The Züri Can study: Can regulated cannabis sales promote lower-risk cannabis use? Mini-review and study protocol.

Background And Aims: Recreational use of cannabis is illegal in most countries. Despite this, it is the third most commonly used psychoactive substance worldwide. As a result of this discrepancy, a growing number of countries have begun to reassess their legal approach to cannabis in recent years.

Cannabis Consumers' View of Regulated Access to Recreational Cannabis: A Multisite Survey in Switzerland.

Introduction: There is considerable effort in legalizing recreational use of cannabis globally. The successful implementation of a program of regulated access to recreational cannabis (PRAC) depends on the consumers' engagement. The aim of this study was to examine the acceptability of twelve different regulatory aspects by cannabis users including those obtaining cannabis from the illicit market and vulnerable populations such as young adults and problematic users.

Impaired glutamate homeostasis in the nucleus accumbens in human cocaine addiction.

Cocaine addiction is characterized by overwhelming craving for the substance, which drives its escalating use despite adverse consequences. Animal models suggest a disrupted glutamate homeostasis in the nucleus accumbens to underlie addiction-like behavior. After chronic administration of cocaine, rodents show decreased levels of accumbal glutamate, whereas drug-seeking reinstatement is associated with enhanced glutamatergic transmission.

Predictors of Employment for People With Mental Illness: Results of a Multicenter Randomized Trial on the Effectiveness of Placement Budgets for Supported Employment.

Individual placement and support (IPS) has proven to be effective for vocational outcomes in people with mental illness. The original concept of IPS requires temporally unlimited provision of support. Using limited placement budgets and investigating factors that predict their effectiveness may inform decisions about resource allocation.

'Placement budgets' for supported employment: impact on employment rates in a multicentre randomised controlled trial.

Background: The most effective rehabilitation model for job (re-)entry of people with mental illness is supported employment. A barrier to introducing supported employment into standard care is its temporally unlimited provision, which conflicts with health and social legislation in many European countries.

Aims: To test the impact of different 'placement budgets', i.

Cannabis use in Switzerland 2015-2045: A population survey based model.

Background: Alternative cannabis regulation models are discussed and implemented worldwide. A baseline scenario under the assumption of no policy or market changes may prove useful to forecast cannabis use and treatment demand and evaluate changes in legislation.

Methods: Based on data of the Continuous Rolling Survey of Addictive Behaviours and Related Risks on cannabis use, age, gender and nationality from 2011 to 2015, we used general estimating equation analysis to model lifetime and 30-days prevalence from 2015 to 2045 in Switzerland accounting for demographic trends.

"Placement Budgets" for Supported Employment-Impact on Quality of Life in a Multicenter Randomized Controlled Trial.

Employment is an important aspect of psychiatric rehabilitation. The objective of this analysis was to explore how quality of life (QoL) may affect the outcome of supported employment and vice versa. A total of 116 participants with severe mental disorders were randomly assigned to either 25, 40, or 55 h placement budgets, which comprises job coaches' time resources to support a client in finding a job.

One size does not fit all-evolution of opioid agonist treatments in a naturalistic setting over 23 years.

Background And Aims: Opioid agonist treatment (OAT) is currently the most effective treatment for people with opioid dependence. In most countries, however, access to the whole range of effective medications is restricted. This study aims to model the distribution of different OAT medications within a naturalistic and relatively unrestricted treatment setting (Zurich, Switzerland) over time, and to identify patient characteristics associated with each medication.

Long-Term Opioid Agonist Treatment Participation after First Treatment Entry is Similar across 4 European Regions but Lower in Non-Nationals.

Heroin users in opioid agonist treatment (OAT) show markedly reduced heroin consumption, less crime and a lower mortality rate. However, the extent of long-term OAT participation over subsequent treatment episodes remains unclear. We analysed the annual proportion of patients in treatment (at least 1 day) since the start of first OAT in 4 European regions: Barcelona (BA) 1996-2012: 8,602 patients; Czech -Republic (CZ) 2000-2014: 4,377 patients; Netherlands (NL) 1994-2014: 33,235 patients, Zurich (ZU) 1992-2015: 11,795.

Predictors of repeat visits to hospital psychiatric emergency departments in Malaga (Spain) and in Lisbon (Portugal).

Objective: This study describes the profile of people with mental disorders attending emergency departments (EDs) in two countries and to identify specific mental disorders associated with repeat emergency visits.

Methods: Retrospective analyses of 1 year of EDs data from two hospitals with psychiatric departments, one in Amadora/Sintra (Lisbon, Portugal, 2008) and the other in Malaga (Spain, 2009), were carried out. To determine which mental disorders were associated with repeat visits in each setting, negative binomial models were calculated.

