DHEA and DHEA-S levels in hospitalized adolescents with first-episode schizophrenia and conduct disorder: A comparison study

IntroductionIncreasing evidence exists indicating an association of DHEA and DHEA-S blood levels with psychosis, however many of the findings remain contradictory based on different phases of the illness, different treatments and at a range of ages. To date no studies exist investigating the levels of these neurosteroids in adolescents with psychosis. Such an investigation would be important in order to exclude effects of chronic illness, long-term treatment and repeated hospitalizations.MethodPeripheral venous blood samples for DHEA, DHEA-S and cortisol determination were collected from first-time hospitalized adolescents with diagnoses of schizophrenia as well as from patients with conduct disorder. Patients were rated with the Positive and Negative Syndrome Scale (PANSS), the Hamilton Scale for depression (HAM-D), the Overt Aggression Scale (OAS) and the impulsivity scale (IS).ResultsDHEA levels in adolescents with schizophrenia were significantly higher than in patients with conduct disorder (p = 0.002). Blood levels of DHEA and DHEA-S in schizophrenia correlated with the total PANSS scores (both p < 0.05). No correlations were detected between any of the neurosteroid blood levels and clinical rating scales in the control group.ConclusionsIt may be proposed that individuals in their early stages of schizophrenia psychosis may develop a protective or compensatory neurosteroid response to the first onset of psychosis. Such a putative upregulatory DHEA mechanism may become desensitized with progression to chronic illness. The temporal relationship of investigation of neurosteroid levels in adolescents compared to such investigation in adults may provide important and relevant information.     

Case–control association analysis of polymorphisms in the delta-opioid receptor,OPRD1, with cocaine and opioid addicted populations

BackgroundAddiction susceptibility and treatment responsiveness are greatly influenced by genetic factors. Sequence variation in genes involved in the mechanisms of drug action have the potential to influence addiction risk and treatment outcome. The opioid receptor system is involved in mediating the rewarding effects of cocaine and opioids. The μ-opioid receptor (MOR) has traditionally been considered the primary target for opioid addiction. The MOR, however, interacts with and is regulated by many known MOR interacting proteins (MORIPs), including the δ-opioid receptor (DOR).MethodsThe present study evaluated the contribution of OPRD1, the gene encoding the DOR, to the risk of addiction to opioids and cocaine. The association of OPRD1 polymorphisms with both opioid addiction (OA) and cocaine addiction (CA) was analyzed in African American (OA n = 336, CA n = 503) and European American (OA n = 1007, CA n = 336) populations.ResultsThe primary finding of this study is an association of rs678849 with cocaine addiction in African Americans (allelic p = 0.0086). For replication purposes, this SNP was analyzed in a larger independent population of cocaine addicted African Americans and controls and the association was confirmed (allelic p = 4.53 × 10^?5; n = 993). By performing a meta-analysis on the expanded populations, the statistical evidence for an association was substantially increased (allelic p = 8.5 × 10^?7) (p-values non-FDR corrected).ConclusionThe present study suggests that polymorphisms in OPRD1 are relevant for cocaine addiction in the African American population and provides additional support for a broad role for OPRD1 variants in drug dependence.     

Effectiveness of a selective alcohol prevention program targeting personality risk factors: Results of interaction analyses

AimTo explore whether specific groups of adolescents (i.e., scoring high on personality risk traits, having a lower education level, or being male) benefit more from the Preventure intervention with regard to curbing their drinking behaviour.DesignA clustered randomized controlled trial, with participants randomly assigned to a 2-session coping skills intervention or a control no-intervention condition.SettingFifteen secondary schools throughout The Netherlands; 7 schools in the intervention and 8 schools in the control condition.Participants699 adolescents aged 13–15; 343 allocated to the intervention and 356 to the control condition; with drinking experience and elevated scores in either negative thinking, anxiety sensitivity, impulsivity or sensation seeking.MeasurementsDifferential effectiveness of the Preventure program was examined for the personality traits group, education level and gender on past-month binge drinking (main outcome), binge frequency, alcohol use, alcohol frequency and problem drinking, at 12 months post-intervention.Intervention and comparatorPreventure is a selective school-based alcohol prevention programme targeting personality risk factors. The comparator was a no-intervention control.FindingsIntervention effects were moderated by the personality traits group and by education level. More specifically, significant intervention effects were found on reducing alcohol use within the anxiety sensitivity group (OR = 2.14, CI = 1.40, 3.29) and reducing binge drinking (OR = 1.76, CI = 1.38, 2.24) and binge drinking frequency (β = 0.24, p = 0.04) within the sensation seeking group at 12 months post-intervention. Also, lower educated young adolescents reduced binge drinking (OR = 1.47, CI = 1.14, 1.88), binge drinking frequency (β = 0.25, p = 0.04), alcohol use (OR = 1.32, CI = 1.06, 1.65) and alcohol use frequency (β = 0.47, p = 0.01), but not those in the higher education group. Post hoc latent-growth analyses revealed significant effects on the development of binge drinking (β = − 0.19, p = 0.02) and binge drinking frequency (β = − 0.10, p = 0.03) within the SS personality trait.ConclusionsThe alcohol selective prevention program Preventure appears to have effect on the prevalence of binge drinking and alcohol use among specific groups in young adolescents in the Netherlands, particularly the SS personality trait and lower educated adolescents.     

