scholarly journals Substance Use and Physical Health in Patients with Bipolar Disorder Under Maintenance Treatment

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
M.P. Garcia-Portilla ◽  
P.A. Saiz ◽  
G. Florez ◽  
M.T. Bascaran ◽  
S. Al-Halabi ◽  
...  

Background:To date, little is known about the impact of substance use on physical health of patients with bipolar disorder. This study provides data on the impact of tobacco, alcohol and cannabis upon weight, metabolic profile and cardiovascular risk in these patients.Methods:Naturalistic, cross-sectional, multicenter study conducted in Spain. Current use of tobacco, alcohol and cannabis was registered based on patient’ self-reports. Patients were evaluated for presence of metabolic syndrome (MetS) according to modified NCEP ATP III criteria, for cardiovascular risk using the Framinghan function (CHD) and the Systematic COronary Risk Evaluation (SCORE) function (CMR).Results:The mean age was 46.6 years and 49% were male. Fitty-one percent used tobacco, 13% alcohol and 12.5% cannabis. Mean body mass index (BMI) was 27.9 kg/m2, 22.4% had MetS and ten-year CHD and CMR risks were 7.6% and 1.8% respectively. Patients who used tobacco had significantly higher CHD risk (8.82 versus 5.74, p < 0.01), and used more antipsychotic (1.23 versus 1.04, p 0.002) and overall (3.18 versus 2.71, p 0.01) drugs for the treatment of their bipolar disorder. Patients who used cannabis had significantly lower BMI (26.0 versus 28.2, p < 0.05) and lower CMR (0.37 versus 1.99, p < 0.001), however, when controlling by age, severity of mania and presence of metabolic syndrome these associations disappear.Conclusions:Substance use, mainly tobacco, is high in patients with bipolar disorder. Use of tobacco is associated with higher cardiovascular risk and greater number of antipsychotic and overall drugs for the bipolar disorder.

Author(s):  
Sara Bartel ◽  
Simon Sherry ◽  
Sherry Stewart

Background: Emergent research suggests there has been an increase in cannabis use levels during the COVID-19 pandemic; however, several gaps remain. It is unclear what impact the pandemic has had on the frequency vs. quantity of cannabis use. Additionally, research has not focused on emerging adults, a population often more likely to use cannabis. Moreover, as existing studies are cross-sectional and retrospective, it is not clear whether participant reports of increasing cannabis use during COVID-19 are accurate. We sought to fill these gaps to provide further information about the impact of COVID-19 on cannabis use and the accuracy of related retrospective self-reports. Design and Methods: Seventy emerging adults in an ongoing longitudinal study on alcohol and cannabis users completed surveys on COVID-19 and substance use between March 23rd-June 5th. Their substance use four months earlier was extracted from the existing dataset. Results: 54% of participants reported an increase in cannabis use frequency during the pandemic, while 39% reported an increase in cannabis quantity. An examination of objective change scores indicated 50% of participants actually increased their cannabis use frequency during the pandemic, while 32% actually increased their cannabis quantity. A comparison of retrospective subjective change with longitudinal objective change scores indicated participants were relatively accurate in their retrospective reports of change in cannabis use frequency but were relatively inaccurate in their retrospective reports of change in cannabis use quantity. Discussion: The COVID-19 pandemic appears to increase cannabis use frequency in the slight majority of cannabis using emerging adults. Our results suggest that retrospective cross-sectional reports may be a reasonable proxy for COVID-19 related cannabis use change in the case of cannabis use frequency. But our results question their use for determining how the pandemic is impacting cannabis use quantity. Importantly, our results suggest the COVID-19 pandemic poses health threats that extend beyond the virus itself. It is essential that public health efforts address the increasing frequency of cannabis use in emerging adult users.


2012 ◽  
Vol 48 (3) ◽  
pp. 435-446 ◽  
Author(s):  
Camila Pedro Plaster ◽  
Danilo Travassos Melo ◽  
Veraci Boldt ◽  
Karla Oliveira dos Santos Cassaro ◽  
Fernanda Campos Rosetti Lessa ◽  
...  

The objective of this study was to determine the impact of a pharmaceutical care (PC) program in a sample of public outpatients with metabolic syndrome (MS) who were being treated in Brazil's health system; the patients were randomized into PC or standard care. The pharmacotherapy follow-up (PF) was performed in a total of 120 patients with type 2 diabetes for 6 months. Adherence to treatment (measured with the Morisky test), negative outcomes associated with medication (NOM) and anthropometric and biochemical parameters were measured before and after PF. The Framingham scoring method was used to estimate changes in 10-year coronary heart disease risk scores in all patients. Ninety-six of 120 patients had characteristics of MS and were randomized into two groups (G): the control group (CG: 36) and the intervention group (IG: 38). Among the MS patients, 100% were taking a glucose-lowering drug; many were also taking anti-hypertensive drugs (CG: 72%; IG: 73%), and some patients were also taking hypolipemic drugs (CG: 12.0%; IG: 14.7%). Only 20.7% of the IG patients were considered adherent to their prescribed drugs. In the CG, an increase of coronary heart disease (CHD) risk (22±2 to 26±3; p<0.05) was observed, while in the IG, there was a reduction in CHD risk (22±2 to 14±2%; p<0.01). The PC program administered to patients with MS monitored through the primary healthcare services of the Brazilian public health system improved patient health, resulting in clinical improvements and a decrease in cardiovascular risk in IG patients over a period of ten years.


