Alcohol Rehabilitation Research Articles

Understanding the perspectives of police officers regarding men who use drugs and drug rehabilitation in China: a qualitative study

ABSTRACT Background: Drug use among men is a significant public health concern in China, with compulsory drug treatment centers being the primary approach. Police officers in these centers play a crucial role in shaping the interactions and experiences of men who use drugs (MWUD). However, little research exists on the attitudes of police officers toward MWUD in China. Objectives: This qualitative study aimed to explore the attitudes of police officers toward MWUD and drug rehabilitation approaches in China. Methods: Semi-structured individual interviews were conducted among 23 police officers recruited from two compulsory drug treatment centers in Jiangsu Province, China. Of the participants, two were females and 21 were males. Thematic analysis was employed to analyze the data. Results: Three key themes emerged: 1) Multifaceted perspectives on MWUD. Participants viewed MWUD as offenders, victims, and patients. 2) Dynamic interactions with MWUD. Relationships were characterized as either adversarial or supportive, influenced by participants’ personalities, experiences, beliefs, workload, and psychological training. 3) Advocating for punitive measures in drug rehabilitation. While the participants generally favored strict penalties for MWUD, they acknowledged the value of community-based rehabilitation. Concerns about social stigma, privacy, motivation, and the costs of voluntary rehabilitation tempered their support. Conclusions: The study highlights the importance of raising awareness and challenging bias among police officers. It emphasizes the need for psychological training to enhance their capacity to provide humane care and foster positive interactions with MWUD. Additionally, ensuring access to affordable, accessible, and stigma-free voluntary rehabilitation is crucial for effective drug rehabilitation efforts.

Endogenous Ethanol Production in the Human Alimentary Tract: A Literature Review.

Endogenous ethanol production, or auto-brewery syndrome (ABS), is a rare condition of the human alimentary canal that results in intoxication without alcohol consumption. Despite its clinical significance, ABS remains largely undiagnosed because of a lack of awareness among clinicians. Published cases have reported extensive biopsychosocial comorbidities accompanying delayed diagnosis and incomplete management; these include social rejection and family separation, court-ordered alcohol rehabilitation and psychiatric admission, legal and employment ramifications, and deteriorating mental health and suicidality. In this mini review, we aim to educate and enlighten clinicians by discussing literature findings pertaining to the pathophysiological mechanisms of gut dysbiosis due to overgrowth of Saccharomyces cerevisiae, E. coli and Klebsiella, impaired intestinal barrier function, and dysregulation of the hypothalamic-pituitary-adrenal axis. Furthermore, we discuss recently discovered associations with sleep quality and mood disorders and explore the medical sequelae of metabolic dysfunction-associated fatty liver disease and metabolic dysfunction-associated steatohepatitis. Drawing on these data, we propose protocols for initial care in the emergency room, subsequent critical care, diagnostic testing with glucose challenge testing, and definitive microbiological testing during the acute phase of illness. We also present an empirical treatment outline while awaiting confirmation of causative organisms and sensitivities.

Is living close to a drug treatment centre associated with stigma?

Multiple studies have documented stigma towards people who use drugs, but a less well studied aspect of stigmatisation is the phenomenon known as "not in my backyard," The aim of this study was to analyse the relationship between living near a drug treatment centre and the degree of perceived public stigma, as well as to identify differences among sociodemographic profiles. Based on the Barcelona Health Survey (N=3270), public stigma was defined as scores at or above the 66th percentile of an index of 2 questions on the general population's perceptions of people who use drugs as failures and as dangerous (Cronbach's alpha = 0.84). Survey participants were categorised into 3 areas based on their proximity to a drug treatment centre: in a buffer within 150 metres, between 150 and 300-metres, and the rest of the city. Logistic regression models were used to evaluate the association between perceived public stigma and spatial proximity to a drug treatment centre, as well as variations among sociodemographic profiles. Living within 150 metres of a drug treatment centre increased the probability of perceived public stigma (odds ratio=1.85 95%CI 1.12-3.07). At the city level, higher public stigma was associated with the older population, those with a lower educational level, and those born in a low-income country. However, the increase in public stigma within the 150-metre buffer was driven by groups that showed low levels of stigma at the city level. Public stigma in the city is high and increases with proximity to a drug treatment centre, especially among groups that exhibit low levels of stigma at the city level. Identifying social groups showing high levels of "not in my back yard"-related stigma may help to redesign harm reduction interventions focusing on specific groups.

