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Mestre-Bach G, Potenza MN, Granero R, Uríszar JC, Fernández-Aranda F, Jiménez-Murcia S. Statistical predictors of the co-occurrence between gambling disorder and problematic pornography use. J Psychiatr Res 2024; 178:125-129. [PMID: 39137720 DOI: 10.1016/j.jpsychires.2024.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 05/23/2024] [Accepted: 07/22/2024] [Indexed: 08/15/2024]
Abstract
Co-occurrence between gambling disorder (GD) and other mental disorders is common, but its association with problematic pornography use (PPU) remains unexplored. This study aimed to investigate relationships between sociodemographic variables, personality measures, psychopathology, emotional regulation, and impulsivity and the co-occurrence of GD and PPU using structural equation modeling (SEM). The sample consisted of 359 adults seeking treatment for GD. The short version of the Problematic Pornography Consumption Scale (PPCS-6) identified patients with GD + PPU. Psychopathology, impulsivity, emotional regulation, and personality were also assessed. Higher impulsivity levels statistically predicted co-occurrence between GD and PPU. Impulsivity mediated the relationship between younger age, maladaptive personality features, and emotional dysregulation and co-occurrence. Psychopathological distress did not directly associate with GD + PPU co-occurrence. Impulsivity relates importantly to the co-occurrence of GD and PPU. Younger age, maladaptive personality, and emotional dysregulation contribute to increased impulsivity levels and co-occurrence. The findings highlight the importance of addressing impulsivity in understanding and treating co-occurring GD and PPU.
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Affiliation(s)
- Gemma Mestre-Bach
- Instituto de Investigación, Transferencia e Innovación, Universidad Internacional de La Rioja, La Rioja, Spain.
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Department of Neuroscience, Yale University, New Haven, CT, USA; Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Departament de Psicobiologia i Metodologia de les Ciencies de la Salut, Universitat Autonoma de Barcelona, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Juan Carlos Uríszar
- Clinical Psychology Department, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; Sub-Directorate General for the Regulation of Gambling, Directorate General for Taxation and Gambling, Secretariat of Finance, Ministry of the Economy and Finance, Generalitat de Catalunya, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Clinical Psychology Department, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Clinical Psychology Department, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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Mestre-Bach G, Potenza MN. Pharmacological management of gambling disorder: an update of the literature. Expert Rev Neurother 2024; 24:391-407. [PMID: 38357896 DOI: 10.1080/14737175.2024.2316833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
INTRODUCTION Gambling disorder (GD) is a mental health condition characterized by persistent and problematic betting behavior. GD generates distress and impairment, and treatment options include psychological and pharmacological interventions. AREAS COVERED This narrative review explores existing pharmacological treatments for GD. The following classes of medications were considered: opioid-receptor antagonists (e.g. naltrexone and nalmefene), serotonin reuptake inhibitors (e.g. fluvoxamine, paroxetine, sertraline, escitalopram, and citalopram), glutamatergic agents (e.g. N-acetylcysteine (NAC), acamprosate, and memantine), mood stabilizers (e.g. topiramate, carbamazepine, lithium), and other medications (e.g. modafinil, nefazodone, olanzapine, haloperidol, tolcapone, and bupropion). EXPERT OPINION Due to the limitations of the studies reviewed, solid conclusions regarding the optimal choice of pharmacotherapy for individuals with GD are challenging to draw at this time. Despite some medications, such as naltrexone and nalmefene, showing promising results, efficacy has varied across studies. The review highlights current gaps/limitations, including small sample sizes, limited diversity in participant demographics, the need for exploring different gambling subtypes and treatment responses, high placebo response rates, lack of longer-term longitudinal information, limited investigation of neurobiological correlates and co-occurring disorders, and the importance of implementation research. Further research is needed to address these gaps and explore additional medications, as well as interventions like neuromodulation.
