Eva Jané-Llopis

Bio: Eva Jané-Llopis is an academic researcher from Centre for Addiction and Mental Health. The author has contributed to research in topics: Mental health & Psychological intervention. The author has an hindex of 18, co-authored 45 publications receiving 1922 citations. Previous affiliations of Eva Jané-Llopis include Radboud University Nijmegen & Public Health Research Institute.

Mental health and alcohol, drugs and tobacco: a review of the comorbidity between mental disorders and the use of alcohol, tobacco and illicit drugs

Abstract: This paper reviews some major epidemiological studies undertaken in high-income countries during the last 15 years which have reported the prevalence of mental disorders and substance use disorders and their relationship. Comorbidity between mental and substance use disorders is highly prevalent across countries. In general, people with a substance use disorder had higher comorbid rates of mental disorders than vice versa, and people with illicit drug disorders had the highest rates of comorbid mental disorders. There is a strong direct association between the magnitude of comorbidity and the severity of substance use disorders. While causal pathways differ across substances and disorders, there is evidence that alcohol is a casual factor for depression, in some European countries up to 10% of male depression. Policies that reduce the use of substances are likely to reduce the prevalence of mental disorders. Treatment should be available in an integrated fashion for both mental and substance use disorders. There is a need to expand the evidence base on comorbidity, particularly in low-income countries.

Predictors of efficacy in depression prevention programmes: Meta-analysis

Abstract: Background Worldwide, 340 million people are affected by depression, with high comorbid, social and economic costs. Aims To identify potential predictors of effect in prevention programmes. Method A meta-analysis was made of 69 programmes to reduce depression or depressive symptoms. Results The weighted mean effect size of 0.22 was effective for different age groups and different levels of risk, and in reducing risk factors and depressive or psychiatric symptoms.Programmes with larger effect sizes were multi-component, included competence techniques, had more than eight sessions, had sessions 60–90 60–90 min long, had a high quality of research design and were delivered by a health care provider in targeted programmes. Older people benefited from social support, whereas behavioural methods were detrimental. Conclusions An 11% improvement in depressive symptoms can be achieved through prevention programmes. Single trial evaluations should ensure high quality of the research design and detailed reporting of results and potential predictors.

Immediate impact of minimum unit pricing on alcohol purchases in Scotland: controlled interrupted time series analysis for 2015-18.

Abstract: Objective To assess the immediate impact of the introduction of minimum unit pricing in Scotland on household alcohol purchases. Design Controlled interrupted time series analysis. Setting Purchase data from Kantar Worldpanel’s household shopping panel for 2015-18. Participants 5325 Scottish households, 54 807 English households as controls, and 10 040 households in northern England to control for potential cross border effects. Interventions Introduction of a minimum price of 50p (€0.55; $0.61) per UK unit (6.25p per gram) for the sale of alcohol in Scotland on 1 May 2018. Main outcome measures Price per gram of alcohol, number of grams of alcohol purchased from off-trade by households, and weekly household expenditure on alcohol. Results The introduction of minimum unit pricing in Scotland was associated with an increase in purchase price of 0.64p per gram of alcohol (95% confidence interval 0.54 to 0.75), a reduction in weekly purchases of 9.5 g of alcohol per adult per household (5.1 to 13.9), and a non-significant increase in weekly expenditure on alcohol per household of 61p (−5 to 127). The increase in purchase price was higher in lower income households and in households that purchased the largest amount of alcohol. The reduction in purchased grams of alcohol was greater in lower income households and only occurred in the top fifth of households by income that purchased the greatest amount of alcohol, where the reduction was 15 g of alcohol per week (6 to 24). Changes in weekly expenditure were not systematically related to household income but increased with increasing household purchases. Conclusions In terms of immediate impact, the introduction of minimum unit pricing appears to have been successful in reducing the amount of alcohol purchased by households in Scotland. The action was targeted, in that reductions of purchased alcohol only occurred in the households that bought the most alcohol.

Mental health promotion works: a review

Abstract: Positive mental health is a value in its own right; it contributes to the individual’s well-being and quality of life; and also contributes to society and the economy by increasing social functioning and social capital. Positive mental health refers to human qualities and life skills such as cognitive functioning, positive self-esteem, social and problem solving skills, the ability to manage major changes and stresses in life and to influence the social environment, the ability to work productively and fruitfully and to make contributions to the community, and a

