Ethanol consumption is widely recognized for its detrimental effects on mental health, particularly its association with depressive disorders. This narrative review aims to explore the intricate molecular mechanisms underlying ethanol-induced depression, synthesizing findings from preclinical and clinical studies. We begin by providing an overview of the relationship between chronic ethanol consumption and depression, highlighting compelling evidence from diverse populations. Subsequently, we delve into insights from animal models that elucidate the pathophysiological changes triggered by prolonged ethanol exposure. Key mechanisms identified include oxidative stress, which contributes to cellular damage; neuroinflammation, characterized by the activation of glial cells and altered cytokine profiles; and disruptions in neurotrophic factors that impair neuronal growth and survival. Furthermore, we discuss the induction of apoptosis in neural cells and the significant impact of ethanol on neurotransmitter receptor remodeling and regulation, leading to altered synaptic transmission. While substantial progress has been made in understanding these mechanisms, we also acknowledge the limitations of current research methodologies and call for further investigations to translate these findings into effective therapeutic strategies for individuals affected by ethanol-induced depression. This review ultimately underscores the need for a comprehensive understanding of the molecular underpinnings of ethanol's impact on mood disorders, paving the way for improved interventions and preventative measures.

The authors aimed to estimate the past-year prevalence of mental and substance use disorders, including schizophrenia spectrum disorders (schizophrenia, schizoaffective, or schizophreniform disorder), among U.S. adults ages 18-65 years from samples of households and prisons and stratified samples from selected homeless shelters and state psychiatric hospitals. Such information is vital to meet the treatment needs of individuals with these disorders.

The Mental and Substance Use Disorders Prevalence Study (MDPS) was conducted between October 2020 and October 2022. Interviewers administered a structured clinical interview for the DSM-5 (N=5,679 participants; N=4,764 in households). Weighted past-year prevalence estimates of mental and substance use disorders were calculated. Level of impairment and the likelihood that a disorder was caused by the COVID-19 pandemic were assessed.

The prevalence estimates of lifetime and past-year schizophrenia spectrum disorders were 1.8% (95% CI=1.3%-2.5%) and 1.2% (95% CI=0.9%-1.8%), respectively. The most common past-year disorders were major depressive disorder (15.5%, 95% CI=13.6%-17.5%) and generalized anxiety disorder (GAD; 10.0%, 95% CI=8.3%-12.1%). About one in 10 participants had at least one substance use disorder (10.6%, 95% CI=8.7%-12.9%). Half of those with an MDPS mental disorder had moderate or serious impairment.

The prevalence rates of lifetime and past-year schizophrenia spectrum disorders were two to four times higher than previously reported. The prevalence rates of major depressive disorder and GAD were substantially higher than reported in past national studies. Almost 20% of these cases were likely due to the pandemic. Increased mental health treatment resources are urgently needed.

People with opioid use disorder (OUD) often exhibit psychiatric symptoms representing primary (PMD) and substance induced mental disorders (SIMD). PMD are associated with increased discontinuation of medications for OUD (MOUD). It is unknown if this relationship holds for SIMD.

To examine the association between SIMD and time to MOUD discontinuation.

In this retrospective cohort study using the Merative™ MarketScan® Commercial and Multi-State Medicaid insurance claims Databases (2015-2019), we identified individuals initiating MOUD (buprenorphine, methadone, and extended-release naltrexone) following a 180-day pre-period of continuous enrollment without MOUD. Episodes were classified based on > 1 SIMD diagnosis in this pre-period. We estimated days to MOUD discontinuation using stepwise multivariable Cox regression, adjusting for age, sex, insurance type (Medicaid or Commercial), Charlson Comorbidity Index, MOUD at initiation, co-occurring substance use disorders (SUD), and PMD.

Of 31,134 MOUD initiation episodes, 3.5 % exhibited SIMD. Episodes with SIMD demonstrated a higher prevalence (p < .001 for all) of mood and psychotic disorders (42.8 vs 16.4 %; 4.0 % vs 0.7 % respectively) but lower prevalence of anxiety-related disorders (51.3 % vs 59.9 %) relative to episodes without SIMD. Unadjusted models illustrated a 44 % (95 %CI:1.34-1.55) increased hazard of MOUD discontinuation associated with SIMD. After adjusting for all covariates but PMD, SIMD retained a 13 % increased hazard of MOUD discontinuation (95 %CI:1.05-1.21). Adjusting for PMD eliminated this association.

SIMD is associated with reduced time to MOUD discontinuation, which may be accounted for by PMD. Further research on SIMD treatment among individuals with OUD is needed to improve OUD treatment outcomes.

We seek to clarify the impact of the Genetic Aptitude for Educational Attainment (GAEA) on risk for 10 psychiatric disorders divided into 4 groups: Internalizing, Externalizing, Eating/Compulsive and Psychotic. Educational attainment and psychiatric and substance use disorder information were obtained from national Swedish registries. GAEA and disorder-specific family genetic risk score (FGRS) were calculated from extended pedigrees. In males, information on IQ and resilience was obtained from the Swedish conscript registry. Affected individuals were born in Sweden from 1973-1995 to Swedish born parents. Controlling for disorder specific FGRS, GAEA were negatively and substantially associated with risk for externalizing and internalizing disorders, minimally associated with psychotic disorder risk and positively and modestly associated with risk for eating/compulsive disorders. While the majority of GAEA effect on risk for externalizing disorders was mediated through impact on IQ, for internalizing disorders, mediation was largely through resilience. For externalizing and internalizing disorders, interactions between GAEA and disorder specific FGRS were robust and negative - the slope of disorder risk with increasing genetic liability was steepest in those with low GAEA. For eating disorders, interactions were modest and positive -the slope of risk with increasing genetic liability being steepest in individuals with high GAEA. We found that the impact of GAEA on risk for psychiatric and substance can be substantial and varies widely across disorders in magnitude, direction, and mediation. GAEA also often interacts, sometimes robustly, with disorder specific genetic risk factors. Comprehensive risk models for psychiatric disorders should consider the inclusion of GAEA.

Understanding the molecular mechanisms underlying anxiety and ethanol-related behaviors is crucial for developing effective therapeutic interventions. This study identifies a novel role for microRNA miR-181a and its target, Sirtuin 1 (SIRT-1), in the hippocampus as contributors to anxiety-like behavior and voluntary ethanol intake. Using male and female C57BL/6 mice, we explored the causal relationship between hippocampal miR-181a expression and these behaviors. Lentivirus vectors were delivered into the hippocampus for focal miR-181a overexpression in mice. Then behaviors were observed by elevated plus maze (EPM) and open field (OF) tests. Results showed that the viral approach employed to overexpress miR-181a, in the hippocampus, resulted in increased anxiety-like behavior in the EPM and OF tests. Additionally, miR-181a overexpression exacerbated voluntary ethanol intake and preference in the two-bottle choice paradigm without affecting saccharin or quinine consumption. Mechanistically, miR-181a gain-of-function reduced SIRT-1 expression in the hippocampus. These findings demonstrate that miR-181a upregulation in the hippocampus promotes anxiety and ethanol-related behaviors, likely through SIRT-1 repression. This work highlights miR-181a as a key molecular mediator in the epigenetic regulation of mood disorders and ethanol consumption.

Multiple studies have demonstrated associations between psychiatric conditions and Parkinson's disease (PD) development; fewer have examined psychotic-spectrum disorders and PD development.

The objective was to assess the prevalence of psychotic-spectrum disorders with and without depression and anxiety preceding a PD diagnosis.

