Substance Use Disorder Symptoms Research Articles

Negative urgency, distress tolerance, and symptoms of substance use, eating, and borderline personality disorders in treatment-seeking young people.

Negative urgency (NU) and distress tolerance (DT) are two similar yet distinct constructs with putative transdiagnostic relevance, particularly across psychopathology characterized by impulsivity (e.g., substance use disorders [SUD], eating disorders featuring binging and/or purging ED-B/P, and borderline personality disorder [BPD]). Yet, there remains a lack of research into NU and DT across SUD, ED-B/P, and BPD symptomatology in clinical populations. The present study sought to elucidate the transdiagnostic utility of NU and DT across impulsive-type psychology by examining the unique and interactive roles of NU and DT across SUD, ED-B/P, and BPD symptomatology within a treatment-seeking sample of young people. Participants (N = 385; 62.3% female; aged 16-25 years) were recruited from youth health services across Melbourne, Australia. Participants completed an online survey including self-report measures of NU and DT as well as SUD, ED-B/P, and BPD symptoms. Mixed effects logistic regression was used to explore unique and interactive associations of NU and DT with symptoms. Both NU (adjusted odds ratio [ORadj ] = 1.22; 95% confidence interval [CI] = [1.16, 1.28]) and global DT (ORadj = 0.59; 95% CI = [0.47, 0.74]) uniquely predicted symptoms. However, associations with global DT and most of its components differed across psychopathology types. No significant interactions between NU and DT in predicting symptoms were found. These results support the transdiagnostic utility of NU across SUD, ED-B/P, and BPD, while suggesting the role of DT across these disorders is more nuanced. These findings have important implications for NU and DT as potential intervention targets.

Deep brain stimulation for substance use disorder: a systematic review and meta-analysis.

Substance use disorder (SUD) is a significant public health issue with a high mortality rate. Deep brain stimulation (DBS) has shown promising results in treating SUD in certain cases. In this study, we conducted a meta-analysis to evaluate the efficacy of DBS in the treatment of SUD and reduction of relapse rates. We performed a thorough and methodical search of the existing scientific literature, adhering to the PRISMA guidelines, to identify 16 original studies that fulfilled our inclusion criteria. We used the evidence levels recommended by the Oxford Centre for Evidence-Based Medicine to assess bias. The R version 4.2.3 software was utilized to calculate the mean effect size. We estimated study heterogeneity by employing tau2 and I2 indices and conducting Cochran's Q test. The results showed that DBS treatment resulted in a significant improvement in the clinical SUD scales of patients, with an average improvement of 59.6%. The observed relapse rate was 8%. The meta-analysis estimated a mean effect size of 55.9 [40.4; 71.4]. Heterogeneity analysis showed a large degree of heterogeneity among the included studies. Subgroup and meta-regression analysis based on age and SUD type suggested that DBS may be more effective for patients above 45 years of age, and for alcohol and opioid addiction compared to nicotine addiction. The current literature suggests that DBS has a moderate effect on SUD symptoms. However, the limited number of studies and small sample size indicate that more research is needed to better understand the factors that influence its effectiveness.

Identifying factors associated with user retention and outcomes of a digital intervention for substance use disorder: a retrospective analysis of real-world data.

Successful delivery of digital health interventions is affected by multiple real-world factors. These factors may be identified in routinely collected, ecologically valid data from these interventions. We propose ideas for exploring these data, focusing on interventions targeting complex, comorbid conditions. This study retrospectively explores pre-post data collected between 2016 and 2019 from users of digital cognitive behavioral therapy (CBT)-containing psychoeducation and practical exercises-for substance use disorder (SUD) at UK addiction services. To identify factors associated with heterogenous user responses to the technology, we employed multivariable and multivariate regressions and random forest models of user-reported questionnaire data. The dataset contained information from 14 078 individuals of which 12 529 reported complete data at baseline and 2925 did so again after engagement with the CBT. Ninety-three percent screened positive for dependence on 1 of 43 substances at baseline, and 73% screened positive for anxiety or depression. Despite pre-post improvements independent of user sociodemographics, women reported more frequent and persistent symptoms of SUD, anxiety, and depression. Retention-minimum 2 use events recorded-was associated more with deployment environment than user characteristics. Prediction accuracy of post-engagement outcomes was acceptable (Area Under Curve [AUC]: 0.74-0.79), depending non-trivially on user characteristics. Traditionally, performance of digital health interventions is determined in controlled trials. Our analysis showcases multivariate models with which real-world data from these interventions can be explored and sources of user heterogeneity in retention and symptom reduction uncovered. Real-world data from digital health interventions contain information on natural user-technology interactions which could enrich results from controlled trials.

