This means that problematic cannabis use can be considered as a real risk factor for the emergence and development of schizophrenic disorder.

Diagnostic and Predictive Capacity of the Spanish Versions of the Opioid Risk Tool and the Screener and Opioid Assessment for Patients with Pain-Revised: A Preliminary Investigation in a Sample of People with Noncancer Chronic Pain.

IntroductionAccurate assessment of the risk of opioid abuse and misuse in people with noncancer chronic pain is crucial for their prevention. This study aimed to provide preliminary evidence of the diagnostic and predictive capacity of the Spanish versions of the Opioid Risk Tool (ORT) and the Screener and Opioid Assessment for Patients with Pain—Revised (SOAPP-R).MethodsWe used the Current Opioid Misuse Measure (COMM) as criterion measure to assess the capacity of each tool to identify patients misusing opioids at the time of the assessment. Eighteen months later, we used the COMM and the Drug Abuse Screening Test-10 (DAST-10) to assess their predictive capacity. In total, 147 people with noncancer chronic pain participated in the diagnostic study, and 42 in the predictive study.ResultsReceiver operating curve analysis showed that the SOAPP-R had an excellent capacity to identify participants who were misusing opioids at the time of assessment (area under the curve [AUC] = 0.827). The diagnostic capacity of the ORT was close to acceptable (AUC = 0.649–0.669), whereas its predictive capacity was poor (AUC = 0.522–0.554). The predictive capacity of the SOAPP-R was close to acceptable regarding misuse (AUC = 0.672) and poor regarding abuse (AUC = 0.423).ConclusionIn the setting of Spanish-speaking communities, clinicians should be cautious when using these instruments to make decisions on opioid administration. Further research is needed on the diagnostic and predictive capacity of the Spanish versions of both instruments.

Screening for intimate partner violence during pregnancy: a test accuracy study.

BackgroundIntimate partner violence (IPV) against women is a serious health problem that affects pregnancy more frequently than other obstetric complications usually evaluated in antenatal visits. We aimed to estimate the accuracy of the Women Abuse Screening Tool-Short (WAST-Short) and the Abuse Assessment Screen (AAS) for the detection of IPV during and before pregnancy.MethodsConsecutive eligible mothers in 21 public primary health antenatal care centres in Andalusia (Spain) who received antenatal care and gave birth during January 2017–March 2019, had IPV data gathered by trained midwives in the first and third pregnancy trimesters. The index tests were WAST-Short (score range 0–2; cut-off 2) and AAS (score range 0–1; cut-off 1). The reference standard was World Health Organization (WHO) IPV questionnaire. Area under receiver operating characteristics curve (AUC), sensitivity and specificity with 95% confidence intervals (CI) were estimated for test performance to capture IPV during and before pregnancy, and compared using paired samples analysis.ResultsAccording to the reference standard, 9.5% (47/495) and 19.4% (111/571) women suffered IPV during and before pregnancy, respectively. For capturing IPV during pregnancy in the third trimester, the WAST-Short (AUC 0.73, 95% CI 0.63, 0.81), performed better than AAS (AUC 0.57, 95% CI 0.47, 0.66, P = 0.0001). For capturing IPV before pregnancy in the first trimester, there was no significant difference between the WAST-Short (AUC 0.69, 95% CI 0.62, 0.74) and the AAS (AUC 0.69, 95% CI 0.62, 0.74, P = 0.99).ConclusionsThe WAST-Short could be useful to screen IPV during pregnancy in antenatal visits.

Clinical Predictors of Engagement in Teleintegrated Care and Telereferral Care for Complex Psychiatric Disorders in Primary Care: a Randomized Trial

