Since the industrial revolution, the relationship between unemployment and psychiatric disorders has been a subject of high interest. Currently, regarding the correlation between unemployment and substance-use disorders (SUDs), only older, often isolated and fragmented research results are available in the literature. This review was based on an extensive literature search of the European and North American literature in most relevant databases for “unemployment” and “substance use” related to “drugs”, “alcohol”, “nicotine”, and “tobacco” between November 2022 and January 2023, according to the PRISMA (Preferred Reporting Items for Systematic review and Meta-Analysis) guidelines. A total of 59,117 papers were identified, of which only 33 articles were identified as relevant to the research objective. The literature showed significantly higher prevalence rates of SUDs involving divergent psychotropic substances among unemployed people. Unemployment was found to be a risk factor for SUD, and vice versa. However, the correlation between unemployment and relapses or smoking cessation was inconsistent. In addition, there appeared to be a mild effect of business cycles on SUD. The results showed significant multifaceted correlations between unemployment and SUD, indicating that prevention and early intervention are required to prevent harmful psychosocial consequences, such as social disintegration and severe psychiatric disorders.

Pharmacological neuroenhancement (PNE) refers to the use of psychoactive substances without doctor’s prescription to enhance cognitive performance or to improve mood. Although some studies have reported that drugs for PNE are also being used to cope with stressful life situations, nothing is known about the relationship of PNE and resilience, i.e. the ability to recover from stress. This study aimed at investigating the relationship of PNE and resilience in the first representative population sample. A cross-sectional survey in a representative sample of 1128 adults (age ≥ 18 yrs.) living in Germany was conducted. The use of PNE and related attitudes, perceptions and behaviours were assessed by structured interviews and self-report questionnaires. Stepwise logistic regression with backward elimination was conducted to identify potential risk factors for PNE use. Lifetime prevalence for the use of stimulating prescription drugs without medical indication was 4.3%, 10.2% for stimulating illicit drugs, 20.3% for mood modulating prescription drugs, and 23.4% for cannabis. Coping with stressful situations was more frequently reported as underlying motive for using stimulant or mood modulating prescription drugs than stimulating illicit drugs or cannabis. The individual perceived stress increased the risk of using stimulating prescription drugs (OR: 2.86; 95% Cl: 1.49–5.46) and the individual ability to recover from stress decreased the risk of using any substance for PNE and especially mood modulating prescription drugs (OR: .62; 95% Cl: .47–.81). The non-medical use of prescription drugs for PNE appears to be more prevalent in subjects who are less resilient to stress. Tailored resilience interventions that improve the ability to adapt to and recover from stressors may prevent the use of prescription medication for PNE. Further research should disentangle the association between psychological resilience and PNE as well as examine the efficacy of resilience interventions in the prevention of PNE.

The relationship between unemployment and mental disorders has been a significant subject of study since at least the Industrial Revolution. However, most data show associations of unemployment and isolated mental disorders, and this study field has been neglected in the last years. Therefore, this narrative review aims to provide an updated overview of the association between unemployment and mental health in general as well as the most prevalent mental disorders. A literature search was conducted using PubMed with the initial search terms “unemployment” and “mental health”. The identified disorders were then used as search terms for a more in-depth search. Two raters screened abstracts and identified the literature containing relevant information. As a main result, it could be demonstrated that regardless of age and sex, there is still a broad association between unemployment and mental well-being in general (e.g., quality of life measure for example by the General Health Questionnaire), suicide attempts, suicide rates, as well as specific psychiatric disorders (substance use disorder, schizophrenia, depression, bipolar disorders, compulsive/obsessive disorders, eating disorders, specific personality disorders, intelligence disorders/impairment, and ADHD). The most significant association was found for affective disorders (depression) and substance use disorders. The association in general was particularly evident for long-term unemployment and mental disorders. Returning to work reduced the prevalence rates of mental disorders significantly. The literature review confirms the results of much older and disease centered studies that unemployment and mental disorders are associated with each other. The main conclusion is that early medical detection and intervention among the mentally ill are as crucial as labor market policy interventions to prevent, avoid, and reduce unemployment.