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Affiliation(s)
- Gemma Mestre-Bach
- Instituto de Investigación, Transferencia e Innovación, Universidad Internacional de La Rioja, La Rioja, Spain
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council On Problem Gambling, Wethersfield, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
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Mestre-Bach G, Potenza MN, Granero R, Uríszar JC, Tarragón E, Chiclana Actis C, Testa G, Fernández-Aranda F, Jiménez-Murcia S. Understanding the Co-occurrence of Gambling Disorder and Problematic Pornography Use: Exploring Sociodemographic and Clinical Factors. J Gambl Stud 2023:10.1007/s10899-023-10274-3. [PMID: 38151657 DOI: 10.1007/s10899-023-10274-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2023] [Indexed: 12/29/2023]
Abstract
The co-occurrence between gambling disorder (GD) and problematic pornography use (PPU) has not yet been explored. Therefore, the present study compared (a) sociodemographic variables, (b) GD-related factors, (c) substance use, (d) psychopathology, (e) personality features, (f) impulsivity, and (g) emotion regulation between individuals with GD (GD group) and those with co-occurring GD and PPU (GD+PPU group). The sample consisted of 359 treatment-seeking individuals with GD: n = 332 individuals had GD only (GD group) and n = 37 individuals had GD and co-occurring PPU (GD+PPU group). GD severity, impulsivity, psychopathology, personality, emotion regulation, and other sociodemographic and clinical variables were assessed. No between-group differences in sociodemographic measures were observed. The GD+PPU group demonstrated greater GD severity and a higher likelihood of substance use compared to those without PPU. Furthermore, the presence of PPU was associated with worse psychopathology, higher impulsivity (except for lack of premeditation and positive urgency), more difficulties in emotion regulation (except for non-acceptance of emotions and limited access to emotions), and a personality profile characterized by lower levels of self-directedness and cooperativeness. The co-occurrence of GD and PPU seems associated with a more dysfunctional clinical profile.
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Affiliation(s)
- Gemma Mestre-Bach
- Instituto de Investigación, Transferencia e Innovación, Universidad Internacional de La Rioja, Avenida de la Paz, 137, 26006, Logroño, La Rioja, Spain.
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Juan Carlos Uríszar
- Clinical Psychology Unit, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Sub-Directorate General for the Regulation of Gambling, Directorate General for Taxation and Gambling, Secretariat of Finance, Ministry of the Economy and Finance, Generalitat de Catalunya, Barcelona, Spain
| | | | - Carlos Chiclana Actis
- Instituto de Investigación, Transferencia e Innovación, Universidad Internacional de La Rioja, Avenida de la Paz, 137, 26006, Logroño, La Rioja, Spain
- Unidad de Sexología Clínica y Salud Sexual, Consulta Dr. Carlos Chiclana, Madrid, Spain
| | - Giulia Testa
- Instituto de Investigación, Transferencia e Innovación, Universidad Internacional de La Rioja, Avenida de la Paz, 137, 26006, Logroño, La Rioja, Spain
| | - Fernando Fernández-Aranda
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain.
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
- Bellvitge University Hospital-IDIBELL and CIBERObn, c/Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain.
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Farkouh R, Audette-Chapdelaine S, Brodeur M. Pharmacotherapy and gambling disorder: a narrative review. J Addict Dis 2023:1-15. [PMID: 37423770 DOI: 10.1080/10550887.2023.2229725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
BACKGROUND Gambling disorder (GD) is a psychiatric disorder classified in the DSM-5 as a non-substance-related and addictive disorder with extensive health and socioeconomic impacts. Its chronic and high-relapsing nature makes it essential to find treatment strategies that improve functioning and reduce impairment associated with it. The purpose of this narrative review is to evaluate and summarize the available evidence on the effectiveness and safety of pharmacotherapy in GD. METHODS An electronic literature search of Medline, Embase, and Cochrane Central was conducted to identify systematic reviews, meta-analyses, and reviews on pharmacological interventions in patients with gambling disorder. A similar search of these databases and of Prospero, Clinicaltrials.gov, and Epistemonikos was conducted to identify clinical trials that were published since 2019. RESULTS The initial search identified 1925 articles. After screening and duplicate removal, 18 articles were included in the review (11 studies were systematic reviews and meta-analyses, 6 were reviews, and 1 was an open-label trial). Eight pharmacological agents (naltrexone, nalmefene, paroxetine, fluvoxamine, citalopram, escitalopram, lithium, and topiramate) that were studied in randomized controlled trials and open-label trials showed small to moderate effect sizes in reducing GD symptoms in some studies during post-hoc analyses. CONCLUSION The overall sum of evidence in the literature on the use of pharmacotherapy in GD is conflicting and inconclusive. Some studies have shown that pharmacotherapy's role in GD is promising, especially when the choice of the agent is guided by comorbid psychiatric disorders. However, significant limitations exist in the study designs, which need to be addressed in future research on the topic. Conducting future and more rigorous trials that address the limitations in the existing literature is necessary to establish more accurate efficacy data on the use of pharmacotherapy in this population.
