Adicción al uso del teléfono móvil inteligente en estudiantes de enfermería / Addiction to the use of smartphones among nursing students / Dependência do uso de smartphones em alunos de enfermagem

Resumen Marco contextual: Los teléfonos móviles inteligentes permiten acceder a información de manera inmediata. La adicción al uso de estos dispositivos es cada vez mayor, los teléfonos móviles inteligentes se han convertido en un elemento importante para los estudiantes de enfermería. Objetivo: Identificar la adicción al uso del teléfono móvil inteligente en estudiantes de enfermería. Metodología: Estudio descriptivo correlacional, el muestreo fue aleatorio, la muestra se calculó considerando un nivel de confianza de 0,05, una potencia de 90%, un tamaño de efecto mediano de 0,09, la muestra se conformó por 149 estudiantes de enfermería. Resultados: El componente de uso, abuso y adicción al teléfono móvil inteligente se relacionó negativamente con el componente rasgo de personalidad (r s = -0,228; p = 0,005), el uso, abuso y adicción al teléfono móvil inteligente se relacionó positivamente con el gasto monetario (r s = 0,376; p = 0,001). Conclusión: Se identificó que existe un alto uso de los teléfonos móviles inteligentes, comprender el alcance de dicho fenómeno puede ayudar a plantear estrategias eficaces para prevenir la adicción al teléfono móvil inteligente.

Abstract Background: Smartphones provide immediate access to information, and nursing students consider them essential tools. However, the addiction to these devices is increasing. Objective: To identify smartphone addiction among nursing students. Methodology: A descriptive correlational study was conducted using the stratified random sampling method. The sample size was calculated based on a confidence level of 0.05, with 90% power, and a median effect size of 0.09. The study included 149 nursing students. Results: The component "Smartphone use, abuse, and addiction" correlated negatively with the component "Personality traits" (r s = -0.228; p = 0.005); the component "Smartphone use, abuse, and addiction" correlated positively with the component "Financial spending" (r s = 0.376; p = 0.001). Conclusion: Smartphone use is high. Understanding the extent of this phenomenon can aid in developing effective strategies to prevent smartphone addiction.

Resumo Enquadramento: Os telemóveis inteligentes estão permitem acesso imediato à informação. O vício no uso desses dispositivos é cada vez maior, os celulares inteligentes tornaram-se um elemento importante para os estudantes de enfermagem. Objetivo: Identificar a dependência do uso do smartphone em estudantes de enfermagem. Metodologia: Estudo correlacional descritivo, a amostragem foi aleatória, a amostra foi calculada considerando nível de confiança de 0,05, poder de 90%, tamanho de efeito médio de 0,09, a amostra foi composta por 149 estudantes de enfermagem. Resultados: O componente de uso, abuso e dependência de smartphone foi negativamente relacionado ao componente de traço de personalidade (r s = -0,228; p = 0,005), o uso, abuso e dependência de smartphone foi relacionado positivamente com gastos monetários (r s = 0,376; p = 0,001). Conclusão: Identificou-se que existe um alto uso de telefones móveis inteligentes, compreender a abrangência desse fenômeno pode ajudar a propor estratégias eficazes para prevenir o vício em celulares.

Anxiety, inhibitory control, physical activity, and internet addiction in Chinese adolescents: a moderated mediation model.

BACKGROUND: Adolescents may have anxiety due to a series of events such as school work and social interaction. Improper handling of anxiety often leads to some negative consequences, such as Internet addiction. Therefore, this study further explored the relationship between anxiety and Internet addiction, as well as the mediating role of inhibitory control between the two, and also considered the moderating role of physical activity between anxiety and inhibitory control. METHODS: A total of 1607 adolescents, comprising 664 boys and 943 girls with an average age of 15.86 years (SD = 0.73), from Shandong, Shanxi, Hebei, and Hunan provinces completed a self-report survey on physical activity, anxiety, inhibitory control, and Internet addiction. Descriptive analysis, correlation analysis, and mediation test were conducted. RESULTS: The results revealed a significant positive correlation between anxiety and adolescent internet addiction (r = 0.413, p < 0.001), and a significant negative correlation with inhibitory control (r = -0.423, p < 0.001). Inhibitory control was found to be significantly positively correlated with physical exercise (r = 0.143, p < 0.001) and significantly negatively correlated with internet addiction (r = -0.368, p < 0.001). After controlling for demographic variables, anxiety significantly positively predicted Internet addiction (ß = 0.311, p < 0.001) in adolescents, and it also indirectly predicted Internet addiction through inhibitory control (ß = -0.231, p < 0.001). Physical activity significantly weakened the predictive effect of anxiety on inhibitory control (ß = -0.092, p < 0.001). CONCLUSIONS: This study further explored the issue of psychological mechanisms between anxiety and Internet addiction in adolescents, and added that physical activity alleviates the negative effects of anxiety on adolescents. Schools and families are encouraged to promote physical exercise among adolescents to alleviate the influence of negative emotions on their psychological and behavioral health.

