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Aim: In this study, it was aimed to evaluate the attachment styles and life satisfaction of adolescents (12–18 years old) with and without smoking, alcohol, and substance use. Method: With the questionnaire applied on the digital platform and 225 adolescents between the ages of 12–18 were reached. The data were collected using a questionnaire, attachment style scale, and life satisfaction scale. The analyzes of the research were performed using the SPSS 25 program. Findings: The rate of young people who stated that they have smoked, or used alcohol and drugs was 40%. Of the adolescents, 35.6% used cigarettes, 0.4% used substances, and 6% used alcohol. Attachment styles and life satisfaction scale mean scores were lower in smoking, alcohol, and substance-using youth than in those who did not use these. It was observed that the average avoidant and anxious context styles scores of adolescents with smoking, alcohol and substance use were higher. Conclusions: It is important to take initiatives to support adolescents with problematic attachment styles and to protect their health [ABSTRACT FROM AUTHOR]

Background: In England, court‐based mental health liaison and diversion (L&D) services work across courts and police stations to support those with severe mental illness and other vulnerabilities. However, the evidence around how such services support those with neurodevelopmental disorders (NDs) is limited. Aims: This study aimed to evaluate, through the lens of court and clinical staff, the introduction of a L&D service for defendants with NDs, designed to complement the existing L&D service. Methods: A realist evaluation was undertaken involving multiple agencies based within an inner‐city Magistrates' Court in London, England. We developed a logic model based on the initial programme theory focusing on component parts of the new enhanced service, specifically training, screening, signposting and interventions. We conducted semi‐structured interviews with the court staff, judiciary and clinicians from the L&D service. Results: The L&D service for defendants with NDs was successful in identifying and supporting the needs of those defendants. Benefits of this service included knowledge sharing, awareness raising and promoting good practice such as making reasonable adjustments. However, there were challenges for the court practitioners and clinicians in finding and accessing local specialist community services. Conclusion: A L&D service developed for defendants with NDs is feasible and beneficial to staff and clinicians who worked in the court setting leading to good practice being in place for the defendants. Going forward, a local care pathway would need to be agreed between commissioners and stakeholders including the judiciary to ensure timely and equitable access to local services by both defendants and practitioners working across diversion services for individuals with NDs. [ABSTRACT FROM AUTHOR]

There is clear need for more effective public health policies. Coupled with calls for more effective policies, increasing demand to address public health disparities experienced by systemically marginalized and historically oppressed groups emphasizes the long-standing need for policies that improve public health equity. Such need is highlighted when examining public health issues such as alcohol- and substance-exposed pregnancy (ASEP): Current policies are ineffective at reducing ASEP, and marginalized groups experience disproportionately lower benefits and higher negative consequences as a result of such policies. Powerful strategies to develop more effective policies that can account for the complexity of such issues, such as systems science methods (SSMs), are becoming popular. However, current best practices for such methods often do not emphasize the additional efforts that will be required to develop equitable, not just effective policies. Using ASEP as an example of a crucial complex issue requiring new policy, we suggest additional steps to include in SSM projects for developing more effective policies that will also help stakeholders determine high-equity policies to reduce health disparities. These steps include modeling structural differences experienced by marginalized groups via systemic racism and oppression, incorporating existing cultural and community sources of strength and resilience as key areas for policy development, and evaluating the sustainability of policies as a dimension of efficacy. We also discuss using community-based participatory approaches as a framework for all SSM processes to ensure that policy development itself is grounded in equitable shared decision-making for marginalized individuals. [ABSTRACT FROM AUTHOR]

Purpose: Use of alcohol and other substances is a multifaceted issue impacting young people across multiple life domains. This paper aims to elucidate patterns of substance use and associated demographic and clinical factors among young people seeking treatment for their mental health. Methods: Young people (12–25 years old) were recruited from five youth-specific primary mental health ("headspace") services in Australia. Self-reported substance use and harms in the past 3 months were measured using WHO-ASSIST. Network analyses were conducted to evaluate interrelationships between use and harms associated with different substances. Subgroups were then identified based on whether participants reported using high centrality substances, and associated demographic and clinical factors were assessed with multinomial logistic regression. Results: 1107 youth participated. 70% reported use of at least one substance in the past 3 months, with around 30% of those reporting related health, social, legal or financial problems. Network analysis highlighted substantial interconnections between use and harm indicators for all substances, with amphetamine-type stimulants (ATS) and cannabis being high central substances. Higher levels of substance use and harms were reported in subgroups with ATS or cannabis use and different risk factors were associated with these subgroups. Conclusions: Findings highlight the importance of screening for substance use in youth primary mental healthcare settings, offering a key opportunity for early intervention. Clinicians should be aware of the inner connections of use and harms of different drugs and the role of cannabis and amphetamine use as a marker for more substance use profiles. [ABSTRACT FROM AUTHOR]

