American Journal on Addictions最新文献

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Third ventricle volume and psychometric alterations in patients with alcohol usage. 酒精使用患者的第三脑室容积和心理测量改变

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2026-02-08 DOI: 10.1111/ajad.70150

Jenna Lee, Michelle A Patriquin, Ramiro Salas, Hyuntaek Oh

Background and objectives: Alcohol use disorder (AUD) is one of the deadliest psychiatric conditions. Previous studies indicate that AUD is linked to several neurological biomarkers in the human brain; however, how alcohol use manifests in brain volumes and the relationships between the subcortical brain regions affected by AUD and clinical outcomes are not fully understood. This study attempts to compare subcortical brain volume differences between patients with AUD and healthy controls (HC) to understand how alcohol use relates to brain volume changes.

Methods: Patients with AUD, as determined by alcohol dependence and abuse criteria from the DSM-IV, (n = 71) were recruited and matched with HC (n = 71) by demographic characteristics. We examined group differences in the volumes of 40 bilateral subcortical structures between patients with AUD and HC. We assessed the relationship between changes in subcortical brain volumes and common co-occurring psychiatric symptoms.

Results: Our results revealed a significant increase of third ventricle volume in patients with AUD compared to HC. Moreover, we also found a positive correlation between the third ventricle volume and generalized anxiety in patients with AUD.

Discussion and conclusions: Our findings indicate significant enlargement of the third ventricle volume in patients with AUD, as well as relatedness between the volume of this area and generalized anxiety.

Scientific significance: This study is the first in the literature to find volume alterations correlated with clinical outcomes among AUD patients, reflecting a complex relationship between brain volumes and psychological symptoms in this population.

背景和目的：酒精使用障碍（AUD）是最致命的精神疾病之一。先前的研究表明，AUD与人脑中的几种神经生物标志物有关；然而，酒精使用如何在脑容量中表现出来，以及受AUD影响的皮质下脑区域与临床结果之间的关系尚不完全清楚。本研究试图比较AUD患者和健康对照（HC）的皮质下脑容量差异，以了解饮酒与脑容量变化的关系。方法：招募根据DSM-IV中酒精依赖和滥用标准确定的AUD患者（n = 71），并根据人口学特征将其与HC （n = 71）匹配。我们检查了40个双侧皮质下结构在AUD和HC患者之间的体积差异。我们评估了皮质下脑容量的变化与共同发生的精神症状之间的关系。结果：我们的研究结果显示，与HC相比，AUD患者的第三脑室容积显著增加。此外，我们还发现AUD患者的第三脑室容积与广泛性焦虑呈正相关。讨论和结论：我们的研究结果表明AUD患者的第三脑室体积显著增大，以及该区域的体积与广泛性焦虑之间的关系。科学意义：本研究首次在文献中发现AUD患者脑容量改变与临床结局相关，反映了该人群脑容量与心理症状之间的复杂关系。

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引用次数: 0

Longitudinal pathway from low academic performance in adolescence to prescription drug misuse in adulthood: The mediating role of substance use and the moderating role of sex. 青少年学习成绩低下到成年期处方药滥用的纵向路径：物质使用的中介作用和性别的调节作用。

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2026-01-27 DOI: 10.1111/ajad.70134

Jung Yeon Lee, Wonkuk Kim

Background and objectives: Prescription drug misuse (PDM) has serious health and social consequences, highlighting the importance of identifying early risk factors. This study examines longitudinal pathways linking low academic performance in adolescence, substance use in emerging adulthood, and PDM in young adulthood, with attention to sex differences.

Methods: Participants were 5114 individuals (54% female) from Waves 1, 3, and 4 of the National Longitudinal Study of Adolescent to Adult Health. A two-group structural equation model stratified by sex was performed to examine the pathways to PDM. Moderated mediation was also tested between males and females.

Results: Low academic performance in adolescence was associated with substance use in emerging adulthood for both males (p < .001) and females (p < .001), which in turn was associated with PDM in young adulthood (males: p < .001; females: p < .001). Only among females, low academic performance in adolescence was negatively associated with PDM in young adulthood (p < .001). The moderation effects of sex on the pathways from substance use to PDM (p < .05) and from low academic performance to PDM (p < .05) were significant at one-tailed test.

Discussion and conclusions: Adolescents with poor academic performance represent a high-risk group for later PDM, emphasizing the need for early preventions. Prevention strategies should consider sex-specific pathways, particularly targeting substance use in emerging adulthood.

Scientific significance: Identifying early academic and behavioral risk factors provides valuable insight for clinicians and prevention professionals aiming to reduce PDM across the life course.