Acceptability of "DIDE", a mobile application designed at facilitating care adherence of patients with substance use disorder.

BACKGROUND: Attrition continues to be a major hurdle for addiction treatment. Through the prism of the attachment theory, this phenomenon can be understood as a manifestation of the patient's insecure attachment style, needing a highly-responsive care delivery. We developed an electronic health mobile application, co-designed with patients, aimed at helping healthcare teams respond to their patients' needs, and fostering adherence to care. This acceptability study evaluated patients everyday use of the application for eight weeks, assessing their satisfaction with the system, and its integration within professionals' current practice in our center. METHODS: This single-center, prospective study was conducted between January 2022 and December 2022. 24 adult patients with any type of addiction were included. They were granted access to the application for eight weeks, and were invited to complete the System Usability Scale questionnaire regarding their satisfaction with application's usability at the end of the study. The application uses active self-reports, which are later discussed with the healthcare team, and foster both the working alliance and the decision-making process. RESULTS: 17 patients out of 24 reached the primary endpoint. On average, over the eight-weeks period, patients logged in the application 38.2 times, and sent 5.9 messages to the healthcare team. Interestingly, 64.3% of the user logins were recorded outside of our center's working hours (either from 5 p.m. to 9 a.m., or during week-ends and bank holidays), and 70.8% of the patients logged into the application at least one time between 10 p.m. and 8 a.m. 18 patients completed the System Usability Scale questionnaire, which averaged a score of 81.8 out of 100. Healthcare professionals logged in the application's messaging system 4.5 times a day on average. CONCLUSIONS: This preliminary study shows promising results, as patients engaged well with various components of the application. It was moreover possible for healthcare workers in our center to integrate this tool in their daily activities. More work is needed to better understand the various patients' needs regarding the application, further strengthen their adherence to the intervention, and understand professionals' motivations to use the application. TRIAL REGISTRATION: ClinicalTrials.gov, Identifier: NCT04659954. Registered 09 December 2020, https://clinicaltrials.gov/study/NCT04659954 .

A Complex Relationship Among the Circadian Rhythm, Reward Circuit and Substance Use Disorder (SUD).

The human brain not only controls the various physiological functions but is also the prime regulator of circadian rhythms, rewards, and behaviors. Environmental factors, professional stress, and social disintegration are regarded as the initial causative factors of addiction behavior. Shift work, artificial light exposure at night, and chronic and acute jet lag influence circadian rhythm dysfunction. The result is impaired neurotransmitter release, dysfunction of neural circuits, endocrine disturbance, and metabolic disorder, leading to advancement in substance use disorder. There is a bidirectional relationship between chronodisruption and addiction behavior. Circadian rhythm dysfunction, neuroadaptation in the reward circuits, and alteration in clock gene expression in the mesolimbic areas influence substance use disorder (SUD), and chronotherapy has potential benefits in the treatment strategies. This review explores the relationship among the circadian rhythm dysfunction, reward circuit, and SUD. The impact of chronotherapy on SUD has also been discussed.

Infectious Diseases Fellowship Training in Caring for People Who Use Drugs: A National Assessment of an Emerging Training Need.

Background: Infectious complications of substance use are increasingly encountered in infectious diseases (ID) clinical care. In this study, we surveyed ID fellows in the United States to assess training experiences, clinical practices, and perspectives in caring for people who use drugs (PWUD). Methods: An 18-item survey was distributed to ID fellows via email and social media platforms. Four focus groups were conducted with a subset of participants to elucidate themes in fellowship experiences and training needs. Results: Among 196 survey respondents (estimated 24% response rate), all reported caring for PWUD in ID fellowship. Forty-nine percent received some formal fellowship-based didactics around care of PWUD, and 64% worked with faculty seen as advocates for PWUD. Integrated care practices for PWUD were infrequently employed: 50% offered risk reduction counseling, and 33% discussed medications for opioid use disorders, naloxone, or HIV preexposure prophylaxis. Risk reduction counseling was felt to be "extremely" within scope of ID practice (69%), although comfort level with this skill was low; fellows' likelihood of offering counseling was significantly associated with their comfort (P ≤ .0001). Common themes in caring for PWUD included an expanded role for ID consultants, a lack of formalized training, and benefits of developing dedicated opportunities in this field. Conclusions: ID fellows frequently care for PWUD but may have gaps in knowledge or comfort that affect care practices. Increased fellowship training in the care of PWUD has potential to improve clinical practices and support growing interest in this field among current and prospective ID fellows.