Farmers in rural areas face unique lifestyle stressors which may cause physical and behavioral health issues. Because of external stressors, and often an internal drive to succeed, farmers in rural areas have high rates of prescription drug use, excessive alcohol use, depression, and suicide. These methods of coping may increase prevalence of distress and mental illness in farmers leading to poor health outcomes. Social norms within rural farming populations are influenced by culture, family, friends, and community beliefs which make it difficult to conduct research about substance use and mental health. The purpose of this study is to identify stressors in rural farmers and positive and negative coping strategies for stress in the farming population. In-depth interviews (35 minutes-1 hour) were conducted with full-time rural farmers (n = 15) in ten counties throughout Georgia. Using qualitative analysis, inductive coding was used to identify themes and patterns among transcribed interview recordings. Stressors reported by farmers included: financial, work-life balance, physical health and disconnect from non-farming populations. Farmers described feeling misperceived by those outside of their community and feeling a distinct lack of control due to external factors. All the farmers identified alcohol use as a primary coping strategy to deal with stressors. This study identifies distinct stressors associated with a farming lifestyle and socio-cultural factors that are barriers to care for mental health and substance use in rural farmers. This study can provide information to health practitioners that may lead to a better understanding of the factors influencing farmer's health outcomes. [ABSTRACT FROM AUTHOR]

Background: Court Mental Health Liaison and Diversion Services (CMHLDS) have developed in some countries as a response to the over-representation of mental illness and other vulnerabilities amongst defendants presenting to criminal justice (or correctional) systems. This study examined the characteristics and rates of mental disorder of 9088 defendants referred to CMHLDS. Method: The study analysed service level data, obtained from the National Health Service's mental health data set, to examine characteristics relating to gender, ethnicity and comorbidity of common mental and neurodevelopmental disorders at five CMHLDS across London between September 2015 and April 2017. Results: The sample included 7186 males (79.1%) and 1719 females (18.9%), the gender of 183 (2%) were not recorded. Of those referred, 6616 (72.8%) presented with an identifiable mental disorder and 503 (5.5%) with a neurodevelopmental disorder (NDD). Significantly higher rates of schizophrenia were reported amongst Black defendants (n = 681; 37.2%) and Asian defendants (n = 315; 29%), while higher rates of depression were found amongst White defendants (n = 1007; 22.1%). Substance misuse was reported amongst 2813 defendants (31%), and alcohol misuse amongst 2111 (23.2%), with significantly high rates of substance and alcohol misuse amongst defendants presenting with schizophrenia or personality disorder. Conclusions: This is one of the largest studies to examine mental health needs and vulnerabilities amongst defendants presenting to CMHLDS. It will enable an improved understanding of the required service designs and resources required to manage the healthcare pathways for people attending CMHLDS. [ABSTRACT FROM AUTHOR]

