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Biomedical subjects

Leo Sher

Publications and source records attributed to Leo Sher.

95 records · Page 6Linked to original sources

Demographic and clinical features of adolescents and young adults with alcohol-related disorders admitted to the psychiatric emergency room.

OBJECTIVES: To determine the incidence of alcohol related problems (ARP) among adolescents admitted to the Psychiatric Emergency Room (PER) and to describe the demographic and clinical characteristics. METHODS: The study was a retrospective review of admissions to the PER, where we reviewed the psychiatric records of all of the 14-30 year olds admitted to the PER during the three-month period between April 1st, 2003 and June 30th, 2003. Demographic and clinical data of subjects with and without ARP were compared. RESULTS: During the three-month time period, 108 patients between the age of 14 and 30 were admitted to the PER. 14 (13.2%) of these had ARP, and ARP tended to occur more in males (chi2 = 3.81; df=l; p = 0.05). The number of psychiatric diagnoses among those who had ARP was significantly higher than among those who did not have ARP (t = -3.12; df=104; p = 0.002). ARP were found to be associated with personality disorder and misuse of other substances. 37.5% of those adolescents and young adults with ARP had a personality disorder, while 13% of those without ARP had a personality disorder (chi2 = 4.64; df=1; p = 0.03). 50% of those with ARP consumed (an)other substance/s, while 12.0% of those patients without ARP consumed (an)other substance/s (chi2 = l2.48; df=1; p < 0.001). Of the female adolescents and young adults with ARP, 50% were admitted to PER after an episode of self-poisoning. CONCLUSION: ARP in young adults admitted to the PER for acute psychiatric care are associated with greater psychiatric comorbidity, especially personality disorders. In females, ARP may be associated with an increased risk for self-poisoning. Adequate detection of ARP in the PER could promote earlier specific interventions specifically tailored to ARP among adolescents and young adults.

Adolescent↗

Psychotherapy in the treatment of alcohol and substance abusing adolescents with suicidal behavior.

Adolescence is a unique time period in an individual's life, one in which suicide and substance abuse become substantial health risks. Currently, suicide accounts for approximately 14% of all deaths among 15-24 year olds in the U.S.A. Drug, alcohol abuse and dependence are the most prevalent causes of adolescent morbidity and mortality in the USA. Numerous studies have demonstrated the link between adolescent alcohol, substance abuse and suicide. When compared to community controls, the rate of a substance abuse disorder was 8.5 times higher in a sample of adolescent suicide completers and the rate of alcohol abuse was 7.5 times higher. Genetic and biological variables may also be responsible for either alcohol and substance abuse or suicide or both alcohol and substance abuse and suicide. There is little empirical research evaluating the effectiveness of alcohol and substance abuse treatments for adolescents. Therapies such as multisystemic therapy, functional family therapy, motivational interviewing, community reinforcement, the 12-step approach and contingency management reinforcement seem to be effective treatments. Despite the strong association between adolescent alcohol and substance use and suicidal behaviors, few studies have investigated the combined treatment of these two issues. Cognitive behavioral therapy, particularly dialectical behavior therapy, seems to be a promising psychotherapy treatment for suicidality in alcohol and substance abusing adolescents. Further research is needed to determine the efficacy of various treatments of alcohol and substance abusing adolescents with suicidal behavior.

Adolescent↗