Delivering substance use prevention interventions for adolescents in educational settings:A scoping review

Currently,a proportion of adolescents use alcohol,tobacco,and illicit drugs,which inevitably harms their health and academic progress.Adolescence is a peak period for substance use initiation and a critical time for preventing substance use problems.Various entities,such as families,schools,and communities,have implemented a variety of interventions to alleviate adolescent substance use problems,and schools play a unique role.To explore the types,characteristics,and effectiveness of substance use interventions in educational settings for adolescents,we conducted a scoping review and identified 32 studies after screening.We divided the 32 studies according to intervention type,including curriculum interventions focusing on cognitive-behavioral skill enhancement,exercise interventions,peer interventions and family-school cooperation,and electronic interventions.Except for the mixed results on electronic interventions,the results showed that the other interventions were beneficial to different extents in alleviating adolescent substance use problems.In addition,we analyzed and summarized the advantages and challenges of intervening in adolescent substance use in educational settings.Schools can use equipment and human resources to provide adolescents with various types of intervention measures,but they also face challenges such as stigmatization,ineffective coordination among multiple resources,and poor implementation effects.In the future,school-based intervention measures can fully utilize big data and artificial intelligence technology and collaborate with families and communities to intervene appropriately while paying attention to the comorbidity risks of substance use disorders and psychological health issues.

Identification and treatment of individuals with attentiondeficit/ hyperactivity disorder and substance use disorder: An expert consensus statement

Attention-deficit/hyperactivity disorder(ADHD)often co-occurs with substance use(SU)and/or substance use disorder(SUD).Individuals with concurrent ADHD and SU/SUD can have complex presentations that may complicate diagnosis and treatment.This can be further complicated by the context in which services are delivered.Also,when working with young people and adults with co-existing ADHD and SU/SUD,there is uncertainty among healthcare practitioners on how best to meet their needs.In February 2022,the United Kingdom ADHD Partnership hosted a meeting attended by multidisciplinary experts to address these issues.Following presentations providing attendees with an overview of the literature,group discussions were held synthesizing research evidence and clinical experience.Topics included:(1)A review of substances and reasons for use/misuse;(2)identification,assessment and treatment of illicit SU/SUD in young people and adults with ADHD presenting in community services;and(3)identification,assessment and treatment of ADHD in adults presenting in SU/SUD community and inpatient services.Discussions highlighted inter-service barriers and fragmentation of care.It was concluded that a multimodal and multi-agency approach is needed.The consensus group generated a table of practice recommendations providing guidance on:identification and assessment;pharmacological and psychological treatment;and multi-agency interventions.

Narrative minireview of the spatial epidemiology of substance use disorder in the United States:Who is at risk and where?

Drug overdose is the leading cause of death by injury in the United States.The incidence of substance use disorder(SUD)in the United States has increased steadily over the past two decades,becoming a major public health problem for the country.The drivers of the SUD epidemic in the United States have changed over time,characterized by an initial heroin outbreak between 1970 and 1999,followed by a painkiller outbreak,and finally by an ongoing synthetic opioid outbreak.The nature and sources of these abused substances reveal striking differences in the socioeconomic and behavioral factors that shape the drug epidemic.Moreover,the geospatial distribution of the SUD epidemic is not homogeneous.The United States has specific locations where vulnerable communities at high risk of SUD are concentrated,reaffirming the multifactorial socioeconomic nature of this epidemic.A better understanding of the SUD epidemic under a spatial epidemiology framework is necessary to determine the factors that have shaped its spread and how these patterns can be used to predict new outbreaks and create effective mitigation policies.This narrative minireview summarizes the current records of the spatial distribution of the SUD epidemic in the United States across different periods,revealing some spatiotemporal patterns that have preceded the occurrence of outbreaks.By analyzing the epidemic of SUD-related deaths,we also describe the epidemic behavior in areas with high incidence of cases.Finally,we describe public health interventions that can be effective for demographic groups,and we discuss future challenges in the study and control of the SUD epidemic in the country.