"When she's there, I no longer worry about her being arrested"-Family perspectives on compulsory drug rehabilitation in Vietnam and implications for community-based services.

Compulsory drug rehabilitation continues to be a major governmental response to illicit drug use in East and Southeast Asia despite repeated calls for its discontinuation. Extensive evidence from individuals with substance use disorders and advocacy groups highlights the adverse health, social and economic outcomes associated with compulsory drug rehabilitation. However, the perspective of families on this issue remains relatively unexplored. Between April 2020 and August 2022, we conducted in-depth interviews in three major cities in Vietnam with 20 family members of people who recently returned from or were about to leave compulsory drug rehabilitation centers. Interviews explored how compulsory rehabilitation met the needs of families, how effective families perceived compulsory rehabilitation was and what families' needs or concerns that remained unmet. Compulsory drug rehabilitation centers, despite their recognized limitations, were perceived as the last resort for family members after multiple failed attempts to protect their loved ones from the consequences of drug use and to relieve themselves from constant drug-related stress. Family members considered the effectiveness of compulsory rehabilitation to be the short-term improvements in the health and mood that their loved ones exhibited while in the centers. However, families predominantly worried about the risk of relapse after release and employed three main strategies consisting of conditional support, employment and close monitoring to prevent it. The support available to families to support recovery at post-release was severely limited. The study underscores the urgent need to alleviate the burden of drug use on families affected by substance use disorders. It is imperative to develop community-based and evidence-based rehabilitation options for PWUD and supportive services for their families.

Application of life history theory to explain the association between childhood maltreatment and adulthood sleep problems in Chinese men with drug abuse: multiple mediating roles of emotion regulation, future-oriented coping, and anxiety

ABSTRACT Background: Despite the practical importance of addressing the drug user’s sleep problems to enhance the efficacy of treatment and rehabilitation, little is known about whether and how history of childhood maltreatment relates to this issue. This study takes an evolutionary perspective to investigate the associations between history of childhood maltreatment and sleep problems in adults with drug abuse via their emotion regulation difficulties, future-oriented coping, and anxiety. Methods: Participants were 604 male adults with drug abuse between the ages of 18–58 years (M = 36.20, SD = 8.17) in a drug rehabilitation centre in China. In addition to bivariate correlation analysis, path analysis was conducted to examine goodness-of-fit of the conceptual model, controlling for the effect of demographic characteristics. Results: Thirty-two percent of participants (n = 194) reported poor sleep quality (PSQI > 5), whereas sleep disturbance (81.3%), daytime dysfunction (77.3%), and sleep latency (66.5%) were the three most common problems among them. Correlation analysis supported the hypothesised positive correlations between poor sleep quality and childhood maltreatment, emotion regulation difficulties, and anxiety, and a negative correlation with future-oriented coping. Results of path analysis showed a significant indirect effect of childhood maltreatment on sleep problems via both emotion regulation difficulties and anxiety, whereas such effects via both future-oriented coping and anxiety were statistically nonsignificant. Conclusions: The findings suggest life history theory is applicable to understanding drug users’ sleep problems, and interventions regarding both emotion regulation difficulties and anxiety can lessen the risk posed by childhood maltreatment on sleep problems.

Factors associated with attention deficit hyperactivity disorder symptoms among patients with substance use in Malaysia.

