Latent Class Analysis of DSM-5 Criteria for Opioid Use Disorders: Results from the Iranian National Survey on Mental Health

2015 ◽  
Vol 21 (3) ◽  
pp. 144-152 ◽  
Author(s):  
Mohammad Javad Tarrahi ◽  
Afarin Rahimi-Movaghar ◽  
Hojjat Zeraati ◽  
Seyed Abbas Motevalian ◽  
Masoumeh Amin-Esmaeili ◽  
...  
Keyword(s):  
Mental Health ◽  
Latent Class ◽  
Composite International Diagnostic Interview ◽  
Opioid Use Disorder ◽  
Diagnostic Interview ◽  
Opioid Use ◽  
Dsm 5 ◽  
Legal Problems ◽  
Dsm Iv ◽  
Opioid Users

Background: Assessments of DSM-IV and DSM-5 criteria with sample populations of opioid users are limited. This study aimed to determine the number of latent classes in opioid users and assessment of the proposed revisions to the DSM-5 opioid use disorder (OUD) criteria. Methods: Data came from the 2011 Iranian National Mental Health Survey (IranMHS) on 7,886 participants aged 15-64 years living in Iran. We used the Composite International Diagnostic Interview (CIDI) version 2.1 in all respondents who indicated using opioids at least 5 times in the previous 12 months (n = 236). Results: A three-class model provided the best fit of all the models tested. Classes showed a spectrum of severity that was compatible with the DSM-5 classification. ‘Legal problems' and ‘desire to cut down' showed poor discrimination between classes. The weighted prevalence of OUD using DSM-5 was 20.7% higher than with DSM-IV. Conclusions: Results support the grouping based on severity of symptoms, combining abuse and dependence into a single diagnosis, omitting legal problems, and addition of craving as a new criterion.

Prevalence, service use, and demographic correlates of 12-month DSM-IV psychiatric disorders in Mexico: results from the Mexican National Comorbidity Survey

2005 ◽  
Vol 35 (12) ◽  
pp. 1773-1783 ◽  
Author(s):  
M. ELENA MEDINA-MORA ◽  
GUILHERME BORGES ◽  
CARMEN LARA ◽  
CORINA BENJET ◽  
JERÓNIMO BLANCO ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychiatric Disorders ◽  
Service Use ◽  
Task Force ◽  
Adult Population ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Selection Scheme ◽  
Demographic Correlates ◽  
Dsm Iv

Background. This paper describes the 12-month prevalence, severity and demographic correlates of 16 DSM-IV psychiatric disorders and service utilization in the Mexican urban population aged 18–65 years of age. This is representative of 75% of the national adult population.Method. The sample design was a strict probability selection scheme. The response rate was 76·6%. The World Mental Health Survey version of the Composite International Diagnostic Interview was installed on laptops and administered by lay interviewers. An international WHO task force carried out its translation into Spanish.Results. The 12-month prevalence of any disorder was 12·1%. The most common disorders were specific phobia (4·0%), major depressive disorder (3·7%) and alcohol abuse or dependence (2·2%). The 12-month prevalence of very severe disorders was 3·7% of which only 24% used any services. Age was the only variable associated with any 12-month disorder, with the younger more likely to report any disorder. Income was associated with severity, with low and low–average incomes more likely to report a 12-month disorder. Females were more likely to report a mood and anxiety disorder, but less likely to report a substance disorder. The group of separated/widowed/divorced was more likely to report a mood and an impulse-control disorder.Conclusions. The results show that while psychiatric disorders are common in the Mexican population, very severe mental disorders are less common and there is extreme under-utilization of mental health services.

scholarly journals Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys

2010 ◽  
Vol 197 (5) ◽  
pp. 378-385 ◽  
Author(s):  
Ronald C. Kessler ◽  
Katie A. McLaughlin ◽  
Jennifer Greif Green ◽  
Michael J. Gruber ◽  
Nancy A. Sampson ◽  
...  
Keyword(s):  
Mental Health ◽  
Family Functioning ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Parental Mental Illness ◽  
Childhood Adversities ◽  
World Mental Health ◽  
First Onset ◽  
Dsm Iv

