Defining substance use disorders: do we really need more than heavy use?

Aims: The aim of the study was to explore whether the concept of heavy substance use over time can be used as definition of substance use disorder. Methods: Narrative review. Results: Heavy use over time clearly underlies the neurobiological changes asso- ciated with current thinking of substance use disorders. In addition, there is evidence that heavy use over time can explain the majority of social problems and of burden of disease (morbidity and mortality). A definition of substance use disorders via heavy use over time would avoid some of the problems of current conceptualizations, for instance the cultural specificity of concepts such as loss of control. Finally, stressing the continuu…

The point prevalence of depression and associated sociodemographic correlates in the general population of Latvia

Abstract Aim To determine the point prevalence of depression in the general Latvian population and to explore the associated sociodemographic characteristics. Methods The study was part of the cross-sectional survey on the general population on substance use in Latvia in 2011. It consisted of face-to-face interviews of a randomised stratified multi-stage probability sample. In total, 4493 persons were included, aged between 15 and 64. To assess depression, the participants were interviewed using the Patient Health Questionnaire-9; a score of ≥10 was defined as indicating the presence of a depressive episode. Socio-demographic, subjective health status and alcohol use were assessed using the…

Validity of the PHQ-9 and PHQ-2 to screen for depression in nationwide primary care population in Latvia

Abstract Background Depression is highly underdiagnosed in primary care settings in Latvia. Screening for depression in primary care is potentially an efficient way to find undetected case s and improve diagnostics. We aimed to validate both a nine-item and two-item Patient Health Questionnaire (PHQ-9 and PHQ-2) in the Latvian and Russian languages in primary care settings using a representative sample in Latvia. Materials and methods The study was carried out within the framework of the National Research Program BIOMEDICINE to assess the prevalence of mental disorders at 24 primary care facilities. During a 1-week period, all consecutive adult patients were invited to complete the PHQ-9 an…

People with Alcohol Use Disorders in Specialized Care in Eight Different European Countries

Aim: To provide a description of patients receiving alcohol treatment in eight different European countries, including the level of comorbidities and functional limitations. Methods: Drinking behaviours, DSM-IV alcohol use disorder (AUD), mental and somatic comorbidities, disability and health services utilization of 1767 patients from various specialized treatment settings were assessed as representative for regions of eight European countries. Severity of alcohol dependence (AD) in terms of drinking level was compared with a large representative US sample. Alcohol and Alcoholism, 2015, 1–9 doi: 10.1093/alcalc/agv009 Article © The Author 2015. Medical Council on Alcohol and Oxford Universi…

The Association Between Smoking Status and Depression in the General Population of Latvia

Introduction Tobacco dependence is the most common substance use disorder in people with mental illness. Smoking and depression are firmly associated and both represent major health problems. Aim The aim of the study was to assess association between smoking status and 12-months depression in representative sample of the general Latvian population. Methods The study was a part of health monitoring survey, a collaborative project between Baltic States and Finland, which monitors health related behaviours; the questionnaire included structured interview and depressive module of the Mini International Neuropsychiatric Interview. Descriptive statistics and binary regression model were applied. …

The 12-month prevalence of depression and health care utilization in the general population of Latvia.

Abstract Background This cross-sectional study aims to assess the 12-month prevalence of major and minor depression in the Latvian population, and to evaluate associated health care utilization. Methods Trained interviewers conducted face-to-face interviews with a multistage stratified probability sample of the Latvian general population, ages 15–64 (n=3003). Participants were interviewed using the depression module of the Mini International Neuropsychiatric Interview. Self-reported health care utilization and somatic illness were also assessed. Multinomial logistic regressions were applied. Results The 12-month prevalence of major depression was 7.9% (95%CI 7.0–8.9), while for minor depres…

Correlation between the patient health questionnaire (PHQ-9) and the mini international neuropsychiatric interview (MINI) items in representative nationwide primary care sample in Latvia

