European Addiction Research最新文献

Sociodemographic background factors, gambling game type, depressive symptoms and comorbid substance use have been associated with gambling disorder, but the associations of these factors with treatment outcomes remains unclear. This study examined background factors in participants of a clinical trial, identifying factors which were associated with treatment outcomes such as gambling urge and quality of life. This was a secondary analysis of a single-center 12-week randomised placebo-controlled clinical trial investigating the effects of as-needed intranasal naloxone combined with psychosocial support in the treatment of gambling disorder. Independent variables were analyzed with linear mixed models, with analyses both including and excluding treatment allocation. Sociodemographic factors or game types were not associated with treatment outcomes. Adherence to trial medication and high self-perceived readiness to change gambling behaviour were associated with greater reduction in gambling urge and severity, and greater increase in gambling self-efficacy and quality of life. Higher scores for depressive symptoms were associated with more severe gambling and a slightly greater decrease in gambling urge, as well as a greater increase in quality of life. When included as a nuisance factor treatment allocation abolished most statistically significant results. Participants with high medication adherence had improved treatment outcomes compared to participants with low medication adherence, possibly representing greater motivation and commitment to treatment. More severe depressive symptoms were associated with a greater reduction in gambling urge but not gambling severity.

Background: Anabolic-androgenic steroid (AAS) consumers frequently experience elevated physical and psychological risks, yet the psychological mechanisms linking risk exposure to health outcomes remain poorly understood. This study examined whether general confidence in managing substance use and minimising harm mediates the relationship between clinical risk and quality of life among AAS consumers engaged with community-based alcohol and other drug (AOD) services.

Methods: Intake data from 517 adults (93.4% male) reporting lifetime AAS use were analysed, drawn from a broader cohort of 18,786 clients at Lives Lived Well services between 2020 and 2024. Mediation analyses tested whether two confidence variables, 1. substance use management and 2. harm minimisation, explained associations between clinical risk (defined by World Health Organisation - Alcohol, Smoking and Substance Involvement Screening Test steroid risk score), and three quality of life domains: physical, psychological, and overall wellbeing.

Results: Higher clinical steroid risk scores were significantly associated with poorer quality of life across domains; however, these effects were fully mediated by lower general confidence in managing substance use and minimising harm among clients who reported AAS use. Confidence in consumption practices buffered against physical undesired effects, while confidence in harm reduction was strongly linked to psychological wellbeing.

Conclusions: Among AAS consumers in AOD treatment, broader substance-use confidence appears meaningfully related to quality of life. While the confidence measures are general rather than AAS-specific, these findings provide a preliminary insight into confidence-related processes in a clinically underexamined group. Interventions that promote these strategies may offer a critical mechanism for ensuring this cohorts physical and psychological wellbeing.

Introduction: Recovery from substance use disorder (SUD) spans clinical, functional, and personal dimensions. However, research covering these domains, particularly in populations with complex problems such as those with mild to borderline intellectual disabilities (MBID), remains limited. This study explored different recovery outcomes and their relationship with treatment dropout during the first 12 weeks of inpatient treatment, while also examining whether the presence of MBID affected the outcomes.

Methods: A naturalistic, prospective cohort study was conducted with patients undergoing inpatient SUD treatment at a Salvation Army clinic in the Netherlands. Recovery outcomes (clinical, functional, personal) and predictors of dropout were assessed over 12 weeks. MBID (yes/no) was determined using the SCIL screening tool. Data were analyzed using repeated measures (M)ANCOVA to evaluate recovery trajectories and logistic regression to explore associations between recovery levels and dropout.