In this retrospective, case-control study of adults > 60 years of age, cases were identified by PD diagnosis and controls were identified in a 3:1 ratio by ambulatory encounter from 2015 to 2020. Psychiatric conditions were identified by diagnosis code up to 5 years prior to the index date. Conditional logistic regression was conducted to assess associations.

Among 13,998 patients, the odds of PD were 76% (95% confidence interval = 1.39-2.22) higher among those with psychotic-spectrum diagnoses. An additional anxiety diagnosis was associated with 166% (95% confidence interval = 1.35-5.25) higher odds of PD.

Awareness of psychiatric conditions, including psychotic-spectrum disorders with comorbid anxiety, can stratify individuals at higher risk of developing PD.

Parental depression is associated with offspring depression and sleep problems are prospectively associated with the development of depression. However, little work has examined sleep problems in the offspring of depressed parents and whether these problems partially account for the association between parent and offspring depression. This longitudinal study examined the indirect effect of sleep problems on the association between parent psychopathology and offspring depression in a sample of 10,953 10 to 12-year-old children participating in the Adolescent Brain and Cognitive Development (ABCD) study. Controlling for age, sex, and other forms of parent psychopathology, we found significant indirect effects of parent to offspring depression through parent and youth reports of youth insomnia and hypersomnia. We also found indirect effects of parent history of anxiety and drug use problems to offspring depression through insomnia, and indirect effects of parent history of anxiety, drug use problems, and alcohol use problems to offspring depression through hypersomnia. Our findings show that sleep may be a mechanism of the transmission of parent depression, anxiety, drug use problems, and alcohol use problems to offspring depression. Mitigating sleep problems represents a potential avenue for preventative interventions in youth with a heightened susceptibility to depression.

We present a psychometric evaluation of the Center for Epidemiologic Studies Depression Boston Form (CES-D-B) for use with different Latino subgroups as there is inconsistency regarding its performance across subgroups of Latinos, a large and rapidly growing cultural group in the United States.

We evaluated the reliability and structural validity of the scores generated by the CES-D-B using four distinct Latino samples residing in US: Mexicans, Venezuelans, Cubans, and "other Latinos" (total N = 1033). To further explore structural validity of CES-D-B scores, we conducted measurement invariance analyses across different countries of origin, gender groups, educational levels, and languages of assessment (English, Spanish).

For all four samples, CES-D-B scores were highly reliable as indicated with the coefficients ranging from 0.82 to 0.88, and the factor structure provided an adequate fit to the data with the fit indices CFI/TLI ranging from 0.96 to 0.99, RMSEA estimates between 0.02 and 0.07, and SRMR estimates between 0.02 and 0.04. While measurement invariance analyses for different educational levels indicated scalar invariance across all samples, the same level of measurement equivalency was achieved only for Mexicans and Venezuelans with varying gender and languages of assessment.

The findings indicated that CES-D-B scores are internally consistent, possess a strong four-factor structure, and have somewhat equivalent psychometric properties across diverse Latino groups. Findings from this study highlight the importance of considering gender and languages of assessment when assessing depressive symptoms of various Latino subgroups.

Objective: Substance use disorders (SUD) still represent a huge worldwide health problem, as, despite withdrawal, medication, social support and psychotherapy, the relapse rate (around 80% at one year following treatment) remains tremendously high. Therefore, an important challenge consists in finding new complementary add-on tools to enhance quality of care. Methods and Results: In this report we focus on new insights reported through the use of three electrophysiological tools (quantitative electroencephalography (EEG), QEEG; cognitive event-related potentials, ERPs; and neurofeedback) suggesting that their use might be helpful at the clinical level in the management of various forms of SUDs. Empirical evidence were presented. Conclusion: In light of encouraging results obtained highlighting how these electrophysiological tools may be used in the treatment of SUDs, further studies are needed in order to facilitate the implementation of such procedures in clinical care units.

Background: Treatment dropout in substance use disorder (SUD) programs poses a significant challenge to achieving successful outcomes and leads to legal and financial issues. Socioeconomic factors have been identified as key contributors to treatment attrition; yet, the specific impact of patients' socioeconomic conditions remains underexplored. The purpose of this study is to examine the relationship between socioeconomic factors and SUD treatment dropout. Methods: We conducted a retrospective analysis of socioeconomic factors associated with treatment dropout among individuals with alcohol, marijuana, and heroin substance abuse. Logistic regression was used to examine the association between patients' socioeconomic factors and treatment dropout. Adjusted odds ratios were calculated to quantify the strength of these associations. Results: Our findings demonstrate that demographic factors and financial status, including age (12-19 years), Black or African American race, and reliance on public assistance, correlate with an increased likelihood of treatment dropout. Black or African American patients receiving public assistance exhibit elevated dropout rates in ambulatory services, while patients of other single races without private insurance show higher dropout rates in detox services. Individuals aged 18-49 who are not part of the labor force have increased dropout rates in rehab services. Interestingly, patients in dependent living situations, who pay for services through private insurance or receive them at no charge, experience lower dropout rates as the number of arrests increases. Conversely, independently living patients with prior SUD treatments have higher dropout rates compared to those undergoing treatment for the first time. Conclusions: This study underscores the critical importance of addressing financial barriers to treatment access and retention in order to improve outcomes for individuals with substance use disorders (SUDs). Targeted interventions that support economically disadvantaged populations are essential for reducing treatment dropout rates and enhancing the effectiveness of SUD treatment programs.

The relationship between stress, hair cortisol and alcohol consumption has mostly been investigated among clinical and adult study samples, with inconsistent findings. The present study aimed to examine cross-sectional and longitudinal associations between chronic stress, hair cortisol and average past-year alcohol consumption within a population-based sample of adolescents and young adults. At baseline of the epidemiological cohort study, N = 1180 individuals aged 14-21 from Dresden, Germany, were assessed (11/2015-12/2016). A maximum N = 1055 were analysed in cross-sectional analyses and a maximum N = 722 in longitudinal analyses (1-year follow-up). Multivariate linear regression analyses were conducted to reveal cross-sectional associations between perceived chronic stress, hair cortisol concentration and average past-year alcohol consumption in males and females. Longitudinally, weighted linear regression models examined relationships between (a) perceived chronic stress at baseline and altered hair cortisol concentration over 1 year, (b) perceived chronic stress/hair cortisol concentration at baseline and altered average alcohol consumption over 1 year and (c) average past-year alcohol consumption at baseline and altered stress/hair cortisol concentration over 1 year. Cross-sectionally, no significant relationships were found between stress, hair cortisol and average past-year alcohol consumption at baseline. In females, higher baseline perceived chronic stress was associated with an increase in hair cortisol concentration over 1 year, whereas no relationship was found in the cross-sectional analysis between baseline perceived chronic stress and baseline past-year average alcohol consumption. When using hair cortisol as a biomarker for stress perception, the focus of future research should be on potential time lags between perceived chronic stress and hair cortisol increase.

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides a comprehensive assessment of health and risk factor trends at global, regional, national, and subnational levels. This study aims to examine the burden of diseases, injuries, and risk factors in the USA and highlight the disparities in health outcomes across different states.

