Community exposure to armed conflict and subsequent onset of alcohol use disorder

International Journal of Methods in Psychiatric Research

Objective The standard method of generating disorder‐specific disability scores has lay raters make rankings between pairs of disorders based on brief disorder vignettes. This method introduces bias due to differential rater knowledge of disorders and inability to disentangle the disability due to disorders from the disability due to comorbidities. Methods We propose an alternative, data‐driven, method of generating disorder‐specific disability scores that assesses disorders in a sample of individuals either from population medical registry data or population survey self‐reports and uses Generalized Random Forests (GRF) to predict global (rather than disorder‐specific) disability assessed by clinician ratings or by survey respondent self‐reports. This method also provides a principled basis for studying patterns and predictors of heterogeneity in disorder‐specific disability. We illustrate this method by analyzing data …

Molecular psychiatry

Despite significant advances in the study of obsessive-compulsive disorder (OCD), important questions remain about the disorder's public health significance, appropriate diagnostic classification, and clinical heterogeneity. These issues were explored using data from the National Comorbidity Survey Replication, a nationally representative survey of US adults. A subsample of 2073 respondents was assessed for lifetime Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV) OCD. More than one quarter of respondents reported experiencing obsessions or compulsions at some time in their lives. While conditional probability of OCD was strongly associated with the number of obsessions and compulsions reported, only small proportions of respondents met full DSM-IV criteria for lifetime (2.3%) or 12-month (1.2%) OCD. OCD is associated with substantial comorbidity, not only with anxiety and mood …

Archives of Sexual Behavior

Forced intercourse is a high prevalence experience among US women, with high potential to produce subsequent major depressive episodes (MDE). However, the extent to which prior risk factors are associated with the timing of both sexual assault experiences and subsequent MDE onset is not known. The aim of this study was to document the associations between childhood depression, subsequent forced intercourse, and later MDE. We used retrospective information on childhood depression, forced intercourse, and MDE after forced intercourse from female respondents in the nationally representative 2017 US Panel Study of Income Dynamics-Transition to Adulthood Supplement (PSID-TAS, N= 1298, response rate: 87%). Multivariable logistic regression estimated these associations, controlling for age, race, poverty, religiosity, family history of depression, and adverse childhood experiences (such as parental …

medRxiv

Despite great progress on methods for case-control polygenic prediction (e.g. schizophrenia vs. control), there remains an unmet need for a method that genetically distinguishes clinically related disorders (e.g. schizophrenia (SCZ) vs. bipolar disorder (BIP) vs. depression (MDD) vs. control); such a method could have important clinical value, especially at disorder onset when differential diagnosis can be challenging. Here, we introduce a method, Differential Diagnosis-Polygenic Risk Score (DDx-PRS), that jointly estimates posterior probabilities of each possible diagnostic category (e.g. SCZ=50%, BIP=25%, MDD=15%, control=10%) by modeling variance/covariance structure across disorders, leveraging case-control polygenic risk scores (PRS) for each disorder (computed using existing methods) and prior clinical probabilities for each diagnostic category. DDx-PRS uses only summary-level training data and does not use tuning data, facilitating implementation in clinical settings. In simulations, DDx-PRS was well-calibrated (whereas a simpler approach that analyzes each disorder marginally was poorly calibrated), and effective in distinguishing each diagnostic category vs. the rest. We then applied DDx-PRS to Psychiatric Genomics Consortium SCZ/BIP/MDD/control data, including summary-level training data from 3 case-control GWAS (N=41,917-173,140 cases; total N=1,048,683) and held-out test data from different cohorts with equal numbers of each diagnostic category (total N=11,460). DDx-PRS was well-calibrated and well-powered relative to these training sample sizes, attaining AUCs of 0.66 for SCZ vs. rest, 0.64 for BIP vs. rest, 0.59 …

medRxiv

Suicide is one of the leading causes of death in the US, and the number of attributable deaths continues to increase. Risk of suicide-related behaviors (SRBs) is dynamic, and SRBs can occur across a continuum of time and locations. However, current SRB risk assessment methods, whether conducted by clinicians or through machine learning models, treat SRB risk as static and are confined to specific times and locations, such as following a hospital visit. Such a paradigm is unrealistic as SRB risk fluctuates and creates time gaps in the availability of risk scores. Here, we develop two closely related model classes, Event-GRU-ODE and Event-GRU-Discretized, that can predict the dynamic risk of events as a continuous trajectory based on Neural ODEs, an advanced AI model class for time series prediction. As such, these models can estimate changes in risk across the continuum of future time points, even without new observations, and can update these estimations as new data becomes available. We train and validate these models for SRB prediction using a large electronic health records database. Both models demonstrated high discrimination performance for SRB prediction (e.g., AUROC > 0.92 in the full, general cohort), serving as an initial step toward developing novel and comprehensive suicide prevention strategies based on dynamic changes in risk.

