Parental substance use (PSU) is associated with increased psychiatric risk among offspring, but evidence from Sub-Saharan Africa remains limited.

To examine cross-sectional associations between PSU and Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) algorithm-defined adolescent psychiatric symptom profiles in Lagos, Nigeria, and assess whether family dysfunction statistically attenuates these associations.

Data came from the Lagos Schools Emotional and Behavioural Health Survey, a school-based sample of 9437 adolescents aged 11–17 years. PSU was categorised as neither parent, only father, only mother or both parents using substances, defined as adolescent-reported at least weekly parental alcohol consumption or tobacco use over the past 12 months. Psychiatric symptom profiles were identified using structured MINI-KID self-report algorithms administered with trained research-assistant support. Logistic regression estimated adjusted odds ratios (aORs). Family dysfunction, defined as domestic violence or high family conflict, was examined using cross-sectional statistical attenuation models.

PSU was reported by 20.0% of adolescents: 17.3% father-only, 1.3% mother-only and 1.4% both parents. Associations followed a graded pattern. Dual-parent PSU was associated with increased odds of symptoms meeting algorithm thresholds for substance use disorder (aOR = 5.84, 95% CI 3.42–9.97), alcohol use disorder (aOR = 4.98, 95% CI 3.09–8.03) and major depressive disorder (aOR = 2.81, 95% CI 1.94–4.07). Family dysfunction partially attenuated selected associations.

PSU was associated with elevated adolescent psychiatric symptom profiles in a graded fashion. Findings are cross-sectional and do not establish causality. Outcomes represent self-reported symptoms meeting MINI-KID algorithm thresholds, not clinician-confirmed diagnoses.

Attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs) commonly co-occur and have overlapping genetic liabilities. Less is known regarding the phenomenology and genetics of ADHD in a cohort enriched for SUDs and the extent to which ADHD genetic liability contributes to SUD risk when controlling for substance specific genetic risk.

We used data from the Yale-Penn cohort, which comprises ~14,000 individuals ascertained for SUDs and/or as controls. Psychiatric and substance use phenotypes were ascertained from the semi-structured assessment for drug dependence and alcohol survey for all participants. Polygenic scores (PGSs) were developed for ADHD and multiple substance-related traits using summary statistics from large genome-wide association studies on participants with genetic data (N = 10,275).

Participants who met DSM-IV Criteria for ADHD had significantly increased odds for every DSM-5 SUD analyzed, greater polysubstance use, and younger age of onset of substance use. Among participants of European-like ancestry, ADHD PGS was associated with multiple SUDs, even after controlling for substance-specific PGS. Of the substance-related PGS, only the smoking initiation PGS was associated with ADHD diagnosis and criterion count and only among individuals of European-like ancestry.

In this sample, ADHD was associated with increased risk for SUDs and earlier onset of substance use. Additionally, genetic liability to ADHD was independently associated with multiple SUDs and SUD criteria counts. PGS for substance-related traits tended to be less significantly associated with ADHD. Further studies in large, diverse populations are needed to enhance our understanding of these associations.

Cannabinoids are increasingly discussed as adjuncts in addiction treatment, yet whether they improve clinically meaningful substance use disorder (SUD) outcomes beyond short-term symptom relief is unresolved. We determined whether cannabinoid exposure confers directional efficacy across opioid, alcohol, cocaine, tobacco, and methamphetamine use disorders, distinguishing symptomatic targets from sustained therapeutic outcomes.

PubMed and Embase (1975–2025) were searched for human studies evaluating cannabinoid exposure in relation to SUD outcomes. Two reviewers independently screened and extracted data. Risk of bias was assessed using RoB 2 for randomized controlled trials (RCTs), ROBINS-I for cohort studies, and JBI checklists for cross-sectional, case, and qualitative designs. Six prespecified endpoints (treatment retention, relapse, abstinence, craving, withdrawal severity, consumption) were mapped to each target SUD. Following Synthesis Without Meta-analysis (SWiM) guidance, structured narrative synthesis used a design-based weighting scheme (RCT 1.00 to qualitative 0.25). PROSPERO: CRD420251151193.

Ninety-seven studies (41,954 participants) contributed 195 endpoint instances: 89 Beneficial (45.6%), 80 No Significant Effect (41.0%), 12 Mixed/Partial (6.2%), and 14 Harmful/Inferior (7.2%). Short-term symptom targets accounted for most Beneficial findings (76.4%). Sustained outcomes were predominantly No Significant Effect, most pronounced in opioid use disorder. Beneficial symptom findings derived overwhelmingly from weaker study designs (craving 81.5%; withdrawal severity 85.7%; consumption 80.0%).

Cannabinoids confer short-horizon symptomatic benefits but do not demonstrate efficacy for sustained abstinence, relapse prevention, or retention, most clearly in opioid use disorder, where evidence is strongest. Findings for other disorders remain preliminary. Adequately powered adjunctive randomized trials with biochemically verified endpoints are needed.

