Common psychiatric disorders(CPDs)and depression contribute significantly to the global epidemic of type 2 diabetes(T2D).We postulated a possible pathophysiological mechanism that through Bridge-Symptoms present in de...Common psychiatric disorders(CPDs)and depression contribute significantly to the global epidemic of type 2 diabetes(T2D).We postulated a possible pathophysiological mechanism that through Bridge-Symptoms present in depression and CPDs,promotes the establishment of emotional eating,activation of the reward system,onset of overweight and obesity and,ultimately the increased risk of developing T2D.The plausibility of the proposed pathophysiological mechanism is supported by the mechanism of action of drugs such as naltrexonebupropion currently approved for the treatment of both obesity/overweight with T2D and as separate active pharmaceutical ingredients in drug addiction,but also from initial evidence that is emerging regarding glucagon-like peptide 1 receptor agonists that appear to be effective in the treatment of drug addiction.We hope that our hypothesis may be useful in interpreting the higher prevalence of CPDs and depression in patients with T2D compared with the general population and may help refine the integrated psychiatric-diabetic therapy approach to improve the treatment and or remission of T2D.展开更多
Nowadays, using the Internet, for academic and non-academic activities, is an integral part of students’ daily life. Studies showed that excessive use of the Internet has negative effects on physical and mental healt...Nowadays, using the Internet, for academic and non-academic activities, is an integral part of students’ daily life. Studies showed that excessive use of the Internet has negative effects on physical and mental health. The present research was conducted in order to compare the psychological disorders of Internet addicted students and ordinary Internet users in Zabol University of medical sciences. It applied a causal-comparative method. Through applying purposive sampling method, 252 undergraduate and postgraduate students of Zabol University of Medical Sciences were selected in May 2015. Data collection was performed using standard questionnaires of Young’s Internet Addiction Test and the Symptom Check List 90-Revised (SCL-90-R). Data analysis was carried out using independent t-test with SPSS21. Results indicated that the Internet addicted students, compared with ordinary Internet users had more psychological disorders. Considering the high prevalence of psychological disorders in the Internet addicted students, teaching appropriate use of the Internet to students is an important factor in controlling the Internet addiction.展开更多
Alcohol use disorder (AUD), mild traumatic brain injury (mTBI), and posttraumatic stress disorder (PTSD) commonly co-occur (AUD + mTBI + PTSD). These conditions have overlapping symptoms which are, in part, ...Alcohol use disorder (AUD), mild traumatic brain injury (mTBI), and posttraumatic stress disorder (PTSD) commonly co-occur (AUD + mTBI + PTSD). These conditions have overlapping symptoms which are, in part, reflective of overlapping neuropathology. These conditions become problematic because their co-occurrence can exacerbate symptoms. Therefore, treatments must be developed that are inclusive to all three conditions. Repetitive transcranial magnetic stimulation (rTMS) is non-invasive and may be an ideal treatment for co-occurring AUD + mTBI + PTSD. There is accumulating evidence on rTMS as a treatment for people with AUD, mTBI, and PTSD each alone. However, there are no published studies to date on rTMS as a treatment for co-occurring AUD + mTBI + PTSD. This review article advances the knowledge base for rTMS as a treatment for AUD + mTBI + PTSD. This review provides background information about these co-occurring conditions as well as rTMS. The existing literature on rTMS as a treatment for people with AUD, TBI, and PTSD each alone is reviewed. Finally, neurobiological findings in support of a theoretical model are discussed to inform TMS as a treatment for co-occurring AUD + mTBI + PTSD. The peer-reviewed literature was identified by targeted literature searches using PubMed and supplemented by cross-referencing the bibliographies of relevant review articles. The existing evidence on rTMS as a treatment for these conditions in isolation, coupled with the overlapping neuropathology and symptomology of these conditions, suggests that rTMS may be well suited for the treatment of these conditions together.展开更多
Event-related potential studies of cognitive function in addiction behaviors have focused on the P300 event-related potential component. The current study investigated the association between P300 component and Intern...Event-related potential studies of cognitive function in addiction behaviors have focused on the P300 event-related potential component. The current study investigated the association between P300 component and Internet addiction disorder. We found that individuals with Internet addiction disorder exhibited significantly longer P300 latencies than controls (N2: P = 0.035; P3a: P = 0.031 P3b: P = 0.043) and similar P300 amplitudes compared to control participants. After 3 months of cognitive behavioral therapy, P300 latencies decreased significantly in the P3a and P3b (P3a: P = 0.045; P3b: P = 0.062). These results suggest that deficits in cognitive function may be involved in Internet addiction disorder, and that clinical psychological treatment may be effective.展开更多