BackgroundTelepsychiatry Collaborative Care (TCC) and Telepsychiatry/Telepsychology Enhanced Referral (TER) expand the reach of specialty mental health services to underserved populations.ObjectiveAssess clinical predictors of treatment engagement for complex psychiatric conditions in TCC—in which remote specialists consult with primary care teams via an onsite care manager who also provides brief psychotherapy—and TER, in which remote specialists provide direct telehealth treatment.DesignA randomized pragmatic trial from twenty-four primary care clinics without onsite psychiatrists or psychologists.ParticipantsA total of 1,004 adult patients screened positive for posttraumatic stress disorder (PTSD)and/or bipolar disorder were randomized to receive TCC or TER for 1 year.Main MeasuresPsychotherapy engagement was measured by the number of sessions completed, and pharmacotherapy engagement by the medication adherence item from the Schizophrenia Care and Assessment Program Health Questionnaire (SCAP-HQ).Key ResultsEngagement in TCC psychotherapy visits was greater compared to TER. There was no association between the PTSD symptom severity and treatment engagement. The internal state scale (ISS) activation subscale, an indicator of mania, was associated with reduced odds of initiating psychotherapy (odds ratio [OR] = 0.70; 95% CI, 0.59 to 0.84) but not the number of sessions attended once psychotherapy started. The Drug Abuse Screening Test-10(DAST-10) score was associated with receipt of fewer psychotherapy sessions (incidence ratio rate [IRR] = 0.88; 95% CI, 0.81 to 0.95). The number of physical health comorbidities was associated with greater engagement in psychotherapy (IRR = 1.11, 95% CI, 1.03 to 1.19) and pharmacotherapy (OR = 1.54; 95% CI, 1.27 to 1.87). None of the findings varied by intervention group.ConclusionsBoth teleintegrated and telereferral care offer an opportunity to treat patients with complex psychiatric conditions. While there was no difference in clinical characteristics predicting engagement, onsite care managers engaged patients in more psychotherapy sessions than remote therapists.Trial RegistrationClinicalTrials.gov Identifier: NCT02738944

Sleep, substance misuse and addictions: a nationwide observational survey on smoking, alcohol, cannabis and sleep in 12,637 adults.

For a good night's sleep, we consensually recommend avoiding alcohol, smoking and drugs. However, these addictions are highly prevalent in the general population, and it is difficult to estimate their real impact on sleep. The aim of this study is to clarify the association between sleep habits and disorders, and addictions. The design was a telephone crossover national recurrent health poll survey (Santé publique France, Baromètre santé, 2017; Questionnaire, pp. 53; Saint Maurice) in a representative sample of French adults. There were 12,367 subjects (18-75years old) who answered the survey. Sleep log items assessed sleep schedules (total sleep time) on work and leisure days: at night, while napping, and over 24hr using a sleep log. Retained items include: (1) short sleep (≤ 6hr/24hr); (2) chronic insomnia (International Classification of Sleep Disorders, 3rd edition criteria); and (3) chronotype (evening-morning-neutral). Psychoactive substances retained included tobacco (current or former users), alcohol (daily consumption and weekly binge drinking), cannabis (Cannabis Abuse Screening Test), and other drugs (consumption during the past year). We found that: (1) daily smokers (lightly or heavily dependent) were more frequently short sleepers than occasional smokers and non-smokers; (2) heavily dependent daily smokers were more likely to suffer from insomnia than other smokers or non-smokers; (3) short sleep and insomnia were not significantly associated with the consumption of alcohol, cannabis or any other drug; (4) the evening chronotype was significantly associated with the consumption of tobacco, alcohol and cannabis. In conclusion, our study highlights significant relationships between the use of psychoactive substances and sleep characteristics among adults, emphasizing the need to take into account each subject individually.

Effects of Early Life Adversity on Pubertal Timing and Tempo in Black and White Girls: The National Growth and Health Study.

Although exposure to abuse in early life predicts earlier pubertal timing, especially for girls, it is unclear if this association generalizes to nonabuse stressors. In addition, the impact of race on the stress-maturation association remains unknown. To address these issues, we examined whether race moderates the effects of early adversity on pubertal timing and tempo using a longitudinal study design. In a cohort of 9- and 10-year-old Black and White girls, pubertal (areolar and pubic hair) maturation was assessed annually for 7 years. In adulthood, 368 participants (186 Black, 182 White) reported on abuse and nonabuse stressors they experienced from ages 0 to 12 years. Early life abuse was associated with earlier pubertal timing, as indexed by younger age at menarche (b = -0.22, p = .005, 95% confidence interval [CI] = -0.39 to -0.06) and greater pubic hair development (b = 0.11, p = .003, 95% CI = 0.04 to 0.18), in addition to slower pubertal tempo, as indexed by slower rate of pubic hair (b = -0.03, p < .001, 95% CI = -0.05 to -0.01) and areolar (b = -0.02, p = .02, 95% CI = -0.03 to -0.003) development. These associations were not found for nonabuse adversity. Black girls with early life abuse had greater pubic hair development (b = 0.23, p < .001, 95% CI = 0.12 to 0.35) and were slower in pubic hair tempo (b = -0.07, p < .001, 95% CI = -0.09 to -0.04) than their White counterparts. Screening for early life abuse may help address health disparities related to earlier pubertal timing.

