Background Internet Gaming Disorder frequently co-occurs with psychiatric conditions, yet many studies overlook these comorbidities, leading to oversimplified interpretations Objectives This study systematically examined thematic and interpretative differences in IGD research according to whether psychiatric comorbidities were explicitly incorporated. Method We analyzed 1,201 IGD-related articles, classified into With Comorbidity (WC; n = 21) and Without Comorbidity (WoC; n = 1,180) groups. After text preprocessing, BERTopic modeling was performed to identify and compare thematic structures. For the WoC group, topics were further classified as "psychiatric-related" if they contained at least two predefined psychiatric disorder keywords. For the WC group, the influence of comorbidity on outcome interpretation was evaluated. We implemented an AI-assisted Natural Language Processing pipeline to compare thematic structure across groups. Results Topic modeling identified 26 topics in WoC and 5 in WC. WoC topics covered diverse themes, whilst WC topics highlighted clinical interactions involving comorbidities such as ADHD, anxiety, and depression. In the WC group, 81% of studies showed that comorbidity significantly influenced outcome interpretations. To statistically compare the distribution of two groups, we performed centroid alignment with a correction factor based on the word-count ratio. Maximum mean discrepancy (MMD) analysis confirmed a significant difference in semantic distribution after correction (MMD distance=1.24*10^-4, p=0.02).Conclusions Explicit consideration of psychiatric comorbidities enhances the clinical and interpretative accuracy of IGD research. Future studies should systematically integrate comorbidity analyses to improve understanding and therapeutic management of IGD. The AI-assisted NLP synthesis offers a scalable evidence-mapping approach to identify clinically relevant gaps and biases in the IGD literature, particularly regarding psychiatric comorbidity.
INTRODUCTION:Our social environment strongly influences behaviors like substance use and sensation seeking. While most research focuses on group pressure and conformity, the role of social attunement - the tendency to align with one's social environment for social reward without explicit pressure - has been largely overlooked. METHODS:This study evaluated the English version of the Social Attunement Questionnaire (SAQ) and examined its links to age, alcohol and cannabis use, impulsivity, and sensation seeking (N = 447; 54.5% female). RESULTS:Confirmatory factor analysis showed acceptable to good fit of the originally proposed two factor structure, with the one factor solution showing a substantially worse fit. Internal consistency was good across the full scale (α = 0.82) and acceptable for the Cognition subscale (α = 0.75) and the Behavior subscale (α = 0.78). The SAQ also showed similar scale and subscale scores and measurement invariance across sex. Higher social attunement was observed in younger individuals. SAQ scores - particularly the behavior subscale - were positively associated with alcohol and cannabis use and with impulsivity. Age moderated these associations: among younger individuals, higher social attunement was linked to greater alcohol use and sensation seeking, while these associations reversed with age. CONCLUSION:These findings suggest that social attunement may act as both a risk and protective factor for risk-taking behaviors, depending on developmental stage. The English SAQ demonstrated solid psychometric properties across its two subscales - Cognition and Behavior - while also proving suitable for use as a single composite scale, supporting its flexibility as a reliable measure of social attunement.
INTRODUCTION:The integration of artificial intelligence (AI) into addiction research has expanded rapidly, yet it remains unclear how psychosocial, behavioral, and social-structural determinants are incorporated into predictive models of addiction treatment outcomes. Because recovery is strongly shaped by psychological, social, and environmental context, assessing how AI approaches operationalize these dimensions is essential for developing clinically meaningful and equitable tools. METHODS:We conducted a systematic review of peer-reviewed studies published from January 1, 2020 to October 30, 2025 across PubMed, Scopus, and Web of Science. Eligible studies applied AI or machine learning (ML) models to addiction treatment outcomes and explicitly included psychosocial, behavioral, or social-structural predictors. Two reviewers independently screened studies, extracted data, and evaluated methodological quality using Joanna Briggs Institute and Cochrane Risk of Bias 2 domain structures. The protocol was prospectively registered on the Open Science Framework and in PROSPERO. RESULTS:Fifteen studies met inclusion criteria, including electronic health record (EHR), administrative-, claims-based, program-level clinical models and psychosocial assessment datasets, digital phenotyping/ecological momentary assessment (EMA) studies, natural language processing/large language model approaches, and one causal ML analysis of randomized controlled trial data. Across modalities, models consistently identified housing instability, psychiatric comorbidity, employment status, craving, stress, legal involvement, prior overdose, treatment history, medication adherence, and neighborhood disadvantage as influential predictors of treatment dropout, discontinuation, overdose risk, relapse, or poor engagement - often adding prognostic value beyond medication-related, diagnostic, and routinely available clinical variables. EMA and digital phenotyping showed the highest short-term predictive accuracy for near-term risk prediction, whereas structured EHR-, administrative-, claims-based, and program-level clinical models achieved moderate but clinically actionable performance. Methodological quality was moderate overall, with limited external validation and infrequent assessment of calibration, fairness, transportability, or reproducibility practices. CONCLUSION:Current evidence indicates that psychosocial, behavioral, and social-structural determinants are central to AI-based prediction of addiction treatment outcomes. Although findings are promising, existing models remain preliminary and should not yet guide clinical decisions without external validation and implementation evaluation. Future work should prioritize multisite validation, transparent reporting, fairness evaluation, and co-development with clinicians and individuals with lived experience to ensure that AI tools strengthen person-centered and equitable addiction care.