Attention deficit hyperactivity disorder (ADHD) often coexists with substance use disorders (SUDs). This study aimed to determine factors associated with ADHD symptoms among adults with SUDs in Malaysia. Patients aged ≥18 years with a ≥1-year history of substance use who were admitted to any of the three drug rehabilitation centres in urban Malaysia for >1 month were invited to participate. Participants were interviewed using the Malay version of the Alcohol, Smoking and Substance Involvement Screening Test to assess substance use and the Malay version of the Adult ADHD Self-Reporting Scale to assess ADHD symptoms. The prevalence of adult ADHD symptoms among participants with SUDs was 47.2%. Compared with participants without ADHD, a lower proportion of participants with ADHD had medical comorbidities (84.9% vs 93.3%, p = 0.018), whereas a higher proportion of participants with ADHD symptoms had a history of imprisonment (80.8% vs 65.6%, adjusted p = 0.018) and first imprisonment before the age of 18 years (24.6% vs 16.8%, adjusted p = 0.048). A high proportion of adults undergoing rehabilitation for SUDs have ADHD symptoms. Screening and interventions for ADHD should be integrated into SUD rehabilitation programmes.

The Impact of Clinical Rotation in Addiction Treatment Centers (AMATEM) on Attitudes and Behaviors of Psychiatry Residents Toward Individuals with Addiction

Aim: Psychiatry residents often feel unprepared and may exhibit negative attitudes toward individuals with substance use disorders, which can undermine treatment access and outcomes. This study examined the impact of a three-month Alcohol and Drug Treatment Center (AMATEM) rotation on residents’ attitudes and explored factors influencing these attitudes. Material and Method: Ninety-one psychiatry residents who applied for a three-month rotation training on addictions at Ankara Training and Research Hospital AMATEM Clinic completed a personal information form and the Attitudes and Behaviors Toward Substance Users Scale at the start and end of the rotation. Results: Residents’ stigmatizing attitudes significantly decreased post-rotation. Those who felt unsafe before the rotation reported higher stigma scores, and residents who believed they needed more education had fewer negative attitudes initially. Paradoxically, participants who anticipated referring patients to AMATEM due to insufficient training showed increased stigma after completion of the rotation. Conclusion: Overall, structured, practical, and case-based training—delivered under experienced supervision—can reduce negative attitudes and help residents feel safer. Further research should clarify how specific training processes influence the knowledge, attitudes, and beliefs of future psychiatrists regarding substance use disorders.

Reading comprehension evaluation by means of the neuropsi assessment tool in patients attending “alcoholics anonymous” due to alcohol consumption

Alcohol drinking negatively affects the reading skill. The article addresses the prevalence of reading difficulties in alcohol rehabilitation patients by applying the neuropsychological assessment tool NEUROPSI. Methodology: non-experimental, exploratory, and observational study based on the Neuropsychological assessment tool NEUROPSI in Spanish (brief version). Findings: In a sample of 20 participants, the results indicate that only 40% fall within the normal values, whilst 60% exhibit low scores in reading comprehension, concentration, and attention. Lastly, 60% of the participants presented alterations in neurocognitive functions, with 25% indicating moderate alterations, 20% revealing severe alterations, and 15% exhibiting mild alterations.

SHADOWS OF BIRTH ORDER: AFFECTIVE TEMPERAMENT, PERCEIVED PARENTAL ATTITUDES, AND SUBSTANCE USE DISORDERS

Aim: In personality development temperamental traits, along with parental attitudes and birth order play a crucial role. These factors—temperamental traits, birth order, perceived parental attitudes—can influence substance use and its continuation. This study aims to explore the relationship between Adler's birth order theory, temperamental traits and perceived parental attitudes in the context of substance use disorders (SUDs). Material and method: The study included 37 SUD patients from XXX Hospital's Alcohol and Drug Treatment Center and 37 siblings without substance use. Participants temperamental traits and parental attitudes were assessed using the Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire (TEMPS-A) and the Short Form of the Perceived Parental Attitudes Scale-Child Form (s-EMBU). Independent samples t-test, one-way analysis of variance, Spearman correlation coefficient, and binary logistic regression analysis were used in data analysis. Results: Individuals with SUD had significantly higher depressive, cyclothymic, irritable, and anxious temperaments than their siblings (p < 0.05), and these traits were linked to perceived rejecting parental attitudes. Birth order analysis showed higher cyclothymic temperament in the first and last children. However, contrary to our hypotheses, no relationship was observed between birth order and perceived parental attitudes in any groups. According to regression analysis, individuals who were last-born had a 5.34 times higher likelihood of developing SUD compared to others. Conclusion: Assessing challenges based on birth order can aid in providing effective addiction treatment services. Our study found a link between perceived parental attitudes and temperamental traits, but not with birth order. This suggests temperamental traits may moderate the effect of birth order on perceived parental attitudes. Given the strong link between affective temperamental traits and rejecting parental attitudes, we recommend implementing behavioral parent training programs to reduce parental anger and hostility.

