scholarly journals Mental disorders as risk factors for later substance dependence: estimates of optimal prevention and treatment benefits

2008 ◽  
Vol 39 (8) ◽  
pp. 1365-1377 ◽  
Author(s):  
M. D. Glantz ◽  
J. C. Anthony ◽  
P. A. Berglund ◽  
L. Degenhardt ◽  
L. Dierker ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Large Scale ◽  
Substance Dependence ◽  
Age Of Onset ◽  
Single Case ◽  
Household Survey ◽  
Cost Effective ◽  
Externalizing Disorders ◽  
Secondary Outcome ◽  
Substance Disorders

BackgroundAlthough mental disorders have been shown to predict subsequent substance disorders, it is not known whether substance disorders could be cost-effectively prevented by large-scale interventions aimed at prior mental disorders. Although experimental intervention is the only way to resolve this uncertainty, a logically prior question is whether the associations of mental disorders with subsequent substance disorders are strong enough to justify mounting such an intervention. We investigated this question in this study using simulations to estimate the number of substance disorders that might be prevented under several hypothetical intervention scenarios focused on mental disorders.MethodData came from the National Comorbidity Survey Replication (NCS-R), a nationally representative US household survey that retrospectively assessed lifetime history and age of onset of DSM-IV mental and substance disorders. Survival analysis using retrospective age-of-onset reports was used to estimate associations of mental disorders with subsequent substance dependence. Simulations based on the models estimated effect sizes in several hypothetical intervention scenarios.ResultsAlthough successful intervention aimed at mental disorders might prevent some proportion of substance dependence, the number of cases of mental disorder that would have to be treated to prevent a single case of substance dependence is estimated to be so high that this would not be a cost-effective way to prevent substance dependence (in the range 76–177 for anxiety-mood disorders and 40–47 for externalizing disorders).ConclusionsTreatment of prior mental disorders would not be a cost-effective way to prevent substance dependence. However, prevention of substance dependence might be considered an important secondary outcome of interventions for early-onset mental disorders.

The WHO World Mental Health (WMH) Surveys

2009 ◽  
Vol 06 (01) ◽  
pp. 5-9 ◽  
Author(s):  
S. Aguilar-Gaxiola ◽  
J. Alonso ◽  
S. Chatterji ◽  
S. Lee ◽  
T. B. Üstün ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Treatment Effectiveness ◽  
Age Of Onset ◽  
Common Mental Disorders ◽  
Mental Health Policy ◽  
Unmet Need ◽  
Cost Effective ◽  
World Mental Health ◽  
Prevalence Estimates

SummaryThe paper presents an overview of the WHO World Mental Health (WMH) Survey Initiative and summarizes recent WMH results regarding the prevalence and societal costs of mental disorders. The WMH surveys are representative community surveys that were carried out in 28 countries throughout the world aimed at providing information to mental health policy makers about the prevalence, burden, and unmet need for treatment of common mental disorders. Results show that mental disorders are commonly occurring in all participating countries. The inter-quartile range (IQR: 25th-75th percentiles) of lifetime DSM-IV disorder prevalence estimates (combining anxiety, mood, disruptive behavior, and substance disorders) is 18.1-36.1%. The IQR of 12-month prevalence estimates is 9.8-19.1%. Analysis of age-of-onset reports shows that many mental disorders begin in childhood-adolescence and have significant adverse effects on subsequent role transitions. Adult mental disorders are found in the WMH data to be associated with high levels of role impairment. Despite this burden, the majority of mental disorders go untreated. Although these results suggest that expansion of treatment could be cost-effective from both the employer perspective and the societal perspective, treatment effectiveness trials are needed to confirm this suspicion. The WMH results regarding impairments are being used to target several such interventions.

scholarly journals The role of mental disorders in the risk and speed of transition to alcohol use disorders among community youth

2010 ◽  
Vol 41 (5) ◽  
pp. 1073-1085 ◽  
Author(s):  
S. Behrendt ◽  
K. Beesdo-Baum ◽  
P. Zimmermann ◽  
M. Höfler ◽  
A. Perkonigg ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Mental Disorders ◽  
Social Phobia ◽  
Age Of Onset ◽  
Alcohol Use Disorders ◽  
Externalizing Disorders ◽  
Increased Risk ◽  
Rapid Transition ◽  
Dsm Iv