Introduction: Population-based surveys indicate that sweet and fruity flavors in the e-liquids are key drivers of attractiveness of e-cigarettes (ECIGs). However, their role in the addictive potential of ECIGs is less well established. This systematic review aimed to synthetize the available evidence on the impact of sweet and fruity flavors on indicators of nicotine dependence. Methods: A systematic review was conducted in PubMed, Embase, and Google Scholar in accordance with PRISMA guidelines. Studies were eligible if they reported the effects of sweet/fruity flavors in ECIGs on (1) consumption rate, (2) vaping topography and nicotine intake, (3) reward and reinforcement, and (4) indicators of nicotine dependence. Studies limited to qualitative assessments of flavor properties were excluded. Initially, 454 studies were identified and screened independently by two reviewers, resulting in 23 eligible studies. Risk of bias and study quality were evaluated using the Johanna Briggs Institute Critical Appraisal Tools. Results: Sweet/fruity flavors were consistently associated with increased consumption rates and a higher puff number and volume, leading to more nicotine exposure. Several studies also demonstrated that sweet flavors enhanced the reward and reinforcement of ECIG use. However, findings regarding their effects on craving and withdrawal were inconsistent. Conclusion: Sweet/fruity flavors appear to increase the abuse liability of ECIGs, but the evidence remains inconclusive. Additional high-quality studies that adequately control for known covariates are required to clarify their contribution and the independent role of flavors in nicotine dependence. These findings, together with emerging toxicological data on ECIGs, should be carefully considered in regulatory decisions regarding flavor bans in ECIGs.
Introduction: Given the widespread prevalence of concomitant polydrug use of ecstasy and alcohol, it is important to better understand the nature and effects of concomitant use. The current study aimed to investigate patterns of concurrent ecstasy and alcohol use and their possible association with mood alterations. Methods: Nightlife attendees who reported having used ecstasy three times or more in the past year were recruited and participated in an ecological momentary assessment protocol as part of a larger study on substance use in the European nightlife context (ALAMA study). Substance use and mood states were assessed on four timepoints per day or night with 2-h intervals on Friday and Saturday over a 5-week period. Results: Analyses of the course of alcohol consumption during an “ecstasy and alcohol” night (i.e., with at least one time ecstasy use) showed that alcohol consumption decreased in the hours following the first night-time use of ecstasy. Alcohol consumption increased more over time on “no ecstasy” nights than on “ecstasy and alcohol” nights. There were stronger improvements in positive mood states and a stronger decline in negative mood states over the course of “ecstasy and alcohol” nights compared to “no ecstasy” nights. Conclusion: Concomitant ecstasy and alcohol use among nightlife attendees is common and is associated with specific use patterns and mood effects. These findings underscore the need for nightlife-specific harm-reduction approaches that consider the social context, patterns, and the reinforcing mood effects associated with combined ecstasy and alcohol use.