Psychiatric disorders,suicidal ideation,and sexually transmitted infections among post-deployment veterans who utilize digital social media for sexual partner seeking

IntroductionDigital social media platforms represent outlets through which individuals may find partners for sexual encounters. Using a sample of US post-deployment military veterans, the current study evaluated the prevalence of digital sex seeking as well as clinical correlates of psychopathology, suicidal ideation, and sexually transmitted infections (STIs).MethodsUsing data from a baseline telephone interview and follow-up internet-based survey, we examined the prevalence of sexual partnering via digital social media platforms in a national sample of 283 US combat veterans.ResultsAmong veterans, 35.5% of men and 8.5% of women reported having used digital social media to meet someone for sex. Individuals who reported having used digital social media to find sexual partners (DSMSP+) as compared to those who did not (DSMSP-) were more likely to be young, male, and in the Marine Corps. After adjusting for sociodemographic variables, DSMSP+ status was associated with post-traumatic stress disorder (OR = 2.26, p = 0.01), insomnia (OR = 1.99, p = 0.02), depression (OR = 1.95, p = 0.03), hypersexuality (OR = 6.16, p < 0.001), suicidal ideation (OR = 3.24, p = 0.04), and treatment for an STI (OR = 1.98, p = 0.04).ConclusionAmong US post-deployment military veterans, DSMSP+ behaviors were prevalent, particularly among men. The association between DSMSP+ behaviors and PTSD, insomnia, depression, hypersexuality, suicidal ideation, and STIs suggest that veterans who engage in DSMSP+ behaviors should be particularly thoroughly screened and evaluated for these psychiatric concerns and counseled on the benefits of safe sexual practices.     

Neurosteroid blood levels in delinquent adolescent boys with conduct disorder

Accumulating data indicates that neurosteroids can modulate aggressive behavior. The aim of the present study was to examine neurosteroid blood levels in delinquent adolescent boys as compared to normal healthy controls. Dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEA-S) and cortisol blood levels were measured in 16 delinquent adolescent (age 15.72 ± 0.95 years) with conduct disorder (CD) and 11 normal controls (16.82 ± 1.83 years). Severity of aggressive behavior was assessed by the Child Behavior Checklist (CBCL) and the Overt Aggression Scale (OAS). The delinquent adolescents tended to have higher DHEA-S levels than the normal control group (p = 0.054). DHEA and cortisol levels did not differ between the two groups. The interaction between neurosteroids ( especial DHEA-S) and genetic, developmental and environmental factors in juvenile delinquency merits further investigation.     

P-glycoprotein function in peripheral T lymphocyte subsets of myasthenia gravis patients: Clinical implications and influence of glucocorticoid administration

