Anxiety disorders and substance abuse

IntroductionPatients with anxiety disorders are more vulnerable to develop other comorbid conditions. In particular, large epidemiological studies show a strong association between different anxiety disorders and substance use disorders.ObjectivesTo show the prevalence of major anxiety disorders and the consumption of different substances. As well as the particular characteristics of this dual diagnosis and treatments that have proven more effective.MethodsExhaustive review of all the material published on this topic in the recent years.ConclusionsNearly 24% of patients with anxiety disorder suffer from a comorbid substance disorder use in their lifetime (17.9% diagnosis of alcohol abuse or dependence diagnosis and 11.9% of abuse or dependence on other drugs). Dual patients show a number of distinctive features, such as more frequency in males, family history of alcohol or other substances abuse and behavioral problems, early parental loss among others.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Forensic psychiatric expertise of patients with anti-social personality

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.909 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S592-S592

Author(s):

M. Turki ◽

N. Charfi ◽

M. Maalej Bouali ◽

J. Ben Thabet ◽

N. Zouari ◽

...

Keyword(s):

Violent Behavior ◽

Epidemiological Studies ◽

University Hospital ◽

School Level ◽

Addictive Behaviors ◽

Psychiatric Expertise ◽

History Of ◽

Forensic Psychiatric ◽

Competing Interest ◽

High Crime

IntroductionEpidemiological studies in the general population confirm the indisputable link between criminological dangerousness and mental disorders especially anti-social personality, which increase clearly the prevalence of violent behavior.AimTo dress socio-demographic, clinical and medico-legal profile of offenders, with anti-social personality, in forensic psychiatric examination.MethodsIt was a retrospective study of a series of 195 patients with antisocial personality (DSM-IV). They were examined, during the period, from 2009 to 2013, on the occasion of a penal expertise in the department of psychiatry C in the Hedi Chaker university hospital, Sfax, Tunisia.ResultsThe mean age of patients at the offense moment, was 29.58 years, with a sex ratio of 26.85. Among them, 66.2% were single, 49.2% had a primary school level and 41% had no profession. Between the patients, 58.5% lived in urban area and 38.5% in a high crime area. Addictive behaviors were reported in 80% of cases. Self-injury behaviors were noted in 33.8% of offenders. Psychiatric histories were reported in 66.2%, and 25.6% of patients have been already hospitalized in psychiatry department. 64.1% had already committed forensic acts, and 36% had been imprisoned at least once. The current offense was: homicide 16.9%; sexual offense 9.2%; violence 18.5%; theft 30.2%. The offense was related to impulsivity (40%) or utilitarian purpose (39%).ConclusionA young single man with no profession, a limited educational attainment and a history of impulsive behaviors, such is the profile most frequently encountered among offenders with anti-social personality. Interventions for reducing forensic behavior should focus on those social and clinical characteristics.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Early alcohol use as prognostic factor for severity in dually diagnosed patients

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1051 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S307-S308

Author(s):

R. Martinez-Riera ◽

G. Mateu-Codina ◽

A. Farre-Martinez ◽

J.L. Perez de Heredia ◽

J. Marti-Bonany ◽

...

Keyword(s):

Substance Use ◽

Alcohol Use ◽

Psychiatric Disorders ◽

Substance Use Disorder ◽

Dual Diagnosis ◽

Late Onset ◽

Long Run ◽

Other Substances ◽

Axis I ◽

Competing Interest

ObjectivesDescribe the distinguishing characteristics between patients with early onset of alcohol use (EARLY, age < 15) and late onset of alcohol use (LATE, age > 16), both affected of acute non-substance use psychiatric disorders (non-SUD) and any substance use disorder admitted in a dual diagnosis unit.Material and methodsData on demographic, family, and clinical factors were gathered among subjects admitted to our dual diagnosis unit along three years, all of them meeting DSM-IV criteria of any non-substance related Axis I or II disorder and comorbid substance use disorder (SUD). Statistical analysis was performed by using SPSS program.ResultsWe show results of 748 patients (437 of EARLY group and 311 of LATE group). Predominantly male (73,53%) with a mean age of 39,60 ± 9,7 years. Most prevalent non-SUD psychiatric disorders were psychotic disorder (39,97%) and personality disorder (39,30%). In our sample, most common substances of abuse were Alcohol (45,05%) and Cocaine (30,35%). EARLY patients had an earlier first contact all substances as well as an earlier age of problematic consumption of cocaine, alcohol, opioids and nicotine; they also had major prevalence of opioid SUD, sedatives SUD and amphetamines SUD (see Tables 1, 2 and 3).ConclusionsPatients who began earlier their consumptions of alcohol had major prevalence of opioid, sedatives and amphetamine use. They also had earlier consumptions of other substances and earlier problematic consumptions of cocaine, alcohol, opioids and nicotine, what probably means greater severity of drug addiction in the long run.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Clinical correlation between Migraine and Generalized Anxiety Disorders: a literature review

10.5327/1516-3180.154 ◽

2021 ◽

Author(s):

Samantha Lia Ziotti Bohn Gonçalves Soares ◽

Letícia Santana Ferreira Gonçalves ◽

Emily Thauara de Souza ◽

Pollyana Yuri Salles Suguinoshita ◽

Luana Isla Rocha Alves ◽

...