Background: Research conducted during the COVID‐19 Pandemic has identified two co‐occurring public health concerns: loneliness and substance use. Findings from research conducted prior to the pandemic are inconclusive as to the links between loneliness and substance use. This study aimed to measure associations of loneliness with three different types of substance use during COVID‐19: daily number of alcoholic drinks, cannabis use, and non‐cannabis drug use. Method: Data were obtained between October 2020 and May 2021 from 2,648 US adults (Mage = 38.76, 65.4% women) diverse with respect to race and ethnicity using online recruitment. Participants completed baseline surveys and daily assessments for 30 days. A daily loneliness measure was recoded into separate within‐ and between‐person predictor variables. Daily outcome measures included the number of alcoholic drinks consumed and dichotomous cannabis and non‐cannabis drug use variables. Generalized linear multilevel models (GLMLM) were used to examine within‐ and between‐person associations between loneliness and substance use. Results: The unconditional means model indicated that 59.0% of the variance in the daily number of alcoholic drinks was due to within‐person variability. GLMLM analyses revealed that, overall, people drank more on days when they felt a particularly high or particularly low degree of loneliness (positive quadratic effect). There was a negative and significant within‐person association between daily loneliness and the likelihood of cannabis use. There was also a positive and significant within‐person association between daily loneliness and the likelihood of non‐cannabis drug use. Conclusions: Associations between loneliness and substance use vary with substance type and whether within‐ or between‐person differences are assessed. These findings are relevant to the persistence of substance use disorders and thus of potential clinical importance. Individuals who do not experience severe loneliness at intake but who show daily increases in loneliness above baseline levels are at heightened risk of alcohol and non‐cannabis drug use. Future research could profitably examine just‐in‐time adaptive interventions that assess fluctuations in loneliness to prevent the development or exacerbation of substance use disorders. [ABSTRACT FROM AUTHOR]

Alcohol and substance use has been a long-standing public health challenge across the globe, including in Africa. Research evidence attests that there is no singular approach to the prevention of this problem. This study used a scoping review to systematically appraise existing research evidence on the prevention of alcohol and substance use in Africa. A systematic search for literature on alcohol and substance use prevention between 2008 and 2018 in African countries was done in PubMed, EBSCOhost, and Web of Science databases. The study employed Arksey and O'Malley scoping review framework. Search terms included those relevant to the prevention of alcohol and substance use. Abstracted data were synthesized, thematically analyzed, and presented in a narrative format. A total of 34 peer-reviewed studies were selected for the final review in the current study. Alcohol is the predominantly used substance in Africa, among many other substances. A wide spectrum of factor risk and protective factors were reported. Prevention interventions were categorized as individual, family, school, workplace, environmental, media, as well as community-based prevention interventions. While a variety of targeted prevention interventions have been implemented in the African continent, their effectiveness remains to be further elucidated, explored, and tested. [ABSTRACT FROM AUTHOR]

This study aims to explore the prevalence of alcohol and substance use among young refugees along with the indicators of experienced psychological difficulties. It is based on a sample of 184 children and adolescents aged 11–18 years old, residing at two refugee centers in the Republic of Serbia. Out of 184 participants, the majority was male (N = 155; 84.29%). More than a half of participants (53.3%) displayed significant symptoms of PTSD. 50% consume energy drinks, 28% use tobacco; 13% use alcohol; 4.6% use marijuana; 1.7% use LSD, amphetamines, glue, tranquilizers and cocaine. Female respondents were more frequently expressing emotional difficulties (p < 0.05) while male participants were more frequent users of alcohol or substances (p < 0.01). Younger children were more frequently expressing symptoms of hyperactivity and prosocial behavior, while they were less frequently using substances. There is also a significant negative correlation between the years of education and individual proneness to substance use. Furthermore, those who resided in a greater number of refugee camps were found to experience greater levels of emotional and behavioral difficulties and face a greater risk of physical abuse. The burden of migration increases proneness to substance use, as a consequence of scarce coping resources and the stress of adjusting. Migrants are vulnerable to substance use, since some of them have commonly witnessed and/or personally experienced pre-and post-migration stress and trauma, including loss of homes and livelihoods, violence, torture and family separation. Preventive programs need to focus on the problem of alcohol and substance use among this vulnerable population.

In Fort McMurray, Alberta, Canada, the wildfire of May 2016 forced the population of 88,000 to rapidly evacuate in a traumatic and chaotic manner. Ten percentage of the homes in the city were destroyed, and many more structures were damaged. Since youth are particularly vulnerable to negative effects of natural disasters, we examined possible long-term psychological impacts. To assess this, we partnered with Fort McMurray Public and Catholic Schools, who surveyed Grade 7–12 students (aged 11–19) in November 2017, 2018, and 2019—i.e., at 1.5, 2.5, and 3.5 years after the wildfire. The survey included validated measurement scales for post-traumatic stress disorder (PTSD), depression, anxiety, drug use, alcohol use, tobacco use, quality of life, self-esteem, and resilience. Data analysis was done on large-scale anonymous surveys including 3,070 samples in 2017; 3,265 samples in 2018; and 3,041 samples in 2019. The results were unexpected and showed that all mental health symptoms increased from 2017 to 2019, with the exception of tobacco use. Consistent with this pattern, self-esteem and quality of life scores decreased. Resilience scores did not change significantly. Thus, mental health measures worsened, in contrast to our initial hypothesis that they would improve over time. Of note, we observed higher levels of mental health distress among older students, in females compared to male students, and in individuals with a minority gender identity, including transgender and gender-non-conforming individuals. These findings demonstrate that deleterious mental health effects can persist in youth for years following a wildfire disaster. This highlights the need for multi-year mental health support programs for youth in post-disaster situations. The indication that multi-year, post-disaster support is warranted is relatively novel, although not unknown. There is a need to systematically investigate factors associated with youth recovery following a wildfire disaster, as well as efficacy of psychosocial strategies during later phases of disaster recovery relative to early post-disaster interventions. [ABSTRACT FROM AUTHOR]

