An investigation comparing primary and secondary substance cravings between mental health and substance use disorder program inpatients

Background: Mental illness symptoms can trigger substance use cravings, which are strongly associated with relapse. Aim: Our study examines differences in substances craved among adults entering inpatient mental health (MH) and substance use disorder (SUD) treatment programs in 2018. Method: Our sample includes 2,486 adults; 1,686 adults admitted to MH programs and 800 adults admitted to SUD programs. We conducted chi-square tests and Fisher’s exact tests to determine group differences, with a Bonferroni correction to adjust the alpha for multiple tests. Results: We found that patients programmed to SUD services more often reported alcohol (39.99 vs. 49.63%; x2 (1, N = 2,488) =20.56, p<0.001) and opioid (8. 00% vs. 35.88%; x2 (1, N = 2,488) =299.48, p < 0.001) cravings. Patients programmed to MH primary more often reported cannabis (16. 35% vs. 1.00%; x2 (1, N=2,488) =299.48, p<0.001), stimulants (10.25% vs. 6.13%; x2(1, N =2,488) = 11.36, p < 0.001), and “other substances” cravings (21.45% vs. 3.25; x2 (2, N = 2,488) =136.52, p <0.001). Both groups mostly did not report secondary cravings. Conclusions: Because cravings can negatively impact treatment success of patients with co-occurring disorders, cravings should be assessed upon admission to mental health or SUD inpatient treatment.

Substance use disorders and suicidality in youth: A systematic review and meta-analysis with a focus on the direction of the association

Background Reviews and meta-analyses suggest that substance use and suicidality (i.e., suicidal ideations and attempts) are associated in youth, but the direction of this association remains unclear. Theoretically, the secondary psychiatric disorder hypothesis (SPDH) posits that substance use leads to suicidality, while the secondary substance use disorder hypothesis (SSUDH) posits that suicidality leads to substance use. To clarify these associations, this meta-analysis systematically reviewed studies that examined the prospective associations between SUDs and suicidality in youth (age 25 and younger) and compared results according to the direction of the association. Methods Web of Science, Embase, PsycINFO, PubMed, Medline and ProQuest Dissertations & Theses Global were searched from inception to March 8, 2020, and 55 effect sizes from 23 samples were included and analyzed using a three-level meta-analysis. Results SUDs significantly predicted subsequent suicidality (OR = 2.16, 95%CI 1.57–2.97), suicidality significantly predicted subsequent SUDs (OR = 2.16, 95%CI 1.53–3.04), and these effect sizes did not differ (p = 0.49). Conclusions Considering that 65% of reviewed studies only examined the SPDH, this review highlights that more attention should be given to the SSUDH, and that studies should examine bidirectional associations between SUDs and suicidality across time. Clinically, because SUDs and suicidality were found to influence each other, results suggest that mental health and SUDs should ideally be detected and treated early, and that co-occurring disorders should be assessed and treated concomitantly.

Effects of Biostimulants on Primary and Secondary Substance Contents in Lettuce Plants

Lettuce (Lactuca sativa L.) is not only easy to grow, but it is also common in diets around the world. This study was conducted to determine the impact of Chinese chive (Allium tuberosum Rottler), soybean (Glycine max L.) leaf, and soybean stem extracts on lettuce plants’ secondary substances, minerals, amino acids, and free sugars. This study was carried out in order to better understand which types of plant extract applications are most effective in increasing lettuce plants’ nutritional value. While not all applications produced an increased nutritional value in the lettuce plants, we found that soybean leaf extract treatments increased the Mg and Ca contents and Chinese chive treatments increased the Fe contents in the lettuce plants. Additionally, glucose and maltose contents in lettuce plants were higher after treatments of Chinese chive and soybean leaf extracts. Finally, all selected extracts increased the total and free amino acid levels in our test plants.

The amount of lichen secondary metabolites in Cladonia foliacea (Cladoniaceae, lichenised Ascomycota)

The terricolous species Cladonia foliacea (Cladoniaceae, lichenised Ascomycota) widely distributed in open, dry lowland steppe and rocky mountain grassland vegetation in Europe was chosen as a potential test organism for ecological experiments, since their thalli are producing cortical solar radiation-protective and UV screening pigment dibenzofuran usnic acid and medullary secondary substance depsidone fumarprotocetraric acid. Significant seasonal differences were found in the amounts of lichen secondary metabolites analysed by HPTLC and HPLC-PDA between summer and winter collected thalli in sandy grassland area in Hungary. The concentrations of usnic acid varied between 7.34 and 15.52 mg/g in summer collected samples and 13.90 and 21.61 mg/g in winter collected ones. A comparable amount (11.61±0.29 mg/g) was measured in pulverised samples. The concentrations of fumarprotocetraric acid varied between 0.60 and 3.01 mg/g in summer collected samples and 2.26 and 5.81 mg/g in winter collected thalli. A comparable amount (2.45±0.21 mg/g) was found in pulverised samples. The range of concentration values is comparable with data known from lichens. A higher amount of usnic acid is produced in winter probably to ensure sufficient protection also for summer. The fumarprotocetraric acid content of the medulla might contribute to the solar irradiation reflecting role of the pale lower surface lobes turning upwards in dry condition.

