Reported Substance Use Research Articles

Treatment with aripiprazole once-monthly injectable formulation is effective in improving symptoms and global functioning in schizophrenia with and without comorbid substance use - a post hoc analysis of the ReLiAM study.

ReLiAM, Real-Life Assessment of Abilify Maintena, was the first reported long-term prospective non-interventional study for patients with schizophrenia treated with aripiprazole once-monthly injectable formulation (AOM) under real-life conditions. ReLiAM's primary aim was to evaluate the evolution of global functional status in patients treated with AOM for 12months in Canada. The objective of this post hoc analysis of the ReLiAM study is to investigate the treatment effects of real-life use of AOM over a 1-year period in the subgroup of patients with reported substance use compared with patients without substance use. The results of this post hoc analysis demonstrate that treatment with AOM for 12months in patients with schizophrenia was comparably effective in improving global functioning in subgroups of patients with and without concomitant substance use. These results support the use of AOM for the treatment of schizophrenia in patients with or without concomitant substance use. ClinicalTrials.gov NCT02131415, first posted on May 6, 2014. Overall trial status: Terminated.

Sexual Violence and Substance Use Diagnosed in Emergency Department Discharges in Hawaii, 2005–2014

Substance use (SU) and sexual violence (SV) present unique challenges when contextualizing their relationship due to underreporting of SU and SV. Both are significant public health concerns with a large magnitude and expense to the overall U.S. and to the state of Hawaii, which is identified as a high-intensity drug-trafficking area. Since substance users have a higher risk for sexual violence than the general public, this study aims to analyze the proportion and demographics of emergency department (ED) visit individuals reporting sexual violence with or without substance use disorder and examine how the number of ED visits of individuals diagnosed with SV and SU disorder compare to all individuals. Data from the Healthcare Cost and Utilization Project was used to examine the relationship between SV and SU. The database contained 3.5 million observations for 24 Hawaii hospitals from 2005-2014. The data was summarized in descriptive statistics and Chi-square tests were run to assess statistical significance for variables of interest. A greater proportion of individuals reporting sexual violence also reported substance use disorders compared to the general population of individuals. While 8% of all ED visits were related to SU, 17% of ED visits involving SV were also related to SU, demonstrating a statistically significant association between SV and SU. There is a greater need to further understand the complexity of the relationship between substance use and sexual violence. Sexual violence and substance use disorders share a complex relationship; survivors of sexual abuse may develop a substance use disorder, and those who use drugs and alcohol may be at an increased risk for sexual violence. Results from this study demonstrate visits for individuals reporting sexual violence have a greater proportion of substance use disorder than visits for the general population.

Substance Use and Adherence to Antiretroviral Therapy among People Living with HIV in the United States.

People with HIV (PWH) report substance use at higher rates than HIV-uninfected individuals. The potential negative impact of single and polysubstance use on HIV treatment among diverse samples of PWH is underexplored. PWH were recruited from the Center for Positive Living at the Montefiore Medical Center (Bronx, NY, USA) from May 2017-April 2018 and completed a cross-sectional survey with measures of substance use, antiretroviral therapy (ART) use, and ART adherence. The overall sample included 237 PWH (54.1% Black, 42.2% female, median age 53 years). Approximately half of the sample reported any current substance use with 23.1% reporting single substance use and 21.4% reporting polysubstance use. Polysubstance use was more prevalent among those with current cigarette smoking relative to those with no current smoking and among females relative to males. Alcohol and cannabis were the most commonly reported polysubstance combination; however, a sizeable proportion of PWH reported other two, three, and four-substance groupings. Single and polysubstance use were associated with lower ART adherence. A thorough understanding of substance use patterns and related adherence challenges may aid with targeted public health interventions to improve HIV care cascade goals, including the integration of substance use prevention into HIV treatment and care settings.