GBD 2021 analysed trends in mortality, morbidity, and disability for 371 diseases and injuries and 88 risk factors in the USA between 1990 and 2021. We used several metrics to report sources of health and health loss related to specific diseases, injuries, and risk factors. GBD 2021 methods accounted for differences in data sources and biases. The analysis of levels and trends for causes and risk factors within the same computational framework enabled comparisons across states, years, age groups, and sex. GBD 2021 estimated years lived with disability (YLDs) and disability-adjusted life-years (DALYs; the sum of years of life lost to premature mortality and YLDs) for 371 diseases and injuries, years of life lost (YLLs) and mortality for 288 causes of death, and life expectancy and healthy life expectancy (HALE). We provided estimates for 88 risk factors in relation to 155 health outcomes for 631 risk-outcome pairs and produced risk-specific estimates of summary exposure value, relative health risk, population attributable fraction, and risk-attributable burden measured in DALYs and deaths. Estimates were produced by sex (male and female), age (25 age groups from birth to ≥95 years), and year (annually between 1990 and 2021). 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws (ie, 500 random samples from the estimate's distribution). Uncertainty was propagated at each step of the estimation process.

We found disparities in health outcomes and risk factors across US states. Our analysis of GBD 2021 highlighted the relative decline in life expectancy and HALE compared with other countries, as well as the impact of COVID-19 during the first 2 years of the pandemic. We found a decline in the USA's ranking of life expectancy from 1990 to 2021: in 1990, the USA ranked 35th of 204 countries and territories for males and 19th for females, but dropped to 46th for males and 47th for females in 2021. When comparing life expectancy in the best-performing and worst-performing US states against all 203 other countries and territories (excluding the USA as a whole), Hawaii (the best-ranked state in 1990 and 2021) dropped from sixth-highest life expectancy in the world for males and fourth for females in 1990 to 28th for males and 22nd for females in 2021. The worst-ranked state in 2021 ranked 107th for males (Mississippi) and 99th for females (West Virginia). 14 US states lost life expectancy over the study period, with West Virginia experiencing the greatest loss (2·7 years between 1990 and 2021). HALE ranking declines were even greater; in 1990, the USA was ranked 42nd for males and 32nd for females but dropped to 69th for males and 76th for females in 2021. When comparing HALE in the best-performing and worst-performing US states against all 203 other countries and territories, Hawaii ranked 14th highest HALE for males and fifth for females in 1990, dropping to 39th for males and 34th for females in 2021. In 2021, West Virginia-the lowest-ranked state that year-ranked 141st for males and 137th for females. Nationally, age-standardised mortality rates declined between 1990 and 2021 for many leading causes of death, most notably for ischaemic heart disease (56·1% [95% UI 55·1-57·2] decline), lung cancer (41·9% [39·7-44·6]), and breast cancer (40·9% [38·7-43·7]). Over the same period, age-standardised mortality rates increased for other causes, particularly drug use disorders (878·0% [770·1-1015·5]), chronic kidney disease (158·3% [149·6-167·9]), and falls (89·7% [79·8-95·8]). We found substantial variation in mortality rates between states, with Hawaii having the lowest age-standardised mortality rate (433·2 per 100 000 [380·6-493·4]) in 2021 and Mississippi having the highest (867·5 per 100 000 [772·6-975·7]). Hawaii had the lowest age-standardised mortality rates throughout the study period, whereas Washington, DC, experienced the most improvement (a 40·7% decline [33·2-47·3]). Only six countries had age-standardised rates of YLDs higher than the USA in 2021: Afghanistan, Lesotho, Liberia, Mozambique, South Africa, and the Central African Republic, largely because the impact of musculoskeletal disorders, mental disorders, and substance use disorders on age-standardised disability rates in the USA is so large. At the state level, eight US states had higher age-standardised YLD rates than any country in the world: West Virginia, Kentucky, Oklahoma, Pennsylvania, New Mexico, Ohio, Tennessee, and Arizona. Low back pain was the leading cause of YLDs in the USA in 1990 and 2021, although the age-standardised rate declined by 7·9% (1·8-13·0) from 1990. Depressive disorders (56·0% increase [48·2-64·3]) and drug use disorders (287·6% [247·9-329·8]) were the second-leading and third-leading causes of age-standardised YLDs in 2021. For females, mental health disorders had the highest age-standardised YLD rate, with an increase of 59·8% (50·6-68·5) between 1990 and 2021. Hawaii had the lowest age-standardised rates of YLDs for all sexes combined (12 085·3 per 100 000 [9090·8-15 557·1]), whereas West Virginia had the highest (14 832·9 per 100 000 [11 226·9-18 882·5]). At the national level, the leading GBD Level 2 risk factors for death for all sexes combined in 2021 were high systolic blood pressure, high fasting plasma glucose, and tobacco use. From 1990 to 2021, the age-standardised mortality rates attributable to high systolic blood pressure decreased by 47·8% (43·4-52·5) and for tobacco use by 5·1% (48·3%-54·1%), but rates increased for high fasting plasma glucose by 9·3% (0·4-18·7). The burden attributable to risk factors varied by age and sex. For example, for ages 15-49 years, the leading risk factors for death were drug use, high alcohol use, and dietary risks. By comparison, for ages 50-69 years, tobacco was the leading risk factor for death, followed by dietary risks and high BMI.

GBD 2021 provides valuable information for policy makers, health-care professionals, and researchers in the USA at the national and state levels to prioritise interventions, allocate resources effectively, and assess the effects of health policies and programmes. By addressing socioeconomic determinants, risk behaviours, environmental influences, and health disparities among minority populations, the USA can work towards improving health outcomes so that people can live longer and healthier lives.

Bill & Melinda Gates Foundation.

College students during the young adult years are at elevated risk for the development of anxiety and depressive difficulties. Moreover, a preliminary body of evidence suggests that, for those who reside in Middle Eastern contexts, despite an established need, sociocultural impediments prevent active psychological help-seeking. Internet-delivered, self-directed mental health programs may hold significant promise to alleviate these difficulties in contexts where individuals would otherwise not enlist the support of a mental health practitioner.

The present study developed a bespoke, 4-module, internet-delivered program based upon acceptance and commitment therapy (ACT) principles and tested its feasibility and efficacy within the context a randomized controlled trial. A total of 129 participants were randomized to receive either the ACT program or to a waitlist control condition. Assessments of generalized anxiety, social anxiety, depressive affect, and wellbeing were administered at baseline and at post-intervention.

Analyses indicated that the intervention was efficacious in mitigating both generalized and social anxiety and in improving wellbeing.

These results provide preliminary evidence of the feasibility and efficacy of internet-delivered ACT in a Middle Eastern context.

Past research has demonstrated a consistent connection between symptoms of posttraumatic stress disorder (PTSD) and problematic gambling in both general and clinical United States (U.S.) populations. Little is known, however, about the mediating role that responsible gambling practices related to positive play might have in the relationships between symptoms of PTSD, problem gambling (PG) severity, and different motives for gambling. Therefore, using mediation analysis, this study investigated these associations within a census-matched national sample of U.S. adults (N = 2,806). Results indicated PTSD symptoms and PG often co-occur in this population (r = .43, p < .01), and coping motives for gambling were the key mechanism connecting PTSD symptoms to PG severity rather than deficits in positive play practices or other gambling motives. Moreover, it was found that the average gambler who had sought treatment for gambling in the past not only had more severe PTSD symptoms and PG but also had the strongest gambling motives, the largest deficits in positive play, and was more likely to be younger than 50 years old. In this sample, approximately 1 in 10 people who gambled in the past year were classified as problem gamblers, 1 in 5 met criteria for a provisional PTSD diagnosis, and 1 in 33 sought out gambling treatment previously. These findings provide further evidence for the relationship between symptoms of posttraumatic stress and problematic gambling behaviors in the U.S. population and offer critical insights into the explanatory roles of coping motives and positive play practices in this connection.

