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Sanchez ZM, Folgar MI, Matias JP, Pimentel MP, Burkhart G. Framing substance use as "recreational" is neither accurate nor helpful for prevention purposes. JOURNAL OF PREVENTION (2022) 2023; 44:795-811. [PMID: 37642907 DOI: 10.1007/s10935-023-00745-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/15/2023] [Indexed: 08/31/2023]
Abstract
This debate paper discusses six reasons why the term "recreational substance use" should be avoided. (1) Social norms and beliefs are drivers of behavior; therefore, the normalized use of the term conveys injunctive norms of a fully socially acceptable substance. Injunctive norms are the most important drivers of initiation into substance use. (2) The illusion of being in control, suggesting that if consumed for leisure and recreation it can easily be controlled; (3) Idealized social representations that fuel an idealized image of an alternative glamourous or mindful consumption culture; (4) Downplaying potential harms; (5) The implicit promise of everyday pleasure, the ever-growing potency of cannabis products does not fit the narrative of its use for recreation; (6) Industry as a trojan horse branding discourse of the concept of medical cannabis to normalize the image of non-medical use: to complement "therapeutic" with "recreational". "Recreational use" is a subjective ill-defined term. This debate paper aims to find a better terminological solution, honestly denominating with a neutral, unbiased, and objective connotation what is now called "recreational use". Thus, we propose using the term "non-therapeutic" use.
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Affiliation(s)
- Zila M Sanchez
- Preventive Medicine Department, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu, 740, Sao Paulo, SP, Brazil.
| | | | - João Pedro Matias
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon, Portugal
| | - Marcos Paulo Pimentel
- GPRED - Grupo de Prevenção ao uso indevido de drogas da Polícia Federal, Sao Paulo, Brazil
| | - Gregor Burkhart
- European Society for Prevention Research (EUSPR), Lisbon, Portugal
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Zhen-Duan J, Colombo D, Cruz-Gonzalez MA, Hoyos M, Alvarez K. Adverse childhood experiences and alcohol use and misuse: Testing the impact of traditional and expanded adverse childhood experiences among racially/ethnically diverse youth transitioning into adulthood. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023; 15:S55-S64. [PMID: 37476532 PMCID: PMC10356013 DOI: 10.1037/tra0001458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Objective Traditional Adverse Childhood Experiences (T-ACEs), such as abuse and neglect, have been associated with an increased risk of youth alcohol use and misuse. This study aims to compare associations of T-ACEs and Expanded ACEs (E-ACEs), an expanded set of ACEs that encompass community-level adversities, with alcohol use and misuse by race/ethnicity. Method Data came from a three-wave (1998-1999; 1999-2000; 2004-2005) community-based study in Houston, including youth transitioning into adulthood. We compared associations between ACEs at Wave 1 and past-year alcohol use, abuse, and dependence at Wave 3. Results Participants (n = 2,391) included White (n =908), Black (n = 898) and Latinx (n = 585) youth (M (SD) = 14.00 (2.04)) transitioning into young adulthood (M (SD) = 19.77 (2.34)). T-ACEs were associated with higher odds of alcohol use, abuse, and dependence (OR = 1.15, OR = 1.18, OR = 1.24, respectively) while E-ACEs increased the odds of alcohol dependence (OR = 1.23) in the total sample. No significant differences by race/ethnicity were found. Racial/ethnic differences in increased alcohol risk were observed for some ACE items, such as bullying and use for Latinx youth (OR = 2.13) and poverty and dependence for White youth (OR = 2.01). Conclusions T-ACES and E-ACEs increase the risk of alcohol use and misuse. Results highlight the importance of preventing ACEs exposure as a risk factor for youth alcohol use and misuse. Public policies must also focus on preventing ACEs through multi-level interventions aimed at reducing violence, bullying, and financial instability.
