American Journal on Addictions最新文献

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Care coordination in screening, brief intervention, and referral to treatment (SBIRT): A scoping review 筛查、短暂干预和转诊治疗中的护理协调（SBIRT）：范围综述。

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2025-11-23 DOI: 10.1111/ajad.70104

Yael Hadani MD, Idil Tarikogullari MD, Tyler S. Oesterle MD, MPH, Michele T. McGinnis MSIS, Nichole Nidey PhD, Benjamin Lai MB, BCh, BAO, Alyssa H. Kalata PhD, Pravesh Sharma MD, Nicholas L. Bormann MD

Background and Objectives

Implementation of screening, brief intervention, and referral to treatment (SBIRT) for substance use in primary care remains challenging. Care coordination (CC) may strengthen SBIRT by supporting brief interventions, improving referral follow-through, and enhancing continuity. CC models and outcomes vary, however, and no prior scoping review has synthesized these.

Methods

A comprehensive search of 10 resources, including Embase, MEDLINE, and PsycINFO, was conducted on 4/15/2025. Eligible studies described outpatient SBIRT models adding CC for any age group. Articles were excluded if they lacked CC, presented no original data, or were not in English. Relevant implementation and patient-level outcomes were extracted to describe CC models and their impact.

Results

Of 737 abstracts and 50 full texts reviewed, 15 met the inclusion criteria. Studies spanned primary care, specialty care, and age ranges. CC models included embedded behavioral health providers, centralized linkage managers, and remote coordinators using phone or digital platforms. CC was associated with higher screening completion, brief intervention delivery, referral initiation, and treatment engagement. Successful integration incorporated structured communication, follow-up protocols, and accessible technology. Barriers included limited billing infrastructure, weak electronic record integration, and unclear roles.

Discussion and Conclusions

CC appears to enhance SBIRT implementation and treatment engagement across outpatient settings. Embedded approaches offer relational benefits, while remote and digital strategies show promise for scalability. Comparative studies are needed to assess effectiveness, cost, and contextual fit.

Scientific Significance

Provides the first review of CC models within SBIRT, highlighting their implementation impact and guiding future optimization.

背景和目的：在初级保健中实施物质使用筛查、短暂干预和转诊治疗（SBIRT）仍然具有挑战性。护理协调（CC）可以加强SBIRT通过支持简短的干预，改善转诊跟进，并加强连续性。然而，CC模型和结果各不相同，并且没有先前的范围审查综合了这些。方法：于2025年4月15日对Embase、MEDLINE、PsycINFO等10个资源进行综合检索。符合条件的研究描述了门诊SBIRT模型为任何年龄组添加CC。没有CC、没有原始数据或不是英文的文章被排除。提取相关的实施和患者水平的结果来描述CC模型及其影响。结果：在检索的737篇摘要和50篇全文中，有15篇符合纳入标准。研究涵盖了初级保健、专科保健和年龄范围。CC模型包括嵌入式行为健康提供者、集中式链接管理器和使用电话或数字平台的远程协调员。CC与较高的筛查完成率、短暂的干预交付、转诊开始和治疗参与相关。成功的集成包括结构化通信、后续协议和可访问技术。障碍包括有限的计费基础设施、薄弱的电子记录集成和不明确的角色。讨论和结论：CC似乎在门诊环境中加强了SBIRT的实施和治疗参与。嵌入式方法提供关系方面的好处，而远程和数字策略显示出可伸缩性的前景。需要进行比较研究来评估有效性、成本和环境适应性。科学意义：首次回顾了SBIRT中的CC模型，突出了它们的实施影响并指导了未来的优化。

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引用次数: 0

Readability, linguistic complexity, and stigma in ChatGPT responses to opioid use disorder FAQs: A comparative analysis. 可读性、语言复杂性和耻辱感在ChatGPT对阿片类药物使用障碍常见问题的反应：一个比较分析。

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2025-11-04 DOI: 10.1111/ajad.70101

Vitor M Campos, Daniel L Heringer, Gabriel P A Costa, Henrique N P Oliva, Akhil Anand

Background and objectives: AI chatbots are increasingly used in patient education. For opioid use disorder (OUD), content must be readable and non-stigmatizing. We compared ChatGPT responses with U.S. health organization FAQs on readability, complexity, and stigma.

Methods: We analyzed 50 OUD FAQs paired with ChatGPT GPT-4o responses. Outcomes included word and sentence counts, lexical density, and six readability indices. Paired differences were tested with t tests or Wilcoxon signed-rank tests.

Results: ChatGPT responses were longer than FAQs, with a mean word count of 253.7 vs. 76.6 (difference 177; 95% CI, 151-203) and sentence count of 18.2 vs. 9.0 (difference 9.2; 95% CI, 7.6-10.9). Lexical density was higher by 6.5 percentage points (95% CI, 4.0-9.0), with more characters (0.55; 95% CI, 0.40-0.70) and syllables per word (0.19; IQR, 0.14-0.24). Readability grade levels were consistently higher: Coleman-Liau +3.43, Gunning Fog +3.47, SMOG + 2.96, Flesch-Kincaid +3.61, Automated Readability Index +4.33, and Flesch Reading Ease -20.4 (all p < .05). Stigmatizing term frequency was similar, 0.98 vs. 0.28 per answer (95% CI, -1.3 to +3.3).