Personality traits in patients with multiple sclerosis: their association with nicotine dependence and polypharmacy.

Background: The modifiable risk factor exerting the most substantial influence on the development and disease course of multiple sclerosis (MS) is cigarette smoking. Furthermore, smoking is associated with a higher risk of suffering from one or more comorbidities and potentially contributes to polypharmacy. We aimed to use personality tests to explore health-promoting and harmful patient characteristics. Objective: To investigate two important factors influencing the course of MS - the degree of smoking dependence and the status of polypharmacy - in association with personality traits. Design: This is a bicentric, cross-sectional study. Methods: We collected sociodemographic, clinical and medical data from patients with MS (n = 375) at two German neurological clinics. The participants were asked to complete the NEO Five-Factor Inventory (NEO-FFI) and the Temperament and Character Inventory-Revised (TCI-R). Relationships between variables were examined using correlation analyses, and differences between groups were examined using linear models. Current smokers with MS were also asked to complete the Fagerström questionnaire to categorize them into patients with mild, moderate and severe smoking dependence. Results: In our sample, 67.5% were women, and the mean age was 48.1 years. The patients had a median Expanded Disability Status Scale of 3.0 at a median disease duration of 10 years. Patients with MS with severe smoking dependence had on average a significantly higher neuroticism score in the NEO-FFI compared to those with mild or moderate smoking dependence. Patients with MS and polypharmacy had significantly higher neuroticism scores than those without. In the extraversion scale of the NEO-FFI, patients with MS and polypharmacy had significantly lower scores on average. Significant differences were also found when analysing the TCI-R in patients with MS and heavy smoking dependence, with higher scores for harm avoidance (HA) and lower scores for reward dependence, self-directedness (S-D) and cooperativeness (CO) in various subscales. Polypharmacy in patients with MS was associated with higher scores for HA and self-transcendence. Furthermore, patients with polypharmacy showed lower values than patients without polypharmacy in individual subscales of the dimensions of persistence, S-D and CO. Conclusion: Using the NEO-FFI, we were able to show that neuroticism is a detrimental trait and extraversion a protective trait in patients with MS in relation to nicotine dependence and polypharmacy. In addition, the evaluation of the TCI-R showed that high HA as well as low S-D and CO scores were more common in patients with MS and nicotine dependence or polypharmacy. With this knowledge, the risk of polypharmacy and smoking can be understood in the context of personality characteristics and targeted treatment and counselling can be provided.

Exploring internet addiction during Covid-19 pandemic: a comparative study considering psychological, social, familial and individual aspects in University students.

Background: Internet addiction causes a variety of social, interpersonal, psychological, and physical issues. We are confronting a worldwide crisis about internet addiction and its effects. Objectives: Utilizing five questionnaires to survey university students during the COVID-19 epidemic, the current study sought to evaluate internet addiction and associated risk variables. Methods: At the University of Medical Sciences in North Iran, a cross-sectional analytical investigation was carried out. The sample was done among 318 students, selected through the random cluster sampling method. Data collection was done during August and September 2021. Results: Based on our findings, the prevalence of internet addiction was 28.9% (92/318). Our results revealed that women are at twice the twice the risk of internet addiction as men (p = 0.028). Students in the medicinal field (p = 0.043; students with a positive history of mental illness in the family) p = 0.001 (and students with a fear of COVID-19) p = 0.002 (recognized in the risk of Internet addiction, thus depression) p < 0.001 (anxiety) p < 0.001 (somatization) p = 0.001 (and psychological distress) p < 0.001 are risk factors for internet addiction. Age, marital status, place of living, total social support, and use of Alcohol/cigarettes are not risk factors for internet addiction. Conclusions: The findings suggest that university students with a fear of COVID-19, depression, anxiety, somatization, psychological distress and a positive history of mental illness in the family, particularly medicinal field students, are at significant risk for Internet addiction.

Implementation of an EMS-based naloxone distribution program: A qualitative evaluation.