Prevalence and correlates of self-harm in a Southern California driving under the influence treatment setting

Background Suicide and driving under the influence of alcohol and other drugs are US public health epidemics. Research exploring the associations between driving under the influence and suicide presents a research gap. This study describes the prevalence and associations between demographic, alcohol and drug-related characteristics, depression, and self-harm (suicidal thoughts, behavior, and non-suicidal self-injury) among participants in a Southern California DUI Program. Methods Participants receiving driving under the influence treatment services (n = 1310) reported substance use, mental health and demographic data upon program intake between July 2019 and March 2020. A descriptive analysis was used to determine the prevalence of lifetime self-harm thoughts or behaviors. Bivariate analyses of associations between lifetime self-harm thoughts or behaviors and sociodemographic, alcohol, drug, and depression severity measures were explored. Manual backward elimination was used to obtain the final logistic regression model with variables statistically significant at p < 0.05 or had at least one category that was significant at p < 0.05 for non-dichotomous variables. For those reporting self-harm, a chart review extracted clinical themes to identify whether the driving under the influence event was reported as a deliberate suicide attempt. Results Ten percent (n = 135) of participants endorsed a lifetime self-harm history. Younger age, female gender, prior alcohol treatment, depressed mood, and family suicide history were significantly associated with self-harm. One individual reported the driving under the influence event as non-suicidal self-injury), and three reported it as a suicide attempt. Conclusion First- and multiple-time driving under the influence offenders represent a clinical population at increased risk for suicidal thoughts and behavior in need of specialized treatment referrals.

The impact of substance use on health care utilization, treatment, and outcomes in patients with non-small cell lung cancer.

Mortality from non-small cell lung cancer (NSCLC) has improved with screening and novel treatments. The substance use epidemic has threatened health outcomes in a variety of diseases, but little is known about how it is associated with NSCLC outcomes. We performed a retrospective cohort study of 211 patients with NSCLC treated at a safety-net hospital. Sociodemographic data and clinical outcomes were extracted via review of electronic medical records. Patients were stratified based on substance use status. Comparative and multivariable analyses were performed to evaluate baseline characteristics and lung cancer outcomes including survival. Among 193 patients (91.5%) with information available on substance use, 24.9% reported substance use; specifically, alcohol, marijuana, and illicit substances. Patients with substance use were more likely to have increased health care utilization and poor social determinants of health, including safe housing, stable employment, and social support. There were no significant differences in treatment adherence. Only 6.3% of patients with substance use did not receive guideline concordant care (GCC) compared to 24.8% of patients without substance use; due to poor performance status, increased comorbidities, or loss to follow up. On univariable analysis, patients with substance use experienced inferior median overall survival (OS) if they had metastatic disease (0.40 vs. 1.03 years, P=0.01). However, in the multivariable analysis, substance use did not predict for survival. Independent predictors of mortality were sex (male HR, 1.67; 95% CI: 1.04-2.68; P=0.04), smoking status (current smoking HR, 2.63; 95% CI: 1.14-6.08; P=0.02), and stage (stage IV HR, 14.96; 95% CI: 6.28-35.63; P=0.008). Substance use is associated with poor social determinants of health and increased health care utilization. On multivariable analysis, substance use was not independently associated with OS once guideline-concordant care was used. Future studies should focus on improving our understanding of these associations, delineating potential mechanisms, and developing evidence-based strategies to reduce health care utilization and overcome challenges related to poor social determinants of health.

Association of State Child Abuse Policies and Mandated Reporting Policies With Prenatal and Postpartum Care Among Women Who Engaged in Substance Use During Pregnancy

