Medical research archives最新文献

{"title":"Implementing a Digital Child Behavioral Health Prevention Program in Faith-Based Settings in Uganda: A Feasibility Study.","authors":"Keng-Yen Huang, Janet Nakigudde, Tusiime Christine, Sabrina Cheng, Dickson Muyomba, Eddie Tinka Mugisa, Elizabeth Nsamba Kisakye, Hafsa Sentongo, Antoinette Schoenthaler, Omar El-Shahawy, Devin Mann","doi":"10.18103/mra.v12i10.5926","DOIUrl":"10.18103/mra.v12i10.5926","url":null,"abstract":"<p><strong>Background: </strong>The burden of pediatric mental disorders in low-and middle-income countries (LMICs) is tremendous, but solutions for addressing the burden remain limited. Although digital solutions have potential to improve prevention services, such solutions have not been systematically tested in these countries.</p><p><strong>Objective: </strong>This study explores the use of a digital parenting intervention tool designed for pediatric behavioral health, known as the Pediatric-Behavioral Health Digital Tool, in a preventive service model for low resource communities. We study the feasibility of implementing this new digital health service model and preliminary estimate the potential impacts on parenting and child social emotional outcomes when the program is implemented in faith-based organizations in Uganda. The Pediatric-Behavioral Health Digital Tool is a preventive intervention designed to be implemented by trained community-health-workers to facilitate caregivers' access to the preventive mental health service in community for their young children. The tool is based on the screening, brief intervention, and referral to treatment prevention service model for promoting pediatric behavioral and mental health.</p><p><strong>Methods: </strong>The evaluation study was designed using a pre-post assessment design. The content in Pediatric-Behavioral Health Digital Tool was co-designed with local expert and iteratively adapted based on parents and caregivers as well as community-health-workers and experts who were invited to provide their feedback and suggestions for improvements in content, functions, and delivery model through a series of focus groups and workshops. This pilot evaluation focuses on the pre-post changes of the intervention families (91 families) and 10 community-health-workers.</p><p><strong>Results: </strong>We found high acceptability, appropriateness, and usefulness of the program based on the intervention families' community-health-workers' report. Intervention parents felt safe in using the digital toolkit. Parents felt comfortable for the CHWs asked them personal questions. In estimating the impacts, we found some expected findings on parenting and child social emotional health. Specifically, we found intervention parents become more mindful in their parenting (d=1.61, p=.049), and felt more effective in discipline their child's misbehavior (d=1.29, p=.003) after they receive the intervention. For children, we found improvement on children's social emotional outcomes, measured by decreased parent-child conflict (d=-1.08, p=.002) and increased child emotional regulation skills (d=1.0, p=.049) after their parents receive the intervention.</p><p><strong>Conclusions: </strong>Our Pediatric-Behavioral Health Digital Tool has potential to provide a cost-effective service solution to provide preventive mental health care in communities to promote child social-emotional and mental wellbeing in low-resource settings.<","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bayesian mediation modeling of racial disparity for maternal birth outcomes in United States.","authors":"James Thompson","doi":"10.18103/mra.v12i9.5858","DOIUrl":"10.18103/mra.v12i9.5858","url":null,"abstract":"<p><strong>Background: </strong>In the United States, racial disparities for adverse maternal health outcomes persist, and the causes remain unknown. The disparities for women of Black ethnicity include increased risk of gestational hypertension, hypertension eclampsia, cesarean section, and admission to an Intensive Care Unit, and reduced risk of parturition induction. Without evaluating racial disparity, studies identify one cause of these conditions as the interaction between pre-gestational body mass index and gestational weight gain. What has not been determined is how body mass index and gestational weight gain contribute to racial disparity. The study's objective was to determine if the interaction between body mass index and gestational weight gain can explain the racial disparity in five maternal outcomes.</p><p><strong>Methods: </strong>The approach involved mediation analysis by performing Bayesian estimation of potential outcomes for each combination of causes. Causes included risk of Black ethnicity, body mass index, and gestational weight gain.