Impact of structured exercise interventions on health outcomes in drug rehabilitation patients: a comparative study of open and closed exercises

Background This study investigates the effects of open and closed exercise interventions on the physical and mental health of individuals undergoing substance use disorder (SUD). We examined changes in tendency of recurrence of use, vital capacity (VC), resting heart rate (RHR), sleep quality, and choice reaction time. Methods Conducted over six months at the drug rehabilitation center, 95 participants were randomly assigned to closed exercise, open exercise, or control group. Outcome measures were taken at baseline, three months, and six months. Results Both exercise groups showed significant improvements in reduction of return-to-use risk and VC compared to baseline. Open exercise groups showed earlier significant improvements in risk of return to use at three months. No significant changes were observed in RHR. Both exercise groups showed significant improvements in sleep quality, with the open exercise group also showing significant improvements in choice reaction time. At six months, both exercise groups showed significant improvements over the control group in tendency of recurrence of use, VC, and sleep quality, with no significant differences between the exercise groups. Conclusions Both exercise interventions led to significant improvements in reducing the risk of return to substance use, VC, sleep quality, and choice reaction time, with the open exercise group showing the most pronounced effects in choice reaction time.

Daily alcohol consumption among UK homeless people during COVID-19: a latent class and cross-sectional study

BackgroundAlcohol consumption and related issues among the homeless population are key public health concerns. The COVID-19 pandemic may have altered drinking patterns among homeless people. We aimed to examine the drinking patterns of homeless people and their association with housing status. Methods1129 participants (82·5% female) from the COVID-19 Homeless Rapid Integrated Screening Protocol (CHRISP) study reported their drinking behaviours (i.e, daily drinking, drinking after waking up, alcohol-related injury, and getting help to stop drinking) and their past housing status (e.g, rough sleeping, with family/friends, and prison). Latent class analysis (LCA) was used to assess the daily drinking patterns and multinomial logistic regression was used to explore the relationship between housing status and daily drinking patterns. FindingsThe prevalence of daily drinking was 14·3%. There were significant gender differences in alcohol-related injury and getting help to reduce/stop drinking (both p<0·05). The LCA identified an optimal three-class model: a high daily consumption group (Class 1, 7·6%), a low daily consumption group with alcohol-related injury (Class 2, 7·1%), and a low daily consumption group without negative consequences (Class 3, 85·3%). Using class 3 as the baseline, people who have lived in prison, as opposed to family/friends (reference group), were 8·6 times more likely to be classified into the high daily consumption group (Class 1). No significant drinking pattern differences were found between the reference group and other housing statuses. InterpretationThe prevalence of daily drinking among the UK homeless population during COVID-19 has been assessed for the first time. The findings suggest that different housing statuses are associated with different drinking patterns, and history of prison residence may reflect broader vulnerabilities or disadvantages. Authorities should enhance support for individuals leaving prison, including referrals and follow-up to alcohol and drug rehabilitation services. FundingNo funding was received in this study.

Mindfulness-based relapse prevention targeting psychological craving and trait mindfulness in young Chinese women with methamphetamine dependence: a randomized controlled trial.

