scholarly journals Incidence, Mortality and Survival in Young People with Co-Occurring Mental Disorders and Substance Use: A Retrospective Linked Routine Data Study in Wales

2022 ◽  
Vol Volume 14 ◽  
pp. 21-38
Author(s):  
Sarah Rees ◽  
Alan Watkins ◽  
Janet Keauffling ◽  
Ann John
Keyword(s):  
Substance Use ◽  
Young People ◽  
Mental Disorders ◽  
Routine Data

Suicidality and Treatment Experience Among Young People Who Inject Drugs

2020 ◽  
Author(s):  
Mary Ellen Mackesy-Amiti ◽  
Lawrence J. Ouellet
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Young People ◽  
Mental Disorders ◽  
Mental Health Treatment ◽  
People Who Inject Drugs ◽  
Multivariable Analysis ◽  
Psychiatric Research ◽  
Health Treatment ◽  
The Past

Background. We examined correlates of past year suicidal thoughts and behavior (STB) and described past year treatment experiences among young people who inject drugs (PWID). Methods. Participants were 570 adults (18-25 years) who injected primarily heroin. Interviews were conducted at field stations operated by Community Outreach Intervention Projects in Chicago, Illinois (USA). Interviewers administered the Psychiatric Research Instrument for Substance and Mental Disorders. Substance use and mental disorders were based on DSM-IV diagnostic criteria. Past year STB was based on multiple questions. Results. Sixteen percent of men and 25% of women reported STB in the past year. In multivariable analysis, STB was associated with non-heterosexual orientation, foster care, and being raised by two parents. Primary major depression, post-traumatic stress disorder, other anxiety disorders, and borderline personality disorder had independent effects on suicidality. Among those reporting past year STB (n=111), 83% ever received mental health treatment, while 44% did so in the past year. While 24% of respondents indicated that at least one treatment matched their needs very well, 30% reported treatment that did not match their needs at all. The most common reason for ending treatment was program completion (about 50%) while getting better was endorsed by about 25%. Nearly half reported ending treatment due to a bad experience, logistical issues, or expense. Conclusions. Young PWID are at high risk for suicidal behavior and their mental health treatment experiences often do not meet their needs. There is a pressing need for more integrated substance use and mental health treatment.

Comorbidity: Coexisting substance use and mental disorders in young people

2007 ◽  
Vol 11 (3) ◽  
pp. 88-97 ◽  
Author(s):  
John Howard ◽  
Matt Stubbs ◽  
Anthony Arcuri
Keyword(s):  
Substance Use ◽  
Young People ◽  
Mental Disorders

scholarly journals Incidence, mortality and survival in children and young people aged 11-25 in Wales with co-occurring mental disorders and problem, hazardous or harmful substance use: estimates derived from linked routine data

2020 ◽  
Author(s):  
Sarah Rees ◽  
Alan Watkins ◽  
Janet Keauffling ◽  
Ann John
Keyword(s):  
Substance Use ◽  
Young People ◽  
Hospital Admissions ◽  
Cox Regression ◽  
Routine Data ◽  
Population Based ◽  
Older Age ◽  
Harmful Substance ◽  
Risk Of Death ◽  
Male Sex

Abstract Background Mental disorder (MD) and problem, hazardous or harmful substance use (SUD) are associated with poorer than average health and greater mortality. We analysed routine data to estimate incidence of co-occurring (CC) MD and SUD, and to estimate all-cause mortality and survival with CC, a single MD or SUD diagnosis or neither condition (NC), in young people aged 11-25 in Wales, UK. Methods A retrospective population-based electronic cohort study using data from the Secure Anonymised Information Linkage (SAIL) Databank. Participants were 958,603 individuals aged 11-25 between 2008 and 2017, with a subset for mortality and survival analysis of 465,242 individuals born between 1983 and 1997 and present in the data on 1st January 2008. Incidence was defined as date of first recorded occurrence of a CC code. Incidence and observed unadjusted mortality were reported as rates per 1,000 person-years at risk (PYAR). We plotted Kaplan-Meier survival curves and carried out Cox regression to estimate hazard ratios for risk of death by condition group (CC; MD or SUD only; NC). Results CC incidence in primary care significantly decreased, from 2.5/1,000 PYAR (95% CI 2.3-2.6) in 2008 to 2.1/1,000 (95% CI 2.0-2.2) in 2017 (Incidence rate ratio (IRR) = 0.9, 95% CI 0.8-1.0, p=0.01), and in hospital admissions remained stable, from 2.3/1,000 (95% CI 2.1-2.4) in 2008 to 2.2/1,000 (95% CI 2.0-2.3) in 2017 (IRR = 1.0, 95% CI 0.9-1.1). Higher incidence was associated with male sex, older age and greater deprivation.Observed unadjusted mortality rates for CC (1.4/1,000 PYAR, 95% CI 1.2-1.5) and SUD only (1.1/1,000, 95% CI 0.9-1.4) were significantly higher than for MD only (0.4/1,000, 95% CI 0.3-0.4) and no condition (NC) (0.3/1,000, 95% CI 0.2-0.3). Risk of death was significantly higher for CC (HR = 8.7, 95% CI 7.5-10.0, p<0.001), SUD only (HR = 4.5, 95% CI 3.4-5.9, p<0.001) and MD only (HR = 2.7, 95% CI 2.4-3.1, p<0.001), compared with NC.Conclusions Male sex, older age and greater deprivation were associated with significantly higher CC incidence. CC, and also SUD or MD only, were associated with greater risk of death, compared with individuals with NC.

