Nordic Studies on Alcohol and Drugs最新文献

Aims: Problematic gaming is a distinguishable problem associated with impairments to personal well-being. The Restart program is a novel digital intervention that was designed to help individuals improve their control over excessive gaming. This study aimed to investigate the feasibility and preliminary outcomes of the Restart program on gaming behaviour and well-being among problematic gamers.

Methods: We utilised a quasi-experimental design, including one group with pre-and post-test measurements; no control group was employed. The analysed data described individuals' life situations, gaming behaviour, problematic gaming, compulsive internet use and subjective well-being. Data were collected at the baseline and post-program time points, as well as 3 months after the end of the program, and analysed using a linear mixed model. At the baseline, 110 individuals engaged in the intervention, and 50 participants completed all pre-, post- and follow-up tests.

Results: Statistically significant differences between the baseline and post-program scores were discerned for all variables. Moreover, the total time spent on gaming and the proportion of problematic gaming time decreased across the post-intervention and follow-up time points, a trend that may reflect changes in gaming control and behaviour. The results also revealed improvements in subjective well-being among participants.

Conclusions: Participants showed improvements in gaming behaviour and well-being, suggesting that participation in the Restart program may be associated with positive changes; however, the findings remain preliminary. Future research should focus on the long-term benefits of such therapeutic approaches.

Background: The death of a family member due to substance use may negatively affect family dynamics and the coping mechanisms of surviving family members, as the loved one may have already been perceived as lost during the period of substance use. Substance-related deaths are considered special due to their sudden nature and the circumstances surrounding the cause of death. The grief of siblings, in particular, is often overlooked, which highlights the importance of collecting comprehensive information about their experiences. Aim: The purpose of this systematic review is to describe siblings' experiences of losing a brother or sister to a substance-related death. The aim is to generate knowledge that enhances understanding of this topic and supports the development of appropriate and targeted support services. Methods: Nine articles were selected through the database search, and four additional articles were manually selected. The data from the initial search was analyzed using inductive content analysis. The results of the updated search were analyzed deductively on the basis of the previous results framework. Findings: The systematic review showed that siblings experienced being abandoned and carried the burden of loss. They also felt environmental insecurity and felt they will recover from grief. Support and assistance resources targeted at siblings are lacking. Attitudes and interactions of others have a significant impact on their grief experience.

Aim: This long-term follow-up study assessed substance related mortality by sex and compared it with the age-matched general population, with the aim of informing the development of treatment services.

Methods: Data included 10,891 former patients who had sought treatment for substance use between 1990 and 2009, and a special group of 1,076 children who had accompanied their parent(s) to family treatment. Treatment data were linked to national register data concerning education, hospitalizations and death by 2019. Age-specific death rates, standardized mortality ratios and causes of death were compared with the Finnish general population.

Results: By 2019, a larger proportion of the 7,334 treatment-seeking men (42.6%) than of the 3,557 women (27.4%) had died. The underlying cause of death was alcohol and/or drug related in one-third of the deaths and two-thirds when further causes were included. Age-specific comparisons with the general population revealed that the studied men and women had markedly higher death rates and the difference increased decade by decade, being highest among the youngest age-groups (standardized mortality ratios were 9.8 for men and 13.8 for women born in the 1980s). Out of the 1,076 children, 15 boys (2.8%) and four girls (0.7%) had died, mostly due to substance use or violence related causes.

Conclusions: Mortality was significantly increased for several years after treatment highlighting the need for long-term follow-up, as well as after-care and easy re-entry to treatment. Special attention should be paid to the relatively higher increase in mortality risk among women.

Aim: The study examines how Swedish welfare professionals linguistically construct and legitimize support for concerned significant others (CSOs) of individuals with alcohol and other drug (AOD) problems. This is studied through the professionals' understandings of AOD problems and how power relations embedded in their language shape the CSO role.

Methods: Semi-structured interviews involving 10 AOD therapists and 10 family care consultants in Sweden were analyzed using Fairclough's critical discourse analysis.

Results: The findings reveal three key logics, in which the CSOs are understood. First, professionals position themselves as educators, aiming to make CSOs understand AOD problems "correctly". Second, AOD problems are described as an evil force, making CSOs appear passive and reactive. Third, medical and resistance discourses dominate, portraying the AOD problem as an uncontrollable disease, legitimizing strategies such as boundary-setting and self-care. While use of these discourses is argued to reduce stigma and challenge traditional caregiving roles, it also pathologizes CSOs, reinforcing professional authority while limiting CSOs' perceived capacity for self-determined action and imposing an expectation of self-sufficiency.

Conclusions: The study highlights how medicalization influences CSO support by describing caregiving as dysfunctional, which legitimizes professional intervention while limiting CSOs' agency. The findings highlight the need for an integrated approach balancing medical and resistance discourses with relational perspectives that emphasize social support.

The study explores the qualifications and competency needs of professionals working at Swedish Maria clinics, specialized in treating youth with co-occurring substance use and mental health problems. A web-based survey was conducted among 87 professionals working at the clinics to assess their qualifications, competence in managing co-occurring problems and perceived needs for further training. Most professionals had high educational qualifications, with backgrounds in social work, nursing and psychology. Although health care and social services professionals had generally similar competencies, there were some notable differences in their professionalism and competency needs. Healthcare professionals were more likely to report competence in managing severe psychiatric conditions. In contrast, social services professionals more often reported using a broader range of treatment methods. Both groups identified a need for further education in managing severe psychiatric conditions, such as trauma, psychosis and eating disorders. Social services professionals more frequently emphasized the need for family-oriented approaches, while healthcare professionals more often identified a need for more in-depth knowledge related to substance use. While professionals at the clinics generally possess strong qualifications, there are differences in their confidence and expertise relating to managing complex mental health conditions. Tailored training initiatives that address specific needs based on professionals' educational backgrounds and organizational affiliations could enhance inter-professional collaboration and improve treatment outcomes for youth with co-occurring substance use and mental health problems.

Aim: This study investigates gender-specific standardized incidence ratios (SIRs) of comorbid psychiatric disorders among adults diagnosed with gambling disorder (GD) and also examines mortality rates and causes of death in this population.

Methods: The study included all individuals aged 18 years or older in Finland diagnosed with GD between 2011 and 2022 (n = 3,605), as defined by ICD-10 code F63.0 (International Classification of Diseases, 10th Revision). Data were drawn from nationwide social and healthcare registers, covering both primary and specialized care. The general population (n = 4,374,192) served as the reference group.

Results: Among individuals with GD, 88.5% were diagnosed with at least one additional psychiatric disorder. After age standardization, the incidence of psychiatric comorbidities was significantly higher in the GD group compared to the general population. Mood and anxiety disorders were the most common disorders in both groups. However, personality disorders (PD), schizophrenia spectrum disorders (SSD) and substance use disorders (SUD) were significantly more common among individuals with GD. Some gender-specific patterns emerged: GD was particularly associated with PD and SUD among women, as well as with PD and SSD among men. Of the GD cohort, 3.6% had died, with suicide accounting for 22% of deaths.

Conclusions: Diagnosed GD is associated with elevated rates of psychiatric disorders, particularly PD, SSD and SUD. These findings highlight the importance of comprehensive mental health assessment in individuals with GD. Frontline social and healthcare professionals should be attentive to the high occurrence of psychiatric comorbidities in this population to ensure timely and appropriate care.