Objective: The use of psychoactive substances increases university students' general morbidity and mortality. Universities run programs to prevent psychoactive substance use since they are associated with the risk of poor academic outcomes. The University of Nairobi (UoN) trains peer mentors who counsel students to prevent substance use. There is, however, inadequate feedback and no evaluation of the effectiveness of this method. This study will pilot mobile health (mHealth) based peer mentoring, evaluate and provide feedback about implementation. It will be based in two campuses of UoN, Nairobi, Kenya. Methods: Three phases study. In the first phase, a baseline survey determines students' knowledge about, attitudes toward, and prevalence of substance use at baseline and the end of the intervention phase. Second phase, mHealth based intervention using a quasi-experimental design. Participants 100 mentors (50 intervention and 50 control groups). Intervention group using mHealth screens for substance use, provide structured brief intervention and treatment referral. A comparative control group, using a paper-based guide will deliver the same program. Phase three, mentors during focussed group discussions will share their experiences. Results: Data will be collected on implementation, acceptability and substance use patterns. Data analysis using descriptive, inferential statistics and thematic content analysis for qualitative data. Conclusions: The study will provide evidence on the implementation and acceptability of mHealth among university students. This will inform national and regional substance use prevention policy and practice. Abbreviations: ASSIST: Assessment of Smoking and Substance Involvement Test; AUDIT: Alcohol Use Disorder Identification Tool; KAP: Knowledge, Attitude, and Prevalence; mHealth: Mobile Health; RDSDQ: Researcher Designed Socio-Demographic Questionnaire; UNODC: United Nations Office on Drugs and Crime; USA: United States of America; WHO: World Health Organization [ABSTRACT FROM AUTHOR]

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Background: Given the rapid increase in prescription and illicit drug poisoning deaths in the 50+ age group, we examined precipitating/risk factors and toxicology results associated with poisoning deaths classified as suicides compared to intent-undetermined death (UnD) among decedents aged 50+.Methods: Data were from the 2005-2015 US National Violent Death Reporting System (N = 15,453). χ2 tests and multinomial logistic regression models were used to compare three groups of decedents: suicide decedent who left a suicide note, suicide decedent who did not leave a note, and UnD cases.Results: Compared to suicide decedents without a note (37.7% of the sample), those with a note (29.4%) were more likely to have been depressed and had physical health problems and other life stressors, while UnD cases (32.9%) were less likely to have had mental health problems and other life stressors but more likely to have had substance use and health problems. UnD cases were also more likely to be opioid (RRR = 2.65, 95% CI = 2.42-2.90) and cocaine (RRR = 2.59, 95% CI = 2.09-3.21) positive but less likely to be antidepressant positive. Blacks were more than twice as likely as non-Hispanic Whites to be UnDs. Results from separate regression models in the highest UnD states (Maryland and Utah) and in states other than Maryland/Utah were similar.Conclusions: Many UnDs may be more correctly classified as unintentional overdose deaths. Along with more accurate determination processes for intent/manner of death, substance use treatment and approaches to curbing opioid and other drug use problems are needed to prevent intentional and unintentional poisoning deaths. [ABSTRACT FROM AUTHOR]

