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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Previous analyses in a large population-based sample of female twins indicated that three dimensions of religiosity--personal devotion, personal conservatism and institutional conservatism--were, in different ways, significantly related to current depressive symptoms and substance use and lifetime psychiatric and substance use disorders. Furthermore, personal devotion, but neither personal conservatism nor institutional conservatism, buffered the depressogenic effects of stressful life events (SLEs). We here explore further these results, using linear, logistic and Cox regression models. Eight personality and six demographic variables had distinct patterns of association with the three dimensions. Personal devotion was positively associated with years of education, age, and optimism and negatively correlated with neuroticism. Personal conservatism was negatively associated with education, income, age, mastery and positively correlated with neuroticism. Institutional conservatism was negatively correlated with self-esteem and parental education. Covarying for these 14 variables produced little change in their association with psychiatric and substance use outcomes. The impact of the dimensions of religiosity differed as a function of the SLE category. High levels of both personal devotion and institutional conservatism protected against the depressogenic effects of death and personal illness. High levels of personal conservatism were associated with increased sensitivity to relationship problems. These results suggest that the association between religiosity and low risk for symptoms of depression and substance use may be in part causal. The relationship between dimensions of religiosity and response to SLEs is complex but probably of importance in clarifying the nature of the coping process.
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PMID:Clarifying the relationship between religiosity and psychiatric illness: the impact of covariates and the specificity of buffering effects. 1048 Jul 48

Depression and substance use disorders are highly prevalent in the general population and often co-occur within the same individual. This association is most commonly explained either by a causal relationship or a shared etiologic factor underlying both disorders. In light of these mechanisms of association, this article summarizes evidence from clinical, epidemiologic, and genetic epidemiologic studies. Details of a large family study designed to addresses key methodological and conceptual issues identified in the review are also presented. The association of alcoholism with depression is likely to be attributable to causal factors rather than a shared etiology, but the scarcity of information for other classes of substance use disorders precludes similar conclusions regarding their association with depression. The lack of unidirectional and consistent patterns of association for depression and substance use disorders indicates that multiple mechanisms of comorbidity are likely to be simultaneously active in this population.
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PMID:The comorbidity of depression and substance use disorders. 1072 96

We investigated whether substance abuse/dependence, conduct disorder, and other psychiatric disorders improved in adolescent females who were referred to outpatient treatment and which variables were related to 1-year outcome. Forty-six out of 60 conduct-disordered (CD) adolescent females with substance abuse or dependence were re-evaluated approximately 1 year after discharge. Treatment length averaged 16 weeks. Significant improvements were seen in three areas: (1) criminality and CD; (2) attention deficit hyperactivity disorder (ADHD); and (3) educational and vocational status. However, neither substance involvement nor depression improved, regardless of length of stay in treatment, and these females demonstrated significant risky sexual behaviors. In contrast to our previous work with adolescent males (Crowley, T.J., Mikulich, S.K., Macdonald, M., Young, S.E., Zerbe, G.O., 1998. Substance-dependent, conduct-disordered adolescent males: severity of diagnosis predicts 2-year outcome. Drug Alcohol Depend. 49, 225-237), we were not able to identify pre-intake variables, other than performance IQ, that were related to substance use and conduct outcomes. Only two post-treatment factors (peer problems and number of ADHD symptoms at follow-up) were found to be related to CD and substance use disorders outcomes. The overall lack of pre- and post-treatment predictors presents interesting challenges for future research on adolescent females with these disorders.
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PMID:One-year outcome of adolescent females referred for conduct disorder and substance abuse/dependence. 1089 26

There is active debate regarding whether diagnosable depression exists on a continuum with subthreshold depressive symptoms or represents a categorically distinct phenomenon. To address this question, multiple indexes of dysfunction (psychosocial difficulties, mental health treatment history, and future incidence of major depression and substance abuse/dependence) were examined as a function of the extent of depressive symptoms in 3 large community samples (adolescent, adult, and older adult; N = 3,003). Increasing levels of depressive symptoms were associated with increasing levels of psychosocial dysfunction and incidence of major depression and substance use disorders. These findings suggest that (a) the clinical significance of depressive symptoms does not depend on crossing the major depressive diagnostic threshold and (b) depression may best be conceptualized as a continuum. Limitations of the present study are discussed.
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PMID:Clinical implications of "subthreshold" depressive symptoms. 1089 74

The relationship between substance use disorders and comorbid psychiatric conditions was investigated among 425 persons in drug treatment who met DSM-III-R criteria for drug dependence. Using the NIMH Diagnostic Interview Schedule to ascertain DSM-III-R psychiatric disorders among these drug dependent subjects, lifetime prevalence rates were 64% for alcohol abuse/dependence, 44% for antisocial personality disorder, 39% for phobic disorders, 24% for major depression, 12% for dysthymia, and 10% for generalized anxiety disorder. We found that antisocial personality disorder and phobias generally had onsets prior to the onset of drug dependence (that is, they were primary disorders). The majority of drug dependent persons with generalized anxiety disorder reported an onset after the onset of drug dependence (that is, they had secondary generalized anxiety). Alcohol dependence, depression, and dysthymia were divided nearly evenly between earlier (primary disorder) and later (secondary disorder). These results are consistent with the body of literature indicating the importance of antisocial syndromes in the etiology of substance abuse and the literature indicating the complex, varying nature of the relationship of psychiatric disorders to substance dependence. Finally, a precise nomenclature for "age of onset," "primary," and "secondary" was developed for this study that is critical to understanding these issues and is recommended for other studies.
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PMID:Psychiatric disorders among drug dependent subjects: are they primary or secondary? 1093 74