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Affiliation(s)
- Jenny Zhen-Duan
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | | | - Mario A. Cruz-Gonzalez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Mercedes Hoyos
- Department of Political Science, Boston College, Chestnut Hill, MA, USA
| | - Kiara Alvarez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Jones G, Ricard JA, Hendricks P, Simonsson O. Associations between MDMA/ecstasy use and physical health in a U.S. population-based survey sample. J Psychopharmacol 2022; 36:1129-1135. [PMID: 36189781 DOI: 10.1177/02698811221127318] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION 3,4-Methylenedioxymethamphetamine (MDMA/"ecstasy") is an empathogen that can give rise to increased pleasure and empathy and may effectively treat post-traumatic stress disorder. Although prior research has demonstrated associations between ecstasy use and favorable mental health outcomes, the associations between ecstasy and physical health have largely been unexplored. Thus, the goal of this study was to examine the associations between ecstasy use and physical health in a population-based survey sample. METHOD This study utilized data from the National Survey on Drug Use and Health (2005-2018), a yearly survey that collects information on substance use and health outcomes in a nationally representative sample of U.S. adults. We used multinomial, ordered, and logistic regression models to test the associations between lifetime ecstasy use and various markers of physical health (self-reported body mass index, overall health, past year heart condition and/or cancer, past year heart disease, past year hypertension, and past year diabetes), controlling for a range of potential confounders. RESULTS Lifetime ecstasy use was associated with significantly lower risk of self-reported overweightness and obesity (adjusted relative risk ratio range: 0.55-0.88) and lower odds of self-reported past year heart condition and/or cancer (adjusted odds ratio (aOR): 0.67), hypertension (aOR: 0.85), and diabetes (aOR: 0.58). Ecstasy use was also associated with significantly higher odds of better self-reported overall health (aOR: 1.18). CONCLUSION Ecstasy shares protective associations with various physical health markers. Future longitudinal studies and clinical trials are needed to more rigorously test these associations.
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Zhang T, Liu Z, Li G, Huang Y, Li Y, Geng H, Cheng HG. Correlates of transitions from alcohol use to disorder diagnosed by DSM-5 in China. BMC Psychiatry 2021; 21:427. [PMID: 34465307 PMCID: PMC8406607 DOI: 10.1186/s12888-021-03413-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 08/03/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND This study aimed to describe the prevalence and lifetime criteria profiles of DSM-5 alcohol use disorder (AUD) and the transitions from alcohol use to disorder in Chifeng, China. METHODS Face-to-face interviews were conducted using Composite International Diagnostic Interview-3.0 (CIDI-3.0) among 4528 respondents in Chifeng. RESULTS The weighted lifetime and 12-month prevalence of DSM-5 AUD were 3.03 and 1.05%, respectively. Mild lifetime AUD was the most prevalent severity level (69.53%). The two most common criteria were "failure to quit/cutdown" and "drinking more or for longer than intended." Lifetime prevalence was 65.59% for alcohol use, and 22.97% for regular drinking. Male and domestic violence were risk factors for the transition from alcohol use to regular drinking or AUD and from regular drinking to AUD. Younger age was risk factor for the transition to AUD from alcohol use or regular drinking. Poverty (OR = 2.49) was risk factor for the transition from alcohol use to regular drinking. The earlier drinkers were more likely to develop to regular drinking (OR = 2.11). CONCLUSION AUD prevalence in Chifeng was not as high as that in Western countries. The study revealed that multiple risk factors might contribute to the transition across different stages of alcohol use. Further research should explore the underlying mechanisms.
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Affiliation(s)
- Tingting Zhang
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100083 China
| | - Zhaorui Liu
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100083 China
| | - Guohua Li
- Chifeng Anding Hospital, No. 18 Gonggeer Road, Chifeng, 024000, Inner Mongolia, China.
| | - Yueqin Huang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100083, China.
| | - Yanxiang Li
- Chifeng Anding Hospital, No. 18 Gonggeer Road, Chifeng, 024000 Inner Mongolia China
| | - Hongchun Geng
- Chifeng Anding Hospital, No. 18 Gonggeer Road, Chifeng, 024000 Inner Mongolia China
| | - Hui G. Cheng
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100083 China
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Levola J, Rose RJ, Mustonen A, Sarala M, Miettunen J, Koskela J, Niemelä AE, Niemelä S. Association of age at first drink and first alcohol intoxication as predictors of mortality: a birth cohort study. Eur J Public Health 2021; 30:1189-1193. [PMID: 32830246 DOI: 10.1093/eurpub/ckaa134] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND More information on the health-related repercussions of age at onset of adolescent drinking is needed. The aim of this study was to examine the associations between self-reported age at first drink and age at first alcohol intoxication with the risk of death by age 30. METHODS The sample (n = 6564; 49.1% males) included all participants of the Northern Finland Birth Cohort Study 1986 (NFBC1986) for whom the two measures of adolescent drinking were available. Self-reported age at onset of first drink and first alcohol intoxication were analyzed along with background variables and data regarding subsequent psychiatric diagnoses. Adolescents were dichotomized into those reporting age at first drink and age at first intoxication before or after age 14. Cox regression was used to calculate hazard ratios (HRs) with 95% confidence interval (95% CI) for death by age 30. RESULTS By the age of 30, 0.7% (n = 47) of all 6564 participants were deceased. In the multivariable models, male gender and a history of illicit substance use in adolescence were associated with both all-cause mortality and mortality due to accidents or suicide. After controlling for confounding variables, age at first alcohol intoxication was associated with all-cause mortality (HR 2.33; 95% CI 1.04-5.20) as well as death due to accidents or suicide (HR 2.99; 95% CI 1.11-8.05). CONCLUSIONS Earlier age at first intoxication carries long-term repercussions with respect to premature loss of life. Efforts should be made targeting the prolongation of initiating binge drinking in adolescence to diminish this mortality risk.
