Search results for ‘Subject term:"mental health problems"’ Sort:
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Dual diagnosis: discovery of a critical role for environmental exposure
- Author:
- GOLD Mark S.
- Journal article citation:
- Journal of Dual Diagnosis, 1(1), 2004, pp.5-13.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
It is estimated that 10 million persons in the United States have at least one mental disorder and at least one substance-related disorder in any given year. Dual disorders are common in psychiatry, but misdiagnosis may be even more common. Drug and alcohol testing should be expanded from routine use in the Olympics and intercollegiate athletics to psychiatric diagnosis of drug intoxication, dependence, and withdrawal states. Major Depression is co-morbid with opiate addiction, alcohol dependency, tobacco smoking, and many other substance abuse disorders. Drug use induces adaptations in brain systems associated with mood and motivation. The acute rewarding effects of drugs change the mesolimbic dopaminergic system. Cessation of drug self-administration induces dysphoria and anhedonia as a result of changes in monoamine levels in brain reward circuits; opposite to the effects that occur after the administration of drugs of abuse. While most models for dual disorders assume compulsive or volitional use or self administration, we have been interested in second-hand exposure which was common in the past among flight attendants and occurs today between smoking parent and child. We expand the concept from parent-to-child environmental tobacco toxicity to a workplace toxicity hypothesis for anesthesiologists. Such a hypothesis can explain the high rates of depression, workplace and social distress, drug abuse, and drug addiction among anesthesiologists. While co-occurring disorders have been the focus of epidemiological studies and twin and genetic studies, the role of exposure to potent drugs of abuse in the intra-uterine, home, and workplace environment has been neglected. We have demonstrated the unequivocal presence of fentanyl and other potent drugs of abuse in the air that anesthesiologists breathe in the operating room. Drug exposure sensitizes the brain. When sensitization is coupled with the stress of operating room, employment may produce the pattern of co-occurring disorders seen in anesthesiologists but not psychiatrists. Prevention is the goal in environmental or toxicity-related illness. After diagnosis, treatment for dual disorders should be vigorous with remission of all disorders in mind. For anesthesiologists, limiting toxic environmental exposure may prevent both drug and affective disorders. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
No need for a crystal ball
- Author:
- HOFFMANN Norman
- Journal article citation:
- Addiction Today, 15(88), May 2004, pp.22-23.
- Publisher:
- Addiction Recovery Foundation
Reports on the findings of a survey of a group of juvenile offenders aged between 13 and 18 in the United States. It was conducted in routine practice from 218 consecutive admissions to two juvenile criminal-justice facilities and adolescent diversion courts in a New England state. Results found that most appeared to have co-existing mental-health and substance-use disorders. Argues that these must be treated to reshape lives and cut re-offending.
When life is a drag: depressive symptoms associated with early adolescent smoking
- Authors:
- ARNOLD Elizabeth Mayfield, et al
- Journal article citation:
- Vulnerable Children and Youth Studies, 9(1), 2014, pp.1-9.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Adolescent nicotine use continues to be a significant public health problem. We examined the relationship between the age of youth reporting current smoking and concurrent risk and protective factors in a large state-wide sample. We analyzed current smoking, depressive symptoms, and socio-demographic factors among 4027 adolescents aged 12–17 years by using multivariate logistic regression (see 2005 California Health Interview Survey (CHIS) Public Use File). Consistent with previous work, Latinos, girls, those whose family incomes were below the poverty level, and those with fair-poor health were more likely to display depressive symptoms. Males, whites, older teens, and those in fair-poor health were more likely to be current smokers. In a multivariate analysis predicting depressive symptoms, the interaction between age and current smoking was highly significant (Wald X2 = 15.8, p < 0.01). At ages 12–14 years, the probability of depressive symptoms was estimated to be four times greater among adolescents who currently smoked compared to those who were not current smokers. The likelihood of depressive symptoms associated with current smoking decreases with age and becomes nonsignificant by 17 years. Interventions to reduce smoking may be most useful among youth before 12 years of age and must be targeted at multiple risks (e.g., smoking and depression). (Publisher abstract)
Use of mental health services by survivors of intimate partner violence
- Authors:
- EDMOND Tonya, BOWLAND Sharon, YU Mansoo
- Journal article citation:
- Social Work in Mental Health, 11(1), 2013, pp.34-54.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The purpose of this study was to assess current rates of posttraumatic stress disorder (PTSD), depression, alcohol, and substance abuse among a sample of 50 abused women and to examine the types of services survivors of intimate partner violence (IPV) had used in the previous 12 months. Participants were recruited from a legal advocacy programme. In addition, the authors sought to understand how the presence of substance abuse, PTSD, and/or depression affects access and utilisation of services by IPV survivors. Fifty-four per cent of these IPV survivors were experiencing either PTSD, clinical depression, or both. While women with either PTSD or depression used a significantly larger number of services overall, the majority had not used any mental health services, even though they frequently reported services were accessible. Given the high rates of PTSD and depression in this sample, these abused women were clearly not receiving adequate mental health care. Many reported having trouble accessing housing, legal services, crisis lines, and medical care services that are fundamental to safety. The authors concluded that practitioners working with abused women should assess for PTSD and depression.
