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Deutsches Arzteblatt International Jun 2022The most common substance use disorders in childhood and adolescence have to do with alcohol and cannabis. These disorders begin as early as puberty, are often... (Review)
Review
BACKGROUND
The most common substance use disorders in childhood and adolescence have to do with alcohol and cannabis. These disorders begin as early as puberty, are often accompanied by other mental disorders, and, if untreated, very frequently persist into adulthood.
METHODS
This review is based on pertinent publications retrieved by a selective search in PubMed on substance use disorders in children and adolescents.
RESULTS
Substance use disorders are among the commonest mental disorders in childhood and adolescence. In Germany, approximately 10% of adolescents have tried cannabis at least once. The prognosis is negatively affected by individual (bio-)psychological traits, mental comorbidities, laws that facilitate consumption, socioeconomic disadvantage, consuming peers, and parental substance use disorders. A timely diagnosis, motivation by the pediatrician, and referral to specialized child and adolescent psychiatric services helps assure that those affected receive appropriate treatment, with the goal of abstinence from the substance as well as improvement in emotional regulation, affectivity, and attention. According to studies from the English-speaking countries and considering all treatment forms, treatment is completed by approximately 60% to 65% of children and adolescents; 20% to 40% of these patients are abstinent six months after the end of treatment. No studies of this type have been carried out to date in Germany.
CONCLUSION
As the results of treatment are generally poor, there is a major need for research on the treatment and care of children and adolescents with substance use disorders. In particular, the interfaces between outpatient and inpatient care need further improvement.
Topics: Adolescent; Adult; Cannabis; Child; Comorbidity; Family; Humans; Mental Disorders; Outpatients; Substance-Related Disorders
PubMed: 35635442
DOI: 10.3238/arztebl.m2022.0122 -
European Psychiatry : the Journal of... Apr 2022There is increasing attention on the association of socioeconomic status and individual behaviors (SES/IB) with mental health. However, the impacts of SES/IB on mental...
BACKGROUND
There is increasing attention on the association of socioeconomic status and individual behaviors (SES/IB) with mental health. However, the impacts of SES/IB on mental disorders are still unclear. To provide evidence for establishing feasible strategies on disease screening and prevention, we implemented Mendelian randomization (MR) design to appraise causality between SES/IB and mental disorders.
METHODS
We conducted a two-sample MR study to assess the causal effects of SES and IB (dietary habits, habitual physical activity, smoking behaviors, drinking behaviors, sleeping behaviors, leisure sedentary behaviors, risky behaviors, and reproductive behaviors) on three mental disorders, including bipolar disorder, major depressive disorder and schizophrenia. A series of filtering steps were taken to select eligible genetic instruments robustly associated with each of the traits. Inverse variance weighted was used for primary analysis, with alternative MR methods including MR-Egger, weighted median, and weighted mode estimate. Complementary methods were further used to detect pleiotropic bias.
RESULTS
After Bonferroni correction and rigorous quality control, we identified that SES (educational attainment), smoking behaviors (smoking initiation, number of cigarettes per day), risky behaviors (adventurousness, number of sexual partners, automobile speeding propensity) and reproductive behavior (age at first birth) were causally associated with at least one of the mental disorders.
CONCLUSIONS
MR study provides robust evidence that SES/IB play broad impacts on mental disorders.
Topics: Bipolar Disorder; Depressive Disorder, Major; Genome-Wide Association Study; Humans; Mendelian Randomization Analysis; Mental Disorders; Social Class
PubMed: 35431011
DOI: 10.1192/j.eurpsy.2022.18 -
Anaesthesia Apr 2021Perinatal mental illness is common, affecting up to 20% of women, but remains under-recognised and under-diagnosed. It may have adverse effects on pregnancy and neonatal... (Review)
Review
Perinatal mental illness is common, affecting up to 20% of women, but remains under-recognised and under-diagnosed. It may have adverse effects on pregnancy and neonatal outcomes, and mental disorder remains one of the leading causes of maternal death in the UK. Women with mental ill health face difficult decisions in balancing risks and benefits of treatment. Stigma related to mental disorder may lead to non-engagement with maternity care. Some disorders bring specific challenges for anaesthetists working in maternity settings and it is vital that anaesthetists have knowledge of these disorders so they may offer care which is sensitive and appropriate.
Topics: Antidepressive Agents; Anxiety Disorders; Depressive Disorder; Electroconvulsive Therapy; Female; Humans; Mental Disorders; Postpartum Period; Pregnancy; Pregnancy Complications
PubMed: 33682099
DOI: 10.1111/anae.15424 -
Journal of the American Academy of... Oct 2010To present estimates of the lifetime prevalence of DSM-IV mental disorders with and without severe impairment, their comorbidity across broad classes of disorder, and...
