• Title/Summary/Keyword: Substance use disorders

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The Effects of Comorbid Anxiety Disorder and Substance use Disorder on Major Depressive Disorder (공존하는 불안장애와 물질사용장애가 주요우울증에 미치는 영향)

  • Shin, Jae Hyun;Kim, Jung Bum;Jung, Sung Won
    • Anxiety and mood
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    • v.9 no.2
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    • pp.93-100
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    • 2013
  • Major depressive disorder causes significant dysfunction and disability. Many of depressed patients tend to have cormobid anxiety disorders, substance use disorders and personality disorders, and so on. In this study, we reviewed researches about the effects of comorbid anxiety disorder, substance use disorder on depressive symptoms, progress, treatment, etc. In addition, the latest knowledges related to treatment was reviewed. If the symptoms of anxiety disorder coexist, They leads to the deterioration of the course and has an adverse effect on treatment response. Comorbid substance use disorder, such as alcohol dependence, causes worsening of symptoms and progression, and a loss of therapeutic response. Therapeutic clinical guidelines and instructions to comorbid psychiatric disorders on major depressive disorder was not established clearly, but consensus-based or evidence-based studies will be necessary for treatment for comorbid psychiatric disorders on major depressive disorder.

Construction of the Structural Equation Model on Substance Use in Adolescents (청소년 물질남용의 구조 모형)

  • Bae, Jeong-Yee;Panuncio, Rosel
    • Journal of Korean Academy of Nursing
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    • v.39 no.3
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    • pp.446-457
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    • 2009
  • Purpose: The aim of this study was to construct a structural equation model that would further explain the continuously increasing substance use disorder in Korean adolescents. Methods: Survey visits using a structured questionnaire were conducted with 3,885 students in 2 middle schools and 2 high schools in Busan. A total of 13 instruments were used in this model. The analysis of data was done with both SPSS 14.0 for descriptive statistics and AMOS 5.0 for covariance structure analysis. Results: Based on the constructed model, belief on substance use was found to have a significantly direct effect in influencing adolescent substance use. In addition, other factors such as family environment, satisfaction with school life, self-concept, social support, and personality vulnerability indirectly affected substance use. The final modified model yielded Chi-square=2,987(p<.001), df=121, ${\chi}^2$/df=22.1, GFI=.96, AGFI=.93, NFI=.91, PNFI=.72, PGFI=.72, RMSEA=.07 and exhibited fit indices. Conclusion: This study constructed a model that addresses the factors related to adolescent substance use and explains the relationship of these factors in influencing substance use among Korean adolescents. Findings from this study can contribute to designing appropriate prevention strategies to reduce substance related disorders in adolescents.

Psychotic Disorder Induced by Appetite Suppressants, Phentermine or Phendimetrazine : A Case Series Study (식욕억제제 Phentermine, Phendimetrazine으로 유발된 정신병적 장애 증례군 연구)

  • Kwak, Sookyoung;Youn, Tak;Lee, Nam Young;Chung, In Won;Kim, Se Hyun
    • Korean Journal of Biological Psychiatry
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    • v.24 no.3
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    • pp.134-141
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    • 2017
  • Objectives A retrospective case series study was conducted to investigate the clinical characteristics of psychotic disorders induced by appetite suppressants, phentermine and phendimetrazine. Methods A retrospective electronic medical record review identified 5 admitted patients who had psychotic symptoms after taking phentermine or phendimetrazine. Clinical information was reviewed and summarized in each case. Results Hallucinations were reported in all cases, including auditory, visual, olfactory and somatic hallucinations. After discontinuation of phentermine or phendimetrazine, the symptoms rapidly improved with low dose of antipsychotics. Patients tended to have less prominent negative symptoms and higher insight into illness, and often showed depressive mood. These clinical characteristics were similar to psychosis induced by amphetamines. Two patients developed stimulant use disorder while using phentermine. Conclusions These findings call for awareness of the risks associated with use of appetite suppressants. Prescription of phentermine or phendimetrazine should be accompanied by close monitoring of mental status, and suspicion for substance/medication-induced psychotic disorder.

Trend and Future of Virtual Reality for Addiction Treatment of Substance Use Disorders: A Systematic Review (가상현실을 활용한 중독치료의 동향과 전망을 위한 체계적 문헌고찰)

  • Amista, Narcie Faith;Kim, Jinsoo Jason;Kim, Nami
    • Journal of Digital Contents Society
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    • v.18 no.8
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    • pp.1551-1560
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    • 2017
  • The aim of this review is to analyze the trend of using Virtual Reality (VR) in addiction treatment by categorizing the types of addictions and methods of Virtual Reality Therapy (VRT) for substance use disorders. VR has been utilized as a new paradigm for treating various mental and psychological problems. In recent years, a number of researches have been done to demonstrate the effectiveness of VRT for addiction treatment, specifically substance use disorders. In order to comprehend the tendency of these researches, the current study performed a systematic review of published book and journal articles using the following bibliographical databases: ScienceDirect, MEDLINE, ProQuest, and Embase. Forty-five (45) articles were retrieved; out of these researches, nicotine/smoking has garnered the highest number of studies (73%, n=33); alcohol (18%, n=8); cannabis/marijuana (2%, n=1); and other drugs such as heroin, cocaine and methamphetamine (7%, n=3). This paper analyzed the results of those studies, found some limitations as well as strengths, and made suggestions for further research on VRT for addiction treatment.