In our previous studies, we showed that frontal lobe and brainstem functions were abnormal in online game addicts. In this study, 14 students with Internet addiction disorder and 14 matched healthy controls underwent ...In our previous studies, we showed that frontal lobe and brainstem functions were abnormal in online game addicts. In this study, 14 students with Internet addiction disorder and 14 matched healthy controls underwent proton-magnetic resonance spectroscopy to measure cerebral function. Results demonstrated that the ratio of N-acetylaspartate to creatine decreased, but the ratio of cho- line-containing compounds to creatine increased in the bilateral frontal lobe white matter in people with Internet addiction disorder. However, these ratios were mostly unaltered in the brainstem, suggesting that frontal lobe function decreases in people with Internet addiction disorder.展开更多
1)Background:The common factors which potentially contribute to the development of eating disorders and exercise dependence during early adulthood are still relatively unclear.The present study aimed to examine the ro...1)Background:The common factors which potentially contribute to the development of eating disorders and exercise dependence during early adulthood are still relatively unclear.The present study aimed to examine the role of BMI,body image inflexibility,and generalized anxiety in these two behavioral problems in a sample of college students.2)Methods:In total,878 habitual exercisers(58.1%male with BMI=22.12±2.39;41.9%female with BMI=20.55±2.21)with age of 20.09±1.76 years participated in this study.The main outcomes of interest are exercise dependence symptoms,eating disorders symptoms,body image inflexibility,and symptoms of generalized anxiety(as measured by Exercise Dependence Scale-Revised,Eating Disorder Examination-Questionnaire-Short Form,Body Image Acceptance and Action Questionnaire,and Generalized Anxiety Disorder-7,respectively).Pearson correlation,path analysis,and model fit information were tested.3)Results:After controlling for age,gender,and field of study,lower BMI was linked to more exercise dependence symptoms but this association was not statistically significant,while a greater BMI was significantly associated with a higher risk of developing eating disorders(β=−0.08,p<0.001).Moreover,higher body image inflexibility significantly and positively contributed to severe exercise dependence(β=0.26,p<0.001)as well as abnormal eating attitudes and behaviors(β=0.74,p<0.001).Furthermore,generalized anxiety is a significant contributor to exercise dependence symptoms(β=0.14,p<0.001)but not eating disorders symptoms.4)Conclusion:Based on our finding that body image inflexibility is a common risk factor for the development of exercise dependence and eating disorders,the prevention and treatment of these two disorders should involve the improvement of psychological flexibility.In addition,the individual with a higher BMI is more vulnerable to developing eating disorders,while those who have severer generalized anxiety symptoms should be given more attention when screening for exercise dependence.展开更多
Objective:This study aimed to estimate the prevalence and determinants of Internet addiction among medical students at the Faculty of Medicine and Pharmacy of Casablanca,Morocco.Methods:This was a cross-sectional stud...Objective:This study aimed to estimate the prevalence and determinants of Internet addiction among medical students at the Faculty of Medicine and Pharmacy of Casablanca,Morocco.Methods:This was a cross-sectional study conducted among students at the Faculty of Medicine and Pharmacy in Casablanca between October and March 2020.An online questionnaire was administered to students to collect data and internet addiction was assessed by the Young questionnaire.A score threshold≥50 was adopted to define addiction.Univariate and multivariate logistic regression analyses were used to identify factors associated with internet addiction.Results:Out of a total of 4093 FMPC students enrolled in the 2020-2021 academic year,506 agreed to participate in this study,including 303 females and 203 males.The mean addiction score assessed on the Young scale was(49.08±16.11).The prevalence of Internet addiction was 44.5%(225/506,95% CI:40% to 49%).Multiple regression analysis showed that being older than 20 years(OR=0.17,95% CI:0.40 to 0.64),being female(OR=1.70,95% CI:1.04 to 2.78),being in the dissertation year(6th year)(OR=5.17,95% CI:2.23 to 11.44),having a history of psychiatric consultation(OR=2.64,95% CI:1.34 to 5.21),having divorced parents(OR=2.64,95% CI:1.05 to 5.87),use of sleeping medication(OR=2.9,95% CI:1.05 to 3.70),sleep disorders(OR=2.06,95% CI:1.25 to 3.79),sleep deprivation(OR=2.26,95% CI:1.39 to 3.65),excessive daytime sleepiness(OR=5.39,95% CI:2.19 to 13.24),anxiety disorders(OR=1.47,95% CI:1.18 to 2.30),duration of internet connection(>4 h)(OR=11.43,95% CI:4.85 to 27.66),and having frequent conflicts with parents(OR=2.37,95% CI:1.49 to 3.79)and friends(OR=0.26,95% CI:0.11 to 0.65)were independently associated with internet addiction.Conclusion:The prevalence of Internet addiction among medical students in Casablanca remains high.Targeted action on the determinants would be of great value in prevention.展开更多