INTRODUCTION:Gambling-related harms constitute a significant public health concern, with adverse effects ranging from financial difficulties to mental health disorders. Therefore, people experiencing gambling-related harm may need different kinds of health care and social services. METHODS:This study examines the social and health care usage between gambling severity groups. We aim to examine whether people with recreational, risk, or problem gambling use more social and health care services compared to non-gamblers, and what increases the probability of using social and health care services for people who gamble on different levels of risk for harms. The study used data from the population-based Healthy Finland survey (N = 28,153; 46%). RESULTS:Our results show that individuals with problem gambling more commonly experienced social and health vulnerabilities. Among individuals with problem gambling, 86% had utilized health care services, and 18% social care services during the past year, which was somewhat higher than among individuals who did not gamble. Among different gambling severity groups, it seemed that the use of health care services is less common among men, younger individuals, people with excessive alcohol use, and among those with higher income. Individuals in the problem gambling groups were 2.1 times more likely to utilize health care services than the non-gambling group. Among individuals with problem gambling and low-risk gambling groups, the utilization of social services was more common among those with lower income, individuals experiencing psychological distress and long-standing illnesses. CONCLUSIONS:These results provide new knowledge on how people with different levels of risk for gambling harm use social and health services and support the development of social and health services in responding to gambling problems.
Background: Crack-cocaine use is associated with severe physical and mental health consequences, including cardiac, pulmonary, and psychiatric conditions. It also heightens the risk of overdose and transmission of infectious diseases such as HIV, tuberculosis, and hepatitis. Equity-deserving populations - more specifically, groups affected by socioeconomic marginalization, discrimination, and systemic inequities - are disproportionately impacted. In recent years, its rising prevalence in European cities has underscored crack-cocaine as a growing social and public health concern. This trend highlights the need to reorient drug policies toward a public health-oriented approach and to implement coherent and inclusive harm-reduction programs and interventions for equity-deserving populations. Summary: We conducted a comprehensive review of harm-reduction programs and interventions for crack-cocaine use, focusing on equity-deserving groups. A literature search was conducted in November 2024, in 9 bibliographic databases. Additional searches were performed using backward citation tracking. A total of 24 publications were included in the final dataset and underwent data extraction, synthesis, and tabulation. Extracted data informed a narrative synthesis by study and population characteristics. Key Messages: Harm-reduction programs and interventions are tailored to women who smoke crack, hospitalized patients, people living with HIV, aboriginal descendants, and marginalized urban populations. They aim to reduce crack-cocaine related mortality and morbidity, by promoting safer consumption practices and healthier lifestyles. They improve living conditions, access to employment, and community engagement. Findings advocate prioritization of harm-reduction services that attend to women's specific experiences of gendered, race-based, social and structural violence, harassment, and discrimination. Besides, despite their vulnerability, street-involved youth, migrants, and refugees are underrepresented in research, underscoring the need for inclusive programs and interventions that consider both age and migration contexts. Most research was conducted in North America, with limited studies from Latin America, Europe, and rural settings, highlighting geographic and contextual gaps. Effective harm reduction must prioritize health equity, addressing stigma, gendered and racial violence, and structural barriers to care. .
Introduction: Many countries are exploring regulations for non-medical cannabis markets to mitigate cannabis-related health risks. Regulations such as restricting opening hours or product variability may be useful tools, yet their effects on cannabis purchases remain understudied due to a lack of comprehensive sales data. Methods: The Züri Can study implements a framework for strictly regulated cannabis sales, with a fixed product portfolio and a maximum purchase volume. The dataset contains all tracked purchases of 2,507 participants from August 22, 2023, to January 17, 2025, across ten Cannabis Social Clubs (CSCs), ten pharmacies, and the municipal Drug Information Centre Zurich (DIZ). It captures detailed information on sales conditions (opening hours, product variety, customers per hour) and purchase behaviour (purchase frequency, number of packages per purchase, THC volume, and expenditure per package). Generalised estimating equations provided means and confidence intervals by type of point of sale (POS). Multilevel survival analysis and random coefficient models examined how sales conditions influenced purchase behaviour, and how purchase behaviour evolved over time. Results: Pharmacies had notably more weekly operating days (5.66), longer daily opening hours (6.16), and fewer customers per hour (1.08) than CSCs (3.81 days; 3.76 h; 4.62 customers per hour) and the DIZ (2.85 days; 3.28 h, 3.37 customers per hour). However, compared to the POS average, longer opening hours and more customers per hour only slightly increased purchase frequency; their impact on purchase amount was negligible. Variations in the number of available products only marginally affected purchasing behaviour. Purchase frequency was higher in the 30 days following the first purchase and declined over 12 months (CSCs, pharmacies) or remained stable (DIZ) while amount obtained per purchase remained stable. Conclusion: These findings suggest that in a strictly regulated non-medical cannabis market similar to the framework of the Züri Can study, variations in sales conditions only have a small impact on purchase behaviour. Legal access to cannabis does not inherently lead to increased purchasing and may even contribute to a decline in purchase frequency.