Discussion: ChatGPT responses were longer and more complex than FAQs, although the frequency of stigmatizing language was similar.

Conclusions: ChatGPT produced more comprehensive but less readable content than FAQs, revealing a gap with health literacy standards. While stigmatizing terms were uncommon unless simplified, length and complexity may hinder use.

Scientific significance: Findings quantify readability and stigma trade-offs in AI-generated OUD education and emphasize the need for plain language prompting and human review.

背景与目标：人工智能聊天机器人越来越多地用于患者教育。对于阿片类药物使用障碍（OUD），内容必须可读且非污名化。我们将ChatGPT的回答与美国卫生组织的常见问题解答在可读性、复杂性和污名方面进行了比较。方法：我们分析了50个与ChatGPT gpt - 40应答配对的OUD faq。结果包括单词和句子计数、词汇密度和6个可读性指标。配对差异采用t检验或Wilcoxon符号秩检验。结果：ChatGPT的回答比faq长，平均字数为253.7比76.6（差异177；95% CI, 151-203），句子数为18.2比9.0（差异9.2;95% CI, 7.6-10.9）。词汇密度提高了6.5个百分点（95% CI, 4.0-9.0），字符数（0.55;95% CI, 0.40-0.70）和每个单词的音节数（0.19；IQR, 0.14-0.24）较多。可读性等级水平持续较高：Coleman-Liau +3.43, Gunning Fog +3.47, SMOG + 2.96, Flesch- kincaid +3.61, Automated Readability Index +4.33, Flesch Reading Ease -20.4（均为p）讨论：ChatGPT的回答比faq更长更复杂，尽管侮辱语言的频率相似。结论：ChatGPT提供了比faq更全面但可读性较差的内容，揭示了与健康素养标准的差距。虽然污名化的术语不常见，除非简化，长度和复杂性可能会阻碍使用。科学意义：研究结果量化了人工智能生成的OUD教育的可读性和耻辱权衡，并强调了简单语言提示和人工审查的必要性。

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引用次数: 0

Neurodevelopmental burden in young adults undergoing opioid substitution therapy: The role of inattentive and hyperactive/impulsive symptoms. 接受阿片类药物替代治疗的年轻人的神经发育负担：注意力不集中和多动/冲动症状的作用

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2025-10-30 DOI: 10.1111/ajad.70103

Maddalena Cesco, Marco Garzitto, Livia Pischiutta, Tiziana Lombardelli, Enrico Moratti, Giuliano Zamparutti, Matteo Balestrieri, Umberto Albert, Marco Colizzi

Background and objectives: Attention-deficit/hyperactivity disorder (ADHD) is recognized as a condition that can persist into adulthood, often with psychiatric comorbidities that worsen the overall prognosis. ADHD has been associated with substance use disorders (SUDs), especially through symptoms like hyperactivity and impulsivity, while the role of inattentive symptoms remains more difficult to judge. This study aimed to estimate the likelihood of ADHD in a sample of young adults with SUDs undergoing opioid agonist treatment, and to evaluate how inattentive and hyperactive/impulsive traits affect their clinical, psychological, and social functioning.

Methods: 57 individuals were evaluated using comprehensive clinical interviews and self-administered questionnaires to assess characteristics of SUDs, current and childhood ADHD symptoms, levels of impulsivity, and psychiatric comorbidities.

Results: Overall, 22.8% of participants were classified as possible ADHD cases (p-ADHD). Compared to the comparison group, p-ADHD patients exhibited more severe SUDs symptomatology and greater impairments in specific domains of adaptive functioning. They also had a higher lifetime prevalence of social anxiety disorder, unspecified Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) diagnoses, and clinically relevant impulsivity. Further, p-ADHD individuals were more likely to experience limitations and craving, with the inattentive symptoms significantly mediating these associations.

Discussion and conclusions: ADHD frequently co-occurs in SUDs patients in OAT and can worsen the SUDs clinical presentation. Moreover, inattentive symptoms may play a prominent role in SUDs development.

Scientific significance: This study suggests that different ADHD presentations influence SUDs manifestations, challenging the idea that impulsivity is the main contributor in SUDs.