Some states have implemented policies that consider substance use during pregnancy as child abuse and require mandated reporting of substance use during pregnancy. Implications of these policies for health care receipt among pregnant people who engage in substance use are unknown. To examine the association of state child abuse policies and mandated reporting policies with prenatal and postpartum care among women who engaged in substance use during pregnancy. In this cross-sectional study, data from the 2016-2019 Pregnancy Risk Assessment Monitoring System survey were analyzed. The study population included 4155 women from 23 states who reported substance use during pregnancy. Data were analyzed between August and November 2021. Delivery in a state with a child abuse policy only (n = 6), a mandated reporting policy only (n = 4), both policies (n = 7), or neither policy (n = 5). One state switched from a mandated reporting policy only to having both policies. Month of gestation at prenatal care initiation (ie, months 1-10, with a higher number of months indicating later initiation), receipt of adequate prenatal care, and receipt of a postpartum health care visit 4 to 6 weeks after delivery. Sample characteristics were calculated using unweighted frequencies and weighted percentages and means. Associations of state policies with the outcomes were examined using generalized linear regression with generalized estimating equations, adjusting for potential confounders and accounting for the complex sampling design of the Pregnancy Risk Assessment Monitoring System survey. The study sample included 4155 women who reported substance use during pregnancy; 33.9% of these women delivered in states with a child abuse policy only, 16.4% in states with a mandated reporting policy only, 32.9% in states with both policies, and 16.8% in states with neither policy. Overall, 14.7% of women were Black, 69.0% were White, and 64.6% were aged 18 to 29 years at delivery. Women who delivered in states with a child abuse policy only, mandated reporting policy only, or both policies initiated prenatal care at a later month of gestation (β = 0.44 [95% CI, 0.10-0.78], 0.32 [95% CI, 0.04-0.59], and 0.40 [95% CI, 0.09-0.72], respectively) and had a lower likelihood of adequate prenatal care (risk ratio, 0.85 [95% CI, 0.79-0.91], 0.94 [95% CI, 0.87-1.01], and 0.95 [95% CI, 0.89-1.03], respectively) and a postpartum health care visit (risk ratio, 0.89 [95% CI, 0.82-0.96], 0.89 [95% CI, 0.80-0.98], and 0.92 [95% CI, 0.83-1.02], respectively) compared with women who delivered in states with neither policy. The results indicate that state child abuse policies and mandated reporting policies are associated with reduced receipt of prenatal and postpartum care among women who engage in substance use during pregnancy.

Validation of the Motivational Inventory Underlying Substance Use Engagement (MI-USE)

Given the growing number of fatalities associated with the use of multiple types of drugs, there is an urgent need for a tool that allows clinicians and researchers to quickly assess diverse reasons for substance use. Here, we sought to validate the Motivational Inventory Underlying Substance Engagement (MI-USE), a new measure that assesses motivations for use across different types of substances. Participants were 538 adults ages 18-60 (48% women) who reported substance use problems and past-year drug or alcohol use. Analyses were conducted to discover and validate the factor structure of the MI-USE and evaluate its construct validity. A 30-item model best fit the MI-USE, with one General Factor capturing overall motivation to engage in substance use and eight motive-specific factors that indexed unique motivations for substance use: Emotional Coping (relief from unpleasant emotions), Pleasure-Seeking (feel pleasurable or exciting emotions and sensations), Dependence Severity (avoid withdrawal and cravings), Expansion (enhance self-insight and spirituality), Social Coping (increase confidence and attractiveness), Advantage (gain a physical or mental advantage), Physical Coping (relief from unpleasant bodily sensations), and Sleep (mitigate sleep problems). Evaluation of the measure’s construct validity and internal consistency support the chosen model and interpretation of the motive-specific factors. Results provide initial validation of the MI-USE as a reliable and valid tool for assessing diverse substance use motivations. It improves upon existing measures by allowing clinicians and researchers to simultaneously evaluate motivations for multiple forms of substance use, which facilitates personalized treatment planning and research on polysubstance use.

Risk Factors for Suboptimal Adherence Identified by Patient-Reported Outcomes Assessments in Routine HIV Care at 2 North American Clinics.

