Etiology of early age onset substance use disorder: A maturational perspective

The etiology of early age onset substance use disorder (SUD), an Axis I psychiatric illness, is examined from the perspective of the multifactorial model of complex disorders. Beginning at conception, genetic and environment interactions produce a sequence of biobehavioral phenotypes during development which bias the ontogenetic pathway toward SUD. One pathway to SUD is theorized to emanate from a deviation in somatic and neurological maturation, which, in the context of adverse environments, predisposes to affective and behavioral dysregulation as the cardinal SUD liability-contributing phenotype. Dysregulation progresses via epigenesis from difficult temperament in infancy to conduct problems in childhood to substance use by early adolescence and to severe SUD by young adulthood.

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Criminal insanity and psychiatric diagnoses in Greek penal cases

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.911 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S593-S593

Author(s):

G. Tzeferakos ◽

M. Papaliaga ◽

C. Papageorgiou ◽

P. Bali ◽

A. Douzenis

Keyword(s):

Substance Use ◽

Personality Disorder ◽

Substance Use Disorder ◽

Criminal Responsibility ◽

Common Mental Disorder ◽

Penal Code ◽

Axis I ◽

Criminal Insanity ◽

Court Of Appeal ◽

Diminished Responsibility

IntroductionTo our knowledge, few studies address the issue of criminal responsibility among psychiatric offenders. In Greece, articles 34 and 36 of the penal code regulate criminal insanity and diminished responsibility, respectively.ObjectivesThe objective of the present study was to provide psychiatric/legal data considering the appeal to articles 34/36 of the Greek penal code.MethodsLegal case files of 100 adult subjects, 90 male/10 female, 88 Greeks/12 foreigners were examined.ResultsAccording to the first degree court, one defendant was found criminally insane, 29 with partial responsibility, while the rest were regarded as fully capable. The decisions of the court of appeal/the supreme court of appeal were 2 criminally insane, 36 partially responsible and 62, fully criminally responsible. The decisions were unanimous in 78% of the cases.The most common diagnoses were schizophrenia spectrum psychosis (18%), antisocial/borderline/mixed personality disorder (15%) and substance use disorder (15%). Court decisions of criminal insanity/diminished responsibility were higher when the perpetrator had an Axis I diagnosis (47.5%), significantly lower in cases of personality disorder (22.2%) and even lower in cases of substance use disorder (16.7%). In patients with prior hospitalizations the percentage of criminal insanity/diminished responsibility was 55.6%, significantly higher than in cases without (24.4%).ConclusionsSchizophrenia is the most common mental disorder correlated with offenders criminally insane/partially responsible, while a history of psychiatric hospitalization is a very strong positive predictive factor for the successful appeal of the aforementioned articles.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Sex differences and developmental stability in genetic and environmental influences on psychoactive substance consumption from early adolescence to young adulthood

Psychological Medicine ◽

10.1017/s003329171000259x ◽

2011 ◽

Vol 41 (9) ◽

pp. 1907-1916 ◽

Cited By ~ 16

Author(s):

J. H. Baker ◽

H. H. Maes ◽

H. Larsson ◽

P. Lichtenstein ◽

K. S. Kendler

Keyword(s):

Substance Use ◽

Young Adulthood ◽

Early Adolescence ◽

Illicit Drug ◽

Common Factor ◽

Environmental Influences ◽

Genetic Effects ◽

Shared Environment ◽

Males And Females ◽

Substance Consumption

BackgroundGenetic and environmental factors are important in the etiology of substance use. However, little is known about the stability of these factors across development. We aimed to answer three crucial questions about this etiology that have never been addressed in a single study: (1) Is there a general vulnerability to substance consumption from early adolescence to young adulthood? (2) If so, do the genetic and environmental influences on this vulnerability change across development? (3) Do these developmental processes differ in males and females?MethodSubjects included 1480 twin pairs from the Swedish Twin Study of Child and Adolescent Development who have been followed since 1994. Prospective, self-reported regular smoking, alcohol intoxication and illicit drug use were assessed at ages 13–14, 16–17 and 19–20 years. Structural modeling was performed with the program Mx.ResultsAn underlying common factor accounted for the association between smoking, alcohol and illicit drug consumption for the three age groups. Common genetic and shared environmental effects showed substantial continuity. In general, as participants aged, the influence of the shared environment decreased, and genetic effects became more substance specific in their effect.ConclusionsThe current report answers three important questions in the etiology of substance use. The genetic and environmental risk for substance consumption is partly mediated through a common factor and is partly substance specific. Developmentally, evidence was strongest for stability of common genetic effects, with less evidence for genetic innovation. These processes seem to be the same in males and females.

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Neurobehavior disinhibition in childhood predicts suicide potential and substance use disorder by young adulthood

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2004.08.006 ◽

2004 ◽

Vol 76 ◽

pp. S45-S52 ◽

Cited By ~ 20

Author(s):

R.E. Tarter ◽

Levent Kirisci ◽

Maureen Reynolds ◽

Ada Mezzich

Keyword(s):

Substance Use ◽

Young Adulthood ◽

Substance Use Disorder

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Prevalence of Psychiatric Disorder in a Methadone Maintenance Population

Australian & New Zealand Journal of Psychiatry ◽

10.1080/0004867010060507 ◽

2001 ◽

Vol 35 (5) ◽

pp. 601-605 ◽

Cited By ~ 62

Author(s):

Tom Callaly ◽

Tom Trauer ◽

Leigh Munro ◽

Greg Whelan

Keyword(s):

Substance Use ◽

Anxiety Disorder ◽

Psychiatric Disorder ◽

Affective Disorder ◽

Diagnostic Criteria ◽

Substance Use Disorder ◽

Psychiatric Illness ◽

Methadone Maintenance ◽

Service Planning ◽

Icd 10

Objective: The objective of this study was to examine the prevalence of psychiatric disorders in a group of patients who had recently entered a methadone maintenance programme. Method: A total of 62 patients were interviewed using the Composite International Diagnostic Interview (CIDI) within 6 months of commencing methadone maintenance. The CIDI was used to establish symptoms of psychiatric illness at interview and in the 12 months prior. Results: In the 12 months prior to interview, 76% of the sample fulfilled ICD-10 criteria for a psychiatric disorder other than substance-use disorder. Over half of the group interviewed fulfilled ICD-10 criteria for an affective disorder, two-thirds fulfilled criteria for an anxiety disorder and just under half fulfilled diagnostic criteria for both an affective disorder and an anxiety disorder in the 12 months prior to interview. At the time of interview, 19% fulfilled ICD-10 diagnostic criteria for a moderate or severe affective disorder. Seventy per cent of males and 89% of females interviewed had a comorbid psychiatric illness. In 71% of the group who had a comorbid psychiatric illness, the onset of psychiatric symptomatology was reported to predate the use of heroin. Conclusion: The prevalence of psychiatric disorder is up to 10 times higher in the population on methadone maintenance than in the general population and is two to three times higher than that found in community surveys of those with a substance-use disorder. These results are consistent with earlier findings and have implications for service planning.

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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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