Nigeria has a very high number of sickle cell disease (SCD) population with addition of 150,000 babies born annually with the disease. Early infant diagnosis and good care make many of these babies survive to adulthoo...Nigeria has a very high number of sickle cell disease (SCD) population with addition of 150,000 babies born annually with the disease. Early infant diagnosis and good care make many of these babies survive to adulthood. Severe pain requiring moderately strong or very strong analgesics is a common presentation of patients with Sickle Cell Anaemia. Paediatricians find ready usefulness of Opioids which are very useful for the painful episodes among these patients. Therefore, the chances of abuse and addiction to these medications become very high and constitute additional burden on the deficient manpower in the health sector. Opioid Use Disorder among Sickle Cell Disease patients has subtle presentation, so a high index of suspicion is required to make both the diagnosis and referral to treatment centres. In this review, the epidemiology, pain pathophysiology, behavioural and pharmacologic therapy have been re-examined.展开更多
Both alcohol-associated liver disease(ALD)and metabolic dysfunction-associated steatotic liver disease are leading contributors to chronic liver diseases.These conditions often coexist,exacerbating disease progression...Both alcohol-associated liver disease(ALD)and metabolic dysfunction-associated steatotic liver disease are leading contributors to chronic liver diseases.These conditions often coexist,exacerbating disease progression.Despite ALD being a leading cause of liver transplantation,many individuals with alcohol use disorder(AUD)do not receive treatment.In this review,we discussed the epidemiology of ALD in AUD,various treatment options for AUD,and their efficacy on liver health.Our critical analysis of current evidence underscores the need for integrated models involving multiple stakeholders to improve ALD management.展开更多
目的:分析青少年网络成瘾患者应用氟伏沙明联合利培酮治疗对其情绪障碍的影响。方法:选取2022年6月~2023年6月期间本院收治的78例青少年网络成瘾患者作为研究对象,随机将患者分为对照组和研究组,各39例。对照组采用利培酮治疗;研究组在...目的:分析青少年网络成瘾患者应用氟伏沙明联合利培酮治疗对其情绪障碍的影响。方法:选取2022年6月~2023年6月期间本院收治的78例青少年网络成瘾患者作为研究对象,随机将患者分为对照组和研究组,各39例。对照组采用利培酮治疗;研究组在对照组基础上联合氟伏沙明治疗。分析比较两组的治疗效果、社交网络成瘾性、情绪障碍严重程度及应对方式。结果:研究组的治疗总有效率明显高于对照组(P<0.05)。治疗前,两组中文网络成瘾性量表(Revised Chen internet addiction scale,CIAS-R)评分、儿童焦虑性情绪障碍筛查表(The screen for child anxiety related emotional disorders,SCARED)评分、积极应对与消极应对评分均无明显差异(P>0.05)。治疗后,两组的CIAS-R评分、SCARED评分、消极应对评分均降低,且研究组明显低于对照组(P<0.05);两组积极应对评分明显增高,且研究组明显高于对照组(P<0.05)。结论:氟伏沙明联合利培酮治疗青少年网络成瘾,能提高临床疗效,抑制青少年网瘾程度,改善患者情绪障碍及应对方式。展开更多
AIM: To provide a comprehensive overview of clinical studies on the clinical picture of Internet-use related addictions from a holistic perspective. A literature search was conducted using the database Web of Science....AIM: To provide a comprehensive overview of clinical studies on the clinical picture of Internet-use related addictions from a holistic perspective. A literature search was conducted using the database Web of Science.METHODS: Over the last 15 years, the number of Internet users has increased by 1000%, and at the same time, research on addictive Internet use has proliferated. Internet addiction has not yet been understood very well, and research on its etiology and natural history is still in its infancy. In 2013, the American Psychiatric Association included Internet Gaming Disorder in the appendix of the updated version of the Diagnostic and Statistical Manual for Mental Disorders(DSM-5) as condition that requires further research prior to official inclusion in the main manual, with important repercussions for research and treatment. To date, reviews have focused on clinical and treatment studies of Internet addiction and Internet Gaming Disorder. This arguably limits the analysis to a specific diagnosis of a potential disorder that has not yet been officially recognised in the Western world, rather than a comprehensive and inclusive investigation of Internet-use related addictions(including problematic Internet use) more generally. RESULTS: The systematic literature review identified a total of 46 relevant studies. The included studies used clinical samples, and focused on characteristics of treatment seekers and online addiction treatment. Four main types of clinical research studies were identified, namely research involving(1) treatment seeker characteristics;(2) psychopharmacotherapy;(3) psychological therapy; and(4) combined treatment. CONCLUSION: A consensus regarding diagnostic criteria and measures is needed to improve reliability across studies and to develop effective and efficient treatment approaches for treatment seekers.展开更多