We recruited 58 MA-dependent young adult females from a compulsory isolation drug rehabilitation center in Sichuan Province and randomly divided them into an MBRP group (n = 29) and a control group (n = 29) according to their degree of psychological craving. The MBRP group received 2 hours of MBRP training twice a week for 4 weeks, alongside routine treatment at the drug rehabilitation center. Meanwhile, the control group solely received routine treatment at the drug rehabilitation center without any additional interventions. The assessment was conducted before and immediately after the intervention, with the Compulsive Drug Use Scale (OCDUS) used to assess craving and the Five-Factor Mindfulness Scale (FFMQ) used to assess trait mindfulness. Also, a "mental feedback monitoring balance" instrument was used to assess concentration and relaxation during some training sessions. This randomized trial was conducted to evaluate the effectiveness of decreasing psychological craving and increasing trait mindfulness. At baseline, there were no significant differences in total or dimension scores for FFMQ or OCDUS between the two groups (all P > 0.05). After the intervention, the repeated measures ANOVA showed a significant time main effect on changes in observing, non-judging, and non-reacting scores (all P < 0.05), and a significant interaction effect between time and group on both FFMQ total score and OCDUS score (P < 0.01 or P < 0.05). Mental feedback monitoring indicated significant improvement in concentration and relaxation after breath meditation exercises (P < 0.05 or P < 0.001). Additionally, the MBRP group showed improved relaxation during the body scan exercise (P < 0.01). MBRP training can improve the trait mindfulness of MA addicts and reduce psychological cravings effectively.

Effect of Severity of Depression and Perceived Social Support on Suicidal Ideation among Patients Hospitalized with Substance Use Disorder

Objective: The aim of this study was to investigate the effects of perceived social support and depression on suicidal ideation in inpatients receiving substance abuse disorder treatment.&#x0D; Method: A total of 110 inpatients in an Alcohol and Drug Treatment Center were included in the study. A sociodemographic and clinical information form, Beck Depression Inventory, Suicidal Ideation Scale, and Multidimensional Perceived Social Support Scale were administered to all patients.&#x0D; Results: No significant correlation was identified between total social support score and suicidal ideation, whereas a weak negative but statistically significant correlation was found between social support from family and suicidal ideation scores (r=-0.231; p=0.016). The mean value of suicidal ideation was 2.22 in the non-depressed groupand 10.13 in the severely depressed group. We also found thatpatients whowere exempted from military service and those who had attempted suicide before had statistically significantly higher scores on the suicidal ideation scale.&#x0D; Conclusion: In patients diagnosed with substance use disorder, various factors may increase the risk of suicidal behavior. In particular, patients with insufficient social support, depressive symptoms, unable to carry out their military service and those who have attempted suicide before should be closely followed for suicidal ideation.

Impaction-Based Exhaled Breath Sampling for Substance Monitoring: A Prospective Pilot Study (DrugXhale).

For decades, intake monitoring of drugs using urine as the matrix of choice is the gold standard in drug treatment centers. A properly conducted urine drug test can identify recent use of prescribed, non-prescribed and illicit drugs. However, issues like adulteration, substitution and privacy issues have driven the search for alternative matrices. This prospective pilot study evaluates the use of an impaction-based breath sampling device, Breath Explor®, as an alternative to traditional urine-based drug monitoring. Breath samples were analyzed using a validated 32-component liquid chromatography-tandem mass spectrometry (LC-MSMS) method. Recovery data represent the efficiency of extracting the analytes from the breath devices. Both automated and manual processing of the Breath Explor® devices showed mean recovery rates ranging from 39.5% to 55.4% for the 32 analytes. Despite the small number of subjects, breath analysis proved to be a convenient and easy-to-use methodology. An overall kappa-values of 0.5 indicated a moderate level of agreement with urine analysis, underscoring its potential as a complementary diagnostic tool. All participants tested positive in their breath sample for methadone (70% methadone and 100% EDDP), while a significant portion (90%) tested positive for 6-monoacetylmorphine (6-MAM). This innovative approach offers several advantages, including non-invasiveness, reduced risk of adulteration, and the ability to perfom repeated automated sampling and confirmation testing. These findings suggest that breath-based substance monitoring could complement or even replace traditional urine-based methods in clinical practice.

Psychosocial well-being needs of alcohol/drug sufferers and therapeutic architectural solutions in rehabilitation centre, Nigeria: a cross-sectional study