Despite advances in characterizing human genotypes, the complex process through which genes exert their influence limits the application of molecular genetics to human diseases. Substance use disorders are necessarily complicated by gene-environment interaction because exposure to an exogenous substance is required for their development. The methods of genetic epidemiology are specifically designed to identify sources of complexity that impede etiologic findings and prevention efforts. The goal of this paper is to illustrate the application of family study methods to identify risk factors for substance abuse and their implications for prevention. The Yale Family Study is a controlled family study of the comorbidity of substance and psychiatric disorders. The sample consists of 223 probands with substance use and/or an anxiety disorders and community controls, 1218 adult first degree relatives and spouses, and 203 offspring (ages 7-17) followed for 8 years. Results indicated familial aggregation of substance disorders in adults and children, independence of familial aggregation of alcoholism and drug dependence, and specificity of familial clustering of some drugs of abuse. Familial factors are more strongly associated with substance dependence than abuse, with an attributable risk of 55%. Premorbid psychiatric disorders--social phobia and bipolar affective disorder in adults, and depression, anxiety, conduct, and oppositional defiant disorders in children--were strongly associated with the subsequent development of substance dependence (attributable risks ranging from 44 to 86%). A family history of substance abuse and premorbid psychopathology are strongly associated with the development of substance use disorders. Implications for primary and secondary prevention are discussed. As specific genetic vulnerability markers for substance use disorders become identified, application of the tools of genetic epidemiology may be employed to identify specific environmental risk factors that may serve as targets for prevention.
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PMID:Implications of genetic epidemiology for the prevention of substance use disorders. 1112 72

Attempted suicide is an act associated with childhood sexual abuse, depression, bipolar illness, substance abuse, and other diagnoses, as documented in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) (American Psychiatric Association [APA], 1994). Three women, who attended a group to decrease their depression and increase their self-esteem and who had histories of multiple suicide attempts, agreed to participate in interviews designed to determine the common factors associated with their suicide attempts and to examine the assertion that their suicide attempts were an addiction, similar to their addictions to alcohol and drugs. The common factors found were depression, substance use disorders with early abuse and risky behaviors, history of sexual abuse, faulty relationships, alteration of mood with a suicide plan, and distorted and illogical thinking and motivation. The similarities to addiction also were described. Based on the complexity of factors that emerged and the addictive nature of the suicide attempts, treatment for similar patients needs to be multidimensional and ongoing to allow sufficient time to monitor progress and address the numerous factors involved.
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PMID:Repeated suicide attempts. 1113 4

This study examined the concurrent validity and clinical correlates of the Constructive Thinking Inventory (CTI), a measure of experiential coping, in 551 adolescents aged 14-18 years with and without Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) substance use disorders (SUDs). The CTI was correlated with depression, anxiety, and conduct problems. After controlling for demographics and comorbid lifetime psychiatric disorders, the CTI scales of Behavioral Coping and Categorical Thinking distinguished adolescents with and without SUDs. Implications of these findings for assessment and treatment are discussed.
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PMID:Constructive thinking in adolescents with substance use disorders. 1141 35

This paper describes the nature and comorbidity of substance use and other psychiatric disorders in 157 impaired practitioners notified to the Medical Practitioners Board of Victoria from 1983 to 1997. Diagnoses were reduced to three diagnostic categories, viz, substance use disorder (n = 62), other psychiatric disorder (n = 62), and combined substance use and other psychiatric disorder (n = 33). Sixty nine percent of those with other psychiatric disorders suffered either bipolar disorder (n = 27), schizophrenia (n = 22), or depression (n = 17). Psychiatric comorbidity in drug-related diagnoses was 26% and in alcohol-related diagnoses 64%. Sixty five percent of substance use disorders were notified more than 12 months after onset of impairment, and 49% of all practitioners (71% with substance use disorder) did not receive treatment prior to notification. This combined with a high relapse rate (41%) makes some impaired practitioners a risk to their patients.
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PMID:Substance use and other psychiatric disorders in impaired practitioners. 1143 82

The impact of psychological trauma in the workplace often goes unaddressed. The untreated aftermath of these critical incidents may manifest itself in various states of anxiety, depression, substance use disorders, and even subsequent violence by the victims. This paper reviews common presentations of untreated traumatic events and provides suggestions for outreach to untreated employee victims as well as basic prevention strategies to reduce the risk of additional episodes of violence and enhance safety in health care facilities, including long-term care (LTC) and special-care units (SCU) for dementia patients.
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PMID:The employee victim of violence: recognizing the impact of untreated psychological trauma. 1150 45


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