Depression is an important global public health problem. Given the scarcity of studies involving African youths, this study was conducted to evaluate the associations of anger expression and violent behavior with symptoms of depression among male college students.

Background: Alcohol use disorder (AUD) accounts for millions of acute care encounters annually in the United States. Hospitalization represents a vital opportunity to intervene pharmacologically, but low medication adherence is a significant barrier. Two single-dose, adherence-independent interventions are well suited for pre-discharge administration: intravenous (IV) ketamine and intramuscular (IM) naltrexone. Their feasibility and readmission-reducing efficacy in hospital settings are not well-established. Methods: A 3-arm, open-label randomized trial was conducted at our safety-net medical hospital among high-utilization inpatients with severe AUD. Consented adults (age 18–65) were randomized to (1) IV ketamine (KET) 0.5 mg/kg over 40 min, (2) IM naltrexone (NTX) 380 mg once, or (3) linkage alone (LA). The primary clinical outcome was 30-day all-cause hospital readmission rate. All were provided enhanced linkage to outpatient addiction clinic. Results: We consented and randomized 44 participants (n = 13, 14, 17 for KET, NTX, LA, respectively), with a mean of 3.2 past-year hospitalizations. Compared to the LA arm, both the KET arm (RR 0.37, p = 0.17) and NTX arm (RR 0.52, p = 0.27) had a lower 30-day readmission rate, though the differences were nonsignificant. Immediate acceptability ratings of KET and NTX were 9.50 and 9.17 out of 10, respectively. No serious adverse events or illicit ketamine use was reported. Conclusions: Both interventions are feasible and showed promise in reducing readmissions for high-utilization AUD inpatients. Despite randomization, baseline characteristics may have differed in ways that biased against the control arm. Additional pragmatic studies—with larger sample size, blinding, and robust follow-up data collection—are needed to verify findings and better understand mediating factors. ClinicalTrials.gov Identifier NCT04562779. Registered 24 September 2020. https://clinicaltrials.gov/ct2/show/NCT04562779

Introduction: Alcohol use disorder (AUD) is widespread and problematic in the United States, and current pharmacotherapy options have relatively modest effects. Therefore, novel interventions such as ketamine therapy have gained interest as potentially efficacious options, known to generate unique psychotherapeutic experiences. The present secondary analysis examines the acute subjective experiences—both quantitatively and qualitatively—of clinical trial participants with AUD who received intravenous (IV) ketamine therapy in the hospital setting. Materials and Methods: Among a subset of inpatient clinical trial participants with AUD who received IV ketamine therapy ( n = 12), acceptability and tolerability were assessed. Next, a brief directed content analysis was performed, utilizing textual data transcribed immediately after ketamine infusion. Six preselected themes from the literature were chosen to apply to our text. Results: Among this sample, IV ketamine therapy appeared well tolerated and highly acceptable (mean 9.5 on 0–10 Likert scale). The mean Clinician-Administered Dissociative States Scale (CADSS) score was 21.7 (out of max 92). It seemed to occasion experiences that were largely positive, transporting, visual, and meaningful. The most frequently assigned themes in our data set were “Meaningful, spiritual, and mystical experiences,” “Positive affect,” and “Inherent contradictions of the acute experience.” Conclusions: Prior themes derived from two theory-generating publications applied widely to our participants' reported experiences. The hospital setting itself did not appear to be a barrier in facilitating these experiences.