Background: Many studies address the different treatments for crack cocaine use disorder without distinguishing between crack use and cocaine use disorder. Furthermore, they highlight various approaches, such as psychotherapeutic methods, medications, and social interventions, whose effectiveness remains contentious for crack use disorder. Our aim was to evaluate the relative effectiveness of these various treatments, specifically for crack use disorder. METHODS:This systematic review followed PRISMA guidelines; we searched PubMed, Embase, and Web of Science for studies between 2014 and July 2024. ELIGIBILITY CRITERIA:Due to the limited number of available studies, we included all studies worldwide with full text available in English or French, published between 2014 and 2024, reflecting the recent increase in interest in crack use. Studies included adults aged 18 years or older with a clinical diagnosis of crack cocaine addiction based on a validated clinical scale. We excluded studies that did not distinguish between crack and cocaine use in their assessment of crack cocaine (or crack/cocaine) use disorder. We reported the randomized controlled trials (RCTs) results based on the type of interventions, including various outcomes: reduction of health (within the biopsychosocial model), increased accessibility and retention in healthcare, and reduction in drug use. The reliability of the evidence was assessed using Cochrane's tool for evaluating the risk of bias. RESULTS:We identified 3,313 records, of which 46 were eligible, and 33 were finally included. Among the 33 studies, 15 were RCTs. Among the RCTs, the majority had a moderate risk of bias (8/15), followed by high risk (6/15), and only one had a low risk of overall bias. Contingency management was associated with higher abstinence, better treatment retention, and improvements in mental health, although the interpretability of these findings is limited by their generalizability. Pharmacological trials with dexamfetamine showed a reduction in drug use and an increase in abstinence, but only in a specific population receiving heroin-assisted treatment. Adjunct trials such as transcranial direct current stimulation yielded mixed findings, with some studies suggesting improvements in abstinence and quality of life, while others reported no significant effects. The findings highlight that tailored interventions supported by a contingency management approach may enhance engagement and treatment effectiveness. .
INTRODUCTION:Motivational interviewing (MI) promotes behavioural change in substance use disorders. Its fidelity is measured using the Motivational Interviewing Treatment Integrity (MITI) framework. While large language models (LLMs) can potentially generate MI-consistent therapist responses, their competence using MITI is not well-researched, especially in real-world clinical transcripts. We aim to benchmark MI competence of proprietary and open-source models compared to human therapists in real-world transcripts and assess distinguishability from human therapists. METHODS:We shortlisted 3 proprietary and 7 open-source LLMs from LMArena, evaluated performance using MITI 4.2 framework on two datasets (96 handcrafted model transcripts and 34 real-world clinical transcripts). We generated parallel LLM-therapist utterances iteratively for each transcript while keeping client responses static and ranked performance using a composite ranking system with MITI components and verbosity. We conducted a distinguishability experiment with two independent psychiatrists to identify human-versus-LLM responses. RESULTS:All 10 tested LLMs had fair (MITI global scores of >3.5) to good (MITI global scores of >4) competence across MITI measures, and the three best-performing models (gemma-3-27b-it, gemini-2.5-pro, and grok-3) were tested on real-world transcripts. All showed good competence, with LLMs outperforming human-expert in complex reflection percentage (39% vs. 96%) and reflection-question ratio (1.2 vs. >2.8). In the distinguishability experiment, psychiatrists identified LLM responses with only 56% accuracy, with d-prime of 0.17 and 0.25 for gemini-2.5-pro and gemma-3-27b-it, respectively. CONCLUSION:LLMs can achieve good MI proficiency in real-world clinical transcripts using the MITI framework. However, a high complex reflection percentage may result in a technically correct but unnatural conversation style. These findings suggest that even open-source LLMs are viable candidates for expanding MI counselling sessions in low-resource settings, warranting further rigorous clinical validation.
