BACKGROUNDSpecialised addiction treatment centers (SAC) and general mental health centers (GMHC) both offer care to people with substance use disorders (SUD) in Belgium, but these sectors often operate in parallel, with little collaboration. This fragmented system may lead to inefficiencies, particularly in the treatment of individuals with dual diagnoses. Despite the recognized challenges, there is limited understanding of the factors that influence whether patients with SUD are treated in SAC or GMHC.OBJECTIVESThis observational study has two main objectives: METHODS: The study used routinely collected data from treatment centers in Belgium from 2019 (Belgian Treatment Demand Indicator). Logistic regression evaluated the weight of drug use and sociodemographic variables for people entering treatment for SUD for the first time (n = 8322). A random forest algorithm was used to study all patients' orientation toward both sectors, across all treatment episodes (n = 29,658).RESULTSThe study found that the primary substance significantly influences sector choice. Patients using illicit substances like cannabis, opiates, cocaine, and stimulants are 6-12 times more likely to be treated in an SAC than those using alcohol. Factors such as income source and referral source (e.g. self-referral, general practitioner, etc) also significantly impact patient orientation.CONCLUSIONThese findings highlight the need for better integration between SAC and GMHC to adequately address the complex needs of people with SUD, especially with dual diagnosis.

01 Dec 2024·Public Health

Attention-deficit hyperactivity disorder is associated with risky and unhealthy behaviours among adolescents

Article

Author: Bromberg, M ; Dichtiar, R ; Namimi-Halevi, C. ; Namimi-Halevi, C ; Bromberg, M. ; Sinai, T. ; Dor, C. ; Dichtiar, R. ; Sinai, T ; Dor, C

OBJECTIVESAttention-deficit hyperactivity disorder (ADHD) is highly prevalent among adolescents globally, particularly in Israel. This study aimed to evaluate associations between ADHD and engagement in risky/unhealthy behaviours among adolescents.STUDY DESIGNCross-sectional study.METHODSStudents participating in the 2015-2016 National Health Survey completed self-administered questionnaires, providing demographic, medical and behavioural information (n = 4616, 11-18 years old, 50.2% male). Multivariable logistic regression analyses assessed the associations between ADHD and risky/unhealthy behaviours, including current tobacco/hookah smoking, alcohol consumption (≥1 serving/month), excessive screen time (≥4 h/d), non-compliance with physical activity and sleep recommendations (<1 h/d, and <8 or <9 h/d depending on age, respectively) and unhealthy lifestyle (engagement in ≥3 of these behaviours).RESULTSA total of 752 participants reported ever being diagnosed with ADHD (287 of whom were treated with stimulants) and 3864 individuals were included in a non-ADHD comparison group. ADHD was significantly associated with higher prevalence of smoking (odds ratio [OR] 2.15; 95% confidence interval [CI]: 1.65, 2.80), alcohol consumption (OR 1.38; 95% CI: 1.10, 1.73) and excessive screen time [OR 1.41; 95% CI: 1.18, 1.70), each adjusted for sociodemographic characteristics and the other risky/unhealthy behaviours. Unhealthy lifestyle was twice as common in the ADHD group (OR 2.03; 95% CI: 1.64, 2.51). Stimulant-treated and non-treated adolescents with ADHD did not differ in demographic or behavioural characteristics.CONCLUSIONSADHD was significantly associated with an unhealthy lifestyle among adolescents. These behaviours should be detected early and prevention measures put in place to limit their harmful consequences in this adolescent population. Additional large-scale prospective research is needed to deepen the understanding of this association.

01 Dec 2024·Developmental Psychobiology

The Relationship Between Prenatal, Perinatal, and Postnatal Factors and ADHD: The Role of Nutrition, Diet, and Stress

Review

Author: Al‐Kaleel, Ali ; Al‐Gailani, Lubna

ABSTRACTAttention‐Deficit Hyperactive Disorder (ADHD) is a neurobehavioral syndrome affecting children aged 6–17 with symptoms manifesting before age 12. ADHD presents heterogeneously and is associated with various psychiatric disorders. The cause remains elusive, but genetic and environmental factors, brain region maturation delays, and neurotransmitter dysregulation are implicated. Effective treatment requires a multi‐disciplinary approach, primarily involving pharmacological and behavioral intervention. Stimulants like methylphenidate and amphetamines are first‐line medications, but non‐stimulants may be considered for some patients. However, stimulants face challenges related to misuse, dependence, and long‐term tolerability issues. The etiology of ADHD involved genetic predisposition, environmental influences, and prenatal, perinatal, and postnatal factors. Prenatal causes encompass maternal diet, alcohol consumption, viral infections, and stress. Postnatal factors include head trauma, meningitis, toxin, nutritional deficiencies, as well as iodine deficiency and hypothyroidism. The gut microbiome's role in ADHD is emerging, influencing neurodevelopment through microbiota–gut–brain axis. Understanding these diverse etiological factors is essential for comprehensive ADHD management.

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Indication	Highest Phase	Country/Location	Organization	Date
Neoplasms	Preclinical	IT	Sigma-Tau BV	24 Jun 2005

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