PurposeUse of patient-reported outcomes assessments (PROs) can improve patient–provider communication and focus provider attention on current health issues. This analysis examines the association between suboptimal antiretroviral therapy (ART) adherence and factors obtained through PROs among people with HIV (PWH) at 2 North American outpatient clinics.Patients and MethodsImmediately before a clinic visit, PWH completed self-administered PROs. Unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated from logistic regression models to identify sociodemographic and health-related factors (satisfaction with ART, difficulty meeting housing costs, depression, intimate partner violence, risk of malnutrition, smoking status, alcohol use, and substance use) associated with suboptimal adherence (defined as self-reporting <95% or <80% adherence). Multiple imputation was performed to account for missing data in the multivariate analyses.ResultsOf 1632 PWH, 1239 (76%) responded to the adherence assessment; of these, 268 (22%) and 106 (9%) reported <95% and <80% adherence, respectively. Of 1580 PWH who responded, 354 (22%) were dissatisfied with their HIV medication. Of responding PWH, 19% reported moderate-to-severe depression, 23% indicated they were at risk of malnutrition, 34% were current smokers, and 62% reported substance use in the past 3 months. Dissatisfaction with ART was significantly associated with <95% and <80% adherence in the unadjusted analysis (unadjusted OR [95% CI], 3.38 [2.51–4.56] and 4.26 [2.82–6.42], respectively) and adjusted analysis (adjusted OR [95% CI], 2.76 [1.91–4.00] and 3.28 [1.95–5.52], respectively); significance remained after multiple imputation. In adjusted analyses, no risk of malnutrition was significantly associated with reduced odds of <95% adherence after multiple imputation (adjusted OR [95% CI], 0.714 [0.511–0.997]); no other factors were associated with <95% or <80% adherence.ConclusionThese results suggest that implementation of PROs evaluating treatment satisfaction may provide value to adherence management in routine HIV care.

Student and School Characteristics Associated With COVID-19-Related Learning Decline Among Middle and High School Students in K-12 Schools.

ABSTRACTBACKGROUNDCOVID‐19‐disrupted schools, including shifts to virtual learning which may have impacted academic progress. This study assessed characteristics associated with changes in academic grades (before and during the pandemic) for different learning modalities for US students ages 13‐19.METHODSStudents (N = 2152) completed a web survey on school‐related experiences during the 2020‐2021 school year. County social vulnerability and SARS‐CoV‐2 transmission data were merged with survey data. Multivariable logistic regression analysis for grade change was conducted with student and school characteristics for each learning modality, controlling for community characteristics.RESULTSGreater proportions of remote/virtual (34.4%) and hybrid (30.1%) learning students reported grade decline compared to in‐person students (19.9%). Among in‐person students, odds of reporting same/improved grades were 65% lower among non‐Hispanic black students and 66% lower among non‐Hispanic students from other races, compared to non‐Hispanic white students. Among hybrid students, odds of reporting same/improved grades for students reporting anxiety were 47% lower than students without anxiety, and odds of reporting same/improved grades among students reporting substance use were 40% lower than students not reporting substance use. Among remote/virtual students, odds of reporting same/improved grades among students with depression were 62% lower than odds of students not reporting depression symptoms. Remote/virtual students who received school‐provided educational services also had 1.55 times the odds of reporting same/improved grades, compared to remote/virtual students not receiving these services.CONCLUSIONSAcademic grades were negatively impacted during COVID‐19 and learning mode may have contributed. Understanding these impacts is critical to student health and academic achievement.

Lesbian, Gay, and Bisexual Students Experiencing Homelessness and Substance Use in the School Context: A Statewide Study.