AIM: To report the results of functional magnetic resonance imaging(f MRI) studies pertaining internet addiction disorder(IAD) in young adults.METHODS: We conducted a systematic review on Pub Med, focusing our attenti...AIM: To report the results of functional magnetic resonance imaging(f MRI) studies pertaining internet addiction disorder(IAD) in young adults.METHODS: We conducted a systematic review on Pub Med, focusing our attention on f MRI studies involving adult IAD patients, free from any comorbid psychiatric condition. The following search words were used, both alone and in combination: f MRI, internet addiction, internet dependence, functional neuroimaging. The search was conducted on April 20^(th), 2015 and yielded 58 records. Inclusion criteria were the following: Articles written in English, patients' age ≥ 18 years, patients affected by IAD, studies providing f MRI results during resting state or cognitive/emotional paradigms. Structural MRI studies, functional imaging techniques other than f MRI, studies involving adolescents, patients with comorbid psychiatric, neurological or medical conditions were excluded. By reading titles and abstracts, we excluded 30 records. By reading the full texts of the 28 remaining articles, we identified 18 papers meeting our inclusion criteria and therefore included in the qualitative synthesis.RESULTS: We found 18 studies fulfilling our inclusion criteria, 17 of them conducted in Asia, and including a total number of 666 tested subjects. The included studies reported data acquired during resting state or different paradigms, such as cue-reactivity, guessing or cognitive control tasks. The enrolled patients were usually males(95.4%) and very young(21-25 years). The most represented IAD subtype, reported in more than 85% of patients, was the internet gaming disorder, or videogame addiction. In the resting state studies, the more relevant abnormalities were localized in the superior temporal gyrus, limbic, medial frontal and parietal regions. When analyzing the task related fmri studies, we found that less than half of the papers reported behavioral differences between patients and normal controls, but all of them found significant differences in cortical and subcortical brain regions involved in cognitive control and reward processing: Orbitofrontal cortex, insula, anterior and posterior cingulate cortex, temporal and parietal regions, brain stem and caudate nucleus.CONCLUSION: IAD may seriously affect young adults' brain functions. It needs to be studied more in depth to provide a clear diagnosis and an adequate treatment.展开更多
Although liver transplantation(LT) is performed increasingly for patients with end-stage alcoholic liver disease(ALD), the topic remains controversial. Traditionally, the role of an addiction specialist focused on the...Although liver transplantation(LT) is performed increasingly for patients with end-stage alcoholic liver disease(ALD), the topic remains controversial. Traditionally, the role of an addiction specialist focused on the screening and identification of patients with a high risk on relapse in heavy alcohol use. These patients were in many cases subsequently excluded from a further LT procedure.Recently, awareness is growing that not only screening of patients but also offering treatment, helping patients regain and maintain abstinence is essential, opening up a broader role for the addiction specialist(team)within the whole of the transplant procedure. Within this context, high-risk assessment is proposed to be an indication of increasing addiction treatment intensity,instead of being an exclusion criterion. In this review we present an overview regarding the state of the art on alcohol relapse assessment and treatment in patients with alcohol use disorders, both with and without ALD.Screening, treatment and monitoring is suggested as central roles for the addiction specialist(team) integrated within transplant centers.展开更多
BACKGROUND Chronic cocaine use is associated with stroke, coronary artery disease and myocardial infarction, resulting in severe impairments or sudden mortality. In the absence of clear cardiovascular symptoms, indivi...BACKGROUND Chronic cocaine use is associated with stroke, coronary artery disease and myocardial infarction, resulting in severe impairments or sudden mortality. In the absence of clear cardiovascular symptoms, individuals with cocaine use disorder (iCUD) seeking addiction treatment receive mostly psychotherapy and psychiatric pharmacotherapy, with no attention to vascular disease (i.e., atherosclerosis). Little is known about the pre-clinical signs of cardiovascular risk in iCUD and early signs of vascular disease are undetected in this underserved population. AIM To assess inflammation, plaque burden and plaque composition in iCUD aiming to detect markers of atherosclerosis and vascular disease. METHODS The bilateral carotid arteries were imaged with positron emission tomography/magnetic resonance imaging (PET/MRI) in iCUD asymptomatic for cardiovascular disease, healthy controls, and individuals with cardiovascular risk. PET with 18F-fluorodeoxyglucose (18F-FDG) evaluated vascular inflammation and 3-D dark-blood MRI assessed plaque burden including wall area and thickness. Drug use and severity of addiction were assessed with standardized instruments. RESULTS The majority of iCUD and controls had carotid FDG-PET signal greater than 1.6 but lower than 3, indicating the presence of mild to moderate inflammation. However, the MRI measure of wall structure was thicker in iCUD as compared to the controls and cardiovascular risk group, indicating greater carotid plaque burden. iCUD had larger wall area as compared to the healthy controls but not as compared to the cardiovascular risk group, indicating structural wall similarities between the non-control study groups. In iCUD, wall area correlated with greater cocaine withdrawal and craving. CONCLUSION These preliminary results show markers of carotid artery disease burden in cardiovascular disease-asymptomatic iCUD. Broader trials are warranted to develop protocols for early detection of cardiovascular risk and preventive intervention in iCUD.展开更多