Psychological medicine

BackgroundSeveral hypotheses may explain the association between substance use, posttraumatic stress disorder (PTSD), and depression. However, few studies have utilized a large multisite dataset to understand this complex relationship. Our study assessed the relationship between alcohol and cannabis use trajectories and PTSD and depression symptoms across 3 months in recently trauma-exposed civilians.MethodsIn total, 1618 (1037 female) participants provided self-report data on past 30-day alcohol and cannabis use and PTSD and depression symptoms during their emergency department (baseline) visit. We reassessed participant's substance use and clinical symptoms 2, 8, and 12 weeks posttrauma. Latent class mixture modeling determined alcohol and cannabis use trajectories in the sample. Changes in PTSD and depression symptoms were assessed across alcohol and cannabis use trajectories …

Translational Psychiatry

Bipolar disorder is a leading contributor to disability, premature mortality, and suicide. Early identification of risk for bipolar disorder using generalizable predictive models trained on diverse cohorts around the United States could improve targeted assessment of high risk individuals, reduce misdiagnosis, and improve the allocation of limited mental health resources. This observational case-control study intended to develop and validate generalizable predictive models of bipolar disorder as part of the multisite, multinational PsycheMERGE Network across diverse and large biobanks with linked electronic health records (EHRs) from three academic medical centers: in the Northeast (Massachusetts General Brigham), the Mid-Atlantic (Geisinger) and the Mid-South (Vanderbilt University Medical Center). Predictive models were developed and valid with multiple algorithms at each study site: random forests, gradient …

Journal of affective disorders

BackgroundChildhood/adolescence adversities and mental disorders are higher among LGB youths.AimsTo evaluate the role of childhood maltreatment, bullying, and mental disorders on the association between sexual orientation and suicidal ideation (SI); and the role of mental disorders on the association between sexual orientation discrimination and SI.MethodsBaseline and 12-month follow-up online surveys of Spanish first-year university students (18–24-year-olds). Multivariable logistic regression models assessed the effects of childhood/adolescence adversities and mental disorders in the relationship between sexual orientation, discrimination and SI.ResultsA total of 1224 students were included (16.4 % LGBs). Risk factors of lifetime SI were sexual orientation (OR 2.4), any bullying (OR 2.4), any childhood maltreatment (OR 4.0), and any mental disorders (OR 3.8). Final model Area Under the Curve (AUC …

American Journal of Preventive Medicine

IntroductionThis study develops a practical method to triage Army transitioning service members (TSMs) at highest risk of homelessness to target a preventive intervention.MethodsThe sample included 4,790 soldiers from the Study to Assess Risk and Resilience in Servicemembers-Longitudinal Study (STARRS-LS) who participated in one of three Army STARRS 2011-2014 baseline surveys followed by the third wave of the STARRS-LS online panel surveys (2020-2022). Two machine learning models were trained: a Stage-1 model that used administrative predictors and geospatial data available for all TSMs at discharge to identify high-risk TSMs for initial outreach; and a Stage-2 model estimated in the high-risk subsample that used self-reported survey data to help determine highest risk based on additional information collected from high-risk TSMs once they are contacted. The outcome in both models was …

medRxiv

BackgroundDepression and Coronary Artery Disease (CAD) are highly comorbid conditions. Approximately 40% of individuals who have one diagnosis will also develop the other within their lifetime. Prior research indicates that polygenic risk for depression increases the odds of developing CAD even in the absence of clinical depression. However, the specific genes and pathways involved in comorbid depression-CAD remain unknown.ResultsWe identified genes that are significantly associated with both depression and CAD, and are enriched for pathways involved in inflammation and for previous association with cardiomyopathy. We observed increased rate of prevalent, but not incident, cardiomyopathy cases in individuals with comorbid depression-CAD compared to those with CAD alone in three electronic large health record (EHR) datasets.ConclusionsThe results of our study implicate genetically regulated inflammatory mechanisms in depression-CAD. Our results also raise the hypothesis that depression-associated CAD may be enriched for cardiomyopathy.Clinical PerspectiveWhat’s New?Gene associations shared between depression and CAD are enriched for prior association with cardiomyopathy phenotypes.Cardiomyopathy is significantly more prevalent in individuals with comorbid depression-CAD than in CAD or depression alone.What are the Clinical Implications?Our work suggests that individuals with comorbid depression-CAD may benefit from screening for cardiomyopathy.