Diagnoses, Dimensions, and DSM-5

2010 ◽  
pp. 254-279
Author(s):  
Thomas A. Widiger ◽  
Maryanne Edmundson
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Paradigm Shift ◽  
Empirical Support ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Dimensional Classification ◽  
Diagnosis And Classification

The Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) is often said to have provided a significant paradigm shift in how psychopathology is diagnosed. The authors of DSM-5 have the empirical support and the opportunity to lead the field of psychiatry to a comparably bold new future in diagnosis and classification. The purpose of this chapter is to address the validity of the categorical and dimensional models for the classification and diagnosis of psychopathology. Considered in particular will be research concerning substance use disorders, mood disorders, and personality disorders. Limitations and concerns with respect to a dimensional classification of psychopathology are also considered. The chapter concludes with a recommendation for a conversion to a more quantitative, dimensional classification of psychopathology.

Considerations for Treating Young People With Comorbid Autism Spectrum Disorder and Substance Use Disorder

2019 ◽  
Vol 58 (12) ◽  
pp. 1139-1141 ◽  
Author(s):  
Benjamin M. Isenberg ◽  
Amy M. Yule ◽  
James W. McKowen ◽  
Lisa A. Nowinski ◽  
Gina A. Forchelli ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Substance Use ◽  
Young People ◽  
Substance Use Disorder ◽  
Autism Spectrum ◽  
Spectrum Disorder

scholarly journals The psychosocial response to a terrorist attack at Manchester Arena, 2017: a process evaluation

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Daniel Hind ◽  
Kate Allsopp ◽  
Prathiba Chitsabesan ◽  
Paul French
Keyword(s):  
Young People ◽  
Process Evaluation ◽  
Terrorist Attack ◽  
Health Sector ◽  
Routine Data ◽  
Recovery Phase ◽  
Normalisation Process Theory ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Response Phase

Abstract Background A 2017 terrorist attack in Manchester, UK, affected large numbers of adults and young people. During the response phase (first seven weeks), a multi-sector collaborative co-ordinated a decentralised response. In the subsequent recovery phase they implemented a centralised assertive outreach programme, ‘The Resilience Hub’, to screen and refer those affected. We present a process evaluation conducted after 1 year. Methods Case study, involving a logic modelling approach, aggregate routine data, and semi-structured interviews topic guides based on the Inter-Agency Collaboration Framework and May’s Normalisation Process Theory. Leaders from health, education and voluntary sectors (n = 21) and frontline Resilience Hub workers (n = 6) were sampled for maximum variation or theoretically, then consented and interviewed. Framework analysis of transcripts was undertaken by two researchers. Results Devolved government, a collaborative culture, and existing clinical networks meant that, in the response phase, a collaboration was quickly established between health and education. All but one leader evaluated the response positively, although they were not involved in pre-disaster statutory planning. However, despite overwhelming positive feedback there were clear difficulties. (1) Some voluntary sector colleagues felt that it took some time for them to be involved. (2) Other VCSE organisations were accused of inappropriate, harmful use of early intervention. (3) The health sector were accused of overlooking those below the threshold for clinical treatment. (4) There was a perception that there were barriers to information sharing across organisations, which was particularly evident in relation to attempts to outreach to first responders and other professionals who may have been affected by the incident. (5) Hub workers encountered barriers to referring people who live outside of Greater Manchester. After 1 year of the recovery phase, 877 children and young people and 2375 adults had completed screening via the Resilience Hub, 79% of whom lived outside Greater Manchester. Conclusions The psychosocial response to terrorist attacks and other contingencies should be planned and practiced before the event, including reviews of communications, protocols, data sharing procedures and workforce capacity. Further research is needed to understand how the health and voluntary sectors can best collaborate in the wake of future incidents.