文摘Common psychiatric disorders(CPDs)and depression contribute significantly to the global epidemic of type 2 diabetes(T2D).We postulated a possible pathophysiological mechanism that through Bridge-Symptoms present in depression and CPDs,promotes the establishment of emotional eating,activation of the reward system,onset of overweight and obesity and,ultimately the increased risk of developing T2D.The plausibility of the proposed pathophysiological mechanism is supported by the mechanism of action of drugs such as naltrexonebupropion currently approved for the treatment of both obesity/overweight with T2D and as separate active pharmaceutical ingredients in drug addiction,but also from initial evidence that is emerging regarding glucagon-like peptide 1 receptor agonists that appear to be effective in the treatment of drug addiction.We hope that our hypothesis may be useful in interpreting the higher prevalence of CPDs and depression in patients with T2D compared with the general population and may help refine the integrated psychiatric-diabetic therapy approach to improve the treatment and or remission of T2D.
文摘Nowadays, using the Internet, for academic and non-academic activities, is an integral part of students’ daily life. Studies showed that excessive use of the Internet has negative effects on physical and mental health. The present research was conducted in order to compare the psychological disorders of Internet addicted students and ordinary Internet users in Zabol University of medical sciences. It applied a causal-comparative method. Through applying purposive sampling method, 252 undergraduate and postgraduate students of Zabol University of Medical Sciences were selected in May 2015. Data collection was performed using standard questionnaires of Young’s Internet Addiction Test and the Symptom Check List 90-Revised (SCL-90-R). Data analysis was carried out using independent t-test with SPSS21. Results indicated that the Internet addicted students, compared with ordinary Internet users had more psychological disorders. Considering the high prevalence of psychological disorders in the Internet addicted students, teaching appropriate use of the Internet to students is an important factor in controlling the Internet addiction.
基金supported with resources by Department of Veterans Affairs(VA),Health Services Research and Development Service and the Office of Academic Affiliations(TPP 42-013)at Edward Hines VA Hospitalsupported by the following:VA OAA Polytrauma Fellowship to AAH,NIDRR Merit Switzer Research Fellowship Award H133F130011to AAH and the VA RR&D CDA-II RX000949-01A2 to AAH
文摘Alcohol use disorder (AUD), mild traumatic brain injury (mTBI), and posttraumatic stress disorder (PTSD) commonly co-occur (AUD + mTBI + PTSD). These conditions have overlapping symptoms which are, in part, reflective of overlapping neuropathology. These conditions become problematic because their co-occurrence can exacerbate symptoms. Therefore, treatments must be developed that are inclusive to all three conditions. Repetitive transcranial magnetic stimulation (rTMS) is non-invasive and may be an ideal treatment for co-occurring AUD + mTBI + PTSD. There is accumulating evidence on rTMS as a treatment for people with AUD, mTBI, and PTSD each alone. However, there are no published studies to date on rTMS as a treatment for co-occurring AUD + mTBI + PTSD. This review article advances the knowledge base for rTMS as a treatment for AUD + mTBI + PTSD. This review provides background information about these co-occurring conditions as well as rTMS. The existing literature on rTMS as a treatment for people with AUD, TBI, and PTSD each alone is reviewed. Finally, neurobiological findings in support of a theoretical model are discussed to inform TMS as a treatment for co-occurring AUD + mTBI + PTSD. The peer-reviewed literature was identified by targeted literature searches using PubMed and supplemented by cross-referencing the bibliographies of relevant review articles. The existing evidence on rTMS as a treatment for these conditions in isolation, coupled with the overlapping neuropathology and symptomology of these conditions, suggests that rTMS may be well suited for the treatment of these conditions together.
基金the Shanxi Soft Science Research Program, No. 2008041061-03
文摘Event-related potential studies of cognitive function in addiction behaviors have focused on the P300 event-related potential component. The current study investigated the association between P300 component and Internet addiction disorder. We found that individuals with Internet addiction disorder exhibited significantly longer P300 latencies than controls (N2: P = 0.035; P3a: P = 0.031 P3b: P = 0.043) and similar P300 amplitudes compared to control participants. After 3 months of cognitive behavioral therapy, P300 latencies decreased significantly in the P3a and P3b (P3a: P = 0.045; P3b: P = 0.062). These results suggest that deficits in cognitive function may be involved in Internet addiction disorder, and that clinical psychological treatment may be effective.