Introduction: Early identification for preventing drug misuse among adolescents and young adults (AYAs) is more cost-effective than drug treatment. However, there is a lack of scientific and comprehensive risk models for early identification. This study aimed to construct risk models and association pathways that integrate psychosocial factors influencing drug misuse in AYAs using a machine learning approach. Methods: This cross-sectional study included 1,012 Chinese AYAs aged 14-35 years and was conducted from June to December 2023. Key psychosocial factors for drug misuse were identified using the least absolute shrinkage and selection operator and Boruta. A voting classifier combining logistic regression, K-nearest neighbors, support vector machine, and 5-fold cross-validation was used for model training and bootstrapping method wan applied for testing. Shapley additive explanation was used to determine the importance of each risk factor. A Bayesian network (BN) model was constructed to explore possible association pathways for drug misuse. Results: A total of 3.85% of participants reported drug misuse. Significant risk factors included environmental exposure to drug misusers, working in nightlife venues (WNVs), cognition of traditional drug types, perceived risks of drug misuse, permissive attitude toward drug misuse, refusal self-efficacy of drug misuse (RSEDM), externalizing problem behavior, sensation-seeking, and adverse childhood experiences (ACEs). The voting model showed strong performance (recall: 94.10%; area under the curve: 98.11%; accuracy: 92.63%; precision: 34.15%; F-score: 49.68%). The BN model revealed that ACEs played a central role in risk assessment of drug misuse. AYAs WNVs, with low RSEDM and exposure to drug misusers, had exceeding 90% probability of drug misuse. Conclusion: ACEs serve as a primary risk factor, with a significant impact on social environmental influences. AYAs with ACEs and those WNVs require targeted and early interventions to prevent drug misuse.
Introduction: Objective measures for the severity of addiction are needed to identify and appropriately stratify patients into effective treatment groups for intervention and recovery. Our aim was to determine if blood-derived, dopamine-related biomarkers hold predictive validity in patients with cocaine use disorder (CUD). Methods: A total of 349 participants (163 patients with moderate-to-severe CUD and 186 healthy control participants without a history of substance use disorder) were recruited for a cross-sectional case-control study in the East of England, UK. Data on individual differences in CUD-related traits, e.g., impulsivity, sensation-seeking, were collected. Measurements included mRNA transcription of dopamine-related genes (DRD2, DRD3, DRD4, and COMT) and risk alleles (rs6277, rs1800497, rs12364283, rs6280, and rs4680). Results: CUD patients showed elevated DRD2 mRNA in peripheral blood (B0 = 0.43, 95% CI [0.13, 0.73], pFDR = 0.020) and the DRD2-related rs6277 risk allele was associated with CUD diagnosis (odds ratio = 2.16, 95% CI [1.15, 4.17], p = 0.02). DRD2 mRNA levels related to self-reported impulsivity (B0 = -0.17, 95% CI [-0.32, -0.03], p = 0.013). Conclusions: Blood-based expression of DRD2 may be a useful biomarker related to CUD diagnosis and related traits.
Introduction: Individuals with alcohol use disorder (AUD) encounter significant barriers to seeking treatment, with these obstacles often greater for cisgender women and transgender individuals. Negative consequences of AUD are particularly severe in these groups, yet research on their specific treatment barriers is lacking. This study aimed to develop and evaluate the Barriers to AUD Treatment Questionnaire (BAT-Q) and to explore differences in reported barriers among cisgender men, cisgender women, and transgender individuals who had considered AUD treatment in the past 5 years. METHODS:Participants were recruited through online platforms in the Netherlands and in-person flyers in the greater Amsterdam area. In total, 112 cisgender men, 154 cisgender women, and 98 transgender individuals completed an online survey that included the BAT-Q questionnaire. RESULTS:Exploratory factor analysis identified seven reliable domains of barriers: social stigma, comorbid problems and negative care experiences, limited care accessibility, fear of limited inclusivity and discrimination, limited social support, socioeconomic constraints, and negative expectations of care. While comparisons among groups yielded preliminary insights these findings should be interpreted with caution, as confirmatory factor analysis have not yet been conducted. However, transgender individuals reported higher barriers than both cisgender men and women across all domains except socioeconomic constraints. Both cisgender women and transgender individuals experienced greater stigma-related barriers than cisgender men. Higher alcohol and drug use severity predicted greater overall treatment barriers in all groups. Notably, poorer perceived socioeconomic status and low social support were more strongly associated with barriers among women than among cisgender men or transgender individuals. CONCLUSION:These findings underscore the need for gender-affirming and accessible AUD services. The BAT-Q provides a promising new tool for identifying and addressing specific barriers to treatment, although further validation of its structure is warranted to strengthen the interpretation of group differences. .
