European Addiction Research最新文献

Introduction: Major depression, anxiety disorders, and post-traumatic stress disorder (PTSD) are among the most prevalent comorbid mental disorders in youth addiction treatment. Hence, screening for these internalizing disorders should be part of the standard routine at intake in substance use disorder treatment. We investigated the usefulness of the Depression, Anxiety and Stress Scale (DASS-21) as a screener for this purpose.

Methods: A nationally representative sample of 421 treatment-seeking youths aged 16-22 years with a primary cannabis, alcohol, cocaine, or amphetamine use disorder participated in the study. At intake, we administered the DASS-21 and the Mini International Neuropsychiatric Interview (MINI; Sheehan et al., 1998) based on the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), as "gold standard," as part of a broader baseline assessment of the Youth in transition study [Moska et al. BMC Psychiatry. 2021;21(1):1-11].

Results: At comparable sensitivity (0.80-0.84), based on the optimal cut-off value, specificity was higher for the DASS-21 total score detecting any DSM-5 internalizing disorder (0.62) than for the DASS subscales specifically detecting depression, anxiety, or PTSD (0.44, 0.49, and 0.51, respectively). Receiver operating characteristic curve analyses showed an area under the curve (AUC) value of 0.80 for the DASS total score to detect any internalizing disorder ("good discrimination"), compared with AUC values of 0.70-0.75 of the DASS depression and anxiety subscales to detect DSM-5 depression, anxiety, and PTSD ("fair discrimination"). The optimal DASS total score cut-off value of ≥44 for detecting any internalizing disorder resulted in 0.81 sensitivity, 0.62 specificity, 0.80 positive predictive value, and 0.64 negative predictive value.

Conclusion: Given the high prevalence of comorbid internalizing disorders in youth addiction care, the need to address these comorbid disorders in treatment, and the favorable accuracy of the DASS to detect these disorders, we recommend to implement the DASS-21 as routine screener in youth addiction treatment in the Netherlands.

Introduction: Data from several areas of public health (e.g., harmful alcohol and tobacco) are consistent with the assertion that children's exposure to advertising strategies increases intention to consume such products. Most studies have measured self-rated impact of gambling advertising using questionnaires. Given that gambling advertisements come in different forms such as print media/television advertising and contain variable content, it is difficult to understand using subjective measures which aspects of the gambling advertisements increase craving and desire to trigger a gambling session. In the present study, we applied a novel data-driven methodology that directly tracks eye movements to reveal attentional biases towards gambling adverts and promotions by examining differences in young people's eye gaze behaviour when watching gambling and non-gambling (control) moving adverts.

Method: A total of 98 (16-18 years old) children who self-identify as having a low or high craving to gambling watched gambling and non-gambling (control) television adverts, while their eye movements were recorded.

Results: The results show that the data-driven method can isolate video clips that best distinguish people on the low-high craving spectrum, reveal the type of each video clip with the largest group differences, and accurately predict young people's gambling craving on the basis of eye movement patterns.

Conclusion: Our findings demonstrate that young people's craving for gambling can be predicted based on their eye movements to video clips of gambling advertisements and that certain features of gambling advertisements may be more appealing to some group of viewers, particularly those with high craving for gambling.

Introduction: Negative affect and anxiety frequently precede the onset of drug use in those with substance use disorder (SUD). Low self-esteem may increase the risk of relapse. We examined the short-term effects of exercise on affect, anxiety, and self-esteem in inpatients with poly-SUD.

Methods: This is a multicenter randomized control trial (RCT) with a crossover design. Thirty-eight inpatients (37.3 ± 6.4 years; 84% male) from three clinics participated in 45 min of soccer, circuit training, and control condition (psychoeducation) in a random order. Positive and negative affect (PANAS), state anxiety (single item), and self-esteem (Rosenberg SE-scale) were measured immediately before, immediately after, 1-h, 2-h, and 4-h post-exercise. Heart rate and ratings of perceived exertion were taken. Effects were assessed using linear mixed effects models.