</p><p><strong>Results: </strong>Improving both body mass index and gestational weight gain to what is considered optimal would increase the racial disparity for gestational hypertension by 19.2%, have a non-significant effect on racial disparity for hypertension eclampsia, reduce the racial advantage for Black women receiving induction by 16.9%, and reduce the racial disadvantage for delivery by cesarean and admission to an Intensive Care Unit by 49.9% and 36.9%, respectively.</p><p><strong>Conclusion: </strong>Preventive programs can have a wide range of effects on racial disparity, from decreasing to increasing the disparity. Implementing the mediation evaluation approach illustrated here would optimize clinical decisions, guide public health policy, and eventually mitigate racial mistrust.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid care model: Combining telemedicine and office visits for diabetes management in older adults with type 1 diabetes.","authors":"Elena Toschi, Atif Adam, Nana Frimpong, Rebecca Hurlbert, Christine Slyne, Lori Laffel, Medha Munshi","doi":"10.18103/mra.v12i9.5728","DOIUrl":"10.18103/mra.v12i9.5728","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the use of hybrid (telehealth and in-person) care on visitation and glycaemia in older adults with type 1 diabetes (T1D).</p><p><strong>Methods: </strong>In this retrospective study, we examined clinical characteristics, number of visits (telehealth and in-person) and continuous glucose monitoring (CGM) metrics for older adults (≥65 years) with T1D from electronic health records during the pre-COVID-19 pandemic (March 1, 2019-March 1, 2020; in-person) and pandemic (September 1, 2020-August 31, 2021; hybrid) periods. Main outcomes were the number of visits and changes in glycaemic control (HbA1c), and in a sub-group of older adults using CGM, changes in CGM metrics between in-person and hybrid care.</p><p><strong>Results: </strong>We analysed data of 661 older adults with T1D (age 72±5 years). The hybrid care resulted in an increased number of annual diabetes visits (6.3 vs 4.2 visits/person) without change in glycaemic control (HbA1c 7.4% vs 7.2%) compared with in-person care alone. In the sub-group of 299 older adults with T1D using CGM, hybrid care compared with in-person care resulted in an improvement of time-in-range (70-180 mg/dL) (68% to 71%; p<0.001) without increasing hypoglycaemia (<70 mg/dL).</p><p><strong>Conclusion: </strong>Compared with in-person only visits, hybrid care maintained visit frequency and preserved glycaemic control measured as HbA1c. In a sub-group of older adults with T1D using CGM, time-in-range improved while time in hypoglycaemia did not change. These data suggest that a hybrid care model is efficacious in maintaining visitation and glycaemic control, and, as demonstrated in a sub-group of older adults with T1D using CGM, safe with respect to time in hypoglycaemia.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric Evaluation of Screens for Common Mental Disorders, Severe Mental Disorders, Substance Use Disorders, and Suicide Risk in Mozambican Healthcare.","authors":"Kathryn L Lovero, Melissa A Stockton, M Claire Greene, Cale Basaraba, Saida Khan, Dirceu Mabunda, Flavio Mandlate, Lidia Gouveia, Wilza Fumo, Melanie M Wall, Cristiane S Duarte, Maria A Oquendo, Milton L Wainberg","doi":"10.18103/mra.v12i8.5294","DOIUrl":"10.18103/mra.v12i8.5294","url":null,"abstract":"<p><p>Globally, mental and substance use disorders are a leading cause of disease burden. In low- and middle-income countries, where there is an extreme shortage of trained mental health specialists, validated, brief screening tools for mental and substance use disorders are required for non-specialists to efficiently identify patients in need of mental health care. Mozambique, one of the poorest countries in the world, has fewer than two mental health specialists for every 100,000 people. In the present study, we evaluated a comprehensive set of seven measures for depression, anxiety, somatization, alcohol use disorder, substance use disorder, psychosis and mania, and suicide risk among N=911 Mozambican adults in general healthcare settings. All instruments demonstrated acceptable internal consistency (α > 0.75). Compared to diagnoses made by the Mini International Neuropsychiatric Interview, all measures showed good criterion validity (AUC > 0.75), except the Psychosis Screening Questionnaire, which showed low sensitivity (0.58) for psychotic disorder. No substantial differences were observed in internal consistency when stratifying by gender, age, education level, primary language, facility-type, and