Substance Related Factors Research Articles

Missing Opportunities in the Screening of Alcohol Use and Problematic Use, and the Provision of Brief Advice and Treatment Information Among Individuals With Alcohol Use Disorder.

The aim of this study was to identify sociodemographic and substance-related factors associated with being screened, receiving advice or treatment information from healthcare providers, among individuals who met the criteria for the past 12-month alcohol use disorder (AUD). The 2015-2019 National Survey on Drug Use and Health data were analyzed to identify factors associated with being (1) asked about alcohol used among adults with AUD, who visited a healthcare provider within the past 12 months, and were not receiving AUD treatment (sample 1, n = 13,321); (2) asked about problematic use; (3) advised to reduce consumption; and (4) offered alcohol treatment information, among those in sample 1 who were asked about their use (n = 6,905). About half (52.9%) in sample 1 were asked about their alcohol use. Among them, 21.6% were asked about problematic use, 17.7% were advised to reduce alcohol consumption, and 7.6% were offered information. The odds of being asked about alcohol use among male participants were 0.72 times the odds of female participants; however once asked, male participants showed greater odds of being asked about problematic use (adjusted odds ratio [aOR] = 1.53, 95% confidence interval [CI] = 1.29-1.82), advised to reduce consumption (aOR = 1.64, 95% CI = 1.24-2.16), and offered treatment information (aOR = 1.77, 95% CI = 1.34-2.35). As compared with non-Hispanic White participants, other racial/ethnic groups were less likely to be asked about alcohol use; however, once asked, no differences were observed for other outcomes. Significant gaps in the screening and provision of advice or treatment information were identified, particularly for racial/ethnic and sex subgroups. Reducing barriers for effective screening could help address AUD-related disparities.

Investigation of Substance Use, Substance-Related Factors and Delinquency in a Nation-Wide Referred Children Sample

ABSTRACT Objective Examine the relationship between sociodemographic and forensic characteristics and alcohol and smoking rates, substance use and delinquency profiles in children. Methods One hundred and five children dragged into crime were evaluated via unstructured interviews and data form. Results Substance use was found significantly higher in children which have family history of substance use. Suicidal attempts were significantly higher in children with history of substance use. Recidivism rates was found significantly higher in children with alcohol or substance use. Conclusion Children dragged into crime are more vulnerable to use substances and more prone to their negative impacts.

RETRACTED ARTICLE: Predictors of depression among school adolescents in Northwest, Ethiopia, 2022: institutional based cross-sectional

BackgroundAdolescent depression is a serious mental disorder that makes family problems, learning challenges, drug addiction, and increases absenteeism from school. It also has a major impact on a person’s ability to manage his or her daily tasks. In the end, the condition may result in self-destruction. Research is scarce among high schools in the study setting. Therefore, this study aimed to assess the prevalence and its associated factors of depression among high school adolescent students in Bahirdar City, Northwest Ethiopia in 2022.MethodsAn institutional-based cross-sectional study was done from June 18 to July 16, 2022, among public and private high school adolescent students in Bahir Dar City, Amhara region, Ethiopia. A two-stage sampling technique was utilized. First, stratification by school type was made and schools were selected 30–40% by using a simple random sampling technique. Finally, an updated sampling frame was taken from each school director to select a sample of 584 study participants after proportional allocation by simple random sampling from six high schools. Patient Health Questionnaires were used to assess depression in high school students. The independent variables, like substance-related factors, were assessed by yes-or-no questions, and the academic stressor by academic stress in secondary education, was assessed by structured questionnaires. Binary and multivariate logistic regressions were used to identify factors associated with depression. Statistical significance was declared at a 95% confidence interval when the value of p was less than or equal to 0.05.ResultsThe response rate of the participants was 96.9%. The overall magnitude of adolescent depression was found to be 22.1% (95%CI 18.7, 25.7%). Being female (AOR: 3.43; 95%CI 2.11, 5.56), small family size (AOR: 3.01; 95%CI 1.47, 6.15); ever alcohol use (AOR: 2.40; 95%CI 1.51, 3.81); attending a public school (AOR: 3.01; 95%CI 1.68, 5.40), and having a history of abuse (AOR: 1.92; 95%CI 2.2, 3.08) were associated with depression.ConclusionIn this study, the magnitude of depression among high school students in Bahir Dar City was higher than the national threshold. There was a significant association between sex, family size of parents, ever alcohol use, public schools, and having a history of abuse with depression among adolescents. Hence, it is better for schools to screen and provide intervention for depression in public high school students and offer therapies, especially in females and those with a history of abuse, small family size, or alcohol use.