基金supported by the National Natural Science Foundation of China,No.30830046,30670751,30570695the National Science and Technology Program of China,No.2007BAI17B02+2 种基金the National 973 Program of China,No.2009CB918303the Natural Science Foundation of Hunan Province of China,No.07JJ3042Department of Public Health of Hunan Province of China,No.B2005048
文摘In our previous studies, we showed that frontal lobe and brainstem functions were abnormal in online game addicts. In this study, 14 students with Internet addiction disorder and 14 matched healthy controls underwent proton-magnetic resonance spectroscopy to measure cerebral function. Results demonstrated that the ratio of N-acetylaspartate to creatine decreased, but the ratio of cho- line-containing compounds to creatine increased in the bilateral frontal lobe white matter in people with Internet addiction disorder. However, these ratios were mostly unaltered in the brainstem, suggesting that frontal lobe function decreases in people with Internet addiction disorder.
基金The information should be replaced with"This project was supported by China Postdoctoral Science Foundation(No:2022M711174).
文摘1)Background:The common factors which potentially contribute to the development of eating disorders and exercise dependence during early adulthood are still relatively unclear.The present study aimed to examine the role of BMI,body image inflexibility,and generalized anxiety in these two behavioral problems in a sample of college students.2)Methods:In total,878 habitual exercisers(58.1%male with BMI=22.12±2.39;41.9%female with BMI=20.55±2.21)with age of 20.09±1.76 years participated in this study.The main outcomes of interest are exercise dependence symptoms,eating disorders symptoms,body image inflexibility,and symptoms of generalized anxiety(as measured by Exercise Dependence Scale-Revised,Eating Disorder Examination-Questionnaire-Short Form,Body Image Acceptance and Action Questionnaire,and Generalized Anxiety Disorder-7,respectively).Pearson correlation,path analysis,and model fit information were tested.3)Results:After controlling for age,gender,and field of study,lower BMI was linked to more exercise dependence symptoms but this association was not statistically significant,while a greater BMI was significantly associated with a higher risk of developing eating disorders(β=−0.08,p<0.001).Moreover,higher body image inflexibility significantly and positively contributed to severe exercise dependence(β=0.26,p<0.001)as well as abnormal eating attitudes and behaviors(β=0.74,p<0.001).Furthermore,generalized anxiety is a significant contributor to exercise dependence symptoms(β=0.14,p<0.001)but not eating disorders symptoms.4)Conclusion:Based on our finding that body image inflexibility is a common risk factor for the development of exercise dependence and eating disorders,the prevention and treatment of these two disorders should involve the improvement of psychological flexibility.In addition,the individual with a higher BMI is more vulnerable to developing eating disorders,while those who have severer generalized anxiety symptoms should be given more attention when screening for exercise dependence.
文摘Objective:This study aimed to estimate the prevalence and determinants of Internet addiction among medical students at the Faculty of Medicine and Pharmacy of Casablanca,Morocco.Methods:This was a cross-sectional study conducted among students at the Faculty of Medicine and Pharmacy in Casablanca between October and March 2020.An online questionnaire was administered to students to collect data and internet addiction was assessed by the Young questionnaire.A score threshold≥50 was adopted to define addiction.Univariate and multivariate logistic regression analyses were used to identify factors associated with internet addiction.Results:Out of a total of 4093 FMPC students enrolled in the 2020-2021 academic year,506 agreed to participate in this study,including 303 females and 203 males.The mean addiction score assessed on the Young scale was(49.08±16.11).The prevalence of Internet addiction was 44.5%(225/506,95% CI:40% to 49%).Multiple regression analysis showed that being older than 20 years(OR=0.17,95% CI:0.40 to 0.64),being female(OR=1.70,95% CI:1.04 to 2.78),being in the dissertation year(6th year)(OR=5.17,95% CI:2.23 to 11.44),having a history of psychiatric consultation(OR=2.64,95% CI:1.34 to 5.21),having divorced parents(OR=2.64,95% CI:1.05 to 5.87),use of sleeping medication(OR=2.9,95% CI:1.05 to 3.70),sleep disorders(OR=2.06,95% CI:1.25 to 3.79),sleep deprivation(OR=2.26,95% CI:1.39 to 3.65),excessive daytime sleepiness(OR=5.39,95% CI:2.19 to 13.24),anxiety disorders(OR=1.47,95% CI:1.18 to 2.30),duration of internet connection(>4 h)(OR=11.43,95% CI:4.85 to 27.66),and having frequent conflicts with parents(OR=2.37,95% CI:1.49 to 3.79)and friends(OR=0.26,95% CI:0.11 to 0.65)were independently associated with internet addiction.Conclusion:The prevalence of Internet addiction among medical students in Casablanca remains high.Targeted action on the determinants would be of great value in prevention.