patient status; criterion validity showed some variability when stratified by sub-population, particularly for education, primary language, and whether the participant was seeking care that day. Exploratory factor analyses indicated that the measures best differentiate categories of diagnoses (common mental disorder, severe mental disorders, substance use disorders, and suicide risk) rather than individual diagnoses, suggesting the utility of a transdiagnostic approach. Our findings support the use of these measures in Mozambique to identify common mental disorders, substance use disorders, and suicide risk, but indicate further research is needed to develop an adequate screen for severe mental disorders. Given the limited mental health specialists in this and other LMIC settings, these brief measures can support non-specialist provision of mental health services and promote closure of the treatment gap.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11391859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of a Novel <i>SCN5A</i> gene variant in a young female with atrioventricular canal defect in the absence of classical Brugada syndrome phenotype.","authors":"Ritwick Mondal, Rahul Manna, Emili Banerjee, Julián Benito-León, Shramana Deb","doi":"10.18103/mra.v12i7.5527","DOIUrl":"10.18103/mra.v12i7.5527","url":null,"abstract":"<p><strong>Background: </strong>Brugada syndrome is generally considered a cardiac channelopathy disorder characterized by syncope or sudden cardiac death. The sodium voltage-gated channel alpha subunit 5 (<i>SCN5A</i>) gene is the most commonly mutated gene associated with Brugada syndrome. Recent discoveries of new variants of this gene, along with current guidance of family screening, have identified several asymptomatic carriers with potentially causative mutations.</p><p><strong>Case presentation: </strong>We present the case of a 25-year-old female patient without any family history of Brugada syndrome nor related congenital cardiovascular disorders, with an extensive atrioventricular canal defect, who tested positive for a novel heterozygous variant NM_198056.3: c.3169G>C (p. Asp1057 His) in the <i>SCN5A</i> gene. She had no history of syncope or aborted sudden cardiac death except for recurrent chest infections since her early childhood. Intriguingly, she did not show a type I Brugada electrocardiogram pattern.</p><p><strong>Conclusions: </strong>This report provides a novel heterozygous variant NM_198056.3: c.3169G>C (p. Asp1057 His) in the <i>SCN5A</i> gene, which may have a potential detrimental effect.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142524005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design and testing of Hepatitis Delta Ribozymes for suppression of Chikungunya virus infection in cell cultures.","authors":"Mark E Fraser, Cheryl Kucharski, Zoe Loh, Erin Hanahoe, Malcolm J Fraser","doi":"10.18103/mra.v12i8.5762","DOIUrl":"https://doi.org/10.18103/mra.v12i8.5762","url":null,"abstract":"<p><p>Chikungunya virus is an emerging pathogen with widespread distribution in regions of Africa, India, and Asia that threatens to spread into temperate climates following the introduction of its major vector, <i>Aedes albopictus</i>. Recent cases have been documented in Europe, the Caribbean, and the Americas. Chikungunya virus causes a disease frequently misdiagnosed as Dengue fever, with potentially life-threatening symptoms that can result in long term debilitating arthritis. There have been ongoing investigations of possible therapeutic interventions for both acute and chronic symptoms, but to date none have proven effective in reducing the severity or lasting effects of this disease. Recently, a promising vaccine candidate has received accelerated approval, indicating the importance of remedies to this emerging worldwide health threat. Nonetheless, therapeutic interventions for Chikungunya and other mosquito borne virus diseases are urgently needed yet remain elusive. The increasing risk of spread from endemic regions via human travel and commerce, coupled with the absence of a vaccine or approved therapeutic, puts a significant proportion of the world population at risk for this disease. In this report we explore the possibility of using Specific On/oFf Adapter Hepatitis Delta Virus Ribozymes as antivirals in cells infected with Chikungunya virus. The results we obtained suggest there could be some role in using these ribozyme molecules as antiviral therapies for not only Chikungunya virus, but potentially other viruses as well.