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Affiliation(s)
- Jonna Levola
- Department of Psychiatry, Hospital District of Helsinki and Uusimaa, Hyvinkää Area, Järvenpää, Finland
| | - Richard J Rose
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Antti Mustonen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Marian Sarala
- Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jari Koskela
- Department of Psychiatry, University of Turku, Turku, Finland
| | | | - Solja Niemelä
- Department of Psychiatry, University of Turku, Turku, Finland.,Addiction Psychiatry Unit, Department of Psychiatry, Turku University Hospital, Turku, Finland
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Abstract
BACKGROUND In recent years, there has been significant research on the mental health effects of classic psychedelic use, but there is very little evidence on how classic psychedelics might influence physical health. AIMS The purpose of the present study was to investigate the associations between lifetime classic psychedelic use and markers of physical health. METHODS Using data from the National Survey on Drug Use and Health (2015-2018) with 171,766 (unweighted) adults aged 18 or above in the United States, the current study examined the associations between lifetime classic psychedelic use and three markers of physical health (self-reported overall health, body mass index, and heart condition and/or cancer in the past 12 months) while controlling for a range of covariates. RESULTS Respondents who reported having tried a classic psychedelic at least once in their lifetime had significantly higher odds of greater self-reported overall health and significantly lower odds of being overweight or obese versus having a normal weight. The association between lifetime classic psychedelic use and having a heart condition and/or cancer in the past 12 months approached conventional levels of significance, with lower odds of having a heart condition and/or cancer in the past 12 months for respondents who had tried a classic psychedelic at least once. CONCLUSION The results of the present study suggest that classic psychedelics may be beneficial to physical health. Future research should investigate the causal effects of classic psychedelics on physical health and evaluate possible mechanisms.
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Affiliation(s)
- Otto Simonsson
- Department of Sociology, University of Oxford, Oxford, UK
| | - James D Sexton
- Department of Brain Sciences, Imperial College London, London, UK
| | - Peter S Hendricks
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, USA
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Short term effects of the REAL media e-learning media literacy substance prevention curriculum: An RCT of adolescents disseminated through a community organization. Drug Alcohol Depend 2020; 214:108170. [PMID: 32693198 DOI: 10.1016/j.drugalcdep.2020.108170] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND The primary aim of this study was to evaluate the short-term effects of testing an e-learning program to reduce adolescent substance use and abuse. Early initiation of substance use is linked to a variety of negative outcomes, thus effective intervention programs are needed. One approach is to use media literacy to capitalize on adolescents' immersion with media in a variety of forms. We developed, implemented, and tested an engaging substance use prevention program by collaborating with a youth-oriented community partner (4-H). METHODS 639 middle adolescents from nine U.S. states participated in an RCT of REAL media. Participants completed a series of online surveys and were randomized to use an online substance prevention program (REAL media) or serve as control (delayed program use). Self-report surveys were administered at three points in time. This short-term evaluation uses data from the pretest (Time 1) and short-term posttest three-month surveys, which measured demographics, self-efficacy to counterargue, and injunctive and descriptive substance use norms. RESULTS Participants who completed the REAL media program reported increased self-efficacy to counterargue and decreased positive injunctive norms compared to control participants who did not complete the program. No significant differences were observed for descriptive norms. CONCLUSIONS We found support for the REAL media program in changing key predictors of youth substance use demonstrating (1) the efficacy of media literacy interventions targeting adolescents and (2) that e-learning substance use prevention efforts can be adapted for and implemented through community organizations.
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Vera BDV, Pilatti A, Pautassi RM. ELSA cohort 2014: association of age of first drink and progression from first drink to drunkenness on alcohol outcomes in Argentinean college freshmen. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 46:58-67. [PMID: 31112434 DOI: 10.1080/00952990.2019.1608223] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: College freshman are at-risk for hazardous alcohol drinking and for experiencing alcohol-related negative consequences. This is exacerbated in those featuring an early age of first alcohol use or of first drunkenness. It remains unclear which of these milestones is more strongly associated with alcohol outcomes. Objective: We examined, in Argentinean college drinkers (n = 4088; 43% men; racially and ethnically homogeneous), the association of age at drinking onset and progression to drunkenness (drunkenness naïve [Drunk-Naïve]; No-Delay [same age of first alcohol use and first alcohol intoxication]; one year of delay between age of first alcohol use and first alcohol intoxication; ≥2years of delay) on several alcohol outcomes. Methods: A survey measured substance use, age at drinking and drunkenness onset and alcohol-related consequences. Results: Alcohol consumption per drinking occasion was significantly greater in men than in women. An early drinking onset (alcohol use before age 13) and lifetime drunkenness independently exacerbated alcohol consumption per drinking occasion and during the last year. In men, Early-Onset was associated with a greater number of alcohol-related consequences when the delay between Early-Onset and the first drunkenness episode was 1 or ≥2 years yet did not significantly alter the number of negative consequences in Drunk-naïve or No-delay drinkers. In women, Early-Onset significantly enhanced the number of negative consequences when the delay was two years, but not when the delay was one-year or in Drunk-naïve or No-delay drinkers. Conclusions: The window between the first contact with alcohol and the first episode of drunkenness is a critical period to reduce alcohol-related problems.