Objectives: We evaluated a novel leave-behind naloxone (LBN) program that allows Emergency Medical Services (EMS) personnel to distribute naloxone after an opioid overdose. Our objective was to explore EMS engagement and experiences with the program, as well as interest in education on addiction and harm reduction. We also assessed the acceptability of LBN programs among people who use drugs (PWUD). Methods: We conducted telephone interviews with EMS personnel and residents of substance use recovery housing between February and September 2023. EMS personnel described their direct experiences with the LBN program and perceived facilitating factors and barriers to naloxone distribution. First responder interactions and support for LBN were explored with PWUD. A rapid assessment method was used to analyze the interview data. Results: Eighteen of the 23 EMS participants had distributed LBN; most agreed EMS agencies should have an LBN program. Barriers included forgetting, patient acuity, patients declining, and perceived liability. Facilitators included having a clear protocol, accessible kits, and minimal documentation burden. The majority expressed interest in harm reduction education. Eight of the 11 PWUD participants reported recent involvement in an opioid overdose. The majority supported LBN and felt comfortable receiving naloxone training from EMS. Conclusion: In this qualitative evaluation, we found broad support for EMS-based naloxone distribution among EMS personnel and PWUD. We identified several modifiable barriers to the success of such programs, which should be the subject of future investigation. EMS and harm reduction communities should support the expansion of LBN programs across the United States.

The consequences of childhood maltreatment on dual-diagnosis psychiatric conditions and clinical outcomes in substance use disorders: A systematic review and meta-analysis.

BACKGROUND: Evidence suggests that the phenotypic expression of substance use disorders (SUD) may be influenced by exposure to childhood maltreatment (CM). OBJECTIVE: To assess how CM could impact severity (relapse, treatment dropout, withdrawal), age of substance use onset, psychiatric dual diagnosis (depression, anxiety, PTSD, distress), and self-harm behavior/suicide attempts in adults with SUD, we performed a systematic review and meta-analyses. METHODS: We searched PubMed, Web of Science, PsycINFO, and Embase to identify articles examining the association of maltreatment (physical, sexual, or emotional abuse or neglect) before age 18 years with clinical features and course of illness SUD. Multilevel random effects models were performed. Heterogeneity was quantified using the I2 statistic. Subgroup/meta-regression analyses were employed to investigate sources of heterogeneity. Risk of bias was assessed using an adapted version of the Newcastle-Ottawa Quality Assessment Scale. RESULTS: Forty-five studies were included. CM was associated with all tested outcomes, such as anxiety (OR = 1.52; 95 % CI = 1.39, 1.65), depression (OR = 1.57; 95 % CI = 1.40, 1.77), PTSD (OR = 1.67; 95 % CI = 1.40, 1.99), psychological distress (OR = 1.49; 95 % CI = 1.24, 1.78), self-harm behavior and suicidal attempts (OR = 1.70; 95 % CI = 1.47, 1.96), SUD severity (OR = 1.15; 95 % CI = 1.04, 1.26), and younger age of onset use (OR = 0.76; 95 % CI = 0.69, 0.84). However, comparisons between outcomes revealed that the association was stronger for dual diagnosis symptoms/conditions than for measures of SUD severity itself. Meta-analyses for some outcomes had large statistical heterogeneity, though these were partly addressed through additional analyses. Gender, mean age of participants, polysubstance use pattern, substance of preference, and CM subtype were found to be moderators of these associations. CONCLUSIONS: The consequences of CM on individuals with SUD are more closely linked to co-occurring psychiatric manifestations than to the severity of common clinical indicators (relapse, treatment dropout, withdrawal), and this finding has important implications. FUNDING: None. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (CRD42021245936).

The prognostic role of food addiction for weight loss treatment outcomes in individuals with overweight and obesity: A systematic review and meta-analysis.

Food addiction (FA) could be a potential prognostic factor of weight loss intervention outcomes. This systematic review with meta-analysis aimed to (1) estimate this prognostic effect of FA diagnosis and symptom count in individuals with overweight or obesity and (2) explore potential sources of heterogeneity based on properties of the weight loss intervention, study, and sample (e.g., age, gender, ethnicity). We searched PubMed, PsycINFO, and Web of Science for studies reporting on associations between pre-intervention FA (assessed with the Yale Food Addiction Scale) and weight outcomes after weight loss intervention in individuals with overweight or obesity without a medically diagnosed eating disorder. Twenty-five studies met inclusion criteria, including 4904 individuals (71% women, Mage = 41 years, BMI = 40.82 kg/m2), k = 18 correlations of weight loss with FA symptom count, and k = 21 mean differences between FA diagnosis groups. Pooled estimates of random-effects meta-analyses found limited support for a detrimental effect of FA symptom count and diagnosis on weight loss intervention outcomes. Negative associations with FA increased for behavioral weight loss interventions and among more ethnically diverse samples. More research on the interaction of FA with pre-existing mental health problems and environmental factors is needed.