This study explored differences between lesbian, gay, and bisexual (LGB)-housed and homeless students regarding substance use patterns on and off school grounds and the unique contribution of homelessness to substance use in school. Data were from the 2013-2015 California Healthy Kids Survey, a statewide survey of school protective factors and risk behaviors. A representative sample of 9th- and 11th-grade students (N=20,337) was used. Comparisons between housed (n=19,456) and homeless (doubled up: n=715; acute homeless: n=166) LGB students were conducted. We used chi-square tests to compare rates of lifetime, past-30-day, and in-school substance use and conducted multivariate logistic regression models for each substance use variables. Chi-square test results indicated significant differences in rates of substance use among students experiencing homelessness (both categories) and housed LGB students. Lesbian, gay, and bisexual students experiencing homelessness were more likely to report substance use off and on school grounds. Results from logistic regression analyses indicated that LGB students who experience homelessness were significantly more likely to report recent and in-school substance use. For example, students experiencing acute homelessness were about 3 times as likely to report heavy episodic drinking (adjusted odds ratio [AOR]=3.13; 95% confidence interval [CI]=2.13, 4.26) and more than 5 times as likely to smoke marijuana in school (AOR=5.38; 95% CI=3.46, 8.36), compared to housed LGB students. LGB students who experience homelessness are at higher risk than housed LGB students of substance use on and off school grounds. Findings highlight the need to provide support in the school context for this subpopulation.

Factors associated with contraceptive use among postpartum women with substance use disorder

ObjectiveRates of unintended pregnancy among women with substance use disorder (SUD) are much higher than the general reproductive-age population, suggesting lower rates of contraceptive use. This study aims to determine the prevalence of contraceptive use in postpartum women with SUD and identify factors associated with its use. MethodsThis retrospective cohort study using electronic health record data from 2016 to 2019 included postpartum adult women with any SUD who received care at a high-risk pregnancy clinic (n = 353). The primary outcome was contraception utilization as identified using diagnosis and procedure codes. An adjusted multivariate logistic regression was used to evaluate the relationship between postpartum contraceptive use and sample characteristics. ResultsOf the 353 postpartum women with SUD, contraceptive use was found in 128 (36.3%) women. Among the study population, the most commonly reported substance use disorders were nicotine use disorder (70.3%), opioid use disorder (51.3%), and cannabis use disorder (15.0%). Among those with opioid use disorder, 45.3% were found to be using medication for opioid use disorder (MOUD). Women who attended a postpartum visit had 2.23 times the odds of using contraception compared to women who did not (OR: 2.23, 95% CI: 1.20–4.15). Those using MOUD had 3.69 times the odds of using contraception compared to those who were not (OR: 3.69, 95% CI: 1.89–7.19). Overall, women who utilized contraception were more likely to be younger than 25, receiving MOUD, and participating in postpartum care. ConclusionsPostpartum women with SUD are not using contraceptive methods and this is associated with a lack of appropriate healthcare interventions in the perinatal period, which can reduce the odds of receiving effective family planning services. Specialized whole-health interventions and policies to increase access to care for women with SUD should be developed.

Molecular surveillance for large outbreaks of tuberculosis in the United States, 2014–2018

ObjectiveThis study describes characteristics of large tuberculosis (TB) outbreaks in the United States detected using novel molecular surveillance methods during 2014–2016 and followed for 2 years through 2018. MethodsWe developed 4 genotype-based detection algorithms to identify large TB outbreaks of ≥10 cases related by recent transmission during a 3-year period. We used whole-genome sequencing and epidemiologic data to assess evidence of recent transmission among cases. ResultsThere were 24 large outbreaks involving 518 cases; patients were primarily U.S.-born (85.1%) racial/ethnic minorities (84.1%). Compared with all other TB patients, patients associated with large outbreaks were more likely to report substance use, homelessness, and having been diagnosed while incarcerated. Most large outbreaks primarily occurred within residences among families and nonfamilial social contacts. A source case with a prolonged infectious period and difficulties in eliciting contacts were commonly reported contributors to transmission. ConclusionLarge outbreak surveillance can inform targeted interventions to decrease outbreak-associated TB morbidity.

