Petra Marinova-Djambazova

The paper evaluates the prevalence of psychoactive substance use in a non-clinical sample of university students and examines its relation to childhood traumatic experiences and common mental health problems. An anonymous online survey was conducted between September 2022 and May 2023 in two major universities in Bulgaria using opportunity sampling. The study has a cross-sectional, observational, and retrospective design, using self-rating scales for depression, anxiety, alexithymia, empathy, quality of life, and lifetime history of substance use. One hundred and forty-six university students completed the survey, with a mean age of 23 years (SD=2), 66% females. Ninety-eight percent of the participants have used caffeine, 90% alcohol, 62% tobacco, 50% cannabis, 26% sedatives, 19% amphetamines, 12% inhalants, 8% hallucinogens, 4% opiates, and 9% other/unknown substances. The mean number of psychoactive substances used within a lifetime is 4 (SD=2). Forty-two (29%) participants have a history of use of multiple (≥ 5) types of psychoactive substances. Statistically significant differences from the rest of the sample include lower empathy (p=.016), higher scores on the childhood trauma scale (p=.001), and a higher percentage of dissociative symptoms (47.6%, p=.012). The binary logistic regression model revealed that higher scores on the childhood trauma scale (p=.003) and lower empathy (p=.004) are statistically significant predictors of multiple substance use. In conclusion, the lifetime use of multiple psychoactive substances in non-clinical settings is related to underlying childhood traumatic experiences and lower empathy.

There is growing evidence of an association of a number of subjective and objective sleep parameters (especially nightmares) and elevated suicidal risk in different clinical populations as well as in the general populations. This is a cross-sectional naturalistic study of 52 inpatients (28 females and 24 males, aged from 24 to 75 years) meeting criteria for a current depressive episode within Recurrent Depressive Disorder (RDD) or Bipolar Disorder (BD) according to ICD-10. All patients were evaluated with the Hamilton Depression Rating Scale (HDRS), followed by a direct interview about their dreams' content and emotional charge, as well as about suicidal thoughts and plans or previous attempts. Patients with RDD suffered significantly more frequently from nightmares than those with BD, p<0.05. Within the RDD group, experiencing nightmares was associated with significantly higher scores on the HDRS suicide risk item (2.36 vs 1.00), higher frequency of suicide attempts (35% vs 6%), and lower likelihood for lack of detectable suicide risk (21% vs 81%), p<0.05. These differences were not explained by significant difference in the severity of depressive symptoms (28.00 vs 24.75, p=0.16). We were unable to detect such differences in the bipolar subgroup. No gender influences on the association of nightmares and suicidal risk were observed. Depressed patients suffering from nightmares showed significantly higher suicide risk. Depression appeared to be a stronger risk factor for suicidal behavior when accompanied with nightmares. This was only valid for unipolar depression, while the results concerning bipolar depression were inconclusive.