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Synthetic Cannabinoids (SCs) K2 clinical manifestation-A literature review
- S. Kamrun, T. Sultana, F. A. Faruki, S. Goddu
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S468
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Introduction
There has been an increase in the use of new psychoactive substances containing synthetic cannabinoids in recent years. It is also known as K2, spice, or fake weed, and these are popular as recreational drugs [Kourouni I et al. JAMA NetW Open 2020 Jul; 1;3(7): e208516]. CB1 agonists in SCs mimic the effects of cannabis, making users feel happy and relaxed. However, recreational SCs may result in unwanted severe consequences such as acute anxiety and psychosis [Gunderson EW et al. AM J Addict 2012 Jul-Aug; 21(4): 320-6]. Relative to tetra-hydro cannabinol (THC), synthetic cannabinoids (SCs) are more potent and efficacious agonists and may exert deleterious effects on health [Gunderson EW et al. AM J Addict 2012 Jul-Aug; 21(4): 320-6].
ObjectivesOur aim of this review is to focus on the typical presentation of SCs use and help clinicians to better understand and be more vigilant about K2 manifestations
MethodsIn conducting the literature review, only English language articles were selected from PubMed and PubMed Central (PMC) databases through August 14, 2022, using the search term “Synthetic cannabinoids k2 clinical manifestation”. Three reviewers conducted the initial review of the titles and abstracts of the electronic search, followed by detailed assessments of the relevant studies. Peer-reviewed Case series, case reports, and systematic review studies were included that met the inclusion criteria (articles in the English language, studies on humans, studies on synthetic cannabinoids (SC) or K2 use and its clinical manifestations.
ResultsElectronic search results showed a total of 60 articles. Fifty articles were excluded based on title review (36 articles), abstract review (4 articles), and full article review (10 articles). Case series on 30 ICU patients (SC intoxication) showed agitation 33%, bizarre behavior, coma 33%, seizure 20%, Acute respiratory failure 60%, Tracheal intubation 70%, Rhabdomyolysis 26%, Invasive mechanical ventilation 40%, Acute kidney injury 26% and cardiotoxic effect [Kourouni I et al. JAMA NetW Open 2020 Jul; 1; 3(7): e208516]. Cross-sectional study on 50 male cases showed altered perception 68%, including auditory and visual hallucination, dizziness and loss of consciousness, palpitation 76%, chest pain 12%, panic attack, and convulsion [Abdelmoneim WM et al. Middle East Current Psychiatry 2022; 29 (1): 24]. Literature reviews has shown the common psychiatric presentations of SC are acute anxiety, agitation, psychosis, paranoia, disorientation, alteration of mood and perception, hallucination, and delusion [Debruyne D et al. Subst Abuse Rehabil. 2015 Oct 20; 6:113-29, Radhakrishnan R et al. Front Psychiatry 2014 May 22;5:54].
ConclusionsThere are limited research related to synthetic cannabinoids in human. Based on our review, SC intoxication can be life-threatening besides psychiatric manifestation. Therefore, clinicians must understand the vast clinical manifestations of SCs.
Disclosure of InterestNone Declared
Anxiety and depressive symptoms among physicians during the COVID-19 pandemic in Bangladesh: a cross-sectional study
- M. Tasdik Hasan, Sahadat Hossain, Farhana Safa, Afifa Anjum, Abid Hasan Khan, Kamrun Nahar Koly, Syeda Fatema Alam, Md. Abdur Rafi, Vivek Podder, Tonima Islam Trisa, Rhedeya Nury Nodi, Dewan Tasnia Azad, Fatema Ashraf, S. M. Quamrul Akther, Helal Uddin Ahmed, Simon Rosenbaum, Graham Thornicroft
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- Journal:
- Global Mental Health / Volume 9 / 2022
- Published online by Cambridge University Press:
- 24 May 2022, pp. 285-297
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Objectives
In addition to risking their physical well-being, frontline physicians are enduring significant emotional burden both at work and home during the coronavirus disease 2019 (COVID-19) pandemic. This study aims to investigate the levels of anxiety and depressive symptoms and to identify associated factors among Bangladeshi physicians during the COVID-19 outbreak.
Methods and designA cross-sectional study using an online survey following a convenience sampling technique was conducted between April 21 and May 10, 2020. Outcomes assessed included demographic questions, COVID-19 related questions, and the Hospital Anxiety and Depression Scale (HADS).
ResultsThe survey was completed by 412 Bangladeshi physicians. The findings revealed that, in terms of standardized HADS cut-off points, the prevalence of anxiety and depressive symptoms among physicians was 67.72% and 48.5% respectively. Risk factors for higher rates of anxiety or depressive symptoms were: being female, physicians who had experienced COVID-19 like symptoms during the pandemic, those who had not received incentives, those who used self-funded personal protective equipment (PPE), not received adequate training, lacking perceived self-efficacy to manage COVID-19 positive patients, greater perceived stress of being infected, fear of getting assaulted/humiliated, being more connected with social media, having lower income levels to support the family, feeling more agitated, less than 2 h of leisure activity per day and short sleep duration. All these factors were found to be positively associated with anxiety and depression in unadjusted and adjusted statistical models.
ConclusionsThis study identifies a real concern about the prevalence of anxiety and depressive symptoms among Bangladeshi physicians and identifies several associated factors during the COVID-19 pandemic. Given the vulnerability of the physicians in this extraordinary period whilst they are putting their own lives at risk to help people infected by COVID-19, health authorities should address the psychological needs of medical staff and formulate effective strategies to support vital frontline health workers.