文摘Nigeria has a very high number of sickle cell disease (SCD) population with addition of 150,000 babies born annually with the disease. Early infant diagnosis and good care make many of these babies survive to adulthood. Severe pain requiring moderately strong or very strong analgesics is a common presentation of patients with Sickle Cell Anaemia. Paediatricians find ready usefulness of Opioids which are very useful for the painful episodes among these patients. Therefore, the chances of abuse and addiction to these medications become very high and constitute additional burden on the deficient manpower in the health sector. Opioid Use Disorder among Sickle Cell Disease patients has subtle presentation, so a high index of suspicion is required to make both the diagnosis and referral to treatment centres. In this review, the epidemiology, pain pathophysiology, behavioural and pharmacologic therapy have been re-examined.
文摘Both alcohol-associated liver disease(ALD)and metabolic dysfunction-associated steatotic liver disease are leading contributors to chronic liver diseases.These conditions often coexist,exacerbating disease progression.Despite ALD being a leading cause of liver transplantation,many individuals with alcohol use disorder(AUD)do not receive treatment.In this review,we discussed the epidemiology of ALD in AUD,various treatment options for AUD,and their efficacy on liver health.Our critical analysis of current evidence underscores the need for integrated models involving multiple stakeholders to improve ALD management.
文摘目的:分析青少年网络成瘾患者应用氟伏沙明联合利培酮治疗对其情绪障碍的影响。方法:选取2022年6月~2023年6月期间本院收治的78例青少年网络成瘾患者作为研究对象,随机将患者分为对照组和研究组,各39例。对照组采用利培酮治疗;研究组在对照组基础上联合氟伏沙明治疗。分析比较两组的治疗效果、社交网络成瘾性、情绪障碍严重程度及应对方式。结果:研究组的治疗总有效率明显高于对照组(P<0.05)。治疗前,两组中文网络成瘾性量表(Revised Chen internet addiction scale,CIAS-R)评分、儿童焦虑性情绪障碍筛查表(The screen for child anxiety related emotional disorders,SCARED)评分、积极应对与消极应对评分均无明显差异(P>0.05)。治疗后,两组的CIAS-R评分、SCARED评分、消极应对评分均降低,且研究组明显低于对照组(P<0.05);两组积极应对评分明显增高,且研究组明显高于对照组(P<0.05)。结论:氟伏沙明联合利培酮治疗青少年网络成瘾,能提高临床疗效,抑制青少年网瘾程度,改善患者情绪障碍及应对方式。
基金Supported by A grant from the European Commission("Tech Use Disorders"Grant ID:FP7-PEOPLE-2013-IEF-627999)awarded to Olatz Lopez-Fernandez
文摘AIM: To provide a comprehensive overview of clinical studies on the clinical picture of Internet-use related addictions from a holistic perspective. A literature search was conducted using the database Web of Science.METHODS: Over the last 15 years, the number of Internet users has increased by 1000%, and at the same time, research on addictive Internet use has proliferated. Internet addiction has not yet been understood very well, and research on its etiology and natural history is still in its infancy. In 2013, the American Psychiatric Association included Internet Gaming Disorder in the appendix of the updated version of the Diagnostic and Statistical Manual for Mental Disorders(DSM-5) as condition that requires further research prior to official inclusion in the main manual, with important repercussions for research and treatment. To date, reviews have focused on clinical and treatment studies of Internet addiction and Internet Gaming Disorder. This arguably limits the analysis to a specific diagnosis of a potential disorder that has not yet been officially recognised in the Western world, rather than a comprehensive and inclusive investigation of Internet-use related addictions(including problematic Internet use) more generally. RESULTS: The systematic literature review identified a total of 46 relevant studies. The included studies used clinical samples, and focused on characteristics of treatment seekers and online addiction treatment. Four main types of clinical research studies were identified, namely research involving(1) treatment seeker characteristics;(2) psychopharmacotherapy;(3) psychological therapy; and(4) combined treatment. CONCLUSION: A consensus regarding diagnostic criteria and measures is needed to improve reliability across studies and to develop effective and efficient treatment approaches for treatment seekers.
