Search results for ‘Subject term:"mental health problems"’ Sort:
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Substance abuse and psychiatric dual disorders: focus on tobacco
- Authors:
- GOLD Mark S., FROST-PINEDA Kimberley
- Journal article citation:
- Journal of Dual Diagnosis, 1(1), 2004, pp.15-35.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Smoking is a leading cause of morbidity and is the single most important preventable cause of mortality in the United States. The link between tobacco smoking and lung cancer, heart disease, stroke, chronic lung disease, other cancers, and other medical diseases is now generally accepted. The link between tobacco and psychiatric diseases has become a focus for recent epidemiological studies, which have even led to the suggestion that in the differential diagnosis of "smoker" highest on the list are depression, alcohol dependence, and schizophrenia. Less is known about the role of second hand tobacco exposure, either in utero or during childhood, in the risk of dual disorders. Here the authors explore the issue of substance abuse and psychiatric dual disorders, prenatal and early childhood Second Hand Smoke (SHS) exposure and the relationship to the genesis of these dual disorders. They describe a novel method of detecting SHS exposure and the public health implications of this development. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
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)
Factors associated with smoking and smoking cessation among primary care patients with depression: a naturalistic cohort study
- Authors:
- GILCHRIST Gail, et al
- Journal article citation:
- Advances in Dual Diagnosis, 8(1), 2015, pp.18-28.
- Publisher:
- Emerald
Purpose: People with a history of depression are more likely to smoke and less likely to achieve abstinence from smoking long term. The purpose of this paper is to understand the factors associated with smoking and smoking cessation among patients with depression. Design/methodology/approach: This paper reports on smoking prevalence and cessation in a cohort of 789 primary care attendees with depressive symptoms (Centre for Epidemiologic Studies Depression Scale score of=16) recruited from 30 randomly selected Primary Care Practices in Victoria, Australia in 2005. Findings: At baseline, 32 per cent of participants smoked. Smokers were more likely to be male, unmarried, receive government benefits, have difficulty managing on available income, have emphysema, a chronic illness, poor self-rated health, to have more severe depressive and anxiety symptoms, to be taking anti-depressants, to be hazardous drinkers, to report suicidal ideation and to have experienced childhood physical or sexual abuse. At 12 months, 20 participants reported quitting. Females and people with good or better self-rated health were significantly more likely to have quit, while people with a chronic illness or suicidal ideation were less likely to quit. Smoking cessation was not associated with increases in depression or anxiety symptoms. Only six participants remained quit over four years. Practical implications: Rates of smoking were high, and long-term cessation was low among primary care patients with depressive symptoms. Primary care physicians should provide additional monitoring and support to assist smokers with depression quit and remain quit. Originality/value: This is the first naturalistic study of smoking patterns among primary care attendees with depressive symptoms. (Publisher abstract)
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.
Cheers?: understanding the relationship between alcohol and mental health
- Author:
- MENTAL HEALTH FOUNDATION
- Publisher:
- Mental Health Foundation
- Publication year:
- 2006
- Pagination:
- 40p.
- Place of publication:
- London
While much debate has taken place recently about alcohol, researchers have failed to draw out the reasons why so many people have troubled relationships with it. The reasons we drink and the consequences of excessive drinking are intimately linked with our mental health, and this holds the key to dealing with growing worries about alcohol misuse. Evidence outlined in this report shows that: there are significant connections between reported alcohol use and depressive symptoms; people report using alcohol to help them sleep people drink more when experiencing moderate to high levels of shyness or fear; anxious people use drinking ‘to cope’ and are more likely to avoid social situations where alcohol is not available; as many as 65% of suicides have been linked to excessive drinking 70% of men who kill themselves have drunk alcohol before doing so almost a third of suicides amongst young people are committed while the person is intoxicated; anxiety and depressive symptoms are more common in heavy drinkers; heavy drinking is more common in those with anxiety and depression; there is a significant relationship between job stress and alcohol consumption. Many GPs believe that alcohol is a cause of mental health problems.
Correlates of depressive symptoms among HIV-positive injection drug users: the role of social support
- Authors:
- MIZUNO Y., et al
- Journal article citation:
- AIDS Care, 15(5), October 2003, pp.689-698.
- Publisher:
- Taylor and Francis
Using cross-sectional data from an ethnically diverse sample of HIV-positive injection drug users (IDUs), we sought to identify correlates of depressive symptoms. We were particularly interested in whether perceived social support was associated with depression among HIV-positive IDUs and whether social support buffered adverse effects of other correlates. Data were collected from a sample of HIV-positive IDUs recruited from a variety of venues in the New York City and San Francisco metropolitan areas in the USA. Multiple regression analysis identified four significant correlates of depressive symptoms. Perceived social support and having a regular place for HIV medical care were significantly associated with lower levels of depressive symptoms, while history of mental health problems and non-injection polydrug use were significantly associated with higher levels of depressive symptoms. Moreover, a significant interaction effect was found between social support and non-injection polydrug use, indicating that social support buffers the association between non-injection polydrug use and depression. These results suggest that increasing social support might be a useful tool for HIV-positive IDUs in reducing depression and the adverse effect of non-injection polydrug use.
Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study
- Authors:
- ARSENEAULT Louise, et al
- Journal article citation:
- British Medical Journal, 23.11.02, 2002, pp.1212-1213.
- Publisher:
- British Medical Association
Although most young people use cannabis in adolescence without harm, a vulnerable minority experience harmful outcomes. A tenth of the cannabis users by age 15 in our sample (3/29) developed schizophreniform disorder by age 26 compared with 3% of the remaining cohort (22/730). Our findings suggest that cannabis use among psychologically vulnerable adolescents should be strongly discouraged by parents, teachers, and health practitioners. Policy makers and law makers should concentrate on delaying onset of cannabis use.
Cannabis use and mental health in young people: cohort study
- Authors:
- PATON George C., et al
- Journal article citation:
- British Medical Journal, 23.11.02, 2002, pp.1195-1198.
- Publisher:
- British Medical Association
The purpose of this article is to determine whether cannabis use in adolescence predisposes to higher rates of depression and anxiety in young adulthood. Weekly or more frequent cannabis use in teenagers predicted an approximately twofold increase in risk for later depression and anxiety after adjustment for potential baseline confounders. In contrast, depression and anxiety in teenagers predicted neither later weekly nor daily cannabis use. Frequent cannabis use in teenage girls predicts later depression and anxiety, with daily users carrying the highest risk. Given recent increasing levels of cannabis use, measures to reduce frequent and heavy recreational use seem warranted.
Exercise and counseling for smoking cessation in smokers with depressive symptoms: a randomized controlled pilot trial
- Authors:
- BERNARD Paquito, et al
- Journal article citation:
- Journal of Dual Diagnosis, 11(3-4), 2015, pp.205-216.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Objective: Despite various strategies to help smokers with depressive disorders to quit, the smoking relapse rate remains high. The purpose of this pilot study was to estimate the effects of adding an exercise and counseling intervention to standard smoking cessation treatment for smokers with depressive disorders. We hypothesized that the exercise and counseling intervention would lead to improved abstinence, reduced depressive symptoms, and increased physical activity. Methods: Seventy smokers with current depressive disorders were randomly assigned to standard smoking cessation treatment plus exercise and counseling (n = 35) or standard treatment plus a time-to-contact control intervention on health education (n = 35). Both programs involved 10 sessions over 8 weeks. The primary outcome was continuous abstinence since the quit date and was measured at week 8 (end of the intervention) and again at 12-, 24-, and 52-week follow-ups. Results: Nearly 60% of participants were female (n = 41), 38 (52.3%) were single, 37 (52.9%) had education beyond high school, and 32 (45.7%) met criteria for major depressive disorder or dysthymia. Participants in the two treatment conditions differed at baseline only in marital status (χ2 = 4.28, df = 1, p =.04); and smoking abstinence self-efficacy, t(66) = -2.04, p =.04). The dropout rate did not differ significantly between groups and participants attended 82% and 75% of the intervention and control sessions, respectively. Intention-to-treat analysis showed that, at 12 weeks after the beginning of the intervention, continuous abstinence did not vary significantly between the intervention and control groups: 48.5% versus 28.5%, respectively, ORadj = 0.40, 95% CI [0.12–1.29], p =.12. There were no group differences in depressive symptoms, but the intervention group did outperform the control group on the 6-minute walking test (Mint = 624.84, SD = 8.17, vs. Mcon = 594.13, SD = 8.96, p =.015) and perceived physical control (Mint = 2.84, SD = 0.16, vs. Mcon = 2.27, SD = 0.18, p =.028). The sample was not large enough to ensure adequate statistical power. Conclusions: This finding, while preliminary, suggests that an exercise and counseling intervention may yield better results than health education in improving smoking abstinence. This study is registered at www.clinincaltrials.gov under # NCT01401569. (Publisher abstract)
I worry when [...] insights into dual diagnosis from those who treat mothers misusing alcohol
- Author:
- MARLOW Sally
- Journal article citation:
- Advances in Dual Diagnosis, 7(1), 2014, pp.24-33.
- Publisher:
- Emerald
Purpose: Alcohol misuse and mental health problems in parents are both known to contribute to impaired outcomes in children, although little is known about the specific parenting behaviours that might be affected. Mental health problems in parents who misuse alcohol may impact parenting in specific ways, and these may be different for mothers and for fathers. The purpose of this paper is to make a preliminary investigation of alcohol misuse and mental health problems in mothers, and explore ways in which these might affect their parenting. Design/methodology/approach: Semi-structured interviews were carried out with professionals involved in services for mothers who misuse alcohol, including those working in addiction psychiatry, in primary care, and in the provision of parenting services. These interviews were then examined using thematic analysis. Findings: Themes emerged including specific mental health problems (depression, anxiety and personality disorders), and related issues, such as self-medication. Particularly relevant for mothers were post-natal depression, the effect on maternal alcohol misuse and mental health when children are removed, the role of domestic violence, and the importance for identification of home visits by services. Different types of alcohol misuse were linked to different mental states and different parenting behaviours in parents. Findings in the general parenting and substance misuse literature were confirmed, and a new addition was that expressed emotion may play a role in families where mothers misuse alcohol. Originality/value: The findings increased the understanding of the relationships between maternal alcohol misuse, mental health issues and parenting, raising several new points for consideration. (Publisher abstract)