Effects of mindfulness-based interventions on depressive symptoms in patients with substance use disorders:a systematic review and meta-analysis

Objective:We examined the effects of mindfulness-based interventions(MBIs)on depressive symptoms in patients with substance use disorders(SUDs)and explored the moderating effects of participant,method,and intervention characteristics.Methods:We systematically searched 8 databases from their inception till November 2021.The inclusion criteria were primary studies evaluating MBIs in patients with SUDs with depression measured as an outcome,those including a control group,and those written in English.We used a random-effects model to compute effect sizes(ESs)using Hedges’g,a forest plot,and Q and I2 statistics as measures of heterogeneity;we also examined moderator analyses.Results:Nineteen studies included 1352 participants(age:38.6±7.0 years).Overall,MBIs showed significantly improved depression(g=0.67,95%confidence interval[CI]:0.29,1.05,I2=89%)compared to controls.With regard to moderators,providing MBIs as an individual plus group intervention had a greater effect(g=2.13)on reducing depressive symptoms than providing MBIs as a group intervention(g=0.64)or an individual intervention only(g=0.33,P=0.034).Using concealed allocation tended to reduce depressive symptoms(g=1.22)as compared to not using concealed allocation(g=0.48,P=0.086).No other quality indicators were demonstrated to have a moderating influence on the value of the ES.Conclusions:MBIs improved depressive symptoms in patients with SUDs.MBIs might be used as an adjunctive or alternative to conventional treatment for depressed patients with SUDs.

An Overview of the Connection between Hoarding Disorder and Substance Use Disorder

This essay explores the connections between Hoarding Disorder and Substance Use Disorder,two distinct mental health conditions with clear diagnostic criteria in the DSM-5.Hoarding Disorder,marked by excessive possession accumulation and difficulties in letting go,affects 2-6%of the global population,leading to severe consequences.Potential causes include genetic predisposition,neural issues,and traumatic experience.Substance Use Disorder is influenced by more societal factors.Both disorders share a comorbidity in Attention-Deficit/Hyperactivity Disorder(ADHD).Network analysis shows a strong direct relationship between Hoarding Disorder and ADHD,while social influences increase ADHD prevalence in Substance Use Disorder individuals.Moreover,both disorders benefit from Cognitive Behavioral Therapy(CBT).Exposure and Ritual Prevention effectively address hoarding symptoms,while CBT for Substance Use Disorder focuses on the interplay between thoughts,emotions,and actions.Despite being classified as a mental illness in DSM-5,Hoarding Disorder receives less attention than Substance Use Disorder.This essay aims to raise awareness of Hoarding Disorder by highlighting its commonalities with Substance Use Disorder in terms of causes,comorbidities,and treatment approaches.

Substance use and self-medication during pregnancy and associations with sociodemographic data:A cross-sectional survey

Objective:To identify women vulnerable to substance use and self-medication during pregnancy based on associations with socio-demographic data.Methods:Data were collected in person,with self-developed questionnaires,from pregnant women(n=422)in Chengdu,China,from July to November 2012.Multivariate logistic regression analysis was used to reveal associations with socio-demographic parameters.Results:Higher educational background,being employed,and higher educational background of the mother were associated with a 37%[odds ratio(OR):0.63,95%CI:0.45-0.89],65%(OR:0.35,95%CI:0.13-0.94),and 29%(OR:0.71,95%CI:0.53-0.96)less likelihood of alcohol use,respectively.Adverse pregnancy outcome was associated with a 2.13-fold(OR:2.13,95%CI:1.07-4.25)greater likelihood of alcohol use.Young age and higher educational background were associated with an 11%(OR:0.89,95%CI:0.81-0.98)and 31%(OR:0.69,95%CI:0.49-0.98)less likelihood of cigarette smoking,respectively.Conclusion:Socio-demographic parameters were associated with substance use during pregnancy and warrants targeted health education provided by nurses to pregnant women.