Risk Factors Associated with Simultaneous Use of Alcohol and Prescription Opioids Among Young Adults in Michigan

Purpose: Alcohol can have serious side effects alone and can enhance the side effects of prescription opioids in unpredictable and dangerous ways. This study aims to identify risk factors for simultaneous use of alcohol and prescription opioids among young adults. Methods: Demographic characteristics, substance use, mental well-being, other substance-related factors, and simultaneous use of alcohol and prescription opioids were utilized to run multiple logistic regression analysis ( N = 1751; aged 18–25). Results: Mental well-being ( OR = 0.971, p = .003) and education level ( OR = 0.383, p < .001) were associated with a lower likelihood of simultaneous use. Knowing someone who had a fatal overdose ( OR = 2.443, p < .001), binge drinking ( OR = 1.065, p = .012), and older age ( OR = 1.250, p < .001) were associated with a greater likelihood of simultaneous use. Conclusion: The risk and protective factors identified in the current study point to specific areas for intervention to reduce simultaneous use. Further efforts are needed to minimize the increasing polysubstance-involved overdose mortality among young adults.

Prevalence and associated factors of social phobia among high school adolescents in Northwest Ethiopia, 2021.

Social phobia is the third most common mental illness in the world. It harms educational achievement by increasing school absentees and prevents students to participate in class, and this leads to a significant impairment of the emotional, psychological, social, and physical wellbeing of students. The research done regarding social phobia and associated factors among high school students in low- and middle-income countries is limited. Therefore, this study aims to assess the prevalence and associated factors of social phobia among adolescents and have a pivotal role in further investigation. To assess the prevalence and associated factors of social phobia among high school adolescents in Northwest Ethiopia, 2021. An institutional-based cross-sectional study was conducted from 15 April to 14 May 2021, by using a simple random sampling technique to select a sample of 936 participants after proportional allocation to the six high schools. Social phobia was assessed by using the social phobia inventory (SPIN), independent variables like social support were assessed by Oslo social support scale, substance-related factors by ASSIST, and the rest of the other factors were assessed by structured questionnaires. Binary and multivariate analyses were done to identify factors associated with social phobia. Statistical significance was declared at a 95% confidence interval (CI) of p-value less than or equal to 0.05. The prevalence of social phobia among adolescents was found to be 40.2% (95% CI 37.0 to 43.4%). In the multivariable analysis, female sex (AOR = 1.374, 95% CI = 1.016, 1.858), poor social support (AOR = 2.408, 95% CI = 1.660, 3.493), having known chronic medical illness (AOR = 2.131, 95% CI = 1.173, 3.870), having a history of mental illness in the family (AOR = 1.723, 95% CI = 1.071, 2.773), and is highly risky alcohol user (AOR = 1.992 95% CI 1.034, 3.838) were factors significantly associated with social phobia symptoms. The overall prevalence of SP among adolescents was high. Therefore, early detection and adequate intervention are crucial to reducing the overall burden of social phobia among adolescents.