BackgroundAmong adolescents and young adults with DSM-IV alcohol use disorders (AUDs), there are inter-individual differences in the speed of transition from initial alcohol use (AU) to AUD. AUDs are highly co-morbid with other mental disorders. The factors associated with rapid transition from first AU to AUD remain unknown and the role of mental disorders in rapid transitions is unclear. Given this background we examined (1) whether prior anxiety, mood, externalizing and non-alcohol substance use disorders are related to the risk and speed of transition from first AU to DSM-IV alcohol abuse (AA) and alcohol dependence (AD) and (2) whether early age of onset of prior mental disorders (PMDs) is a promoter of rapid transition.MethodA total of 3021 community subjects (97.7% lifetime AU) aged 14–24 years at baseline were followed up prospectively for up to 10 years. AU and mental disorders were assessed with the DSM-IV/M-CIDI.ResultsAmong subjects with lifetime AU, several PMDs, such as specific phobia, bipolar disorder and nicotine dependence, were associated with an increased risk of AUD independent of externalizing disorders. Associations of PMDs with the speed of transition to AUDs were mostly weak and inconsistent. Only social phobia and externalizing disorders were associated with faster transitions to AD even after adjustment for other PMDs. Earlier age of onset of PMD was not associated with rapid transition.ConclusionsMental disorders are associated with the risk of AUD. With the possible exception of social phobia and externalizing disorders, they do not promote rapid transition, even if they occur particularly early. Future research needs to identify factors relevant to rapid transition to AUD.

scholarly journals Externalizing disorders: Cluster 5 of the proposed meta-structure for DSM-V and ICD-11

2009 ◽  
Vol 39 (12) ◽  
pp. 2061-2070 ◽  
Author(s):  
R. F. Krueger ◽  
S. C. South
Keyword(s):  
Mental Disorders ◽  
Substance Dependence ◽  
Task Force ◽  
Externalizing Disorders ◽  
Study Group ◽  
Good Reliability ◽  
Dsm V ◽  
Co Morbidity ◽  
Valid Cluster ◽  
Icd 10

BackgroundThe extant major psychiatric classifications DSM-IV and ICD-10 are purportedly atheoretical and largely descriptive. Although this achieves good reliability, the validity of a medical diagnosis is greatly enhanced by an understanding of the etiology. In an attempt to group mental disorders on the basis of etiology, five clusters have been proposed. We consider the validity of the fifth cluster, externalizing disorders, within this proposal.MethodWe reviewed the literature in relation to 11 validating criteria proposed by the Study Group of the DSM-V Task Force, in terms of the extent to which these criteria support the idea of a coherent externalizing spectrum of disorders.ResultsThis cluster distinguishes itself by the central role of disinhibitory personality in mental disorders spread throughout sections of the current classifications, including substance dependence, antisocial personality disorder and conduct disorder. Shared biomarkers, co-morbidity and course offer additional evidence for a valid cluster of externalizing disorders.ConclusionExternalizing disorders meet many of the salient criteria proposed by the Study Group of the DSM-V Task Force to suggest a classification cluster.

Alcohol Use and Alcohol Use Disorders

2010 ◽  
pp. 405-446 ◽  
Author(s):  
Kenneth J. Sher ◽  
Andrew K. Littlefield ◽  
Julia A. Martinez
Keyword(s):  
Alcohol Use ◽  
Mental Disorders ◽  
Substance Dependence ◽  
Alcohol Use Disorders ◽  
Basic Research ◽  
The United States ◽  
Externalizing Disorders ◽  
Normal Personality ◽  
Considerable Controversy ◽  
Adult Roles