背景和目的：注意力缺陷/多动障碍（ADHD）被认为是一种可以持续到成年的疾病，通常伴有精神合并症，使总体预后恶化。ADHD与物质使用障碍（sud）有关，尤其是多动症和冲动等症状，而注意力不集中症状的作用仍然难以判断。本研究旨在评估接受阿片类激动剂治疗的年轻成年sud患者患ADHD的可能性，并评估注意力不集中和多动/冲动特征如何影响他们的临床、心理和社会功能。方法：采用综合临床访谈和自填问卷对57名个体进行评估，以评估sud的特征、当前和儿童ADHD症状、冲动水平和精神合并症。结果：总体而言，22.8%的参与者被归类为可能的ADHD病例（p-ADHD）。与对照组相比，p-ADHD患者在适应功能的特定领域表现出更严重的sud症状和更大的损伤。他们也有更高的社交焦虑症的终生患病率，未明确的精神障碍诊断和统计手册第五版（DSM-5）的诊断，以及临床相关的冲动。此外，p-ADHD个体更有可能经历限制和渴望，注意力不集中的症状显著地介导了这些关联。讨论与结论：ADHD经常在OAT的sud患者中同时发生，并可使sud的临床表现恶化。此外，注意力不集中症状可能在sud的发展中起重要作用。科学意义：本研究表明，不同的ADHD表现会影响sud的表现，挑战了冲动是sud主要诱因的观点。

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引用次数: 0

The mediating role of impulsivity in the relationship between childhood maltreatment and depression in methamphetamine patients. 冲动在甲基苯丙胺患者童年虐待与抑郁关系中的中介作用。

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2025-10-30 DOI: 10.1111/ajad.70102

Saad Ullah, Yang Tian, Jia-Jing Chen, Arsalan Haider, Abdur Rab Tariq Kiyani, Han Chen, Ren Huang, Dong-Mei Wang, Xiang-Yang Zhang

Background and objectives: Childhood maltreatment (CM) significantly increases the risk of depression in patients with methamphetamine use disorder (MAUD). However, the underlying psychological mechanism remains unclear. The purpose of this study was to explore whether impulsivity mediates the relationship between CM and depression in patients with MAUD.

Methods: We recruited 577 Chinese male inpatients with MAUD. CM, depression, and impulsivity were assessed using standardized questionnaires.

Results: A total of 321 of 577 (55.63%) patients with MAUD had experienced at least one form of CM. Maltreated patients exhibited elevated impulsivity and severe depression compared to nonmaltreated patients (both p < .001). CM, impulsivity, and depression were significantly interrelated (all p < .01). In addition, impulsivity partially mediated the CM-depression link in patients with MAUD (β = .015, 95% CI [0.007, 0.026]).

Discussion and conclusions: Our findings indicate that CM has a long-term effect on depression, and impulsivity is an essential contributor to depressive symptoms in patients with MAUD who have experienced CM. Future research should investigate these associations using multimodal approaches and assess focused interventions that may reduce impulsivity and mitigate the psychological impact of adverse childhood experiences (ACEs) in patients with MAUD.

Scientific significance: We identified impulsivity as a key mechanism in the CM-depression link, offering a novel intervention target. Our findings advance the understanding of the psychological mechanisms in addiction psychiatry and suggest that interventions targeting impulsivity may help mitigate depression in this population.

背景和目的：儿童虐待（CM）显著增加甲基苯丙胺使用障碍（MAUD）患者抑郁的风险。然而，潜在的心理机制尚不清楚。本研究的目的是探讨冲动性是否介导MAUD患者CM与抑郁之间的关系。方法：我们招募577例中国男性住院MAUD患者。CM、抑郁和冲动采用标准化问卷进行评估。结果：577例MAUD患者中有321例（55.63%）经历过至少一种形式的CM。与未受虐待的患者相比，受虐待的患者表现出更高的冲动性和严重的抑郁症(p讨论和结论：我们的研究结果表明，CM对抑郁症有长期影响，而冲动性是经历过CM的MAUD患者抑郁症状的重要因素。未来的研究应该使用多模式方法来调查这些关联，并评估可能减少冲动和减轻MAUD患者不良童年经历（ace）心理影响的重点干预措施。科学意义：我们发现冲动性是cm -抑郁联系的关键机制，提供了一个新的干预目标。我们的发现促进了对成瘾精神病学心理机制的理解，并表明针对冲动的干预可能有助于减轻这一人群的抑郁症。

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引用次数: 0

Opioid Recover Network - ORN: Recruiting qualified consultants for the ORN 阿片类药物恢复网络- ORN：为ORN招聘合格的顾问

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2025-10-27 DOI: 10.1111/ajad.70095

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引用次数: 0

Call for Review Papers 2025 2025年征稿

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2025-10-27 DOI: 10.1111/ajad.70094

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引用次数: 0

Call for Special Issue Papers 2025 征集2025年特刊论文

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2025-10-27 DOI: 10.1111/ajad.70093

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STILL TIME TO REGISTER: Don't miss out on the chance to attend this year's AAAP Annual Meeting, Nov. 6 – 9, 2025 仍有时间报名：不要错过参加2025年11月6日至9日举行的今年AAAP年会的机会

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2025-10-27 DOI: 10.1111/ajad.70098

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FREE WEBINAR: Cultural Considerations in Tribal Behavioral Health Practice, December 10, 2025 免费网络研讨会：部落行为健康实践中的文化考虑，2025年12月10日

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2025-10-27 DOI: 10.1111/ajad.70097

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AAAP NEWSLETTER: What do your colleagues have to say about the latest updates in Addiction Psychiatry? AAAP通讯：你的同事对成瘾精神病学的最新进展有什么看法？

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2025-10-27 DOI: 10.1111/ajad.70096

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