Title : Personality assessment in substance users at the risk of cardiovascular comorbidity
Abstract:
Personality refers to the enduring configuration of characteristics and behaviour that comprises an individual’s unique adjustment to life, including major traits, interests, drives, values, self-concept, abilities, and emotional patterns. The tendency to search out and engagein thrilling activities as a method of increasing stimulation and arousal is known as sensation seeking. It typically takes the form of engaging in highly stimulating activities that have an element of danger, such as skydiving or race-car driving. Impulsivity refers to describing and displaying behaviour characterized by little or no forethought, reflection, or consideration of the consequences of an action, particularly one that involves taking risks. A crossectional study was conducted in the department of psychiatry, in year2020, Indra Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India. In total 240 Opd patients having substance dependence were assessed, using Impulse sensation seeking scale, a questionnaire designed by Zuckerman and McDaniel in 2003(recent version). Assessing abnormal personality trait and using therapeutic and behavioural approaches in such patients can be used to decrease substance use and prevent cardiovascular co morbidity in opioid, alcohol, cannabis nicotine, and polysubstance dependent patients. Out of 240 subjects 90 of them were jail inmates managed for substance dependence. Rest of them were regular opd patients having substance dependence. All the subjects in the study were males. Among regular opd patients majority were in the age group between 21 to 30 years, with history of opioid and nicotine dependence in the majority of patients followed by alcohol in the second order and thereafter cannabis and lastly polysubstance dependence. Among jail inmates all were males, majority were in the age group above 40, having alcohol and nicotene dependence in the highest percentage followed by cannabis, thereafter opiod and polysubstance dependence lastly. Regular opd patients were found to have high sensation seeking than impulsivity whereas jail inmates were found having decreased percentage of sensation and impusivity as compared to regular opd patients. Incomparison to impusivity sensation seeking was found marginally high in jail inmates. Brain imaging studies in humans have identified structural and functional alterations in impulsive and increased sensation seeking individuals.In impulsive individuals corticostriatal circuit is found affected. In particular dysfunctional monoaminergic signalling (most notabily within dopaminergic and serotonergic system) is found in impulsive individuals. On the other hand high sensation seeking individuals are known to engage in activities of risky activites or negative consequences. They also exhibit greater brain activation for rewards and gains. Such individuals also show reduced neural responses in thalamus and dorsomedial prefrontal cortex during risk taking activities. Assessing personality aspects about impulsivity and sensation seeking can be used as preventive tool. In the patients of known abnormal personality traits, cognitive errors can be rectified and psychotherapy can be given. In substance dependent patients based on particular abnormal personality trait and associated changes in specific regions of the brain specific pharmacological treatment can be given. Impulsivity, sensation seeking traits in substance dependent individuals can be managed, used to decrease substance intake and further can be used as a preventive measure, to reduce the risk of associated co morbidities in patients of opioid,alcohol,cannabis and nicotine dependence.