OBJECTIVE
To present estimates of the lifetime prevalence of DSM-IV mental disorders with and without severe impairment, their comorbidity across broad classes of disorder, and their sociodemographic correlates.
METHOD
The National Comorbidity Survey-Adolescent Supplement NCS-A is a nationally representative face-to-face survey of 10,123 adolescents aged 13 to 18 years in the continental United States. DSM-IV mental disorders were assessed using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview.
RESULTS
Anxiety disorders were the most common condition (31.9%), followed by behavior disorders (19.1%), mood disorders (14.3%), and substance use disorders (11.4%), with approximately 40% of participants with one class of disorder also meeting criteria for another class of lifetime disorder. The overall prevalence of disorders with severe impairment and/or distress was 22.2% (11.2% with mood disorders, 8.3% with anxiety disorders, and 9.6% behavior disorders). The median age of onset for disorder classes was earliest for anxiety (6 years), followed by 11 years for behavior, 13 years for mood, and 15 years for substance use disorders.
CONCLUSIONS
These findings provide the first prevalence data on a broad range of mental disorders in a nationally representative sample of U.S. adolescents. Approximately one in every four to five youth in the U.S. meets criteria for a mental disorder with severe impairment across their lifetime. The likelihood that common mental disorders in adults first emerge in childhood and adolescence highlights the need for a transition from the common focus on treatment of U.S. youth to that of prevention and early intervention.
Topics: Adolescent; Age of Onset; Alcoholism; Anxiety Disorders; Comorbidity; Cross-Cultural Comparison; Cross-Sectional Studies; Diagnostic and Statistical Manual of Mental Disorders; Female; Health Surveys; Humans; Interview, Psychological; Male; Mental Disorders; Mood Disorders; Personality Assessment; Socioeconomic Factors; Substance-Related Disorders; United States
PubMed: 20855043
DOI: 10.1016/j.jaac.2010.05.017 -
The American Journal of Psychiatry Sep 2018In both child and adult psychiatry, empirical evidence has now accrued to suggest that a single dimension is able to measure a person's liability to mental disorder,... (Review)
Review
In both child and adult psychiatry, empirical evidence has now accrued to suggest that a single dimension is able to measure a person's liability to mental disorder, comorbidity among disorders, persistence of disorders over time, and severity of symptoms. This single dimension of general psychopathology has been termed "p," because it conceptually parallels a dimension already familiar to behavioral scientists and clinicians: the "g" factor of general intelligence. As the g dimension reflects low to high mental ability, the p dimension represents low to high psychopathology severity, with thought disorder at the extreme. The dimension of p unites all disorders. It influences present/absent status on hundreds of psychiatric symptoms, which modern nosological systems typically aggregate into dozens of distinct diagnoses, which in turn aggregate into three overarching domains, namely, the externalizing, internalizing, and psychotic experience domains, which finally aggregate into one dimension of psychopathology from low to high: p. Studies show that the higher a person scores on p, the worse that person fares on measures of family history of psychiatric illness, brain function, childhood developmental history, and adult life impairment. A dimension of p may help account for ubiquitous nonspecificity in psychiatry: multiple disorders share the same risk factors and biomarkers and often respond to the same therapies. Here, the authors summarize the history of the unidimensional idea, review modern research into p, demystify statistical models, articulate some implications of p for prevention and clinical practice, and outline a transdiagnostic research agenda. [AJP AT 175: Remembering Our Past As We Envision Our Future October 1910: A Study of Association in Insanity Grace Helen Kent and A.J. Rosanoff: "No sharp distinction can be drawn between mental health and mental disease; a large collection of material shows a gradual and not an abrupt transition from the normal state to pathological states."(Am J Psychiatry 1910; 67(2):317-390 )].
Topics: Humans; Mental Disorders; Models, Psychological; Psychopathology
PubMed: 29621902
DOI: 10.1176/appi.ajp.2018.17121383 -
Psychological Medicine Apr 2021The question of 'what is a mental disorder?' is central to the philosophy of psychiatry, and has crucial practical implications for psychiatric nosology. Rather than... (Review)
Review
The question of 'what is a mental disorder?' is central to the philosophy of psychiatry, and has crucial practical implications for psychiatric nosology. Rather than approaching the problem in terms of abstractions, we review a series of exemplars - real-world examples of problematic cases that emerged during work on and immediately after DSM-5, with the aim of developing practical guidelines for addressing future proposals. We consider cases where (1) there is harm but no clear dysfunction, (2) there is dysfunction but no clear harm, and (3) there is possible dysfunction and/or harm, but this is controversial for various reasons. We found no specific criteria to determine whether future proposals for new entities should be accepted or rejected; any such proposal will need to be assessed on its particular merits, using practical judgment. Nevertheless, several suggestions for the field emerged. First, while harm is useful for defining mental disorder, some proposed entities may require careful consideration of individual v. societal harm, as well as of societal accommodation. Second, while dysfunction is useful for defining mental disorder, the field would benefit from more sharply defined indicators of dysfunction. Third, it would be useful to incorporate evidence of diagnostic validity and clinical utility into the definition of mental disorder, and to further clarify the type and extent of data needed to support such judgments.
