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Introduction:Dropout from inpatient treatment for substance use disorder (SUD) is an ongoing challenge. The aim of this study was to identify demographic, substance use, and psychological factors that predict dropout from postdetoxification inpatient SUD treatment.Materials and methods:A total of 454 patients from 5 inpatient SUD centers in Central Norway were consecutively included in this naturalistic, prospective cohort study.Results:A total of 132 patients (28%) did not complete the planned treatment stay (dropped out). Cox regression analysis showed that higher levels of intrinsic motivation for changing personal substance use reduced the dropout risk (adjusted hazard ratio [adjHR]: 0.62, 95% confidence interval [CI]: 0.48-0.79). Higher levels of mental distress were associated with an increased risk for dropout (adjHR: 1.48, 95% CI: 1.11-1.97).Conclusions:The role of mental health and motivation in reducing dropout risk from inpatient SUD treatment should be targeted in future prospective intervention studies.

BackgroundWe investigated the associations between symptoms of anxiety and depression and alcohol drinking behavior among adolescents, by focusing on the importance of symptom load, as well as gender differences.MethodsData was derived from a cross-sectional school based survey among adolescents in upper secondary schools in Norway. Among other variables adolescents reported on symptoms of anxiety and depression, time of onset and extent of alcohol use. The sample consisted of 6238 adolescents aged 16–18 years. We estimated prevalence of alcohol drinking behaviors in relation to severity of symptoms of anxiety and depression.ResultsHigher levels of depression symptoms were associated with earlier onset of alcohol use, more frequent consumption and intoxications. The associations between anxiety and depression symptoms and early drinking onset were stronger for girls than for boys. Higher levels of anxiety symptoms were only associated with alcohol consumption among girls.ConclusionsBoys and girls with depressive symptoms and girls with anxiety symptoms are more likely to have unhealthy patterns of alcohol drinking. Preventive strategies at all levels could possibly profit from a common approach to mental health and alcohol use, in particular for girls in mid-adolescence.

Aim-To assess the relative significance for cognitive development of small for gestational age, parental demographic factors, and factors related to the child rearing environment. Methods-IQ of a population based cohort of 338 term infants who were small for gestational age (SGA) and without major handicap, and a random control sample of 335 appropriate for gestational age (AGA) infants were compared at 5 years of age. Results-The mean non-verbal IQ was four points lower, while the mean verbal IQ was three points lower for the children in the SGA group. The results were not confounded by parental demographic or child rearing factors. However, parental factors, including maternal non-verbal problem solving abilities, and child rearing style, accounted for 20% of the variance in non-verbal IQ, while SGA versus AGA status accounted for only 2%. The comparable numbers for verbal IQ were 30 and 1%. Furthermore, we found no evidence that the cognitive development of SGA children was more sensitive to a non-optimal child rearing environment than that of AGA children. Maternal smoking at conception was associated with a reduction in mean IQ comparable to that found for SGA status, and this eVect was the same for SGA and AGA children. The cognitive function of asymmetric SGA was comparable to that of symmetric SGA children. Conclusions-Our findings indicate that child cognitive development is strongly associated with parental factors, but only marginally associated with intrauterine growth retardation. (Arch Dis Child 2000;83:25-30)

In this follow-up study, 20 of a geographically based year cohort of 31 surviving non-disabled VLBW (birthweight < 1500 g) children were examined at six years of age. The aim of the study was to relate cerebral MRI findings to neuro-development in these non-disabled children at six years of age. All MRI scans were evaluated for myelination pattern, periventricular gliosis, ventricular dilation and cortical atrophy. The Peabody motor test and the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) were used in the evaluation of motor, mental and perceptual function. A diagnosis of attention deficit disorder with hyperactivity was made based on the examiner's impression of the child during the examination and based on the parent's history. We found that ten (50%) of the children had periventricular gliosis, mainly in centrum semiovale (CS) (nine children) and in central occipital white matter (COW) (six children). Gliosis in CS was related to lower scores on the Peabody gross motor test for locomotion, indicating involvement of corticospinal tracts. Additional gliosis in COW was related to both fine motor and gross motor impairments. We speculate that this indicates damage to both motor and visual pathways, affecting eye-hand coordination and balance function. No relationship between MRI deviations at six years and mental function based on performance, verbal and total IQ scores was found. However, there was a significant relationship between periventricular gliosis in COW and C5 and low scores on the WPPSI performance subtests: Picture completion test and Block design test. This may indicate visual and spatial perception problems, caused by damage to posterior visual pathways and occipito-thalamic tracts dealing with visuo-motor integration.