Individual-, peer-, and parent-level substance use-related factors among 9- and 10-year-olds from the ABCD Study: Prevalence rates and sociodemographic differences

BackgroundAlthough a relatively large body of research has identified multiple factors associated with adolescent substance use, less is known about earlier substance-related factors during preadolescence, including curiosity to use substances. The present study examined individual-, peer-, and parent-level domains pertaining to substance use and how these domains vary by sociodemographic subgroups and substance type. MethodsParticipants were 11,864 9- and 10-year-olds from the baseline sample of the Adolescent Brain Cognitive Development (ABCD) Study. Youth-reported measures were curiosity to use substances and perceived peer substance use. Parent-reported measures were availability of and rules about substances. Generalized logistic mixed models (GLMM) were used to compare these measures across alcohol, nicotine, and marijuana and across sociodemographic subgroupings (sex, race/ethnicity, household income, and family history of alcohol problems). GLMM was then used to examine predictors of curiosity to use by substance type. ResultsThe most striking descriptive differences were found between race/ethnicity and income categories (e.g., positive associations between greater income and greater availability of alcohol). In multivariable analyses, greater curiosity to use alcohol was associated with being male, higher household income, perceived peer alcohol use, and easy alcohol availability; greater curiosity to use nicotine was associated with being male, perceived peer cigarette use, easy availability of cigarettes, and no parental rules about cigarette use. ConclusionsThis study identified substance use-related individual-, peer-, and parent-level factors among a diverse, national sample. Findings highlight the importance of considering sociodemographic and substance-specific variability and may help identify risk and protective factors preceding adolescent substance use.

Why are Youth Engaged in Substance Use? A Qualitative Study Exploring Substance Use and Risk Factors Among the Youth of Jimma Town, Southwest Ethiopia.

IntroductionSubstance use refers to the use of psychoactive substances such as khat, alcohol, cigarettes, and illicit drugs. Young people are more vulnerable to substance use than older people. Substance use has varying impacts on the health and socio-economics of countries, and is a major public health concern globally. Currently, substance use is a common public health concern among the youth of Ethiopia, mainly in Jimma town. Therefore, this study aimed to explore the substance use and risk factors among the youth of Jimma town in 2019.MethodsThe study was conducted in Jimma town among youth who were engaged in substance use, from March to April 2019. A descriptive qualitative study design was employed and the study participants were acquired using purposive/judgmental sampling techniques. In total, 20 interviews were conducted with young people using in-depth and key informant interview methods. The data were analyzed by using ATLAS.ti version 7. Thematic analyses were performed in order to extract the main themes and categories. Direct quotations were presented with a thick description of the findings.ResultsThe findings of this study were discussed under six themes and 12 categories, which emerged from thematic analysis of the data: substance use setting, time and means of distribution, substance-related factors, social and economic factors, individual factors, psychological factors, and legal and policy factors.ConclusionThe study indicated that khat, alcohol, cigarettes and shisha or water pipes were the most commonly used substances. Different factors that drive the youth to engage in substance use were identified; individual factors, social and economic factors, substance-related factors, and legal and policy factors were most common. Generally, to overcome this problem, the community, lawyers, and policemen should participate in the implementation and enforcement of rules and regulations on substance use. Family should monitor their children and need to act as good role models by avoiding substance use.

Nicotine and cannabis vaping among adolescents in treatment for substance use disorders

This study examined nicotine and cannabis vaping among adolescents in treatment for substance use disorders. Participants were 363 adolescents aged 12–17 (66% male, mean age = 15.5 [SD = 1.3], 46% non-Hispanic white) seen for a specialty addiction intake evaluation between 2017 and 2019 at one of six medical offices of a large, integrated health care system in Northern California. Multivariable logistic regression models tested for associations of sociodemographics, cigarette smoking, and substance use disorders with vaping behaviors. A majority of adolescents reported ever (68%) or current vaping (60%) of nicotine and/or cannabis; current vaping was similar for nicotine (50%) and cannabis (51%); 40% reported current vaping of both. Current smokers (6% of the sample) had higher odds of ever vaping (aOR = 3.95, 95%CI: 1.04–14.95). Black (versus non-Hispanic white) adolescents had lower odds of current nicotine vaping (aOR = 0.08, 95%CI: 0.02–0.37) and current vaping of both nicotine and cannabis (aOR = 0.12, 95%CI: 0.03–0.60). Having an alcohol use disorder was associated with current vaping (aOR = 2.14, 95%CI: 1.06–4.33). Those who endorsed that most friends get drunk/high (aOR = 1.87, 95%CI: 1.02–3.42) or that cannabis was their substance of choice (aOR = 2.36, 95%CI: 1.16–4.81) had higher odds of current cannabis vaping. Higher neighborhood household income ($80,000–$120,000 and >$120,000 vs. <$80,000, aORs = 2.05–9.48), never versus ever blunt use (aORs = 2.47–8.68), and intakes in 2018 and 2019 versus 2017 (aORs = 2.18–5.38) were associated with higher odds of all vaping outcomes. Vaping was common among adolescents in addiction treatment and varied with sociodemographics and substance-related factors. Research should assess how vaping impacts the development of substance use disorders and whether it interferes with addiction treatment.