BackgroundAlthough significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders.AimsTo examine joint associations of 12 childhood adversities with first onset of 20 DSM–IV disorders in World Mental Health (WMH) Surveys in 21 countries.MethodNationally or regionally representative surveys of 51 945 adults assessed childhood adversities and lifetime DSM–IV disorders with the WHO Composite International Diagnostic Interview (CIDI).ResultsChildhood adversities were highly prevalent and interrelated. Childhood adversities associated with maladaptive family functioning (e.g. parental mental illness, child abuse, neglect) were the strongest predictors of disorders. Co-occurring childhood adversities associated with maladaptive family functioning had significant subadditive predictive associations and little specificity across disorders. Childhood adversities account for 29.8% of all disorders across countries.ConclusionsChildhood adversities have strong associations with all classes of disorders at all life-course stages in all groups of WMH countries. Long-term associations imply the existence of as-yet undetermined mediators.

scholarly journals Syringe service program-based telemedicine linkage to opioid use disorder treatment: protocol for the STAMINA randomized control trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dennis P. Watson ◽  
James A. Swartz ◽  
Lisa Robison-Taylor ◽  
Mary Ellen Mackesy-Amiti ◽  
Kim Erwin ◽  
...  
Keyword(s):  
Study Protocol ◽  
Randomized Control Trial ◽  
Treatment Protocol ◽  
Opioid Use Disorder ◽  
Additional Treatment ◽  
Initial Assessment ◽  
Opioid Use ◽  
Structured Interviews ◽  
Randomized Control ◽  
Opioid Users

Abstract Background A key strategy for mitigating the current opioid epidemic is expanded access to medications for treating opioid use disorder (MOUD). However, interventions developed to expand MOUD access have limited ability to engage opioid users at higher levels of overdose risk, such as those who inject opioids. This paper describes the study protocol for testing STAMINA (Syringe Service Telemedicine Access for Medication-assisted Intervention through NAvigation), an intervention that engages high-risk opioid users at community-based syringe service programs (SSP) and quickly links them to MOUD using a telemedicine platform. Methods This randomized control trial will be conducted at three SSP sites in Chicago. All participants will complete an initial assessment with a provider from a Federally Qualified Health Center who can prescribe or refer MOUD services as appropriate. The control arm will receive standard referral to treatment and the intervention arm will receive immediate telemedicine linkage to the provider and (depending on the type of MOUD prescribed) provided transportation to pick up their induction prescription (for buprenorphine or naltrexone) or attend their intake appointment (for methadone). We aim to recruit a total of 273 participants over two years to provide enough power to detect a difference in our primary outcome of MOUD treatment linkage. Secondary outcomes include treatment engagement, treatment retention, and non-MOUD opioid use. Data will be collected using structured interviews and saliva drug tests delivered at baseline, three months, and six months. Fixed and mixed effects generalized linear regression analyses and survival analysis will be conducted to compare the probabilities of a successful treatment linkage between the two arms, days retained in treatment, and post-baseline opioid and other drug use. Discussion If successful, STAMINA’s telemedicine approach will significantly reduce the amount of time between SSP clients’ initial indication of interest in the medication and treatment initiation. Facilitating this process will likely lead to stronger additional treatment- and recovery-oriented outcomes. This study is also timely given the need for more rigorous testing of telemedicine interventions in light of temporary regulatory changes that have occurred during the COVID-19 pandemic. Trial registration ClinicalTrials.gov (Clinical Trials ID: NCT04575324 and Protocol Number: 1138–0420). Registered 29 September 2020. The study protocol is also registered on the Open Science Framework (DOI 10.17605/OSF.IO/4853 M).

scholarly journals Substance Use and Mental Health in Emerging Adult Vs Older Adult Men and Women With Opioid Use Disorder