Myasthenia gravis (MG) is an autoimmune neuromuscular disorder with a chronic clinical course that requires long-term glucocorticoid (GC) therapy. A drug efflux pump, P-glycoprotein (P-gp), actively transports GC out of target cells, thereby reducing its efficacy. We evaluated the P-gp function of peripheral-blood mononuclear cells in 59 MG patients. P-gp function was estimated from a decrease in fluorescent P-gp substrate Rhodamine 123 and its inhibition by the conformation-sensitive UIC2 monoclonal antibody. P-gp function on CD8⁺ T cells in 21 MG patients having experienced GC therapy was higher than that in 19 MG patients having no history of GC therapy (p = 0.026). There was a significant correlation between P-gp function in CD3⁺ (r = 0.55, p = 0.014) or CD4⁺ (r = 0.48, p = 0.034) T cells and the total dose of prednisolone for treatment. P-gp function on CD4⁺ T cells in MG patients who showed low responses to prednisolone therapy (n = 8) was higher than that in patients who showed relatively high responses to prednisolone therapy (n = 10) (p = 0.045). These results suggest that higher P-glycoprotein activity on CD3⁺ or CD4⁺ cells necessitated treatment with higher steroid doses in order to achieve a clinical response. The measurement of P-gp function on CD4⁺ T cells is useful in the assessment of clinical response to GC therapy.     

Prevalence and correlates of a lifetime cannabis use disorder among pregnant former tobacco smokers

BackgroundFollowing tobacco and alcohol, cannabis is the most commonly used substance during pregnancy. Given the high prevalence of concurrent cannabis and tobacco use as well as the health consequences associated with prenatal substance use, we sought to document the relative contributions of psychosocial and psychiatric factors commonly associated with cannabis use in predicting a lifetime cannabis use disorder (CUD) among women who had quit smoking tobacco as a result of pregnancy.MethodsPregnant former tobacco smokers (n = 273) enrolled in a larger randomized controlled trial for postpartum tobacco relapse prevention completed semi-structured psychiatric interviews and self-reported demographic, pregnancy, health, psychosocial, and tobacco use factors during their third trimester of pregnancy.ResultsIn total, 14% (n = 38) of women met criteria for a lifetime CUD. The strongest predictors of a lifetime CUD were a history of having multiple psychiatric disorders (OR = 36.44; 95% CI = 5.03–264.27; p < 0.001) followed by a lifetime alcohol use disorder (OR = 3.54; 95% CI = 1.27–9.87; p < 0.05). In addition, more frequent attempts to quit smoking tobacco (OR = 1.12; 95% CI = 1.01–1.25; p < 0.05) and lower self-efficacy about weight management after quitting smoking tobacco (OR = 0.78; 95% CI = 0.62–0.97; p < 0.05) also were significantly associated with a lifetime CUD.ConclusionsWomen with a history of both cannabis and tobacco dependence may represent a subset of women who need more specialized treatment during the perinatal period to improve substance use outcomes.     

Perceived unmet need for alcohol and drug use treatments and future use of services: Results from a longitudinal study

BackgroundThis study assessed the association of perceived need for and perceived barriers to treatments for substance use disorder (SUD) with subsequent use of these treatments in community settings.MethodsDrawing on data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we examined the association of perceived need and barriers to SUD treatments in waves 1 of NESARC (2001–2002; n = 43,093) with the subsequent use of these treatments in the follow-up wave 2 (2004–2005; n = 34,625).ResultsOnly 8.5% (n = 195) of the 2333 NESARC participants with an untreated 12-month SUD in wave 1 perceived a need for SUD treatment. Participants who reported a perceived need were more likely to use these services in follow-up than those who did not report such a need (14.8% vs. 4.9%, adjusted odds ratio [aOR] = 3.16, 95% confidence intervals [CI] = 1.70–5.90, P < 0.001). Among participants who perceived a need, those who reported pessimistic attitudes towards treatments as a barrier were less likely than others to use services in follow-up (aOR = 0.08, 95% CI = 0.01–0.73, P = 0.027). Other barriers, including financial barriers and stigma were not significantly associated with treatment seeking.ConclusionsThe findings suggest the need for a two-pronged approach to improving treatment seeking for SUD in community settings: one focusing on enhancing recognition of these disorders, the other focusing on educating potential consumers regarding the benefits of SUD treatments.     

