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BACKGROUND: Current scientific literature supports classical psychedelic efficacy in many psychiatric disorders. However, less attention has been given to the neurological effects of these substances. The aim of this medical thesis was to conduct a systematic review examining the neuroimaging correlates of the effects of psychedelics. METHOD: We performed an electronic research through Medline and Science Direct databases. A comprehensive search yielded 460 articles published up to May 2022. After a cautious screening process, we selected 49 scientific papers for further analysis. RESULTS: Major findings included reduced functional network integration, increased between-network functional connectivity, and expansion of functional connectivity patterns repertoire under psychedelics. Thalamic gating and emotional processing were also impaired. These results positively correlated with symptom improvement in pathological populations. CONCLUSION: To this day, our knowledge concerning psychedelic effects remains partial. Several neurocognitive theories have been developed in recent years to model psychedelic phenomenology, but no unifying theory has emerged. Studies involving larger populations investigating various psychiatric disorders, including several neuroimaging modalities and considering medium- and long-term effects, would be necessary to deepen current knowledge.
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Present in all social circles with proven effects on health, alcohol is the second leading cause of avoidable death after tobacco. Like men, women can be affected by alcohol misuse, or even addiction. As the female organism is more vulnerable to the deleterious effects of alcohol, women are particularly exposed in terms of risks and complications for their physical and mental health.
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Comportamento Aditivo , Masculino , Humanos , Feminino , Saúde Mental , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologiaRESUMO
Dysfunctional use of cybersex has often been conceptualized as a "behavioral addiction" sharing common traits with substance addiction. We describe the case of a treatment-seeking man, who displayed addictive use of pornography. The case is presented from two perspectives: (1) a symptom-based approach inspired by the addiction model of excessive sexual behaviors and (2) a process-based approach aimed to identify the psychological processes and risk factors that may foster the development of addiction-like symptoms. This article shows how case conceptualization according to a process-based approach is likely to result in psychological intervention that targets the specific processes and risk factors involved in addictive cybersex use.
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Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Comportamento Aditivo/psicologia , Literatura Erótica/psicologia , Adulto , Humanos , Internet , Masculino , Fatores de RiscoRESUMO
Sex addiction or dependency is a complex and debilitating pathology characterised by a disproportionate preoccupation with sex or sexual activity. The aim of scientific research carried out into this disorder is both nosographic, to establish which subtype of mental disorder it belongs to, and physiopathological, to explain its origin and develop potential therapies. A state of the science on sexual dependency is charted, in the world of psychiatry, based on its very first mention to the present day.
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Comportamento Aditivo , Transtornos Mentais , Comportamento Sexual/psicologia , Tabu , HumanosRESUMO
Psychiatric and addictologic complications of new synthetic products. New synthetic products (NSP) have completely changed the current scene of addictions. Also known as designer drugs, legal highs, herbal highs, bath salts, plant fertilizers, incense, research chemicals, they have made their emergence on the drug market in the late 1990s. Legal or herbal highs consist of uncontrolled psychoactive substances, obtained by chemical synthesis or derived from plants. Essentially produced in China and India, but also in Europe, their diffusion brings new communication technologies, fixes the offer and directs the users' demand on this specific market. They are mostly sold over the Internet and are generally a "legal" pseudo- alternative to controlled and regulated psychoactive products. They are consumed because of their effects mimicking those of an illicit substance such as cocaine, amphetamine, methamphetamine, cannabis, opioids for example. NSP induce numerous psychiatric, somatic, addictologic and social complications.
Complications psychiatriques et addictologiques des nouveaux produits de synthèse. Les nouveaux produits de synthèse ont complètement modifié la scène actuelle des addictions. Dénommés également designer drugs, legal highs ou euphorisants légaux, herbal highs ou euphorisants végétaux, sels de bain ou bath salts, engrais pour plantes, encens, produit chimique pour la recherche non consommable par l'homme ou research chemicals, les nouveaux produits de synthèse ont fait leur apparition sur le marché des drogues à la fin des années 1990. Les euphorisants légaux et végétaux correspondent à des substances psychoactives non contrôlées, obtenues par synthèse chimique ou dérivées de plantes. Essentiellement produits en Chine et en Inde, mais également en Europe, leur diffusion met en jeu les nouvelles technologies de communication, fixe l'offre et oriente la demande des usagers sur ce marché spécifique. Aujourd'hui, ces produits sont essentiellement vendus sur Internet et constituent généralement une pseudo-alternative « légale ¼ aux produits psychoactifs contrôlés et réglementés. Ils sont consommés en raison de leurs effets mimant ceux d'une substance illicite comme la cocaïne, les amphétamines, la méthamphétamine, le cannabis, les opioïdes par exemple. Ces nouveaux produits de synthèse sont source de nombreuses complications psychiatriques, somatiques, addictologiques et sociales.
