scholarly journals Psychiatry In-patient Substance Profile Changes in COVID year 2020 from 2019 in a Teaching hospital of Eastern Nepal

2021 ◽  
Vol 5 (3) ◽  
pp. 01-04
Author(s):  
Dhana Ratna Shakya
Keyword(s):  
Substance Use ◽  
Teaching Hospital ◽  
Policy Changes ◽  
Subsequent Time ◽  
Other Substances ◽  
Icd 10 ◽  
Benzodiazepine Use ◽  
Harmful Use ◽  
Profile Changes ◽  
Patient Service

Subsequent time, after declaration of COVID-19 pandemic, witnessed variable changes in various aspects due to COVID circumstances around the globe. We report and reflect here over the observation regarding substance use and use disorder scenario in initial COVID year 2020 in reference to 2019 (year preceding COVID-19 pandemic). It is an observation in psychiatry in-patient service of a teaching hospital of eastern Nepal. There were 420 (284 male, 136 female) and 279 (194 male and 85 female) admissions in 2019 and 2020 respectively. The most striking and significant change was seen for Nicotine, both overall and use disorder-wise. Over all, the proportion increased for Nicotine (34.05 to 48.03%) and Cannabis (16.67 to 17.92%) whereas decreased for Alcohol (38.33 to 31.18%), Opiote (7.62 to 6.81%), Benzodiazepine (6.43 to 5.73%) and other substance (0.71% to nil) among the in-patients in 2020. Categorically, both the Use and Dependence syndrome (ICD-10) increased for Nicotine (8.81 to 21.86%% and 25.24 to 26.17%) and Cannabis (10.71 to 11.47% and 5.72 to 6.45%). Proportion of Alcohol use and Harmful use decreased whereas Alcohol dependence increased, Opiote use increased whereas Harmful use and Dependence decreased, Benzodiazepine use and Dependence decreased and other substances decreased too. The observation shows various changes in the pattern of substance among the psychiatry in-patients which indicates the need for some strategic and policy changes to tackle this pandemic situation.

scholarly journals Adolescent cannabis use, baseline prodromal symptoms and the risk of psychosis

2018 ◽  
Vol 212 (4) ◽  
pp. 227-233 ◽  
Author(s):  
Antti Mustonen ◽  
Solja Niemelä ◽  
Tanja Nordström ◽  
Graham K. Murray ◽  
Pirjo Mäki ◽  
...  
Keyword(s):  
Substance Use ◽  
General Population ◽  
Birth Cohort ◽  
Psychotic Disorders ◽  
Temporal Order ◽  
Population Based ◽  
Cannabis Use ◽  
Prodromal Symptoms ◽  
Increased Risk ◽  
Icd 10

BackgroundThe association between cannabis use and the risk of psychosis has been studied extensively but the temporal order still remains controversial.AimsTo examine the association between cannabis use in adolescence and the risk of psychosis after adjustment for prodromal symptoms and other potential confounders.MethodThe sample (n = 6534) was composed of the prospective general population-based Northern Finland Birth Cohort of 1986. Information on prodromal symptoms of psychosis and cannabis use was collected using questionnaires at age 15–16 years. Participants were followed up for ICD-10 psychotic disorders until age 30 years using nationwide registers.ResultsThe risk of psychosis was elevated in individuals who had tried cannabis five times or more (hazard ratio, (HR) = 6.5, 95% CI 3.0–13.9). The association remained statistically significant even when adjusted for prodromal symptoms, other substance use and parental psychosis (HR = 3.0, 95% CI 1.1–8.0).ConclusionsAdolescent cannabis use is associated with increased risk of psychosis even after adjustment for baseline prodromal symptoms, parental psychosis and other substance use.Declaration of interestNone.

scholarly journals Pre-Existing Mental Disorder, Clinical Profile, Inpatient Services, And Costs in People Hospitalised Following Traumatic Spinal Injury: A Population Record-Linkage Study

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Lisa Nicole Sharwood ◽  
Taneal Wiseman ◽  
Emma Tseris ◽  
Kate Curtis ◽  
Bharat Vaikuntam ◽  
...  
Keyword(s):  
Mental Illness ◽  
Substance Use ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Dual Diagnosis ◽  
Record Linkage ◽  
Injury Severity ◽  
Spinal Injury ◽  
Linkage Study ◽  
Icd 10