Long-term functional, psychological, emotional, and social outcomes in pediatric victims of violence

BackgroundTo evaluate the long-term functional, psychological, and emotional outcomes in individuals who survived violence-related injuries as children. MethodsWe retrospectively identified all pediatric patients (age <18y at time of injury) treated for a violent traumatic injury (gun-shot wound, stab, or assault) at our institution (1/2011–12/2020). We then prospectively attempted to contact and survey, via telephone, all patients that had reached adulthood (age ≥18y at time of study) using 7 Patient-Reported Outcomes Measurement Information System (PROMIS) instruments and the Primary Care Post Traumatic Stress Disorder (PTSD) screen. ResultsOf the 270 patients identified, we attempted to contact 218, successfully contacted 68, and 24 participated in the study. Of participants, 15 (62.5%) sustained gunshot wounds, 8 (33.3%) were stabbed, and 1 (4.2%) was assaulted with a median time from injury of 6.7(3.4) years. Based on PROMIS metrics, Global Physical Health (55.0 vs. 50.0, p = 0.013) and Emotional Support (55.4 vs. 50.0, p = 0.004) were better in participants compared to reference populations. However, a disproportionate number of participants reported substance use in the past 30 days (45.8 vs 13.0%; p < 0.001), 41.7% screened positive for PTSD, and 62.5% requested resources and/or referral for medical care. ConclusionsMany individuals who survive violent injuries as children continued to experience negative physical and mental outcomes extending into adulthood that required ongoing medical and psychological support. Further resources are needed to better understand the long-term effects of violent injury and to care for the complex needs of this population.

Assessment of substance use among injured persons seeking emergency care in Nairobi, Kenya.

IntroductionTrauma is a leading cause of morbidity and mortality in Kenya. In many countries, substance use is common among patients presenting with injuries to an emergency center (EC).ObjectiveTo describe the epidemiology of self-reported substance use among adult injured patients seeking ED care in Nairobi, Kenya.MethodsThis prospective cross-sectional study, assessed patients presenting with injuries to the Kenyatta National Hospital ED in Nairobi, Kenya from March through June of 2021. Data on substance use, injury characteristics and ED disposition were collected. Substances of interest were alcohol, stimulants, marijuana, and opiates. The Alcohol Use Disorders Identification Test-Concise (AUDIT-C) tool was used to characterize hazardous alcohol use.ResultsA total of 1,282 patients were screened for participation, of which 646 were enrolled. Among participants, 322 (49.8%) reported substance use in the past month (AUDIT-C positive, stimulants, opiates, and/or marijuana). Hazardous alcohol use was reported by 271 (42.0%) patients who screened positive with AUDIT-C. Polysubstance use, (≥2 substances) was reported by 87 participants in the past month. Median time from injury to ED arrival was 13.1 h for all enrolees, and this number was significantly higher among substance users (median 15.4 h, IQR 5.5 - 25.5; p = 0.029).ConclusionsIn the population studied, reported substance use was common with a substantial proportion of injured persons screening positive for hazardous alcohol use. Those with substance use had later presentations for injury care. These data suggest that ED programming for substance use disorder screening and care linkage could be impactful in the study setting.

Mental Health, Chronic Disease, and Substance Use: Findings From Rural Texas

There are vital links among mental health conditions, chronic diseases, and substance use disorders. Simultaneous examination of the relationship among these three conditions is essential for providing well-integrated care to rural residents who have limited resources and for representing medically underserved areas. We aimed to assess the burden of behavioral health conditions and chronic diseases from a rural Texas community to garner context-specific insights and inform effective health promotion strategies in similar communities. We conducted a cross-sectional study among 181 residents from various zip codes in a rural Texas county. A self-administered, 18-item health-needs questionnaire was used to collect data from the participants. Of the total participants, 30.0% reported mental health conditions, 16.0% reported substance use disorders, and 44.2% reported having at least one type of chronic disease. Overall, mental health conditions were associated with substance use disorders [OR: 1.58 (95% CI: 0.73–2.42)] and chronic disease [OR: 1.07 (95% CI: 0.39–1.75)], but no associations were observed between substance use and chronic disease [OR: 0.62 (95% CI: -0.20–1.43)]. The economic and accessibility barriers that rural residents commonly face call attention to the need for integrated care that combines primary care and behavioral health services.