Results: Of the 157 participants, 66% screened positive for potential MBID, and 40% dropped out within 12 weeks. For completers, significant improvements were observed across all recovery domains over time (all p < .001). Psychological problems decreased by a mean of 9.6 points (95% CI 7.5-11.8), physical problems by a mean of 3.7 points (95% CI 2.0-5.4), and craving by a mean of 7.5 points (95% CI 6.4-8.6). Functional recovery increased by a mean of 5.1 points (95% CI -1.4-11.7), and personal recovery by a mean of 5.7 points (95% CI 3.5-7.9). Lower baseline recovery levels were associated with greater relative improvements but lower endpoint scores. Lower baseline functional recovery was a small but significant predictor of dropout. MBID status did not affect recovery trajectories.

Conclusions: The findings suggest a multidimensional recovery process during early phases of inpatient treatment, irrespective of MBID status. Baseline recovery levels play a crucial role in shaping outcomes, underscoring the importance of early assessments. Importantly, these findings indicate that those worst off at baseline profit most from treatment.

Introduction: Individuals with compulsive buying-shopping disorder (CBSD) often engage in criminal behaviors like fraud and theft, influenced by materialistic values, impaired moral judgment, and low self-control. Psychological mechanisms linking CBSD and criminality are yet not well understood. This study examines psychological/personality factors contributing to criminal tendencies in individuals with CBSD.

Methods: An online survey recruited participants through social media, websites, and academic institutions. Eligible participants were ≥18 years with German language skills. Ethical approval was granted by Hannover Medical School. Measures included the Pathological Buying Screener (PBS), Materialistic Value Scale, Big Five Inventory, Rosenberg Self-Esteem Scale, the Dirty Dozen for Dark Triad traits, and a self-developed questionnaire on criminal behavior.

Results: Forty-three participants scored above (CBSD+) and 166 participants below (CBSD-) the PBS cutoff for CBSD. The CBSD+ group showed higher materialism, lower self-esteem, elevated Dark Triad traits, and more criminal behaviors compared to the CBSD- group. Nearly 70% of the CBSD+ group reported at least one criminal behavior. A multiple linear regression (enter method) identified higher PBS scores, younger age, and lower extraversion as predictors of more criminal buying-shopping-related behaviors.

Conclusion: The findings reveal the intricate factors contributing to criminal behavior in CBSD. The lack of significant association between neuroticism, dark personality features and the amount of criminal behaviors needs further investigation. The explained variance of 39% indicates that additional influences on criminal behavior remain to be explored. Future research should aim for more diverse samples and longitudinal designs to enhance generalizability and understanding of these complex relationships.

Introduction: Recurrent depression is a challenging and common disorder in clinical psychiatry. Comorbid substance use disorder poses a challenge to effective treatments. The association between depression and substance abuse is widely documented, but less is known about how the recurrence of depression is associated with substance use disorders and the temporal connections between the two disorders in adolescence and early adulthood.

Methods: In this study, we analyzed the associations between recurrent depression and substance use patterns in former adolescent psychiatric inpatients, during initial inpatient hospitalization and follow-up period of 10-15 years. Study population consisted of 235 individuals admitted for adolescent psychiatric inpatient care, of whom 84 were in recurrent depression group and 151 were in single depressive episode group. Substance use experimentation ages, substance use frequencies during adolescence, onset ages of substance use disorders, and number of substance use disorder diagnoses in adolescence and early adulthood were analysed between the two groups.

Results: Recurrent depression was associated with alcohol use disorders (p = 0.014) and multiple drug use disorders (p = 0.034) in early adulthood in males. In logistic regression analysis, alcohol use disorder was found to associate with recurrent depression in males (OR 3.6, 95% CI 1.27-10.75, p = 0.017). There was no statistically significant difference in temporal associations between recurrent or single-episode depression in regard to onset age of substance use.

Conclusions: Our results emphasize the need for early recognition and integrated treatment of substance use and depression in adolescence.

In the article by Bretteville-Jensen and Nesse entitled "Non-Prescribed Use of Opioid Agonist Medications and Associations with Non-Fatal Overdoses: A Repeated Cross-Sectional Study across a Decade of Reduced Monitoring" [Eur Addict Res. 2025; https://doi.org/10.1159/000547909], an error was introduced during production concerning the license. The article was mistakenly published under a CCC license instead of the intended CC BY 4.0 license.The original article has been updated.