Nature Medicine

Polygenic risk scores (PRSs) have improved in predictive performance, but several challenges remain to be addressed before PRSs can be implemented in the clinic, including reduced predictive performance of PRSs in diverse populations, and the interpretation and communication of genetic results to both providers and patients. To address these challenges, the National Human Genome Research Institute-funded Electronic Medical Records and Genomics (eMERGE) Network has developed a framework and pipeline for return of a PRS-based genome-informed risk assessment to 25,000 diverse adults and children as part of a clinical study. From an initial list of 23 conditions, ten were selected for implementation based on PRS performance, medical actionability and potential clinical utility, including cardiometabolic diseases and cancer. Standardized metrics were considered in the selection process, with …

International Journal of Mental Health Systems

BackgroundMental health service providers are increasingly interested in patient perspectives. We examined rates and predictors of patient-reported satisfaction and perceived helpfulness in a cross-national general population survey of adults with 12-month DSM-IV disorders who saw a provider for help with their mental health.MethodsData were obtained from epidemiological surveys in the World Mental Health Survey Initiative. Respondents were asked about satisfaction with treatments received from up to 11 different types of providers (very satisfied, satisfied, neither satisfied nor dissatisfied, somewhat dissatisfied, very dissatisfied) and helpfulness of the provider (a lot, some, a little, not at all). We modelled predictors of satisfaction and helpfulness using a dataset of patient-provider observations (n = 5,248).ResultsMost treatment was provided by general medical providers (37.4%), psychiatrists (18.4%) and …

Psychological medicine

BackgroundSuicidal behaviors are prevalent among college students; however, students remain reluctant to seek support. We developed a predictive algorithm to identify students at risk of suicidal behavior and used telehealth to reduce subsequent risk.MethodsData come from several waves of a prospective cohort study (2016–2022) of college students (n = 5454). All first-year students were invited to participate as volunteers. (Response rates range: 16.00–19.93%). A stepped-care approach was implemented: (i) all students received a comprehensive list of services; (ii) those reporting past 12-month suicidal ideation were directed to a safety planning application; (iii) those identified as high risk of suicidal behavior by the algorithm or reporting 12-month suicide attempt were contacted via telephone within 24-h of survey completion. Intervention focused on support/safety-planning, and referral to services for this …

medRxiv

Objective Early identification of bipolar disorder (BD) provides an important opportunity for timely intervention. In this study, we aimed to develop machine learning models using large-scale electronic health record (EHR) data including clinical notes for predicting early-onset BD. Method Structured and unstructured data were extracted from the longitudinal EHR of the Mass General Brigham health system. We defined three cohorts aged 10-25 years: (1) the full youth cohort (N=300,398); (2) a sub-cohort defined by having a mental health visit (N=105,461); (3) a sub-cohort defined by having a diagnosis of mood disorder or ADHD (N=35,213). By adopting a prospective landmark modeling approach that aligns with clinical practice, we developed and validated a range of machine learning models including neural network-based models, across different cohorts and prediction windows. Results We found the two tree-based models, Random forests (RF) and light gradient-boosting machine (LGBM), achieving good discriminative performance across different clinical settings (area under the receiver operating characteristic curve 0.76-0.88 for RF and 0.74-0.89 for LGBM). In addition, we showed comparable performance can be achieved with a greatly reduced set of features, demonstrating computational efficiency can be attained without significant compromise of model accuracy. Conclusion Good discriminative performance for early-onset BD is achieved utilizing large-scale EHR data. Our study offers a scalable and accurate method for identifying youth at risk for BD that could help inform clinical decision making and facilitate early intervention …