Methamphetamine use disorder is associated with severe psychiatric symptoms and psychosocial problems. Women seem to be more affected than men. Therefore, this study examined psychiatric comorbidities and psychopathology, drug use patterns, and treatment outcomes in women addicted to methamphetamine compared to men. Data on methamphetamine-dependent inpatients were collected in two centers specialized for addiction treatment at admission (T0) and discharge (T1, after treatment for 24 weeks). Sociodemographic and clinical measures were collected with the semi-structured clinical interview I at baseline; the self-reported standardized questionnaire (SCL-90-R) was administered at admission and discharge and after 24 weeks. During the entire treatment procedure, treatment relevant aspects were monitored. Out of all 108 treatment-seeking participants (86 men, 22 women), 64 completed the study (51 men, 13 women; drop-out rate: 40.7% (n = 44)). Methamphetamine-dependent women used other stimulants more often than men, while men used hallucinogens significantly more frequently than women. Female inpatients differed significantly from men in various sociodemographic variables (e.g., having children, single parenting) and were significantly more often affected by current (p < 0.001) and lifetime mental stress disorders (p < 0.001), as well as specific psychiatric disorders (p < 0.001) (e.g., posttraumatic stress disorder). At discharge, mental symptoms decreased significantly in men but not in women. Both before and after treatment, women seem to be more vulnerable to psychiatric comorbidities and psychopathologic symptoms compared to men. Although this study only provides preliminary data on gender-specific characteristics of methamphetamine-dependent patients and their treatment, it seems appropriate to discuss the development of gender-specific treatment options. Further studies in this field are needed.

Introduction: Pharmacological neuroenhancement (PN) is a topic of increasing importance and prevalence among students. However, there is a lack of differentiating PN substances, according to their psychoactive effects. In particular, there is a lack of data about PN by caffeinated drinks, even if coffee is a common and broadly used Neuroenhancer because of its cognitively enhancing effects regarding wakefulness, alertness and concentration.Materials and Methods: A web-survey was developed for German students and alumni about the non-medical use of caffeine for PN contained questions about coffee, caffeinated drinks and energy drinks, caffeine pills and methylxanthine tea regarding frequency and further contextual factors.Results: Six hundred and eighty-three participants completed the survey. Nearly all participants knew about PN (97.7%). 88.1% admitted using some over-the-counter substances. For PN purposes, coffee was used by 72.9% followed by energy drinks (68.2%) and cola drinks (62.4%). Methylxanthine containing tea was used for PN purposes, too (black tea 52.3%, green tea 51.7%). 1.8% admitted using illegal substances or prescription drugs, too.Discussion: Using legal methylxanthine containing drinks for PN seems to be extremely common with coffee and energy drinks being the preferred substances, while illegal and prescription drugs are only minimally used. Further studies should investigate the awareness of methylxanthine containing drinks as well as its character to be a flavoring drink or a neuroenhancer.

Nach einem kurzen Überblick über Epidemiologie und Klinik von Missbrauch und Abhängigkeit von Amphetaminen und speziell „Crystal“ werden aktuelle Konzepte zur Behandlung von Crystal-Konsumenten und Ergebnisse der Therapieforschung dargestellt. Die Wirksamkeit zweier stationärer Therapiemodelle wird dabei in einer vom BMG geförderten Studie untersucht werden. Der Studienplan wird vorgestellt. Klinische Implikationen werden diskutiert. Following a short overview on the epidemiology and clinical correlates of amphetamine abuse and dependence, with special emphasis on metamphetamine (“crystal”), current treatment concepts and recent results of therapy research are discussed. The efficacy of two inpatient treatment models for methamphetamine dependence are currently studied in a study funded by the German Ministry of health. The study concept is given and possible implications are discussed.