Results: Compared to the control condition, there were significant post-exercise improvements in positive affect (β = 2.99, CI = 0.39: 5.58), self-esteem (β = 1.84, CI = 0.49: 3.20), and anxiety (β = -0.69, CI = -1.34: -0.04) after circuit training (shown) and soccer. Effects persisted 4-h post-exercise. Reductions in negative affect were observed 2-h (circuit training: β = -3.39, CI = -6.35: -1.51) and 4-h (soccer: β = -3.71, CI = -6.03: -1.39) post-exercise, respectively.

Conclusion: Moderately strenuous exercise undertaken in naturalistic settings may improve mental health symptoms in poly-SUD inpatients for up to 4-h post-exercise.

Background: Borderline personality disorder (BPD) is one of the most common personality disorders among persons with substance use disorders (SUDs) and is characterized by severe clinical symptoms. The aim of this study was to investigate if the effect of dialectical behavior therapy for substance use disorders (DBT-S) inpatient treatment on psychopathological symptom load in patients suffering from both BPD and SUD can be augmented by weekly 60-min "Trauma Informed Hatha Yoga" sessions.

Materials and methods: Thirty-nine patients suffering from comorbid BPD and SUD were consecutively in time included in this quasi-experimental pilot study (first intervention then control group). In the intervention group, weekly Trauma Informed Hatha Yoga sessions were added to standard DBT-S for 8 weeks. The participants of the control group received standard DBT-S. All participants completed several self-report questionnaires to assess symptoms of depression, anxiety, symptoms of BPD, and their subjective stress perception at three points in time during the study course.

Results: A repeated measures analysis of variance with patients' psychopharmacological medication as covariate revealed a significant main effect of time for each of the psychometric scales (State and Trait Anxiety Inventory subscale for state anxiety [STAI-S] p = 0.001, Beck Depression Inventory [BDI] p < 0.001; Borderline Symptom List 23 [BSL] p = 0.036) indicating that the psychopathological symptom load of the patients was significantly lower at the end of the DBT-S therapy compared to the beginning in both study groups. Moreover, there was a significant interaction effect of group*time on the psychometric scales STAI-T (subscale for trait anxiety) sum score (p = 0.010) and the sum score of the Perceived Stress Scale (PSS) (p = 0.043). This was expressed by the fact that the participants of the intervention group showed a significant reduction of the STAI-T sum score as well as the sum score of the Perceived Stress Scale (PSS), while the control group did not. Due to the exploratory nature of this study, correction for multiple testing was omitted.

Conclusion: Although they are very preliminary, our results suggest that practicing Trauma Informed Hatha Yoga on a regular basis in addition to DBT-S inpatient treatment seems to reduce the level of trait anxiety and perceived stress significantly more than DBT-S inpatient treatment alone. Nevertheless, the effectiveness of Trauma Informed Hatha Yoga in reducing trait anxiety and perceived stress in patients suffering from SUD und BPD must be tested in large randomized controlled trials.

Background: There is a lack of studies on methamphetamine (MA) exposure and morbidity in children beyond the perinatal period.

Objectives: We compared morbidity in children (0-3 years) with prenatal MA exposure to opioid-exposed and to non-exposed children.

Methods: We used data from a Czech nationwide, registry-based cohort study (2000-2014). Children, who reached 3 years of age, of mothers hospitalized with (i) MA use disorder during pregnancy (MA; n = 194), (ii) opioid use disorder during pregnancy (opioids; n = 166), and (iii) general population (GP; n = 1,294,349) with no recorded history of substance use disorder (SUD). Information on inpatient contacts, length of stay, and diagnoses (International Statistical Classification of Diseases and Related Health Problems 10th Revision [ICD-10]) were assessed. Crude and adjusted odds ratios (aOR), 95% confidence interval (CI) for the risk of hospitalization, and for getting diagnosis from the ICD-10 diagnosis chapters were calculated using binary logistic regression. A stratified analysis on hospitalizations with SUD of mothers was performed.