Screening Tools for Child Abuse Used by Healthcare Providers: A Systematic Review.

The early detection of child abuse is essential for children at risk. Healthcare professionals working at hospitals and in the community are often the first to encounter suspected cases of child abuse. Therefore, an accurate identification of child abuse is critical for intervention. However, there is no consensus on the best method to screen for child abuse. This systematic review was designed to evaluate the relevant psychometric properties and critically appraise the methodological quality of child abuse screening tools used by healthcare providers with children less than 18 years old. We searched the Cochrane Library, MEDLINE, Embase, CINAHL, Education Resources Information Center, PubMed, Airiti Library, and OpenGray databases for studies on screening tools used to identify abuse in children published through October 2019 in English or Chinese. Information regarding populations, assessment methods, and accuracy parameters were extracted. Study quality was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments checklist and Grading of Recommendation, Assessment, Development, and Evaluation criteria. Nine hundred thirty-nine abstracts and 23 full-text articles were reviewed for eligibility, and 15 screening tools for child abuse used by healthcare providers were identified. Screening tools often assess the presence of more than one form of abuse, but no single tool covered all forms. Of these, 10 tools screened for a single, discrete type of abuse, including nine physical abuse screening tools (three abusive head trauma tools) and one sexual abuse tool. Eighty percent (n = 12) of the screening tools had a moderate-to-high quality of evidence based on the Grading of Recommendation, Assessment, Development, and Evaluation criteria. However, none of these screening tools achieved an adequate level of evidence based on the COnsensus-based Standards for the selection of health Measurement INstruments checklist. In this systematic literature review, 15 assessment tools of child abuse used by healthcare providers were identified, of which nine screened for physical abuse. Screening tools must be valid, succinct, user-friendly, and amenable for use with children at every point of care in the healthcare system. Because of the paucity of informative and practical studies in the literature, findings related to the quality of child abuse screening tools were inconclusive. Therefore, future research should focus on the use of screening tools in the healthcare system to identify effective screening interventions that may help healthcare providers identify child abuse cases as early as possible.

Prevalence and Screening of Tobacco and Substance Abuse among patients visiting Emergency Department

Aim: To prevalence and screening of tobacco and substance abuse among patients visiting emergency. Methods: This is a cross-sectional study conducted in the emergency department of Usman Memorial Hospital, Karachi during the period of Jan, 2020 to June, 2021. In the 18 months of study, we included patients visiting to our emergency department due to any acute complaint who is older than 18 years of age. All the participants were to be asked National Institute of Drug Abuse (NIDA) quick screen and tobacco addiction screening was done by CAGE questionnaire. Data was collected and analyzed using SPSS version 2. Results: During the 18 months’ time, we received 642 patients matching our inclusion criteria for this study. Out of these 371(59.4%) participants agreed to participate in the study whereas the 40.6% refused to enter the study. Out of these there were 242(65.2%) males and 129(34.7%) females in the study sample. All these participants were asked the single screen question for drug use and 178(47.9%) of the participants have used an illegal drug or prescription drugs for non-medical reason. Among the total 194 participants who smoke currently there were 146(75.2%) participants with positive CAGE modified results suggests nicotine dependence. Conclusion: The above study suggests that substance abuse/misuse of prescription drugs and nicotine dependence is common in our population and awareness regarding smoking cessation and drugs use is needed. Screening of individuals at emergency department is an efficient method for identifying severe cases and provide them proper medical help. Keywords: Tobacco, Nicotine, Smoking.