Socio-demographic and substance-related factors associated with mental distress among Wollo university students: institution-based cross-sectional study

BackgroundThe presence of mental distress among students affects their cognitive, emotional, physical, and interpersonal functioning. Besides, it predisposes to substance use problems and finally affects academic performance negatively. Therefore, this study was designed to estimate the magnitude and identify associated factors for the mental distress of students at Wollo University, Dessie, Ethiopia.MethodsThis institution-based cross-sectional survey assessed mental distress among 585 undergraduate students at Wollo University from April 10 to May 10/2019 using a multi-stage stratified sampling technique. Kessler-10 item scale was used to collect data about mental distress. Variables with p-value < 0.25 in bivariate logistic regression were pooled into a multi-variable logistic regression model and p-value < 0.05 in the multi-variable model was considered significant statistically. The strength of the relationship was interpreted using the odds ratio with 95% CI. The model adequacy in multi-variable regression was approved with Hosmer and Lemeshow goodness of fit test.ResultsAmong 585 questionnaires distributed, 548 clear and completed questionnaires were included in the analysis with a response rate of 93.7%. The mental distress prevalence in the current study was 106 (19.3%). From this 65 (11.9%), 28 (5.1%), and 13 (2.4%) were found to be mild, moderate and severe mental distress respectively. Never attending a place of worship (AOR = 4.2, 95% CI 1.73, 10.39), family history of mental illness (AOR = 2.1, 95% CI 1.12, 3.95), current cigarette smoking (AOR = 3.2, 95% CI 1.69, 6.20), current alcohol use (AOR = 2.5, 95% CI 1.49, 4.25), and current cannabis use (AOR = 3.4, 95% CI 1.18, 9.57) were the associated factors for mental distress.ConclusionOne in five students was affected by mental distress. Never attending a place of worship, family history of mental illness, current cigarette smoking, current alcohol use, and current cannabis use were the factors associated with it. Therefore, all stakeholders should be involved in overcoming this public health problem. Besides, clubs should be established in the university and have to play an active role in bringing behavioral change to substance use.

Predictors of Substance Use Latent Classes Among American Indian Youth Attending Schools On or Near Reservations.

Identical latent classes of substance use for 7 to 8 grade and9 to 12 grade American Indian (AI) youth living on or near reservations suggest that patterns of substance use are established early among these youth. This study examines relationships of substance-related factors to latent class membership and whether these relationships differ by grade group. In-school surveys were administered to 1503 7 to 8 grade and 1995 9 to 12 grade students from 46 schools on or near reservations during the 2009/2010 to 2012/2013 school years. Four-class latent class models of substance use were specified and five classes of substance-related factors (peers, substance availability, perceived harm, family, early initiation), plus grade level and gender, were evaluated as predictors. For 7 to 8 grade students, substance-related factors differentiated nonusers from users, while for 9 to 12 graders, these factors also differentiated types of users. Early initiation and peer factors were strongly related to class membership, while other factors were less strongly related. Early initiation of alcohol or marijuana is strongly related to being in a substance-using class for AI youth. Because these youth tend to initiate use earlier that other US youth, prevention resources should be targeted to reaching them and their families before age 12. Predictors of latent classes of substance use were identified for reservation-based AI youth. While the classes were identical for 7 to 8 grade and 9 to 12 grade youth, predictors varied across grade group, which may inform how best to develop prevention efforts unique to middle and high school AI youth.