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Affiliation(s)
- Rezkalla Farkouh
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sophie Audette-Chapdelaine
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Magaly Brodeur
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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Pettorruso M, Di Carlo F, Romeo VM, Jimenez-Murcia S, Grant JE, Martinotti G, Di Giannantonio M. The pharmacological management of gambling disorder: if, when, and how. Expert Opin Pharmacother 2023; 24:419-423. [PMID: 36690348 DOI: 10.1080/14656566.2023.2172329] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Gambling disorder (GD) consists of a persistent, recurrent pattern of gambling that is associated with substantial distress or impairment. The etiology is multifactorial. GD frequently co-occurs with other psychiatric disorders and is often untreated. Different psychosocial interventions, particularly cognitive-behavioral therapy, are useful in the treatment of GD. Pharmacological therapy may also be helpful . No formal guidelines exist, and the management of the disease is often guided by few clinical elements. AREAS COVERED A literature search was performed using PubMed, Scopus, and Web of Science databases about treatment options for GD, considering both psychosocial treatments and available pharmacological ones. EXPERT OPINION The authors address whether and when it is appropriate to initiate pharmacological treatment for GD. They focus on providing clinicians with guidance on how to approach patients with GD in those situations where pharmacological therapy may be necessary. The reasons for the clinician to start thinking about a medication are examined. As specific traits in the psychopathology of GD may be managed with a strategic choice of the pharmacologic agent, the different available options are analyzed on the basis of their potential usefulness in GD. Issues that remain open about the pharmacological management of GD are summarized.
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Affiliation(s)
- Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Francesco Di Carlo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Vincenzo Maria Romeo
- Faculty of Psychological Sciences and Techniques, Dante Alighieri University, Reggio Calabria, Italy
| | - Susana Jimenez-Murcia
- Gambling Unit, Department of Psychiatry, University Hospital Bellvitge, Barcelona, Spain
| | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy.,Department of Pharmacy, Pharmacology and Clinical Science, University of Hertfordshire, Hatfield, UK
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy
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Widinghoff C, Berge J, Hakansson A. Psychiatric Drug Prescription and Temporal Associations with a First Diagnosis of Gambling Disorder—Results from a National Register Study. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00636-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
AbstractPsychiatric comorbidity is common in gambling disorder (GD), but there are few studies on larger nationwide samples of treatment-seeking patients. Also, temporal associations between GD and other psychiatric disorders are often difficult to study. To address the prevalence and the temporal associations of prescriptions for psychiatric disorders — both in specialized care and primary care — in patients with a GD diagnosis (ICD-10 F63.0). Data was derived from national health registers in Sweden. All patients who were diagnosed with GD in specialized health care in 2005–2016 were included and run against the nationwide database on prescription of pharmaceuticals aimed for psychiatric disorders (n = 2018). Prevalence of psychiatric drug prescription was used as a proxy for psychiatric comorbidity and studied for two 2-year periods (period 1 and 2) prior to GD and one 2-year period (period 3) after the diagnosis. Controlling for gender, age, and time periods, for eight drug categories (anti- epileptics, anti-psychotics, benzodiazepine derivatives, anxiolytics, hypnotics, anti- depressants and drugs used in addictive disorders), significant increases in drug prescription were seen. For central stimulants, a significant increase was seen upon receiving the GD diagnosis (from period 2 to 3), and for benzodiazepines, an increase was seen prior to the GD diagnosis (from period 1 to 2), but not upon diagnosis (from period 2 to 3). Psychiatric comorbidity in GD is common. Drug prescription for psychiatric problems increased markedly in the years temporarily associated with a first diagnosis of GD. The findings may call for early screening for problem gambling in patients with treatment contacts for increasingly poor mental health.
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Pharmacological and Psychosocial Treatment of Adults With Gambling Disorder: A Meta-Review. J Addict Med 2021; 14:e15-e23. [PMID: 31651561 DOI: 10.1097/adm.0000000000000574] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Gambling disorder (GD) leads to impaired socioeconomical functioning and increased social costs. Although the research on GD has been rising over the years, approved treatment guidelines are currently not available. The aim of this study was to systematically review the literature on the pharmacological and psychosocial treatment of adults with GD, and to identify possible agreed-upon standards of care. METHODS MEDLINE, PubMed, Cochrane, Web of Science, Embase, and CINAHL electronic databases were searched up to April 2019 for systematic reviews on pharmacological, psychosocial, and combined treatment of adults with GD. Twenty-six studies were eventually included in this meta-review. RESULTS Studies reported promising results of opioid antagonists and mood stabilizers in reducing GD-related symptomatology. Lithium was particularly effective in subjects with comorbid bipolar disorders. Cognitive behavioral therapy (CBT) was the most commonly used psychological intervention and reduced global severity, gambling frequency, and financial loss. Motivational interviewing (MI) seemed to improve several GD domains, alone or in combination with CBT. Self-help interventions (SHIs) showed some efficacy in promoting treatment-seeking, and in combination with other treatments. CONCLUSIONS We found moderate evidence of effect for CBT, but weaker evidence for pharmacotherapy and SHIs. Results suggested some efficacy for MI in the short but not in the long term. It is likely that certain interventions might be more effective than others on specific features of GD. Further studies are needed to compare the efficacy and acceptability of individual and combined psychosocial and pharmacological interventions, to deliver patient-tailored treatments.