Adverse childhood experiences (ACEs) are strong, preventable risk factors for emotion dysregulation in adolescence, but whether ACEs-emotion dysregulation associations differ by race/ethnicity or gender remains unclear.

We examined (a) how race/ethnicity and gender jointly impact latent ACEs classes and emotion dysregulation phenotypes, and (b) how these ACEs classes in childhood (by age 9) transition to latent emotion dysregulation phenotypes in adolescence (at age 15).

Participants were 3,273 children from two waves of data from the Future of Families and Child Wellbeing Study, a large, nationally representative cohort. The sample consisted of 26.6% non-Hispanic (NH) Black boys, 25.4% NH Black girls, 12.9% Hispanic boys, 12.6% Hispanic girls, 11.8% NH White boys, and 10.7% NH White girls.

We estimated latent class models to identify ACEs patterns across ten indicators and dysregulation phenotypes across affective, attentional, and behavioral domains. Latent transition analysis was used to examine how ACEs classes transitioned into dysregulation phenotypes from childhood into adolescence.

The findings revealed significant variation in the number and nature of latent classes of both ACEs and emotion dysregulation across the intersection of race/ethnicity and gender. NH Black and Hispanic children were more likely to be in the Poverty and Parental Separation class than NH White children. Hispanic boys had the highest prevalence of Severe Dysregulation (16%), whereas NH White boys had the highest prevalence of Low Symptoms (52%). Individuals in the Poverty and Parental Separation class had a higher probability of transitioning to the Low Symptoms class. In contrast, those in the Abuse and Family Dysfunction class were more likely to transition to the Severe Dysregulation class, with NH White girls showing the highest probability (.34), nearly twice that of NH Black girls (.19). These gender differences in these transition probabilities were observed for Whites but not Blacks.

These findings thus highlight the need for adopting an intersectional, person-centered approach when studying the effects of ACEs on adolescent development.

While considerable data on the alcohol drinking behavior of the general population are available for the United States and Europe, data from Asian countries are scarce. We attempted to estimate the social backgrounds and other factors associated with high Alcohol Use Disorders Identification Test (AUDIT) scores in Japan.

This web-based survey was conducted in 2023. In order to ensure the representativeness of the sample, the population distribution by age and region was determined from the Statistics Bureau Census Basic Population Summary. The survey questionnaire items included AUDIT, educational background, occupation, income, marital status, body mass index (BMI), age at the time of the first alcoholic drink, age at the start of habitual drinking, Kessler Psychological Distress Scale (K6), and Link's Devaluation Discrimination Scale.

A total of 40,720 responses were received from people aged between 20 and 75 years old. The proportion of potential alcohol use disorder based on AUDIT score ≥15 was 9.2% in men and 2.0% in women. The number of people with AUDIT scores ≥15 tended to be high in men in their 50s and women in their 20s and 40s. Among those with AUDIT scores ≥15, the age at the first drink and age at the start of habitual drinking were significantly lower, and the K6 score was significantly higher.

This web survey showed an association between AUDIT scores and age at first drinking and mental health condition. Since this survey was a web-monitored survey, caution should be taken in generalizing the prevalence.

The aim of this paper is to study the measurement of the DSM5 self-rated transversal symptoms level 1 (CCSM1) from a dimensional perspective in line with current models of psychopathology in three factors: internalization, thought disorders, externalization.

Based on the 670 non-clinical protocols we collected, we verified that the VSS is composed of three factors. We studied the 3-factor composition with half of the sample and confirmed this composition with the other half. To show that these three factors were more relevant than the original 13 dimensions, we compared the results to three clinical groups and, after a cluster analysis, we investigated the intensity and frequency of people at risk across the original dimensions.

While the 13 initial dimensions of the CCSM1 do not completely differentiate this sample from the clinical groups, the three high-order dimensions are discriminating. Clustering confirms these results when comparing the least and most affected subjects and allows us to see that these three HODs have significant impacts on the observation of cases at risk of clinical disorders in this non-clinical sample.

To be further validated, these three HODs should be studied in relation to tools that assess internalization, thought disorders or externalization.

The increase in college enrollment for Hispanic college students warrants increased attention to their health and wellness. Given that a common threat to health and well-being in college students is alcohol use and that Hispanic college students are at elevated risk for alcohol-related problems, it is essential to investigate factors that might lead to heightened alcohol-related problems among this population. The present study is a secondary data analysis of an NIAAA-funded study investigating brief interventions for alcohol use among 583 heavy-drinking college students. Specifically, we examined the relationship between Hispanic student status and alcohol-related problems measured one month later. Additionally, we examined the indirect effects of Hispanic status on alcohol-related problems through drinking motives. Analyses revealed a significant association between Hispanic status and alcohol-related problems at baseline but no association between Hispanic status and problems at 1-month, controlling for baseline problems. An indirect effect of the prospective association between Hispanic student status and alcohol-related problems was evident for only one of the four drinking motives (coping). Our findings suggest that reducing coping motives for drinking among Hispanic college students may reduce alcohol-related problems.

Every year, many opioid users undergo surgery, experiencing increased postoperative complications, inadequate pain control, and opioid-related adverse effects. This overview aims to summarise and critically assess the systematic reviews about perioperative pain management interventions, identify the knowledge gaps, and potentially provide high-quality recommendations to improve postoperative analgesia and surgical outcomes.

A systematic search was conducted from the following databases, PubMed, Cochrane Database of Systematic Reviews, Embase, APA PsycINFO, CINAHL, AMED, Scopus, PROSPERO, ProQuest, and Epistemonikos, in June 2023. Additionally, reference lists were reviewed. The identified studies were assessed based on eligibility criteria and data extracted by a self-designed form and two independent reviewers. Qualitative data were synthesised, and all included studies were assessed by The Assessment of Multiple Systematic Reviews 2 (AMSTAR 2) checklist.

Nine studies were included. The methodological quality of the studies was mostly critically low. Various interventions were identified, including perioperative management of buprenorphine, ketamine administration, multimodal analgesia, higher doses of medications, patient education, and interprofessional collaboration. The level of certainty of the evidence ranged from very low to high. One high-quality study showed that ketamine administration may improve perioperative analgesia supported with moderate to very low-quality evidence, and low and critically low studies indicated the efficacy of perioperative continuation of buprenorphine with low to very low-quality evidence.

Perioperative continuation of buprenorphine and ketamine administration as a multimodal analgesia approach, with moderate to very low-quality evidence, improves pain management in opioid users and decreases opioid-related adverse effects. However, high-quality systematic reviews are required to fill the identified gaps in knowledge.

Young adults in the United States, including college students, have the highest prevalence of cannabis use compared with other age groups. Although cannabis vaping is increasingly prevalent during young adulthood, little is known about factors contributing to the onset of cannabis vaping during this developmental period.

Participants were 3085 cannabis vaping naïve young adults aged 18-25 years (M = 20.60; SD = 1.80), initially recruited from 24 Texas colleges and participating in a multi-wave, longitudinal study. A survival analysis was conducted to determine if participants reporting elevated depressive symptoms had an increased risk of onset of cannabis vaping over six follow-up waves from fall 2015 to spring 2019 compared to their peers with lower levels of depressive symptoms. Socio-demographic characteristics, time-varying past 30 day substance use, and time-varying peer nicotine vaping were included as covariates in the model.