Exercise and Physical Activity in Mental Disorders: Clinical and Experimental Evidence

  • Zschucke, Elisabeth;Gaudlitz, Katharina;Strohle, Andreas
    • Journal of Preventive Medicine and Public Health
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    • v.46 no.sup1
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    • pp.12-21
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    • 2013
  • Several epidemiological studies have shown that exercise (EX) and physical activity (PA) can prevent or delay the onset of different mental disorders, and have therapeutic benefits when used as sole or adjunct treatment in mental disorders. This review summarizes studies that used EX interventions in patients with anxiety, affective, eating, and substance use disorders, as well as schizophrenia and dementia/mild cognitive impairment. Despite several decades of clinical evidence with EX interventions, controlled studies are sparse in most disorder groups. Preliminary evidence suggests that PA/EX can induce improvements in physical, subjective and disorder-specific clinical outcomes. Potential mechanisms of action are discussed, as well as implications for psychiatric research and practice.

Phentermine and Phendimetrazine-Induced Psychotic Disorder and Bipolar Disorder: A Case Series (Phentermine 및 Phendimetrazine으로 유발된 정신병적 장애 및 양극성 장애 증례군 연구)

  • Kim, Soo Young;Kim, Tae-Suk;Kim, Dai-Jin;Chae, Jeong-Ho;Lee, Chang Uk;Joo, Soo Hyun
    • Korean Journal of Biological Psychiatry
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    • v.29 no.1
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    • pp.22-31
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    • 2022
  • Objectives Recently, weight loss has emerged as a national concern in South Korea, and this has resulted in an increase in the frequency of use of central nervous system (CNS)-stimulating appetite suppressants. This study aimed to collect cases of psychotic disorders and bipolar disorders triggered by phentermine and phendimetrazine and explore the clinical features and courses. Methods In this retrospective study, we analyzed the electronic medical records of patients and selected eight patients who developed psychotic symptoms and manic symptoms for the first time after taking phentermine and phendimetrazine. All cases were reviewed, and their clinical features and course were summarized. Results All eight patients developed psychotic symptoms, and one had accompanying manic symptoms. The final diagnosis was appetite-suppressant-induced psychotic disorder in four patients, schizophrenia in three, and appetite-suppressant-induced bipolar disorder in one. In addition, three patients were diagnosed as having substance-use disorder. The key psychotic symptoms of these patients were hallucinations and paranoia. Conclusions These case findings suggest that phentermine and phendimetrazine can cause psychotic disorder, bipolar disorder, or substance use disorder and that medical professionals and the public should practice caution when prescribing and using these drugs.

Rising Burden of Psychiatric and Behavioral Disorders and Their Adverse Impact on Health Care Expenditure in Hospitalized Pediatric Patients with Inflammatory Bowel Disease

  • Aravind Thavamani;Jasmine Khatana;Krishna Kishore Umapathi;Senthilkumar Sankararaman
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.26 no.1
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    • pp.23-33
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    • 2023
  • Purpose: The incidence and prevalence of inflammatory bowel disease (IBD) are increasing along with an increasing number of patients with comorbid conditions like psychiatric and behavioral disorders, which are independent predictors of quality of life. Methods: Non-overlapping years (2003-2016) of National Inpatient Sample and Kids Inpatient Database were analyzed to include all IBD-related hospitalizations of patients less than 21 years of age. Patients were analyzed for a concomitant diagnosis of psychiatric/ behavioral disorders and were compared with IBD patients without psychiatric/behavioral disorder diagnoses for outcome variables: IBD severity, length of stay and inflation-adjusted hospitalization charges. Results: Total of 161,294 IBD-related hospitalizations were analyzed and the overall prevalence rate of any psychiatric and behavioral disorders was 15.7%. Prevalence rate increased from 11.3% (2003) to 20.6% (2016), p<0.001. Depression, substance use, and anxiety were the predominant psychiatric disorders. Regression analysis showed patients with severe IBD (odds ratio [OR], 1.57; confidence interval [CI], 1.47-1.67; p<0.001) and intermediate IBD (OR, 1.14; CI, 1.10-1.28, p<0.001) had increased risk of associated psychiatric and behavioral disorders than patients with a low severity IBD. Multivariate analysis showed that psychiatric and behavioral disorders had 1.17 (CI, 1.07-1.28; p<0.001) mean additional days of hospitalization and incurred additional $8473 (CI, 7,520-9,425; p<0.001) of mean hospitalization charges, independent of IBD severity. Conclusion: Prevalence of psychiatric and behavioral disorders in hospitalized pediatric IBD patients has been significantly increasing over the last two decades, and these disorders were independently associated with prolonged hospital stay, and higher total hospitalization charges.