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Black DW, Allen J, Bormann NL. Are Comorbid Disorders Associated with Changes in Gambling Activity? A Longitudinal Study of Younger and Older Subjects with DSM-IV Pathological Gambling. J Gambl Stud 2021; 37:1219-1230. [PMID: 33475936 DOI: 10.1007/s10899-021-10000-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2021] [Indexed: 12/29/2022]
Abstract
This study investigates the association of comorbid disorders with gambling activity in a longitudinal follow-up study of younger and older adult subjects with DSM-IV pathological gambling (PG). The subjects included 57 younger adults with PG (≥ 18/ < 40 years) and 48 older adults with PG (≥ 60 years). Subjects were assessed at baseline and every 6 months for a mean (SD) of 31.4 (13.1) months. Comorbidity was assessed using a modification of the Longitudinal Interval Follow-up Evaluation (LIFE). During follow-up, rates of problem severity were highest for anxiety disorders, mood disorders, and impulse control disorders. Among all subjects with PG, greater severity of depression or posttraumatic stress disorder was associated with increased gambling activity. In older subjects, greater severity of agoraphobia and social phobia were associated with lowered gambling activity. In younger subjects, greater severity of any substance use disorder, an alcohol use disorder, or compulsive computer use were associated with lowered gambling activity. The latter findings provide presumptive evidence for the substitute addiction hypothesis. We conclude that increased severity of several comorbid disorders could serve as triggers for increased gambling or predict lowered gambling activity. On the other hand, certain comorbid disorders could be triggered by increased gambling activity. Knowing these interrelationships is important to gaining a better understanding of PG and its clinical management.
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Affiliation(s)
- Donald W Black
- Department of Psychiatry, University of Iowa Carver College of Medicine, 2-126bMEB/Psychiatry Research, Iowa City, IA, 52242, USA.
| | - Jeff Allen
- Department of Psychiatry, University of Iowa Carver College of Medicine, 2-126bMEB/Psychiatry Research, Iowa City, IA, 52242, USA
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Yuan M, Lin H, Wu H, Yu M, Tu J, Lü Y. Community engagement in public health: a bibliometric mapping of global research. ACTA ACUST UNITED AC 2021; 79:6. [PMID: 33436063 PMCID: PMC7801880 DOI: 10.1186/s13690-021-00525-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/04/2021] [Indexed: 12/12/2022]
Abstract
Background Community engagement (CE) has been regarded as a critical element of successful health programs to achieve “the health for all” goals. Numerous studies have shown that it plays a significant role in reducing inequalities, improving social justice, enhancing benefits, and sharing responsibility towards public health. Despite this, the extant literature of community engagement in public health (CEPH) has topic-focused boundaries and is scattered across disciplinary. Large-scale studies are needed to systematically identify current status, hotspots, knowledge structure, dynamic trends, and future developments in this field. Methods The bibliometric techniques were applied in the analysis of publications on CEPH in Web of Science Core Collection from Thomson Reuters. One thousand one hundred two papers out of 70.8 million publications over the period of 1980 to 2020 and their 15,116 references were retrieved as the sample set. First, basic characteristics of publications, including distributions of geography, journals and categories, productive authors and frequently cited articles, etc. were obtained. Then, four bibliometric methods, i.e. social network analysis, co-citation analysis, co-occurrence clustering, and burst detection, were further conducted to sketch the contours of the structure and evolution of CEPH. Results Between Jan 1, 1980, and Apr 25, 2020, CEPH has attracted a sharp increase in interest all over the world. Total 117 countries or regions have participated in the field of CEPH and the contributions are geographically and institutionally distinct. The United States is the key region performing such research, which accounts for more than half of the total number of publications. Developing countries, such as South Africa, India, Brazil and China also contributed a lot. The advancements of CEPH are marked by historically momentous public health events and evolved from macroscopic strategies to mesoscopic and microscopic actions. Based on keyword clustering and co-citation clustering, we propose a 4O (i.e. orientation, object, operation, and outcome) framework of CEPH to facilitate a better understanding of the current global achievements and an elaborate structuring of developments in the future. Conclusion This study draws an outline of the global review on the contemporary and cross-disciplinary research of CEPH which might present an opportunity to take stock and understand the march of knowledge as well as the logical venation underlying research activities which are fundamental to inform policy making.