Author(s):  
Danica Loralyn Taylor ◽  
Janice F. Bell ◽  
Susan L. Adams ◽  
Christiana Drake

Abstract Introduction Passage of cannabis laws may impact cannabis use and the use of other substances. The suggested association is of particular concern in pregnant women where exposure to substances can cause harm to both the pregnant woman and fetus. The present study contributes to the minimal literature on factors associated with cannabis use during the preconception, prenatal, and postpartum periods including state legalization status, concurrent use of tobacco and e-cigarettes and adequacy of prenatal care. Methods We conducted a cross-sectional analysis using combined survey data from the 2016–2018 Pregnancy Risk Assessment Monitoring System (PRAMS) collected from 36,391 women. Logistic regression was used to estimate the impact of state-legalization, adequacy of prenatal care, and other substance use on cannabis use during the preconception, prenatal, and post-partum periods. Results In the preconception model, residence in a recreationally legal state (OR: 2.37; 95% CI, 2.04–2.75) or medically legal state (OR:3.32; 95% CI, 2.90–3.80) compared to a non-legal state was associated with higher odds of cannabis use. In the prenatal model, residence in a recreationally legal state was associated with higher odds of cannabis use (OR: 1.51; 95% CI, 1.29–1.79) whereas there was no association with residence in a medically legal state. Tobacco use including e-cigarettes and moderate prenatal alcohol use were also significantly associated with cannabis use. Conclusion Recreational cannabis legalization is associated with the use of cannabis prior to, during, and after pregnancy. Renewed clinical and policy efforts may be warranted to update prenatal substance use prevention programs, educational campaigns, and provider education as cannabis legalization evolves.


2010 ◽  
Vol 28 ◽  
pp. e483
Author(s):  
D Tsounis ◽  
N Brellas ◽  
G Stamos ◽  
V Laschos ◽  
D Voutsela ◽  
...  

2020 ◽  
Author(s):  
Cheryl L Currie ◽  
Richard Larouche ◽  
M. L. Voss ◽  
Erin K. Higa ◽  
Rae Spiwak ◽  
...  

Abstract Background: COVID-19 has resulted in an increased demand for online mental health services globally. There is emerging evidence for the efficacy for group online interventions that support population-based mental health, but a systematic review is lacking. The primary objective of this rapid systematic review is to summarize the evidence for online group counselling programs for adults. A second objective is to assess, within studies selected for our primary objective, the impact of online group counselling programs that encourage PA on outcomes compared to those that do not.Methods and Design: Randomized controlled trials that assess the impact of online group counselling programs on substance use, mental health, or physical health among community dwelling adults will be searched in MEDLINE, PsycInfo, CINHAL, and the Central Register of Controlled Trials. The review will be structured using PRISMA guidelines. Studies will be synthesized using the Cochrane Handbook and Synthesis Without Meta-Analysis (SWiM) reporting guideline. Quality will be evaluated using GRADE. Risk of bias will be assessed using the Cochrane Risk of Bias tool; with higher quality studies prioritized when drawing conclusions. The role of sex and gender will be considered as well as possible gender biases at all stages of the review.Discussion: This review will examine the effectiveness of online counselling programs that can be delivered to populations in a group format, and thus in a potentially cost-effective way. Findings will inform the decisions of governments, communities, and health care organizations responding to the COVID-19 pandemic in Canada. Systematic review registration: The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020187551).


2020 ◽  
Vol 42 (4) ◽  
pp. 373-381
Author(s):  
Hanife Kocakaya ◽  
Emrah Songur ◽  
Sedat Batmaz ◽  
Zekiye Çelikbaş ◽  
Önder Küçük

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Seyfe Asrade Atnafie ◽  
Niguse Yigzaw Muluneh ◽  
Kefyalew Ayalew Getahun ◽  
Asegedech Tsegaw Woredekal ◽  
Wubayehu Kahaliw