Analysis of the relationship between school bullying, cyberbullying, and substance use

The use of alcohol and other substances among underage adolescents continues to cause social concern nowadays, but it is not the only challenge that professionals face while working with this population. School bullying and cyberbullying remain another main issue affecting the well-being and development of the students. The main objective of the present study was to analyse the possible relationship between both school bullying and cyberbullying with substance use. A selective methodology was used, administering a survey among students from state funded Secondary schools in the Autonomous Community of Galicia (Spain), and obtaining a sample of 3,173 adolescents aged 12 to 17 years. The questionnaire included items referring to the consumption of several substances, specific screening scales for the evaluation of risky consumption (Alcohol Use Disorders Identification Test, Cannabis Abuse Screening Test and CRAFFT Abuse Screening Test) and validated multi-item scales to assess school bullying and cyberbullying involvement (European Bullying Intervention Project Questionnaire and European Cyberbullying Intervention Project Questionnaire). The results showed that the most consumed substances were alcohol, tobacco and cannabis, finding also high risky consumption rates. Adolescents involved in either school bullying or cyberbullying in any role (victims, perpetrators and bully-victims) presented significantly higher rates in the consumption habits and risky consumptions analysed. These results highlight the need for a comprehensive prevention approach that addresses both school bullying, cyberbullying, and addictions at the same time.

Positive Urine Drug Screens and External Mortality in Teenagers Who Present for Medical Care.

Objective: To examine whether a positive urine drug of abuse screen in youth who receive medical care is associated with subsequent risk of external mortality (eg, overdose, suicide, homicide, accident).Methods: This was a population-based retrospective cohort study of all Olmsted County (Minnesota) residents who were 13-18 years of age at the time of urine drug screen (UDS) testing (January 1, 1999, to November 28, 2012). Cox regression models were used to examine the relationships between having a positive UDS and external mortality, adjusted for sex, race, age, alcohol exposure, psychiatric diagnoses as defined by the International Classification of Diseases (ICD-9/ICD-10), and medical setting of UDS testing. Separate analyses were done for (1) overall UDS results, (2) tetrahydrocannabinol (THC), and (3) cocaine.Results: Of the 2,772 teenagers included in this study (47.2% male), a total of 26 died of external causes during a median follow-up period of 11.8 years. Testing positive for any illicit substance was not associated with significantly increased risk of external mortality (hazard ratio [HR] = 1.9; 95% CI, 0.9-4.2). Testing positive for cocaine was associated with significantly increased risk of external mortality (HR = 7.0; 95% CI, 1.9-25.0). Testing positive for THC was associated with a marginally significantly increased risk of external mortality (HR = 2.1; 95% CI, 1.0-4.7); however, when cocaine was added as a covariate in the analysis, the relationship between THC-positive UDS and mortality was still elevated but was no longer statistically significant (HR = 1.8; 95% CI, 0.8-4.1).Conclusions: History of cocaine-positive UDS may help identify a population of young people who are at high risk of premature death.

Cross-sectional survey of underreported violence experienced by adolescents: a study from Indonesia

BackgroundGlobal studies on adolescent victims of violence require serious attention due to the possibility that underreported cases may be higher than official records indicate. Since Indonesia expects to witness a demographic bonus, extensive research is needed to strengthen early detection, case handling, and prevention. Here, we report the outcomes of a survey on physical, verbal, and sexual violence experienced by adolescents in West Java, an Indonesian province inhabited by 18% of the country’s total population.MethodsWe conducted a cross-sectional survey in 2017 using the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool for Children (ICAST-C) questionnaire for detecting child abuse; an expert panel translated, simplified, and validated it based on a theoretical framework that combines paediatrics, public health, and medicolegal perspectives. We aimed to cover a large sample size and explore three types of violence (physical, verbal, and sexual) that have high evidentiary value in the forensic context. The respondents were adolescents in the first and second grades of middle school (12 to 14 years old) and high school (15 to 17 years old) in seven cities/municipalities in the province, selected through several stages of simple random sampling (N = 3452). We analysed the samples through univariate (percentage), odds ratio (OR), comparison, correlation, and correspondence analyses.ResultsThe results showed that 78.7% of the adolescents experienced violence in 2017, comprising those who encountered at least one incidence of physical violence (43.1%), verbal violence (12.2%), and sexual violence (4.5%). Data overlap includes 14.3% who experienced one type of violence in 2017, 7.4% who experienced two forms of violence, and 1.4% who underwent all three kinds of violence. The offenders were mainly adolescents across all types of violence, except for being forced to engage in sexual intercourse. Several victims of sexual violence did not state who the offenders were. Further, several characteristics showed a higher chance of experiencing violence than other characteristics, especially for adolescents who were still in middle school and those who lived only with their mothers. Correspondence analysis suggested subtle differences between characteristics.ConclusionWe expect this study to help identify risk and protective factors that are essential to strengthening early detection efforts, decisive medicolegal examinations, case handling, and policy-making.