The Reappraisal and Appropriate Use of Benzodiazepine (Benzodiazepine의 재평가 및 적절한 사용)

  • Park Sung-Hyouk;Kim Chan-Hyung
    • Anxiety and mood
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    • v.1 no.1
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    • pp.31-36
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    • 2005
  • Benzodiazepine (BDZ) has the possibilities of development of tolerance, withdrawal symptoms, and abuse/addiction, as well as chronically adverse effects. Although many guidelines have proposed the restricted prescription of them, their uses in many psychiatric areas as well as primary practice are still wide spread. So we tried to reappraise the clinical characteristics of BDZ and then to consider the appropriate use. Firstly, meta-analyses on long-term use of BDZ indicated the cognitive impairment, which could be improved after discontinuation of BDZ. Next, there have been some evidences that the long-term use of BDZ does not develop tolerance, contrary to our concern, and maintains good anxiolytic effects. Also, physiological dependence should be discriminated from abuse/addiction, assuming the reality that the risk of BDZ abuse/addiction is surely overestimated. These issues are discussed in detail.

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Auricular acupuncture for sleep quality in participants with mental and behavioral disorders due to prior multiple drug use: a retrospective consecutive case series

  • Yuri Gimelfarb;Eran Goldstien
    • Journal of Yeungnam Medical Science
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    • v.40 no.1
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    • pp.78-85
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    • 2023
  • Background: Poor sleep quality is associated with psychoactive substance abuse/addiction/withdrawal. Auricular acupuncture (AA) is a nonpharmacological method used for the treatment of sleep disturbances. This study aimed to examine the quality of sleep before and after AA in participants with mental and behavioral disorders due to prior multiple drug use in the therapeutic community. Methods: This was a consecutive case series of 27 participants (25 male [92.6%]). The median age was 35.0 years (interquartile range [IQR], 29.0-37.2 years), methadone/buprenorphine were not used, and the participants were treated with AA (median number of treatments, 15.0 [IQR, 12.0-18.0]) during a median period of 51.0 days (IQR, 49.0-51.0 days) according to the National Acupuncture Detoxification Association (NADA)-Acudetox protocol. Sleep quality was determined using the Pittsburgh Sleep Quality Index (PSQI), a self-rated questionnaire that assesses sleep quality and disturbances over a 1-month interval. Results: The global PSQI score dropped (indicating better sleep quality) by a median of 3.0 points (IQR, 0.0-8.0 points) after treatment. In the multivariate logistic regression analysis, with an increase in global PSQI score during AA by 1 point, there was a 0.73-fold reduction in the risk of poor sleep quality post-AA (adjusted odds ratio, 0.73; 95% confidence interval, 0.52-1.01; p<0.055; Nagelkerke's R2 =0.66). Conclusion: The results revealed a positive effect of AA (by the NADA-Acudetox protocol) on sleep quality (as measured by PSQI) among participants in a treatment center with mental and behavioral disorders due to multiple drug use.

Prevention, diagnosis, and treatment of opioid use disorder under the supervision of opioid stewardship programs: it's time to act now

  • Kim, Eun-Ji;Hwang, Eun-Jung;Yoo, Yeong-Min;Kim, Kyung-Hoon
    • The Korean Journal of Pain
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    • v.35 no.4
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    • pp.361-382
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    • 2022
  • The third opium war may have already started, not only due to illicit opioid trafficking from the Golden Crescent and Golden Triangle on the international front but also through indiscriminate opioid prescription and opioid diversion at home. Opioid use disorder (OUD), among unintentional injuries, has become one of the top 4 causes of death in the United States (U.S.). An OUD is defined as a problematic pattern of opioid use resulting in clinically significant impairment or distress, consisting of 2 or more of 11 problems within 1 year, as described by the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition. Observation of aberrant behaviors of OUD is also helpful for overworked clinicians. For the prevention of OUD, the Opioid Risk Tool and the Current Opioid Misuse Measure are appropriate screening tests before and during opioid administration, respectively. Treatment of OUD consists of 3 opioid-based U.S. Food and Drug Administration-approved medications, including methadone, buprenorphine, and naltrexone, and non-opioid-based symptomatic medications for reducing opioid withdrawal syndromes, such as α2 agonists, β-blockers, antidiarrheals, antiemetics, non-steroidal anti-inflammatory drugs, and benzodiazepines. There are at least 6 recommendable guidelines and essential terms related to OUD. Opioid stewardship programs are now critical to promoting appropriate use of opioid medications, improving patient outcomes, and reducing misuse of opioids, influenced by the successful implementation of antimicrobial stewardship programs. Despite the lack of previous motivation, now is the critical time for trying to reduce the risk of OUD.