Dermal Advanced REACH Tool (dART)-Development of a Dermal Exposure Model for Low-Volatile Liquids.

This article describes the development of a mechanistic model for underpinning the dermal Advanced REACH Tool (dART), an extension of the existing ART model and its software platform. It was developed for hand exposure to low volatile liquids (vapour pressure ≤ 10 Pa at 20°C) including solids-in-liquid products. The model is based on an existing conceptual dermal source-receptor model that has been integrated into the ART framework. A structured taxonomy of workplace activities referred to as activity classes are adopted from ART. Three key processes involved in mass transport associated with dermal exposure are applied, i.e. deposition, direct emission and contact, and transfer. For deposition, the model adopts all the relevant modifying factors (MFs) applied in ART. In terms of direct emission and contact (e.g. splashes) and transfer (e.g. hand-surface contacts), the model defines independent principal MFs, i.e. substance-related factors, activity-related factors, localized- and dispersion control and exposed surface area of the hands. To address event-based exposures as much as possible, the model includes crucial events during an activity (e.g. hand immersions) and translates objective information on tools and equipment (manual or automated) to probable events (e.g. splashes) and worker behaviours (e.g. surface contacts). Based on an extensive review of peer-reviewed literature and unpublished field studies, multipliers were assigned to each determinant and provide an approximated (dimensionless) numerical value. In the absence of (sufficient) evidence, multipliers were assigned to determinants based on assumptions made during discussions by experts in the consortium. A worked example is presented to illustrate the calculation of hand exposure for a specific scenario. The dART model is not yet implemented in the ART software platform, and a robust validation of the model is necessary to determine its predictive ability. With advancing knowledge on dermal exposure and its determinants, this model will require periodic updates and refinements, in addition to further expansion of the applicability domain of the model.

Psychedelic medicine: The biology underlying the persisting psychedelic effects

Psychedelic substances have regained interest as therapeutic agents in the treatment of stress-related disorders. The effects seem to be of persisting nature even after a single dose. Also in lower than ‘regular’ recreational doses, so-called micro-doses, without the typical effects on consciousness, users report beneficial effects on cognitive processes and well-being. The exact neurobiological mechanism underlying these persisting effects is not clear. While previous research has mainly focused on the central nervous system including the immune system and the neuroendocrine system, I propose a central role for sleep and the microbiome in the effects of regular and low doses of psychedelics respectively. It will be explained why this is hypothesized and studies to test this idea proposed. It is concluded that while these studies are needed to understand the biology underlying psychedelic medicine, it is also important to approach it in a holistic way, including all the above mentioned biological processes psychedelics are known to affect, and explore the role of other substance-related factors like route of administration and form, and factors like diet and lifestyle which are part of the psychedelic experience.

The Prevalence and Characteristics of Intellectual and Borderline Intellectual Disabilities in a Sample of Inpatients with Substance Use Disorders: Preliminary Clinical Results

ABSTRACTIntroduction: There is reason to believe that many individuals with substance use disorders (SUD), who are in contact with services, have an undiagnosed intellectual disability. The aim of the present study was to investigate the prevalence of intellectual and borderline intellectual disabilities (ID/BID) among inpatients with SUD and to further explore their characteristics. Methods: Ninety-one SUD inpatients aged 19–64 participated in the study. SUD was diagnosed according to the ICD-10. ID/BID was diagnosed through the Wechsler Adult Intelligence Scale, the Vineland Adaptive Behavior Scale, and self-reported childhood learning difficulties. Results: ID/BID prevalence was up to 30%. There were significant differences between ID/BID and non-ID groups for several social variables. With the exception of substance-use relapse, there were no significant differences in substance-related factors. Conclusions: ID/BID prevalence in SUD might be high. These conditions often go undiagnosed in SUD treatment. The conditions and associated difficulties should be identified for better understanding and individually adapted treatment.