The use of alcohol and substances among students and young adults in South Africa is alarmingly high. Peer pressure, social activities and external influences have been reported as major factors driving students’ drinking behaviour. Nursing students may be vulnerable to alcohol and substance abuse, as they face various stressful situations in their personal and professional lives as developing healthcare professionals. This article describes the self-reported prevalence of alcohol and substance use among second-year nursing students in the Faculty of Health Sciences at a South African university, as well as the possible association between alcohol and substance use and academic performance. This was determined as part of a larger study. In this quantitative, cross-sectional study, data were collected by means of a questionnaire. Of the 75 second-year nursing students approached to participate, 69 completed the questionnaire (response rate 92.0%). The majority of the respondents (81.2%) reported alcohol consumption, 52.2 per cent consumed alcohol with an energy drink, and 17.4 per cent consumed alcohol in conjunction with cannabis. Less than half (40.6%) smoked cigarettes or tobacco and 21.7 per cent indicated cannabis use. One and a half per cent (1.5%) reported smoking smokeless tobacco. A small percentage (8.7%) indicated medication use for attention deficit hyperactivity disorder (ADHD), which was obtained with a prescription and 7.3 per cent obtained the medication without a prescription. Sedatives and tranquilisers were reportedly used by 8.7 per cent with a prescription, and 5.8 per cent without. The use of glue and solvents, “spice” and LSD was reported by 5.8, 2.3 and 1.5 per cent, respectively. Substance use may lead to unprofessional behaviour. Intervention programmes could contribute to decreased academic stress, effective time management and educated professional students. [ABSTRACT FROM AUTHOR]

Context: Substance use interventions for methamphetamine-using men who have sex with men (MSM) are limited by the assumption that they are a uniform group. We hypothesized that an LCA would identify distinct patterns of substance use and demographic and psychosocial variables associated with different substance-using groups would aid in understanding distinctions. Using cross-sectional data from 343 methamphetamine-using MSM, we conducted an LCA to model the patterns of polysubstance use then examined how the classes varied on psychosocial variables defined by the Information-Motivation-Behavioral Skills (IMB) model.Findings: Because we were interested in identifying patterns of polysubstance use (PSU) among our sample, we identified four classes: minimal PSU, marijuana PSU, cocaine/hallucinogens PSU, and designer drugs/heroin PSU. Men in the marijuana PSU class were less likely to have positive attitudes towards methamphetamine than participants in the other three classes. Men in the Cocaine and Hallucinogens PSU class were more likely to have higher PANAS scores (OR = 13.00 [3.25, 52.07]) compared to the other classes, and they were more likely to have higher self-efficacy to enact safer substance use strategies (OR = 10.72 [3.23, 35.47]). MSM in the Designer Drug and Heroin PSU class were more likely to have a diagnosis of Hepatitis B (OR = 4.07 [0.86, 19.36] despite having higher knowledge of sexual health practices (OR = 0.55 [0.36, 0.84].Conclusions: Differential classification for methamphetamine-using MSM suggests an opportunity for tailored interventions and secondary prevention programs. By understanding how men vary on illicit substance use, interventionists can routinely screen and link men before they potentially progress to another classification. [ABSTRACT FROM AUTHOR]

Objective To examine any association of birth decade, sex and exposure to alcohol and/or substance use disorders (ASUD) with age at onset (AAO) of bipolar I disorder (BD-I). Methods Using data from a representative clinical sample of 3896 BD-I cases recruited from 14 European countries, we examined AAO distributions in individuals born in consecutive birth decades. Cumulative probabilities with Mantel-Cox log-rank tests, pairwise comparisons and Odds Ratios (OR) with 95% confidence intervals (95% CI) were employed to analyze AAO according to birth decade, sex, and presence or absence of an ASUD. Results In the total sample, median AAO of BD-I decreased from about 41 years for those born in the 1930s to about 26 years for those born in the 1960s. In a sub-sample of 1247 individuals (selected to minimize confounding), AAO significantly decreased for males and females born in each consecutive decade between 1930 and 50 (OR: 0.65; 95% CI: 0.51, 0.81), and for cases with an ASUD as compared to without (OR: 0.77, 95% CI: 0.69, 0.87). The best fitting regression model identified an independent effect for each birth decade and an interaction between ASUD status and sex, with a consistently earlier AAO in males with an ASUD (OR: 0.79: 95% CI: 0.70, 0.91). Conclusions In BD-I cases diagnosed according to internationally recognized criteria and recruited to pan-European clinical observational studies, the AAO distributions are compatible with a birth cohort effect. A potentially modifiable risk factor, namely ASUD status, was associated with the observed reduction in AAO, especially in males. [ABSTRACT FROM AUTHOR]