背景和目的：处方药滥用（PDM）具有严重的健康和社会后果，突出了确定早期风险因素的重要性。本研究考察了青春期学习成绩差、成年初期药物使用和成年早期PDM之间的纵向联系，并关注了性别差异。方法：参与者为5114人（54%为女性），来自全国青少年到成人健康纵向研究的第1、3和4波。采用按性别分层的两组结构方程模型来检验PDM的通路。在男性和女性之间也测试了有调节的中介作用。结果：青少年时期学习成绩差与成年初期的药物使用有关(p讨论和结论：学习成绩差的青少年是后期PDM的高危人群，强调早期预防的必要性。预防策略应考虑性别特异性途径，特别是针对成年初期的药物使用。科学意义：识别早期学术和行为风险因素为临床医生和预防专业人员提供了有价值的见解，旨在减少PDM的整个生命过程。

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引用次数: 0

Identifying clinical correlates of drinking clusters during treatment for alcohol use disorder. 在酒精使用障碍治疗过程中确定饮酒集群的临床相关性。

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2026-01-27 DOI: 10.1111/ajad.70132

Robert J Kohler, Hang Zhou, Yasmin Zakiniaeiz, Terril L Verplaetse, Vernon Garcia-Rivas, MacKenzie R Peltier, Bubu A Banini, Sherry A McKee, Walter Roberts

Background and objectives: Despite the availability of treatments for alcohol use disorder (AUD), relapse prevalence and health-related consequences associated with AUD remains high. Using data-driven approaches that enhance generalizability can help elucidate relationships between treatment outcomes and alcohol consumption, aiding in the discovery of novel treatment targets for AUD subtypes.

Methods: We merged data (n = 2045) across four Phase 2 randomized clinical trials affiliated with the NIAAA Clinical Investigations Group and a Phase 3 trial (NIAAA Sponsored). Participants were clustered based on self-reported drinking during treatment maintenance. A gradient boosted machine learning model with end-of-treatment clinical features was used to predict the clusters we identified.

Results: We identified a three-cluster solution corresponding to low (M_{Standard Drinking Units (SDU)} = 1.68, n = 1677), moderate (M_SDU = 6.70, n = 253), and high (M_SDU = 12.92, n = 115) clusters of alcohol consumption during treatment maintenance. We achieved modest prediction of the clusters (Accuracy_Train= 71.0%; AUC_Train = 0.79) using demographics and end-of-treatment clinical and biological assessments. Between-cluster differences were observed between low and high clusters on measures of depression and anxiety (M_Difference= 0.49, SE = 0.13, p = .004), drinking consequences (M_Difference= 1.02, SE = 0.13, p < .001) and liver functioning (0.39 ≤ M_Difference ≤ 0.52, 0.12 ≤ SE ≤ 0.13, 0.001 ≤ p ≤ .005) DISCUSSION AND CONCLUSIONS: These findings suggest that generalizable clusters of alcohol consumption exist across these clinical trials characterized by core demographics, clinical, and biological phenotypes, irrespective of the treatment received. We further show that some assessments may not be useful in distinguishing between higher levels of consumption.

Scientific significance: Identifying predictive features of AUD subtypes, across different phases of treatment, can assist clinicians in identifying individuals who require additional support.

背景和目的：尽管有酒精使用障碍（AUD）的治疗方法，但与AUD相关的复发率和健康相关后果仍然很高。使用数据驱动的方法可以增强概括性，有助于阐明治疗结果与饮酒之间的关系，有助于发现AUD亚型的新治疗靶点。方法：我们合并了NIAAA临床研究组下属的4项2期随机临床试验和一项3期试验（NIAAA赞助）的数据（n = 2045）。参与者根据自我报告的治疗维持期间的饮酒情况进行分组。使用具有治疗结束临床特征的梯度增强机器学习模型来预测我们确定的聚类。结果：我们确定了一个三聚类溶液，对应于治疗维持期间酒精消耗的低聚类（MStandard Drinking Units， SDU） = 1.68, n = 1677)、中等（MSDU = 6.70, n = 253）和高聚类（MSDU = 12.92, n = 115）。我们使用人口统计学和治疗结束时的临床和生物学评估实现了适度的群集预测（AccuracyTrain = 71.0%; AUCTrain = 0.79）。低聚类和高聚类在抑郁和焦虑的测量上存在聚类间差异(MDifference = 0.49, SE = 0.13, p =。004),喝酒的后果(MDifference = 1.02, = 0.13, p差≤0.52,0.12≤SE≤0.13,p≤≤0.001。讨论和结论：这些研究结果表明，无论接受何种治疗，在这些临床试验中都存在以核心人口统计学、临床和生物学表型为特征的可概括的酒精消费集群。我们进一步表明，一些评估可能对区分较高的消费水平没有用处。科学意义：在不同的治疗阶段，识别AUD亚型的预测特征，可以帮助临床医生识别需要额外支持的个体。

