Cannabis is one of the most commonly used substances in the world. However, its effects on human cognition are not yet fully understood. Although the cerebellum has the highest density of cannabinoid ...receptor type 1 (CB1R) in the human brain, literature on how cannabis use affects cerebellar-dependent learning is sparse. This study examined the effect of chronic cannabis use on sensorimotor adaptation, a cerebellar-mediated task, which has been suggested to depend on endocannabinoid signaling.
Chronic cannabis users (n = 27) with no psychiatric comorbidities and healthy, cannabis-naïve controls (n = 25) were evaluated using a visuomotor rotation task. Cannabis users were re-tested after 1 month of abstinence (n = 13) to assess whether initial differences in performance would persist after cessation of use.
Cannabis users showed lower adaptation rates compared to controls at the first time point. However, this difference in performance did not persist when participants were retested after one month of abstinence (n = 13). Healthy controls showed attenuated implicit learning in the late phase of the adaptation during re-exposure, which was not present in cannabis users. This explains the lack of between group differences in the second time point and suggests a potential alteration of synaptic plasticity required for cerebellar learning in cannabis users.
Overall, our results suggest that chronic cannabis users show alterations in sensorimotor adaptation, likely due to a saturation of the endocannabinoid system after chronic cannabis use.
Gender-based violence (GBV) among female refugees/asylum seekers is a major underreported/understudied psychosocial issue. The aims of this study were: to describe the proportion of GBV-related ...experiences among female refugees/asylum seekers referred to a Cultural Consultation Service (CCS) in Montreal; to describe their sociodemographic and clinical characteristics; and to compare these characteristics among women who make GBV their principal refugee claim (Group A), those who did not but had suffered GBV (Group B1), and those who had never reported GBV (Group B2). Data on sociodemographic and clinical variables and GBV were gathered by chart review. Data were analyzed using chi-square for categorical and ANOVA for continuous comparisons. A total of 91 female refugees/asylum seekers were evaluated from 2000 to 2013; 80% (73/91) having reported GBV, with 38.5% (35/91) using GBV as the principal reason for seeking asylum in Canada (Group A), mainly due to intimate partner violence (IPV). Fully 66.6% (38/56) of women who sought asylum for reasons other than GBV reported having experienced GBV (Group B1). When compared to the other groups, Group A women exhibited a number of statistically significant differences: they tended to migrate alone (p < .001), be divorced/single (p = .02), have more suicidal thoughts/behaviors (p < .001), and report a history of IPV (p < .001). Women from Group B1 were more likely to be diagnosed with Affective Disorders (p = .045), and to have suffered sexual violence (p < .001). Results suggest that GBV is frequently experienced by refugee/asylum seeker women in this small, tertiary care clinical sample. When assessing refugee women such as these, differences in the kind of violence suffered, migration process, family/social support, and clinical related features should be taken into account and explored by clinicians in a culturally appropriate and safe manner.
Although cannabis is widely used, it remains unclear which consumption patterns are more likely to produce future consequences (risky/hazardous use) or current damage (problematic/harmful use). This ...unresolved issue contributes to cannabis public health implications. In order to facilitate further consensus, this review analyzes previously used definitions in the literature. Methods: This systematic review was performed following the PRISMA guidelines. Articles published before October 2015 in the Medline, Scopus-Elsevier, ISI-Web of Knowledge and Cochrane databases and fulfilling a-priori decided criteria were retrieved. Definitions in preselected websites of national and international organizations addressing drug problems were also included. Results: Definitions identified in articles (n = 46) and official websites (n = 3) widely varied from each other. Weekly cannabis use was mostly considered risky. Problematic cannabis use was mostly described with the Cannabis Abuse and Screening Test. Evidence-based definitions as well as information on quantities consumed, time-frames and special considerations for risky groups were very limited. Conclusions: Working on official definitions is highly necessary as criteria used remain incomplete, leading to increased confusion in the field. Recommendations to improve existing definitions are given.
Celotno besedilo
Dostopno za:
DOBA, FSPLJ, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Affective psychoses include those disorders with psychotic and affective symptoms described in the DSM-IV-TR. In these pathologies, the prevalence of nicotine dependence is very high. The objective ...here is to carry out a review of the relation between nicotine use and psychiatric disorders considered as affective psychoses at the epidemiological, clinical, prognostic and treatment levels. We review studies published in the PubMed database that include the keywords smoking, tobacco, nicotine and schizoaffective or bipolar disorder. Comorbidity of bipolar and schizoaffective disorder with nicotine consumption is 66-82.5 % and 67%, respectively. On the basis of this review it can be concluded that smoking results in poorer prognosis and greater clinical seriousness of bipolar and schizoaffective disorders. Use of other substances, psychiatric diagnosis, clinical seriousness and caffeine consumption are risk factors for nicotine use. The most effective treatment approach is pharmacological treatment in combination with psychological interventions. The first-line medication for tobacco detoxification and dishabituation are substitution therapy (transdermal patches, sprays, sublingual tablets, sucking pills or nicotine chewing gums), varenicline and bupropion. The medically indicated treatment for psychotic symptoms is atypical antipsychotics, due to their better tolerability profile and better results in smoking cessation.