Topics: Diagnostic and Statistical Manual of Mental Disorders; Humans; Mental Disorders; Terminology as Topic
PubMed: 33843505
DOI: 10.1017/S0033291721001185 -
Academic Psychiatry : the Journal of... Oct 2015Attending college can be a stressful time for many students. In addition to coping with academic pressure, some students have to deal with the stressful tasks of... (Review)
Review
Attending college can be a stressful time for many students. In addition to coping with academic pressure, some students have to deal with the stressful tasks of separation and individuation from their family of origin while some may have to attend to numerous work and family responsibilities. In this context, many college students experience the first onset of mental health and substance use problems or an exacerbation of their symptoms. Given the uniqueness of college students, there is a need to outline critical issues to consider when working with this population. In this commentary, first, the prevalence of psychiatric and substance use problems in college students and the significance of assessing age of onset of current psychopathology are described. Then, the concerning persistent nature of mental health problems among college students and its implications are summarized. Finally, important aspects of treatment to consider when treating college students with mental health problems are outlined, such as the importance of including parents in the treatment, communicating with other providers, and employing of technology to increase adherence. It is concluded that, by becoming familiar with the unique problems characteristic of the developmental stage and environment college students are in, practitioners will be able to better serve them.
Topics: Humans; Mental Disorders; Students; Universities
PubMed: 25142250
DOI: 10.1007/s40596-014-0205-9 -
Journal of Autism and Developmental... Jan 2019Since Hans Asperger's first description (Arch Psych Nervenkrankh 117:76-136, 1944), through Lorna Wing's translation and definition (Psychol Med 11:115-129, 1981), to... (Comparative Study)
Comparative Study
Since Hans Asperger's first description (Arch Psych Nervenkrankh 117:76-136, 1944), through Lorna Wing's translation and definition (Psychol Med 11:115-129, 1981), to its introduction in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM, 1994), Asperger Syndrome has always aroused huge interest and debate, until vanishing in the DSM fifth edition (2013). The debate regarded its diagnostic validity and its differentiation from high functioning autism (HFA). The present study aimed to examine whether AS differed from HFA in clinical profiles and to analyze the impact of DSM-5's innovation. Differences in cognitive, language, school functioning and comorbidities, were revealed when 80 AS and 70 HFA patients (3-18 years) were compared. Results suggested that an AS empirical distinction within autism spectrum disorder should be clinically useful.
Topics: Academic Success; Adolescent; Asperger Syndrome; Autism Spectrum Disorder; Autistic Disorder; Child; Child, Preschool; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Male; Mental Disorders
PubMed: 30043350
DOI: 10.1007/s10803-018-3689-4 -
Preventing Chronic Disease Jan 2010Understanding of the definitions of wellness and illness has changed from the mid-20th century to modern times, moving from a diagnosis-focused to a person-focused...
Understanding of the definitions of wellness and illness has changed from the mid-20th century to modern times, moving from a diagnosis-focused to a person-focused definition of mental illnesses, and from an "absence of disease" model to one that stresses positive psychological function for mental health. Currently, wellness refers to the degree to which one feels positive and enthusiastic about oneself and life, whereas illness refers to the presence of disease. These definitions apply to physical as well as mental illness and wellness. In this article, we build on the essential concepts of wellness and illness, discuss how these definitions have changed over time, and discuss their importance in the context of health reform and health care reform. Health reform refers to efforts focused on health, such as health promotion and the development of positive well-being. Health care reform refers to efforts focused on illness, such as treatment of disease and related rehabilitation efforts.
Topics: Attitude to Health; Health Promotion; History, 20th Century; Humans; Mental Disorders; Terminology as Topic; United States
PubMed: 20040234
DOI: No ID Found -
International Journal of Molecular... Apr 2023Mental disorders and substance use disorders affect approximately 13% of the world's population [...].
Mental disorders and substance use disorders affect approximately 13% of the world's population [...].
Topics: Humans; Mental Disorders; Substance-Related Disorders
PubMed: 37108266
DOI: 10.3390/ijms24087104