Depression and anger as risk factors underlying the relationship between maternal substance involvement and child abuse potential
- Authors:
- HIEN Denise, et al
- Journal article citation:
- Child Abuse and Neglect, 34(2), February 2010, pp.105-113.
- Publisher:
- Elsevier
In this study, aiming to advance the understanding of child abuse potential in mothers with substance use histories by examining the contribution of depression and emotion regulation deficits in a multifaceted model, a group of substance abusing women are compared to a group of mothers with depressive disorders and a community comparison group on measures of diagnosis, anger arousal and reactivity and child abuse potential, using a sample of 152 mothers recruited through a clinic in a public hospital in New York City, in order to identify targeted areas for prevention and treatment. The findings showed that anger arousal and reactivity exceeded diagnostic and demographic variables in predicting maternal child abuse potential. The article discusses the findings in relation to a multifaceted model of child abuse potential. The researchers conclude that models and approaches which help clients to manage and regulate difficult feeling states, specifically anger, could be helpful.
Predictors of depressive symptomatology in family caregivers of women with substance use disorders or co-occurring substance use and mental disorders
- Authors:
- BIEGEL David E., et al
- Journal article citation:
- Journal of Family Social Work, 13(1), January 2010, pp.25-44.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Families play a significant role in the well-being of relatives with co-occurring substance misuse and mental health problems through the provision of direct care, management of symptoms, retention of treatment and emotional support. This paper describes a stress-process model to investigate the impact of having a female family member with substance use or co-occurring substance use and mental disorder on family caregivers’ depressive symptomatology. Eighty two women receiving substance abuse treatment and the family member providing the most social support for each woman participated. Findings showed that greater caregiver depressive symptomatology was predicted by greater care recipient emotional problems, less care recipient social support, and poor caregiver health. The caregivers were twice as likely to suffer from depressive symptomatology compared to those in the general population. In conclusion, the author suggests that interventions aimed at improving the care recipients’ social network may help to improve the carers well-being.
Twelve-month prevalence of DSM-IV mental disorders among older Asian Americans: comparison with younger groups
- Authors:
- KIM Jinseok, CHOI Namkee G.
- Journal article citation:
- Aging and Mental Health, 14(1), January 2010, pp.90-99.
- Publisher:
- Taylor and Francis
Both lifetime and current prevalence estimates of mental disorders in the general population have consistently shown ages differences. Using public-use data from the National Latino and Asian American Study (NLAAS), 2002-2003, this study aimed to compare the 12-month prevalence of depressive, anxiety, or intermittent explosive disorder among older Asian Americans to that among younger groups, and to examine age group differences in correlates for these mental disorders. The results found that the 12-month prevalence rate among older adults, 7.4% in the 60+ group, was significantly lower than those among younger groups. They also found that correlates of mental disorder were not the same among different age groups. Among the 60+ group, ethnicity, work status, years in the United States, family conflict, and social disability score were the significant covariates of a diagnosis of mental disorder. The findings appear to suggest that, compared with younger cohorts, older Asian Americans may have lower reactivity to life stressors and more adaptive coping strategies.