Individuals with substance use disorder are prone to develop different psychiatric disorders. Substance abuse and associated problems are of current global concern that leads to mental health disorders which contributed about 14% of the global burden of the disease. It has become an epidemic in some parts of the African region with adolescents being the main victims of the ill health and social effects of substance use. This study is aimed at assessing the prevalence of depression, anxiety, and stress and associated factors among khat chewers in the Amhara region, 2019. A community-based cross-sectional study was done from February 14 to April 15, 2019. A purposive sampling technique was used to enroll the subjects. Data was collected using the face-to-face interview technique using the Depression Anxiety Stress Scale 21 (DASS-21) questionnaire. Descriptive statistics and bivariate and multivariate logistic regression were used to summarize the results. p value < 0.05 was considered statistically significant. A total of 478 participants were enrolled in the study with a response rate of 94.1%. The overall prevalence of depression, anxiety, and stress was 27.4%, 40.6%, and 18.8%, respectively. Around 43% of the respondents develop dependency from khat chewing. Working in a private sector, being self-employed, being jobless, spending 90 to 180 minutes and more, chewing 51-100 g and more, and chewing khat more than once per week were positively associated with stress. On the other hand, being a private sector worker, being jobless, completing secondary education, earning 1001-5000 ETB per month, chewing khat more than once per week, being khat dependent, and the presence of chronic illness were positively associated with anxiety. History of chronic illness and being khat dependent were positively associated with depression. The prevalence of depression, anxiety, and stress was high among khat chewers in the Amhara region. Special attention has to be given to khat chewers since khat chewing will double the burden of mental illness. Proper awareness and evaluation activities will reduce the impact of the problem.


2006 ◽  
Vol 50 (2) ◽  
pp. 368-376 ◽  
Author(s):  
Maria Teresa Zanella ◽  
Marcelo Hiroshi Uehara ◽  
Artur Beltrame Ribeiro ◽  
Marcelo Bertolami ◽  
Ana Claudia Falsetti ◽  
...  

Weight loss improves metabolic abnormalities and reduces cardiovascular risk in obese hypertensive patients. To evaluate the impact of a sustained weight loss on coronary risk, 181 hypertensive patients with metabolic syndrome underwent to orlistat therapy, 120 mg, t.i.d., plus diet for 36 weeks. During therapy, Framingham risk scores (FRS) were calculated for determination of coronary heart disease risk in ten years. Body mass index decreased from 35.0 ± 4.2 to 32.6 ± 4.5 kg/m² (p< 0.0001) and waist circumference from 108.1 ± 10.1 to 100.5 ± 11.1 cm (p< 0.0001), at the end of the study period (week 36). Systolic and diastolic blood pressure showed reductions after the two first weeks, which were maintained up to the end of the study. A clear shift to the left in FRS distribution curve occurred at the end of the study, compared to baseline, indicating a reduction in coronary risk. Over all patients at risk, 49.2% moved to a lower risk category. A weight loss > 5% occurred in 64.6% of all patients, associated with improvement in glucose metabolism. Among those with abnormal glucose metabolism, 38 out 53 patients (71.7%) improved their glucose tolerance (p< 0.0005). In conclusion, long-term orlistat therapy helps to reduce and maintain a lower body weight, decreasing risk of coronary disease and improving glucose metabolism, thus protecting against type 2 diabetes.


2007 ◽  
Vol 20 (3) ◽  
pp. 519-527 ◽  
Author(s):  
K. Falasca ◽  
C. Ucciferri ◽  
L. Manzoli ◽  
P. Mancino ◽  
E. Pizzigallo ◽  
...  

In this cross-sectional study, we evaluate potential predictors of Metabolic Syndrome (MS) in a group of 54 Caucasian chronically HIV-infected patients with lipodystrophy. According to ATP-III criteria, 22 patients were affected by MS and 32 were not. The mean age of the sample was 41.2 ± 8.6 years, and most patients were males (74.1%); the two groups were homogeneous for gender, age, viro-immunologic status and the duration of antiviral therapy. The independent association between MS and several factors including demographic characteristics, type of highly-active antiviral therapy (HAART), viro-immunologic response, common cardiovascular risk factors (including Framingham scores), and selected cytokines (IFN-γ, TNF-α, IL-2, IL-4, IL-6, IL-10 and IL-18), was investigated using stepwise forward logistic regression. At multivariate analysis, the only independent predictors of the metabolic syndrome were triglycerides and IL-18. A10 mg/dL increase in triglycerides corresponds to an adjusted risk ratio for MS of 1.11 (95% IC: 1.04–1.19); and patients in the top tertile of IL-18 (those with IL-18 ≥ 530 pg/L) had more than three times the likelihood of MS, as compared to the bottom and medium fertiles of IL-18 (patients with IL-18 < 530 pg/L). This relationship was not attenuated by the inclusion of any other variable in the multivariate model. However, the association between metabolic syndrome and IL-18 is no longer significant when IL-18 is treated as a continuous variable (trend p = 0.087). Our results on HIV patients with lipodystrophy confirm previous findings on a strong independent association between IL-18 and MS in the general population. Further research is needed to clarify the mechanism of this association and its role in the development of cardiovascular disease in HIV patients.


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