Alcohol use disorders (AUDs), alcohol abuse, and alcohol dependence, are among the most prevalent mental disorders in the United States and elsewhere. Considerable controversy exists concerning the optimal way of classifying these disorders and the boundaries between normal and abnormal drinking. Although AUDs can occur over much of the life span, from an epidemiological perspective, it is largely a disorder of adolescence and young adulthood. Many who experience AUDs are “mature out” of them as they age and acquire adult roles and, perhaps, as a function of normal personality. However, a significant minority of individuals fail to mature out, and some individuals develop AUDs later in adulthood. A number of etiological pathways are associated with developing an AUD; foremost among them, a pathway shared with other externalizing disorders such as conduct disorder, adult antisociality, and other substance dependence. However, pathways associated with internalizing disorders and with individual differences in alcohol effects also exist. All of these pathways likely involve major genetic and environmental determinants. Given the etiological pathways that have been documented, it is not surprising that AUDs are often comorbid with other mental disorders. A number of effective approaches to the prevention and treatment of AUDs have been developed. Additionally, basic research is setting the stage for further advances in both behavior and drug treatments of AUDs.

scholarly journals Does the ‘gateway’ matter? Associations between the order of drug use initiation and the development of drug dependence in the National Comorbidity Study Replication

2008 ◽  
Vol 39 (1) ◽  
pp. 157-167 ◽  
Author(s):  
L. Degenhardt ◽  
W. T. Chiu ◽  
K. Conway ◽  
L. Dierker ◽  
M. Glantz ◽  
...  
Keyword(s):  
Drug Use ◽  
Drug Dependence ◽  
Illicit Drugs ◽  
Mental Health Problems ◽  
Age Of Onset ◽  
Household Survey ◽  
Composite International Diagnostic Interview ◽  
Externalizing Disorders ◽  
World Health ◽  
Drug Use Initiation

BackgroundThe ‘gateway’ pattern of drug initiation describes a normative sequence, beginning with alcohol and tobacco use, followed by cannabis, then other illicit drugs. Previous work has suggested that ‘violations’ of this sequence may be predictors of later problems but other determinants were not considered. We have examined the role of pre-existing mental disorders and sociodemographics in explaining the predictive effects of violations using data from the US National Comorbidity Survey Replication (NCS-R).MethodThe NCS-R is a nationally representative face-to-face household survey of 9282 English-speaking respondents aged 18 years and older that used the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) to assess DSM-IV mental and substance disorders. Drug initiation was estimated using retrospective age-of-onset reports and ‘violations’ defined as inconsistent with the normative initiation order. Predictors of violations were examined using multivariable logistic regressions. Discrete-time survival analysis was used to see whether violations predicted progression to dependence.ResultsGateway violations were largely unrelated to later dependence risk, with the exception of small increases in risk of alcohol and other illicit drug dependence for those who initiated use of other illicit drugs before cannabis. Early-onset internalizing disorders were predictors of gateway violations, and both internalizing and externalizing disorders increased the risks of dependence among users of all drugs.ConclusionsDrug use initiation follows a strong normative pattern, deviations from which are not strongly predictive of later problems. By contrast, adolescents who have already developed mental health problems are at risk for deviations from the normative sequence of drug initiation and for the development of dependence.

Alcohol Use and Alcohol Use Disorders

2014 ◽  
pp. 409-451 ◽  
Author(s):  
Kenneth J. Sher ◽  
Julia A. Martinez ◽  
Andrew K. Littlefield
Keyword(s):  
Alcohol Use ◽  
Mental Disorders ◽  
Substance Dependence ◽  
Alcohol Use Disorders ◽  
Basic Research ◽  
The United States ◽  
Externalizing Disorders ◽  
Normal Personality ◽  
Drug Treatments ◽  
Adult Roles

Alcohol use disorders (AUDs), alcohol abuse and alcohol dependence, are among the most prevalent mental disorders in the United States and elsewhere. Controversy exists with respect to the optimal way of classifying these disorders and the boundaries between normal and abnormal drinking. Although AUDs can occur over much of the life span, from an epidemiological perspective it is largely a disorder of adolescence and young adulthood. Many who experience AUDs “mature out” of them as they age and acquire adult roles and, perhaps, as a function of normal personality. However, a significant minority of individuals fails to mature out, and some individuals develop AUDs later in adulthood. There are a number of etiological pathways associated with developing an AUD; foremost among them is a pathway shared with other externalizing disorders such as conduct disorder, adult antisociality, and other substance dependence. However, pathways associated with internalizing disorders and with individual differences in alcohol effects also exist. All of these pathways likely involve major genetic and environmental determinants. Given the etiological pathways that have been documented, it is not surprising that AUDs are often comorbid with other mental disorders. A number of approaches to the prevention and treatment of AUDs have been developed that are effective. Additionally, basic research is setting the stage for further advances in both behavior and drug treatments of AUDs.