Aristotle on Secondary Substance

At the beginning of Categories 5, Aristotle distinguishes between two kinds of substance: primary substance and secondary substance. Primary substances include particular living organisms, inanimate objects, and their parts. Secondary substances are the species and genera of these. This distinction is unique to the Categories, which raises the question of why Aristotle treats species and genera as substances. I argue that Aristotle has two distinct reasons for doing so, and contrast my interpretation with recent alternatives. On my view, species and genera enjoy two kinds of fundamentality – ontological and epistemological – in virtue of which they warrant their status as substances.

Standardized drug and alcohol questions at admission to an acute adult mental health unit: clarifying the burden of dual diagnoses across a five-year period

Objectives: We aimed to report substance use across a five-year period in individuals admitted to an acute mental health unit, utilizing data from a routine clinical measure, diagnoses, and findings related to gender, ethnicity and the implementation of a new dual-diagnosis policy. Methods: Data was extracted from the electronic records of 2118 individuals who had consecutive admissions to the acute inpatient unit. Analysis focused on demographic and diagnosis variables and the drug and alcohol question in the Health of the Nations Outcome Scale. Results: Some 57.6% of the sample was in the at-risk drug and alcohol category. Male and indigenous inpatients were most at risk. More than 50% of patients with schizophrenia, anxiety and personality disorders were deemed at-risk. Following implementation of the dual-diagnosis policy, recorded primary and secondary substance use disorder (SUD) diagnoses significantly increased. Conclusions: The study replicated previous findings of a high proportion of patients with co-morbid drug and alcohol use. In this sample it seems likely that the dual-diagnosis policy and related activities increased the rate of SUD diagnoses recorded, although it is likely to still be under-reported.

A new species-level taxonomy forTrapelia(Trapeliaceae, Ostropomycetidae) with special reference to Great Britain and the Falkland Islands

Trapeliais a small genus of worldwide distribution.Trapelia coarctatahas long been regarded as a morphologically variable species and phylogenetic studies have suggested that it is non-monophyletic, or at least that species are frequently misidentified. The phylogenetic relationships of freshly-collected material ofTrapeliawere studied using ITS, mitochondrial SSU rDNA and to a small extent also beta-tubulin sequence data, together with chemical and morphological characters. Sequence data combined with morphology and chemistry confirm that the diversity of the genus at species-level has been underestimated.Trapelia coarctatais defined in a more restricted way and many specimens previously referable to this taxon are assigned to the reinstated speciesT. elacista, which differs in subtle morphological characters including a crack separating the thallus and apothecium in well-developed thalli.Trapelia involutais reinstated as a separate, though closely related, species toT. glebulosabased on sequence data, morphology and chemistry, and is lectotypified.Trapelia collarisis a distinctive species described as new from Great Britain which has an extensive, cracked thallus with abruptly thickening marginal areoles arising on an inconspicuous prothallus, relatively small apothecia (rarely exceeding 300 µm diameter) and contains 5-O-methylhiascic acid as the major secondary substance.Trapelia obtegensis shown to include frequent non-sorediate morphs which have doubtless been misidentified as other species. The number of species ofTrapeliaconsidered to occur in Europe is thus raised from five to eight. The genus is newly reported for the Falkland Islands where seven species occur:T. coarctata,T. placodioides,T. sitienssp. nov. (with a thin, extensive thallus, sessile apothecia, 5-O-methylhiascic acid as the major secondary substance and the presence of conidiomata),T. tristissp. nov. (with relatively small apothecia up to 460 µm diameter, presence of gyrophoric acid as the major substance and an absence of conidiomata) and three unidentified species represented by very sparse material. All the species studied, with the possible exception of the three unidentified species, can usually be distinguished by morphological features, particularly the method of development of the thallus and the shape and distribution of the areoles, but morphological variation in response to microhabitat variation is likely to make a proportion of specimens difficult to assign to species in the absence of sequence data.