Introduction: Anabolic-androgenic steroid (AAS) consumers frequently experience elevated physical and psychological risks, yet the psychological mechanisms linking risk exposure to health outcomes remain poorly understood. This study examined whether general confidence in managing substance use and minimising harm mediates the relationship between clinical risk and quality of life among AAS consumers engaged with community-based alcohol and other drug (AOD) services. Methods: Intake data from 517 adults (93.4% male) reporting lifetime AAS use were analysed, drawn from a broader cohort of 18,786 clients at Lives Lived Well services between 2020 and 2024. Mediation analyses tested whether two confidence variables: (1) substance use management and (2) harm minimisation, explained associations between clinical risk (defined by World Health Organisation - Alcohol, Smoking and Substance Involvement Screening Test steroid risk score), and three quality of life domains: physical, psychological, and overall wellbeing. Results: Higher clinical steroid risk scores were significantly associated with poorer quality of life across domains; however, these effects were fully mediated by lower general confidence in managing substance use and minimising harm among clients who reported AAS use. Confidence in consumption practices buffered against physical undesired effects, while confidence in harm reduction was strongly linked to psychological wellbeing. Conclusions: Among AAS consumers in AOD treatment, broader substance use confidence appears meaningfully related to quality of life. While the confidence measures are general rather than AAS-specific, these findings provide a preliminary insight into confidence-related processes in a clinically underexamined group. Interventions that promote these strategies may offer a critical mechanism for ensuring this cohort physical and psychological wellbeing.
Introduction: Recovery from substance use disorder (SUD) spans clinical, functional, and personal dimensions. However, research covering these domains, particularly in populations with complex problems such as those with mild to borderline intellectual disabilities (MBIDs), remains limited. This study explored different recovery outcomes and their relationship with treatment dropout during the first 12 weeks of inpatient treatment, while also examining whether the presence of MBID affected the outcomes. METHODS:A naturalistic, prospective cohort study was conducted with patients undergoing inpatient SUD treatment at a Salvation Army Clinic in The Netherlands. Recovery outcomes (clinical, functional, personal) and predictors of dropout were assessed over 12 weeks. MBID (yes/no) was determined using the SCIL screening tool. Data were analyzed using repeated measures (M)ANCOVA to evaluate recovery trajectories and logistic regression to explore associations between recovery levels and dropout. RESULTS:Of the 157 participants, 66% screened positive for potential MBID, and 40% dropped out within 12 weeks. For completers, significant improvements were observed across all recovery domains over time (all p < 0.001). Psychological problems decreased by a mean of 9.6 points (95% CI: 7.5-11.8), physical problems by a mean of 3.7 points (95% CI: 2.0-5.4), and craving by a mean of 7.5 points (95% CI: 6.4-8.6). Functional recovery increased by a mean of 5.1 points (95% CI: -1.4 to 11.7), and personal recovery by a mean of 5.7 points (95% CI: 3.5-7.9). Lower baseline recovery levels were associated with greater relative improvements but lower endpoint scores. Lower baseline functional recovery was a small but significant predictor of dropout. MBID status did not affect recovery trajectories. CONCLUSIONS:The findings suggest a multidimensional recovery process during early phases of inpatient treatment, irrespective of MBID status. Baseline recovery levels play a crucial role in shaping outcomes, underscoring the importance of early assessments. Importantly, these findings indicate that those worst off at baseline profit most from treatment. .
Introduction: Individuals with compulsive buying-shopping disorder (CBSD) often engage in criminal behaviors like fraud and theft, influenced by materialistic values, impaired moral judgment, and low self-control. Psychological mechanisms linking CBSD and criminality are yet not well understood. This study examines psychological/personality factors contributing to criminal tendencies in individuals with CBSD. METHODS:An online survey recruited participants through social media, Websites, and academic institutions. Eligible participants were ≥18 years with German language skills. Ethical approval was granted by Hannover Medical School. Measures included the Pathological Buying Screener (PBS), Materialistic Value Scale, Big Five Inventory, Rosenberg Self-Esteem Scale, the Dirty Dozen for Dark Triad traits, and a self-developed questionnaire on criminal behavior. RESULTS:Forty-three participants scored above (CBSD+) and 166 participants below (CBSD-) the PBS cutoff for CBSD. The CBSD+ group showed higher materialism, lower self-esteem, elevated Dark Triad traits, and more criminal behaviors compared to the CBSD- group. Nearly 70% of the CBSD+ group reported at least one criminal behavior. A multiple linear regression (enter method) identified higher PBS scores, younger age, and lower extraversion as predictors of more criminal buying-shopping-related behaviors. CONCLUSION:The findings reveal the intricate factors contributing to criminal behavior in CBSD. The lack of significant association between neuroticism, dark personality features, and the amount of criminal behaviors needs further investigation. The explained variance of 39% indicates that additional influences on criminal behavior remain to be explored. Future research should aim for more diverse samples and longitudinal designs to enhance generalizability and understanding of these complex relationships. .