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引用次数: 0

Nicotine use and patient-directed discharge rate in psychiatric inpatients: A retrospective cohort. 精神科住院病人尼古丁使用与病人自行出院率：一项回顾性队列研究。

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2026-01-19 DOI: 10.1111/ajad.70107

Steven Sprenger, Robyn Meadows, Olivia Gawrych

Background and objectives: Disproportionate use of tobacco among psychiatric patients exacerbates psychiatric symptoms, increases suicide risk, alters therapeutic drug levels, and negatively affects adherence. Patient-directed discharge (PDD) rates are higher among patients who smoke, and smoking cessation treatments have been reported to reduce this risk. This study investigates the association of tobacco use and cessation treatments with PDD rates.

Methods: A retrospective analysis was performed on a random sample of 25,829 adult patients admitted voluntarily to inpatient psychiatric facilities nationwide. Exclusion criteria included medical discharge, electroconvulsive therapy, hospital stays longer than 29 days, and incomplete demographic or smoking status data. Binary logistic regression with a Firth correction assessed the associations between PDD rates and smoking status, smoking cessation treatments, demographic variables, comorbidities, and smoking use patterns.

Results: Smoking was significantly associated with an increased likelihood of PDD (χ² = 49.42, p < .0001, OR = 2.16). Nicotine replacement therapy (NRT) alone significantly reduced PDD rates (χ² = 8.16, p < .01, OR = 1.42), whereas bupropion and varenicline did not show significant effects. Smoking-related PDD rates remained elevated despite treatment compared to non-smokers (χ² = 22.02, p < .0001, OR = 1.86).

Discussion and conclusions: A significant association was found between smoking status and PDD rate. NRT alone was associated with lower PDD rates.

Scientific significance: This study is the first to investigate the association of individual smoking cessation treatments with PDD rates. Contrary to previous findings, the risk remained elevated despite treatment in our large national sample.

背景和目的：精神病患者过度使用烟草会加剧精神病症状，增加自杀风险，改变治疗药物水平，并对依从性产生负面影响。吸烟患者的病人自行出院率（PDD）较高，据报道，戒烟治疗可降低这一风险。本研究调查了烟草使用和戒烟治疗与PDD发病率的关系。方法：对全国自愿住院的25,829例成人精神病患者进行回顾性分析。排除标准包括医疗出院、电休克治疗、住院时间超过29天、不完整的人口统计或吸烟状况数据。采用Firth校正的二元逻辑回归评估了PDD发病率与吸烟状况、戒烟治疗、人口统计学变量、合并症和吸烟使用模式之间的关系。结果：吸烟与患PDD的可能性增加显著相关（χ²= 49.42,p）。讨论和结论：吸烟状况与PDD发生率显著相关。单纯NRT与较低的PDD发生率相关。科学意义：这项研究首次调查了个体戒烟治疗与PDD发病率之间的关系。与之前的研究结果相反，尽管在我们庞大的全国样本中进行了治疗，但风险仍然升高。

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FREE WEBINAR: Acceptance and Commitment Therapy for Addictive Behavior, January 12, 2026 免费网络研讨会：成瘾行为的接受和承诺治疗，2026年1月12日

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2025-12-29 DOI: 10.1111/ajad.70113

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NEW SELF ASSESSMENT EXAM: Get ready for the boards with this re-vamped self-assessment exam 新的自我评估考试：准备好参加这个重新设计的自我评估考试

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2025-12-29 DOI: 10.1111/ajad.70111

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Call for Review Papers 2026 2026年征稿

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2025-12-29 DOI: 10.1111/ajad.70110

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PCSS-MOUD AND ORN: Find out more about AAAP's national grant initiatives pss - mode和ORN：了解更多AAAP的国家资助计划

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2025-12-29 DOI: 10.1111/ajad.70114

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Call for Special Issue Papers 2026 征集2026年特刊论文

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2025-12-29 DOI: 10.1111/ajad.70109

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AAAP MEMBERSHIP: Reap the benefits of belonging to AAAP AAAP会员资格：获得属于AAAP的好处

IF 1.9 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions

Pub Date : 2025-12-29 DOI: 10.1111/ajad.70116

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American Journal on Addictions

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