Bernard Plancherel

Substance use and depression. Comparative course in adolescents.

ObjectiveTo examine the relation between depression and substance use in adolescents and the concomitant courses of both disorders.MethodsFour individual interviews were administered to 85 adolescent substance users aged 14–19 years (mean 17.1 years, SD 1.4) over a 3.5 year period using the Adolescent Drug Abuse Interview (ADAD) and the Beck Depression Inventory (BDI-13).ResultsNo predictive effect was observed on one dimension over the other, but each dimension was predictive of its own course. A decrease in substance-use severity paralleled a decrease in depressive state. Similarly, stable substance-use rates, either at a low or a high level, tended to be associated with low or high levels of depression, respectively. However, an increase in substance use was not accompanied by an increase in depressive states. Moreover, depression varied greatly between adolescents, and according to gender and age.ConclusionsDepressive states and substance use in adolescents can vary considerably overtime, and are closely but rather synchronically related. Since most of the adolescents do not seek help for substance-related problems, substance use should be systematically assessed in adolescents presenting with a depressive state.

Detection of cognitive impairment with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in adolescents with psychotic symptomatology

Cognitive impairment has been identified in the early phase of schizophrenia spectrum disorders, and is a major contributor to disease-related disability. While screening tools assessing cognitive impairment have been validated for adult schizophrenic populations, there is a need for brief, easily administered, standardized instruments that provide clinically relevant information for adolescents. This study examines the utility of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in identifying and quantifying neurocognitive impairment in adolescents with schizophrenia spectrum disorders and other serious psychiatric illnesses. 112 adolescents, including 32 healthy subjects and 80 patients, were administered the RBANS. Patients with psychotic disorders demonstrated significant impairment on the RBANS total score compared to patients with other disorders and healthy controls, but this impairment appeared somewhat less severe than is typically reported for in adult patients with schizophrenia on this measure. The RBANS appears to be sensitive in the detection of neurocognitive impairment in a psychiatric population of adolescents with psychotic symptomatology, and may therefore have utility as a clinical screening instrument and/or neurocognitive outcome measure in this population.

Sensation seeking: a personality trait characteristic of adolescent girls and young women with eating disorders?

The aim of the following study was to evaluate the role of sensation seeking in eating disorders (anorexia and bulimia), taking into account the subtypes (purging versus nonpurging) and the concept of binge-eating disorder. The study involved 141 adolescent girls and young women, aged 14 to 25 years who lived in the French speaking part of Switzerland (79 clinical subjects with eating disorders according to DSM-IV criteria, and 62 control subjects without eating disorders from the general population). All the subjects completed the Sensation Seeking Scale (SSS, Zuckerman, 1971). The results show that subjects with bulimic behaviours characterized by recurrent episodes of binge-eating, whatever their exact diagnosis and subtype, do not significantly differ from one another on the Sensation Seeking Scale. They all had higher scores than the control group especially on the ‘Thrill and Adventure Seeking’ dimension. In contrast, restricting anorexics had lower scores on the Sensation Seeking Scale than the control group, especially on the ‘Experience Seeking’ dimension. Copyright

Adolescent's Suicide Attempts: Populations at Risk, Vulnerability, and Substance Use #

Adolescence corresponds to a transition period that requires adaptation and change capacities and skills. Most young people succeed with this challenge, whereas a minority fail. In order to identify with the teenage culture, become autonomous, and differentiate from their parents, some adolescents choose to use drugs, beginning with the use of cigarettes, alcohol, cannabis, followed by other illicit drugs such as opiates and stimulants. A high proportion of these adolescents attempt suicide, which is the primary cause of death during adolescence in many European countries. Who are the “vulnerable” adolescents? What are the mechanisms that can explain the varieties of drug-use initiation or suicide attempts? Can “protective factors” be identified? What kind of strategies might be developed at a social and political level in order to prevent or to minimize drug abuse and suicide attempts, among other harmful behaviors? These issues will be discussed on the basis of the recent literature and in the light of a recent study carried out in the French-speaking part of Switzerland on large cohorts of adolescent drug users. Unresolved critical issues are noted and future needed research is suggested.