Individuals with co-occurring eating and substance use disorders have poorer psychosocial adjustment than those with only eating pathology or substance misuse patterns; these complex cases are often challenging to treat in clinical settings. Eating and substance use disorders share personality, affective, and cognitive etiologic factors, suggesting the importance and opportunities to treat them simultaneously in an integrative intervention approach. The integrative cognitive-affective therapy (ICAT) validated to treat bulimia nervosa follows an evidence-based conceptual framework; it addresses many shared risk factors that underlie eating and substance use disorders. A Latina American with comorbid bulimia nervosa, alcohol and cocaine use disorders, and bipolar I disorder was treated using ICAT; therapy was augmented with an explicit examination of, and cognitive restructuring surrounding, negative meta-emotions. ICAT and treatment around metaemotions were delivered in the context of an intensive outpatient program. Over the course of 15 individual sessions and at 1-month follow-up, the patient reported a decrease in dietary restraint, binge eating episodes, body dissatisfaction, and negative attitudes toward obesity and alcohol and cocaine abuse, and maintained a stable weight. The patient also saw improvements in depression- and anxiety-related symptoms, and self-evaluation. This case supports the flexibility and benefits of examining meta-emotion philosophy in the context of ICAT for the treatment of co-occurring eating and substance use disorders for adults in a clinical setting. [ABSTRACT FROM AUTHOR]

Using the National Longitudinal Surveys of Youth 1979, this study examines the roles of alcohol and substance use as mediators in the mechanism between self-esteem and depression, and investigates whether the mechanism works for both men and women. Results demonstrate that alcohol and substance use during young adulthood mediates the effect of self-esteem on depression among men. Furthermore, self-esteem during young adulthood remains a determinant of high depression in middle adulthood. However, we did not find evidence to support that same mechanism among women. Our findings provide insight into how self-esteem affects depression over the transition from young to middle adulthood, and elucidate potential gendered responsivity to low self-esteem. [ABSTRACT FROM PUBLISHER]

Background: Studies have shown that adolescents with attention-deficit/hyperactivity disorder (ADHD) have an increased risk of alcohol and substance abuse in adulthood. An unequivocal reason for this association has not yet been identified but it has been shown that pharmacological treatment is likely to reduce this risk. Aims: To test whether adolescents with ADHD in pharmacological treatment have a higher prevalence of smoking and use of alcohol and drugs than a matched control group from the general population. The study will also analyse associations between smoking, alcohol and drug use and comorbid psychiatric symptoms. Methods: The sample in this case-control study comprised 219 adolescents aged 13-18 years, including a case group of 117 adolescents with ADHD and a control group of 102 adolescents without ADHD. Participating subjects completed a questionnaire about their use of cigarettes, drugs and alcohol and the self-report version of the Strengths and Difficulties Questionnaire (SDQ). Results: 21% of ADHD probands vs. 16% controls were daily smokers ( P = 0.326). Among alcohol users, 52% of ADHD probands vs. 70% controls confirmed monthly alcohol intake ( P = 0.014); 4% of cases compared with 7% of controls used illicit drugs within last month ( P = 0.260). Conclusion: No significant group differences were found in the prevalence of ever having smoked cigarettes, drinking alcohol or using illicit drugs between adolescents with ADHD and controls. Contrary to expectations, subjects in the control group had a more regular and heavier use of alcohol. However, ADHD patients had a heavier use of cigarettes than controls. [ABSTRACT FROM AUTHOR]