Twenty-five percent of participants initiated cannabis vaping during the four-year study period, with stable initiation rates from 2015 to 2017 but doubling from 2017 to 2019. Analyses, both unadjusted and adjusted for study covariates, indicated that elevated depressive symptoms were significantly associated with an increased risk of cannabis vaping initiation.

Findings indicate that initiation of cannabis vaping during young adulthood is common, and particularly more likely among those with greater depressive symptoms, thus underscoring the importance of prevention programs that include mental health support services tailored to young adults.

Gambling disorder affects 0.5-2.4% of the population and shows strong associations with lifetime alcohol use disorder. Very little is known regarding whether lifetime alcohol use disorder can impact the clinical presentation or outcome trajectory of gambling disorder.

Data were pooled from previous clinical trials conducted on people with gambling disorder, none of whom had current alcohol use disorder. Demographic and clinical variables were compared between those who did versus did not have lifetime alcohol use disorder.

Of the 621 participants in the clinical trials, 103 (16.6%) had a lifetime history of alcohol use disorder. History of alcohol use disorder was significantly associated with male gender (relative risk [RR] = 1.42), greater body weight (Cohen's D = 0.27), family history of alcohol use disorder in first-degree relative(s) (RR = 1.46), occurrence of previous hospitalization due to psychiatric illness (RR = 2.68), and higher gambling-related legal problems (RR = 1.50). History of alcohol use disorder was not significantly associated with other variables that were examined, such as severity of gambling disorder or extent of functional disability. Lifetime alcohol use disorder was not significantly associated with the extent of clinical improvement in gambling disorder symptoms during the subsequent clinical trials.

These data highlight that lifetime alcohol use disorder is an important clinical variable to be considered when assessing gambling disorder because it is associated with several untoward features (especially gambling-related legal problems and prior psychiatric hospitalization). The study design enabled these associations to be disambiguated from current or recent alcohol use disorder.

Unhealthy alcohol use increases the risk for and exacerbation of chronic health conditions. As such, screening, prevention, and management of unhealthy alcohol use is especially critical to improving health outcomes for patients with multiple chronic health conditions. It is unclear to what extent multiple chronic condition status is a barrier to screening for unhealthy alcohol use in the primary care setting. The authors hypothesized that patients with multiple chronic conditions would be at lower odds of being screened for unhealthy alcohol use than patients without multiple chronic conditions.

The authors performed a secondary analysis of electronic health record data for patients from 67 primary care practices in Virginia (2020-2023). Using the Center for Medicare and Medicaid Services' chronic disease framework, they classified patients by multiple chronic condition status: no multiple chronic conditions, physical multiple chronic conditions, mental health multiple chronic conditions, and physical and mental health multiple chronic conditions. They used multiple logistic regressions with an added practice-level random effect to analyze the relationship between multiple chronic condition status and the odds of receiving an alcohol-related assessment, of being screened for unhealthy alcohol use with a U.S. Preventive Services Task Force-recommended instrument, and of screening positive for unhealthy alcohol use within the past 2 years.

Within a final cohort of n=11,789, a total of 6,796 patients (58%) had multiple chronic conditions (29% physical multiple chronic conditions, 4% mental health multiple chronic conditions, and 25% physical and mental health multiple chronic conditions). In all, 69% of patients were screened for unhealthy alcohol use, whereas 16% were screened with a U.S. Preventive Services Task Force-recommended instrument, and 7% screened positive for unhealthy alcohol use. Patients with physical and mental health multiple chronic conditions had 0.9 times lower odds of receiving any screening for unhealthy alcohol use than those with no multiple chronic conditions (95% CI=0.8, 1.0; p=0.0240), whereas patients with only physical multiple chronic conditions or only mental health multiple chronic conditions had similar odds. There was no difference in the odds of being screened with a U.S. Preventive Services Task Force-recommended instrument on the basis of multiple chronic condition status. Patients with mental health multiple chronic conditions and physical and mental health multiple chronic conditions had 1.8 and 1.5 times greater odds of screening positive for unhealthy alcohol use, respectively (95% CI=1.3, 2.7; p=0.0014 and 95% CI=1.2, 1.8; p=0.0003).

Although patients with chronic mental health conditions were more likely to screen positive for unhealthy alcohol use than patients without multiple chronic conditions, Virginia primary care patients with physical and mental health multiple chronic conditions were less likely to receive an alcohol-related assessment during the past 2 years. Given the overall modest rate of screening with a U.S. Preventive Services Task Force-recommended instrument, further efforts are needed to create the conditions for high-quality alcohol-related preventive service delivery in primary care, particularly for patients with high complexity and/or mental health conditions.

Alcohol use has profound public health impact on women; however, modifiable factors that may influence alcohol use progression/recovery, including health service utilization, are understudied in women.

To investigate the association between mental health (MH) and substance use (SU) treatment with alcohol use progression and recovery among women who currently use alcohol or have in the past.

This study is a secondary data analysis of prospective data from waves 1 (2001-2002) and 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; a US-nationally representative sample of adults). The analytic sample was limited to women who reported past or current alcohol use at wave 1 (N = 15,515). Latent transition analysis (LTA) examined whether receiving SU/MH treatment in the year prior to wave 1 was associated with transitioning between three empirically-derived stages of alcohol involvement (no, moderate, and severe problems classes), between Waves 1 and 2 adjusting for possible confounders using propensity score weight.

Compared to White female drinkers, female drinkers who were from Black, Hispanic, or other races were less likely to receive SU/MH treatment (p-values ≤. 001). SU/MH treatment in the year prior to wave 1 was associated with transitioning from the moderate problems class to the no problems class between Waves 1 and 2 (p-value = .04).

Receipt of SU or MH treatment among women, was associated with a higher likelihood of remission from moderate alcohol use problems to no problems over time. Future research, including investigation into treatment characteristics (e.g., frequency, duration, type) should further explore why women initially experiencing severe alcohol use problems did not experience similar remission.

Background: Substance use disorders (SUDs) are heterogeneous across multiple functional domains. Various frameworks posit that domains (e.g., executive function) contribute to the persistence of SUDs; however, the domains identified in different studies vary.Objectives: We used factor analysis to identify the underlying latent domains present in a large sample (N = 5,244, 55.8% male) with a variety of SUDs to yield findings more generalizable than studies with a narrower focus.Method: Participants (1,384 controls and 3,860 participants with one or more SUDs including alcohol, cocaine, cannabis, and/or opioid use disorders) completed the Semi-Structured Assessment for Drug Dependence and Alcoholism, the NEO Personality Inventory, and the Wisconsin Card Sorting Test. Exploratory factor analysis (EFA) and fit indices (root mean-squared error of approximation (RMSEA), Comparative Fit Index (CFI), and Tucker-Lewis Index (TLI)) were used to examine different latent variable models. A multiple indicators, multiple causes (MIMIC) approach-tested associations of the latent variables with sociodemographics, substance use, and a history of abuse/neglect.Results: A six-factor model (predominant alcohol, predominant cocaine, predominant opioid, externalizing, personality, and executive function) provided the best fit [RMSEA = 0.063 (90% CI 0.060, 0.066), CFI = 0.98, TLI = 0.96]. All factors were moderately correlated (coefficient = 0.25-0.55, p < .05) with the exception of executive function. MIMIC analysis revealed different patterns of associations (all p < .0001) with sociodemographics, substance use, and a history of abuse/neglect among the factors.Conclusions: The domains identified, particularly executive function, were parallel to those observed previously. These factors underscore the heterogeneous nature of SUDs and may be useful in developing more targeted clinical interventions.