Associations of anxiety sensitivity and emotional symptoms with the subjective effects of alcohol,cigarettes, and cannabis in adolescents

Maladaptive emotional traits (anxiety sensitivity [AS], fear of anxiety-related sensations and consequences) and symptoms (major depressive disorder [MDD] and generalized anxiety disorder [GAD] symptoms) could play a role in altering sensitivity to the subjective effects of drugs of abuse in adolescents. Data were drawn from a longitudinal study of high school students in Los Angeles, CA, USA who completed surveys and reported past six-month use of alcohol (n = 1054), cigarettes (n = 297), or cannabis (n = 706). At each of the four semi-annual waves during mid-adolescence (14–16 years old), students reported positive and negative subjective drug effects experienced in the prior six-months. Controlling for covariates and the simultaneous covariance across the three domains of emotional dysfunction, AS was associated with more positive and negative cannabis effects (βs = 0.09–0.16, ps < 0.05), and MDD symptoms were associated with fewer negative cigarette effects (β = − 0.13, p = 0.04) and more negative cannabis effects (β = 0.10, p = 0.004). The acceleration of positive alcohol and cannabis effects over time was slower among adolescents with higher baseline MDD (MDD × time: β = − 0.04, p = 0.044) and GAD (GAD × time: β = − 0.05, p = 0.03) symptoms, respectively. These findings suggest that emotional dysfunction factors show differential and overlapping effects on subjective drug effects, which may vary across time. Future research should investigate emotional dysfunctions and subjective drug effects in relation to substance use across adolescence and emerging adulthood.     

Vitamin D Binding Protein rs7041 polymorphism and high-residual platelet reactivity in patients receiving dual antiplatelet therapy with clopidogrel or ticagrelor

BackgroundVitamin D deficiency represents a major health problem in general population, especially for its association with cardiovascular disorders and thrombotic risk, even in patients on dual antiplatelet therapy (DAPT). Vitamin D Binding Protein (VDBP) is the main transporter of vitamin D in the bloodstream and genetic polymorphisms of this protein have been shown to account for a significant variability of vitamin D levels and its systemic effects. Contrasting data have linked the rs7041 T → G substitution with cardiovascular disease. However, no study has so far addressed the role of rs7041 polymorphism on platelet reactivity in patients on DAPT, that was the aim of the present study.MethodsPatients treated with DAPT (ASA and clopidogrel or ticagrelor) for an ACS or elective PCI were scheduled for platelet function assessment at 30–90 days post-discharge. Platelet function was assessed by Multiplate® (Roche Diagnostics AG), and VDBP genetic status by polymerase chain reaction and restriction fragment length polymorphism technique. Fasting samples were obtained for main chemistry parameters and vitamin D levels assessment.ResultsWe included 400 patients, 187 (46.8%) receiving clopidogrel and 213 (53.2%) ticagrelor. The genetic polymorphism rs7041 (T → G) was observed in 318 patients, (79.5%), in 38.7% of them in homozygosis. Main clinical and chemistry features did not significantly differ according to genetic status, but for a higher rate of ACE-inhibitors and beta-blockers use among the carriers of the G allele (p = 0.04 and p = 0.01, respectively).VDBP genetic status did not affect the rate of HRPR with ADP-antagonists (25.6% vs 24.6% vs 28.5%, p = 0.59; adjusted OR[95%CI] = 0.94[0.52–1.7], p = 0.83 for T/G patients; adjusted OR[95%CI] = 1.14[0.6–2.2], p = 0.67 for G homozygotes).However, the rate of HRPR with ADP-antagonists was influenced by severe hypovitaminosis D (< 10 ng/ml) only in patients carrying the G allele, especially in homozygosis (T/T: 25.9% vs 26.1%, p = 0.99; G carriers: 22.1% vs 35.3%, p = 0.02, p_interaction = 0.019; adjusted OR[95%CI] = 1.93[1.11–3.34], p = 0.02 for G carriers).ConclusionThe present study shows that rs7041 polymorphism of Vitamin D Binding Protein does not affect platelet reactivity or the rate of HRPR among patients receiving DAPT. However the carriage of the G allele could condition the impact of hypovitaminosis D on the response to antiplatelet agents, increasing the occurrence of HRPR especially in homozygotes, thus suggesting a more significant role of vitamin D deficiency among these patients.     