Keyword(s):

Anxiety Disorder ◽

Anxiety Disorders ◽

Generalized Anxiety Disorder ◽

Low Income ◽

Epidemiological Studies ◽

Generalized Anxiety ◽

Epidemiological Factors ◽

Painful Sensation ◽

Generalized Anxiety Disorders ◽

History Of

Background: Migraine and anxiety are common neuro-psychiatric disorders in clinical practice, sharing symptoms and epidemiological factors among themselves. The presence of both pathologies in the same individual is frequently reported in the literature. Objectives: To report the clinical and epidemiological correlations established between generalized anxiety disorder and migraine. Methodology: Systematic review of studies published between 2016 and 2021, exploring the association between generalized anxiety disorders and Migraine. The descriptors “association”, “Migraines” and “Generalized Anxiety Disorder” were used in the LILACS, SCIELO and PUBMED databases. Fourteen articles were selected, mostly dealing with epidemiological studies. Results: Evidence suggests that these pathologies are associated and share common symptoms, pathophysiology and epidemiological factors. Studies corroborate that anxiety and painful sensation are more strongly associated with migraine than with other psychiatric illnesses. It has also demonstrated some characteristics of patients who are predisposed to develop both comorbidities such as smoke, low income and a history of other previous diseases. Common triggering factors such as pain, sleep disorders and stress can also contribute to the association between pathologies. Conclusions: Based on the studies analyzed in full, the high prevalence of both diseases in the same individual highlights the importance of research on the cause and consequence relationship between Anxiety and Migraine, since this is not yet clarified in the medical literature. In addition, paying attention to migraine correlation to generalized anxiety disorder increases the quality of life of the patient in the short and long term, as well as help in the choice of better treatments.

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Prevalence of Cannabis Residues in Psychiatric Patients: A Case Study of Two Mental Health Referral Hospitals in Uganda

Substance Abuse Research and Treatment ◽

10.4137/sart.s13254 ◽

2014 ◽

Vol 8 ◽

pp. SART.S13254 ◽

Cited By ~ 2

Author(s):

Epaenetus A. Awuzu ◽

Emmanuel Kaye ◽

Patrick Vudriko

Keyword(s):

Mental Health ◽

Medical Records ◽

Psychiatric Patients ◽

Strong Association ◽

Diagnostic Kits ◽

Referral Hospitals ◽

Other Substances ◽

History Of ◽

Diagnostic Capacity

Various studies have reported that abuse of cannabis is a risk factor for psychosis. The aims of this study were to determine the prevalence of delta 9-tetrahydrocanabinol (Δ 9 -THC), a major metabolite of cannabis, in psychiatric patients in Uganda, and to assess the diagnostic capacity of two referral mental health hospitals to screen patients for exposure to cannabis in Uganda. Socio-demographic characteristics of the patients were collected through questionnaires and review of medical records. Urine samples were collected from 100 patients and analyzed using Δ 9 -THC immunochromatographic kit (Standard Diagnostics®, South Korea). Seventeen percent of the patients tested positive for Δ 9 -THC residues in their urine. There was strong association ( p < 0.05) between history of previous abuse of cannabis and presence of Δ 9 -THC residues in the urine. Alcohol, cocaine, heroin, pethidine, tobacco, khat and kuber were the other substances abused in various combinations. Both referral hospitals lacked laboratory diagnostic kits for detection of cannabis in psychiatric patients. In conclusion, previous abuse of cannabis is associated with occurrence of the residues in psychiatric patients, yet referral mental health facilities in Uganda do not have the appropriate diagnostic kits for detection of cannabis residues as a basis for evidence-based psychotherapy.

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Methylone consumption characterized through samples handled by users

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.129 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S117-S117 ◽

Cited By ~ 1

Author(s):

L. Martínez Sadurní ◽

M. Grifell ◽

L. Galindo ◽

I. Ezquiaga ◽

P. Quintana ◽

...