Childhood and Adult Sexual Violence Exposures as Predictors of PTSD, Dissociation, and Substance Use in Women in Jail

ABSTRACT Women involved in the criminal legal system report high rates of interpersonal violence, particularly sexual violence, and mental health problems. Although existing research has linked experiences of interpersonal violence to multiple negative mental health outcomes, few researchers have examined concurrent psychopathology as an outcome of child and adult sexual violence in system-involved women. The purpose of this study was to examine child sexual abuse (CSA) and adult sexual violence, while controlling for other forms of interpersonal violence, as predictors of current symptoms of posttraumatic stress disorder (PSTD), substance use disorder (SUD), and dissociation in women in jail in the Mountain West. Randomly selected participants (N = 146) completed clinician-administered measures of trauma histories and mental health symptoms. The majority of the women (73%) reported experiences of CSA and about half reported experiences of adult sexual violence. Over half of the women reported symptoms consistent with current probable PTSD, about 20% reported dissociation symptoms in a clinical range, and over 70% met criteria for a SUD in the past year. The proposed model was tested with path analysis. CSA significantly predicted current symptoms of PTSD while adult sexual violence exposure predicted symptoms of SUD and dissociation. These results illustrate the high rates of sexual violence exposure as well as the complexity of mental health needs associated with these exposures in system-involved women. Findings highlight the need to comprehensively assess incarcerated women’s trauma exposure and psychological distress to better meet the needs of this population.

Mobile Assessments of Mood, Cognition, Smartphone-Based Sensor Activity, and Variability in Craving and Substance Use in Patients With Substance Use Disorders in Norway: Prospective Observational Feasibility Study.

Patients with substance use disorders (SUDs) are at increased risk for symptom deterioration following treatment, with up to 60% resuming substance use within the first year posttreatment. Substance use craving together with cognitive and mental health variables play important roles in the understanding of the trajectories from abstinence to substance use. This prospective observational feasibility study aims to improve our understanding of specific profiles of variables explaining SUD symptom deterioration, in particular, how individual variability in mental health, cognitive functioning, and smartphone use is associated with craving and substance use in a young adult clinical population. In this pilot study, 26 patients with SUDs were included at about 2 weeks prior to discharge from inpatient SUD treatment from 3 different treatment facilities in Norway. Patients underwent baseline neuropsychological and mental health assessments; they were equipped with smartwatches and they downloaded an app for mobile sensor data collection in their smartphones. Every 2 days for up to 8 weeks, the patients were administered mobile ecological momentary assessments (EMAs) to evaluate substance use, craving, mental health, cognition, and a mobile Go/NoGo performance task. Repeated EMAs as well as the smartphone's battery use data were averaged across all days per individual and used as candidate input variables together with the baseline measures in models of craving intensity and the occurrence of any substance use episodes. A total of 455 momentary assessments were completed out of a potential maximum of 728 assessments. Using EMA and baseline data as candidate input variables and craving and substance use as responses, model selection identified mean craving intensity as the most important predictor of having one or more substance use episodes and with variabilities in self-reported impulsivity, mental health, and battery use as significant explanatory variables of craving intensity. This prospective observational feasibility study adds novelty by collecting high-intensity data for a considerable period of time, including mental health data, mobile cognitive assessments, and mobile sensor data. Our study also contributes to our knowledge about a clinical population with the most severe SUD presentations in a vulnerable period during and after discharge from inpatient treatment. We confirmed the importance of variability in cognitive function and mood in explaining variability in craving and that smartphone usage may possibly add to this understanding. Further, we found that craving intensity is an important explanatory variable in understanding substance use episodes.