IntroductionRisk of traumatic injury is increased in individuals with mental illness, substance use disorder and dual diagnosis (mental disorders); these conditions will pre-exist among individuals hospitalised with acute traumatic spinal injury (TSI). Although early intervention can improve outcomes for people who experience mental disorders or TSI, the incidence, management, and cost of this often complex comorbid health profile is not sufficiently understood. Objectives and ApproachIn a whole-population cohort of patients hospitalised with acute TSI, we aimed to describe the prevalence of pre-existing mental disorders, and compare differences in injury epidemiology, costs and inpatient allied health service access. Record-linkage study of all hospitalised cases of TSI between June 2013 and June 2016 in New South Wales, Australia. TSI was defined by specific ICD-10-AM codes. Mental disorder status was considered as pre-existing where specific ICD-10-AM codes were recorded in incident admissions. Results13,489 individuals sustained acute TSI during this study. 13.11%, 6.06%, and 1.82% had pre-existing mental illness, substance use disorder, and dual diagnosis, respectively. Individuals with mental disorder were older (p<0.001), more likely to have had a fall or self-harmed (p<0.001), experienced almost twice the length of stay and inpatient complications, and increased injury severity compared to individuals without mental disorder (p<0.001). Conclusion / ImplicationsIndividuals hospitalised for TSI with pre-existing mental disorder have greater likelihood of increased injury severity and more complex, costly acute care admissions compared to individuals without mental disorder. Care pathway optimisation including prevention of hospital acquired complications for people with pre-existing mental disorders hospitalised for TSI is warranted.

Abstract 16520: Predictors of Thirty Day Readmission in a Vulnerable and Underserved Urban Heart Failure Population

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Alexandra B Steverson ◽  
Paul Marano ◽  
Caren Chen ◽  
Yifei Ma ◽  
Rachel Stern ◽  
...  
Keyword(s):  
Heart Failure ◽  
Substance Use ◽  
San Francisco ◽  
Chart Review ◽  
Safety Net ◽  
Housing Status ◽  
Medical Comorbidities ◽  
Increased Risk ◽  
Safety Net Hospital ◽  
Icd 10

Introduction: Heart failure (HF) readmission quality metrics disproportionately impact reimbursement in safety net hospitals. Prior research has demonstrated the effect of medical comorbidities on readmission, however, there is a paucity of data on predictors of readmission in vulnerable and underserved HF patients. We sought to evaluate the effect of demographics, medical and social comorbidities on risk of 30 day readmission in an academic safety net hospital in San Francisco. Methods: We performed a retrospective chart review from 2018 to 2020. Patients were included if treated for HF while on inpatient cardiology or medicine services and were assigned an ICD-10 discharge code for HF. Patients less than 21 years old were excluded. Demographics and comorbidities were obtained through evaluation of ICD-10 discharge codes and chart review. Multivariate modeling was used to determine predictors of 30 day readmission. Results: The study population included 383 patients in which the mean age was 60±13 years and 73% (n=282) were male. 44% (170) were Black, 23% (88) were Latinx, 33% (127) were not housed, 97% (371) had public insurance, and 21% (81) had a diagnosis of mental illness. 46% (177) had CAD, 76% (291) hypertension, and 36% (177) DM. Substance use was common with 30% (114) using methamphetamines, 36% (138) cocaine, 18% (69) opioids, and 35% (135) alcohol. On multi-variate analysis, EF less than 40% (75%, 285) was the only medical comorbidity associated with an increased risk of readmission (OR 1.86, 1.1-3.1, p= 0.018). Social variables associated with increased risk of readmission included identifying as Black (OR 2.26, 1.03-5.0, p= 0.043) or Latinx (OR 3.43, 1.41-7.59, p= 0.006), homelessness (OR 3.02, 1.76-5.18, p=<0.001), and specific substance use: methamphetamine (OR 2.23, 1.39-3.57, p=0.001), cocaine (OR 1.63, 1.03-2.57, p= 0.037), opioids (OR 1.81, 1.05-3.13, p= 0.033), and alcohol (OR 2.26, 1.43-3.58, p= 0.001). Conclusion: Race, housing status and substance use were more strongly associated with readmission risk than medical comorbidities in a population of urban, vulnerable and underserved HF patients. Interventions to improve HF readmission metrics should consider addressing racial and social disparities in similar populations.