Problem-drinking among university students is common and poses serious health-related risks. Therefore, identifying and addressing associated factors is important.

A large cross-sectional online-survey with 12,914 university students from Berlin was conducted from November 2016 to August 2017. Relative-risk- and correlation-analysis was used to identify factors associated with problem-drinking and regular heavy-drinking. Independent t-tests compared impulsivity and personality traits, chi-square-tests compared drinking motives between risk- and non-risk-drinkers.

Male gender, tobacco-smoking, illegal substance use, impulsivity and various sociodemographic and psychosocial variables were significantly related to problem/heavy-drinking. Extraversion was a risk, conscientiousness and agreeableness were protective factors. Drinking-motives did not differ significantly between risk- and non-risk-drinkers. Generally, the main drinking-motives were to feel elated, relax and social purposes.

The identified markers and related problem behaviors may serve as a tool to enhance the identification of student subgroups at risk for problem/heavy-drinking, and hence improve targeted health-intervention-programs.

Alcohol use is pervasive in the Caribbean; however, the prevalence and correlates of alcohol use and drinking problems in the elderly have not been extensively studied.

Data were obtained from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study, a cohort study of Caribbean people from Puerto Rico, Barbados, Trinidad, and Tobago, and the U.S. Virgin Islands, collected between 2013 and 2018 (baseline study sample, ages 60+, n = 811). Descriptive statistics were used to compare the differences in drinking status (current vs. former vs. never), alcohol problems (Cut-down, Annoyed, Guilty, and Eye-opener (CAGE) scale score ≥2 vs. <2), and binge drinking days (0 days vs. 1-2 days vs. ≥3 days) across sample characteristics. Logistic regression analyses estimated the association of these alcohol measures with sociodemographic (e.g., sex), psychological (depression), and cultural (e.g., religion) correlates.

Thirty-six percent were 70 + years of age, 64 % were female, and 41 % had less than a high school education. Alcohol problems (≥2 CAGE score) was 21 %. Binge drinking ≥3 days was 30.6 %. Never attending religious services (vs. attending once a week or more) was associated with almost three times higher odds of alcohol problems (adjusted Odds Ratio: OR = 2.88, 95 % CI = 1.02, 8.15) four times higher odds of increasing binge drinking days (aOR = 4.04, 95 % CI = 1.11, 14.96). College education was protective against both the outcomes.

We provide current estimates of alcohol problems among elderly Eastern Caribbean people. Among the sociodemographic, psychological, and cultural correlates examined, religious attendance was significant. Replicate longitudinal studies using DSM-5 alcohol dependence are recommended.

Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic.

The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic.

Global DALYs increased from 2·63 billion (95% UI 2·44-2·85) in 2010 to 2·88 billion (2·64-3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7-17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8-6·3) in 2020 and 7·2% (4·7-10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0-234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7-198·3]), neonatal disorders (186·3 million [162·3-214·9]), and stroke (160·4 million [148·0-171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3-51·7) and for diarrhoeal diseases decreased by 47·0% (39·9-52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54-1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5-9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0-19·8]), depressive disorders (16·4% [11·9-21·3]), and diabetes (14·0% [10·0-17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7-27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6-63·6) in 2010 to 62·2 years (59·4-64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6-2·9) between 2019 and 2021.

Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades.

Bill & Melinda Gates Foundation.

We aimed to identify alcoholic beverage types more likely to be consumed by demographic subgroups with greater alcohol-related health risk than others, mainly individuals with low socio-economic status, racial/ethnic minority status and high drinking levels.

Fractional logit modelling was performed using a nationally representative sample of US adult drinkers (analytic N = 37,657) from the National Epidemiologic Survey on Alcohol and Related Conditions Waves 2 (2004-2005) and 3 (2012-2013). The outcomes were the proportions of pure alcohol consumed as beer, wine, liquor and coolers (defined as wine-/malt-/liquor-based coolers, hard lemonade, hard cider and any prepackaged cocktails of alcohol and mixer).

Adults with lower education and low or medium income were more likely to drink beer, liquor and coolers, while those with a 4-year college/advanced degree and those with high income preferred wine. Excepting Asian adults, racial/ethnic minority adults were more likely to drink beer (Hispanics) and liquor (Blacks), compared with White adults. High- or very-high-level drinkers were more likely to consume liquor and beer and less likely to consume wine (and coolers), compared with low-level drinkers. High-level and very-high-level drinkers, who were less than 10% of all drinkers, consumed over half of the total volume of beer, liquor and coolers consumed by all adults.

Individuals with low socio-economic status, racial/ethnic minority status or high drinking level prefer liquor and beer. As alcohol taxes, sales and marketing practices all are beverage-specific, targeted approaches to reduce consumption of these beverages, particularly among individuals with these profiles, are warranted.

Few studies have systematically examined the safety and effectiveness of antidepressant versus mood stabilizer monotherapy of bipolar II depression. To date, there are no aggregated or mega-analyses of prospective trials of individual participant-level data (IPD) to inform future treatment guidelines on the relative safety and effectiveness of antidepressant or lithium monotherapy.

Data from a series of four independent, similarly designed trials of antidepressant or lithium monotherapy (where longitudinal IPD were available) (n = 393) were aggregated into an IPD dataset (i.e., mega-analysis). Hierarchical log-linear growth models were used to analyze primary outcome of change over time in Hamilton Rating Scale for Depression (HRSD) scores; while secondary outcomes examined Clinical Global Impressions severity (CGI/S) and change (CGI/C) scores, and change over time in Young Mania Rating (YMR) scores.

Relative to lithium monotherapy, antidepressant monotherapy demonstrated significantly greater symptom reduction on HRSD scores across time (b = -2.33, t = -6.68, p < 0.0001), significantly greater symptom reduction on the CGI/S across time (b = -0.414, t = -6.32, p < 0.001), and a significant improvement in CGI/C across time (b = -0.47, t = -7.43, p < 0.0001). No differences were observed in change over time for YMR scores between antidepressant and lithium monotherapy (b = 0.06, t = 0.49, p = 0.62).

Findings from this IPD mega-analysis of bipolar II depression trials suggest a divergence from current evidence-based guidelines recommending combined mood stabilizer plus antidepressant therapy. The current mega-analysis suggests that antidepressant monotherapy may provide superior short-term effectiveness without clinically meaningful increase in treatment-emergent hypomanic symptoms compared to lithium monotherapy.

Recent research suggests that alcohol use disorder may be more prevalent in the Deaf community, a diverse sociolinguistic minority group. However, rates of treatment-seeking among Deaf individuals are even lower than in the general society. This study used the Theory of Planned Behavior to identify Deaf adults' beliefs about treatment that may prevent their treatment-seeking behaviors.

This study conducted elicitation interviews with 16 Deaf adults. The study team recruited participants from across the U.S. and conducted interviews on Zoom. Participant ages ranged from 27 to 67 years (M = 40, SD =10.8). Seventy-five percent of the sample was male, 75 % were White, and 12.5 % were Hispanic/Latine. The study conducted interviews in American Sign Language, subsequently interpreted into English by a nationally certified interpreter, and transcribed for data analyses. The study analyzed transcripts using the Framework Method. The study team coded the interviews in groups and assessed for saturation (≤ 5 % new themes) of themes throughout the analysis. This study reached saturation in the third group (six total groups).