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Drogas Desenhadas , Drogas Ilícitas , Internet , Transtornos Relacionados ao Uso de Substâncias , Anfetaminas , Europa (Continente) , PsicotrópicosRESUMO
New psychoactive substances (NPS) have completely modified the drug scene and the current landscape of addiction. Synthetic substances, such as substituted or synthetic cathinones, also known as « legal highs ¼, are often produced and used to mimic the effects of controlled drugs such as cocaine, methylenedioxymethamphetamine (MDMA, ecstasy), and methamphetamine. The overwhelming majority of synthetic cathinones are produced in China and South East Asian countries. The Internet has emerged as the new marketplace for NPS, playing a major role in providing information on acquisition, synthesis, extraction, identification, and substance use. All these compounds are intentionally mislabeled and sold on-line under slang terms such as bath salts, plant food, plant feeders and research chemicals. They are sometimes labeled « not for human use ¼ or « not tested for hazards or toxicity ¼. The rapid spread of NPS forces member countries of the European Union to adapt their response to the potential new dangers that may cause. To date, not only health actors but also the general public need to be clearly informed and aware of dangers resulting from NPS spread and use. Here, we review the major clinical effects of synthetic cathinones to highlight their impact on public health. A literature search was conducted from 2009 to 2014 based on PubMed, Google Scholar, Erowid, and governmental websites, using the following keywords alone or in combination: "new psychoactive substances", "synthetic cathinones", "substituted cathinones", "mephedrone", "methylone", "MDPV", "4-MEC", "addiction", and "substance use disorder".
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Alcaloides/síntese química , Alcaloides/farmacologia , Drogas Ilícitas/síntese química , Drogas Ilícitas/farmacologia , Psicotrópicos/farmacologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Alcaloides/efeitos adversos , Drogas Desenhadas/química , Usuários de Drogas , Humanos , Drogas Ilícitas/efeitos adversos , Psicotrópicos/efeitos adversos , Psicotrópicos/síntese químicaRESUMO
An acute substance induced psychotic disorder is a cause to raise with a state of agitation in an acute delusional clinical setting. Patients are most often seen in hospital emergency rooms. Rapid diagnosis must be made. An integrated therapeutic management should be considered. Both psychiatric and addiction problems must be taken into account.
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Transtornos Psicóticos/etiologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Doença Aguda , Humanos , Transtornos Psicóticos/psicologia , Transtornos Relacionados ao Uso de Substâncias/diagnósticoRESUMO
Adolescence is a period with a specific risk to develop addictive behaviours. During this key period, addictions can be at the root of very damaging consequences, both on the health and social sides, which is nowadays a public health issue. Paradoxically, teenagers are often not requesting for aid and access aid with difficulty. So, first aid operators play a central role in teenagers' care, since they can detect precociously at-risk teenagers and orientate them to specialized care if necessary.
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Comportamento do Adolescente/psicologia , Comportamento Aditivo/psicologia , Comportamento Aditivo/terapia , Adolescente , Humanos , Fatores de RiscoRESUMO
Adolescence is a period of physical and mental transition between childhood and adulthood, two supposedly quieter periods. Puberty and social pressures generate painful psychic conflicts even for a subject without particular problem. Behavioral disorders of adolescents are numerous and heterogeneous. It is oppositional defiant disorder, conduct disorder, hyperactive disorder with attention deficit which often begin during childhood to evolve negatively in adolescence. Eating disorders, addictive disorders, self-mutilation and scarification are also found. Therapeutic management should be multimodal and involve different actors in the health, education and social areas.
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Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/terapia , Consumo Excessivo de Bebidas Alcoólicas/complicações , Adolescente , Antidepressivos/uso terapêutico , Antipsicóticos/uso terapêutico , Consumo Excessivo de Bebidas Alcoólicas/psicologia , Terapia Familiar , HumanosRESUMO
Delirium tremens (DT) is a specific type of delirium occurring in patients who are in alcohol withdrawal states. It has a high mortality of about 8%. Hence, it is important for clinicians to be able to predict it. Treatment of DT is best achieved by the use of intravenous diazepam administered at frequent intervals while closely monitoring the patient during the procedure. Refractory DT is defined by a high requirement of intravenous diazepam with poor control of withdrawal symptoms. Once the acute phase medically controlled, the patient should be managed for his addiction to alcohol.