Unexpected improvement in nicotine consumption after low-frequency repetitive magnetic stimulation.

BACKGROUND: We report a case on the efficiency of low-frequency repetitive transcranial magnetic stimulation (rTMS) on cigarette consumption cessation.The patient was 29 years old, He received intensive psychiatric treatments along with ten years of history of depressive and obsessive-compulsive disorders.The first four years of treatment were marked by good outcomes. However, the last 6 years were marked by persisting depressive symptoms associating with psychotic features and sexual obsessions. METHODS: The patient received 20 sessions of rTMS over two weeks, 10 times per week at 1 Hz frequency, each session lasted 20 min with 200 pulses and 100% of motor threshold. In the meanwhile, the patient continued his full drug-based treatment according to the reported prescription. RESULTS AND CONCLUSION: After 20 sessions, the patient reported a decreased severity of his depressive symptoms with a BDI (Beck Depression Inventory) score of 6 but without significant improvement of OCD with a YBOCS score of 32. However, the patient reported great improvement in his tobacco craving and a diminishing number of consumed cigarettes in the second week of the rTMS protocol of treatment. This ended with tobacco cessation within a month. However, this occurred without any medication or psychological support for treating tobacco dependence.

The patient 29 years old has received intensive psychiatric treatments along with ten years of history of depressive and obsessive-compulsive disorders.The last 6 years were marked by persisting depressive symptoms associated with psychotic features and alternatives or adjuncts to conventional anxiolytics.The patient received rTMS in meanwhile, the patient continued his full drug-based treatment according to the reported prescription.An improvement in tobacco craving that ended with tobacco cessation within a month without significant improvement in OCDHowever, this occurred without any medication or psychological support for treating tobacco dependence.

Prevalence of alcohol use among U.S. older adults with pain: A scoping review.

The majority of older adults in the United States (U.S.) have been bothered by pain in the past month and over one-third report pain that has persisted or recurred for >3 months (i.e., chronic pain). Accumulating evidence indicates that behavioral factors, such as alcohol use, can influence the impact of pain on health and functioning in older adults. However, most studies exploring the prevalence of alcohol use among individuals with pain have not focused on older adults, specifically. Therefore, the goal of this scoping review was to examine what is known about the prevalence of alcohol use in older adults with pain. Relevant articles published prior to April 2024 were identified through a comprehensive search strategy, developed in collaboration with content experts and a medical librarian. A total of 13 studies met inclusion criteria for this paper. Results indicated that 53-64 % of older adults with pain reported alcohol consumption, 11-28 % engaged in hazardous patterns of alcohol use, and 1-10 % had a documented alcohol use diagnosis. Moreover, there is evidence that pain severity is positively associated with likelihood of alcohol consumption among older adults. These findings are worrisome given evidence that alcohol use has been shown to lead to poorer pain outcomes, and that older adults may be at risk for experiencing detrimental alcohol-related effects at comparatively low doses, given unique challenges faced by this population (e.g., high rates of multimorbidity/polypharmacy). Collectively, findings underscore the need for enhanced assessment and treatment of alcohol use in older adults with pain.

Exploring the Experiences, Perceptions and Social Dynamics of Electronic Cigarette Users: A Qualitative Study.

INTRODUCTION: Electronic cigarettes, or e-cigarettes, are rapidly gaining popularity throughout the globe as safer alternatives to traditional cigarette smoking. There are significant public health concerns due to the uncertainty of long-term health consequences. This study aims to examine the experiences, attitudes and social dynamics of e-cigarette users to provide guidance for public health policies and interventions. METHODS: In this qualitative descriptive study, semi-structured interviews were conducted. Fifteen e-cigarette users were recruited using a snowball sampling strategy, where initial participants referred other suitable users. All participants had at least 6 months of regular e-cigarette use. Data were collected through face-to-face interviews with open-ended questions. The interviews were transcribed verbatim and reviewed by the researchers. This review identified four main themes and eight sub-themes. RESULTS: The four main themes identified as a result of the analysis are as follows: (1) initiation and usage experiences; (2) perceptions of health effects; (3) social and environmental factors and (4) addiction and future plans. Participants primarily began using e-cigarettes out of curiosity, due to the appealing fragrance and the belief that they were less harmful than traditional cigarettes. Usage patterns varied among participants, with some reporting minimal cravings in the early morning hours. Opinions on the long-term health effects of e-cigarettes were diverse, with many participants acknowledging uncertainty. Peers and family members perceived e-cigarettes as more socially acceptable than traditional smoking, resulting in fewer negative reactions. Finally, participants' levels of addiction and intentions to quit varied, with some expressing a desire to reduce or cease usage due to health concerns. CONCLUSION: The findings of this study indicate that the adoption of e-cigarettes is influenced by a confluence of factors, including curiosity, the perception of reduced damage in comparison to conventional cigarettes and social acceptance. Notwithstanding these claimed advantages, users have a diverse array of beliefs and understandings concerning the enduring health consequences of e-cigarettes. The presence of varying levels of addiction and the corresponding aspirations to cease the behaviour highlight the necessity for focused public health interventions. PATIENT OR PUBLIC CONTRIBUTION: E-cigarette users were actively involved in this study, providing essential insights and feedback throughout. Their first-hand experiences shaped the interview guide and contributed to the identification of key themes. Participants also reviewed and confirmed the accuracy of the interview transcripts, ensuring the reliability of the data.