Significance of the genetic polymorphism of CYP2D6 and NAT2 in patients with inflammatory bowel diseases

BackgroundThe main types of inflammatory bowel diseases (IBD) are ulcerative colitis (UC) and Crohn's disease (CD). There is evidence that, in addition to immunological and environmental factors, genetic factors also play an important role in the pathogenesis of IBD. Determination of polymorphism of CYP2D6 and NAT2 genes encoding I and II phase enzymes of xenobiotic biotransformation may have clinical value as an indicator of individual predisposition to diseases, and also contribute to effective and safe pharmacotherapy. The aim of this study was to investigate the association between genetic polymorphism of CYP2D6 and NAT2 and the incidence of IBD, including UC and CD, among inhabitants of central Poland.MethodsThe study was performed in 258 individuals from central Poland (115 patients with IBD, including 65 patients with UC and 50 with CD; and in 143 healthy controls). The CYP2D6 genotypes of oxidation and NAT2 genotypes of acetylation were analyzed using the PCR-RFLP method.ResultsThere were no statistically significant differences in the frequency of the CYP2D6 genotypes and alleles in patients with IBD, UC and CD in comparison with the control group. The relative risk (OR) of IBD, UC and CD was higher in carriers of the allele NAT2*7 and was OR = 3.49 (p = 0.0019), OR = 3.86 (p = 0.0019), and OR = 3.02 (p = 0.0247), respectively.ConclusionsPolymorphism of the gene encoding CYP2D6 does not affect the incidence of inflammatory bowel diseases. The carriers of the NAT2*7 allele which determines slow acetylation may be more predisposed to inflammatory bowel diseases, including ulcerative colitis and Crohn's disease.     

The effects of alcohol hangover on future drinking behavior and the development of alcohol problems

IntroductionAlcohol hangover experiences in young adulthood have been shown to predict more subsequent alcohol problems. Hangover susceptibility appears to be partially heritable and related to family history of alcohol use disorders. However, very little is known about the developmental course of these associations and whether they are accounted for by an individual's drinking history. The goal of this study is to investigate the prospective and unique relationships between family history of alcohol use disorders, severity of alcohol hangover experiences in adolescence, and later alcohol use and related problems measured over 13 years.MethodsParticipants were first assessed on family history at age 12–14, prior to initiating drinking, and re-assessed annually on hangover severity, drinks per drinking day (DPDD), and alcohol-related problems throughout the 13-year follow-up period (n = 205; 59% male).ResultsIn mixed effects negative binomial regression models, greater family history density scores predicted more future DPDD (Incidence Rate Ratio [IRR] = 1.19, p = 0.04), alcohol problems (IRR = 1.64, p = 0.05), and future hangover severity (IRR = 1.24; p = 0.01). In turn, greater hangover severity predicted more future DPDD (IRR = 1.03; p = 0.002) and alcohol problems (IRR = 1.12, p < 0.001), and hangover severity mediated the relationship between family history and alcohol use/problems. All models controlled for participant age, sex, and past drinking behavior (where relevant).ConclusionsThese results advance the alcohol hangover experience during late adolescence as a clinically relevant and uniquely informative marker of future alcohol use and problems, above and beyond that of prior personal or familial drinking history.     

A clinical comparison of the efficacy and safety of biosimilar G-CSF and originator G-CSF in haematopoietic stem cell mobilization

BackgroundRecombinant granulocyte colony-stimulating factor (G-CSF) is widely used to mobilize haematopoietic stem cells. We compared the efficacy and safety of a biosimilar G-CSF (Zarzio^®, Sandoz Biopharmaceuticals) with the originator G-CSF (Neupogen^®, Amgen) in patients with haematological malignancies.MethodsA total of 108 patients were included in this study, 59 of whom were female (49 male), with an overall median age of 51 years (range 19–69). Patients had multiple myeloma (n = 46), non-Hodgkin's lymphoma (n = 28), Hodgkin's lymphoma (n = 26), or other diagnosis (n = 8). After administration of mobilizing regimens (primarily high-dose etoposide, high-dose cyclophosphamide, intermediate-dose Ara-C or ESHAP), patients were randomized to a standard daily 10 μg/kg dose of biosimilar G-CSF (n = 54) or originator G-CSF (n = 54).ResultsMedian duration of G-CSF administration was 8 days with both biosimilar G-CSF (range 4–17) and originator G-CSF (range 4–14). Both groups had a median of one apheresis with a median time until first apheresis of 11 days. There were no statistically significant differences between groups in the mean ± SD number of mobilized CD34+ cells/μL in peripheral blood or the number of CD34+ cells/kg body weight. Five patients (9%) in the originator G-CSF group and six patients in the biosimilar G-CSF group (11%) did not mobilize sufficient CD34+ cells. The adverse event profile was similar between groups.ConclusionsA biosimilar G-CSF (Zarzio^®) demonstrated similar efficacy and safety as the reference originator G-CSF (Neupogen^®) in hematopoietic stem cell mobilization in patients with haematological malignancies.     