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Delirium por Abstinência Alcoólica , Anticonvulsivantes/uso terapêutico , Diazepam/uso terapêutico , Delirium por Abstinência Alcoólica/diagnóstico , Delirium por Abstinência Alcoólica/tratamento farmacológico , Delirium por Abstinência Alcoólica/epidemiologia , Anticonvulsivantes/administração & dosagem , Diazepam/administração & dosagem , Hidratação , Humanos , Injeções Intravenosas , Pacientes Internados , Prevalência , Fatores de Risco , Resultado do TratamentoRESUMO
Adolescence is a period of confrontation and initiation to psychoactives drugs. Teenager's substance disorder remains an important concern for families and public authorities. The seriousness of consequences due to cannabis use, both on the health and social points, depends on the age of first use, the duration of use and the user himself. Teenagers, who do not often request to be taken care, are a population who has difficulty to access to medical treatment, even if the offer of medical treatment has increased. It is necessary to develop an early detection among vulnerable populations like teenagers, to train first aid operators to early detection strategies, as well as to increase the knowledge of the care system to improve teenagers' orientation in the care system.
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Abuso de Maconha/diagnóstico , Abuso de Maconha/terapia , Adolescente , Algoritmos , Cannabis , Necessidades e Demandas de Serviços de Saúde , Humanos , Abuso de Maconha/complicações , Fumar Maconha/epidemiologia , Fumar Maconha/prevenção & controle , Detecção do Abuso de Substâncias/métodosRESUMO
Cannabis is the most widely used illicit substance, especially among young people. Cannabis use is extremely commonplace and frequently comorbid with psychiatric disorders that raise questions about the etiology. The use of cannabis is an aggravating factor of all psychiatric disorders. Psychiatric complications are related to the age of onset, duration of exposure and individual risk factors of the individual (mental and social health). The panic attack is the most common complication. The link with psychosis is narrow that leads to increased prevention for vulnerable populations. Cannabis is also an indicator of increased depressive vulnerability and an aggravating factor for bipolar disorder.
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Cannabis/efeitos adversos , Abuso de Maconha/complicações , Abuso de Maconha/psicologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/etiologia , Humanos , Abuso de Maconha/epidemiologia , Transtornos do Humor/epidemiologia , Transtornos do Humor/etiologia , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/etiologiaRESUMO
Cannabis can have negative effects in its users, and a range of acute and chronic health problems associated with cannabis use has been dentified. Acute cannabis consumption is rarely lethal but it is associated with an increased risk of motor vehicle accident because of longer reaction time or impaired motor coordination. Chronic effects of cannabis use include generally cardiovascular and respiratory consequences but there are also oral, gastrointestinal, cutaneous and mucous, metabolic, gynecologic and obstetrical, sexual consequences, and cancer But associated tobacco smoking or other potential confounders may explain part of those somatic consequences.
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Cannabis/efeitos adversos , Fumar Maconha/efeitos adversos , Acidentes de Trânsito/estatística & dados numéricos , Doença Crônica , Humanos , Fumar Maconha/epidemiologia , Síndrome de Abstinência a Substâncias/complicações , Síndrome de Abstinência a Substâncias/epidemiologiaRESUMO
BACKGROUND: Cyberchondria is characterized by repeated and compulsive online searches for health information, resulting in increased health anxiety and distress. It has been conceptualized as a multidimensional construct fueled by both anxiety and compulsivity-related factors and described as a "transdiagnostic compulsive behavioral syndrome," which is associated with health anxiety, problematic internet use, and obsessive-compulsive symptoms. Cyberchondria is not included in the International Classification of Diseases 11th Revision or the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and its defining features, etiological mechanisms, and assessment continue to be debated. OBJECTIVE: This study aims to investigate changes in the severity of cyberchondria during the COVID-19 pandemic and identify the predictors of cyberchondria at this time. METHODS: Data collection started on May 4, 2020, and ended on June 10, 2020, which corresponds to the first wave of the COVID-19 pandemic in Europe. At the time the study took place, French-speaking countries in Europe (France, Switzerland, Belgium, and Luxembourg) all implemented lockdown or semilockdown measures. The survey consisted of a questionnaire collecting demographic information (sex, age, education level, and country of residence) and information about socioeconomic circumstances during the first lockdown (eg, economic situation, housing, and employment status) and was followed by several instruments assessing various psychological and health-related constructs. Inclusion criteria for the study were being at least 18 years of age and having a good understanding of French. Self-report data were collected from 725 participants aged 18-77 (mean 33.29, SD 12.88) years, with females constituting the majority (416/725, 57.4%). RESULTS: The results showed that the COVID-19 pandemic affected various facets of cyberchondria: cyberchondria-related distress and compulsion increased (distress z=-3.651, P<.001; compulsion z=-5.697, P<.001), whereas the reassurance facet of cyberchondria decreased (z=-6.680, P<.001). In addition, COVID-19-related fears and health anxiety emerged as the strongest predictors of cyberchondria-related distress and interference with functioning during the pandemic. CONCLUSIONS: These findings provide evidence of the impact of the COVID-19 pandemic on cyberchondria and identify factors that should be considered in efforts to prevent and manage cyberchondria at times of public health crises. In addition, they are consistent with a theoretical model of cyberchondria during the COVID-19 pandemic proposed in 2020. These findings have implications for the conceptualization and future assessment of cyberchondria.