The tangible common denominator of substance use disorders: a reply to commentaries to Rehm et al. (2013a)

In response to our suggestion to define substance use disorders via ‘heavy use over time’, theoretical and conceptual issues, measurement problems and implications for stigma and clinical practice were raised. With respect to theoretical and conceptual issues, no other criterion has been shown, which would improve the definition. Moreover, heavy use over time is shown to be highly correlated with number of criteria in current DSM-5. Measurement of heavy use over time is simple and while there will be some underestimation or misrepresentation of actual levels in clinical practice, this is not different from the status quo and measurement of current criteria. As regards to stigma, research ha…

EPA-1513 - Utilization of health care among people with depression in Latvia

Background Depression is highly prevalent and disabling mental disorder, less than one third of all cases receive any treatment, suggesting a remarkable level on unmet needs. Aim The aim of the study was to assess differences in health care utilization among people with depression and those with no symptoms in representative sample of the general Latvian population. Methods The study was a part of the FINBALT health monitoring survey in 2012, a collaborative project between Baltic States and Finland, which monitors health related behaviours; the questionnaire included depression module of the Mini International Neuropsychiatric Interview (MINI). A total of 3003 15-64 years old persons were …

Alcohol use disorders in Europe: A comparison of general population and primary health care prevalence rates

Aims Alcohol use disorders (AUDs) are prevalent in Europe but occurrence in primary care and the proportion of treated cases are understudied. This study reports prevalence of AUDs and their treatment in European primary health care settings and compares them with general population estimates. Procedure We sampled 358 general practitioners (GPs, refusal rate: 56.4%) across six European countries (Germany, Hungary, Italy, Latvia, Poland, and Spain), who assessed 13,003 patients including providing AUD diagnoses. A subsample of 8,476 patients (refusal rate: 17.8%) was interviewed subsequently, assessing DSM-IV AUD diagnoses via the Composite International Diagnostic Interview. Final AUD diagn…

Depression and its correlation with the risk of cardiovascular mortality in primary care population in Latvia

IntroductionDepression is one of several preventable causes of disability worldwide, with coronary heart disease (CHD) being the largest cause of disability. Depression has been confirmed as a risk factor for CHD.ObjectivesFew studies tried to find an interrelation between depression and a risk of cardiovascular mortality according to systematic coronary risk evaluation (SCORE) chart.AimsThe aim of study was to examine the correlation of depression with the risk of cardiovascular mortality (SCORE).MethodsStudy was conducted in 2015 within the framework of National Research Programme BIOMEDICINE. All patients aged 18 and older at 24 primary care facilities were interviewed with a sociodemogr…

Prevalence of and potential influencing factors for alcohol dependence in Europe.

Alcohol use disorders (AUDs), and alcohol dependence (AD) in particular, are prevalent and associated with a large burden of disability and mortality. The aim of this study was to estimate prevalence of AD in the European Union (EU), Iceland, Norway, and Switzerland for the year 2010, and to investigate potential influencing factors. The 1-year prevalence of AD in the EU was estimated at 3.4% among people 18-64 years of age in Europe (women 1.7%, men 5.2%), resulting in close to 11 million affected people. Taking into account all people of all ages, AD, abuse and harmful use resulted in an estimate of 23 million affected people. Prevalence of AD varied widely between European countries, and…

Adaptation and validation of the Patient Health Questionnaire-9 to evaluate major depression in a primary care sample in Latvia

Background: Depression is one of the most common mental disorders in primary care settings and is often underdiagnosed and undertreated by general practitioners (GPs). To date, no depression screening instruments have been validated for use in primary care settings in Latvia. The aim of this study was to establish the validity and cutoff score of the Patient Health Questionnaire-9 (PHQ-9) among primary care patients in Latvia. Materials and methods: During a one-week period, all consecutive patients aged 18 years or older visiting their GP of health concerns at 6 primary care settings were invited to complete the PHQ-9 questionnaire in their native language (Latvian or Russian). Criterion v…