基金Department of Neuroscience,Imaging,and Clinical Sciences,University"G.d’Annunzio",Chieti,ItalyDr.Sepede’s post hoc grant has been funded by the European Union’s Seventh Framework Programme for research,technological development and demonstration under grant agreement,No.602450
文摘AIM: To report the results of functional magnetic resonance imaging(f MRI) studies pertaining internet addiction disorder(IAD) in young adults.METHODS: We conducted a systematic review on Pub Med, focusing our attention on f MRI studies involving adult IAD patients, free from any comorbid psychiatric condition. The following search words were used, both alone and in combination: f MRI, internet addiction, internet dependence, functional neuroimaging. The search was conducted on April 20^(th), 2015 and yielded 58 records. Inclusion criteria were the following: Articles written in English, patients' age ≥ 18 years, patients affected by IAD, studies providing f MRI results during resting state or cognitive/emotional paradigms. Structural MRI studies, functional imaging techniques other than f MRI, studies involving adolescents, patients with comorbid psychiatric, neurological or medical conditions were excluded. By reading titles and abstracts, we excluded 30 records. By reading the full texts of the 28 remaining articles, we identified 18 papers meeting our inclusion criteria and therefore included in the qualitative synthesis.RESULTS: We found 18 studies fulfilling our inclusion criteria, 17 of them conducted in Asia, and including a total number of 666 tested subjects. The included studies reported data acquired during resting state or different paradigms, such as cue-reactivity, guessing or cognitive control tasks. The enrolled patients were usually males(95.4%) and very young(21-25 years). The most represented IAD subtype, reported in more than 85% of patients, was the internet gaming disorder, or videogame addiction. In the resting state studies, the more relevant abnormalities were localized in the superior temporal gyrus, limbic, medial frontal and parietal regions. When analyzing the task related fmri studies, we found that less than half of the papers reported behavioral differences between patients and normal controls, but all of them found significant differences in cortical and subcortical brain regions involved in cognitive control and reward processing: Orbitofrontal cortex, insula, anterior and posterior cingulate cortex, temporal and parietal regions, brain stem and caudate nucleus.CONCLUSION: IAD may seriously affect young adults' brain functions. It needs to be studied more in depth to provide a clear diagnosis and an adequate treatment.
文摘Although liver transplantation(LT) is performed increasingly for patients with end-stage alcoholic liver disease(ALD), the topic remains controversial. Traditionally, the role of an addiction specialist focused on the screening and identification of patients with a high risk on relapse in heavy alcohol use. These patients were in many cases subsequently excluded from a further LT procedure.Recently, awareness is growing that not only screening of patients but also offering treatment, helping patients regain and maintain abstinence is essential, opening up a broader role for the addiction specialist(team)within the whole of the transplant procedure. Within this context, high-risk assessment is proposed to be an indication of increasing addiction treatment intensity,instead of being an exclusion criterion. In this review we present an overview regarding the state of the art on alcohol relapse assessment and treatment in patients with alcohol use disorders, both with and without ALD.Screening, treatment and monitoring is suggested as central roles for the addiction specialist(team) integrated within transplant centers.
基金Supported by NIDA,No.K23DA045928-01(to Bachi K) and No.R01DA041528(to Goldstein RZ)NIH/NHLBI,No.R01HL071021+1 种基金Translational and Molecular Imaging Institute internal funding(to Fayad ZAF)American Heart Association Grant in Aid,No.17GRNT33420119(to Mani VM)
文摘BACKGROUND Chronic cocaine use is associated with stroke, coronary artery disease and myocardial infarction, resulting in severe impairments or sudden mortality. In the absence of clear cardiovascular symptoms, individuals with cocaine use disorder (iCUD) seeking addiction treatment receive mostly psychotherapy and psychiatric pharmacotherapy, with no attention to vascular disease (i.e., atherosclerosis). Little is known about the pre-clinical signs of cardiovascular risk in iCUD and early signs of vascular disease are undetected in this underserved population. AIM To assess inflammation, plaque burden and plaque composition in iCUD aiming to detect markers of atherosclerosis and vascular disease. METHODS The bilateral carotid arteries were imaged with positron emission tomography/magnetic resonance imaging (PET/MRI) in iCUD asymptomatic for cardiovascular disease, healthy controls, and individuals with cardiovascular risk. PET with 18F-fluorodeoxyglucose (18F-FDG) evaluated vascular inflammation and 3-D dark-blood MRI assessed plaque burden including wall area and thickness. Drug use and severity of addiction were assessed with standardized instruments. RESULTS The majority of iCUD and controls had carotid FDG-PET signal greater than 1.6 but lower than 3, indicating the presence of mild to moderate inflammation. However, the MRI measure of wall structure was thicker in iCUD as compared to the controls and cardiovascular risk group, indicating greater carotid plaque burden. iCUD had larger wall area as compared to the healthy controls but not as compared to the cardiovascular risk group, indicating structural wall similarities between the non-control study groups. In iCUD, wall area correlated with greater cocaine withdrawal and craving. CONCLUSION These preliminary results show markers of carotid artery disease burden in cardiovascular disease-asymptomatic iCUD. Broader trials are warranted to develop protocols for early detection of cardiovascular risk and preventive intervention in iCUD.