Internet addiction, social phobia, substance abuse, and depression in the university setting: a cross-sectional study in the southern region of Morocco.

Aim: Internet addiction is a mental health issue that can have detrimental effects on an individual's life. This study aims to estimate the prevalence of Internet Addiction and identify the risk factors associated with this behavioral addiction. Methods: This cross-sectional study was conducted in 6 universities in southern Morocco, involving 1,690 students who completed a self-administered questionnaire. The questionnaire collected socio-demographic data, and information on substance use, and included validated tools to assess Internet addiction (Young's IADQ), depressive symptoms (Patient Health Questionnaire. PHQ-9), and social phobia (Mini Neuropsychiatric International Interview. M.I.N.I). Results: The findings of our study indicate that the prevalence of Internet addiction was 30.60% (95% CI), depressive symptoms were present in 44.10% of participants, and the prevalence of social Phobia was 30.20%. A significant correlation was identified between early initiation of tobacco and Internet addiction (p = 0.05). The multivariate regression model revealed a possible association between cocaine use and Internet Addiction (OR = 5.67, IC 95%: 0.45 to 10.80) (p = 0.03), as well as a significant association between social phobia and a higher internet addiction score (OR = 3.45, IC 95%: 1.70-5.02) (p < 0.001). However, depressive symptoms were not significantly associated with internet addiction (p = 0.38). Conclusion: These results highlight the urgent need to address internet addiction in the coming years. Implementing Multidisciplinary prevention strategies, early diagnosis, and follow-up measures are essential to mitigate the physical, psychosocial, and academic impacts of this addiction on students.

Temporal Dynamics of Neural Response to Drug Cues in abstinent Methamphetamine Users.

Introduction: Cue-induced craving is central to addictive disorders. Most cue-reactivity functional magnetic resonance imaging studies are analyzed statically and report averaged signals, disregarding the dynamic nature of craving and task fatigue. Accordingly, this study investigates temporal dynamics of the neural response to drug cues as a functional magnetic resonance imaging study among methamphetamine users. Methods: A total of 32 early abstinent methamphetamine users underwent functional magnetic resonance imaging while viewing visual methamphetamine cues. A craving > neutral contrast was obtained in regions of interest. To explore the changes over time, the pre-processed signal was divided into three intervals. Contrast estimates were calculated within each interval, and were compared using the analysis of variance followed by the post hoc t-tests. The results were compared with those from a static analysis across all blocks. Results: A priori expected activations in the prefrontal cortex, insula, and striatum not detected by static analysis were discovered by the dynamic analysis. Post hoc tests revealed distinct temporal activation patterns in several regions. Most patterns showed rapid activation (including both ventral/dorsal striata and most regions in the prefrontal, insular, and cingulate cortices), whereas some had delayed activation (the right anterior insula, left middle frontal gyrus, and left dorsal anterior cingulate cortex). Conclusion: This study provided preliminary insights into the temporal dynamicity of cue-reactivity, and the potential of a conventional blocked-design task to consider it as a simple dynamic analysis. We highlight regional activations that were only uncovered by dynamic analysis and discuss the interesting and theoretically expected early versus late regional activation patterns. Rapidly activated regions are mostly those involved in the earlier stages of cue reactivity, while regions with later activation participate in cognitive functions relevant later, such as reappraisal, interoception, and executive control.

Safety and efficacy of CyTisine for smoking cessation in a hOSPital context (CITOSP): study protocol for a prospective observational study.