The influence of lifestyles to cope with stress over mental health in pregnant and postpartum women during the COVID-19 pandemic.

The COVID-19 pandemic affected daily life routines and lifestyles of pregnant and postpartum women and increased their stress and risk of suffering from mental health problems. The aim of this study was to analyse which sociodemographic variables, COVID-19 exposure variables and lifestyles to cope with stress variables predicted anxiety, depression, and PTSD symptoms in pregnant and postpartum women during the COVID-19 pandemic. A cross-sectional design was performed with a sample of 3356 Spanish women participating in the Riseup-PPD-COVID-19 study. These participants completed an online survey composed of measures of anxiety (GAD-7), depression (EPDS), and PTSD related to COVID-19 (Checklist DSM-5), as well as demographics, exposure to COVID-19, and lifestyles to cope with stress. Regarding results, 47.2% showed depression and a third reported anxiety, whereas moderate scores were observed in PTSD symptoms. The most commonly used strategies to cope with stress in the COVID-19 pandemic were talking with friends and family and increasing time with social networks. Better results in mental health were associated with coping strategies such as talking with family and friends or participating in family activities, physical activity, sleeping well at night, eating healthier, and increasing personal care. Furthermore, poor results in mental health were observed in those participants who increased time with screens, ate fast food, reported substance use, and talked more frequently with health professionals. More symptoms were also observed in younger women, primiparous women, and those who reported more exposure to COVID-19. The results underline the need to strengthen the mental health of pregnant and postpartum women. Trial registration: ClinicalTrials.gov Identifier: NCT04595123.

Impact of the covid-19 pandemic on Moroccan health workers who were not on the frontline

IntroductionSince March2019, successive waves of the COVID-19pandemic have challenged the mental health of frontline healthcare workers, who have been shown in numerous studies to be at increased risk for characterized psychiatric disorders. However, healthcare professionals who were not directly involved in the care of patients withCOVID-19 were often not investigated. In Morocco, the literature dealing with the psychological impact of the pandemic on backline health professionals is still scarce.ObjectivesThe purpose of our survey is to assess the stress, anxiety, and depression of health workers who were not on the front lines of care forCOVID-19 patients.MethodsIt is a survey developed on googleforms and disseminated via social networks targeting groups of health professionals in Morocco, during June2020. We used the DASS21 scale(depression, anxiety and stress scale with21 items). The results were analyzed using the JAMOVI application.Resultsout of80 participants: 54%are men, 56%are aged between 31 and 40years old, 38%have been in practice for less than 5years of exercise, 66%are married, 41%are specialists 36%are residents and 21%are nurses, 44% work in psychiatric ward. Psychiatric symptoms: 64%have worries, 64% tired, 63% irritability, 59% sadness, 53% insomnia and 51% somatic complaints. 6.3%report substance use. DASS-21: 50%of participants have depression (7.5%mild, 26.25%moderate, 11.25%severe, 5%extremely severe), 48.75%have Anxiety (7.5%mild, 25%moderate, 8.25%severe, 7.5%extremely severe) and 30%report Stress (8.75%mild, 15%moderate, 6.25%severe, 0%extremely severe).ConclusionsThe high level of job stress during the early months of the pandemic exposed health workers who were not on the front line of care forCOVID-19 patients to an increased risk of psychological decompensation.DisclosureNo significant relationships.

Relationship to physical and psychological pain as factors of deviant behavior in Russian female adolescents