Persons with substance use disorders (SUD) often suffer from additional comorbidities. Researchers have explored this overlap via phenome-wide association studies (PheWASs). However, PheWASs are largely cross-sectional, limiting our understanding of whether diagnoses predate the development of an SUD. We characterize whether polygenic scores (PGSs) are associated with time to comorbid diagnoses in electronic health records (EHR) after the first documented SUD diagnosis.

Using data from All of Us (N = 393,596), we explored: (1) whether social determinants of health (SDoHs) are associated with lifetime risk of SUD (N cases = 42,568) and (2) within a subset those with a diagnosed SUD and available genetic data SUD (N = 21,357), whether PGS for alcohol use disorders, cannabis use disorders, depression, externalizing, posttraumatic stress disorder, and schizophrenia were associated with subsequent diagnoses via a phenome-wide survival analysis.

Multiple SDoHs were associated with lifetime SUD diagnosis, with annual household income having the largest overall associations (e.g. <$10 K annually vs $100 K–$150 K annually: OR = 4.18; 95% CI = 3.92, 4.45). There were 86 phenome-wide significant PGS associations with subsequent diagnoses across various bodily systems. PGSs for alcohol use disorders, posttraumatic stress disorder, and schizophrenia were each associated with time to their respective diagnoses.

Social determinants, especially those related to income, have profound associations with lifetime SUD risk. Additionally, PGSs for psychiatric conditions are associated with multiple post-SUD diagnoses within those with a SUD, suggesting PGS may capture information beyond lifetime risk, including timing and severity of comorbidities related to SUD.

Sexual minority (lesbian, gay, bisexual, queer and other non-heterosexual) people experience significant disparities in addiction problems compared with heterosexual people.

We aimed to answer the question, what are the barriers and facilitators to accessing drug/alcohol addiction treatment services for sexual minority adults?’.

A systematic review was conducted by searching Medline, PsycINFO, CINAHL, Web of Science, and Sociological Abstracts for any English-language primary research article (qualitative, quantitative or mixed methods) relevant to the study aims, from inception up to 18 April 2025. Quality of included studies was assessed using the Mixed-Methods Appraisal Tool (MMAT-2018). Barriers and facilitators were categorised into ‘service-related’ and ‘patient-related’ dimensions of accessibility, and synthesised narratively.

We screened 3282 abstracts, with full-text review of 238 articles; 62 studies met the inclusion criteria. Common service-related barriers included explicit harassment, discrimination, violence or abuse toward sexual minority people in services and lack of expertise or ‘culturally competent’ provision for their specific addiction problems. Facilitators included affirming, non-judgemental staff attitudes and sexual minority-specific treatment or outreach services. Patient-related barriers included ambivalence around drug/alcohol use and a fear of stigma (e.g. around sexualised drug use). Facilitators included signposting to services via community networks or peer advocates, and allowing patients to set their own treatment goals.

Although barriers and facilitators vary across global contexts and time periods, both qualitative and quantitative research highlighted similar key issues. Implementing practical changes to address these may improve sexual minority people’s access to addiction services, reducing the burden of addiction-related health inequity for this community.

In England, 354 000 people were homeless on a given night in 2024. It has long been recognised that the physical and mental health of people who are homeless is poorer than for those who are stably housed. There are few peer-reviewed studies to inform health- and social care around depression or anxiety for people who are homeless in this setting.

To measure the symptoms of depression and anxiety among adults who are homeless and who have difficulty accessing healthcare, and to describe the distribution of symptoms across sociodemographic, health-related characteristics and indicators of social vulnerability.

We surveyed 311 adults between August and December 2021. We measured anxiety and depression symptoms using the four-item Patient Health Questionnaire (PHQ-4) score. We compared median PHQ-4 scores across strata of sociodemographic, social vulnerability and health-related characteristics, and tested for associations with the Kruskal–Wallis test.

The median PHQ-4 score was 7 out of 12, with 38% having scores warranting clinical attention. While PHQ-4 scores were consistently high across a range of socioeconomic, social vulnerability and health-related characteristics, they were positively associated with young age; food insecurity; recent and historic abuse; joint, bone or muscle problems; and marijuana use. The most common barrier to accessing healthcare related to transportation (60%).

People who are homeless and have difficulty accessing healthcare have high levels of depression and anxiety symptoms. Our findings support further coordination between health- and social care sectors.

Adults with intellectual disability (ID) experience marked mental health inequities, yet population-wide estimates that capture both primary- and specialist-care diagnoses remain scarce.