ObjectiveCollege students have high rates of mental health problems and low rates of treatment. Although sociodemographic disparities in student mental health treatment seeking have been reported, findings have not been synthesized and quantified. The extent to which differences in perceived need for treatment contribute to overall disparities remains unclear.MethodsA systematic search of PubMed, PsycInfo, and Embase was conducted. Studies published between 2007 and 2022 were included if they reported treatment rates among college students with mental health problems, stratified by sex, gender, race-ethnicity, sexual orientation, student type, student year, or student status. Random-effects models were used to calculate pooled prevalence ratios (PRs) of having a perceived need for treatment and of receiving treatment for each sociodemographic subgroup.ResultsTwenty-one studies qualified for …

medRxiv

Genome-wide association studies (GWAS) have been instrumental in identifying genetic associations for various diseases and traits. However, uncovering genetic underpinnings among traits beyond univariate phenotype associations remains a challenge. Multi-phenotype associations (MPA), or genetic pleiotropy, offer important insights into shared genes and pathways among traits, enhancing our understanding of genetic architectures of complex diseases. GWAS of biobank-linked electronic health record (EHR) data are increasingly being utilized to identify MPA among various traits and diseases. However, methodologies that can efficiently take advantage of distributed EHR to detect MPA are still lacking. Here, we introduce mixWAS, a novel algorithm that efficiently and losslessly integrates multiple EHRs via summary statistics, allowing the detection of MPA among mixed phenotypes while accounting for …

Despite recognizing the critical association between social and behavioral determinants of health (SBDH) and suicide risk, SBDHs from unstructured electronic health record (EHR) notes for suicide predictive modeling remain underutilized. This study investigates the impact of SBDH, identified from both structured and unstructured data utilizing a natural language processing (NLP) system, on suicide prediction within 7, 30, 90, and 180 days of discharge. Using EHR data of 2,987,006 Veterans between October 1, 2009, and September 30, 2015, from the US Veterans Health Administration (VHA), we designed a case-control study that demonstrates that incorporating structured and NLP-extracted SBDH significantly enhances the performance of three architecturally distinct suicide predictive models-elastic-net logistic regression, random forest (RF), and multilayer perceptron. For example, RF achieved notable improvements in suicide prediction within 180 days of discharge, with an increase in the area under the receiver operating characteristic curve from 83.57–84.25%(95% CI= 0.63%-0.98%, p-val< 0.001) and the area under the precision recall curve from 57.38–59.87%(95% CI= 3.86%-4.82%, p-val< 0.001) after integrating NLP-extracted SBDH. These findings underscore the potential of NLP-extracted SBDH in enhancing suicide prediction across various prediction timeframes, offering valuable insights for healthcare practitioners and policymakers.

Addiction

We would like to thank Mr Angus and Drs Livingston, Holmes and Greenfield for their commentaries on our debate article [1-4]. These commentaries focus upon (i) the definition, operationalization and communication of health consequences from alcohol use and (ii) the need to communicate how per occasion drinking impacts health.

Addiction

Gambling advertising is a common feature in international jurisdictions that have liberalized gambling. In the Anglosphere, countries such as Australia, New Zealand and the United Kingdom have experienced extensive gambling advertising during the past decade. This advertising is particularly prominent in relation to professional sports and lottery products. More recently, some Canadian provinces and US states have also witnessed a similar rise in gambling advertising. Several European governments, including Belgium, Italy, Netherlands and Spain, have more recently restricted gambling advertising and sponsorship in professional sports, but the UK government did not announce any action on gambling advertising and sponsorship in its 2023 White Paper. In September 2023, the UK’s Minister for Sport, Gambling and Civil Society addressed a governmental select committee, stating:‘We have very much gone …

Addiction

Background and aims Problematic pornography use (PPU) is a common manifestation of the newly introduced Compulsive Sexual Behavior Disorder diagnosis in the 11th edition of the International Statistical Classification of Diseases and Related Health Problems. Although cultural, gender‐ and sexual orientation‐related differences in sexual behaviors are well documented, there is a relative absence of data on PPU outside Western countries and among women as well as gender‐ and sexually‐diverse individuals. We addressed these gaps by (a) validating the long and short versions of the Problematic Pornography Consumption Scale (PPCS and PPCS‐6, respectively) and the Brief Pornography Screen (BPS) and (b) measuring PPU risk across diverse populations. Methods Using data from the pre‐registered International Sex Survey [n = 82 243; mean age (Mage) = 32.4 years, standard deviation …