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Affiliation(s)
- Ming Yuan
- School of Civil Engineering, Zhengzhou University of Aeronautics, Zhengzhou, China
| | - Han Lin
- Jiangsu Key Laboratory of Public Project Audit, School of Information Engineering, Nanjing Audit University, Nanjing, China.
| | - Hengqin Wu
- College of Civil and Transportation Engineering, Shenzhen University, Shenzhen, China
| | - Mingchuan Yu
- School of Finance and Business, Shanghai Normal University, Shanghai, China
| | - Juan Tu
- The Institute of Acoustics, School of Physics, Nanjing University, Nanjing, China
| | - Yong Lü
- College of Computer and Information Engineering, Hohai University, Nanjing, China
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Rogier G, Beomonte Zobel S, Morganti W, Ponzoni S, Velotti P. Metacognition in gambling disorder: A systematic review and meta-analysis. Addict Behav 2021; 112:106600. [PMID: 32861990 DOI: 10.1016/j.addbeh.2020.106600] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 07/31/2020] [Accepted: 08/01/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION In recent literature, abnormalities in the metacognitive domain have been pointed out as psychological variables that may account for a wide range of psychopathologies, including gambling disorder (GD). Considering the growing but scattered nature of the research concerning the relationship between metacognition and GD, a systematic review and meta-analysis of the existing results are required. METHODS We performed a systematic search through five scientific databases for research published till December 10, 2019, following PRISMA guidelines. We also searched grey literature. After removing the redundancy, 16.855 records were screened. RESULTS Unanimously, authors selected 10 articles based on the inclusion criteria. Four of the selected studies evaluated metacognitive abilities towards cognitive performances, mostly considering metacognitive deficits about decision-making, while metacognitive beliefs were assessed by six of the selected articles. Only one study examined metacognitive functioning regarding GD. The meta-analytic procedure was performed on 10 identified studies based on the criteria adopted, which comprised 1.655 individuals. Results showed that the average effect size linking metacognitive dysfunctions and GD was significant and moderated by the instrument used to measure metacognition. CONCLUSIONS The examined line of research is highly heterogeneous owing to the type of operationalization adopted for metacognition. The systematic review also showed a grey area, evidencing the lack of research on metacognitive functions. Results demonstrated by this meta-analysis call for future studies examining the role of metacognitive deficits in GD in order to delineate useful clinical indications.
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Affiliation(s)
- Guyonne Rogier
- Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | | | | | - Sara Ponzoni
- School of Social Sciences, University of Genoa, Italy
| | - Patrizia Velotti
- Faculty of Medicine and Psychology, Sapienza University of Rome, Italy.
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Abstract
Mixed affective states occur in approximately 40% of patients with mood disorders and are burdened with a significant rate of comorbidities, including addictive disorders (AD). The co-occurrence of mixed features and AD represents a challenge for clinicians because the reciprocal, negative influence of these conditions leads to a worse course of illness, treatment resistance, unfavorable outcome, and higher suicide risk. This article discusses clinical presentation, possible common pathogenetic pathways, and treatment options. Further investigations are required to clarify the determinants and the implications of this co-occurrence, and to detect suitable approaches in clinical management.
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Kraus SW, Etuk R, Potenza MN. Current pharmacotherapy for gambling disorder: a systematic review. Expert Opin Pharmacother 2020; 21:287-296. [PMID: 31928246 DOI: 10.1080/14656566.2019.1702969] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: Gambling disorder is classified as an addictive disorder and is associated with significant distress and impairment in personal, social, occupational or other important areas of functioning. Although no pharmacotherapy has a formal indication for gambling disorder, data suggest potential benefits of specific medications.Area covered: This systematic review evaluated findings from 19 randomized controlled trials testing pharmacotherapies for the treatment of gambling disorder.Expert opinion: Few randomized controlled trials have studied pharmacotherapies for gambling disorder. Though results are limited, opioid antagonists like naltrexone showed promise in the pharmacological treatment of gambling disorder. Pharmacotherapy combined with psychotherapy treatments for gambling disorder may provide better rates of patient retention in comparison to pharmacology-only treatments, though further research is needed in this area. Future studies should address gaps relating to considerations of racial, ethnic, gender and other individual differences in clinical studies. Because gambling disorder often co-occurs with other psychiatric disorders, additional research is needed to test treatments for dually diagnosed patients.