CONTRIBUTION OF DNA COPY-NUMBER VARIATION (CNV) TO CANCER SUSCEPTIBILITY AND LARGE-SCALE GENOME ALTERATIONS IN OSTEOSARCOMA (OS)

2008 ◽  
Vol 31 (4) ◽  
pp. 19
Author(s):  
I Pasic ◽  
A Shlien ◽  
A Novokmet ◽  
C Zhang ◽  
U Tabori ◽  
...  
Keyword(s):  
Genomic Instability ◽  
Large Scale ◽  
Structural Variation ◽  
Age Of Onset ◽  
Cancer Susceptibility ◽  
Small Sample Size ◽  
Snp Array ◽  
Tumour Suppressor Gene ◽  
Small Sample ◽  
International Hapmap Project

Introduction: OS, a common Li-Fraumeni syndrome (LFS)-associated neoplasm, is a common bone malignancy of children and adolescents. Sporadic OS is also characterized by young age of onset and high genomic instability, suggesting a genetic contribution to disease. This study examined the contribution of novel DNA structural variation elements, CNVs, to OS susceptibility. Given our finding of excessive constitutional DNA CNV in LFS patients, which often coincide with cancer-related genes, we hypothesized that constitutional CNV may also provide clues about the aetiology of LFS-related sporadic neoplasms like OS. Methods: CNV in blood DNA of 26 patients with sporadic OS was compared to that of 263 normal control samples from the International HapMap project, as well as 62 local controls. Analysis was performed on DNA hybridized to Affymetrix genome-wide human SNP array 6.0 by Partek Genomic Suite. Results: There was no detectable difference in average number of CNVs, CNV length, and total structural variation (product of average CNV number and length) between individuals with OS and controls. While this data is preliminary (small sample size), it argues against the presence of constitutional genomic instability in individuals with sporadic OS. Conclusion: We found that the majority of tumours from patients with sporadic OS show CN loss at chr3q13.31, raising the possibility that chr3q13.31 may represent a “driver” region in OS aetiology. In at least one OS tumour, which displays CN loss at chr3q13.31, we demonstrate decreased expression of a known tumour suppressor gene located at chr3q13.31. We are investigating the role ofchr3q13.31 in development of OS.

Efficient Schedule of Energy-Constrained UAV Using Crowdsourced Buses in Last-Mile Parcel Delivery

2021 ◽  
Vol 5 (1) ◽  
pp. 1-23
Author(s):  
Yan Pan ◽  
Shining Li ◽  
Qianwu Chen ◽  
Nan Zhang ◽  
Tao Cheng ◽  
...  
Keyword(s):  
Traffic Congestion ◽  
Large Scale ◽  
Load Capacity ◽  
Scheduling Algorithm ◽  
Cost Effective ◽  
Promising Alternative ◽  
Logistics Industry ◽  
Last Mile ◽  
Delivery Scheduling ◽  
Schedule Approach

Stimulated by the dramatical service demand in the logistics industry, logistics trucks employed in last-mile parcel delivery bring critical public concerns, such as heavy cost burden, traffic congestion and air pollution. Unmanned Aerial Vehicles (UAVs) are a promising alternative tool in last-mile delivery, which is however limited by insufficient flight range and load capacity. This paper presents an innovative energy-limited logistics UAV schedule approach using crowdsourced buses. Specifically, when one UAV delivers a parcel, it first lands on a crowdsourced social bus to parcel destination, gets recharged by the wireless recharger deployed on the bus, and then flies from the bus to the parcel destination. This novel approach not only increases the delivery range and load capacity of battery-limited UAVs, but is also much more cost-effective and environment-friendly than traditional methods. New challenges therefore emerge as the buses with spatiotemporal mobility become the bottleneck during delivery. By landing on buses, an Energy-Neutral Flight Principle and a delivery scheduling algorithm are proposed for the UAVs. Using the Energy-Neutral Flight Principle, each UAV can plan a flying path without depleting energy given buses with uncertain velocities. Besides, the delivery scheduling algorithm optimizes the delivery time and number of delivered parcels given warehouse location, logistics UAVs, parcel locations and buses. Comprehensive evaluations using a large-scale bus dataset demonstrate the superiority of the innovative logistics UAV schedule approach.