Addiction

Background and aims Identifying effective opioid treatment options during pregnancy is a high priority due to the growing prevalence of opioid use disorder across North America. We assessed the temporal impact of three population‐level interventions on the use of opioid agonist treatment (OAT) during pregnancy in Ontario, Canada. Design This was a population‐based time‐series analysis to identify trends in the monthly prevalence of pregnant people dispensed methadone and buprenorphine. The impact of adding buprenorphine/naloxone to the public drug formulary, the release of pregnancy‐specific guidance and the start of the COVID‐19 pandemic were assessed. Setting and participants The study was conducted in Ontario, Canada between 1 July 2013 and 31 March 2022, comprising people who delivered a live or stillbirth in any Ontario hospital during the study period. Measurements We identified …

Addiction

Background and Aims Impoverished people who inject drugs (PWID) are at the epicenter of US drug‐related epidemics. Medicaid expansion is designed to reduce cost‐related barriers to care by expanding Medicaid coverage to all US adults living at or below 138% of the federal poverty line. This study aimed to measure whether Medicaid expansion is (1) positively associated with the probability that participants are currently insured; (2) inversely related to the probability of reporting unmet need for medical care due to cost in the past year; and (3) positively associated with the probability that they report receiving substance use disorder (SUD) treatment in the past year, among PWID subsisting at ≤ 138% of the federal poverty line. Design A two‐way fixed‐effects model was used to analyze serial cross‐sectional observational data. Setting Seventeen metro areas in 13 US states took part in the study …

Addiction

Background and Aims Recently, we demonstrated that a distinct pattern of structural covariance networks (SCN) from magnetic resonance imaging (MRI)‐derived measurements of brain cortical thickness characterized young adults with alcohol use disorder (AUD) and predicted current and future problematic drinking in adolescents relative to controls. Here, we establish the robustness and value of SCN for identifying heavy alcohol users in three additional independent studies. Design and Setting Cross‐sectional and longitudinal studies using data from the Pediatric Imaging, Neurocognition and Genetics (PING) study (n = 400, age range = 14–22 years), the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) (n = 272, age range = 17–22 years) and the Human Connectome Project (HCP) (n = 375, age range = 22–37 years). Cases Cases were defined based on …

Addiction

Background and Aims Inadequate reporting of smoking cessation intervention trials is common and leads to significant challenges for researchers. The aim of this study was to tailor CONSORT (Consolidated Standards of Reporting Trials)‐SPI (Social and Psychological Interventions) guidelines to improve reporting of trials of behavioural interventions to promote smoking cessation. Method Informed by missing data from the IC‐SMOKE (Intervention and Comparison group support provided in SMOKing cEssation) systematic review project, this study used a multi‐stage Delphi process to examine which items could be added or modified to improve the reporting of smoking cessation trials. The first stage involved an on‐line survey of 17 international experts in smoking cessation and trial methodology voting on the importance of items for inclusion in the updated guidelines. This was followed by a face‐to‐face expert …

Addiction

Medications for opioid use disorder (MOUD) increase retention in care and decrease mortality during active treatment; however, information about the comparative effectiveness of different forms of MOUD is sparse. Observational comparative effectiveness studies are subject to many types of bias; a robust framework to minimize bias would improve the quality of comparative effectiveness evidence. This paper discusses the use of target trial emulation as a framework to conduct comparative effectiveness studies of MOUD with administrative data. Using examples from our planned research project comparing buprenorphine‐naloxone and extended‐release naltrexone with respect to the rates of MOUD discontinuation, we provide a primer on the challenges and approaches to employing target trial emulation in the study of MOUD.

Addiction

Background and aims A lack of consensus on the optimal outcome measures to assess opioid use disorder (OUD) treatment efficacy and their precise definition and computation has hampered the pooling of research data for evidence synthesis and meta‐analyses. This study aimed to empirically contrast multiple clinical trial definitions of treatment success by applying them to the same dataset. Methods Data analysis used a suite of functions, developed as a software package for the R language, to operationalize 61 treatment outcome definitions based on urine drug screening (UDS) results. Outcome definitions were derived from clinical trials that are among the most influential in the OUD treatment field. Outcome functions were applied to a harmonized dataset from three large‐scale National Drug Abuse Treatment Clinical Trials Network (CTN) studies, which tested various medication for OUD (MOUD) options …