Using nationwide Swedish registries, including primary care, specialist, inpatient, prescription drug, criminal, and suspicion registers, we included all individuals born in Sweden between 1958 and 1997 (N = 3,970,600), including 38,818 individuals with ID diagnoses (0.98%; 49.1% mild, 13.3% moderate, and 9.6% severe/profound). Hazard ratios (HR) were calculated using Cox proportional hazards regression to estimate the relative risk of lifetime diagnoses of major depression, anxiety disorders (ANX), obsessive-compulsive disorder (OCD), bipolar disorder (BD), attention-deficit/hyperactivity disorder (ADHD), drug use disorder, alcohol use disorder, schizophrenia, and other nonaffective psychosis. Additionally, cohort effects on psychiatric diagnosis risks in adults with intellectual disabilities versus the general population were evaluated.

People with ID were at higher risk for all psychiatric and substance use disorders, with HRs ranging from 1.7–2.0 for major depression and anxiety, drug and alcohol use disorders, 3.5–5.8 for BD, OCD and ADHD, and 10.9–12.7 for schizophrenia and other nonaffective psychosis. Higher prevalence was consistently seen among those with mild versus moderate or severe/profound intellectual disability. Relative risks narrowed modestly in successive birth cohorts, although absolute differences remained substantial.

Across six decades of follow-up, adults with ID faced markedly higher psychiatric and substance-use morbidity – most pronounced for psychotic disorders – than the general population. Whole-system mental-health screening and tailored interventions are required to address this persistent disparity.

Attention-deficit hyperactivity disorder (ADHD) in childhood is associated with various adverse long-term outcomes.

We aimed to examine the independent associations between ADHD symptoms at age 14–16 years and long-term mental health and psychosocial functioning outcomes in a 40-year birth cohort study.

Study members from the Christchurch Health and Development Study, a population-based New Zealand birth cohort study (N = 1265 at birth) were followed to age 40 years. Generalised estimating equations were used to model associations between ADHD symptoms at age 14–16 years and outcomes at age 18–40. Adjusted models were fitted to account for confounding by antecedent individual and familial risk factors, and coexisting symptoms of conduct disorder or oppositional defiant disorder.

Adolescents in the highest quartile for ADHD symptoms at age 14–16 years were at elevated risk of substance use disorder, depression, suicidal ideation, criminal offending and unemployment across early adulthood. They also had lower income, home ownership, relationship stability and living standards. The size of these associations attenuated after adjusting for confounding factors and the effect of coexisting conduct disorder and oppositional defiant disorder. However, in adjusted models, ADHD symptoms remained associated with elevated odds of substance use and criminal offending outcomes, with odds ratios ranging from 1.4 to 1.6.

Higher levels of adolescent ADHD symptoms are associated with substance use problems and criminal offending in adulthood. Long-term secondary prevention activities are needed to detect and manage coexisting problems among adults with a history of ADHD.

There is a pressing need for standardised and comprehensive research frameworks to evaluate both the therapeutic benefits and risks of dependency and misuse associated with medical cannabis. We address the issue of abuse potential or misuse liability by examining research data and what amounts to existing clinical dogma for validity and generalisability. We undertook a broad scoping approach to exploring recent literature, focusing on clinical studies that investigated abuse/misuse and dependence among users of medical and/or recreational cannabis and cannabinoids. The search provided over 350 articles, mostly (∼90%) dated post 2002. Abstract analysis narrowed the selection to under 50 papers, according to their relevance as judged by the authors, an experienced clinician and a public health toxicologist.

We identified and commented upon some broad assumptions within the abuse liability literature that included (a) a standard cannabis formulation; (b) standard routes of administration and standard potency dosing; (c) a standard pattern of use; (d) a standard user or patient; and (e) a standard vulnerability to misuse or dependence.

Unpacking and questioning these assumptions leads to the conclusion that far more rigorous language and research design are needed to address the question of cannabis abuse definitively but, based on the best available evidence, it appears that the abuse liability of medically supervised cannabis is comparable to any other class of widely used and well-regulated pharmaceutical agents.

We investigate whether, in Swedish national registers, social and psychiatric outcomes for six major psychiatric and substance disorders – drug use disorder (DUD), alcohol use disorder (AUD), major depression (MD), bipolar disorder (BD), anxiety disorder (AD), and schizophrenia (SZ) – reflect the primary genetic risk for each disorder and the level of genetic heterogeneity.

We utilize Genetic Risk Ratios – defined as the ratio of the genetic risk for secondary disorders to the genetic risk for the primary disorder – derived from Family Genetic Risk Scores. Poor social outcome was defined by a common factor of four variables: receipt of social welfare, sick leave, early retirement pension, and residence in a socially deprived area. Psychiatric outcome was defined as days of inpatient psychiatric hospitalization.