What Is the Evidence for "Food Addiction?" A Systematic Review.

The diagnostic construct of “food addiction” is a highly controversial subject. The current systematic review is the first to evaluate empirical studies examining the construct of “food addiction” in humans and animals. Studies were included if they were quantitative, peer-reviewed, and in the English language. The 52 identified studies (35 articles) were qualitatively assessed to determine the extent to which their findings indicated the following addiction characteristics in relation to food: brain reward dysfunction, preoccupation, risky use, impaired control, tolerance/withdrawal, social impairment, chronicity, and relapse. Each pre-defined criterion was supported by at least one study. Brain reward dysfunction and impaired control were supported by the largest number of studies (n = 21 and n = 12, respectively); whereas risky use was supported by the fewest (n = 1). Overall, findings support food addiction as a unique construct consistent with criteria for other substance use disorder diagnoses. The evidence further suggests that certain foods, particularly processed foods with added sweeteners and fats, demonstrate the greatest addictive potential. Though both behavioral and substance-related factors are implicated in the addictive process, symptoms appear to better fit criteria for substance use disorder than behavioral addiction. Future research should explore social/role impairment, preoccupation, and risky use associated with food addiction and evaluate potential interventions for prevention and treatment.

Factors associated with successful vs. unsuccessful smoking cessation: Data from a nationally representative study

IntroductionA substantial proportion of smokers who attempt to stop smoking relapse in the first months. Yet to date, there is limited understanding of the predictors of smoking attempts and their success. We examine the role of tobacco use characteristics, other substance-related factors, as well as socio-demographic characteristics in relation to successful and unsuccessful smoking cessation. MethodsDePICT (Description des Perceptions, Images, et Comportements liés au Tabagisme) is a nationally representative sample of adults aged between 18 and 64years residing in metropolitan France, who were interviewed by telephone survey (n=4342). Among current or former smokers (n=2110) we distinguished participants characterized by: a) no quit attempt or quit <6months; b) unsuccessful smoking cessation (current smokers who previously quit smoking ≥6months); c) successful smoking cessation (≥6months). Factors associated with successful vs. unsuccessful smoking cessation were studied using multivariate multinomial logistic regression analyses. ResultsSuccessful and unsuccessful smoking cessation share some predicting factors including no cannabis use, older age, and intermediate or high occupational grade. Factors specifically associated with successful smoking cessation included no e-cigarette use, no environmental tobacco exposure, fear of the health consequences of smoking, perceived harmfulness of smoking, and high educational attainment and a good overall health. ConclusionsSmokers' environmental tobacco exposure, concurrent cannabis use, and the perception of the health consequences of smoking should be taken into account in efforts aiming to promote smoking cessation at the individual as well as collective levels. Our data also suggest that e-cigarette use is associated with unsuccessful rather than successful smoking cessation, which should be verified in additional, longitudinal, studies.

Intellectual Functioning in In-Patients with Substance Use Disorders: Preliminary Results from a Clinical Mediation Study of Factors Contributing to IQ Variance

Aims: To investigate the direct effect of different childhood difficulties on adult intelligence coefficient (IQ) and their possible indirect effect through the mediating pathways of education and severity substance use. Participants: Ninety in-patients aged 19–64. The participants had abstained from substance use for at least 6 weeks and had different substance use profiles. Measurements: Substance use disorder (SUD) and psychiatric illnesses were diagnosed according to the International Classification of Diseases 10th edition criteria. IQ was measured with the Wechsler Adult Intelligence Scale, 4th edition. Childhood difficulties, severity of substance use and level of education were assessed through a self-report questionnaire. Findings: Mean full scale IQ for the studied population was 87.3. Learning and attention deficit/hyperactivity difficulties in childhood were directly related to adult IQ. Education had a mediating effect between childhood learning difficulties/conduct problems and the verbal comprehension index. There was no significant difference in IQ due to the specific substance used or severity of substance use. Conclusion: IQ variance in in-treatment individuals with SUD was related to childhood functioning alone or through the mediator of education. Substance-related factors did not contribute to IQ variance. The results fit a normal theory of IQ development with commonly known risk factors and no disturbing effect of substance use.