Addiction

Gambling advertising is a common feature in international jurisdictions that have liberalized gambling. In the Anglosphere, countries such as Australia, New Zealand and the United Kingdom have experienced extensive gambling advertising during the past decade. This advertising is particularly prominent in relation to professional sports and lottery products. More recently, some Canadian provinces and US states have also witnessed a similar rise in gambling advertising. Several European governments, including Belgium, Italy, Netherlands and Spain, have more recently restricted gambling advertising and sponsorship in professional sports, but the UK government did not announce any action on gambling advertising and sponsorship in its 2023 White Paper. In September 2023, the UK’s Minister for Sport, Gambling and Civil Society addressed a governmental select committee, stating:‘We have very much gone …

Addiction

Aims To measure the change in proportion of opioid‐related overdose deaths attributed to people experiencing homelessness and to compare the opioid‐related fatalities between individuals experiencing homelessness and not experiencing homelessness at time of death. Design, setting and participants Population‐based, time‐trend analysis using coroner and health administrative databases from Ontario, Canada from 1 July 2017 and 30 June 2021. Measurements Quarterly proportion of opioid‐related overdose deaths attributed to people experiencing homelessness. We also obtained socio‐demographic and health characteristics of decedents, health‐care encounters preceding death, substances directly contributing to death and circumstances surrounding deaths. Findings A total of 6644 individuals (median age = 40 years, interquartile range = 31–51; 74.1% male) experienced an accidental …

Addiction

Background and aims Network centrality, an indicator of an individual's importance and potential to drive behavioral change, is rarely used to select peer educators. Individual‐level predictors of network centrality might be useful to identify people who inject drugs (PWID) for potential roles as peer navigators or change agents in network‐based interventions in settings where sociometric data are unavailable. We assessed the relationship between network centrality and HIV prevention service engagement to determine whether centrally‐positioned PWID share measurable commonalities. Design Observational study and survey using baseline data from a sociometric network cohort of PWID, enumerated using network software and biometric data (2017‐2020). Network ties corresponded to direct injection partnerships in the prior month. Setting New Delhi, India. Participants A total of 2512 PWID who were ≥18 …

Addiction

Background and Aims Impoverished people who inject drugs (PWID) are at the epicenter of US drug‐related epidemics. Medicaid expansion is designed to reduce cost‐related barriers to care by expanding Medicaid coverage to all US adults living at or below 138% of the federal poverty line. This study aimed to measure whether Medicaid expansion is (1) positively associated with the probability that participants are currently insured; (2) inversely related to the probability of reporting unmet need for medical care due to cost in the past year; and (3) positively associated with the probability that they report receiving substance use disorder (SUD) treatment in the past year, among PWID subsisting at ≤ 138% of the federal poverty line. Design A two‐way fixed‐effects model was used to analyze serial cross‐sectional observational data. Setting Seventeen metro areas in 13 US states took part in the study …

Addiction

Background and aims Problematic pornography use (PPU) is a common manifestation of the newly introduced Compulsive Sexual Behavior Disorder diagnosis in the 11th edition of the International Statistical Classification of Diseases and Related Health Problems. Although cultural, gender‐ and sexual orientation‐related differences in sexual behaviors are well documented, there is a relative absence of data on PPU outside Western countries and among women as well as gender‐ and sexually‐diverse individuals. We addressed these gaps by (a) validating the long and short versions of the Problematic Pornography Consumption Scale (PPCS and PPCS‐6, respectively) and the Brief Pornography Screen (BPS) and (b) measuring PPU risk across diverse populations. Methods Using data from the pre‐registered International Sex Survey [n = 82 243; mean age (Mage) = 32.4 years, standard deviation …

Addiction

Aims To measure the independent consequences of community‐level armed conflict beatings on alcohol use disorders (AUD) among males in Nepal during and after the 2000–2006 conflict. Design A population‐representative panel study from Nepal, with precise measures of community‐level violent events and subsequent individual‐level AUD in males. Females were not included because of low AUD prevalence. Setting Chitwan, Nepal. Participants Four thousand eight hundred seventy‐six males from 151 neighborhoods, systematically selected and representative of Western Chitwan. All residents aged 15–59 were eligible (response rate 93%). Measurements Measures of beatings in the community during the conflict (2000–2006), including the date and distance away, were gathered through neighborhood reports, geo‐location and official resources, then linked to respondents' life histories of AUD …

