Mental Disorders and Mental Health Service Use Across Asian American Subethnic Groups in the United States

This study analyzed the National Epidemiological Survey on Alcohol and Related Conditions data, 2001–2002, to compare the prevalence and odds of DSM-IV mood, anxiety, and substance use disorders and mental health service use across Asian American subethnic groups (648 East Asians, 485 Southeast Asians, 298 South Asians). Asian American subethnic groups varied in lifetime prevalence of psychiatric disorders (p = 0.004), mainly due to differences in the presence of any substance use disorder (p = 0.06), and specifically, drug use disorders (p = 0.02). While Southeast Asians had the highest prevalence of substance use disorders (16.7 %), fewer Southeast Asians with substance use disorders used mental health services (11.1 %) compared to South Asians with substance use disorders (24.2 %). East Asians compared to South Asians had significantly lower odds of mental health service use for substance use disorders (confidence interval = 0.08–0.84). Asian American subethnic groups vary in the prevalence of mental disorders and in mental health service use, especially for substance use disorders

Gender-specific profiles of adverse childhood experiences, past year mental and substance use disorders, and their associations among a national sample of adults in the United States

Purpose: This study examined profiles of adverse childhood experiences (ACEs) and mental and substance use disorders (MSUDs), and associations between distinct profiles of ACEs and MSUDs. Methods: Participants were adults (N = 34, 652) involved in the National Epidemiologic Survey on Alcohol and Related Conditions. Latent class analysis was used to examine both profiles of ten ACEs and ten past year MSUDs. Dual latent class analysis regression was used to examine associations between profiles of ACEs and MSUDs. Given gender differences in ACEs and MSUDs, analyses were conducted separately for females and males. Results: Four profiles of ACEs and three profiles of MSUDs were selected for both genders. The four profiles of ACEs were characterized by the following probabilities: high multiple ACEs, high parental substance abuse, high childhood physical abuse, and low ACEs. The three profiles of MSUDs were characterized by the following probabilities: high multiple MSUDs for females and low MSUDs except alcohol use disorders for males, moderate-to-high major depressive episode, and low MSUDs. When compared to the low ACEs and MSUDs profiles, members in the higher ACEs profiles had 3.71–89.75 times greater odds of also being members in the higher MSUDs profiles. However, more than one-third of members in the high multiple ACEs profiles were also in the low MSUDs profiles. Conclusions: Study findings suggest four profiles of the ACEs widely studied as part of the Adverse Childhood Experiences study and risk and resilience for recent MSUDs among men and women nationally affected by ACEs

Pathological Gambling in Women: A Review

Pathological gambling was only recently recognized as a psychiatric disorder (DSM-III, APA, 1980). Most studies of pathological gambling include only male subjects. Despite the paucity of information, it is likely that at least one-third of pathological gamblers are women. The objective of this article is to review clinical and epidemiological characteristics of female gamblers as compared to their male counterparts. MEDLINE and PsycINFO were searched for investigational studies and reviews of the past 10 years on clinical (sociodemographic, course and progression, psychiatric comorbidities, genetics, and personality) and epidemiological aspects of female gamblers. Other relevant articles were also selected from reference lists. It is concluded that the current literature indicates some common characteristics in female and male gamblers, but it also indicates the possibility that each gender may carry etiopathogenic differences that when better understood should lead to improved treatment and prevention strategies

Perceived risk of regular cannabis use in the United States from 2002 to 2012: Differences by sex, age, and race/ethnicity