Adaptation of a mindfulness-based intervention for trauma-exposed, unhoused women with substance use disorder.

Women experiencing homelessness (WEH) report exceedingly high rates of trauma exposure, posttraumatic stress disorder (PTSD), and substance use disorder (SUD). Mindfulness-based interventions including Mindfulness-based Stress Reduction (MBSR) may help lower traumatic stress-related symptoms and reduce SUD, but have been underexplored in community-based settings serving WEH with symptoms of PTSD and SUD. We used a mixed-method, community-engaged approach that implemented a Community Advisory Board and the ADAPT-ITT (assessment, decision, adaptation, production, topical experts, integration, training, testing) framework, including intervention demonstrations, to adapt and refine MBSR for WEH experiencing symptoms of PTSD/SUD. Trauma-exposed WEH (N = 28) living at a drug treatment site provided perspectives and feedback on an MBSR demonstration via quantitative questionnaires and four focus groups. Quantitative measures indicated high perceived acceptability and feasibility: Nearly all WEH reported MBSR activities (including yoga, meditation, body scans, class discussion, and home practice) would be at least "somewhat helpful"; between 71.43% to 89.29% reported each activity would be "a great deal helpful." Most reported the focus group sessions were useful for providing feedback relevant for improving program design and administration. Qualitative findings revealed four themes aligning with quantitative findings that provided useful suggestions to guide MBSR implementation with trauma-exposed WEH: (a) perception of feasibility and effectiveness of MBSR, (b) strategies for successful recruitment, (c) strategies for successful retention, and (d) characteristics of the MBSR trainer. Focus group recommendations could bolster intervention compliance, engagement, and completion for MBSR and community-based programs for WEH more generally. Results provide suggestions for implementing a trauma-sensitive approach when administering MBSR to trauma-exposed WEH. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Inaugural outcomes study released by NAATP

Designed as a long‐term project, the first report on the outcomes‐monitoring research done by the National Association of Addiction Treatment Providers (NAATP) has been released. In answer to the question, “Does treatment work?,” the report found that there was a decrease in severity of symptoms of substance use disorder (SUD), depression, and anxiety over the course of treatment and throughout the first year of follow‐up.

Predictors of substance use disorder symptoms among women in Katsina State, Nigeria

BackgroundProblems associated with substance use are on the rise among women in northern Nigeria, creating a need to understand factors contributing to this trend. MethodData on substance use, symptoms of substance use disorder (SUD) using DSM-5 criteria, and risk and protective factors associated with SUD symptoms, including adverse childhood experiences (ACE), were collected in a community-based study of young adult women (M age = 25.76, SD = 4.71 years) from Katsina State. ResultsThe analytic sample included 360 women with valid SUD symptom data. SUD symptoms were correlated in expected directions with the majority of risk and protective factors, including ACE. A hierarchical linear regression analysis predicting SUD symptoms revealed that age, ACE, and peer drug use were uniquely associated with higher levels of SUD symptoms; more education and endorsing a positive relationship with parents was associated with fewer SUD symptoms. Notably, ACE remained a unique contributor to SUD symptom totals in the context of protective factors and additional risk factors, although the association of ACE and SUD symptoms was attenuated. ConclusionsThese data illustrate the enduring impact of ACE on risk for SUD symptoms in women, and the protective role that a positive relationship with parents may play in reducing this risk. Further, these patterns of findings reveal the utility of assessing risk and protective factors across multiple life domains to gain a comprehensive picture of risk for SUD symptoms in women.