2020 ◽  
Vol 29 (6) ◽  
pp. 536-542 ◽  
Author(s):  
Celestina Barbosa‐Leiker ◽  
Aimee N.C. Campbell ◽  
Martina Pavlicova ◽  
Jennifer Scodes ◽  
A. Kathleen Burlew ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Older Adult ◽  
Emerging Adult ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Men And Women ◽  
Adult Men

scholarly journals Correlates of transitions from alcohol use to disorder diagnosed by DSM-5 in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tingting Zhang ◽  
Zhaorui Liu ◽  
Guohua Li ◽  
Yueqin Huang ◽  
Yanxiang Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Alcohol Use ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Face To Face ◽  
Multiple Risk Factors ◽  
Dsm 5 ◽  
Common Criteria ◽  
Underlying Mechanisms

Abstract Background This study aimed to describe the prevalence and lifetime criteria profiles of DSM-5 alcohol use disorder (AUD) and the transitions from alcohol use to disorder in Chifeng, China. Methods Face-to-face interviews were conducted using Composite International Diagnostic Interview-3.0 (CIDI-3.0) among 4528 respondents in Chifeng. Results The weighted lifetime and 12-month prevalence of DSM-5 AUD were 3.03 and 1.05%, respectively. Mild lifetime AUD was the most prevalent severity level (69.53%). The two most common criteria were “failure to quit/cutdown” and “drinking more or for longer than intended.” Lifetime prevalence was 65.59% for alcohol use, and 22.97% for regular drinking. Male and domestic violence were risk factors for the transition from alcohol use to regular drinking or AUD and from regular drinking to AUD. Younger age was risk factor for the transition to AUD from alcohol use or regular drinking. Poverty (OR = 2.49) was risk factor for the transition from alcohol use to regular drinking. The earlier drinkers were more likely to develop to regular drinking (OR = 2.11). Conclusion AUD prevalence in Chifeng was not as high as that in Western countries. The study revealed that multiple risk factors might contribute to the transition across different stages of alcohol use. Further research should explore the underlying mechanisms.

scholarly journals Mindfulness-Oriented Recovery Enhancement remediates anhedonia in chronic opioid use by enhancing neurophysiological responses during savoring of natural rewards

2021 ◽  
pp. 1-10
Author(s):  
Eric L. Garland ◽  
Spencer T. Fix ◽  
Justin P. Hudak ◽  
Edward M. Bernat ◽  
Yoshio Nakamura ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Skin Conductance Level ◽  
Opioid Therapy ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Natural Reward ◽  
Before And After ◽  
Natural Rewards ◽  
Chronic Opioid Use ◽  
Opioid Users

Abstract Background Neuropsychopharmacologic effects of long-term opioid therapy (LTOT) in the context of chronic pain may result in subjective anhedonia coupled with decreased attention to natural rewards. Yet, there are no known efficacious treatments for anhedonia and reward deficits associated with chronic opioid use. Mindfulness-Oriented Recovery Enhancement (MORE), a novel behavioral intervention combining training in mindfulness with savoring of natural rewards, may hold promise for treating anhedonia in LTOT. Methods Veterans receiving LTOT (N = 63) for chronic pain were randomized to 8 weeks of MORE or a supportive group (SG) psychotherapy control. Before and after the 8-week treatment groups, we assessed the effects of MORE on the late positive potential (LPP) of the electroencephalogram and skin conductance level (SCL) during viewing and up-regulating responses (i.e. savoring) to natural reward cues. We then examined whether these neurophysiological effects were associated with reductions in subjective anhedonia by 4-month follow-up. Results Patients treated with MORE demonstrated significantly increased LPP and SCL to natural reward cues and greater decreases in subjective anhedonia relative to those in the SG. The effect of MORE on reducing anhedonia was statistically mediated by increases in LPP response during savoring. Conclusions MORE enhances motivated attention to natural reward cues among chronic pain patients on LTOT, as evidenced by increased electrocortical and sympathetic nervous system responses. Given neurophysiological evidence of clinical target engagement, MORE may be an efficacious treatment for anhedonia among chronic opioid users, people with chronic pain, and those at risk for opioid use disorder.