The relationship of waterpipe use with cigarette smoking susceptibility and nicotine dependence: A cross-sectional study among Hong Kong adolescents

IntroductionWaterpipe smoking has become increasingly popular in adolescents. We examined the association of waterpipe smoking with cigarette smoking susceptibility and nicotine dependence among adolescents in Hong Kong.MethodsWe analyzed the data of School-based Survey on Smoking among Students 2012/13 from a representative sample of 45,857 secondary school students (US grades 7–12) in Hong Kong. Among never cigarette smokers (n = 37,740), we conducted chi-square test to compare cigarette smoking susceptibility by current (past 30-day) waterpipe smoking status, and used multivariate logistic regression to examine the association between current waterpipe smoking and cigarette smoking susceptibility controlling for age, sex, peer cigarette smoking, and living with a cigarette smoker. Then we conducted chi-square test and multivariate logistic regression among current cigarette smokers (n = 1694) to examine the relationship of current waterpipe smoking with two nicotine dependence outcomes, including heavier smoking (≥ 5 cigarettes/day) and first cigarette within 30 min of waking, controlling for demographics and the number of smoking days in the past 30 days.ResultsAmong never cigarette smokers, current waterpipe use was associated with cigarette smoking susceptibility (adjusted odds ratio [AOR] = 3.58, 95% confidence interval [CI]: 1.61–7.97). Of current cigarette smokers, waterpipe use was associated with heavier smoking (AOR = 1.56, 95% CI: 1.00–2.43) and first cigarette within 30 min of waking (AOR = 2.08, 95% CI: 1.35–3.19).ConclusionsSurveillance, prevention, and intervention programs should address waterpipe use in addition to cigarette smoking. Educational programs need to inform youth about the harmful and addictive effects of waterpipe smoking. Public health campaigns deglamourizing waterpipe use may help reduce waterpipe smoking among youth.     

E-cigarette advertisements,and associations with the use of e-cigarettes and disapproval or quitting of smoking: Findings from the International Tobacco Control (ITC) Netherlands Survey

BackgroundMuch attention has been directed towards the possible effects of e-cigarette advertisements on adolescent never smokers. However, e-cigarette advertising may also influence perceptions and behaviours of adult smokers. The aim of our study was to examine whether noticing e-cigarette advertisements is associated with current use of e-cigarettes, disapproval of smoking, quit smoking attempts, and quit smoking success.MethodsWe used longitudinal data from two survey waves of the ITC Netherlands Survey among smokers aged 16 years and older (n = 1198). Respondents were asked whether they noticed e-cigarettes being advertised on television, on the radio, and in newspapers or magazines in the previous 6 months.ResultsThere was a significant increase in noticing e-cigarette advertisements between 2013 (13.3%) and 2014 (36.0%), across all media. The largest increase was for television advertisements. There was also a substantial increase in current use of e-cigarettes (from 3.1% to 13.3%), but this was not related to noticing advertisements in traditional media (OR = 0.99, p = 0.937). Noticing advertisements was bivariately associated with more disapproval of smoking (Beta = 0.05, p = 0.019) and with a higher likelihood of attempting to quit smoking (OR = 1.37, p = 0.038), but these associations did not reach significance in multivariate analyses. There was no significant association between noticing advertisements and quit smoking success in either the bivariate or multivariate regression analysis (OR = 0.92, p = 0.807).ConclusionNoticing e-cigarette advertisements increased sharply in the Netherlands between 2013 and 2014 along with increased e-cigarette use, but the two appear unrelated. The advertisements did not seem to have adverse effects on disapproval of smoking and smoking cessation.     