The centrality of craving in network analysis of five substance use disorders

Background and aimsAmong the 11 current diagnostic criteria, craving is a potential central marker for understanding and for treatment of Substance Use Disorders (SUD). Our objective was to explore craving centrality across SUD based on the study of symptom interactions in cross-sectional network analyses of DSM-5 SUD diagnostic criteria. We hypothesized the centrality of “Craving” in SUD across substance types. DesignParticipants from the ADDICTAQUI clinical cohort with regular use (2 times per week threshold for a substance) and at least one DSM-5 SUD. SettingOutpatient substance use treatment services in Bordeaux, France. ParticipantsThe sample of 1359 participants, had a mean age of 39 years old and 67% were males. The prevalence of SUD over the time course of the study was: 93% for alcohol, 98% for opioids, 94% for cocaine, 94% for cannabis and 91% tobacco. MeasurementsConstruction of a Symptom Network Model conducted on the DSM-5 SUD criteria evaluated over the past 12 months for Alcohol-, Cocaine-, Tobacco-, Opioid- and Cannabis Use disorder. FindingsThe only symptom that consistently remained in terms of centrality was “Craving” [3.96 – 6.17] (z-scores), indicating that it exhibits a high degree of connections in the entire symptom network regardless of the substance. ConclusionIdentifying craving as central in SUD symptoms network confirms the role of craving as a marker of addiction. This constitutes a major avenue in the understanding of the mechanisms of addiction, with implications to ameliorate diagnostic validity and clarify treatment targets.

A meta‐analysis of neurofeedback for treating substance use disorders

AbstractA meta‐analysis was conducted to assess the efficacy of neurofeedback (NFB) in the treatment of individuals with substance use disorder (SUD) in between‐group studies. This study reports findings from the first exhaustive search of the literature on the topic and included articles selected from a total of 58 databases/repositories. Studies were evaluated using Hedge's g as the effect size measure and were assessed for risk of bias using funnel plot, Fail‐Safe N, and Trim and Fill analysis. Ten studies, containing 30 effect sizes were evaluated to determine the overall efficacy of NFB for decreasing symptoms of SUD (N = 397), yielding a mean effect size of g = –1.49 (CI 95 = –1.95, –1.03; PI 95 = –4.37 to 1.39). This meta‐analysis provides strong evidence for the efficacy of NFB in treating SUD while also highlighting the value of wholistic client care in SUD treatment.

Intimate partner violence, substance use, and health comorbidities among women: A narrative review.

Exposure to intimate partner violence (IPV), including physical, sexual, and psychological violence, aggression, and/or stalking, impacts overall health and can have lasting mental and physical health consequences. Substance misuse is common among individuals exposed to IPV, and IPV-exposed women (IPV-EW) are at-risk for transitioning from substance misuse to substance use disorder (SUD) and demonstrate greater SUD symptom severity; this too can have lasting mental and physical health consequences. Moreover, brain injury is highly prevalent in IPV-EW and is also associated with risk of substance misuse and SUD. Substance misuse, mental health diagnoses, and brain injury, which are highly comorbid, can increase risk of revictimization. Determining the interaction between these factors on the health outcomes and quality of life of IPV-EW remains a critical need. This narrative review uses a multidisciplinary perspective to foster further discussion and research in this area by examining how substance use patterns can cloud identification of and treatment for brain injury and IPV. We draw on past research and the knowledge of our multidisciplinary team of researchers to provide recommendations to facilitate access to resources and treatment strategies and highlight intervention strategies capable of addressing the varied and complex needs of IPV-EW.

Sociological Study about prevention of drug among Children and Adolescents in Pakistan

In Pakistan and all the world use of drug are a serious problem Although some studies have shown short-term benefits from drug-use prevention programs for young adolescents and adults, few have looked at the long-term impacts. Such data is critical for determining how long preventative benefits endure. Inappropriate use of substances, addictions, and dependence are all problems that may be avoided and that disrupt normal healthy functioning. A strong mental, emotional, and behavioral foundation is essential for the growth and development of a person into an effective adult. The study looks into the Sociological study about prevention of substance use of drug among children and adolescents. To explore side effects of drugs in children, adolescents, and young adults. To decrease access and use among children, adolescents, and young adults, The study incorporates qualitative data from secondary source government, magazine, books. This examination clarifies the use of drugs in adolescents and youngsters and its prevention methods that can be performed to control and prevent drugs use among children. Not only should more study investigate the levels of drug use, but it should also investigate the effects that are encountered, such as the signs and symptoms of substance use disorders in later life.

Low carbohydrate and psychoeducational programs show promise for the treatment of ultra-processed food addiction.