With poorer social outcomes, the primary genetic risks rose robustly for all disorders except SZ, as did the secondary genetic risks for DUD, AUD, and attention-deficit hyperactivity disorder. With poorer psychiatric outcomes, available only for BD and SZ, the primary genetic risks increased sharply. Overall, MD, AD, and BD became substantially more genetically heterogenous as their social outcomes became poorer, while for AUD, DUD, and SZ, the increase in heterogeneity was more modest. By contrast, with poorer psychiatric outcome, genetic risks for SZ became substantially more genetically homogeneous, with a similar but less robust trend seen for BD.

Despite important differences between our primary disorders, social and psychiatric outcomes are often robust indices of genetic risk and can reflect the levels of genetic heterogeneity.

Genetic and environmental factors, including adverse childhood experiences (ACEs), contribute to substance use disorders (SUDs). However, the interactions between these factors are poorly understood.

We examined associations between SUD polygenic scores (PGSs), ACEs, and the initiation of use and severity of alcohol (AUD), opioid use disorder (OUD), and cannabis use disorder (CanUD) in 10,275 individuals (43.5% female, 47.2% African-like ancestry [AFR], and 52.8% European-like ancestry [EUR]). ACEs and SUD severity were modeled as latent factors. We conducted logistic and linear regressions within ancestry groups to examine the associations of ACEs, PGS, and their interaction with substance use initiation and SUD severity.

All three SUD PGS were associated with ACEs in EUR individuals, indicating a gene–environment correlation. Among EUR individuals, only the CanUD PGS was associated with initiating use, whereas ACEs were associated with initiating use of all three substances in both ancestry groups. Additionally, a negative gene-by-environment interaction was identified for opioid initiation in EUR individuals. ACEs were associated with all three SUD severity latent factors in EUR individuals and with AUD and CanUD severity in AFR individuals. PGS were associated with AUD severity in both ancestry groups and with CanUD severity in AFR individuals. Gene-by-environment interactions were identified for AUD and CanUD severity among EUR individuals.

Findings highlight the roles of ACEs and polygenic risk in substance use initiation and SUD severity. Gene-by-environment interactions implicate ACEs as moderators of genetic susceptibility, reinforcing the importance of considering both genetic and environmental influences on SUD risk.

The mental health of incarcerated individuals is a widely recognized public health issue, but little is known about the mental health status of the incarcerated individuals upon release. This study aimed to measure the prevalence of psychiatric disorders and substance use disorders (SUDs) among incarcerated men scheduled to be released from jail soon.

We conducted a cross-sectional national survey from September 2020 to September 2022 across 26 jails (selected at random) in France. Each participant was interviewed within 30 days prior to their release via a structured questionnaire, including the Mini International Neuropsychiatric Interview.

A total of 579 individuals were included in the analysis (participation rate: 66.2%). The prevalence of mood disorders, anxiety disorders, post-traumatic stress disorder, and psychotic episodes were 30.7% (95% confidence interval [CI]: 27.1%–34.6%), 28.7% (95% CI: 25.1%–32.5%), 11.1% (95% CI: 8.8%–13.9%), and 10.5% (95% CI: 8.3%–13.3%), respectively. Additionally, almost half of the individuals had an SUD, and dual disorders were identified in 21.9% (95% CI: 18.8%–25.5%) of the cases. The analysis of mental health care pathways raised questions about access to certain types of care, such as full-time psychiatric hospitalization while in prison, as well as questions about the continuity of care upon release.

This study shows that the mental health of incarcerated men who are scheduled to be released soon is precarious. Complex mental health problems, particularly dual disorders, are common and require better coordination between mental health care systems in prisons and the community.

Self-harm, self-poisoning or self-injury, irrespective of the motivation, is a central risk factor for suicide. Still, there is limited knowledge of self-harm among patients with substance use disorders (SUDs) who die by suicide.

We aimed to describe the prevalence of a history of self-harm and identify the factors associated with self-harm, comparing individuals who died by suicide with and without SUDs.

We used data from the Norwegian Surveillance System for Suicide in Mental Health and Substance Use Services, which is based on a national linkage between the Norwegian Cause of Death Registry and the Norwegian Patient Registry, to identify individuals who died by suicide within 1 year after last contact with mental health or substance use services (n = 1140). A questionnaire was retrieved for 1041 (91.3%) of these individuals. We used least absolute shrinkage and selection operator (LASSO) regression to select variables and compared patients with and without SUDs. Conditional selective inference was used to improve 90% confidence intervals and p-values.

The prevalence of self-harm was 55% in patients with SUDs and 52.6% in patients without SUDs. Suicidal ideation (odds ratio 2.98 (95% CI 1.74–5.10)) emerged as a factor shared with patients without SUDs, while personality disorders (odds ratio 1.96 (1.12–3.40)) and a history of violence (odds ratio 1.86 (1.20–2.87)) were unique factors for patients with SUDs.

A history of self-harm is prevalent in patients with SUDs who die by suicide and is associated with suicidal ideation, a history of violence and personality disorders in patients with SUDs.