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Affiliation(s)
- Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Repairer Etuk
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA.,Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA.,The Connecticut Council on Problem Gambling, Wethersfield, CT, USA.,The Connecticut Mental Health Center, New Haven, CT, USA
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Aragay N, Pijuan L, Cabestany À, Ramos-Grille I, Garrido G, Vallès V, Jovell-Fernández E. Current Addiction in Youth: Online Sports Betting. Front Psychiatry 2020; 11:590554. [PMID: 33519547 PMCID: PMC7838454 DOI: 10.3389/fpsyt.2020.590554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 12/14/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Gambling landscape has changed in recent years with the emergence of online gambling (OG). Greater accessibility and availability of this betting modality can increase the risk of developing a gambling disorder (GD). Online sports betting (OSB) is currently the most common type of OG, but little is known about the clinical characteristics of OSB compared to slot-machine (SM) gamblers, the most common offline gambling disorder. Methods: This was a prospective study conducted between October 2005 and September 2019, and included outpatients diagnosed with GD seen in a Pathological Gambling and Behavioral Addictions referral unit. Only patients with OSB and SM disorders were included. The main objective was to assess the clinical profile of OSB compared to SM gamblers, and to define clinical predictors for developing OSB gambling disorder. Logistic regression was performed to determine the effects of variables on the likelihood of this disorder. Results: Among 1,186 patients attended in our Unit during the study period, 873 patients were included; 32 (3.7%) were OSB gamblers and 841 (96.3%) were SM gamblers. Overall, mean age was 45 ± 13 years and 94.3% were men. Compared to SM patients, OSB patients were younger (34.9 ± 9.5 vs. 45.3 ±13), more frequently single (43.8 vs. 20.6%) and had a university education level (43.8 vs. 4.5%); they were also more frequently non-smokers (18.7 vs. 66.7%) and had fewer psychiatric comorbidities (12.5 vs. 29.4%) than SM gamblers. GD duration before treatment initiation was shorter in OSB patients than in SM gamblers, most of them (81.3 vs. 42.4%) with ≤ 5 years of GD duration. OSB gamblers showed significant differences in weekly gambling expenditure, spending higher amounts than SM patients. Younger age (OR: 0.919; 95% CI: 0.874-0.966), university education level (OR: 10.658; 95% CI: 3.330-34.119), weekly expenditure >100€ (OR: 5.811; 95% CI:1.544-21.869), and being a non-smoker (OR:13.248; 95% CI:4.332-40.517) were associated with an increased likelihood of OSB gambling behavior. Conclusions: We identified different profiles for OSB and SM gamblers. Younger age, university education level, higher weekly expenditure, and non-smoking habit were associated with OSB compared to SM disorders. Prevention strategies should help young people become aware of the severe risks of OSB.
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Affiliation(s)
- Núria Aragay
- Pathological Gambling Unit, Department of Mental Health, Consorci Sanitari de Terrassa, Terrassa, Spain.,Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Laia Pijuan
- Department of Mental Health, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Àngela Cabestany
- Department of Mental Health, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Irene Ramos-Grille
- Pathological Gambling Unit, Department of Mental Health, Consorci Sanitari de Terrassa, Terrassa, Spain.,Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.,Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gemma Garrido
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.,Community Mental Health Service, Department of Mental Health, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Vicenç Vallès
- Pathological Gambling Unit, Department of Mental Health, Consorci Sanitari de Terrassa, Terrassa, Spain.,Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.,Department of Mental Health, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Esther Jovell-Fernández
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.,Department of Epidemiology, Consorci Sanitari de Terrassa, Terrassa, Spain
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14
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Rogier G, Beomonte Zobel S, Velotti P. Pathological personality facets and emotion (dys)regulation in gambling disorder. Scand J Psychol 2019; 61:262-270. [PMID: 31625173 DOI: 10.1111/sjop.12579] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 08/02/2019] [Indexed: 12/15/2022]
Abstract
A number of researches showed high prevalence of personality disorders among addicted gamblers. However, there are still few studies investigating the role of pathological personality facets in Gambling Disorder (GD). Moreover, the nature of the relationship between GD and pathological personality is not clear. We administered to a group of addicted gamblers (N = 79) and a group of healthy participants (N = 101) a battery of self-report questionnaires encompassing the South Oaks Gambling Screen (SOGS), The Personality Inventory for DSM-V (PID-5), the Difficulties in Emotion Regulation Scale (DERS) and the Emotion Regulation Questionnaire (ERQ). Analyses of variance showed that addicted gamblers, compared to healthy participants, scored higher on most of the subscales of the DERS, on the Suppression Dimension of the ERQ and on the five main domains of the PID-5 whereas they obtained lower scores on the Reappraisal subscale of the ERQ. Moreover, multiple regression analyses indicated that some specific facets of pathological personality, emotion dysregulation and lack of cognitive reappraisal, significantly predict GD's severity. Finally, emotion dysregulation levels and lack of cognitive reappraisal partially mediated the relationship between these and GD's severity. Our results confirmed the central roles played by both pathological personality and deficit in emotion regulation capacities in GD. Specifically, Impulsivity, Lack of Perseverance and Suspiciousness may be important predictors of GD severity. Moreover, emotion dysregulation and lack of adaptive emotion regulation strategies partially explained such relationship. As such, training for emotion regulation abilities appears strategically useful in the treatment of addicted gamblers with pathological personality traits.