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Cannabis is the most widely used illicit drug in the world. It is consumed by age groups, the main ones being adolescents and young adults. Its consumption leads to somatic, psychiatric and social complications. Data in our context are scarce. The purpose of our work was to describe the epidemiological and clinical profile of patients with cannabis addiction at the Centre for Care, Support and Prevention of the Laquintinie Hospital in Douala. We conducted a retrospective cross-sectional study of patients followed from March 2021 to July 2022 for cannabis addiction at the Addiction Care, Support and Prevention Center of the Laquintinie Hospital in Douala. The diagnosis of use disorder was based on a dependency syndrome related to cannabis use (single event usage). Data entry and analysis were performed using SPSS version 7.1 software. Of the 45 cases of cannabis addiction, 44 (98%) were male patients with an average age of 21,97 years. The most affected age group was between 20 and 24 years (28/44 or 63%); 49% of consumers were students, 62% of mothers accompanying patient to the consultation. The age of cannabis use initiation was 16 years (31%), the most commonly used form of cannabis was herbal (100%) and 100% of patients used inhalation (smoking). The most common complication was amotivational syndrome (31%). Cannabis use initiation occurs at an early age. The most commonly used form of cannabis is herbal administered through inhalation (smoking). The most common complications are amotivational syndrome, cognitive disorders, sleep disorders and withdrawal syndrome.
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Comportamento Aditivo , Cannabis , Abuso de Maconha , Adolescente , Adulto Jovem , Humanos , Masculino , Adulto , Feminino , Camarões/epidemiologia , Estudos Transversais , Estudos Retrospectivos , Abuso de Maconha/complicações , Abuso de Maconha/epidemiologiaRESUMO
Background and aims: Social network use is widespread, and the study of Instagram seems to have captured more attention in recent years. However, scale development and validation in the field has fallen short of providing sound scales of Instagram motives and usage patterns that consider the uniqueness of Instagram-related behavior. This paper describes the development, psychometric and cross-cultural validation of two new measurement instruments: the "Instagram Motives Questionnaire" (IMQ) and the "Instagram Uses and Patterns Questionnaire" (IUPQ). Methods and results: A preliminary set of items was developed for each questionnaire based on a previous qualitative interview study on Instagram motives, uses, and consequences. In the first study, the questionnaires were distributed to a sample of 312 participants aged 18-35 years (M = 23.81; SD = 4.49), and an exploratory factor analysis was performed. A parsimonious and interpretable 6-factor solution that displayed adequate factor loadings and adequate Omega coefficients for both instruments were found. In a second study, the two instruments and other measures of known social network usage correlates and mental health consequences were administered online to 1,418 English-speaking participants aged 18-34 years (M = 21.35; SD = 3.89). Both scales showed good psychometric properties and the factor structure identified in study 1 was reproduced through confirmatory factor analysis. Omega reliability coefficients were adequate. Finally, when performing multi-group CFA along with a French (n = 1,826) and a Spanish (n = 3,040) sample, language and gender invariance were supported. Correlations with other relevant measures indicate good convergent validity of both scales. Conclusions: The present research provides psychometrically sound instruments for further investigations on Instagram use behaviors.