Food addiction, specifically ultra-processed food addiction, has been discussed in thousands of peer-reviewed publications. Although 20% of adults meet criteria for this condition, food addiction is not a recognized clinical diagnosis, leading to a dearth of tested treatment protocols and published outcome data. Growing numbers of clinicians are offering services to individuals on the basis that the food addiction construct has clinical utility. This audit reports on clinical teams across three locations offering a common approach to programs delivered online. Each team focused on a whole food low-carbohydrate approach along with delivering educational materials and psychosocial support relating to food addiction recovery. The programs involved weekly sessions for 10–14 weeks, followed by monthly support. The data comprised pre- and post- program outcomes relating to food addiction symptoms measured by the modified Yale Food Addiction Scale 2.0, ICD-10 symptoms of food related substance use disorder (CRAVED), mental wellbeing as measured by the short version of the Warwick Edinburgh Mental Wellbeing Scale, and body weight. Sample size across programs was 103 participants. Food addiction symptoms were significantly reduced across settings; mYFAS2 score −1.52 (95% CI: −2.22, −0.81), CRAVED score −1.53 (95% CI: −1.93, −1.13) and body weight was reduced −2.34 kg (95% CI: −4.02, −0.66). Mental wellbeing showed significant improvements across all settings; short version Warwick Edinburgh Mental Wellbeing Scale 2.37 (95% CI: 1.55, 3.19). Follow-up data will be published in due course. Further research is needed to evaluate and compare long-term interventions for this complex and increasingly burdensome biopsychosocial condition.

Prevalence and comorbidity in a Swedish adolescent community sample – gambling, gaming, substance use, and other psychiatric disorders

BackgroundThis study investigates a broad spectrum of psychiatric disorders, substance use disorders, gambling, and internet gaming disorders in Swedish 18-year-old boys and girls with the aim of estimating the prevalence of disorders and comorbidity.MethodsWe used a two-phase design with screening to detect candidates for clinical interviews. Screening included 949 adolescents (55.6% girls), out of which 758 adolescents (57.0% girls) were selected for interview with at least one of four instruments: M.I.N.I., ADDIS, NODS and IGDS. Of these, 387 (61.2% girls) were interviewed. Gender separated prevalence was estimated on the assumption that those selected but not interviewed had the same distribution as those interviewed based on similar outcomes above screening cut-offs. Comorbidity between types of disorders was estimated on similar assumptions. In addition, comorbidity between dyads of the ten most common specified disorders was calculated based on recorded data without these assumptions.ResultsWe estimated that 14.6% met the criteria of a substance use disorder (SUD), mostly concerning alcohol and more frequent in girls than in boys. Those meeting the criteria lifetime of at least one of 16 other psychiatric disorders were 26.7%, more than twice as frequent in girls compared to boys, and with depression being the most common disorder. Gambling and gaming disorders were found almost exclusively in boys, of which 5.8% met the criteria for gambling, and 2.3% for gaming disorders. Of girls with a SUD, 40% also had a psychiatric disorder, while on the other hand more than 28% of girls with a psychiatric disorder also had a SUD. In boys with a SUD, 22% had another psychiatric disorder, while 15% of those with a psychiatric disorder also had a SUD.ConclusionsPsychiatric comorbidity is common in SUDs in adolescents, which calls for screening and diagnostic efforts in young patients presenting with symptoms of SUDs. Girls with SUDs are at higher risk of also suffering from psychiatric conditions. Gambling and gaming disorders appear in a substantial minority of adolescents and warrant further study of their comorbidity. Since prevalences and comorbidity were estimated on the assumptions mentioned, some caution in interpreting the results is needed.

Systematic review: Wearable remote monitoring to detect nonalcohol/nonnicotine-related substance use disorder symptoms.