Results: No significant differences were found in the measures of hospitalization between the MA and opioid groups. Children prenatally exposed to MA and opioids had higher numbers of hospitalizations and diagnoses and longer stays in hospital than children in the GP. Increased risks of certain infectious and parasitic diseases were found in both MA (aOR = 1.6; CI: 1.1-2.3) and opioid (aOR = 1.9; 1.3-2.8) groups as compared to the GP group. The most pronounced difference in stratified analysis on maternal hospitalizations related to SUD after birth was observed for injury, poisoning, and certain other consequences of external causes in the strata of the MA group who had hospitalized mothers (aOR 6.3, 1.6-24.6) compared to the strata without maternal hospitalizations (aOR 1.4, 0.9-2.3).

Conclusion: This study suggests that children born to mothers using MA during pregnancy have similar morbidity during the first 3 years of life but higher than the GP. The excess of risk was primarily due to infections and injuries in the MA group.

Introduction: Internet gaming disorder (IGD) is an emerging condition within the field of behavioural addictions. IGD has been demonstrated to be highly comorbid with many other mental health disorders. Among these, substance use has been associated with IGD, and there are underlying similarities between behavioural addictions and substance use disorders. The main aims of the present study were (i) to investigate the association between high-risk gaming and substance use among young adults drawn from the general Italian population; and (ii) to explore the psychopathological correlates of high-risk gaming.

Methods: Lifetime substance use, type of substances consumed, and frequency of use were investigated through an online survey in a sample of 913 adults aged 18-40 years. High-risk gaming was assessed using the ten-item Internet Gaming Disorder Test (IGDT-10). Psychopathology was assessed using the Revised 90-item Symptom Checklist (SCL-90-R).

Results: High-risk gaming prevalence rate was 4.4%. High-risk gamers scored higher on all dimensions of psychopathology, confirming the association between high-risk gaming and psychiatric distress. Regarding substance use, high-risk gamers were more commonly polysubstance users and more commonly made use of psychodysleptic substances. High-risk gamers were more commonly frequent substance users, and 32.5% of high-risk gamers used or had used psychoactive substances often or everyday throughout their lives.

Discussion and conclusion: The findings are in line with the concept of a common neurobiological vulnerability for both gaming and substance use. There is the need for more research to examine the phenomenology of gaming and its interplay with substance use to help develop effective interventions and prevention strategies.

Introduction: The standard screening instrument for alcohol problems in the current primary care, the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C), contains a question about alcohol consumption "on a typical day." Since this is a term that leaves room for multiple interpretations and the differences between alcohol consumption on weekends and weekdays are not taken into account, this study examines whether the latter distinction improves the prediction validity of the screening instrument.

Methods: A subgroup of 852 participants of the Dutch version of Dry January ("NoThanks") 2022 got the annual "NoThanks" survey, including questions about their alcohol consumption on weekends and weekdays, and the original ten AUDIT questions. The full AUDIT was used as golden standard. Sensitivity, specificity, and receiver operating characteristic curves were calculated for the original and different versions of the AUDIT-C.

Results: Of all participants, 67 percent were hazardous drinkers (AUDIT ≥8) and 27 percent were harmful drinkers (AUDIT ≥16). For the original AUDIT-C, the cut-off score with the most balanced combination of sensitivity and specificity for hazardous drinking in men was 7 and in women was 6. For harmful drinking, this was 8 and 7, respectively. Certain versions performed equally well as the original. For harmful drinkers, the highest area under the receiver operating characteristic curve (AUROC) was 0.814 and 0.866 for the original AUDIT-C, for men and women, respectively. Only for hazardous drinking men, the AUDIT-C with weekend day (AUROC = 0.887) performed slightly better than the original.