Tobacco addiction is the primary preventable factor contributing to global mortality, and nicotine is one of the substances with the greatest potential for addiction. With a strong affinity for the α4ß2 subtype receptor, cytisine (CYT) functions as a partial agonist of the acetylcholine nicotinic cholinergic receptor. It counteracts the effects of nicotine without causing any withdrawal symptoms. These features, combined with its limited mild adverse effects and minimal drug-drug interactions, make cytisine a cost-effective treatment for smoking cessation. The current protocol describes a prospective observational study on the safety and efficacy of CYT administered to inpatient smokers of the Integrated University Hospital of Verona (IUHVR), Veneto (Italy). This is a monocentric, observational, and prospective study on both sex smokers over the age of 18 years admitted to the IUHVR who meet the criteria for recruitment and have given their consent. Eligible participants will be assigned to the CYT intervention based on the West dosing schedule and will be followed up for 12 months from treatment initiation. Evaluation of safety, efficacy, and compliance will be assessed at 7 and 25 days, with follow-up at 3, 6, and 12 months from the start of the treatment (quit day). During each visit, any adverse events or adverse reactions reported by patients following the intake of CYT will be evaluated. This study will contribute, for the first time, to the knowledge about the use of CYT for smoking cessation in a hospital setting.

Reduced brain connectivity underlying value-based choices and outcomes in stimulant use disorder.

BACKGROUND: Patients with stimulant use disorder (SUD) show impairments when making value-based choices that are associated with disruptions in neural processing across brain networks. Making optimal choices requires learning from outcomes to update knowledge and further optimise ongoing behaviour. The optimal functioning of neural systems that underpin the ability to make favourable choices is an essential component for life functioning, and successful recovery in patients with SUD. Therefore, we sought to investigate the neural processes that underpin value-based choices in SUD patients. We hypothesise that patients with SUD have reduced functional connectivity while making financial choices during a probabilistic reinforcement learning task. METHODS: We investigated connectivity associated with loss and reward value-based choices and their outcomes in patients with SUD and healthy control participants during a pharmacological magnetic resonance imaging study. Participants received a single dose of a dopamine receptor agonist, pramipexole, and a dopamine receptor antagonist, amisulpride, in a randomised, double-blind, placebo-controlled, balanced, crossover design. Functional task-related connectivity was analysed taking a whole brain connectomics approach to identify networks that are differentially modulated by dopaminergic receptor functioning. RESULTS: SUD patients showed widespread reductions in connectivity during both reward and loss value-based choices and outcomes, which were negatively correlated with the duration of stimulant drug use. Disturbances to functional brain connectivity in SUD patients during task performance were not modulated acutely by either amisulpride or pramipexole. CONCLUSIONS: Reductions in brain connectivity, particularly when making value-based choices and processing outcomes, may underlie learning impairments in SUD patients. Given that acute dopaminergic modulation did not improve brain connectivity impairments in SUD patients, it is likely that alternative treatments are needed.

Understanding e-Cigarette Addictiveness: Triangulation of Focus Group and Netnographic Data.

BACKGROUND: Numerous studies have shown that e-cigarettes are addictive. For example, we previously showed that users of e-cigarette online forums discuss experiences of addiction in a netnographic analysis. However, it is unclear what makes e-cigarettes addictive apart from nicotine. In a focus group analysis, we recently identified 3 unique features of e-cigarettes that users linked to experiences of addiction: the pleasant taste, unobtrusiveness, and unlimited usability of e-cigarettes. OBJECTIVE: This study aimed to validate the previously identified features of e-cigarette addictive potential by triangulating data from the netnographic analysis and focus group discussions. METHODS: Drawing on a netnographic analysis of 3 popular, German-language e-cigarette forums, we studied whether experiences of addiction were linked to specific e-cigarette features. We included 451 threads in the analysis that had been coded for addictive experiences in a previous study by our team. First, we conducted a deductive analysis with preregistered codes to determine whether the features of pleasant taste, unobtrusiveness, and unlimited usability were mentioned in relation to the addictive potential of e-cigarettes in the online forums. Second, an inductive approach was chosen to identify further possible addictive features of e-cigarettes. RESULTS: Our deductive analysis confirmed that the features highlighted in our previous focus group study (pleasant taste, unobtrusiveness, and unlimited usability) were also frequently discussed in online forums in connection to addictive symptoms. In addition, our inductive analysis identified nicotine dosage as a significant feature linked to addiction. Users reported varying their nicotine doses for different reasons, leading to the identification of four distinct user types based on dosing patterns: (1) high doses for intermittent, (2) high doses for constant use, (3) low doses for constant use, and (4) switching between high and low doses depending on the situation. CONCLUSIONS: Our comprehensive analysis of online forum threads revealed that users' experiences of addiction are linked to 4 specific features unique to e-cigarettes: pleasant taste, unobtrusiveness, unlimited usability, and nicotine dosage. Recognizing these addictive features of e-cigarettes is crucial for designing cessation programs and informing public health policies to reduce the addictiveness of e-cigarettes.