Coping Strategies in Early and Mid-Adolescence

The way an adolescent handles different internal and external sources of stress depends partially on coping strategies. The aim of this study is to answer the following questions: Do coping strategies vary according to age and gender? And do relationships between coping and mental health vary according to age? Participants in this study consist of a community sample (N = 140; 73 girls and 67 boys, 11 through 15 years of age) in an urban area of the French-speaking part of Switzerland. The population was divided into two groups: a subsample of 70 subjects with a mean age of 12.25 years (early adolescents) and a subsample of 70 subjects with a mean age of 13.75 years (mid-adolescents). Coping was measured by the A-COPE (Patterson & McCubbin, 1987). Findings show that there are less family-oriented coping strategies and more relaxing strategies in mid-adolescents compared to early adolescents. Girls more often use social relationships as well as ventilating feelings and self-reliance, whereas boys more often...

Adolescent Substance-Use Assessment: Methodological Issues in the Use of the ADAD (Adolescent Drug Abuse Diagnosis)

THis article has been retracted.

Psychosocial Predictors of Cannabis Use in Adolescents at Risk

ABSTRACTThis research has tested a social disintegration model in conjunction with risk and protection factors that have the power to differentiate relative, weighted interactions among variables in different socially disintegrated groups. The model was tested in a cross-sectional sample of 1082 at-risk youth in Switzerland. Structural equation analyses show significant differences between the social disintegration (low, moderate, high) groups and gender, indicating that the model works differently for groups and for gender. For the highly disintegrated adolescents results clearly show that the risk factors (negative mood, peer network, delinquency) are more important than the protective factors (family relations, secure sense of self). Family relations lose all protective value against negative peer influence, but personal variables, such as secure self, gain protective power.

DRUG USE AND SUICIDE ATTEMPTS: THE ROLE OF PERSONALITY FACTORS

This study on suicide attempts is part of a large research project on dependent behavior in adolescents and young adults. 228 subjects aged 14–25 (107 “drug abusers,” 121 controls) from the French speaking part of Switzerland were evaluated on the basis of a semi-structured interview (Mini International Neuropsychiatric Interview), enabling a DSM-IV diagnosis, and self-reports (SSS by Zuckermann, MMPI-2, IDI by Hirschfeld). 31.5% of “drug abuser” males and 41.2% of “drug abuser” females committed one or more suicide attempts. The results of a logistic regression show that the significant factor explaining suicide attempts in drug users is emotional reliance for males and experience-seeking for females.

Adolescent drug use escalation and de-escalation: A 3-year follow-up study

This study aims to assess adolescents drug use with a longitudinal perspective in order to identify factors interacting with drug use onset and course. Supported by the Swiss Federal Office of Public Health, the study was initiated in 1999 with a follow-up in 2001 and 2002. The first objective was to measure risk factors for substance use initiation. The second objective was to analyse the co-variation of substance use with environmental, social, relational, medical and psychological factors. A total of 102 adolescents, aged 14–19 years, were recruited for the study in the French-speaking part of Switzerland. Results clearly show that substance use is not a disorder per se in adolescence, but that it is part of a multidimensional complex of problems that some adolescents may encounter: increase and decrease in substance use is paralleled with an increase or decrease in the other areas. This implies that prevention of substance use should not be focused mainly on substances but should consider the adolescent’s environment and significant life areas.

A gender specific model of substance use

This research has tested a structural model of risk and protection factors among 1437 at-risk adolescents in Switzerland. The model was used to identify important gender and age differences. Our research shows that interactions between parents, peers, negative mood, and secure self create a range of risk factors for girls and boys, and for younger and older teens. Negative peer group was a greater risk for young girls than for young boys. Negative mood can serve as an early warning sign for boys, as can negative peer group for girls. Mood for boys was marginally associated with a substance-using peer group and with poor relationships in the family. This suggests that for boys the focus of prevention should be on family relationships and for girls on peer relationships. For older girls, secure self was the greatest protector against substance-using peers, whereas for younger boys and girls, parents continued to offer some protection. The focus on development of secure self in older girls holds promise for secondary prevention.