Background In a rehabilitation centre designed for drug and alcohol recovery, the therapeutic environment may enhance the psychosocial well-being of sufferers and facilitate a speedy recovery. This study aims to investigate the psychosocial well-being needs (PWNs) of users in an alcohol and drug rehabilitation centre (ADRC) and how therapeutic architectural solutions (TASs) can promote a healing environment through design. Methods The study employed a mixed research method (qualitative and quantitative). The research strategy was a case study of four rehabilitation centres in Nigeria’s busiest cities; Lagos, Abuja, Port Harcourt, and Enugu. Data were collected via survey questionnaires, an in-depth interview guide, an observation guide, and a checklist of TACs in a healthcare facility. We first investigated what the PWNs of alcohol and drug sufferers (ADSs) are, then identified the therapeutic architectural components (TACs) of an ADRC, before determining what effect TACs have on the recovery process of substance abuse patients. Results The findings identify eight PWNs and nine TACs essential in an ADRC. The result indicates that TACs have a significant effect on the recovery process of ADSs. However, based on the study results, a framework (framework here refers to using an intelligent and sensitive conceptual design structure as a standard guide for the building archetype rehabilitation facility, which supports mental health service delivery) may be recommended for rehabilitation facilities with TASs for Substance Abuse Disorder (SUD). Conclusion The study result presents a correlation between ADSs’ recovery rates and a well-designed therapeutic environment. So, there is a need for evidence-based design (EBD) of rehabilitation centres with full compliments of a therapeutic architectural environment and integration of mental health services into routine care in sub-Saharan Africa. Limitations include that analyses were cross-sectional and thus may not deduce causal directions, and the authors based the result on self-report.

Diversion or death? The moral framework shaping bifurcated punishments for drug offences in Indonesia

Background As the UN urges states to move from harsh punishments for drug offences towards treatment programmes, Indonesia has adopted a bifurcated penal policy. Most of those convicted are sentenced to imprisonment or death, but some ‘minor’ offenders are diverted to drug treatment centres. We explore the moralities that shape drug policy, justice professionals’ interpretation and application of laws and policies, and judgements about who is deserving of diversion. Methods We draw on experiences and perceptions of 136 Indonesian criminal justice professionals, through in-depth qualitative interviewing and focus groups, to reveal the moral landscapes shaping policy and practice. Results Justice narratives blur penal concerns with moral judgments about drug offending, with normative responses shaping punishments in law and practice. While there is some compassion for ‘minor’ drug offenders, driving rationales for diversion, drug traffickers are regarded as morally deserving of prison and capital punishment, with traditionalist perceptions of harm amplified by a purgative rationale. Conclusion This article highlights the analytical potential of moralities such as ‘compassion’ and ‘traditionalism’ in criminal justice research and policy in Southeast Asia. Understanding the formation and navigation of these normative values may assist in challenging harsh penal policy in Indonesia and the wider region.

Pilot model of hepatitis C virus micro-elimination in high-risk populations in Hong Kong: Barriers and facilitators

BackgroundAlthough the general seroprevalence of hepatitis C virus (HCV) infection in Hong Kong is <0.5 %, Hong Kong is still striving for HCV elimination owing to barriers in care cascade encompassing linkage-to-care (LTC), treatment initiation and adherence. We aimed to evaluate the feasibility of a pilot model of micro-elimination to strengthen the HCV care cascade for high-risk groups in Hong Kong. MethodsWe initiated the pilot Conquering Hepatitis vIa Micro-Elimination (CHIME) program which adopts an integrated care approach involving outreach visits to halfway house or drug rehabilitation centers run by non-governmental organizations. Participants with history of injection drug use (PWID), recreational drug use, or imprisonment were included. We performed point-of-care test for anti-HCV with reflex HCV RNA testing. LTC with government-subsidized direct acting antiviral was provided to viremic participants. We compared the impact on the care cascade with a cohort of HCV patients (17.8 % PWID) under usual care. Results396 participants (62.9 % PWID) were screened and 187 (47.2 %) were viremic, of which 29.8 % had cirrhosis. Proportion with LTC, treatment initiation and adherence were 76.5 % and 63.7 %, 90.9 % and 85.8 %, and 90.0 % and 92.2 %, for the CHIME program and usual care, respectively. The CHIME program was significantly associated with higher odds of LTC (OR 1.797, 95 % CI 1.221–2.644). Non-engagement in care (affecting 37.9 % participants with HCV viremia) was associated with unemployment (OR 2.165, 95 % CI 1.118–4.190). ConclusionThe pilot CHIME program demonstrated feasibility of an integrated approach to consolidate the HCV care cascade in high-risk populations in Hong Kong.