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Affiliation(s)
- Belén Del Valle Vera
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina.,Instituto de Investigaciones Psicológicas, IIPSI, Unidad Ejecutora CONICET, Córdoba, Argentina
| | - Angelina Pilatti
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina.,Instituto de Investigaciones Psicológicas, IIPSI, Unidad Ejecutora CONICET, Córdoba, Argentina
| | - Ricardo Marcos Pautassi
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina.,Instituto de Investigación Médica M. y M. Ferreyra, INIMEC-CONICET-UNC, Córdoba, Argentina
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Analysis of the alcohol drinking behavior and influencing factors among emerging adults and young adults: a cross-sectional study in Wuhan, China. BMC Public Health 2019; 19:458. [PMID: 31039783 PMCID: PMC6492408 DOI: 10.1186/s12889-019-6831-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 04/15/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The relationship between alcohol use in adolescents and young adults and outcomes has not been widely researched in China. The aim of the current study was to understand the current status of drinking behavior of Chinese youth transitioning into adulthood. METHODS The cross-sectional study included 1634 participants between 18 and 34 years of age. The participants were randomly chosen from 13 administrative districts in Wuhan, and invited to complete a questionnaire. Univariate analysis was performed to describe the demographic distribution of alcohol consumption and the association with drinking status. Stepwise Logistic regression analysis was undertaken analyzing the factors influencing the drinking behaviors. The data were weighted to the population in Wuhan and analyzed using SAS version 9.3. RESULTS For our sample of emerging and young Chinese adults the prevalence of drinking alcohol was 45.84%. The non-drinkers predominated, accounting for 54.16% and light drinkers accounted for 42.94%, while moderate and heavy drinkers were in the minority (2.90%). The earlier the age of first alcohol drinking or the age of first being intoxicated, the greater the likelihood of being a moderate or heavy drinker. People with high emerging adulthood were more likely to have moderate or heavy drinking behaviors. The logistic regression analysis indicated that heavy drinkers were more likely to not be married and to be classified as high emerging adulthood. CONCLUSIONS Our findings suggested that the drinking pattern should be further evaluated over time to explore the ways in which social and cultural factors shape the drinking route of this age group. Effective drinking behavior prevention and interventions and appropriate guidance should be formulated to establish an appropriate attitude towards drinking alcohol and develop a drinking behavior which is conducive to physical and mental health between this particular demographic.
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Abstract
Excessive alcohol consumption is the second leading preventable cause of death in France (49,000/year), after tobacco consumption. Several recent studies found that the alcohol-related negative health consequences may occurs with small amounts of alcohol, in particular cancers. Therefore, the risk thresholds for alcohol consumption have been recently recommended not to be higher than 100g/week. Early age of onset of alcohol use is a strong predictor of alcohol use disorders and alcohol-related negative health outcomes. Subjects with alcohol use disorders are underdiagnosed and undertreated, with less than 10-15% of patients with severe alcohol use disorders per DSM-5 criteria receiving treatment. Early treatment of patients with alcohol use disorders decreases the alcohol-related negative health outcomes.
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Affiliation(s)
- Xavier Laqueille
- Centre hospitalier Sainte-Anne, service d'addictologie, 1, rue Cabanis, 75014 Paris, France; Université Paris 5, Descartes, 75006 Paris, France
| | - Marjorie Lacombe
- Centre hospitalier Sainte-Anne, service d'addictologie, 1, rue Cabanis, 75014 Paris, France; Université Paris 5, Descartes, 75006 Paris, France
| | - Alain Dervaux
- CHU Sud, service de psychiatrie et d'addictologie de liaison, 80054 Amiens cedex, France; Université de Picardie Jules-Verne, groupe de recherche sur l'alcool et les pharmacodépendances (GRAP), équipe de recherche Inserm U1247, chemin du Thil, 80000 Amiens, France; Université Paris Descartes, faculté de médecine Paris Descartes, laboratoire de physiopathologie des maladies psychiatriques, centre psychiatrie et neurosciences, Inserm U894, 15, rue de l'École-de-Médecine, 75006 Paris, France.
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