Craving variations in patients with substance use disorder and gambling during COVID-19 lockdown:The Italian experience

BACKGROUND Following the development of the coronavirus disease-2019(COVID-19)pandemic in Italy,a strict lockdown was imposed from March 9 to May 5,2020.The risks of self-medication through alcohol or psychoactive substance abuse were increased,as well as the tendency to adopt pathological behaviors,such as gambling and internet addiction.AIM To evaluate the impact of the COVID-19 pandemic and associated containment measures on craving in a group of patients suffering from substance use disorder and/or gambling disorder who were in treatment in outpatient units or in residency programs as inpatients.METHODS One hundred and fifty-three patients completed a structured questionnaire evaluating craving and other behaviors using a visual analogue scale(VAS).Forty-one subjects completed a pencil and paper questionnaire during the interview.The clinician provided an online questionnaire to 112 patients who had virtual assessments due to lockdown restrictions.Statistical analyses were performed using Statistica version 8.0.Quantitative parameters are presented as the mean±SD and qualitative parameters as number and percentage per class.The Kolmogorov-Smirnov test was used to check for normality of distributions.Analysis of variance and Duncan post hoc test were employed to analyze differences among subgroup means.The associations between variables were measured using Pearson's correlation.A P value of<0.05 was considered significant.RESULTS The variation in craving between the present and the month before showed VASrelated reductions of craving in 57%,increases in 24%,and no significant change in 19%of the sample.The level of craving was significantly higher(F=4.36;P<0.05)in outpatients(n=97;mean=3.8±3.1)living in their own home during the quarantine compared with inpatients(n=56;mean=2.8±2.8)in residential programs.Craving for tetrahydrocannabinol was the greatest(4.94,P<0.001)among various preferred substances.CONCLUSION The unexpected result of this study may be explained by a perceived lack of availability of substances and gambling areas and/or decreased social pressure on a subject usually excluded and stigmatized,or the acquisition of a new social identity based on feelings of a shared common danger and fate that overshadowed the sense of exclusion and rejection in the abuser.

Treatment outcome,cognitive function,and psychopathology in methamphetamine users compared to other substance users

BACKGROUND The rising number of people using methamphetamine leads to an increasing need for treatment options for this patient group.Evidence-based research on the efficacy of treatment programs for methamphetamine users is limited.Due to specific characteristics of methamphetamine users,the question arises whether established treatment methods for individuals using other substances can be effective for the treatment of methamphetamine dependence as well.We hypothesize that there are significant differences between the two groups that may affect the effectiveness of treatment and worsen the prognosis of treatment outcomes for methamphetamine users compared to consumers of other substances.AIM To investigate potential differences in cognitive functioning and psychopathology between methamphetamine users and other substance users and possible correlations with treatment outcomes.METHODS A total of 110 subjects were recruited for an observational,longitudinal study from a German inpatient addiction treatment center:55 patients with methamphetamine dependence and 55 patients with dependence of other substances(“OS group”).Both groups were examined at beginning(baseline)and end of treatment(after 6 mo)with regard to treatment retention,craving,cognitive functioning,psychosocial resources,personality traits,depression,and other psychiatric symptoms.Instruments used were Raven’s IQ test,Mannheimer craving scale,cognitrone cognitive test battery,NEO personality factors inventory,Hamilton depression scale,Becks depression inventory,and a symptom checklist.The statistical methods used were χ^(2)-test,t-test and multiple mixed ANOVAs.RESULTS A total drop-out rate of 40%(methamphetamine-group:36.4%;OS-group:43.6%)was observed without significant differences between groups.At baseline,methamphetamine-group subjects significantly differed from OS-group individuals in terms of a lower intelligence quotient,fewer years of education,slower working speed,and decreased working accuracy,as well as less cannabinoid and cocaine use.Methamphetamine-group subjects further showed a significantly lower score of conscientiousness,depressive,and psychiatric symptoms than subjects from the OSgroup.In both groups,a reduction of craving and depressive symptoms and an improvement of working speed and working accuracy was noted after treatment.CONCLUSION There are differences between methamphetamine users and users of other drugs,but not with regard to the effectiveness of treatment in this inpatient setting.There are differences in cognitive function and psychopathology between methamphetamine and other drugs users.The existing treatment options seem to be an effective approach in treating methamphetamine dependence.