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11423935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Mistrust on Prostate Cancer Screening: A mixed method study among African Americans, Caribbean immigrants and African immigrants.","authors":"Malika Nipher, Roberts Lisa, Alemi Qais, Casiano Carlos A, Montgomery Susanne","doi":"10.18103/mra.v12i8.5727","DOIUrl":"10.18103/mra.v12i8.5727","url":null,"abstract":"<p><strong>Objectives: </strong>The contribution of medical mistrust to healthcare utilization delays has been gaining increasing attention. However, few studies have examined these associations among subgroups of Black men (African Americans, Caribbean, and African immigrants) in relation to prostate cancer (PCa). This study addresses this gap by assessing how medical mistrust affects PCa screening behavior and to further understand perceptions of medical mistrust among subgroups of Black men.</p><p><strong>Methods: </strong>This research employs a mixed-methods approach comprising two distinct phases. In Phase 1, a cross-sectional examination was conducted to evaluate the influence of medical mistrust toward healthcare organizations on prostate cancer screening among 498 Black men. In Phase 2, a qualitative investigation was undertaken to delve into the nuances of medical mistrust through six focus groups (n=51) and ten key informant interviews (n=10). Logistic regression and grounded theory methods were employed for data analysis.</p><p><strong>Results: </strong>Quantitative findings unveiled disparities in mistrust among subgroups, with Caribbean immigrants exhibiting higher levels of medical mistrust. Nevertheless, individuals with a family history of PCa showed elevated likelihoods of undergoing screening, despite mistrust. Qualitative results revealed 1) differences in reasons for medical mistrust among Black subgroups, 2) cultural perceptions which influence medical mistrust and medical care seeking, 3) lack of education in relation to PCa that contributes to medical mistrust, 4) negative past experiences and poor provider communication contribute, and 5) when PCa directly affected one's life, either personally or within the family, there was a recognized importance placed on monitoring one's risk despite mistrust.</p><p><strong>Conclusion: </strong>While medical mistrust may not significantly deter healthcare utilization among individuals with a family history or diagnosis of PCa, it underscores the variability of medical mistrust and its underlying reasons among different Black subgroups.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for small for gestational age as defined by a birthweight z-score below minus one: A prospective observational study.","authors":"Hein Odendaal, Lucy T Brink, Anusha Lachman, Daan Nel","doi":"10.18103/mra.v12i8.5731","DOIUrl":"10.18103/mra.v12i8.5731","url":null,"abstract":"<p><strong>Objective: </strong>To determine the maternal risk factors for small-for-gestational-age newborns as defined by a birthweight <i>z</i>-score (BWZS) < -1.0.</p><p><strong>Design: </strong>A prospective cohort study with recruitment from August 2007 to January 2015.</p><p><strong>Setting: </strong>Recruitment at a community health centre with assessments at Tygerberg Academic Hospital, Cape Town, South Africa.</p><p><strong>Population: </strong>A largely homogeneous population in a low socioeconomic residential area in Cape Town.</p><p><strong>Methods: </strong>This study is a further analysis of the data of the Safe Passage Study which investigated whether exposure to alcohol and tobacco was associated with increased risk of stillbirth and sudden infant death syndrome (SIDS).</p><p><strong>Main outcome measures: </strong>Birthweight <i>z</i>-score < -1.0.</p><p><strong>Results: </strong>Individual odds ratios (ORs), in descending order, were associated with smoking, drinking, and preeclampsia (2.45), previous stillbirth (1.85), smoking (including smokers only and drinkers who also smoked) (1.55), preeclampsia (1.52), smoking and drinking (does not include smokers only or drinkers only)(1.43), hypertension (1.28), drug use (1.24), drinking during pregnancy (including drinkers only and drinkers who also smoked) (1.18), thoughts of self-harm (1.13), and crowding (1.10). After multiple logistic regression, highly significant ORs were found for previous stillbirth (1.89), cigarette smoking (1.84), hypertension (1.40), education (0.94) and body mass index (BMI) (0.95). Thoughts of self-harm then had an OR of 1.08 (95% confidence interval (CI) 1.00-1.18).</p><p><strong>Conclusion: </strong>Previous stillbirth, cigarette smoking, hypertension, lesser education, and a lower BMI were associated with the highest risks for low BWZS.