Keyword(s):

Mass Spectrometry ◽

Gas Chromatography ◽

Potential Risk ◽

Significant Proportion ◽

Epidemiological Studies ◽

Synthetic Cathinones ◽

Gas Chromatography Mass Spectrometry ◽

Energy Control ◽

Other Substances ◽

Competing Interest

IntroductionIn recent years, the increasing use tendency of NPS has motivated both awareness and concern about their identification and potential harmfulness. Synthetic cathinones represent a significant proportion of the NPS available and methylone is one of the most frequently found in Europe.ObjectivesThe aim of the present study is to determine methylone presence and characteristics from the samples analyzed by Energy Control between the years 2009 and 2015 in Spain.MethodsFrom all 21,198 samples analyzed from august 2009 to august 2015, only those in which methylone was found are studied (n = 140). The samples have been analyzed by Energy Control, a spanish harm-reduction NGO that offers to users the possibility of analyzing the substances they intend to consume. The analysis is done by gas chromatography–mass spectrometry.ResultsFrom the 140 samples containing methylone, 87 were handled as methylone, 20 as MDMA, 8 as other synthetic cathinones and 25 as other substances. The peak of consume was registered in 2011 with 41 samples then the number decreased until 10 samples in 2015.ConclusionsResults suggest that methylone is most frequently handled as methylone or as MDMA and that its consumption could be decreasing. Further pharmacokinetic, pharmacodynamic, clinical and epidemiological studies should be conducted to enhance the knowledge not only about methylone consumption, but also about synthetic cathinones in general in order to assess their potential risk and study the complications and its management.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Hereditary influence in alcohol dependence

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1097 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S320-S320

Author(s):

J. Teixeira ◽

G. Pereira ◽

T. Mota ◽

J. Cabral Fernandes

Keyword(s):

Family History ◽

Alcohol Dependence ◽

Genetic Factors ◽

Treatment Unit ◽

Final Sample ◽

Affected Relative ◽

Other Substances ◽

Hereditary Factors ◽

History Of ◽

Competing Interest

IntroductionAlcohol dependence is one of the psychiatric disorders for which hereditary influence is strongest. In fact, the importance of genetic factors in transmission of vulnerability to alcohol dependence was first described in literature many years ago by psychiatrists who dedicate to its study. That vulnerability may be explained by an epigenetic model in which biological hereditary factors associate with environmental factors to cause alcohol dependence.ObjectivesStudy the influence of genetic factors on alcohol dependence.MethodsDuring 4 consecutive months a sample of alcoholic patients was collected from the Alcohol Treatment Unit of CHPL (inpatients and outpatients). Biographic data, patient's psychiatric diagnosis and family history of alcohol dependence or of dependence of other drugs were recorded.ResultsInitial sample included 122 patients. After exclusion of patients who were also hospitalized in that period, the final sample included 102 patients (26% female), with a mean age of 48 years old. Main patients’ diagnosis was alcohol dependence but most of them (52%) presented psychiatric comorbidity. Most patients (55%) had family history of alcohol dependence or dependence of other substances, 26% did not have and 19% did not know. For 61% of patients, the father and/or mother were the affected relative. Most patients (61%) who had a family history of alcohol dependence or dependence of other substances had 2 or more affected relatives.ConclusionsMost patients with alcohol dependence have family history of alcohol dependence or dependence of other substances, usually in more than 1 relative, which must be taken in account during treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Anxiety and undiagnosed pheochromocitoma

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1299 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S362-S362

Author(s):

C. Cocho Santalla ◽

C. Sanahuja

Keyword(s):

Anxiety Disorders ◽

Urinary Catecholamine ◽

Potential Source ◽

Clinical Presentations ◽

Pubmed Search ◽

History Of ◽

Competing Interest ◽

Manual Review ◽

Previous Medical History ◽

Acute Anxiety

IntroductionPheochromocytomas are rare catecholamine-secreting tumours from the adrenal medulla. The clinical presentations may mimic other disorders due to nonspecific symptoms produced by catecholamines in blood.ObjectivesWe report a case of undiagnosed pheochromocytoma in a 29-year-old woman with a two year history of anxiety. We undertook a literature review.MethodsPubMed search using “pheochromocytoma”, “anxiety” as key words. Follow by a manual review of identified publication. We report a case of a 29-year-old with a two-year history of anxiety pharmacologically treated without success. She presents episodes of acute anxiety accompanied, sometimes, by nausea or headache, without high blood pressure. She presented a previous medical history of thyroid carcinoma. The patient was referred to the endocrinology service for thyroid review, postulated as potential source for drug resistance. High catecholamine levels were found and pheochromocytoma diagnosis was confirmed histopathologically.ResultsThe releasing catecholamine in blood can lead to a number of symptoms that can include paroxysmal hypertension, headache, palpitations, anxiety, chest/abdominal pain, nausea. Hypertension may not be the main symptom. These symptoms can be misinterpreted as psychiatric disorders, in particularly anxiety disorders. Elevated urinary catecholamine suggested the diagnosis of pheochromocytoma.ConclusionsPheochromocytoma should be included in the differential diagnosis of anxiety disorders, especially if pharmacological treatment is not effective. The suspected cases should be investigated, even in the absence of hypertension, due to the potential morbidity of untreated pheochromocytoma.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Suicidal Behavior in German Adolescents

Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie ◽

10.1024/1422-4917/a000331 ◽

2015 ◽

Vol 43 (1) ◽

pp. 39-45 ◽

Cited By ~ 4

Author(s):

Joana Straub ◽

Ferdinand Keller ◽

Nina Sproeber ◽

Michael G. Koelch ◽

Paul L. Plener

Keyword(s):

Suicidal Behavior ◽

Suicide Attempts ◽

Depression Scale ◽

Epidemiological Studies ◽

Present Sample ◽

Manic Symptoms ◽

Symptoms Of Depression ◽

Adolescent Sample ◽

History Of ◽

Sum Scores

Objective: Research in adults has identified an association between bipolar disorder and suicidal behavior. This relationship, however, has been insufficiently investigated in adolescents to date. Methods: 1,117 adolescents from 13 German schools (mean age = 14.83, SD = .63; 52.7% females) completed an extended German version of the Center for Epidemiological Studies Depression Scale (CES-D), which assesses depressive and manic symptoms during the last week, as well as the Self-Harm Behavior Questionnaire (SHBQ) for the assessment of lifetime suicidal behavior. Results: In the present sample 39.4% of the girls and 23.1% of the boys reported lifetime suicidal thoughts and 7.1% of the girls as well as 3.9% of the boys a lifetime history of suicide attempts. 18.7% of the adolescent sample revealed elevated symptoms of depression and 9% elevated levels of mania symptoms. Elevated sum scores of depression and mania were associated with a higher number of suicidal ideations and suicide attempts. A block-wise regression analysis revealed that sum scores of depression and mania predicted suicidal ideations best. Concerning suicide attempts, the best predictors were age as well as depression and mania sum scores. Conclusions: Suicidal behavior was reported more often when adolescents demonstrate symptoms of mania as well as symptoms of depression than when they demonstrate only depressive symptoms. The presence of bipolar symptoms in adolescents should alert clinicians to the heightened possibility of suicidal behavior.

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Factor V Leiden Is Associated with Repeated and Recurrent Unexplained Fetal Losses

Thrombosis and Haemostasis ◽

10.1055/s-0038-1656060 ◽

1997 ◽

Vol 77 (05) ◽

pp. 0822-0824 ◽

Cited By ~ 145

Author(s):

Elvira Grandone ◽

Maurizio Margaglione ◽

Donatella Colaizzo ◽

Marina d'Addedda ◽

Giuseppe Cappucci ◽

...

Keyword(s):

Protein C ◽

Strong Association ◽

Activated Protein C ◽

Fetal Loss ◽

Factor V Leiden ◽

Factor V ◽

Significant Difference ◽

History Of ◽

Fv Leiden ◽

Caucasian Women

SummaryActivated protein C resistance (APCR) is responsible for most cases of familial thrombosis. The factor V missense mutation Arg506>Gln (FV Leiden) has been recognized as the commonest cause of this condition. Recently, it has been suggested that APCR is associated with second trimester fetal loss. We investigated the distribution of FV Leiden in a sample (n = 43) of Caucasian women with a history of two or more unexplained fetal losses. A group (n = 118) of parous women with uneventful pregnancies from the same ethnical background served as control. We found the mutation in 7 cases (16.28%) and 5 controls (4.24%; p = 0.011). A statistically significant difference between women with only early fetal loss vs those with late events (p = 0.04) was observed. Our data demonstrate a strong association between FV Leiden and fetal loss. Furthermore, they indicate that late events are more common in these patients.

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Anxiety Disorders’ Effect on College and University Students’ Mental Health: A Common and Growing Concern

Current Psychopharmacologye ◽

10.2174/2211556009999200408105509 ◽

2020 ◽

Vol 9 (2) ◽

pp. 82-90

Author(s):

Matthew J. Pesko

Keyword(s):

Mental Health ◽

Anxiety Disorders ◽

University Students ◽

Best Practice ◽

Epidemiological Studies ◽

Student Population ◽

Adult Student ◽

College And University ◽

The Past ◽

Mental Health Settings

Anxiety disorders are commonly experienced by college and university students and should be routinely assessed in mental health settings. Epidemiological studies suggest that the burden of these illnesses has greatly expanded even over the past decade. Factors that contribute to the experience of an anxiety disorder in a young adult student population are considered herein. The best practice for evaluation and treatment of these disorders is presented based on the review of available literature in this field. Special attention is paid to the concept of resilience as it pertains to anxiety disorders in the student population.

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