Prevalence and clinical implication of adverse childhood experiences and their association with substance use disorder among patients with schizophrenia

BackgroundAdverse childhood experiences (ACEs) and substance use disorder (SUD) are well-known risk factors for psychosis and dramatically affect schizophrenia. In this research, we aimed to measure the prevalence of adverse childhood experiences and substance use disorder in patients with schizophrenia and assess the effect of ACEs on the clinical presentation and overall functioning and the association between them and SUD in patients with schizophrenia. A cross-sectional study included a random sample of 165 schizophrenic patients who were examined by doing drug screen in urine, structured questionnaire to collect Socioeconomic characteristics, history of schizophrenia, structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders-fifth edition, Positive and Negative Syndrome Scale (PANSS), Adverse Childhood Experiences International Questionnaire (ACE-IQ), World Health Organization Disability Assessment Schedule 2.0, compliance rating scale, addiction severity index fifth edition (ASI) for individuals with positive urine drug screen.ResultsOnly 14.4% of the studied patients had no adverse childhood experiences. The prevalence of positive substance abuse screening was 18.2%. There were statistically significant negative correlations between total ACE score and educational level, socioeconomic level, and the onset of schizophrenia. On the other hand, statistically significant positive correlations were found between the total ACE score and PANSS score and ASI score. The first most frequent ACE was significantly associated with female gender, lower education levels, low and middle socioeconomic classes, lifetime substance use, smokers, and positive drug screening. Emotional neglect and contact sexual abuse were significantly associated with positive drug screening. At the same time, Physical abuse was significantly associated with both lifetime substance use and positive drug screening.ConclusionThe current study’s findings indicate that childhood adverse experiences and substance abuse are prevalent problems in patients with schizophrenia. Given that there is an association between both issues, they may affect the symptomatology of the disorder, the prognosis, and the therapeutic plan. It is advised that a greater emphasis on and identification of childhood trauma and drug use disorder may be a necessary step in assessing patients with schizophrenia.

Personal and Social Consequences of Psychotropic Substance Use: A Population-Based Internet Survey.

Background and objectives: Drug abuse has become a major worldwide health concern among all age groups. The present study analyses substance misuse and its social and personal consequences using a population-based internet survey in Spain. Materials and Methods: Screening for drug abuse (of alcohol, marijuana/hashish and psychostimulants) and its related risks and problems was performed using the Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) score. Socio-demographic factors, depressive, anxiety and stress symptoms as well as health habits were also evaluated. We used Linear regression methods to compare each variable’s individual contribution so as to determine which one best explains the results. Results: In this population-based study, 1224 people completed and returned the online survey. Of all participants, 57% reported consuming at least one substance based on the CRAFFT scale. While increasing age reduces the probability of personal and social consequences of consumption, people who smoke receive up to three times more (OR = 3.370) recommendations from family and friends to reduce their consumption. As for the type of substance, the consumption of marijuana increases the risk of forgetting (OR = 2.33) and the consumption of other psychostimulant substances almost triples the risk of consuming alone (OR = 2.965). Combining substances can increase the rate of driving a vehicle after consumption by 3.4 times. Conclusions: Although age, smoking and the type of substances used increase the risk of suffering from social and personal consequences of the use or abuse of substances, future studies are needed to determine the influence of new variables as a potential tool for treating and minimizing the adverse consequences of drug abuse.