Substance Use Pattern among Nursing Students in Jos, North Central Nigeria

Aim: To establish the substance use pattern and psychological distress among the in-coming nursing students of the College with a view towards recommending ways to prevent or reduce complications of substance use disorder in the college. Study design: A cross-sectional design was used. Place and duration: The study took place at the College of Nursing and Midwifery, Jos, Plateau state between the 3rd and 14th of February, 2020. Methodology: The study was carried out during the orientation program of the 206 first-year students of the college. Following approval, a health talk and explanation of the aims and objectives, their consent was obtained in writing. Two-staged sampling with a sociodemographic questionnaire and Hopkins Symptom Checklist-25 followed by urine drug testing was done. The participants were debriefed on the findings while maintaining strict confidentiality. There were 65 males and 141 females. Results: Lifetime prevalence rate of any substance use was 21.8%. More females 33 (23.4%) than males 12 (18.5%) used substances. Only 9 (4.5%) volunteered their substance use, the rest was revealed by the urine testing. Prevalence of alcohol was 23 (11.2%), ketamine 13 (6.3%), nicotine 3 (1.5%), benzodiazepines 3 (1.5%), cannabis 2 (1.0%) and opiods 1 (0.5%). Symptoms of psychological distress were high as 118 (57.3%) and 82 (38.8%) were symptomatic for anxiety and depression respectively. Alcohol use was significantly related with having symptomatic anxiety (P = 0.02) and depression (P = 0.00) in the study. Conclusion: Considering the high prevalence of substance use among the participants, educational intervention and policies should be designed to prevent substance dependence with its complications within the students.

The Addiction Profiles of Substance Users with Comorbid Attention Deficit-Hyperactivity Disorder: The Comparison with Substance Users without Comorbid Attention Deficit-Hyperactivity Disorder

Objective: The aim of this study is to compare the addiction profiles of substance users with comorbid attention deficit-hyperactivity disorder (ADHD) and of those without attention-deficit hyper-activity disorder (ADHD) comorbidity. Method: 100 patients with substance use disorder (SUD) who continued to undergo inpatient treatment during September 2014-August 2015 in Private Balikli Rum Hospital were included in the study. Based on DSM-5 diagnostic criteria, 50 patients who have SUD with ADHD comorbidity were considered as study group, the other 50 patients with only SUD were evaluated as control group. Sociodemographic Data Form, Buss-Perry Aggression Questionnaire (BPAQ), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Addiction Profile Index (BAPI), and Adult ADHD Self-Report Scale (ASRS ADHD) were given to the patients who participated to the study. Results: It was found that the age of onset for substance use was younger in a statistically significant manner in the patients who had SUD with comorbid ADHD (ADHD-SUD group) than the control group (SUD group) (t = 3.57, p = 0.001). Regarding to scores in the scales of these two groups, scores of aggression questionnaire (BPAQ) and craving subscale (BAPI) in ADHD-SUD group were significantly higher comparing to SUD group. Conclusion: In this study, it was revealed that the age of onset for substance use was younger in substance users with comorbid ADHD and that the level of aggression and craving was higher again in this group. Craving and level of aggression might have negative impacts on the treatment process. Therefore, we believe that it is essential to consider ADHD comorbidity in patients with substance use disorders.

Community Action Plan for Adolescent Substance Use Prevention: The First Step to Creating a Community Participatory Action

Background: The study was designed to explore and catalyze the development of action plan for adolescent substance use prevention in a rural community in Ebonyi State, Nigeria. Methodology: This study adopted a two-phase multi-method design. The first phase was a quantitative assessment that determined the real-life situation of adolescents’ substance use in the community using 417 respondents. Contemporaneously, the second qualitative phase focused on the development of an action plan by community stakeholders for adolescent substance use prevention using thirty (30) participants selected through purposive sampling. The reliability of the instrument for quantitative data was established using a test re-test method and computed using Pearson moment correlation. A coefficient of 0.8 was obtained. Validity was established for both quantitative and qualitative instruments. The generated data were subjected to descriptive statistics whereas the qualitative data from respondents’ narratives were analysed thematically. Result: The data revealed that participants who have ever used substances consisted of 128 (59.5%) males and 87 (40.5%) females. The findings on the opinion of 30 participants interviewed about the consequences of substance use brought out majorly four consequences of substance use. The result of catalysing the involvement of community residents towards developing community action for adolescent substance use showed that the challenges associated with adolescents’ substance use as identified by the participants were discussed under one theme—living with the cause and three elements. Conclusion: Substance use prevention policies and plans in the local community have strong potential for stimulating local adolescent substance use prevention actions.