scholarly journals Multi-Country Scale Assessment of Available Energy Recovery Potential Using Micro-Hydropower in Drinking, Pressurised Irrigation and Wastewater Networks, Covering Part of the EU

Water ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 899
Author(s):  
Djordje Mitrovic ◽  
Miguel Crespo Chacón ◽  
Aida Mérida García ◽  
Jorge García Morillo ◽  
Juan Antonio Rodríguez Diaz ◽  
...  
Keyword(s):  
Drinking Water ◽  
Northern Ireland ◽  
Energy Recovery ◽  
Large Scale ◽  
Significant Proportion ◽  
Value Added ◽  
Cost Effective ◽  
Net Energy ◽  
Water Networks ◽  
Scale Assessment

Studies have shown micro-hydropower (MHP) opportunities for energy recovery and CO2 reductions in the water sector. This paper conducts a large-scale assessment of this potential using a dataset amassed across six EU countries (Ireland, Northern Ireland, Scotland, Wales, Spain, and Portugal) for the drinking water, irrigation, and wastewater sectors. Extrapolating the collected data, the total annual MHP potential was estimated between 482.3 and 821.6 GWh, depending on the assumptions, divided among Ireland (15.5–32.2 GWh), Scotland (17.8–139.7 GWh), Northern Ireland (5.9–8.2 GWh), Wales (10.2–8.1 GWh), Spain (375.3–539.9 GWh), and Portugal (57.6–93.5 GWh) and distributed across the drinking water (43–67%), irrigation (51–30%), and wastewater (6–3%) sectors. The findings demonstrated reductions in energy consumption in water networks between 1.7 and 13.0%. Forty-five percent of the energy estimated from the analysed sites was associated with just 3% of their number, having a power output capacity >15 kW. This demonstrated that a significant proportion of energy could be exploited at a small number of sites, with a valuable contribution to net energy efficiency gains and CO2 emission reductions. This also demonstrates cost-effective, value-added, multi-country benefits to policy makers, establishing the case to incentivise MHP in water networks to help achieve the desired CO2 emissions reductions targets.

scholarly journals Modeling Fused Filament Fabrication using Artificial Neural Networks

2021 ◽  
Author(s):  
Paul Oehlmann ◽  
Paul Osswald ◽  
Juan Camilo Blanco ◽  
Martin Friedrich ◽  
Dominik Rietzel ◽  
...  
Keyword(s):  
Real Time ◽  
Large Scale ◽  
Cost Effective ◽  
Print Quality ◽  
Ann Model ◽  
Production Environment ◽  
Fused Filament Fabrication ◽  
Artificial Neural ◽  
Using Data ◽  
Artificial Neural Network Ann

AbstractWith industries pushing towards digitalized production, adaption to expectations and increasing requirements for modern applications, has brought additive manufacturing (AM) to the forefront of Industry 4.0. In fact, AM is a main accelerator for digital production with its possibilities in structural design, such as topology optimization, production flexibility, customization, product development, to name a few. Fused Filament Fabrication (FFF) is a widespread and practical tool for rapid prototyping that also demonstrates the importance of AM technologies through its accessibility to the general public by creating cost effective desktop solutions. An increasing integration of systems in an intelligent production environment also enables the generation of large-scale data to be used for process monitoring and process control. Deep learning as a form of artificial intelligence (AI) and more specifically, a method of machine learning (ML) is ideal for handling big data. This study uses a trained artificial neural network (ANN) model as a digital shadow to predict the force within the nozzle of an FFF printer using filament speed and nozzle temperatures as input data. After the ANN model was tested using data from a theoretical model it was implemented to predict the behavior using real-time printer data. For this purpose, an FFF printer was equipped with sensors that collect real time printer data during the printing process. The ANN model reflected the kinematics of melting and flow predicted by models currently available for various speeds of printing. The model allows for a deeper understanding of the influencing process parameters which ultimately results in the determination of the optimum combination of process speed and print quality.

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