scholarly journals Family functioning but not social capital is associated with better mental health in adolescents affected by violence and displacement by armed conflict in Colombia

2021 ◽  
pp. 002076402110454
Author(s):  
William Tamayo-Aguledo ◽  
Alida Acosta-Ortiz ◽  
Aseel Hamid ◽  
Carolina Gómez-García ◽  
María Camila García-Durán ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Capital ◽  
Family Functioning ◽  
Armed Conflict ◽  
Composite International Diagnostic Interview ◽  
Poor Mental Health ◽  
Diagnostic Interview ◽  
Cross Sectional ◽  
Nationally Representative ◽  
Cognitive Social Capital

Background: The effect of the Colombian armed conflict on the mental health of adolescents is still poorly understood. Aims: Given social interventions are most likely to inform policy, we tested whether two potential intervention targets, family functioning and social capital, were associated with mental health in Colombian adolescents, and whether this was moderated by experience of violence and displacement. Methods: We examined the cross-sectional association between family functioning, cognitive social capital, structural social capital and 12-month prevalence of Composite International Diagnostic Interview (CIDI) diagnosed psychiatric disorder, using data on 12 to 17-year-old adolescents ( N = 1,754) from the 2015 National Mental Health Survey of Colombia, a nationally representative epidemiological study. We tested whether associations survived cumulative adjustment for demographic confounders, experience of non-specific violence and harm and displacement by armed conflict. Results: Neither structural nor cognitive social capital were associated with better mental health. Better family functioning was associated with reduced risk of poor mental health in an unadjusted analysis (OR 0.90 [0.85–0.96]), and after cumulative adjustments for demographic confounders (OR 0.91 [0.86–0.97]), non-specific violence and harm (OR 0.91 [0.86–0.97]) and social capital variables (OR 0.91 [0.85–0.97]). In the final model, each additional point on the family APGAR scale was associated with a 9% reduced odds of any CIDI diagnosed disorder in the last 12 months. Conclusions: Better family functioning was associated with better mental health outcomes for all adolescents. This effect remained present in those affected by the armed conflict even after accounting for potential confounders.

Empirical Investigation of Two Assumptions in the Diagnosis of DSM-IV Major Depressive Episode

2007 ◽  
Vol 41 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Chika Sakashita ◽  
Tim Slade ◽  
Gavin Andrews
Keyword(s):  
Depressive Episode ◽  
Major Depressive Episode ◽  
Sleep Problems ◽  
Composite International Diagnostic Interview ◽  
Population Based ◽  
Diagnostic Interview ◽  
Major Depressive ◽  
Diagnostic Threshold ◽  
Dsm Iv ◽  
The Relationship

Objective: The aim of the current study was to examine two major assumptions behind the DSM-IV diagnosis of major depressive episode (MDE): that depression represents a distinct category defined by a valid symptom threshold, and that each depressive symptom contributes equally to the diagnosis. Methods: Data were from the Australian National Survey of Mental Health and Wellbeing. Participants consisted of a random population-based sample of 10 641 community volunteers, representing a response rate of 78%. DSM-IV diagnoses of MDE and other mental disorders were obtained using the Composite International Diagnostic Interview, version 2.0. Analyses were carried out on the subsample of respondents who endorsed either depressed mood or loss of interest (n =2137). Multivariate linear regression analyses examined the relationship between the number and type of symptoms and four independent measures of impairment. Results: The relationship between the number of depressive symptoms and the four measures of impairment was purely linear. Three individual symptoms (sleep problems, energy loss, and psychomotor disturbance) were all independent predictors of three of the four measures of impairment. Conclusions: Counting symptoms alone is limited in guiding a clear diagnostic threshold. The differential impact of individual symptoms on impairment suggests that impairment levels may be more accurately estimated by weighting the particular symptoms endorsed.

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