Determinants of substance use among young people attending an urban primary health center in Delhi

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
KA Mogan ◽  
U Venkatesh ◽  
Richa Kapoor ◽  
Mukesh Kumar
Keyword(s):  
Substance Use ◽  
Family History ◽  
Young People ◽  
Economic Status ◽  
Primary Health Center ◽  
Socio Economic Status ◽  
Primary Health ◽  
History Of ◽  
Study Participants ◽  
Substance Involvement

AbstractIntroductionSubstance abuse remains one of the major challenges in young people, as it is one of the top five causes of disability-adjusted life years (DALY). The present study aims to find the prevalence and determinants of substance use among young people attending an urban primary health center in Delhi.MethodologySystematic random sampling was used to enroll the calculated sample size of 190. Substance use was assessed using ASSIST (an Alcohol Smoking Substance Involvement Screening Tool) and brief intervention was given based on the standard guidelines of ASSIST. The total score among the substance users is calculated and divided into Grades 1, 2 or 3. Log binomial regression was performed to quantify the association between substance use and covariates such as age, sex, education, occupation, family history of substance use, socio-economic status and family type. The association was expressed in odds ratio (OR) with 95 percent confidence interval (CI).ResultThe mean age of study participants was 18.6 ± 4.1, ranges from 10 to 24 years. Out of 48 substance users, 43.7% were consuming only tobacco, 22.9% were consuming only alcohol and 33.3% were polysubstance users. The history of substance use among family members of participants was found to be 46.3%. Median substance involvement score of tobacco, alcohol and cannabis users was 19 (IQR: 14.5–22), 19 (IQR: 13.5–25) and 22.5 (IQR: 22–23), respectively. Among tobacco users, 2.7% were Grade 1 and 7.2% were Grade 2. Four (16%), 20 (80%) and one (4%) of alcohol users were Grades 1, 2 and 3, respectively. Among the cannabis users, four (100%) were in the Grade 2 category. The median age of initiation of substance use among users was 16 (range 13–21) years. The analysis shows substance use was almost 25 times (adjusted OR = 25.84, 95% CI 5.65–118.09) more common among males and it increase by 2.5 times with a decrease in socio-economic status (adjusted OR = 2.52, 95% CI 1.27–5.02) and the result is significant. The substance use was almost 7 times higher when there is a family history of substance usage (adjusted OR = 7.40, 95% CI 2.15–25.4). Residential and marital status were not significantly associated with substance use.ConclusionMale sex, lower socio-economic status, participants currently not going to school/college, family history of substance use were found to be significant predictors of substance use among the study participants.

scholarly journals Socio-economic consequences of mental distress: quantifying the impact of self-reported mental distress on the days of incapacity to work and medical costs in a two-year period: a longitudinal study in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gerhard Müller ◽  
Manuela Bombana ◽  
Monika Heinzel-Gutenbrenner ◽  
Nikolaus Kleindienst ◽  
Martin Bohus ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Mental Distress ◽  
Linear Models ◽  
Longitudinal Research ◽  
Depression Scale ◽  
Routine Data ◽  
Medical Costs ◽  
First Year ◽  
Second Year ◽  
The Impact

Abstract Background Mental disorders are related to high individual suffering and significant socio-economic burdens. However, it remains unclear to what extent self-reported mental distress is related to individuals’ days of incapacity to work and their medical costs. This study aims to investigate the impact of self-reported mental distress for specific and non-specific days of incapacity to work and specific and non-specific medical costs over a two-year span. Method Within a longitudinal research design, 2287 study participants’ mental distress was assessed using the Hospital Anxiety and Depression Scale (HADS). HADS scores were included as predictors in generalized linear models with a Tweedie distribution with log link function to predict participants’ days of incapacity to work and medical costs retrieved from their health insurance routine data during the following two-year period. Results Current mental distress was found to be significantly related to the number of specific days absent from work and medical costs. Compared to participants classified as no cases by the HADS (2.6 days), severe case participants showed 27.3-times as many specific days of incapacity to work in the first year (72 days) and 10.3-times as many days in the second year (44 days), and resulted in 11.4-times more medical costs in the first year (2272 EUR) and 6.2-times more in the second year (1319 EUR). The relationship of mental distress to non-specific days of incapacity to work and non-specific medical costs was also significant, but mainly driven from specific absent days and specific medical costs. Our results also indicate that the prevalence of presenteeism is considerably high: 42% of individuals continued to go to work despite severe mental distress. Conclusions Our results show that self-reported mental distress, assessed by the HADS, is highly related to the days of incapacity to work and medical costs in the two-year period. Reducing mental distress by improving preventive structures for at-risk populations and increasing access to evidence-based treatments for individuals with mental disorders might, therefore, pay for itself and could help to reduce public costs.

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