Introduction: The purpose of this study was to evaluate the effect of biperiden on nicotine craving in a proof-of-concept clinical study.

Method: The study involved 46 male participants (mean age: 45.3 ± 9.31 years) who smoked an average of 20.8 (10.0) cigarettes per day. Participants were randomly assigned to either a biperiden (4 mg/day) or placebo group, with treatment lasting 7 days. The outcomes were assessed at baseline (T0) and after 7 days (T1) using self-reported questionnaires, including the Questionnaire of Smoking Urges-Brief, the Fagerström Tolerance Questionnaire, and the Beck Anxiety and Depression Inventories.

Results: Repeated measures ANOVA revealed a significant time × treatment interaction between cigarette consumption (p < 0.001, ηp2 = 0.340) and craving (p = 0.002, ηp2 = 0.203), indicating that participants in the biperiden group showed greater reductions than those receiving placebo. For dependence, anxiety, and depression, only the main effect of time was significant (p < 0.05), suggesting general improvement across both groups. Ethnicity did not significantly influence any outcomes, and no relevant adverse effects were reported.

Conclusions: These findings suggest that biperiden may represent a promising pharmacological approach for reducing nicotine craving. Further studies with prolonged administration are warranted to evaluate its therapeutic potential for smoking cessation.

Introduction: Buprenorphine, a partial opioid agonist, is widely used as treatment for opioid use disorder. Traditionally, the original opioids are abruptly stopped, whereafter the buprenorphine is titrated over the course of several days. An alternative approach is low-dose buprenorphine initiation (LDBI), where buprenorphine is titrated more gradually, while the original opioids are still being used. Literature suggests LDBI may be associated with less withdrawal symptoms, though no standardized protocol for LDBI currently exists. This study aimed to establish consensus on the application of LDBI in Dutch clinical practice.

Methods: A Delphi method was employed, involving a systematic literature review to develop statements on the application of LDBI. Experts reviewed these statements across three rounds, achieving consensus at a 75% agreement threshold.

Results: Thirteen physicians with demonstrated expertise in LDBI participated, with nine completing all three rounds. Over three consultation rounds, consensus was achieved on 28 statements about indications for LDBI and dosing regimens, though variation in titration procedures was observed. The panel agreed that the starting dose can range between 10 and 20 μg/h for transdermal patches and 0.2-1.0 mg for sublingual tablets; dose can be increased daily with a maximum of 100% of the previous daily dose. Further, the original opioids should not be discontinued before day 7 after LDBI.

Conclusion: Though various protocols for LDBI exist, physicians experienced with LDBI agreed on the range of safe LDBI regimens. Further research is necessary to develop comprehensive guidelines for LDBI in patients with opioid use disorder.

Background: Cigarette smoking is a major preventable cause of morbidity and mortality worldwide. Despite its well-known harms, epidemiological studies have reported potential protective associations between smoking and certain diseases, necessitating a critical appraisal of these claims.

Summary: This review evaluates evidence on smoking's impact across eight conditions: endometrial carcinoma, rheumatoid arthritis, ulcerative colitis, Parkinson's disease, uterine leiomyoma, pre-eclampsia, COVID-19, and psychological stress. While observational data suggest inverse associations in some cases, such effects are often modest, mechanistically unclear, and confounded by biases. The review underscores the scarcity of randomized clinical trials and highlights the complexity of disentangling nicotine's biological actions from the broader toxic effects of tobacco smoke.

Key messages: The potential "protective" effects of smoking do not outweigh its well-established detrimental health consequences. Smoking cessation remains paramount, and further rigorous clinical research is needed to clarify these paradoxical findings and to explore the therapeutic potential of nicotine independent of tobacco use.