Child behavior and psychological comorbidities in relation to different forms of child abuse among working children

Background Childhood labor exposes children to the risk of violence and abuse that may adversely affect their psychological well-being.Aim To explore psychological comorbidities and their relation to different forms of abuse among labored children and identify risk factors for exposure to abuse in working children.Patients and methods This cross-sectional study included 158 male working children aged 12–17 years. Sociodemographic data, education level, and type of work were collected. The type of abuse was categorized into physical, emotional, and sexual abuse using the International Child Abuse Screening Tool (children’s version institution questionnaire). Social competence and behavioral problem assessment was done using the Child Behavior Checklist (the youth self-report). Regression analysis to determine predictors of abuse among working children was done.Results About 59.5% of included children were exposed to at least one type of child abuse last year, 75% reported exposure during work time. The commonest form was psychological, followed by physical abuse, and last, sexual abuse. Social competence was impaired in abused children, regardless of the type of abuse. Behavioral problems were significantly higher in children exposed to physical and sexual abuse. Younger age (odds ratio 4.09; 95% confidence interval 1.03:16.18) and working in small industrial shops (odds ratio 3.28; 95% confidence interval 1.40:7.71) were risk factors for abuse exposure in working children.Conclusion Working children at higher risk for child abuse adversely affect their social competence and increase their behavioral problems.

A cross-sectional study of substance use in patients with schizophrenia hospitalized for relapse at the Ar-Razi Psychiatric Hospital in Salé, CHU Ibn Sina Rabat, Morocco.

Introductionsubstance use disorders are becoming increasingly common among schizophrenic patients and often raise problems in their care. This work aims to assess the rate and level of substance use in schizophrenic patients hospitalized for relapse and to identify factors associated with this comorbidity.Methodswe conducted a cross-sectional study of 115 patients with schizophrenia selected by convenience sampling in the Psychiatric Hospital of Salé. A questionnaire was used to collect socio-demographic data, evolutionary and prognostic criteria of the disease. Tobacco use was assessed with the fagerström test for nicotine dependence (FTND), cannabis use was assessed with the cannabis abuse screening test (CAST) and alcohol use was assessed with the alcohol use disorders test (AUDIT).Resultsthe results showed that tobacco was the most consumed substance, followed by cannabis and alcohol. Certain factors such as gender (P<0.016) and family smoking history (P<0.045) were significantly associated with the scale (FTND). Other factors such as social life (P<0.05) and the educational level (P<0.004) showed a significant association with CAST. Only a history of suicide attempts was significantly associated with the scale (AUDIT).Conclusionthe results confirm that the majority of schizophrenic subjects are psychoactive substance users and that a good number of them are dependent on substances. Early outpatient follow-up in specialized drug treatment centers could improve the health status of these patients.

Tell me who your friends are?! The mediating role of friends' use in cannabis abuse.

Objectives To evaluate the relationship between age at onset of cannabis use and cannabis abuse in a sample of Portuguese cannabis users, testing the mediating role of the number of friends using cannabis and comparing these relationships between male and female subsets.Method A sample of 529 Portuguese cannabis users comprising 276 males and 244 females aged from 14 to 21 years completed a sociodemographic questionnaire, the Cannabis Abuse Screening Test (CAST), and answered four questions related to cannabis use. Data were analyzed using the PROCESS macro in SPSS version 26.0.Results Age at onset of cannabis use was negatively related to the number of friends using cannabis, while the number of friends using cannabis had a positive relationship with cannabis abuse. As predicted, the number of friends using cannabis seems to have a mediating role in the relationship between cannabis onset age use and cannabis abuse, since the indirect effect was found to be significant. The pattern of the relationships among the variables observed was found to be similar for both male and female subsets of the sample. However, males reported higher cannabis abuse than females.Conclusion The results highlight the mediating role of friends’ use of cannabis in the relationship between age at onset of cannabis use and users’ abuse. These results highlight the importance of early intervention in cannabis use. In particular, the pattern of the relationships observed among the studied variables emphasizes the need to monitor and conduct peer training interventions or interventions to promote of social skills.