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Affiliation(s)
- Guyonne Rogier
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Roma, Italy
| | - Sara Beomonte Zobel
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Roma, Italy
| | - Patrizia Velotti
- Department of Educational Sciences, University of Genoa, Genova, Italy
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15
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Fusar-Poli L, Surace T, Vanella A, Meo V, Patania F, Furnari R, Signorelli MS, Aguglia E. The effect of adjunctive nutraceuticals in bipolar disorder: A systematic review of randomized placebo-controlled trials. J Affect Disord 2019; 252:334-349. [PMID: 30999090 DOI: 10.1016/j.jad.2019.04.039] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/11/2019] [Accepted: 04/07/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Nutraceuticals are a group of compounds of growing interest for mental health professionals. Given the implication of certain nutrients in the onset of bipolar disorder, it has been hypothesized that nutraceuticals might be effective in improving symptoms of the condition (i.e. mania or depression). Our systematic review aimed to evaluate the effectiveness of adjunctive nutraceuticals compared to placebo. METHODS We searched the following databases from inception to February 2019: Web of Science, CINAHL, Embase, and PsycINFO. We included only original randomized controlled trials written in English, testing the efficacy of nutraceuticals in add-on to standard care, compared to placebo, in patients with bipolar disorder. RESULTS After identifying 6584 potentially relevant publications, we finally included 25 studies, among which six used fatty acids, seven micronutrients, seven amino acids. One study tested probiotics, while in four trials a combination of different types of nutraceuticals was used. Even if some compounds have shown promising results (i.e. fatty acids and N-acetyl cysteine for depression, amino acid drinks and folic acid for mania), the majority of nutraceuticals did not cause significant improvements in comparison to placebo. LIMITATIONS We could not perform a meta-analysis due to the high heterogeneity of trials, which were also affected by some methodological caveats. CONCLUSIONS Evidence regarding the efficacy of adjunctive nutraceuticals in bipolar disorder is inconsistent. Nevertheless, they appear generally free from relevant side effects. Well-designed trials are needed to further explore the potential role of nutraceuticals in different mood episodes.
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Affiliation(s)
- Laura Fusar-Poli
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Italy; U.O.C. Clinica Psichiatrica, A.O.U. Policlinico-Vittorio Emanuele, Presidio "G. Rodolico", Catania, Italy.