Telecommunications Network Measurements of Online Gambling Behavior in Switzerland: A Feasibility Study.

Background: Methodological shortcomings of gambling studies relying on self-report or on data sets derived from gambling operators tend to result in biased conclusions. The aim of this study was to analyze online gambling behavior using a novel network database approach.

Methods: From October 13 to October 26, 2014, telecommunications network data from a major telecommunications provider in Switzerland were analyzed.

[Acute day hospital as a cost-effective alternative to inpatient therapy].

Background: This is a study of the cost-benefit advantage of the model project acute day hospital (ATK) compared to inpatient care.

Methods: The study was performed retrospectively and examined the direct costs and the Global Assessment of Functioning (GAF) in a matched sample.

Results: The day clinic treatment compared to inpatient therapy showed at a cost benefit of 2.

Changes in substance use in patients receiving opioid substitution therapy and resulting clinical challenges: a 17-year treatment case register analysis.

Background: Although the beneficial effects of opioid substitution for the reduction of heroin use are well established, its effect on other substance use is unclear. We aimed to evaluate short-term and long-term changes in substance use in opioid-dependent patients on opioid substitution therapy. We focused on frequent use of heroin, cocaine, benzodiazepines, and alcohol under naturalistic conditions (ie, with non-selected patients and clinical practice as usual) over 17 years.

Association of Supported Employment With Cognitive Functioning and Employment Outcomes.

Objective: Cognitive functioning affects employment outcomes in supported employment. This study examined which cognitive parameters are associated with employment outcomes for persons with mental illnesses and discusses possible mechanisms involved.

Methods: Data stem from a randomized controlled trial conducted as part of the Zürich Impulse Program for the Sustainable Development of Mental Health Services (ZInEP).

Rethinking retention in treatment of opioid dependence-The eye of the beholder.

Opioid dependence often is a chronic relapsing disorder. The evidence for medication-assisted treatment (MAT) being the treatment of first choice is unequivocal. Yet, health systems, professionals and patients often fail to offer or, respectively, to enter long-term and low-threshold MAT and instead treat opioid dependence as a semi-acute disorder.

Neurocognition in help-seeking individuals at risk for psychosis: Prediction of outcome after 24 months.

An important aim in schizophrenia research is to optimize the prediction of psychosis and to improve strategies for early intervention. The objectives of this study were to explore neurocognitive performance in individuals at risk for psychosis and to optimize predictions through a combination of neurocognitive and psychopathological variables. Information on clinical outcomes after 24 months was available from 118 subjects who had completed an extensive assessment at baseline.

Evaluation of medication-assisted treatment of opioid dependence-The physicians' perspective.

Background: There is controversy about which outcome parameters should be employed to assess substance use treatment. Subjective measures of medication-assisted treatment (MAT) of opioid dependence are increasingly important. However, while patients' perspectives have been examined, the caregivers' views remain largely unknown.

Age- and gender-specific mortality risk profiles for depressive outpatients with major chronic medical diseases.

Background: As leading causes of death, chronic medical diseases, particularly common cardiovascular diseases, are associated with depression. The combination of depression and chronic medical disease in turn is linked with poorer health and premature death. Despite numerous studies on mortality in people with depression and chronic medical disease, the effects of age and gender were not consistently considered.

Supported Employment for the Reintegration of Disability Pensioners with Mental Illnesses: A Randomized Controlled Trial.

Work is beneficial for the recovery from mental illness. Although the approach of individual placement and support (IPS) has been shown to be effective in Europe, it has not yet been widely implemented in European health care systems. The aim of this randomized controlled trial was to assess the effectiveness of IPS for disability pensioners with mental illnesses new on disability benefits in Switzerland.

Does "Individual Placement and Support" Satisfy the Users' Needs?

This study aims to investigate clients' satisfaction with individual placement and support (IPS) at the University Hospital for Psychiatry Zurich (PUK). Furthermore, this study aims to investigate if clients feel the approach of IPS as a useful approach to fulfill their needs. One hundred twenty-five people were recruited from one of the three IPS services of PUK and were asked to complete a structured questionnaire.

A comprehensive model of treatment participation in chronic disease allowed prediction of opioid substitution treatment participation in Zurich, 1992-2012.

Objectives: Chronic diseases are often associated with cycling in and out of treatment. We used data of a large opioid substitution treatment case register to (1) identify associated factors and (2) integrate retention and readmission into a model of overall participation over subsequent treatment episodes of various groups.

Study Design And Setting: Data of all 9,407 patients undergoing 26,545 methadone or buprenorphine substitution treatment episodes between 1992 and 2012 in the canton of Zurich, Switzerland, were analyzed.