Identified themes followed the Theory of Planned Behavior constructs. The study identified nine Behavioral Beliefs with four advantages and five disadvantages of seeking treatment, four Normative Beliefs with one support and three oppositions to seeking treatment, and thirteen Control Beliefs with five facilitators and eight barriers to seeking treatment. Overall, the Deaf participants reported several unique beliefs based on their cultural and linguistic perspectives, including a concern about unqualified providers, experiencing stress in treatment with hearing providers, stigma within the Deaf community, less access to cultural information about alcohol and mental health, less encouragement of traditional treatment in marginalized communities, and additional barriers (e.g., communication, limited Deaf treatment options, discrimination, etc.).

A thorough understanding of individual beliefs about treatment is necessary to develop interventions that may increase treatment-seeking behaviors. Previous research has demonstrated that individual beliefs may be modified using Cognitive Behavioral Therapy techniques to increase treatment-seeking behaviors among hearing individuals. Similar interventions may be useful with Deaf individuals; however, they must consider the unique cultural and linguistic perspectives of the community.

Problematic alcohol use is a serious threat to the behavioral health of active-duty Service Members (ADSM), resulting in numerous calls from governmental agencies to better understand mechanistic factors contributing to alcohol misuse within the military. Alcohol use motives are reliable predictors of alcohol-related behaviors and are considered malleable targets for prevention and intervention efforts. However, empirical research indicates that drinking motives vary across contextually distinct populations. Although some research has been conducted among veteran and reservist populations, limited work has been specifically focused on ADSM and no research has evaluated motives and alcohol metrics among ADSM based on military rank. Participants for the current study included 682 ADSM recruited from a large military installation in the U.S. Structural equation modeling evaluated associations between four drinking motives (i.e., enhancement, social, conformity, coping) and three alcohol misuse metrics (i.e., alcohol frequency, binge frequency, alcohol problems). Three models were evaluated: one full (combined) model and two separate models based on military rank - junior enlisted (i.e., E1-E4) and non-commissioned officers (NCOs) (i.e., E5-E9). Results for junior enlisted ADSM indicated that coping and enhancement motives were most strongly associated with all alcohol misuse metrics. However, among NCOs, results indicated that alcohol problems were only associated with coping motives. Notably, results also indicated that alcohol use motives accounted for substantively more variance across all alcohol-related metrics among NCOs. Findings generally support extant military-related literature indicating use of alcohol for coping (e.g., with anxiety) as the motivation most consistently associated with increased alcohol misuse. However, novel findings highlight enhancement motives - using alcohol to attain some positive internal reward - as another, often stronger, motivation impacting alcohol use outcomes. Further, findings highlight notable distinctions between alcohol use motives (i.e., coping vs. enhancement) and the impact of alcohol use motives (i.e., effect size) on alcohol metrics between junior enlisted and NCOs.

Borderline personality disorder (BPD) is thought to involve aberrant social learning, including impaired revision of social interpretations with new evidence (social interpretation inflexibility). However, this topic has received little empirical attention outside of specific literatures, such as moral inference or behavioral economics. Further, the contribution of comorbid depression to BPD-related interpretation inflexibility has not yet been assessed.

In two independent samples (Study 1: N = 213; Study 2: N = 210, oversampled for BPD features), we assessed the associations between BPD symptoms, depressive symptoms, and task-based measures of social interpretation flexibility.

We found that BPD symptoms, particularly volatility of identity and relationships, were associated with less revision of social interpretations with both positive and negative evidence. Meanwhile, depressive symptoms were associated with a pattern of less revision of social interpretations with positive versus negative information.

The use of cross-sectional, crowdsourced samples limits causal interpretations. Translation to clinical populations should be assessed in future studies.

Results suggest that inflexible social interpretations across valences may be a feature of BPD-related pathology, and could be connected to symptoms involving volatility in social contexts. Future studies should investigate whether treatments geared toward increasing the flexibility of social interpretations are effective in treating BPD symptoms, especially those involving interpersonal difficulties.

To investigate the association between mental health symptoms, alcohol use, and alcohol misuse among psychiatrists in China during the early stage of the COVID-19 pandemic.

We conducted an online survey to collect data regarding mental health symptoms and alcohol use among psychiatrists in early 2020. The Depression Anxiety Stress Scale-Chinese Version (DASS-21) was used to assess depression, anxiety, and stress symptoms, and the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) was used to assess alcohol use.

In total, 3774 psychiatrists completed the survey. AUDIT-C scores were positively correlated with DASS total and depression, anxiety, and stress subscales (total: r = 0.015, depression: r = 0.121, anxiety: r = 0.103, and stress: r = 0.096, all p < 0.05). Alcohol misuse was associated with male sex (OR = 4.754), cigarette smoking (OR = 2.441), administrative position (OR = 1.811), depression (OR = 1.489), and stress (OR = 1.504). Those who reported increased alcohol use during the pandemic were more likely to be male (OR = 2.174), endorse anxiety symptoms (OR = 2.386), or increased stress (OR = 2.402).

Mental health symptoms were common among psychiatrists during the COVID-19 pandemic. Depression and stress symptoms were significantly associated with alcohol misuse. Anxiety and stress symptoms were associated with reported increases in alcohol use. Though a causal relationship cannot be inferred, our findings suggest that strategies promoting healthcare professionals' mental well-being should include alcohol use.

Introduction: Genetic factors impact alcohol consumption and use disorder (AUD), with large-scale genome-wide association studies (GWAS) identifying numerous associated variants. Aggregate genetic methods in combination with important environmental factors (e.g., interpersonal trauma [IPT]) can be applied to expand our understanding of the ways by which genetic and environmental variables work together to influence alcohol consumption and disordered use. The present study aimed to detail the relationships between genome-wide polygenic scores (PGS) for alcohol phenotypes (i.e., alcohol consumption and AUD status) and IPT exposure as well as the interaction between them across ancestry. Methods: Data were drawn from the Spit for Science (S4S) study, a US college student population, where participants reported on IPT exposure prior to college and alcohol consumption and problems during college (N = 9,006; ancestry: 21.3% African [AFR], 12.5% Admixed Americas [AMR], 9.6% East Asian [EAS], 48.1% European [EUR], 8.6% South Asian [SAS]). Two trans-ancestry PGS were constructed, one for alcohol consumption and another for AUD, using large-scale GWAS summary statistics from multiple ancestries weighted using PRS-CSx. Regression models were applied to test for the presence of associations between alcohol-PGS and IPT main and interaction effects. Results: In the meta-analysis across ancestry groups, IPT exposure and PGS were significantly associated with alcohol consumption (βIPT = 0.31, P IPT = 0.0002; βPGS = 0.09, P PGS = 0.004) and AUD (ORIPT = 1.12, P IPT = 3.5 × 10-8; ORPGS = 1.02, P PGS = 0.002). No statistically significant interactions were detected between IPT and sex nor between IPT and PGS. When inspecting ancestry specific results, the alcohol consumption-PGS and AUD-PGS were only statistically significant in the EUR ancestry group (βPGS = 0.09, P PGS = 0.04; ORPGS = 1.02, P PGS = 0.022, respectively). Discussion: IPT exposure prior to college was strongly associated with alcohol outcomes in this college-age sample, which could be used as a preventative measure to identify students at high risk for problematic alcohol use. Additionally, results add to developing evidence of polygenic score association in meta-analyzed samples, highlighting the importance of continued efforts to increase ancestral representation in genetic studies and inclusive analytic approaches to increase the generalizability of results from genetic association studies.