Introduction: Cannabis is one of the most widely used psychoactive substances in the United States (U.S.). Perceived risk of use is associated with substance use; the recent debate surrounding medicalization and legalization of cannabis in the U.S. has the potential to impact perceived risk of use. Recent estimates are needed to assess temporal changes in, and identify correlates of, perceived risk of cannabis use. Methods: Utilizing data from the 2002–2012 survey years of the National Survey on Drug Use and Health, chi-squared statistics and logistic regression were used to describe temporal changes in perceived risk of regular cannabis use (i.e., once or twice a week), to explore correlates of perceived risk, and to report frequency of cannabis use. Results: Between 2002 and 2012, perceived great risk of regular cannabis use varied significantly overall (p < 0.001). The prevalence of past year non-daily (p < 0.001) and daily use varied significantly during this time (p < 0.001). Controlling for survey year and other confounders, characteristics associated with increased odds of perceived great risk of regular cannabis use included: female sex; Non-White race/ethnicity; age 50+; and family income of $20,000-49,999. Characteristics associated with decreased odds of perceived great risk included: ages 12–17 and 18–25; high school education or greater; total family income of$75,000+; past year non-daily and daily cannabis use; and survey years 2008–2012. Conclusions: Findings characterize trends of perceived risk of regular cannabis use, and past year non-daily and daily cannabis use. Longitudinal studies of the influence of legal status of cannabis at the state-level are needed

Substance Use Disorders and Adolescent Psychopathology

Adolescence is a vulnerable developmental stage where significant changes occur in a youth’s body, brain, environment and socialization, which may increase vulnerability to substance use, development of addiction, and psychiatric disorders. A co-occurrence of mental and behavioral disturbances with drug involvement in adolescence is common, as reflected in both a high risk for drug use in youth with mental illness and a high frequency of psychopathology among drug users. In this review we provide a broad and basic overview of some of the research evidence indicating a strong co-occurrence of drug use disorders (abuse and dependence) with externalizing and internalizing disorders, as well as a few other serious mental health conditions among adolescents. Increasing awareness and knowledge of the high probability of the co-occurrence of mental and behavioral disturbances with drug involvement informs the understanding of the etiology, course, and treatment of psychiatric problems among adolescents

Cigarette smoking and drug use among a nationally representative sample of HIV-positive individuals

Background and Objectives: Among HIV-positive populations, the prevalence of cigarette smoking remains disproportionately high and is associated with significant morbidity and mortality. Little is known about this topic among HIV-positive persons in the general population. Methods: Data came from the 2005 to 2011 National Survey on Drug Use and Health (NSDUH) public use data files. Unadjusted and adjusted multinomial logistic regression analyses explored the associations between socio-demographic, drug and alcohol use, and drug and/or alcohol treatment characteristics with smoking status among HIV-positive individuals (n = 349). Results: More than 40% of the sample was current smokers. In adjusted analyses, females (aRRR = .11, 95% CI = .03–.41) and participants who had never been married (aRRR = .19, 95% CI = .05–.58), were more likely to be former smokers than never smokers. Females (aRRR = .37, 95% CI = .14–.96) and individuals older than age 35 (aRRR = .37, 95% CI = .16–.89) were less likely to be current smokers than never smokers. Conversely, previously married persons (aRRR = 5.72, 95% CI = 1.40–23.31), participants reporting binge drinking (aRRR = 5.96, 95% CI = 2.27–15.64), and lifetime drug or alcohol treatment (aRRR = 5.12, 95% CI = 2.09–12.55) were more likely to be current smokers than never smokers. Conclusions: Findings help confirm the high prevalence of smoking among HIV-positive persons suggesting the need for integrated substance use and smoking cessation treatment among HIV-positives. Scientific Significance: The present findings have implications for the development and implementation of targeted smoking cessation programs for HIV-positive smokers

Worldwide Prevalence and Trends in Unintentional Drug Overdose: A Systematic Review of the Literature

