Prescription Stimulant Use, Misuse, and Motivations

Approximately 16 million US adults used prescription stimulants in the preceding year (annual average), 5 million misused prescription stimulants without use disorders, and 0.4 million had use disorders, according to a recent study. Researchers conducted a nationally representative household population study of adults aged ≥18 years from the 2015 and 2016 National Surveys on Drug Use and Health (n=102,000). They found:

  • Among US adults, 6.6% used prescription stimulants overall; 4.5% used without misuse, 1.9% misused without use disorders, and 0.2% had use disorders.
  • The most commonly reported motivations for misuse were to help be alert or concentrate (56.3%).
  • The most likely source of misused prescription stimulants was by obtaining them free from friends or relatives (56.9%).
  • More frequent prescription stimulant misuse and use disorder were associated with an increased likelihood of obtaining medications from physicians or from drug dealers or strangers and less likelihood of obtaining them from friends or relative

Citation:Compton WM, Han B, Blanco C, Johnson K, Jones, CM. Prevalence and correlates of prescription stimulant use, misuse, use disorders, and motivations for misuse among adults in the United States. [Published online ahead of print April 16, 2018]. Am J Psychiatry. doi:10.1176/appi.ajp.2018.17091048.

Insomnia Mediates Anxiety-Depression Relationship

Anxiety may increase risk for the development of later depression through insomnia, according to a recent study. Researchers utilized data from Waves I, II, and IV of the National Longitudinal Study of Adolescent to Adult Health, a nationally representative prospective study conducted over a 14‐year period (n=20,745, 50.5% female, M age at Wave I = 16.20). Participants completed portions of the Center for Epidemiologic Studies Depression Scale at Waves I and IV to assess depressive symptoms, a 6‐item anxiety measure at Wave I, and 3 items assessing insomnia, sleep quality, and sleep duration at Wave II. They found:

  • Structural equation modeling indicated that insomnia and unrestful sleep significantly mediated the relationship between anxiety and subsequent depression.
  • The relationship between anxiety and depression was not significantly mediated by sleep duration.

Citation:Li YI, Starr LR, Wray-Lake L. Insomnia mediates the longitudinal relationship between anxiety and depressive symptoms in a nationally representative sample of adolescents. [Published online ahead of print April 26, 2018]. Depress Anxiety. doi:10.1002/da.22764.

Examining PTSD, Depression, and Suicide in Veterans

As suicidal ideation is a known risk factor for suicide attempts and completions, veterans with comorbid posttraumatic stress disorder (PTSD) and depression represent a vulnerable group who may need more intensive monitoring and treatment to reduce risk of suicide, according to a recent study that investigated the association of suicidal ideation with comorbid PTSD and depression and examined the role of military and psychosocial covariates. Researchers evaluated 746 veterans to assess PTSD and measure depression and suicidal ideation. Covariates were assessed via validated self-report measures. They found:

  • 49% of veterans with comorbid PTSD and depression endorsed suicidal ideation, making them more likely to do so than those with depression alone (34%), PTSD alone (11%), or neither (2%).
  • In multivariate logistic regression models, this association remained significant after controlling for demographics and symptom severity.
  • Anger, hostility, anxiety, alcohol use, optimism, and social support did not explain the elevated risk of suicidal ideation in the comorbid group in fully adjusted models. 

Citation:Arenson MB, Whooley MA, Neylan TC, Maguen S, Metzler TJ, Cohen BE. Posttraumatic stress disorder, depression, and suicidal ideation in veterans: Results from the Mind Your Heart Study. [Published online ahead of print April 22, 2018].Psychiatry Res. doi:10.1016/j.psychres.2018.04.046.