IntroductionBorderline personality manifests in female adolescence and youth by higher frequency of deviant behaviors and suicidal ideations. Psychological models suggests that both perception and relationship to physical pain (Joiner, 2005, O’Connor, Kirtley, 2018, Galynker, 2017) as well as psychological pain (Eisenberger et al., 2003) could increase the risk.ObjectivesThis study concentrates on the relationship between relationship to physical and psychological pain and reported deviant behavior in female adolescents.Methods204 female adolescents (13-21 years old) filled checklist appraising alcohol use, drug use, aggressive behavior, suicidal ideations and emotional difficulties (Cronbach’s alphas .67-.89), Interpersonal Needs Questionnaire (Van Orden et al., 2012), Discomfort Intolerance Scale (Schmidt et al., 2006), The Pain Catastrophizing Scale (Sullivan et al., 1995).ResultsElder females more frequently reported substance use (r=.23-.28) and less frequently aggressive behavior (r=-.19) while suicidal ideations were unrelated to age. Females reporting higher perceived burdensomeness and emotional difficulties also reported higher alcohol use (r=.25-.29), aggressive behavior (r=.37-.42) and suicidal ideations (r=.64-.84). Thwarted belongingness correlated with suicidal ideations (r=.50) and aggressive behavior (r=.26). Higher alcohol use was associated with catastrophizing of pain in the form of magnification and helplessness (r=.17) while suicidal ideations and aggressive behavior were related to ruminations, magnification and helplessness (r=.23-.33). Only correlations between aggression and pain catastrophizing remained significant after statistical control of psychological pain (r=.15-.22).ConclusionsAfter control for psychological pain, only aggressive behavior is related to catastrophizing of physical pain. Study is supported by Russian science Foundation, project 22-28-01524.DisclosureStudy is supported by Russian Science Foundation, project 22-28-01524.

Investigating differences of medications in hospitalized schizophrenia and schizoaffective disorder patients: impact of substance use

ABSTRACT Background Substance use is a clinical comorbidity resulting in poor prognosis, non-adherence and increased admissions in schizophrenia and related disorders. This study investigated differences in treatment preferences in hospitalized schizophrenia and schizoaffective disorder patients with or without substance use. Method Retrospective recordings regarding patients hospitalized between July 2017 and July 2018 were obtained from a mental health hospital database. Results Younger people and males were prevalent in those reporting substance use. Total and involuntary hospitalization numbers were similar across groups. Admission to a psychiatry unit due to forensic issues was higher in substance users. Electroconvulsive therapy (ECT), long-acting injection antipsychotics (LAI APs) and clozapine use were more frequent in substance non-users. Total and involuntary hospitalization numbers predicted LAI AP use, while younger age, total hospitalization and illness duration predicted clozapine use. Substance use was predictive for clozapine use. Conclusions Substance use should be monitored in young, male cases with schizophrenia spectrum disorders. LAI AP, clozapine, and ECT use should be investigated more comprehensively in this group.

Daily-level associations between sleep duration and next-day alcohol and cannabis craving and use in young adults

Study objectivesTo examine the effects of sleep duration on next-day alcohol and cannabis craving and use among young adults. MethodA community sample of young adults who reported recent simultaneous alcohol and cannabis use at screening (N = 409; Mage = 21.61; 50.9% female) completed twice daily surveys (morning and afternoon) for five 14-day sampling bursts (i.e., 70 days total). Daily measurements included sleep duration, alcohol and cannabis craving, and alcohol and cannabis use (i.e., number of drinks, hours high). Multilevel models enabled examining associations between sleep duration and substance use/craving at three distinct levels: daily-level, burst-level, and person-level. ResultsAt the day-level, sleep duration was inversely associated with craving for both alcohol and cannabis: Stronger craving was reported on mornings and afternoons after relatively shorter sleep duration. At the burst-level, sleep duration was inversely associated with morning and afternoon alcohol craving indicating stronger alcohol craving, but not cannabis craving, during two-week periods when young adults have accumulated shorter sleep duration. Pertaining to alcohol and cannabis use, no daily-level effects were found, but the burst-level effect showed that participants engaged in greater alcohol use during two-week bursts with shorter sleep duration. ConclusionsBased on a non-clinical sample of young adults reporting substance use, results suggest shorter sleep duration may be a modifiable risk factor as it pertains to substance use and cravings. Results highlight day-level effects of shorter sleep duration on substance use cravings and adverse effects of cumulative sleep deficit on alcohol use.