European Addiction Research最新文献

Introduction: Alcohol is widely used but motives for consumption vary. Since drinking motives are proximal predictors of initiation and escalation of alcohol use, accurate measurement of these motives is crucial. The aim of this study was to assess the psychometric properties - including factor structure, internal consistency, and test-retest reliability - of the 12-, 18-, and original 20-item versions of the Drinking Motives Questionnaire (DMQ). Additionally, this study aimed to examine the associations between drinking motives and alcohol use outcomes using network analysis, providing insights into the direct and conditional relationships between different drinking motives and their real-life outcomes.

Methods: A total of 434 adults (77.4% female) completed the baseline questionnaires and 130 (85.3% female) participated in a follow-up approximately 2 weeks later.

Results: Results showed that the subscales of the DMQ had good internal consistency (α ≥ 0.80) regardless of version. Test-retest reliability was acceptable to good (rs = 0.71 to rs = 83) but was higher for social and enhancement than for conformity and coping motives. Confirmatory factor analysis showed that the 12-item short form outperformed the original 20-item version and the more recently proposed 18-item version. Partial correlation networks including DMQ subscales and alcohol outcomes revealed consistent positive association between social motives and binge drinking, alcohol use quantity per drink occasion and enhancement motives, while frequency of use was primarily associated with coping motives. However, while associations amongst drinking motives were identical in the 12- and 18-item version, these differed from the 20-item version.

Conclusion: This study demonstrates how network models can be valuable tools in the validation and comparison of questionnaires and shows that the 12-item DMQ could be a good alternative for the often used longer forms.

Introduction: Synthetic cannabinoids are novel psychoactive substances with potential for abuse and severe withdrawal symptoms. Despite widespread use, research on withdrawal is limited. We conducted a systematic review of case reports describing SC withdrawal symptoms.

Methods: Literature searches were conducted across databases, including PubMed/Medline, Scopus, EMBASE, and PsycINFO, to identify case reports from inception to March 2025. Eligible studies involved human cases with confirmed SC use and clearly described withdrawal symptoms. Study quality was assessed using the CARE guidelines checklist.

Results: N = 11 eligible case reports on SC withdrawal identified. The cases involved predominantly male (82%), mean age of 28.08 (SD 7.78). Most frequent withdrawal symptoms: psychosis (n = 9), agitation/irritability (n = 8), nausea/vomiting (n = 6), seizures (n = 5), tachycardia (n = 4), and insomnia (n = 3). Rarer effects like delirium, rhabdomyolysis, and auditory/visual hallucinations were also documented. Symptoms emerged within 24-48 h (62%) and resolved within 1 week. Case report quality was variable, with an average of 8 out of 13 CARE checklist items reported.

Conclusion: SC withdrawal manifests with a broad spectrum of physiological and psychological symptoms that can rapidly escalate and require prompt medical management in certain cases. SC withdrawal symptoms are more severe and unpredictable compared to natural cannabinoids, particularly among daily and frequent users. The findings highlight SC withdrawal as an understudied yet clinically important syndrome, necessitating further research to elucidate neurobiological mechanisms and develop evidence-based treatment protocols.

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.

Introduction: Recovery from substance use disorder (SUD) is increasingly recognized as a personal journey, necessitating an approach that considers individual goals and priorities. Research on recovery priorities in inpatient settings is limited. Our study employs Q-methodology to explore recovery priorities among clients with multimorbid SUD, aiming to guide targeted, recovery-oriented care.

Methods: This cross-sectional study employed Q-methodology to explore recovery priorities among 129 individuals entering inpatient addiction treatment. A collaboratively developed Q-set of 42 statements covered clinical, functional, and personal recovery goals. Participants ranked statements by importance, and rotated factor analysis was used to identify clusters of recovery priorities. Qualitative interview data were then analyzed for further interpretation.

Results: We found 12 consensus statements and two distinct factors. Factor 1 (n = 60) emphasized personal growth and coping, while factor 2 (n = 51) highlighted practical aspects such as securing income and housing. Qualitative data supported these findings.

Conclusions: Despite the individual nature of recovery and the diversity within the addiction treatment population, our study identified shared goals and two distinct factors. This insight can inform tailored interventions, with factor 1 individuals potentially favoring psychological approaches and factor 2 individuals focusing on practical goals.