Introduction: The purpose of this study was to evaluate the effect of biperiden on nicotine craving in a proof-of-concept clinical study. METHOD:The study involved 46 male participants (mean age: 45.3 ± 9.31 years) who smoked an average of 20.8 (10.0) cigarettes per day. Participants were randomly assigned to either a biperiden (4 mg/day) or placebo group, with treatment lasting 7 days. The outcomes were assessed at baseline (T0) and after 7 days (T1) using self-reported questionnaires, including the Questionnaire of Smoking Urges-Brief, the Fagerström Tolerance Questionnaire, and the Beck Anxiety and Depression Inventories. RESULTS:Repeated measures ANOVA revealed a significant time × treatment interaction between cigarette consumption (p < 0.001, ηp2 = 0.340) and craving (p = 0.002, ηp2 = 0.203), indicating that participants in the biperiden group showed greater reductions than those receiving placebo. For dependence, anxiety, and depression, only the main effect of time was significant (p < 0.05), suggesting general improvement across both groups. Ethnicity did not significantly influence any outcomes, and no relevant adverse effects were reported. CONCLUSIONS:These findings suggest that biperiden may represent a promising pharmacological approach for reducing nicotine craving. Further studies with prolonged administration are warranted to evaluate its therapeutic potential for smoking cessation. .
INTRODUCTION:Buprenorphine, a partial opioid agonist, is widely used as treatment for opioid use disorder. Traditionally, the original opioids are abruptly stopped, whereafter the buprenorphine is titrated over the course of several days. An alternative approach is low-dose buprenorphine initiation (LDBI), where buprenorphine is titrated more gradually, while the original opioids are still being used. Literature suggests LDBI may be associated with less withdrawal symptoms, though no standardized protocol for LDBI currently exists. This study aimed to establish consensus on the application of LDBI in Dutch clinical practice. METHODS:A Delphi method was employed, involving a systematic literature review to develop statements on the application of LDBI. Experts reviewed these statements across three rounds, achieving consensus at a 75% agreement threshold. RESULTS:Thirteen physicians with demonstrated expertise in LDBI participated, with nine completing all three rounds. Over three consultation rounds, consensus was achieved on 28 statements about indications for LDBI and dosing regimens, though variation in titration procedures was observed. The panel agreed that the starting dose can range between 10 and 20 μg/h for transdermal patches and 0.2-1.0 mg for sublingual tablets; dose can be increased daily with a maximum of 100% of the previous daily dose. Further, the original opioids should not be discontinued before day 7 after LDBI. CONCLUSION:Though various protocols for LDBI exist, physicians experienced with LDBI agreed on the range of safe LDBI regimens. Further research is necessary to develop comprehensive guidelines for LDBI in patients with opioid use disorder.
Introduction: Sociodemographic background factors, gambling game type, depressive symptoms, and comorbid substance use have been associated with gambling disorder, but the associations of these factors with treatment outcomes remain unclear. This study examined background factors in participants of a clinical trial, identifying factors which were associated with treatment outcomes such as gambling urge and quality of life. Methods: This was a secondary analysis of a single-center 12-week randomized placebo-controlled clinical trial investigating the effects of as-needed intranasal naloxone combined with psychosocial support in the treatment of gambling disorder. Independent variables were analyzed with linear mixed models, with analyses both including and excluding treatment allocation. Results: Sociodemographic factors or game types were not associated with treatment outcomes. Adherence to trial medication and high self-perceived readiness to change gambling behavior were associated with greater reduction in gambling urge and severity, and greater increase in gambling self-efficacy and quality of life. Higher scores for depressive symptoms were associated with more severe gambling and a slightly greater decrease in gambling urge, as well as a greater increase in quality of life. When included as a nuisance factor, treatment allocation abolished most statistically significant results. Conclusion: Participants with high medication adherence had improved treatment outcomes compared to participants with low medication adherence, possibly representing greater motivation and commitment to treatment. More severe depressive symptoms were associated with a greater reduction in gambling urge but not gambling severity.