Substance use disorders (SUDs) are chronic relapsing diseases characterized by significant morbidity and mortality. Phenomenologically, patients with SUDs present with a repeating cycle of intoxication, withdrawal, and craving, significantly impacting their diagnosis and treatment. There is a need for better identification and monitoring of these disease states. Remote monitoring chronic illness with wearable devices offers a passive, unobtrusive, constant physiological data assessment. We evaluate the current evidence base for remote monitoring of nonalcohol, nonnicotine SUDs. We performed a systematic, comprehensive literature review and screened 1942 papers. We found 15 studies that focused mainly on the intoxication stage of SUD. These studies used wearable sensors measuring several physiological parameters (ECG, HR, O2 , Accelerometer, EDA, temperature) and implemented study-specific algorithms to evaluate the data. Studies were extracted, organized, and analyzed based on the three SUD disease states. The sample sizes were relatively small, focused primarily on the intoxication stage, had low monitoring compliance, and required significant computational power preventing "real-time" results. Cardiovascular data was the most consistently valuable data in the predictive algorithms. This review demonstrates that there is currently insufficient evidence to support remote monitoring of SUDs through wearable devices. This is the first systematic review to show the available data on wearable remote monitoring of SUD symptoms in each stage of the disease cycle. This clinically relevant approach demonstrates what we know and do not know about the remote monitoring of SUDs within disease states.

The Impact of COVID-19 Pandemic on Mental Health among Individuals in Dar es Salaam, Tanzania

This study aimed at examining the impact of COVID-19 on mental health in Dar es Salaam, Tanzania. Specifically, this study was guided by the assumption that the COVID-19 pandemic had impacted on individuals’ mental health in Tanzania in various ways. The study used a Social Cognitive Theory to illuminate insights generated from the empirical findings from the field. Using a survey questionnaire, the study collected data from a sample of 258 respondents. The findings have shown that COVID-19 affected individuals differently, with fewer symptoms of substance use disorders, depression, and schizophrenia experienced by the respondents interviewed. Overall, there were high symptoms of obsession and bipolar disorder. In conclusion, people’s cognitive perception influenced their view of severity of COVID-19 and consequently predisposed their behaviour. Given the changing nature of the virus globally, this study recommends for a countrywide survey to determine the trend and magnitude of mental disorders in the country.

Perceptions of Women With Comorbid PTSD and Substance Use Disorder on Mechanisms Underlying Mindfulness-Based Interventions

Women with comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD) demonstrate the greatest psychiatric severity when entering mental health treatment, and poorest rates of treatment completion and relapse compared to those with either disorder alone. Mindfulness-based interventions (MBIs) for women with comorbid PTSD–SUD may be an effective treatment approach as it targets mechanisms underlying self-medication of trauma-related symptoms via substance use. Little is known, however, of the benefits of MBIs for this population. Thus, the purpose of this study was to qualitatively elucidate mechanisms of action in a pilot MBI adapted for women with comorbid SUD and PTSD, with the goal of identifying the most salient aspects of MBIs that target self-medication of PTSD symptoms via substance use. Following completion of a trauma-integrated MBI, women (N = 39) diagnosed with PTSD–SUD were invited to attend one of ten, 60-minute, audio-recorded focus groups. A semistructured interview protocol was utilized to investigate how participants perceived the utility of MBIs in mitigating PTSD and SUD symptoms over the course of the intervention. Conventional content analysis guided qualitative analysis and reporting. Participants described four mechanisms through which they experienced MBIs attenuating the relationship between PTSD and SUD: increased attention to trauma- and substance-related triggers occurring in the present moment; greater cultivation of nonjudgmental acceptance to aversive experiences; development of self-compassionate attitudes toward suffering; and increased tolerance to aversive experiences. Building upon these mechanisms of action, we propose a moderated mediation model, in which increased present-moment awareness, nonjudgmental attitudes toward distress, and self-compassion reduce impulsivity and negative affect, which then increases tolerance for aversive experiences, thereby attenuating the relationship between PTSD and SUD symptoms. Interventions targeting the four proposed mechanisms may be considered when treating women diagnosed with comorbid PTSD–SUD.