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linking alcohol use to Alzheimer's disease: Interactions with aging and APOE along immune pathways.","authors":"Mollie Monnig, Krish Shah","doi":"10.18103/mra.v12i8.5228","DOIUrl":"10.18103/mra.v12i8.5228","url":null,"abstract":"<p><p>Although it is known that APOE genotype is the strongest genetic risk factor for late-onset Alzheimer's disease, development is a multifactorial process. Alcohol use is a contributor to the epidemic of Alzheimer's disease and related dementias in the US and globally, yet mechanisms are not fully understood. Carriers of the APOE ε4 allele show elevated risk of dementia in relation to several lifestyle factors, including alcohol use. In this review, we describe how alcohol interacts with APOE genotype and aging with potential implications for Alzheimer's disease promotion. Age-related immune senescence and \"inflammaging\" (i.e., low-grade inflammation associated with aging) are increasingly recognized as contributors to age-related disease. We focus on three immune pathways that are likely contributors to Alzheimer's disease development, centering on alcohol and APOE genotype interactions, specifically: 1) microbial translocation and immune activation, 2) the senescence associated secretory phenotype, and 3) neuroinflammation. First, microbial translocation, the unphysiological movement of gut products into systemic circulation, elicits a proinflammatory response and increases with aging, with proposed links to Alzheimer's disease. Second, the senescence associated secretory phenotype is a set of intercellular signaling factors, e.g., proinflammatory cytokines and chemokines, growth regulators, and proteases, that drives cellular aging when senescent cells remain metabolically active. The senescence associated secretory phenotype can drive development of aging-diseases such as Alzheimer's disease. Third, neuroinflammation occurs via numerous mechanisms such as microglial activation and is gaining recognition as an etiological factor in the development of Alzheimer's disease. This review focuses on interactions of alcohol with APOE genotype and aging along these three pathways that may promote Alzheimer's disease. Further research on these processes may inform development of strategies to prevent onset and progression of Alzheimer's disease and to delay associated cognitive decline.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-occurring trauma- and stressor-related and substance-related disorders in youth: A narrative review.","authors":"Jesse D Hinckley, Zachary W Adams, Trey V Dellucci, Steven Berkowitz","doi":"10.18103/mra.v12i8.5688","DOIUrl":"10.18103/mra.v12i8.5688","url":null,"abstract":"<p><p>Adolescence is characterized by ongoing neurodevelopment and psychosocial development, resulting in a unique window to the adverse effects of traumatic events and substance use. In addition, trauma- and stressor-related disorders and substance use disorders (SUDs) commonly co-occur in adolescents. Youth with interpersonal violence and who have experienced multiple past traumas, or poly-victimization, are at the highest risk of developing these co-occurring disorders. There is a strong bidirectional relationship between traumatic events and substance use that predisposes youth to developing post-traumatic stress symptoms (PTSS) and SUDs. PTSD and states of substance intoxication and withdrawal also exhibit overlap in symptomatology. High rates of comorbidity may be explained in part by the self-medication hypothesis, that posits that individuals use substances to temporarily alleviate trauma-related symptoms. However, this results in negative reinforcement, often with increasing patterns of substance use and worsening symptoms of hyperarousal, dysphoria, and anxiety. In addition, PTSS and substance use problems share common risk factors and neurobiologic etiology, conceptualized as the susceptibility hypothesis. Youth who experience traumatic events and/or have substance use problems access the healthcare system at multiple levels, including through acute care and crisis services. Notably, substance use in adolescence increases the likelihood of experiencing a traumatic event, and youth presenting to the emergency department for substance-related problems are at higher risk of having a PTSD. Youth presenting for mental health, behavioral, or substance-related problems should be screened for PTSS and substance use problems. Given the strong clinical overlap and bidirectional relationship, evidence-based treatment integrates management of both disorders. An interdisciplinary approach with psychotherapy, psychopharmacologic therapy, and case management is often vital to engaging and maintaining youth in treatment.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"12 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}