Serological and molecular survey of rat hepatitis E virus (Rocahepevirus ratti) in drug users

ABSTRACT Rat hepatitis E virus (ratHEV) is an emerging cause of acute hepatitis of zoonotic origin. Since seroprevalence studies are scarce, at-risk groups are almost unknown. Because blood-borne infections frequently occur in people with drug use, who are particularly vulnerable to infection due to lack of housing and homelessness, this population constitutes a priority in which ratHEV infection should be evaluated. Therefore, the aim of this study was to evaluate the ratHEV seroprevalence and RNA detection rate in drug users as a potential at-risk population. We designed a retrospective study involving individuals that attended drug rehabilitation centres. Exposure to ratHEV was assessed by specific antibody detection using ELISA and dot blot (DB) assay and the presence of active infection by ratHEV RNA detection using RT-qPCR. Three-hundred and forty-one individuals were included, the most of them being men (67.7%) with an average age of 45 years. A total of 17 individuals showed specific IgG antibodies against ratHEV (4.6%; 95% CI; 3.1%–7.9%). One case of active ratHEV infection was identified (0.3%; 95% CI: 0.1%–1.8%). This was a 57-year-old homeless woman with limited financial resources, who had active cocaine and heroin use via parenteral route. In conclusion, we identified a potential exposure to ratHEV among drug users. Targeted studies in drug users with proper control groups are necessary to evaluate high-risk populations and transmission routes more accurately.

The Dark Triad and aggression among drug abstainers: a moderated mediation model of self-control and physical exercise

BackgroundDrug addiction is a significant public health concern, and aggression is common among people with drug addiction. Despite mounting evidence showing that the Dark Triad is a risk factor for aggression, the mediating and moderating mechanisms underlying this relationship are less known. This study tested the mediation effect of self-control in the association between the Dark Triad and aggression and whether this mediation was moderated by physical exercise.MethodsA cross-sectional study was conducted in two compulsory drug rehabilitation centers in Nanning, China. A convenience sample of 564 drug abstainers completed a questionnaire to assess their Dark Triad, self-control, aggression, and physical exercise levels. Mediation and moderation analyses were carried out in SPSS macro-PROCESS.ResultsSelf-control partially mediated the positive association between the Dark Triad and aggression. Physical exercise moderated the indirect effect of the Dark Triad on aggression via self-control, with the effect decreasing with the increase in physical exercise levels.ConclusionsThis study offers fresh insights into the underlying mediating and moderating mechanisms between the Dark Triad and aggression. The findings provide important practical implications for future intervention and prevention programs to address aggression among drug abstainers, which may be realized through strengthening self-control and physical exercise.

Sensitivity and specificity of Aboriginal-developed items to supplement the adapted PHQ-9 screening measure for depression: results from the Getting it Right study.

To determine the psychometric properties of an Aboriginal and Torres Strait Islander-developed depressive symptom screening scale. Prospective diagnostic accuracy study. Ten primary health care services or residential alcohol and other drug rehabilitation services in Australia that predominantly serve Aboriginal and Torres Strait Islander peoples. 500 adults (18 years or older) who identified as Aboriginal and/or Torres Strait Islander and were able to communicate sufficiently to respond to questionnaire and interview questions. Recruitment occurred between 25 March 2015 and 2 November 2016. Criterion validity of seven Aboriginal and Torres Strait Islander-developed items, using the adapted Patient Health Questionnaire 9 (aPHQ-9) and depression module of the Mini International Neuropsychiatric Interview (MINI) 6.0.0 as the criterion standards. The seven-item scale had good internal consistency (α=0.83) and correlated highly with the aPHQ-9 (ρ=0.76). All items were significantly associated with diagnosis of a current major depressive episode. Discriminant function and decision tree analysis identified three items forming a summed scale that classified 85% of participants correctly. These three items showed equivalent sensitivity and specificity to the aPHQ-9 when compared with the MINI-identified diagnosis of a current major depressive episode. Three items developed by and for Aboriginal and Torres Strait Islander people may provide effective, efficient and culturally appropriate screening for depression in Aboriginal and Torres Strait Islander health care contexts.