Addiction

Aim The aim of this study was to estimate how ongoing stimulant use affects return to illicit opioid use after initiation onto medication for opioid use disorder (MOUD). Design This was a secondary analysis of pooled data from two clinical trials comparing buprenorphine (BUP‐NX) and extended‐release naltrexone (XR‐NTX). Setting Thirteen opioid treatment programs and HIV clinics across 10 states in the United States from 2014 to 2019 took part in this study. Participants A total of 528 participants who initiated MOUD as part of trial participation were included. Nearly half (49%) were between 30 and 49 years of age, 69% were male and 66% were non‐Hispanic White. Measurements The primary outcome was first self‐reported day of non‐prescribed opioid use following MOUD initiation, and the exposure of interest was daily stimulant use (methamphetamine, amphetamines or cocaine). Both were defined …

ADDICTION

Issue Information Page 1 © 2024 Society for the Study of Addiction ADDICTION Volume 119 Number 2 February 2024 404 EDITORIAL How research and policy can shape driving under the influence of cannabis Jane Metrik & Denis M. McCarthy 208 REVIEW Prescription psychostimulants for the treatment of amphetamine-type stimulant use disorder: A systematic review and meta-analysis of randomized placebo-controlled trials Heidar Sharafi, Hamzah Bakouni, Christina McAnulty, Sarah Drouin, Stephanie Coronado-Montoya, Arash Bahremand, Paxton Bach, Nadine Ezard, Bernard Le Foll, Christian G. Sch ü tz, Krista J. Siefried, Vitor S. Tardelli, Daniela Ziegler & Didier Jutras-Aswad 211 RESEARCH REPORTS Tailoring CONSORT-SPI to improve the reporting of smoking cessation intervention trials: An expert consensus study Zoe Swithenbank, Alessio Bricca, Nicola Black, Jamie Hartmann Boyce, Marie Johnston…

Addiction

Gambling advertising is a common feature in international jurisdictions that have liberalized gambling. In the Anglosphere, countries such as Australia, New Zealand and the United Kingdom have experienced extensive gambling advertising during the past decade. This advertising is particularly prominent in relation to professional sports and lottery products. More recently, some Canadian provinces and US states have also witnessed a similar rise in gambling advertising. Several European governments, including Belgium, Italy, Netherlands and Spain, have more recently restricted gambling advertising and sponsorship in professional sports, but the UK government did not announce any action on gambling advertising and sponsorship in its 2023 White Paper. In September 2023, the UK’s Minister for Sport, Gambling and Civil Society addressed a governmental select committee, stating:‘We have very much gone …

Addiction

Aim To compare effects of three post‐relapse interventions on smoking abstinence. Design Sequential three‐phase multiple assignment randomized trial (SMART). Setting Eighteen Wisconsin, USA, primary care clinics. Participants A total of 1154 primary care patients (53.6% women, 81.2% White) interested in quitting smoking enrolled from 2015 to 2019; 582 relapsed and were randomized to relapse recovery treatment. Interventions In phase 1, patients received cessation counseling and 8 weeks nicotine patch. Those who relapsed and agreed were randomized to a phase 2 relapse recovery group: (1) reduction counseling + nicotine mini‐lozenges + encouragement to quit starting 1 month post‐randomization (preparation); (2) repeated encouragement to quit starting immediately post‐randomization (recycling); or (3) advice to call the tobacco quitline (control). The first two groups could opt into …

Addiction

Aims The aim of this study was to examine the safety of e‐cigarettes (EC) and nicotine patches (NRT) when used to help pregnant smokers quit. Design A recent trial of EC versus NRT reported safety outcomes in the randomized arms. We conducted a further analysis based on product use. Setting Twenty‐three hospitals in England and a stop‐smoking service in Scotland took part. Participants The participants comprised 1140 pregnant smokers. Interventions We compared women using and not using EC and NRT regularly during pregnancy. Measurements Measurements included nicotine intake compared with baseline, birth weight, other pregnancy outcomes, adverse events, maternal respiratory symptoms and relapse in early abstainers. Findings Use of EC was more common than use of NRT (47.3% vs 21.6%, P < 0.001). Women who stopped smoking (abstainers) and used EC at the end‐of …