Detection and Characterization of Online Substance Use Discussions Among Gamers: Qualitative Retrospective Analysis of Reddit r/StopGaming Data.

BACKGROUND: Video games have rapidly become mainstream in recent decades, with over half of the US population involved in some form of digital gaming. However, concerns regarding the potential harms of excessive, disordered gaming have also risen. Internet gaming disorder (IGD) has been proposed as a tentative psychiatric disorder that requires further study by the American Psychological Association (APA) and is recognized as a behavioral addiction by the World Health Organization. Substance use among gamers has also become a concern, with caffeinated or energy drinks and prescription stimulants commonly used for performance enhancement. OBJECTIVE: This study aimed to identify substance use patterns and health-related concerns among gamers among a population of Reddit users. METHODS: We used the public streaming Reddit application programming interface to collect and analyze all posts from the popular subreddit, r/StopGaming. From this corpus of posts, we filtered the dataset for keywords associated with common substances that may be used to enhance gaming performance. We then applied an inductive coding approach to characterize substance use behaviors, gaming genres, and physical and mental health concerns. Potential disordered gaming behavior was also identified using the tentative IGD guidelines proposed by the APA. A chi-square test of independence was used to assess the association between gaming disorder and substance use characteristics, and multivariable logistic regression was used to analyze whether mental health discussion or the mention of any substance with sufficient sample size was significantly associated with IGD. RESULTS: In total, 10,551 posts were collected from Reddit from June 2017 to December 2022. After filtering the dataset for substance-related keywords, 1057 were included for further analysis, of which 286 mentioned both gaming and the use of ≥1 substances. Among the 286 posts that discussed both gaming and substance use, the most mentioned substances were alcohol (n=132), cannabis (n=104), and nicotine (n=48), while the most mentioned genres were role-playing games (n=120), shooters (n=90), and multiplayer online battle arenas (n=43). Self-reported behavior that aligned with the tentative guidelines for IGD was identified in 66.8% (191/286) posts. More than half, 62.9% (180/286) of the posts, discussed a health issue, with the majority (n=144) cited mental health concerns. Common mental health concerns discussed were depression and anxiety. There was a significant association between IGD and substance use (P<.001; chi-square test), and there were significantly increased odds of IGD among those who self-reported substance use (odds ratio 2.29, P<.001) and those who discussed mental health (odds ratio 1.64, P<.03). CONCLUSIONS: As gaming increasingly becomes highly prevalent among various age groups and demographics, a better understanding of the interplay and convergence among disordered gaming, substance use, and negative health impacts can inform the development of interventions to mitigate risks and promote healthier gaming habits.

Choice of alcohol over a natural reward: an experimental study in light and heavy social drinkers.

RATIONALE & OBJECTIVES: A core symptom of alcohol use disorder (AUD) is a progressively increased choice of alcohol over alternative rewards despite negative consequences. Here, we investigated choice between personalized alcohol vs. natural rewards in a laboratory setting, and compared this behavior between non-treatment-seeking heavy drinkers and light social drinkers. METHODS: 30 light social drinkers (15 men drinking < 15 drinks/week and 15 women drinking < 10 drinks/week) and 30 heavy, non-treatment-seeking drinkers (drinking more than these levels; 15 women). In the Concurrent Choice Alcohol Food (CCAF) task, participants chose between individually tailored images of alcohol and snack rewards and collected points towards the respective reward. To assess cost sensitivity, points associated to the images varied so that they favored alcohol or snack, or were equal, creating three relative point levels. RESULTS: Choice preference for alcohol was strongly correlated with Alcohol Use Disorder Identification Test (AUDIT) scores, supporting the external validity of the choice procedure. Compared to light drinkers, heavy drinkers showed increased choice preference for alcohol, as indicated by a between-group difference in points of subjective equality, a metric that quantifies the relative point level at which alcohol and snacks were equally likely to be chosen. In both groups, choice preference strongly depended on the relative point level of alcohol compared to snacks, suggesting that responding for alcohol in heavy drinkers was sensitive to costs. CONCLUSIONS: Our results replicate previous findings of a relationship between self-reported alcohol use and choice preference for alcohol. We also found that choice behavior was strongly dependent on relative cost of alcohol in both groups, although price sensitivity was lower in heavy compared to light drinkers. An increased choice preference for alcohol in heavy drinkers suggests that they attribute a higher relative reinforcing value to alcohol compared to natural rewards.