Characterizing movement disorders and their associations with substance use and psychosis in adults living in precarious housing or homelessness
Notice bibliographique
Résumé
Background: Many individuals who are precariously housed or homeless live with multimorbid conditions, including substance use, psychotic, and neurological disorders. Despite high levels of susceptibility, movement disorders are understudied in these socially marginalized people. The general objective of the current dissertation was to characterize movement disorders in relation to substance use and psychosis, and also to examine their longitudinal characteristics. Methods: Participants were recruited from an impoverished neighborhood of downtown Vancouver, Canada. Data were collected on the diagnosis of psychiatric disorders, severity of signs of movement disorders and symptoms of psychosis, and recent use of drugs and substances. Cross-sectional and longitudinal mixed-effects regression analyses were used to examine the associations in question. Results: Among different types of substance use examined, methamphetamine was most consistently associated with movement disorders, including parkinsonism and dyskinesia, and the association was stronger in older female participants. Moreover, underlying psychotic disorders were associated with higher odds of clinically relevant signs of movement disorders as a result of methamphetamine and cannabis use. In turn, movement disorders were associated with impaired psychosocial functioning, greater symptoms of psychosis (negative, disorganized, and excited symptoms), and poorer cognitive functioning, especially in participants with underlying psychotic disorders. Furthermore, there were temporal relationships between movement disorders and cardinal psychotic symptoms, where preceding delusions and unusual thought content were associated with subsequent parkinsonism, and preceding dyskinesia was associated with subsequent conceptual disorganization. Lastly, parkinsonism was commonly observed in all age groups of precariously housed and homeless participants relative to the general population. The proportion affected by parkinsonism rapidly increased during the peak of the opioid epidemic, although urine fentanyl detection was not associated with parkinsonism. On the other hand, the proportion affected by dyskinesia decreased during the post-declaration period, and urine fentanyl detection was associated with lower severity of orofacial dyskinesia. Conclusions: Overall, these results suggest that movement disorders are important neurological complications in precariously housed and homeless individuals, and future studies should aim to reveal the mechanisms underlying substance use-associated movement disorders (e.g., neuroimaging markers), differentially diagnose parkinsonism (e.g., idiopathic Parkinson’s disease), and establish intervention and prevention strategies for these signs and symptoms.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».