Primary Care for Mentally Ill Adults in Acute Residential Treatment Facilities

ABSTRACTPsychiatric bed capacity has decreased nationally with an impact on the number and the types of patients admitted to acute in-patient units. Acute residential programs provide alternatives to hospitals for patients with problems that do not meet criteria for admission. However, these settings may not have resources to respond to the medical co-morbidities associated with severe mental illness. To understand the medical needs of patients in these settings, this research examined data from a nurse-managed primary care outreach service. Prevalent problems included acute issues and chronic disorders associated with severe mental illness. In multivariate analyses, demographic and substance related factors contributed to all chronic illness. However, age was the over-riding predictor of cardio-metabolic disorders. Drug abuse consistently predicted HIV/AIDS and HCV risk. Findings demonstrate that patients diverted to alternative forms of acute psychiatric care are no less in need of medical services than those admitted to hospitals. This underscores the importance of primary care that is provided at the site of acute residential treatment and integrated with overall care.

T26 - Brief Assessment Of Major Depression For Genetic Studies: Validation Of Cidi-Sf Screening With Scid Interviews

Background Studies of common genetic variants in complex psychiatric disorders such as major depression require samples that are too large (tens or hundreds of thousands) than can typically be collected with phenotyping methods involving direct interviews by trained clinicians. Many studies are no identifying cases and controls with self-report questionnaires, electronic medical records or registry data. Few data are available to determine the accuracy of these methods compared to direct interviews. Here, we present data on 1,263 individuals for whom online and direct interview data were available. Methods The Depression Genes and Networks study (DGN) recruited cases with recurrent MDD and controls with no lifetime MDD for a study of whole-blood gene expression. A research company emailed invitations to 14,463 survey panel members; 9,569 completed an online screen including the CIDI-Short Form depression and substance dependence modules, of whom 1,263 eventually gave blood samples and completed telephone SCID-IV interviews: 669 prospective cases (CIDI-SF recurrent MDD without current substance dependence) and 594 prospective controls (no 2-week period of depression or anhedonia with >2 MDD criteria; no current substance dependence). For this analysis we also identified narrow screening criteria for controls (no 2-week period with both depression and anhedonia; or one of these but not most of the day, nearly every day; no lifetime antidepressant [AD] use [SCID]). Polygenic score predictions were then examined in the GenRED-I GWAS cohort (which used non-overlapping controls screened with CIDI-SF) using broad vs. narrow controls. Results Among prospective cases, SCID diagnosis was MDD recurrent (N=547, 81.2%; some were excluded from DGN for other reasons) or uncomplicated single episode (39, 5.8%) totaling 87% with diagnoses that would be included in most genetic studies of MDD; 18 (2.7%) had major depressive episodes with complications that would typically be excluded (bereavement, medical or substance-related factors), and 65 (9.7%) had such exclusions as bipolar disorders (28, 4.2%), no MDD (30, 4.5%), or unreliable histories (7, 1%). Among prospective controls, 108 (18.2%) were excluded by SCID, primarily for MDD (57, 9.6%), sub-threshold depression (25, 4.2%), or a bipolar disorder (6, 1%). Narrow screening criteria would have excluded 76 (70%) of the 108 ineligible controls (57 by CIDI-SF clinical screening, 19 for self-reported AD use) and 44 (9.1%) of the SCID-eligible controls, thus predicting 93.2% validation by SCID. PRS prediction was improved in the GenRED cohort using only narrow controls. Discussion Online CIDI-SF screening for MDD-R has a high rate of validation by SCID interviews: 81.8% for MDD-R, and 87.6% if uncomplicated single-episode MDD is considered part of the genetic spectrum. Only 4.5% had no major depressive episode by SCID, but 4.2% received bipolar diagnoses. Although self-report screening for mania is only modestly accurate, we recommend using it to increase the proportion of positive cases. The false-positive rate in controls could be largely controlled by using a very strict threshold for self-reported history of depression (basically, not endorsing depression screening items) and by excluding for any self-reported antidepressant use. This excludes a small proportion of true controls, but an excess of prospective controls is typically available

Many correlates of poor quality of life among substance users entering treatment are not addiction-specific.