Gender and contituity on alcohol, tobacco and cannabis use among young people / Genero y continuidad en el consumo de alcohol, tabaco y cannabis en jóvenes

2006 ◽  
Vol 5 (2) ◽  
Author(s):  
Marina Muñoz-Rivas ◽  
José Manuel Andreu ◽  
Patricia Gutierrez
Keyword(s):  
Substance Use ◽  
Young People ◽  
Cannabis Use ◽  
Entire Sample ◽  
Large Sample ◽  
Other Substances ◽  
Las Mujeres ◽  
High Level

En el presente trabajo se analiza el consumo de alcohol en sus diversas formas (cerveza, vino, licores y combinados), tabaco y cannabis en una amplia muestra de 4.034 jóvenes de ambos sexos con edades comprendidas entre los 14 y los 18 años pertenecientes a la Comunidad de Madrid. Se confirma un elevado uso habitual de todas las sustancias de análisis siendo los varones los que consumencerveza en mayor porcentaje que las mujeres y son éstas las que realizan un consumo mucho más mayoritario de otras, como el tabaco. Para el total de la muestra de estudio, la edad de comienzo en el consumo se sitúa alrededor de 13-14 años en ambos sexos a excepción del uso habitual del vino y cannabis en el que las mujeres se incorporan más tarde que los varones. Finalmente, se analiza la continuidad en el consumo una vez iniciado éste y se comprueba nuevamente el poder adictivo de las sustancias analizadas puesto que el porcentaje de consumidore habituales en ambos sexos se incrementa significativamente con la edad. AbstractThis work analyzes the consumption of alcohol in its diverse forms(beer, wine, liquor, and cocktails), tobacco, and cannabis in a large sample of 4,034 youths of both sexes, ages between 14 and 18 years old, from the Community of Madrid. The high level of habitual use of all the substances analyzed was confirmed, with a higher percentage of men consuming beer than women, and womenconsuming much more of other substances, such as tobacco, than men. For the entire sample, the initiation age of substance use was around 13-14 years old in both sexes, except for the regular use of wine and cannabis, in which the women started later than the men. Lastly, once initiated, consumption continuity was analyzed and once again the addictive power of the substances analyzed was confirmed, as the percentage of habitual consumers in both sexes increased significantly with age.

Gamma-Butyrolactone Overdose Potentially Complicated by Co-Ingestion of Industrial Solvent N-Methyl-2-Pyrrolidone

2020 ◽  
Author(s):  
Jonathan Melamed ◽  
Roy Gerona ◽  
Paul D Blanc ◽  
Paul Takamoto ◽  
Stephanie Conner ◽  
...  
Keyword(s):  
Substance Use ◽  
Psychoactive Substance ◽  
New Psychoactive Substance ◽  
Use Patterns ◽  
Endogenous Metabolism ◽  
Gamma Hydroxybutyrate ◽  
Other Substances ◽  
History Of ◽  
Psychoactive Substance Use ◽  
Gamma Butyrolactone

Abstract Gamma-hydroxybutyrate (GHB) is misused as an intoxicant, either alone or concurrently with other substances. Because GHB is illegal, the precursor chemicals 1,4-butanediol and gamma-butyrolactone are also misused for the same effect, either through pre-ingestion alteration or endogenous metabolism to GHB. We describe a case of a 50-year-old man with a history of polysubstance misuse who experienced an overdose of GHB from gamma-butyrolactone ingestion. The patient also co-ingested a common industrial solvent, N-methyl-2-pyrrolidone (NMP). This co-ingested substance raised theoretical concern of metabolism to a GHB congener, underscoring that the emergence of new psychoactive substance use patterns requires ongoing vigilance and toxicologic confirmation.

scholarly journals Classification in psychiatry: ICD–10 v. DSM–IV

1999 ◽  
Vol 175 (3) ◽  
pp. 205-209 ◽  
Author(s):  
Michael B. First ◽  
Harold Alan Pincus
Keyword(s):  
Mental Disorders ◽  
American Psychiatric Association ◽  
Classification Systems ◽  
Diagnostic Classification ◽  
Two Systems ◽  
Icd 10 ◽  
Harmful Use ◽  
Dsm Iv

The editorial by Andrews et al (1999) usefully calls attention to issues of compatibility between diagnostic classification systems but we believe that the editorial greatly overstates the compatibility problem as well as its implications. The article begins with the suggestion that the DSM–IV authors' position is to downplay the differences between DSM–IV and ICD–10. After stating that the American Psychiatric Association “felt sufficiently confident to publish a DSM–IV International Version in which the DSM–IV criteria are listed against the ICD–10 codes”, the authors go on to report concordances between the classifications for the main mental disorders as ranging from a low of 33% (for substance harmful use or abuse) to 87% (for dysthymia), with an overall concordance of only 68%. The authors conclude that if this “unnecessary dissonance between the classification systems continues, patients, researchers and clinicians will be all the poorer”. Although we acknowledge that there are a number of differences between the two systems, the authors fail to assess fully the sources, significance and solutions for this compatibility problem.

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