Suchergebnisse

Fragestellung: Welche neurobiologischen Erkenntnisse zu Ursachen und Folgen übermäßigen Alkoholkonsums bei Kindern und Jugendlichen sind gegenwärtig bekannt? </p><p> Methodik: Überblick über einschlägige epidemiologische und experimentelle Studien. </p><p> Ergebnisse: Eine Reihe neurobiologischer Faktoren beeinflusst das Trinkverhalten Jugendlicher und das Risiko für spätere Alkoholabhängigkeit. Sie sind größtenteils genetisch beeinflusst, entfalten ihr Risikopotential jedoch erst durch wechselseitige Interaktion mit Umwelteinflüssen. Bereits im Jugendalter können Alkoholfolgeschäden am Gehirn und seiner Funktion auftreten. </p><p> Schlussfolgerungen: Das Vermeiden übermäßigen Alkoholkonsums im Jugendalter begünstigt den noch im Ablauf befindlichen Prozess der Gehirnreifung und verringert die Gefahr späterer Alkoholsucht.

BACKGROUND: Integrated care is a promising model for pregnant and parenting women with problems related to methamphetamine use. Yet more research is imperative to guide services for this vulnerable population as methamphetamine use contributes to housing instability, which is associated with heavier use and overdose death. METHOD: This prospective observational study analyzed how housing at discharge from psychiatric care was related to patient characteristics, program participation, and aftercare in 102 pregnant and/or parenting women. RESULTS: Twelve of 23 women who were unstably housed at admission (three of six homeless) achieved stable housing by discharge from integrated care. Women were more likely unstably housed at discharge when unstably housed at admission, single, living apart from at least one minor, or when the other parent had a substance use disorder (p < 0.05). Unstably housed women at discharge were also more likely to have used social and inpatient services, and to transition to inpatient rehabilitation (p < 0.05). Among baseline characteristics, logistic regression identified unstable housing at admission (OR = 6.07) and being single (OR = 4.01) as the strongest unique contributors to unstable housing at discharge (p < 0.05). CONCLUSION: Unstably housed women and single women seem particularly at risk of remaining in precarious living conditions despite accessing integrated care for problems associated with methamphetamine use. Future work should investigate whether stronger partnerships with government and community agencies could be a way forward to help these women attain and maintain stable housing.

Background: Methamphetamine use is a rapidly increasing cause of morbidity and mortality. Pregnant women and new parents who consume methamphetamine are at high risk since they seldom seek health services despite having multiple needs. We addressed this care gap by implementing an easily accessible program that pools resources from psychiatric, obstetric, and pediatric departments as well as community and government agencies. Method: This real-life observational study evaluated an integrated care program in 27 expecting parents and 57 parents of minors. The outcome criteria were treatment retention, psychosocial functioning, and abstinence. We compared participant demographics according to outcome and applied ordinal logistic regression to predict treatment success. Results: Patients received integrated care for almost 7 months on average. Nearly half achieved stable abstinence and functional recovery. Only one pregnant woman dropped out before a care plan could be implemented, and all women who gave birth during treatment completed it successfully. Three-fourths of patients had psychiatric comorbidities. Patients with depressive disorders were almost 5 times less likely to succeed with treatment. Attention-deficit hyperactivity disorder (ADHD) was diagnosed in nearly 30% of patients who dropped out of a care plan, which was about 4 times more often than in the successful outcome group. Conclusion: Our program engaged pregnant women and parents in treatment and helped them recover from methamphetamine-related mental disorders. Management of comorbid ADHD and depression should be an integral part of care initiatives to counter the methamphetamine crisis that affects parents and children across the globe.

<b><i>Background/Aims:</i></b> Adolescent alcohol binge-induced hospital admissions (BIHAs) are an increasing problem in Europe. We investigated whether psychosocial factors (e.g., drinking situations, drinking occasions and neighborhood unemployment) are associated with particularly risky patterns of alcohol or substance use. <b><i>Method:</i></b> We performed a systematic retrospective chart review of all the respective cases in 2003-2008 (n = 586; age range: 12-17 years) from both pediatric hospitals in the city of Dresden, Germany. <b><i>Results:</i></b> The vast majority of adolescent BIHAs were associated with drinking together with peers at weekend parties. Compared to this 'typical' drinking pattern, adolescents drinking 'atypically' (i.e., drinking either alone, to cope or despite the fact that the next day was a school/work day) more often had already used alcohol and illegal substances before and were more often diagnosed with substance use disorders and other mental disorders prior to BIHA. The unemployment rate in the patients' neighborhood was positively related to the incidence proportion of adolescent BIHAs in the respective subdistricts (r_s = 0.61). <b><i>Conclusion:</i></b> Adolescent atypical drinking may indicate an increased risk for the development of alcohol and substance use disorders. This information is quickly accessible and can alert clinicians to initiate psychosocial aftercare; their infrastructure should address the strong relation between BIHA probability and neighborhood unemployment rates.

Background: Treatment of patients with acute mania remains a considerable medical challenge since onset of action of antimanic medication is delayed for several days. Psychostimulants could have an earlier onset of action. This assumption is based on the 'vigilance regulation model of mania' which postulates that vigilance is unstable in manic patients. Accordingly, vigilance-stabilising psychostimulants could be more useful than conventional treatment in acute mania. We present here the study protocol of a trial intended to study the efficacy and safety of methylphenidate in the initial treatment of acute mania. Methods/design: A multi-centre, randomised, double-blind, placebo-controlled clinical trial will be conducted in 88 bipolar inpatients with acute mania. Male and female patients older than 18 years will be randomised to treatment with either methylphenidate (20 to 40 mg/day) or placebo for 2.5 days, given once or twice daily. The main outcome measure is the reduction in the Young Mania Rating Scale (YMRS) after 2.5 days of treatment. Other outcome measures include the Positive and Negative Syndrome Scale-Excited Component (PANSS-EC) the Clinical Global Impression–Bipolar Scale (CGI-BP), the Screen for Cognitive Impairment in Psychiatry (SCIP), actigraphy and the EEG-'Vigilance Algorithm Leipzig' (VIGALL). Discussion: A positive study outcome of the proposed study could substantially impact our understanding of the etiopathogenesis of mania and open new treatment perspectives. ; The study is supported by a grant of the Spanish 'Ministerio de Sanidad, Politica Social e Igualdad' (Ministry of Health, Social Politics and Equality) which was provided after a peer review process and by the Instituto de Salud Carlos III of Spain. Study drug is kindly provided by Medice, Iserlohn, Germany. Training videos for training on the YMRS are kindly provided by Bracket, Wayne, USA