Antipsychotic polypharmacy is prevalent, however literature on antipsychotic polypharmacy during treatment among patients with dual diagnosis is largely non-existent. This study aims to investigating the extent of antipsychotic polypharmacy dual diagnosis patients during hospitalisations.

Utilizing cohort data from an integrated dual diagnosis in-patient facility from patients hospitalized between 1 March 2012, to 31 December 2016, we compared the mean antipsychotic medication administered at admission and discharge and examined covariate associations with logistic regressions.

The study identified 907 hospital admissions, of which 641 were the first for each patient during the period. At admission, 74.1% received antipsychotics; polypharmacy spanned psychiatric disorders. categories. Patients with affective or personality spectrum disorders were less likely to have antipsychotic polypharmacy upon admission compared to those with psychosis spectrum disorders. 2013-2016 admissions presented less polypharmacy than 2012. Mean antipsychotic numbers remained unchanged for >30-day hospitalizations. Patients admitted without antipsychotic polypharmacy with an affective spectrum disorder or aged 41-50 or over 51 years old were less likely to be discharged with antipsychotic polypharmacy when compared to patients with psychosis spectrum disorder or aged 18-30 years old.

Approximately three-quarters of admitted patients were treated with antipsychotic medication. Antipsychotic polypharmacy was observed across all psychiatric disorder categories, indicating potential off-label use. Addressing antipsychotic polypharmacy during treatment is challenging, even for specialised facilities. Rational antipsychotic prescribing, deprescribing protocols, and further prescription pattern research are needed.

Cannabis use and social anxiety disorder (SAD) are prevalent during emerging adulthood. Previous work has demonstrated that SAD is related to cannabis use in adults; however, less is known about what correlates relate to this association in emerging adults. A subsample of individuals ages 18-25 years old from the NESARC-III (N = 5194) was used to (a) evaluate the association between cannabis use and SAD and (b) examine what correlates may be associated with cannabis use and SAD in emerging adulthood. Weighted cross-tabulations assessed sociodemographics and lifetime psychiatric disorder prevalence estimates among the emerging adult sample. Multinomial logistic regressions examined associations between sociodemographics and psychiatric disorders and four groups (i.e., no cannabis use or SAD; cannabis use only; SAD only; cannabis use + SAD). The prevalence of co-occurring cannabis use and SAD was 1.10%. Being White, a part-time student, or not a student were associated with increased odds of having co-occurring cannabis use + SAD (OR range: 2.26-3.09). Significant associations also emerged between major depressive disorder, bipolar I disorder, generalized anxiety disorder, specific phobia, agoraphobia, and panic disorder and co-occurring cannabis use + SAD (AOR range: 3.03-19.05). Results of this study may have implications for better identifying and screening emerging adults who are at risk of co-occurring cannabis use and SAD.

Bipolar Affective Disorder (BPAD) merits careful consideration within the medical and healthcare communities, researchers, and policymakers. This is due to its substantial disability burden, elevated prevalence of co-morbidities, heightened lifetime risk of suicidality, and a significant treatment gap. This article focuses on the lifetime and current prevalence, correlates, co-morbidities, associated disabilities, socio-economic impact, and treatment gap for BPAD in the adult population of the National Mental Health Survey (NMHS) 2016.

The NMHS 2016 was a nationally representative study conducted across 12 Indian states between 2014 and 2016. A multi-stage, stratified, random cluster sampling technique based on probability proportionate to size at each stage was used. The diagnosis of BPAD was based on Mini-International Neuropsychiatric Interview 6.0.0. Sheehan's Disability Scale was used to assess the disability.

A total of 34,802 adults were interviewed. The overall weighted prevalence of BPAD was 0.3% [95% confidence interval (CI): 0.29-0.31] for current and 0.5% (95% CI: 0.49-0.51) for lifetime diagnosis. Male gender [odds ratio (OR) 1.56] and residence in urban metropolitans (OR 2.43) had a significantly higher risk of a lifetime diagnosis of BPAD. Substantial cross-sectional co-morbidities were noted as per MINI 6.0.0 with the diagnosis of current BPAD such as tobacco use disorder (33.3%), other substance use disorders (14.6%), and anxiety disorders (10.4%). Two-thirds of persons with current BPAD reported disability of varying severity at work (63%), social (59.3%), and family life (63%). The treatment gap for current BPAD was 70.4%.

Most individuals with current BPAD reported moderate-severe disability. There were substantial co-morbidities and a large treatment gap. These warrant concentrated efforts from policymakers in devising effective strategies.

This study reexamined the factor structure of drinking motives using 205 unique items from 18 drinking motives scales with the inclusion of social tension reduction motives, which have been largely neglected in the literature. A new scale was created and compared with the Drinking Motives Questionnaire-Revised (DMQ-R) to predict alcohol use/problems. Young adults (N = 1,049) completed questionnaires assessing drinking motives and alcohol use/problems. A subset (N = 368) of participants completed a 6-month follow-up. Hierarchical factor analyses informed the creation of a four-factor (i.e., coping, social, enhancement, and social tension reduction) scale (i.e., the Young Adult Alcohol Motives Scale [YAAMS]). In general, the YAAMS performed similarly to the DMQ-R in predicting concurrent and prospective alcohol consumption (i.e., typical drinking quantity and frequency) and alcohol problems (i.e., Alcohol Use Disorder Identification Test [AUDIT] and Brief Young Adult Alcohol Consequences Questionnaire [B-YAACQ] scores), but there were some notable differences, including that the novel social tension reduction scale of the YAAMS was particularly relevant in predicting drinking frequency in those with social anxiety. Results suggest that drinking motives can be described by multiple factor structures and predict alcohol-related outcomes.

Return-to-work (RTW) resources for persons with mental health disorders are limited and costs are typically shared by several stakeholders in society. Occupational therapists (OT) provide RTW interventions for this target group, however, increased knowledge of health, and employment effects, as well as costs are needed to better inform decision makers in their prioritisations.

To identify and summarise evidence of cost-effectiveness of RTW interventions for persons with mental health disorders which OTs provide.

A systematic search was applied and resulted in 358 articles. After screening, nine articles met inclusion criteria and were reviewed. Quality assessment was conducted using the economic evaluation tool by Joanna Briggs Institute.

Supported employment, Individual Placement and Support was cost-effective in several contexts while three studies showed larger effects and higher costs. An OT intervention added to treatment for major depression was indicated to be cost-beneficial and an advanced supported employment was cost-saving. The methodological quality varied considerably between studies.

The results of the included studies are promising, however, to further strengthen the economic perspective in OT RTW interventions, the need for conducting more and methodologically robust economic evaluations is crucial in future studies.

There is a paucity of research on the true prevalence of psychiatric disorders in Muslim Americans. This research aims to explore the prevalence, correlates and impact of mood disorders, anxiety disorders, and posttraumatic stress disorders (PTSD) in Muslims as compared with a non-Muslim sample. We used propensity scores to match 372 individuals who self-identified as Muslims from The National Epidemiologic Survey on Alcohol and Related Conditions III with a control group (n = 744) from the same dataset. The prevalence of psychiatric disorders was similar in Muslim Americans and non-Muslims. Help-seeking was generally low, but Muslims with a lifetime history of PTSD were less likely than non-Muslims with PTSD to seek help through self-help groups (2.2% vs. 21.1%, p < 0.05). Moreover, Muslims with mood disorders experienced lower mental health scores compared to non-Muslims with mood disorders. Efforts need to be made to identify psychiatric disorders in this faith group and engage in treatment.