Introduction: Personal recovery is an important target in mental health care settings and has been suggested as the "bridging principle" between mental health care and substance use disorder (SUD) treatment. However, few psychometrically evaluated scales exist for measuring personal recovery in SUD research, and the questionnaire about the process of recovery (QPR), a measure of personal recovery widely used in the mental health field, has not been previously psychometrically evaluated in such a context. The aim of this study was to explore the psychometric properties of the 22- and 15-item versions of the Norwegian translation of the QPR in terms of factor structure and internal consistency in an opioid use disorder (OUD) sample.

Methods: A total of 156 people with OUD filled out the QPR. Exploratory factor analysis with principal axis factor and maximum likelihood as extraction method was performed to assess the dimensionality of the 22- and 15-item versions of the Norwegian translation of the QPR. Internal consistency was calculated according to Cronbach's alpha.

Results: Internal consistency for the 22-item version was α = 0.917. After removal of three items with low factor loadings internal consistency was α = 0.922. Internal consistency for 15-items version was α = 0.915. Exploratory factor analyses showed a clear one-factor solution for both the 22-item and 15-item version.

Conclusion: Both the 15- and the 22-item versions of QPR showed a clear one-factor solution; however, the 15-item version showed the strongest results in terms of explained variance. Thus, the 15-item version is the recommended version to use in SUD samples.

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.

Introduction: Studies report a high variability of cognitive impairment in people who use drugs, ranging from 20% to 80%. Most research focuses on individuals who use drugs who are either admitted to treatment facilities or incarcerated and being abstinent from substances. The present study aimed to assess cognitive function among populations with ongoing, severe, habitual substance use, mimicking a real-world day-to-day situation.

Methods: Cross-sectional design with 171 participants (70.2% male) with severe substance use, recruited from two sites in Oslo, Norway. All participants were screened for cognitive function using the Montreal Cognitive Assessment (MoCA). A cutoff of <26 points was used to classify possible cognitive impairment. Participants also provided information on their alcohol and substance use, as well as demographic data.

Results: 74.9% of the participants scored below the MoCA cutoff for possible cognitive impairment. We did not find any associations between scoring below the MoCA cutoff <26 and the substance use variables (substance use, number of substances used, history of overdoses, injection drug use, and past substance use treatment).

Conclusion: A high proportion of people with severe substance use may experience a functional cognitive impairment. This study provides novel insights into cognitive function within a population actively engaged in habitual substance use, offering a real-world perspective with high external validity. This knowledge is highly relevant for service providers who aim to deliver tailored follow-up services to this population outside of traditional treatment settings.

Introduction: With a global rise in opioid-related mortality, there comes a need to address this with novel therapies. Cannabinoid receptors are highly expressed and co-localised with opiate receptors of the mesolimbic system. Cannabis-based medicinal products (CBMPs) have been suggested as a measure to reduce harm as maintenance therapy for substance use disorder (SUD). This aim of this study was to assess changes in patient-reported outcomes measures (PROMs) and opioid medications in individuals treated with CBMPs for SUD.

Methods: Data from patients with SUD from the UK Medical Cannabis Registry were analysed. Outcomes included changes at 1, 3, and 6 months from baseline of the EQ-5D-DL, single-item sleep quality scale (SQS), and Generalised Anxiety Disorder-7 (GAD-7) questionnaire. Change in opioid medications was assessed as change in oral morphine equivalent (OME).

Results: 34 patients were included. Twenty-seven (79.41%) participants were male. Twenty-nine (85.29%) participants were illicit cannabis consumers at baseline. The most common SUD was opioid use disorder (n = 18; 52.94%). Four (11.76%), 14 (41.18%), and 16 (47.05%) patients were prescribed oils, dried flower, or a combination of dried flower and oils, respectively. Improvements in GAD-7, SQS, and EQ-5D-5L at 1, 3, and 6 months from baseline were observed (p < 0.050). Median OME consumption at baseline was 274.95 (79.50-441.80) mg/day. This was reduced at 6 months (204.45 [61.88-354.85] mg/day; p = 0.043), there was no significant difference at 1 or 3 months (p > 0.050). Three (8.81%) participants reported 17 (50.00%) adverse events.

Conclusions: There was an associated improvement in health-related quality of life PROMs and reduction in prescribed opioids in individuals with SUD treated with CBMPs. CBMPs were well tolerated by most individuals in this 6-month analysis. Further evaluation through randomised controlled trials is needed to determine causality.

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.