Telehealth for Substance Use Disorders Treatment in Nigeria: Implementation Strategies Post-COVID-19

The COVID-19 pandemic has changed the way healthcare services are delivered. These changes will likely persist as countries recover from the economic crises following lockdowns. In developing countries, services for substance use disorders (SUDs) are inadequate and as countries prioritize infectious diseases, individuals with SUDs may suffer further neglect. This paper is a narrative review of peer-reviewed and grey literature on the current challenges with SUD treatment in Nigeria assesses how telehealth may positively affect access to evidence-based treatments and suggests strategies for implementation considering the unique challenges and opportunities in the country. If prioritized in her policy, telehealth has the potential to improve treatment outcomes for SUDs in Nigeria.

Pilot Study of Problem Gambling in Specialized Substance Use Disorder Treatment—High Lifetime Prevalence of Problem Gambling in Opioid Maintenance Treatment Patients

Problem gambling is over-represented in patients treated for substance use disorders, but substance-specific prevalence of problem gambling is rarely reported. In specialized addiction treatment facilities for opioid maintenance treatment and for alcohol and prescription drug dependence, respectively, 129 patients were screened for problem gambling using the NODS-CLiP. The lifetime prevalence of problem gambling was markedly higher in opioid maintenance treatment (61 percent) than in alcohol and prescription drug dependence treatment (11 percent, p < 0.001). When controlling for gender and age, problem gambling remained significantly associated with opioid maintenance treatment. The present study demonstrated a very high prevalence of lifetime problem gambling in opioid maintenance treatment patients. This calls for active screening for problem gambling in substance use disorder patients, and mainly in treatment for opioid dependence.

Could school programs based on social-emotional learning prevent substance abuse among adolescents?

In this editorial,we comment on the article Adolescent suicide risk factors and the integration of social-emotional skills in school-based prevention programs by Liu et al.While the article focused on the issue of suicide and social-emotional learning programs as a possible intervention,we here discuss evidence of other reported outcomes and if it could be an effective way to prevent substance abuse among adolescents.

National trends in alcohol and substance use among adolescents from 2005 to 2021:a Korean serial cross‑sectional study of one million adolescents

Background Although previous studies have provided data on early pandemic periods of alcohol and substance use in adolescents,more adequate studies are needed to predict the trends of alcohol and substance use during recent periods,including the mid-pandemic period.This study investigated the changes in alcohol and substance use,except tobacco use,throughout the pre-,early-,and mid-pandemic periods in adolescents using a nationwide serial cross-sectional survey from South Korea.Methods Data on 1,109,776 Korean adolescents aged 13–18 years from 2005 to 2021 were obtained in a survey operated by the Korea Disease Control and Prevention Agency.We evaluated adolescents’alcohol and substance consumption prevalence and compared the slope of alcohol and substance prevalence before and during the COVID-19 pandemic to see the trend changes.We define the pre-COVID-19 period as consisting of four groups of consecutive years(2005–2008,2009–2012,2013–2015,and 2016–2019).The COVID-19 pandemic period is composed of 2020(early-pandemic era)and 2021(midpandemic era).Results More than a million adolescents successfully met the inclusion criteria.The weighted prevalence of current alcohol use was 26.8%[95%confidence interval(CI)26.4–27.1]from 2005 to 2008 and 10.5%(95%CI 10.1–11.0)in 2020 and 2021.The weighted prevalence of substance use was 1.1%(95%CI 1.1–1.2)from 2005 to 2008 and 0.7%(95%CI 0.6–0.7)between 2020 and 2021.From 2005 to 2021,the overall trend of use of both alcohol and drugs was found to decrease,but the decline has slowed since COVID-19 epidemic(current alcohol use:βdiff 0.167;95%CI 0.150–0.184;substance use:βdiff 0.152;95%CI 0.110–0.194).The changes in the slope of current alcohol and substance use showed a consistent slowdown with regard to sex,grade,residence area,and smoking status from 2005 to 2021.Conclusion The overall prevalence of alcohol consumption and substance use among over one million Korean adolescents from the early and mid-stage(2020–2021)of the COVID-19 pandemic showed a slower decline than expected given the increase during the prepandemic period(2005–2019).