QuikFix: enhanced motivational interviewing interventions for youth substance use
- Authors:
- HIDES Leanne, et al
- Journal article citation:
- Advances in Dual Diagnosis, 9(2/3), 2016, pp.53-65.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore the background principles, theories and components of the QuikFix intervention for primary and comorbid substance use in young people. Design/methodology/approach: QuikFix is a brief motivational interviewing (MI) intervention utilising cognitive-behavioural coping skills training to reduce vulnerability to substance use and comorbid mental health problems in young people. It is delivered in two to three brief sessions including an assessment. A new version, QuikFix personality intervention (PI) which incorporates coping skills training targeting sensation seeking, impulsive, depressive and anxious personality styles that may underlie primary and comorbid substance use problems is presented. Findings: The original QuikFix intervention has demonstrated efficacy in young alcohol and cannabis users with comorbid depression and anxiety symptoms. The efficacy of the new personality targeted version of QuikFix is currently being tested in a large randomized controlled trial among young people with alcohol related injuries/illnesses. Future research is required to determine the efficacy of QuikFix PI in comorbid populations including those with behavioural disorders. Practical implications: QuikFix interventions can be delivered via telephone or face-to-face in clinical settings for clients with primary substance use and comorbid depression and anxiety symptoms. (Edited publisher abstract)
Smartphones for smarter delivery of mental health programs: a systematic review
- Authors:
- DONKER Tara, et al
- Journal article citation:
- Journal of Medical Internet Research, 15(11), 2013, Online only
- Publisher:
- JMIR Publications
Objective: To systematically review the research evidence supporting the efficacy of mental health mobile phone applications (apps) for mobile devices (such as smartphones and tablets) for all ages. Methods: A comprehensive literature search (2008-2013) in MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, PsycINFO, PsycTESTS, Compendex, and Inspec was conducted. Trials that examined the effects of mental health apps (for depression, anxiety, substance use, sleep disturbances, suicidal behavior, self-harm, psychotic disorders, eating disorders, stress, and gambling) delivered on mobile devices with a pre- to posttest design or compared with a control group were included. The control group could consist of wait list, treatment-as-usual, or another recognized treatment. Results: In total, 5464 abstracts were identified. Of those, 8 papers describing 5 apps targeting depression, anxiety, and substance abuse met the inclusion criteria. Four apps provided support from a mental health professional. Results showed significant reductions in depression, stress, and substance use. Within-group and between-group intention-to-treat effect sizes ranged from 0.29-2.28 and 0.01-0.48 at posttest and follow-up, respectively. Conclusions: Mental health apps have the potential to be effective and may significantly improve treatment accessibility. However, the majority of apps that are currently available lack scientific evidence about their efficacy. The public needs to be educated on how to identify the few evidence-based mental health apps available in the public domain to date. Further rigorous research is required to develop and test evidence-based programs. Given the small number of studies and participants included in this review, the high risk of bias, and unknown efficacy of long-term follow-up, current findings should be interpreted with caution, pending replication. Two of the 5 evidence-based mental health apps are currently commercially available in app stores. (Edited publisher abstract)
Impact of physical health on treatment for co-occurring depression and substance dependence
- Authors:
- TRIPP Jessica C., et al
- Journal article citation:
- Journal of Dual Diagnosis, 9(3), 2013, pp.239-248.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Objective: There is a high rate of comorbidity among substance dependence, depression, and physical health problems. This study aimed to examine the impact of pre-treatment physical health stressors (acute and chronic conditions) on outcomes of treatment in a sample of veterans with dual disorders (depression and substance dependence) who were randomised to integrated cognitive behavioural therapy versus 12-step interventions. Methods: This study included 205 veterans (89.8% male, mean age = 49.5 years) enrolled in a clinical treatment outcomes trial. Chronic health problems (persistent, ongoing conditions lasting 2 weeks or more; e.g., arthritis, diabetes) and acute health events (occurring on a discrete date; e.g., injury, surgery, myocardial infarction) were coded dichotomously (presence versus absence) and evaluated separately. The impact of physical health stressors on abstinence (defined dichotomously), percentage of days abstinent, and depression symptoms were analyzed at the end of 12 and 24 weeks of treatment. Additionally, associations between intake motivation to change, health stressors, and substance use were examined. Results: Analyses revealed that participants who had experienced a pre-treatment acute health event had higher rates of abstinence at 12 weeks, higher percentage of days abstinent at 24 weeks, and higher depression symptoms at intake. Participants with chronic health difficulties had more severe depression at intake and those participants with severe chronic difficulties had greater depression symptoms across all time points. Chronic health difficulties were related to the “taking steps” factor of motivation to change substance use, but acute health events were not related to motivation to change. Motivation to change was also not related to substance outcomes in our sample. Conclusions: Physical health appears to have a complex relationship with co-occurring depression and substance dependence. Acute health problems predicted lower substance use, whereas chronic health problems were associated with higher depression levels. Explicitly addressing the connection between substance use and health events during treatment may improve addiction treatment outcomes. However, individuals with chronic health problems may benefit from extending treatment or adjunct strategies focused on addressing chronic health concerns. This is an analysis of data collected as part of a clinical trial registered at www.ClinicalTrials.gov as NCT00108407. (Publisher abstract)