Sociodemographic Attributes and Prevalence of Arrest With Possession of Substances in Incarcerated Population in the United States.

Background and objectives In recent years, there has been an increase in the US imprisonment rate. A substantial percentage of those incarcerations are for drug-related offenses. The authors investigated the relationship between the pattern of substance use and drug-related offenses across a broad spectrum of various sociodemographic attributes of the incarcerated population in the United States. Methods Cross-sectional data from the 2016 Survey of Prison Inmates conducted by the Bureau of Judicial Statistics were extracted with inmates who reported possession of a drug at the time of arrest as a primary outcome of interest. Using SAS 9.4 statistical software (SAS Institute Inc., Cary, USA), the authors used multivariate analyses to determine the odds ratios between various sociodemographic attributes of the inmates and possession of substance at the time of the arrest. Logistic regression analysis for age groups in relation to substance possession at the time of arrest is presented in the form of an adjusted odds ratio and their respective confidence interval at p ≤0.5. Results Out of the total 23,798 inmates who reported possession of a drug at the time of arrest, 34.07% were Non-Hispanic Whites, and 31.5% were within the age group of 25-34 years. Only 59.47% of inmates were employed 30 days before the arrest, and 58.02% had less than a high school education. Different patterns of drug use were linked with different types of drugs found in their possession at the time of the arrest. Possession of cannabis at the time of arrest was highest in the age group 18-24 years compared to other age groups (odds ratio: 1.362; 95% CI: 1.159 - 1.602). Inmates with a history of stimulant or hypnotic use were more likely to have another psychoactive substance during a time of the arrest. Only 8.46% of inmates had psychiatric and psychological treatment as part of their sentence. Conclusions A large proportion of incarcerations in the US is because of drug-related offenses, with most of the burden on the younger age group. Inmates should receive psychiatric and psychological treatments for substance use as part of their sentencing while in prison and after release as a form of targeted intervention for this vulnerable group.

Cannabis Use in Inpatients With Schizophrenia Spectrum Disorders at a Community Hospital.

BACKGROUND: Cannabis is the second most used recreational drug in the United States and one of the most used substances in patients with schizophrenia spectrum disorder (SSD). Unfortunately, the increased use is likely to continue as more states legalize recreational use of cannabis. Although the association between cannabis and schizophrenia has been studied extensively, the understanding of the relationship is still evolving. In this study, we sought to determine the prevalence and potential factors associated with cannabis use (CU) among inpatients with SSD at a community teaching hospital. METHODS: We performed a retrospective review of the electronic medical charts of patients discharged from the psychiatric unit of our hospital from July 1, 2017 through October 31, 2017. Patients were included in this study if: 1) They were ≥ 18 years old; 2) They had discharge diagnosis of SSD; and 3) They had urine drug testing performed. Pertinent sociodemographic and clinical variables, including substance use status and hospital length of stay (LOS), were abstracted. Univariate frequencies and summary statistics were performed. Odds ratios (ORs) were determined by logistic regression analysis of bivariate and multivariate analyses. RESULTS: Three hundred sixty-five (52.2%) patients had a discharge diagnosis of SSD, and only 322 had urine toxicology result for cannabinoids and were included in analysis. Of the 322 patients, 41.5% (n = 133) screened positive for cannabinoids. Of the 133 patients, 78% were African American, 15% were Hispanic and 5% were White; 77% were male and the median age was 36 years. Bivariate analyses showed tobacco use (OR: 2.8, 95% confidence interval (CI): 1.7 - 4.6), alcohol use (OR: 3.4, 95% CI: 2.9 - 7.0), younger age (OR: 2.8, 95% CI: 1.8 - 4.5), male gender (OR: 2.9, 95% CI: 2.2 - 3.2), unemployment (OR: 3.91, 95% CI: 3.49 - 7.35), homelessness (OR: 3.18, 95% CI: 2.76 - 3.84) and LOS (OR: 3.46, 95% CI: 2.93 - 4.31) were significantly associated with CU. Result of multivariate analysis was similar to that found in bivariate analysis. CONCLUSIONS: CU appears to be prevalent among patients with SSD. Clinicians and public health professionals are encouraged to understand the health implications of its use in patients with mental illness especially against the backdrop of current marijuana laws.

Two Cases of Persistent Complex Bereavement Disorder Diagnosed in the Acute Inpatient Unit.

Pathological grief has been noted to have considerable adverse effects on affected individuals. In the DSM-5, the diagnosis of complicated grief is included under conditions for further study as Persistent Complex Bereavement Disorder (PCBD). PCBD can be easily missed because it is a relatively new and developing diagnosis. It can also be overlooked when it is comorbid with more common psychiatric disorders. We present 2 patients with PCBD diagnosed in the inpatient unit, while the patients were admitted for comorbid disorders. PCBD contributed immensely to both patients' suffering and decline in functioning. This report highlights the presentation, diagnoses, and management of these patients. We theorize that paying attention to separation distress, reactive distress to loss, and identity disruption in individuals who have been bereaved for over 12 months will enhance treatment specificity and lead to better patient outcomes.

Neuropsychiatric Manifestations of Partial Agenesis of the Corpus Callosum: A Case Report and Literature Review.

Agenesis of the corpus callosum is a rare congenital defect that has been linked to psychiatric disorders, cognitive deficits, learning disabilities, and developmental delays. We present the case of a patient with partial agenesis of the corpus callosum who exhibits depressed mood, transient loss of memory, and history of cognitive, social, and behavioral disturbances that developed during his childhood. Recent and pertinent literature was reviewed and the agenesis of the corpus callosum and its associated neuropsychiatric manifestations are discussed.