Background. Drug overdose is an important, yet an inadequately understood, public health problem. Global attention to unintentional drug overdose has been limited by comparison with the scope of the problem. There has been a substantial increase in drug overdose incidence and prevalence in several countries worldwide over the past decade, contributing to both increased costs and mortality. Objectives. The aim of this study was to systematically synthesize the peer-reviewed literature to document the global epidemiological profile of unintentional drug overdoses and the prevalence, time trends, mortality rates, and correlates of drug overdoses. We searched different combinations of Medical Subject Headings (MeSH) terms in PubMed for articles published from 1980 until July 2013, and we organized these results in tabular spreadsheets and compared them. We restricted the search to English-language articles that deal with unintentional overdose, focusing on 1 or more of the following key constructs: prevalence, time trends, mortality rates, and correlates. The term “overdose” as a MeSH major topic yielded 1076 publications. In addition, we searched the following combinations of nonmajor MeSH terms: “street drugs” and “overdose” yielded 180, “death” and “overdose” yielded 114, and “poisoning” and “drug users” yielded 17. There was some overlap among the searches. Based on the search and inclusion and exclusion criteria, we selected a total of 169 relevant articles for this article based on a close review of abstracts. Results. We found wide variability in lifetime prevalence of experiencing a nonfatal overdose or witnessing an overdose, and in mortality rates attributable to overdose. Lifetime prevalence of witnessed overdose among drug users (n = 17 samples) ranged from 50% to 96%, with a mean of 73.3%, a median of 70%, and a standard deviation of 14.1%. Lifetime prevalence of drug users personally experiencing a nonfatal overdose (n = 27 samples), ranged from 16.6% to 68.0% with a mean of 45.4%, a median of 47%, and a standard deviation of 14.4%. Population-based crude overdose mortality rates (n = 28 samples) ranged from 0.04 to 46.6 per 100 000 person-years. This range is likely attributable to the diversity in regions, time periods, and samples. Most studies on longitudinal trends of overdose death rates or overdose-related hospitalization rates showed increases in overdose death rates and in overdose-related hospitalization rates across time, which have led to peaks in these rates at the present time. An overall trend of increasing deaths from prescription opioid use and decreasing deaths from illicit drug use in the past several years has been noted across most of the literature. With the increase in prescription opioid overdose deaths, drug overdose is not just an urban problem: rural areas have seen an important increase in overdose deaths. Lastly, cocaine, prescription opioids, and heroin are the drugs most commonly associated with unintentional drug overdoses worldwide and the demographic and psychiatric correlates associated with unintentional drug overdoses are similar globally. Conclusions. There is a need to invest in research to understand the distinct determinants of prescription drug overdose worldwide. Several other countries need to collect in a systematic and continuous fashion such data on sales of prescription opioids and other prescription drugs, nonmedical use of prescription drugs, and hospitalization secondary to overdoses on prescription drugs. The sparse evidence on the environmental determinants of overdose suggests a need for research that will inform the types of environmental interventions we can use to prevent drug overdose. Methodological issues for future studies include enhancing data collection methods on unintentional fatal and nonfatal overdoses, and collecting more detailed information on drug use history, source of drug use (for prescription drugs), and demographic and psychiatric history characteristics of the individual who overdosed

Jogo patológico em mulheres: uma revisão

Pathological gambling was only recently recognized as a psychiatric disorder (DSM-III, APA, 1980). Most studies of pathological gambling include only male subjects. Despite the paucity of information, it is likely that at least one-third of pathological gamblers are women. The objective of this article is to review clinical and epidemiological characteristics of female gamblers as compared to their male counterparts. MEDLINE and PsycINFO were searched for investigational studies and reviews of the past 10 years on clinical (sociodemographic, course and progression, psychiatric comorbidities, genetics, and personality) and epidemiological aspects of female gamblers. Other relevant articles were also selected from reference lists. It is concluded that the current literature indicates some common characteristics in female and male gamblers, but it also indicates the possibility that each gender may carry etiopathogenic differences that when better understood should lead to improved treatment and prevention strategies.Ainda que jogos de azar e os problemas a eles relacionados sejam antigos para a humanidade, o Jogo Patológico, como alteração do comportamento humano, somente passou a ser reconhecido oficialmente como transtorno psiquiátrico a partir de sua inclusão na 3ª Edição do Manual Diagnóstico e Estatístico de Transtornos Mentais (APA,1980). A maioria dos estudos sobre jogadores patológicos tem como base uma população eminentemente masculina. Entretanto, estima-se que pelo menos um terço dos indivíduos que recebem este diagnóstico sejam mulheres. O objetivo deste estudo foi revisar características clínicas e epidemiológicas de jogadoras comparadas a jogadores. As bases de dados MEDLINE e PsycINFO foram consultadas a respeito de estudos sobre Jogo Patológico publicados nos últimos dez anos, com especial enfoque para características clínicas (dados sócio-demográficos, curso e evolução, comorbidade psiquiátrica, genética e personalidade) e epidemiologia. Artigos relevantes publicados anteriormente ao período escolhido de revisão foram selecionados a partir da lista original de referências. Os autores concluem que a literatura atual indica que jogadoras e jogadores apresentam semelhanças, mas carreiam possíveis diferenças etiopatogênicas cujo esclarecimento deverá aprimorar as estratégias de tratamento e prevenção