The phenomenology, socio-demographic, and clinical profile of substance abusers admitted to drug de-addiction unit at eradah and mental health hospital, taif, Saudi Arabia

Background:Substance abuse has become an increasingly serious socio-medical issue in recent decades.Human health is affected by the socio-cultural environment,which has a direct impact on his psychophysical development and well-being.However,sociocultural factors such as bad habits influence lifestyle and behavior,leading to significant health and social problems for substance abusers.Objective:The present study is to evaluate the phenomenology and socio-demographic characteristics of abusers and compare some of the characteristics randomly.The main objectives of this study are a.To evaluate the socio-demographic profile.b.To find out the pattern of substance use.c.To evaluate the association of phenomenology.d.To find out about substance-related disorders among the substance abuse patients.Materials and methods:There was an observational study conducted in the drug de-addiction unit at Taif,Eradah,and Mental Health Hospital in Saudi Arabia.This study included all substance abusers admitted to the hospital who met the inclusion and exclusion criteria.The study included patients of both genders admitted to the drug de-addiction unit between April 2021 and October 2022.Based on a descriptive statistical analysis,categorical variables were presented as frequencies and percentages.Results:An observational study was conducted for nearly one and a half years.We interviewed 358 substance abuse patients following a systematic sampling procedure in a peaceful,non-threatening environment.Among the 358 substance users,353(98.60%)were male and 5(1.39%)were female.According to the survey,117(32.68%)of the participants reported abusing substances during their 31-40 years of age,followed by 102(28.49%)during their 25-30 years of age.The predominant level of substance abuse was among the unemployed 163(45.53%),followed by students 105(29.33%).It was found that 58.66%of all respondents had initiated abuse between the ages of 18-24 years of age.Conclusion:In our study,combined substances like amphetamine and cannabis abusers were most prevalent because these are the most popular illicit drugs which are easily available.Islamic culture prohibits alcohol consumption both religiously and legally,making alcohol abuse the least prevalent of all drug addictions.

Excess Alcohol Use and Death among Tuberculosis Patients in the United States, 1997-2012

Rationale: Excess alcohol use (EAU) is associated with adverse TB treatment outcomes. Objective: We investigated the relationship between EAU and death among TB patients 15 years and older prescribed anti-TB treatment in the United States. Design: Using data reported to the National Tuberculosis Surveillance System for 1997-2012, we calculated adjusted odds ratios and excess attributable risk percent for death among TB patients with reported EAU. Results: EAU was associated with death among patients younger than 65. The excess attributable risk percent for death among those with reported EAU for those younger than 65 was >35%. Conclusions: Interventions to reduce EAU in patients <65 years may reduce deaths.

Alcohol and drug use disorders in adult attentiondeficit/hyperactivity disorder:Prevalence and associations with attention-deficit/hyperactivity disorder symptom severity and emotional dysregulation

BACKGROUND High risk of alcohol and drug use disorders in people with attentiondeficit/hyperactivity disorder(ADHD)calls for exploratory research of relationships with clinical features of ADHD.AIM To estimate prevalence of alcohol/drug use disorders and associations with ADHD symptom severity and emotional dysregulation,in adults with ADHD.METHODS This observational cross-sectional clinical study consisted of patients admitted to a private psychiatric outpatient clinic in Oslo,Norway(2014-2018).Five-hundred and fifty-eight eligible patients diagnosed with ADHD(Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)criteria)agreed to participate.Alcohol and drug use disorders were diagnosed using the Mini International Neuropsychiatric Interview(MINI).Dependence and abuse were merged into“use”disorder as in MINI version 7.0/DSM-5.Questions were related both to lifetime and the past 12-mo.ADHD severity was assessed by the Adult ADHD Self Report Scale(ASRS).Subdivisions of the ASRS questionnaire as inattentive items and hyperactive/impulsivity items were recorded separately.Emotional dysregulation was assessed by the eight-item version of Barkley’s Current Behavior Scale-Self Report.RESULTS The 12-mo prevalence was 5.3%for alcohol use disorder and 13.7%for drug use disorder.The lifetime prevalence was 12.0%for alcohol use disorder and 27.7%for drug use disorder.Men had higher rates of both alcohol use disorder and drug use disorder compared to women.The prevalence of drug use disorder was more than twice that of alcohol use disorder for both sexes.The drugs most participants reported having used were(in descending order):Amphetamine(19.1%),cannabis(17.1%),cocaine or ecstasy(7.4%),benzodiazepines(7.4%),and heroin or other opioids(2.9%).Lifetime drug use disorder was significantly associated with both hyperactivity-impulsivity symptoms and emotional dysregulation symptom severity.Lifetime alcohol use disorder,on the other hand,was not significantly associated with ADHD symptoms or emotional dysregulation when adjusted for gender and age.CONCLUSION Patients with ADHD have a high lifetime prevalence of drug use disorder,which is associated with higher levels of hyperactivity-impulsivity symptoms and emotional dysregulation.