BackgroundQuality of life (QoL) is an important measure and outcome within chronic disease management and treatment, including substance use disorders (SUD). The aim of this paper was to investigate correlates of poorer QoL of individuals entering SUD treatment in Norway, in order to identify subgroups that may most benefit from different interventions.MethodsTwenty-one treatment facilities invited all incoming patients to participate. Five hundred forty-nine patients who enrolled between December 2012 and April 2015 are analyzed. QoL, substance use, mental and physical comorbidities, and exercise behaviors were measured. Multinomial regression analysis was used to determine variables significantly associated with poorer QoL.ResultsThe majority of both genders (75 %) reported “poor” or “very poor” QoL at intake. Depression showed a strong association with poor QoL (relative risk ratio [RRR] 3.3, 95 % confidence interval [CI] 1.0–10.3) and very poor QoL (RRR 3.8, 1.2–11.8) among women. Physical inactivity among men was associated with very poor QoL (RRR 2.0, 1.1–3.7), as was reporting eating most meals alone (RRR 2.6, 1.4–4.8). Evaluating one’s weight as too low was also associated with poor QoL (RRR 2.0, 1.0-3.9) and very poor QoL (RRR 2.0, 1.1–3.7) among men. Consuming methadone/buprenorphine was a protective factor for men reporting poor QoL (RRR 0.5, 0.3–0.9) and very poor QoL (RRR 0.4, 0.2–0.9), as well as for women reporting very poor QoL (RRR 0.2, 0.0–0.6).ConclusionsFactors associated with poorer QoL among other healthy and clinical populations, such as impaired social and physical well-being and psychological distress, were also seen associated in this sample. Treatment should be targeted towards patients with these particular vulnerabilities in addition to focusing on substance-related factors, and interventions proven to improve the QoL of other populations with these vulnerabilities should be explored in a SUD context.

Magnitude of Mental Illness and Associated Factors among Holy Water Users at Entoto St. Mary Church, Addis Ababa, Ethiopia, 2014

Introduction: Mental disorders are among the major causes of impairment which results in serious economical, social and other consequences. Many people with this disorder get religious help before or after getting modern treatment. Despite this there is lack of information which indicates the magnitude of mental illness among holy water users and associated factors. Objective: The aim of the study was to assess the prevalence and associated factors of mental illness among holy water users at Entoto St. Mary Church, Addis Ababa, Ethiopia, 2014. Method: Cross sectional study design was conducted from April 28-May 28, 2014 at Entoto St. Mary church. A total of 416 holy water users were included in the study. The participants were selected using systematic random sampling method. Data were collected by face-to-face interviews using structured questionnaire for socio demographic factors, substance related factors using WHO’s ASSIST, interview and observation by Brief Psychiatric Rating Scale (BPRS) for mental illness symptoms and clinical factors were collected using structured questionnaires. Result: A total of 416 participants were interviewed and observed with a response rate of 98.35%. The prevalence of mental illness was 60.1% with 95% CI, (54.34, 65.86). Being jobless [AOR=2.42, 95% CI (1.37,4.28)], ever use of more than one substance (i.e. alcohol, tobacco, khat and cannabis) [AOR=2.4, 95% CI (1.39, 4.17)], current daily drinking of alcohol [AOR=5.08, 95% CI (2.08, 12.2)], having previous history of mental illness [AOR=5.82, 95% CI (2.732,12.378)] and having a known medical or surgical problem [AOR=2.46, 95% CI (1.39,4.34)] were significantly associated with mental illness. Conclusion: More than half of holy water users had mental illness so it needs to give attention to develop reference link between psychiatric institutions and religious places, people’s awareness about the cause, consequence and treatment options of mental illness must be enhanced.