With increasing burden on schools and requirements for active parental consent, low student survey participation rates are problematic, including where ethnic minority students are often underrepresented in behavioural risk surveys. To improve parent permission rates and survey participation, incentive use (individual vs. group) and mode of survey administration (web-based vs. paper-pencil) were examined in a sample of ethnically diverse students ( n == 2488) in the 6th, 8th, 10th and 12th grades from eight schools in Hawai'i. Mode of survey administration was also compared for student reporting of alcohol and other substance use and associated risk and protective factors. Classes were assigned to one of four conditions based on incentive type and route of survey administration. The group incentive was associated with a significantly higher rate of parental permission compared to individual incentive; however, it did not impact survey completion rate. Students who took the web-based version compared to the paper-pencil version of the survey were more likely to report use of alcohol, tobacco and other drugs in the past 12 months. The use of web-based surveys may increase reporting of sensitive behaviours such as substance use among adolescents compared to paper-pencil versions. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to determine the incidence of alcohol and other substance use in patients presenting to an emergency department with acute psychiatric illnesses and to clarify the role of urine drug screens. Method: This was an unblinded prospective (observational) cohort study incorporating retrospective review of patient medical records, history of alcohol and substance use, results of urine drug screens and blood alcohol concentrations. Results: Of 196 acute psychotic patients, 104 were diagnosed with schizophrenia and 92 with 'other psychosis'. Results of urine drug screens were consistent with self-reported use of substances and only identified an additional 5% of substance users. Cannabis was the commonest illicit substance used by both groups of patients, followed by psychostimulants, mainly amphetamines. Younger males were more likely to use psychostimulants and to present with violence. Conclusions: Patients with co-existing mental health problems and substance use present a major problem for our emergency departments. Cannabis was the most common substance used. Youth, male gender and psychostimulant use are associated with violent presentations. A comprehensive history of alcohol and substance use is important to implement appropriate dual diagnosis treatment. Urine drug screening is recommended for patients who do not admit to substance use. [ABSTRACT FROM AUTHOR]

The Sacred Mountain Youth Project was conducted to investigate risk and protective factors related to alcohol and drug use among American Indian youth. Findings indicated that stressful life events were positively associated with depressed mood, substance use, and risky behavior; cultural identity had no direct effects, but a secondary model showed that social support and protective family and peer influences were related to cultural identity. These findings suggest that the relationships between stressors and their negative sequelae are complex. Emphasis on protective processes that are culturally specific to American Indian youth may lead to effective alcohol and drug use prevention programs. [ABSTRACT FROM AUTHOR]

Problematic lifestyle behaviors and high rates of physical illness are well documented in people with schizophrenia, contributing to premature mortality. Yet, there is a notable absence of research examining general lifestyle and health issues in participants at risk for psychosis. This form of research may help identify concerns that exist during prodromal periods related to future outcomes. Accordingly, the current study examined lifestyle and health in a nonclinical sample of 530 young adults with varying levels of schizotypy. Increasing symptom severity was associated with greater somatic symptoms and poorer sleep quality across positive, negative, and disorganized domains. Elevated negative and disorganized symptoms were associated with significantly reduced health-related quality of life, while evidence for reduced engagement in health behaviors was largely limited to those with elevated negative schizotypy. No relationships emerged between symptom presentation/severity and body mass index or substance use, although zero-order correlations suggested an association between disorganized schizotypy and nicotine use. The pattern of relationships in the current study was consistent with findings from the ultra-high risk and clinical literature suggesting that lifestyle and health concerns may exist on a continuum with psychosis. Future research should seek to clarify if these patterns are associated with long-term physical or mental health outcomes. [ABSTRACT FROM AUTHOR]

Older adolescence (16–19 years) is characterised by an increase in alcohol and illicit substance use, however limited age-appropriate prevention programs exist to target this critical group. Schools are increasingly opting for web-based programs to deliver health education due to their effectiveness, accessibility and scalability. This study outlines the web-based adaptation of a neuroscience-based harm reduction program targeting older adolescents known as, The Illicit Project , and the study protocol to evaluate its effectiveness. A cluster randomised controlled trial will be conducted with Year 10, 11 and/or 12 students (aged 16–19 years) from 8 secondary schools across New South Wales, Australia. Participating schools will be randomised into the control group (health education as usual) or the intervention group (The Illicit Project program; a three-lesson, web-based program delivered fortnightly over 6 weeks) and will complete four web-based assessments at baseline, 6-, 12- and 24-months post baseline. Primary outcomes are the quantity and frequency of substance use, alcohol-related harms and drug literacy levels, with the 12-month follow-up, the primary end point. Secondary outcomes include intentions to use alcohol and other drugs in the future and risk perceptions. This trial has been registered with Australia and New Zealand Clinical Trials Registry (ACTRN12620000805976). Intervention effects will be estimated using multilevel mixed effects models with an intention-to-treat sample. This is the first evaluation of a web-based, age-appropriate neuroscience-based prevention program for substance use targeting older adolescents. [ABSTRACT FROM AUTHOR]