Evaluation of Perinatal and Developmental Outcomes in Neonates with Abstinence Syndrome Admitted to NICU

Drug abuse by pregnant women is one of the significant problems for mothers and their neonates.This study aimed to investigate the effects of maternal substance use disorder during pregnancy on neonatal developmental criteria.In a case-control study,clinical records of 90 neonates diagnosed with neonatal abstinence syndrome who were admitted to NICU in one of four hospitals affiliated with Shahid-Beheshti University of Medical Sciences in Tehran,Iran between 2017 and 2020 were compared to 90 neonates without neonatal abstinence syndrome(control group).Demographic information and data for neonatal developmental characteristics and complications were extracted from the clinical records of this convenience sample.Data for the type and method of maternal substance use during pregnancy were collected through a telephone call with mothers.Our data showed that the prevalence of drug addiction was 1.8%among pregnant women,and the most common drugs used by mothers were opium(n=45%,50%),amphetamine(n=30%,33%),and methadone(n=14%,16%).Neonates with abstinence syndrome had a higher prevalence of transient tachypnea of the newborn(TTN)(P=0.004),and a prevalence of being admitted to NICU(P=0.05)and for a longer duration(P<0.001).Their mothers had a higher prevalence of having pre-eclampsia(P=0.010).Using morphine vs.amphetamine showed no difference based on their effects on mothers and neonates.Substance use during pregnancy increased the prevalence of pregnancy complications(pre-eclampsia)and neonatal complications(TTN and prevalence and duration of hospitalization).Therefore,planning for the development of health policies to raise awareness among women and more broadly,all members of the community,is important to prevent the tendency to engage in this potentially high-risk behavior.

Cross-Sectional Associations of Lifestyle Behaviors with Depressive Symptoms in Adolescents

This study aimed to examine the associations between lifestyle behaviors and depressive symptoms in adolescents.Self-reported data from the 2019 Youth Risk Behavior Survey(YRBS)was analyzed.Depressive symptoms were set as the outcome variable.Movement variables(physical activity,muscle-strengthening exercise,physical education attendance,sports team participation,television watching,video or computer games,and sleep),eating behaviors(fruit intake,vegetable intake,milk intake,and eating breakfast or not),and substance use(alcohol use and cigarette use)were included as explanatory variables.Binary logistic regression was used to explore the asso-ciations between lifestyle behaviors and depressive symptoms after adjusting for sex,age,grade,race,and weight status.Of 13,677 participants who completed the investigation,girls were more than boys(50.3%vs.48.6%).The proportion of participants in grades 9,10,11,and 12 was 26.6,27.2,24.3,and 20.8,respectively.Of them,the prevalence of depressive symptoms was 36.0%(weighted%:36.7%[35.1%,38.3%]).Among all the lifestyle behaviors included,participating in no sports teams(OR=1.53[1.32,1.77]),spending more than 2 h in video or computer games(OR=1.64[1.40,1.92]),sleeping less than 8 h nightly(OR=1.79[1.45,2.20]),not eating breakfast(OR=1.56[1.37,1.78]),alcohol use(OR=1.74[1.49,2.02]),and cigarette use(OR=1.83[1.42,2.37])were associated with higher odds of depressive symptoms.To reduce depressive symptoms in adolescents,interventions can consider encouraging adolescents to engage in team sports activity,limit time for video or com-puter games,sleep enough,regularly eat breakfast,and avoid using alcohol and cigarette.Future studies are encouraged to verify our researchfindings by using a more improved study design.