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Comparação Transcultural , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Pesquisa QualitativaRESUMO
The dopamine (DA) system is known to be involved in the reward and dependence mechanisms of addiction. However, modifications in dopaminergic neurotransmission associated with long-term tobacco and cannabis use have been poorly documented in vivo. In order to assess striatal and extrastriatal dopamine transporter (DAT) availability in tobacco and cannabis addiction, three groups of male age-matched subjects were compared: 11 healthy non-smoker subjects, 14 tobacco-dependent smokers (17.6 ± 5.3 cigarettes/day for 12.1 ± 8.5 years) and 13 cannabis and tobacco smokers (CTS) (4.8 ± 5.3 cannabis joints/day for 8.7 ± 3.9 years). DAT availability was examined in positron emission tomography (HRRT) with a high resolution research tomograph after injection of [11C]PE2I, a selective DAT radioligand. Region of interest and voxel-by-voxel approaches using a simplified reference tissue model were performed for the between-group comparison of DAT availability. Measurements in the dorsal striatum from both analyses were concordant and showed a mean 20% lower DAT availability in drug users compared with controls. Whole-brain analysis also revealed lower DAT availability in the ventral striatum, the midbrain, the middle cingulate and the thalamus (ranging from -15 to -30%). The DAT availability was slightly lower in all regions in CTS than in subjects who smoke tobacco only, but the difference does not reach a significant level. These results support the existence of a decrease in DAT availability associated with tobacco and cannabis addictions involving all dopaminergic brain circuits. These findings are consistent with the idea of a global decrease in cerebral DA activity in dependent subjects.
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Encéfalo/metabolismo , Proteínas da Membrana Plasmática de Transporte de Dopamina/metabolismo , Abuso de Maconha/metabolismo , Tabagismo/metabolismo , Adulto , Gânglios da Base/diagnóstico por imagem , Gânglios da Base/metabolismo , Encéfalo/diagnóstico por imagem , Estudos de Casos e Controles , Núcleo Caudado/diagnóstico por imagem , Núcleo Caudado/metabolismo , Humanos , Masculino , Abuso de Maconha/diagnóstico por imagem , Nortropanos , Tomografia por Emissão de Pósitrons , Putamen/diagnóstico por imagem , Putamen/metabolismo , Compostos Radiofarmacêuticos , Substância Negra/diagnóstico por imagem , Substância Negra/metabolismo , Núcleos Talâmicos/diagnóstico por imagem , Núcleos Talâmicos/metabolismo , Tabagismo/diagnóstico por imagemRESUMO
Methamphetamine is an illicit drug used in North America, Asia, and East European countries. Methamphetamine addiction is a serious public health problem in those countries. it is a very powerful psychostimulant drug. It is derived from amphetamine and illegally manufactured from ephedrine. Cause of abuse and dependence it causes significant somatic, psychiatric and cognitive complications. Because of its vasoconstrictor properties, methamphetamine is the cause of cardiovascular diseases but also pulmonary, neurological, dental diseases... Its neurotoxicity is responsible for significant cognitive impairment. It also causes acute psychotic disorders, depressive disorders and suicidal behavior. Treatment of somatic or psychiatric complications should be integrated within a global addiction treatment. To date, no pharmacological therapeutic is specific. However, recent studies with naltrexone, modafinil and bupropion show promising leads. More, dopamine agonist drugs (dextroamphetamine, methylphenidate) are proposed as possible replacement medications. Despite those pharmacological treatments, psychotherapy has to be associated to offer a combined approach with pharmacological treatments.
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Drogas Ilícitas , Metanfetamina/farmacologia , Estimulantes do Sistema Nervoso Central/administração & dosagem , Estimulantes do Sistema Nervoso Central/efeitos adversos , Estimulantes do Sistema Nervoso Central/farmacologia , Humanos , Drogas Ilícitas/efeitos adversos , Drogas Ilícitas/farmacologia , Metanfetamina/administração & dosagem , Metanfetamina/efeitos adversos , Síndrome de Abstinência a Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/etiologia , Transtornos Relacionados ao Uso de Substâncias/terapiaRESUMO
Designer drugs include, among others, synthetic cannabinoids and synthetic cathinones. These new "legal highs" drugs are sold on line for recreational public or private use. Synthetic cannabinoids are a psychoactive herbal and chemical product that, when used, mimics the effects of cannabis. Cathinone is a naturally occurring betaketone amphetamine analogue found in the leaves of the Catha edulis plant. Synthetic cathinones are phenylalkylamines derivatives, and may possess both amphetamine-like properties. They are often sold as "bath salts" or "plant food" and labeled "not for human consumption" to circumvent drug abuse legislation. The absence of legal risks, the ease of obtaining these drugs, the moderate cost, and the avaibility via Internet are the main criteria attracting the user. There is evidence that negative health and social consequences may occur in recreational and chronic users. The addictive potential of designer drugs is not weak. Furthermore, there is a lack of epidemiological, pharmacological, animal, clinical, psychological and therapeutic data concerning these new synthetic agents.