A Longitudinal Study of the Temporal Relation Between Problem Gambling and Mental and Substance Use Disorders Among Young Adults

Objective: Relatively little is known about the temporal relation between at-risk gambling or problem gambling (PG) and mental and substance use disorders (SUDs) in young adulthood. Our study aimed to examine whether past-year, at-risk, or PG is associated with incident mental disorders and SUDs (that is, depression, generalized anxiety disorder, obsessive–compulsive disorder [OCD], or alcohol dependence) and illegal drug use, and whether past-year mental disorders and SUDs and illegal drug use is associated with incident at-risk or PG. Method: Data for this longitudinal study were drawn from the Manitoba Longitudinal Study of Young Adults (MLSYA). Respondents aged 18 to 20 years in 2007 were followed prospectively for 5 years. Results: In cross-sectional analyses, at-risk or PG was associated with increased odds of depression, OCD, alcohol dependence, and illegal drug use. In longitudinal analysis at-risk or PG at cycle 1 was associated with incident major depressive disorder, alcohol dependence, and illegal drug use in the follow-up period. Only illegal drug use at cycle 1 was associated with incident at-risk or PG during follow-up. Conclusions: At-risk or PG was associated with more new onset mental disorders and SUDs (depression, alcohol dependence, and illegal drug use), compared with the reverse (illegal drug use was the only association with new onset at-risk or PG). Preventing at-risk or PG from developing early in adulthood may correspond with decreases in new onset mental disorders and SUDs later in adulthood

Parental monitoring trajectories and gambling among a longitudinal cohort of urban youth

Aim: To test the strength of the association between parental monitoring trajectories throughout early adolescence (ages 11–14) and gambling behaviours by young adulthood (age 22). Design: Longitudinal cohort design. Setting: Baltimore, Maryland. Participants: The sample of 514 participants with gambling data between ages 16–22 and parental monitoring data between ages 11–14 were predominantly African American and received subsidized lunches at age 6. Measurements: The South Oaks Gambling Screen and South Oaks Gambling Screen–Revised for Adolescents collected self-reports on annual gambling and gambling problems between ages 16–22. The Parental Monitoring Subscale of the Structured Interview of Parent Management Skills and Practices–Youth Version collected self-reports on annual parental monitoring between ages 11–14. Findings: General growth mixture modelling identified two parental monitoring trajectories: (i) ‘stable’ class (84.9%) began with a high level of parental monitoring at age 11 that remained steady to age 14; (ii) ‘declining’ class (15.1%) began with a significantly lower level of parental monitoring at age 11 and experienced a significant to through age 14. The declining class had increased significantly unadjusted (OR = 1.91; 95% CI = 1.59, 2.23; P ≤ 0.001) and adjusted (aOR = 1.57; 95% CI = 1.24, 1.99; P = 0.01) odds of problem gambling compared with non-gambling. Conclusion: Low and/or declining parental monitoring of children between the ages of 11 and 14 is associated significantly with problem gambling when those children reach young adulthood