Physiology and Neurobiology of Stress and Adaptation: Central Role of the Brain

Abstract: The brain is the key organ of the response to stress because it determines what is threatening and, therefore, potentially stressful, as well as the physiological and behavioral responses which can be either adaptive or damaging. Stress involves two-way communication between the brain and the cardiovascular, immune, and other systems via neural and endocrine mechanisms. Beyond the "flight-or-fight" response to acute stress, there are events in daily life that produce a type of chronic stress and lead over time to wear and tear on the body ("allostatic load"). Yet, hormones associated with stress protect the body in the short-run and promote adaptation ("allostasis"). The brain is a target of stress, and the hippocampus was the first brain region, besides the hypothalamus, to be recognized as a target of glucocorticoids. Stress and stress hormones produce both adaptive and maladaptive effects on this brain region throughout the life course. Early life events influence life-long patterns of emotionality and stress responsiveness and alter the rate of brain and body aging. The hippocampus, amygdala, and prefrontal cortex undergo stress-induced structural remodeling, which alters behavioral and physiological responses. As an adjunct to pharmaceutical therapy, social and behavioral interventions such as regular physical activity and social support reduce the chronic stress burden and benefit brain and body health and resilience.

Central role of the brain in stress and adaptation: links to socioeconomic status, health, and disease.

Abstract: The brain is the key organ of stress reactivity, coping, and recovery processes. Within the brain, a distributed neural circuitry determines what is threatening and thus stressful to the individual. Instrumental brain systems of this circuitry include the hippocampus, amygdala, and areas of the prefrontal cortex. Together, these systems regulate physiological and behavioral stress processes, which can be adaptive in the short-term and maladaptive in the long-term. Importantly, such stress processes arise from bidirectional patterns of communication between the brain and the autonomic, cardiovascular, and immune systems via neural and endocrine mechanisms underpinning cognition, experience, and behavior. In one respect, these bidirectional stress mechanisms are protective in that they promote short-term adaptation (allostasis). In another respect, however, these stress mechanisms can lead to a long-term dysregulation of allostasis in that they promote maladaptive wear-and-tear on the body and brain under chronically stressful conditions (allostatic load), compromising stress resiliency and health. This review focuses specifically on the links between stress-related processes embedded within the social environment and embodied within the brain, which is viewed as the central mediator and target of allostasis and allostatic load.

Australian guidelines to reduce health risks from drinking alcohol

Abstract: Australian Guidelines to Reduce Health Risks from Drinking Alcohol The National Health and Medical Research council (NHMRC) released revised guidelines which aim to reduce the risks associated with alcohol consumption. The Guidelines can be found on the National and Medical Research Council website — http://www.nhrrirc.dov.au/publications/synobses/ds10s_yn.htnn It provides universal guidance for healthy adults aged 18 years and over and guidelines specific to children and young people and to pregnant and breastfeeding women. The guidelines do not represent a 'safe" or "no-risk" level. Rather, it is an advisory drinking level that enables healthy adults to maintain a low risk of alcohol-related accidents, injuries, diseases and death. What is a standard drink? The term "standard drink" should not be confused with a serving of alcohol, which is often much larger. For example, with wine, a standard drink corresponds to 100mL of wine, whereas a typical serve is at least 150mL. Australian law requires that all cans, bottles and casks containing alcoholic beverages be labelled with the approximate amount of standard drinks it contains. However, it can sometimes be difficult to translate standard drinks into real-life scenarios. There are no common glass sizes used across all drinking environments and people often underestimate how much they are drinking. This is compounded where large containers such as jugs and casks, are shared, where glasses are topped up by others, where the composition of mixed drinks is not known eg. cocktails or punch, and when pre-mixed spirit drinks contain a variable amount of alcohol per bottle or can.

What is resilience

Abstract: Objective:While everyone—including front-line clinicians—should strive to prevent the maltreatment and other severe stresses experienced by many children and adults in everyday life, psychiatrists ...

Alcohol and depression

Abstract: Aims To examine the literature on the associations between alcohol use disorders (AUD) and major depression (MD), and to evaluate the evidence for the existence of a causal relationship between the disorders. Methods PsycInfo; PubMed; Embase; Scopus; ISI Web of Science database searches for studies pertaining to AUD and MD from the 1980 to the present. Random-effects models were used to derive estimates of the pooled adjusted odds ratios (AOR) for the links between AUD and MD among studies reporting an AOR. Results The analysis revealed that the presence of either disorder doubled the risks of the second disorder, with pooled AORs ranging from 2.00 to 2.09. Epidemiological data suggest that the linkages between the disorders cannot be accounted for fully by common factors that influence both AUD and MD, and that the disorders appear to be linked in a causal manner. Further evidence suggests that the most plausible causal association between AUD and MD is one in which AUD increases the risk of MD, rather than vice versa. Potential mechanisms underlying these causal linkages include neurophysiological and metabolic changes resulting from exposure to alcohol. The need for further research examining mechanisms of linkage, gender differences in associations between AUD and MD and classification issues was identified. Conclusions The current state of the literature suggests a causal linkage between alcohol use disorders and major depression, such that increasing involvement with alcohol increases risk of depression. Further research is needed in order to clarify the nature of this causal link, in order to develop effective intervention and treatment approaches.