Sleep characteristics in patients with substance use disorder after detoxification treatment: self-report and actigraphy data

IntroductionSleep problems are common in patients with substance use disorders (SUD) and have been related to poor treatment outcomes. Little is known about the sleep characteristics in patients with opioid and alcohol use disorders after detoxification program.ObjectivesTo compare sleep quantitative and qualitative characteristics between patients with opioid and alcohol use disorders.MethodsThis is a secondary data analysis of the longitudinal data from the observational study in St. Petersburg, Russia. The sample included 75 patients (22.7% female) who received detoxification treatment for alcohol (n=49) or opioid (n=26) withdrawal. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and underwent daily wrist actigrahy.Results Good internal consistency was demonstrated for self-report and actigraphy data (r =-0,405, p<0,01). Sleep duration and sleep onset latency were not different between alcohol and opioid groups (5.7 vs. 6.1 hours; 74 vs. 65 minutes, respectively) based on self-report data. The majority of the patients (57-100%) had sleep complaints and low quality of sleep after detoxification completion (at baseline). In both groups, the mean PSQI score had a tendency to decrease, representing better sleep quality, over the 1-week following detoxification program completion (from 12 at baseline to 10 at 1-week in alcohol group; from 13 to 12 in opioid group, p<0,001).ConclusionsThe findings show that sleep characteristics are similar in patients with different SUD and insomnia symptoms are prevalent after detoxification, suggesting the rationale for sleep assessment before hospital discharge. Despite the positive changes in sleep quality over 1-week abstinence, patients might benefit from the therapeutic sleep interventions.DisclosureThis work was financially supported by a research grant from Russian Foundation for Basic Research, 18-013-00481.

Network Analysis of DSM Symptoms of Substance Use Disorders and Frequently Co-Occurring Mental Disorders in Patients with Substance Use Disorder Who Seek Treatment.

Background: Substance use disorders (SUD) often co-occur with other psychiatric conditions. Research on SUD and comorbid disorders generally flows from a categorical diagnostic or dimensional latent variable perspective, where symptoms are viewed as independent indicators of an underlying disorder. In contrast, the current study took a network analysis perspective to examine the relationships between DSM symptoms of SUD, ADHD, conduct disorder (CD), depression (MDD), and borderline personality disorder (BPD). In addition, we explored possible gender differences in the network structures of these symptoms. Method: In a sample of 722 adult treatment-seeking patients with SUD from the International ADHD in Substance Use Disorders Prevalence Study (IASP) we estimated the network structure for 41 symptoms of SUD, ADHD, CD, MDD, and BPD. We described the structure of symptom networks and their characteristics for the total sample, and we compared the symptom networks for males and females. Results: Network analyses identified seven clusters of symptoms, largely corresponding with the DSM diagnostic categories. There were some connections between clusters, mainly between some hyperactivity symptoms and CD and depressive symptoms. ADHD hyperactivity was most central in the symptom network. Invariance tests revealed no significant gender differences in the structure of symptom networks. Conclusions: The current findings support the categorical DSM classification of mental disorders in treatment-seeking patients with SUD. Future network analyses should include a broader range of symptoms and prospectively explore changes in the symptoms network of patients during treatment.

Nurses' substance use disorder in disciplinary procedures: A retrospective document analysis.

To describe nurses with substance use disorder (SUD) in authority disciplinary actions. Nurses with SUD risk patient safety. Research evidence on the identification of nurses' SUD and related management procedures is currently sparse. Retrospective document analysis of decisions related to SUD in nurses' disciplinary actions. Decisions on nurses (N=171) made by the Finnish National Supervisory Authority for Welfare and Health in Finland during 2007-2016 were used as data. An electronic extraction sheet was developed for data collection including variables (N=34), of which 18 were analysed in this study with descriptive statistical methods and chi-squared statistics. The study reported in accordance with the STROBE checklist for cross-sectional studies. The mean age of the nurses was 43years (SD 8.7). The most mentioned reasons for notifications leading to disciplinary actions were substance abuse with working while intoxicated and drug theft. The most mentioned intoxicants used were medicines and alcohol. On average, the first disciplinary decision was given at 6.4months (SD 3.9) and the final decision was given at 17.9months (SD 13.1). The most common decision was restriction of the right to practice. The results supported findings from previous decades and different continents, showing similar trends are prevalent globally and continue today. In future studies, countries' registers of nurses with SUD could be used to clarify the profile of nurses and develop appropriate procedures. Qualitative studies could be conducted to investigate to shed light on concealment of the phenomenon. There is a need for early identification, intervention and referral to treatment as well as effective protocols for reducing nurses' risks of disciplinary actions related to SUD. It is important to be aware of the signs and symptoms of SUD and training for this is needed.