Impact of quitting smoking and smoking cessation treatment on substance use outcomes: An updated and narrative review

BackgroundHistorically, smoking cessation was thought to negatively impact substance use outcomes among smokers who use other substances. We sought to synthesize recent reports on this association.MethodsGoogle Scholar, PubMed, and Cinahl were searched for studies published from 2006 to March 29, 2016 that reported impact of smoking cessation treatment or quitting smoking on substance use or substance use disorder treatment outcomes in the general population and among those in substance abuse treatment. Studies were grouped by reported impact as follows: “positive” (i.e. improved), “null” (i.e. no change), or “negative” (i.e. worsened).ResultsTwenty-four studies were included. Eighteen reported the impact of quitting smoking and six reported the impact of smoking cessation treatment intervention, independent of quitting, on substance use outcomes. Eleven studies (46%) reported solely positive impact; four (17%) reported solely null impact; eight (33%) reported mixed positive and null impact by analysis (combined and subgroup, n = 1); substance (n = 4); length of follow-up (n = 2); and comparison group (n = 1). One study (4%) reported mixed negative and null impact by ethnic group. No studies reported increased substance use.ConclusionSmoking cessation does not appear to have a negative effect, and often has a positive effect on substance use outcomes. Smoking cessation advice should be offered, without hesitation, to smokers who report substance use and those in treatment for substance use disorder.     

Development and initial testing of the brief adolescent smoking curiosity scale (ASCOS)

BackgroundAlthough the reasons behind tobacco smoking at young age are complex, research has identified curiosity as a potent driver of smoking among adolescents.ObjectiveThe objective of the current study is to develop and provide initial evidence of reliability and validity of a short scale assessing smoking curiosity among adolescents (first measure of its kind). In particular, we developed and tested the adolescent smoking curiosity scale (ASCOS).MethodsAfter scale development, 101 adolescents completed a survey on smoking-related measures, including ASCOS (June to August 2014). We conducted exploratory factor analysis and Cronbach's alpha calculation to inspect factor-structure and reliability. We conducted multiple linear regression models to examine the scale's capacity to predict antecedents of smoking initiation.ResultsFactor analysis supported a single-factor structure of smoking curiosity. ASCOS was internally reliable (Cronbach's alpha = 0.83). Controlling for demographics, the measure correlated significantly with temptation to try smoking (β = 0.41, p < 0.01), number of friends who smoke (β = 0.27, p < 0.01), agreeing with the pros of smoking (β = 0.41, p < 0.001), sensation seeking (β = 0.21, p < 0.05), and depression (β = 0.23, p < 0.01). When controlling for a single-item measure for smoking curiosity, ASCOS significantly predicted susceptibility to smoke cigarettes (OR = 3.40, p < 0.05) and cigars (OR = 6.66, p < 0.01).ConclusionsASCOS presented good psychometric properties and passed initial validity-testing through associations with antecedents of smoking. ASCOS was a better predictor of susceptibility to smoke than did a traditional single-item measure used by previous research. As an implication, ASCOS can be crucial to the development of tailored interventions for smoking prevention that can reduce smoking curiosity.     

Neurocognitive,psychiatric, and substance use characteristics in opioid dependent adults

AimsTo describe neurocognitive function among opioid-dependent adults seeking buprenorphine treatment and to explore the impact of lifetime psychiatric conditions on neurocognitive function. To explore the additive interaction of patient-based characteristics that may help to inform treatment.DesignCross-sectional assessment of neurocognitive function, substance use, and psychiatric characteristics of adults seeking buprenorphine treatment within substance use treatment centers in New York City.ParticipantsThirty-eight opioid-dependent adults seeking buprenorphine treatment.MeasurementsA comprehensive battery, which included measures of executive functioning, learning, memory, verbal fluency, attention, processing speed, and motor functioning were administered. The Wide Range Achievement Test-Third Edition, the Composite International Diagnostic Interview, and an audio computer assisted structured interview were also completed. Correlations and independent sample t-tests were used to ascertain group differences.FindingsThirty-nine percent of participants were impaired in global neurocognitive function (n = 15). Over one third were impaired in either: learning (n = 28), memory (n = 26), executive functioning (n = 17), motor functioning (n = 17), attention/working memory (n = 14) or verbal fluency (n = 12). Lifetime history of alcohol dependence was associated with impairment in global neurocognitive, executive functioning, and motor functioning. Lifetime history of cocaine dependence was associated with impairment in executive functioning and motor functioning (all p's < 0.05). Major depressive disorder history was not associated with neurocognitive impairment.ConclusionsAmong this sample of opioid-dependent adults, there were high rates of global and domain-specific neurocognitive impairment, with severe impairment in learning and memory. Lifetime alcohol and cocaine dependence were associated with greater neurocognitive impairment, particularly in executive functioning. Because executive functioning is critical for decision-making and learning/memory dysfunction may interfere with information encoding, these findings suggest that opioid-dependent adults may require enhanced support for medical decision-making.