Conclusion: Distinguishing weekend- and weekday alcohol consumption in the AUDIT-C does not lead to better predictions of problematic alcohol use. However, the distinction between weekends and weekdays provides more detailed information for healthcare professionals and can be used without having to compromise too much on validity.

Background: People with substance or alcohol use disorders (SUDs/AUDs) are likely to be more vulnerable to COVID-19 infection than the general population, but the evidence of COVID-19-related mortality in these patients is unclear.

Objectives: The aim of the study was to verify whether patients with AUD and SUD have a higher mortality rate for COVID-19-related mortality compared to the general population.

Method: We performed a follow-up study to assess mortality in 2020 in a cohort of patients diagnosed for the first time with AUDs or SUDs at the Public Health Services in the metropolitan area of Bologna (Northern Italy) from 2009 to 2019.

Results: SUDs/AUDs patients present an excess mortality with respect to the general population for all causes of death and for COVID-19-related mortality.

Conclusions: Our data support the need for prevention strategies in SUDs/AUDs patients such as vaccinations.

Introduction: This study offers insights into Dutch young people's expected social and personal consequences of ecstasy use. Substance use expectancies are assumed to be an essential component in explaining substance use behaviour and, therefore, the development of effective substance use prevention and treatment strategies.

Method: Dutch young adults with an online interest in drug-related social media posts were targeted with an online survey about their use of alcohol and drugs. This resulted in a convenience sample (N = 4182, 73.4% female, Mage = 21.11), of which 35.5% had used ecstasy at least once in their life and 29.3% had used ecstasy last year. Latent class analyses were used to identify subgroups based on both positive and negative expectancies of ecstasy use. Cross-class differences were examined using multinomial logistic regression.

Results: This study yielded four distinct classes: only negative expectancies (13.6%), high positive and negative expectancies (23.5%), low to moderate positive and negative expectancies (20.6%), and mostly positive expectancies (22.4%). These classes differed significantly in lifetime experience with ecstasy use, intention to use ecstasy, perception of harmfulness and availability, and social norms regarding the use of ecstasy.

Conclusion: Findings show that ecstasy use expectancies can be used to create meaningful classes of users and non-users, and that these classes are different enough to warrant varied prevention approaches. Expectancies young people have regarding the use of ecstasy are associated with various ecstasy use-related variables and should be taken into consideration when developing and implementing preventive interventions.

Introduction: Due to the high rate of mortality, recognizing the contributing factors of alcohol-related delirium tremens (DT), which is the most severe form of alcohol withdrawal state (AWS) is pivotal in clinical settings. Previous studies suggested relationship between seasonality and other types of delirium; however, to our knowledge, this is the first empirical study which examined the role of seasonality in DT in alcohol dependence syndrome (ADS).

Methods: A retrospective study was undertaken between 2008 and 2015; medical records of 1,591 patients were included, which yielded 2,900 hospital appearances. Three groups were formed based on the ICD-10 diagnoses: ADS, AWS, and DT. The characteristics of the groups were analysed with one-way ANOVA and χ2 tests. Multinomial logistic regression was used to explore the potential predictors of DT, including seasonality.

Results: The highest incidence of DT was in spring (36.8%; χ2 (3) = 27.666; p < 0.001), especially in March (13.9%; χ2 (11) = 33.168; p < 0.001). Spring, higher mean age, higher presence of comorbid somatic disorders, and lower occurrence of comorbid psychiatric disorders were significant predictive variables for DT with the control of socio-demographic and clinical variables.

Conclusions: The present study revealed that spring, especially March is a critical period in temperate climate zone regarding DT. This can be interpreted as a late winter effect since the temperature is lower in this month compared to other spring months. Furthermore, higher age and the occurrence of comorbid somatic disorders can be considered as risk factors in case of DT. These results support the need of further clinical studies to better understand the impact of seasonality on DT.