The Standard Joint Unit Casajuana Kögel, Cristina; Balcells-Olivero, María Mercedes; López-Pelayo, Hugo ...
Drug and alcohol dependence,
07/2017, Letnik:
176
Journal Article
Recenzirano
Highlights • Standard units exist for alcohol but not for cannabis. • A Standard Joint Unit (SJU) accounts for Delta-9-Tetrahydrocannabinol (9-THC) content. • It converts information typically given ...by cannabis users into 9-THC quantities. • 1 SJU = 1 joint of marihuana or hashish = 0.25 g of cannabis = 7 mg of 9-THC. • The SJU is useful for in clinical, epidemiological, and research purposes.
Alcoholic hepatitis (AH) is a life-threatening complication of alcohol use disorder (AUD). Alcohol abstinence is the main predictor of the long-term prognosis of AH. It is unknown whether AUD ...treatment retention (TR) after an AH episode impacts alcohol relapse and mortality or what baseline factors influence TR.
Design: case-control study; Study population: hospitalized patients (1999–2012) with an episode of biopsy-proven AH were included (n = 120); Assessment: demographic and clinical data, the High-Risk Alcoholism Relapse (HRAR) scale, mortality and alcohol relapse were assessed through clinical records and telephone or personal interviews; Follow-up period: short-term and long-term TRs were assessed at 12 and 24 months, respectively.
The overall short-term and long-term TRs were 37% and 27.8%, respectively. The severity of liver disease at baseline predicted both short-term and long-term TR (OR 3.7 and 3.3, respectively), whereas HRAR >3 and a history of psychiatric disorders predicted long-term TR (OR 2.9 and 2.6, respectively). Moreover, HRAR >3 (OR 3.0) and previous treatment for AUD (OR 2.9) increased the risk of relapse in the short term. Importantly, receiving alcohol therapy in a centre different from the hospital where the patient was admitted was associated with increased risk of alcohol relapse over the long term (OR 5.4).
Experiencing an alcohol-related life-threatening complication is insufficient motivation to seek treatment for AUD. AUD treatment after an episode of AH is suboptimal, with a low TR rate, high risk of alcohol relapse and poor impact of treatment on alcohol relapse.
•Alcohol Use Disorder treatment retention rate after alcoholic hepatitis is low.•There is a high risk of alcohol relapse after an alcoholic hepatitis episode.•The Impact of Alcohol Use Disorder treatment is insufficient.•Strategies for managing Alcohol Use Disorders after alcoholic hepatitis are required.
To examine the association between drinking levels and inpatient health service utilization in people with a lifetime diagnosis of alcohol dependence.
A longitudinal prospective study was conducted ...in a cohort of patients with alcohol dependence who had undergone treatment in 1987. Current results refer to the association between drinking patterns at 20-year follow-up and subsequent inpatient health service utilization. At 20 years after baseline, 530 of 850 patients were alive with administrative data available. Follow-up interview was conducted on 378 patients. There were 88 refusals and 64 could not be traced. Three categories of alcohol consumption were established (abstainers, moderate drinkers and heavy drinkers) depending on the pattern of alcohol use during the last year prior to the evaluation. Health service utilization was based on official statistics, including admissions to general, rehabilitation and psychiatric hospitals. The time period analysed was 5 years after the assessment of drinking patterns.
Admission rates were lowest for abstainers compared to people with moderate and heavy drinking. With respect to hospital days, heavy drinking was associated with significantly higher adjusted rates than both abstainers and moderate drinkers. Alcohol-related diagnoses in hospital admissions were more frequent for both moderate and heavy drinkers.
Abstinence and moderate alcohol consumption were both associated with lower hospitalization in people with a lifetime diagnosis of alcohol dependence. Thus, not only abstinence-oriented treatment strategies but also those to reduce alcohol intake would reduce inpatient hospitalizations.
Abstention and reduced drinking in lifetime alcohol-dependent patients were associated with lower health care utilization compared to heavy drinking. Alcohol treatment strategies for alcohol-dependent patients have a positive impact on the reduction in health care utilization. An increase in treatment rate for alcohol use disorders will consequently have marked population health improvements.
Pre-exposure prophylaxis (PrEP) is a biomedical intervention that has demonstrated efficacy in HIV prevention in individuals at high-risk, among them chemsex users. Out of 190 PrEP users followed at ...Hospital Clinic of Barcelona until October 2020, 89% reported drug use, and 63% disclosed that they had engaged in chemsex practices, initiated in 64% of cases within the past year. Twenty-one percent used 3 or more drugs simultaneously, being GHB/GBL, nitrites, sildenafil, and methamphetamine the most prevalent combination. Eight percent reported slamming. Forty-one percent described having had negative experiences and 8% did not remember the last time they had sober sex. Methamphetamine, mephedrone, GHB/GBL, and having had open relationships, group sex, double penetration, and fisting were significantly more prevalent. Forty-nine percent admitted being worried about chemsex use, and 18% said they needed help. A comprehensive, interdisciplinary approach is mandatory to enable the attainment of a healthy approach to one’s sex life.
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