| | - Teresa Surace
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Italy; U.O.C. Clinica Psichiatrica, A.O.U. Policlinico-Vittorio Emanuele, Presidio "G. Rodolico", Catania, Italy
| | - Antonio Vanella
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Italy; U.O.C. Clinica Psichiatrica, A.O.U. Policlinico-Vittorio Emanuele, Presidio "G. Rodolico", Catania, Italy
| | - Valeria Meo
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Italy; U.O.C. Clinica Psichiatrica, A.O.U. Policlinico-Vittorio Emanuele, Presidio "G. Rodolico", Catania, Italy
| | - Federica Patania
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Italy; U.O.C. Clinica Psichiatrica, A.O.U. Policlinico-Vittorio Emanuele, Presidio "G. Rodolico", Catania, Italy
| | - Rosaria Furnari
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Italy; U.O.C. Clinica Psichiatrica, A.O.U. Policlinico-Vittorio Emanuele, Presidio "G. Rodolico", Catania, Italy
| | - Maria Salvina Signorelli
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Italy; U.O.C. Clinica Psichiatrica, A.O.U. Policlinico-Vittorio Emanuele, Presidio "G. Rodolico", Catania, Italy
| | - Eugenio Aguglia
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Italy; U.O.C. Clinica Psichiatrica, A.O.U. Policlinico-Vittorio Emanuele, Presidio "G. Rodolico", Catania, Italy
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16
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Fernández-Aranda F, Granero R, Mestre-Bach G, Steward T, Müller A, Brand M, Mena-Moreno T, Vintró-Alcaraz C, del Pino-Gutiérrez A, Moragas L, Mallorquí-Bagué N, Aymamí N, Gómez-Peña M, Lozano-Madrid M, Menchón JM, Jiménez-Murcia S. Spanish validation of the pathological buying screener in patients with eating disorder and gambling disorder. J Behav Addict 2019; 8:123-134. [PMID: 30932708 PMCID: PMC7044599 DOI: 10.1556/2006.8.2019.08] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND AIMS Pathological buying (PB) is a behavioral addiction that presents comorbidity with several psychiatric disorders. Despite the increase in the prevalence estimates of PB, relatively few PB instruments have been developed. Our aim was to assess the psychometric properties of the Spanish version of the pathological buying screener (PBS) and to explore the associations between PB, psychopathology, and personality traits. METHODS A total of 511 participants, including gambling disorder (GD) and eating disorder (ED) patients diagnosed according to DSM-5 criteria, as well as healthy controls (HCs), took part in the study. RESULTS Higher PB prevalence was obtained in ED patients than in the other two study groups (ED 12.5% vs. 1.3% HC and 2.7% GD). Confirmatory factor analysis (CFA) verified the 13-item structure of the PBS, and indexes of convergent and discriminant capacity were estimated. CFA confirmed the structure in two factors (excessive buying behavior and loss of control) with excellent internal consistency (α = .92 and .86, respectively). Good convergent capacity was obtained with external psychopathology and personality measures (positive correlations with novelty seeking and negative associations with self-directedness and harm avoidance were found). Good discriminative capacity to differentiate between the study groups was obtained. DISCUSSION AND CONCLUSIONS This study provides support for the reliability and validity of the Spanish adaptation of the PBS. Female sex, higher impulsivity, and higher psychopathology were associated with PB.
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Affiliation(s)
- Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Corresponding authors: Susana Jiménez-Murcia, PhD; Head of Gambling Disorder Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain; Phone: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mail: ; Fernando Fernández-Aranda, PhD; Head of ED Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain; Phone: +34 93 260 72 27; Fax: +34 93 260 76 58; E-mail:
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Trevor Steward
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany,Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Teresa Mena-Moreno
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Vintró-Alcaraz
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Amparo del Pino-Gutiérrez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Departament d’Infermeria de Salut Pública, Salut Mental i Maternoinfantil, Escola Universitària d’Infermeria, Universitat de Barcelona, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Núria Mallorquí-Bagué
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Neus Aymamí
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - María Lozano-Madrid
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - José M. Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Corresponding authors: Susana Jiménez-Murcia, PhD; Head of Gambling Disorder Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain; Phone: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mail: ; Fernando Fernández-Aranda, PhD; Head of ED Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain; Phone: +34 93 260 72 27; Fax: +34 93 260 76 58; E-mail:
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17
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Varo C, Murru A, Salagre E, Jiménez E, Solé B, Montejo L, Carvalho AF, Stubbs B, Grande I, Martínez-Arán A, Vieta E, Reinares M. Behavioral addictions in bipolar disorders: A systematic review. Eur Neuropsychopharmacol 2019; 29:76-97. [PMID: 30420190 DOI: 10.1016/j.euroneuro.2018.10.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/18/2018] [Accepted: 10/23/2018] [Indexed: 12/16/2022]
Abstract
Clinical and epidemiological research suggests that behavioral addictions (BA) are associated with a wide range of psychiatric disorders. However, the relationship between BA and bipolar disorders (BD) has not been thoroughly explored. The aim of this systematic review was to critically summarize and evaluate the current available evidence regarding a possible association between BA and BD. A systematic review of major electronic databases according to PRISMA guidelines was conducted from inception to 31st December 2017. We sought quantitative studies data concerning prevalence of comorbidity, features and treatment related to BA-BD comorbidity. Data were narratively synthesized. Of the 1250 studies returned from the search, a total of 28 articles were included in this review. BA may be overrepresented in BD samples, and the other way around. Pathological gambling and kleptomania were the most prevalent conditions followed by compulsive buying, compulsive sexual behavior and internet addiction. BA was also associated with other mood disorders, anxiety disorders and substance use disorder. BD-BA comorbidity was related with more severe course of illness. Studies on treatment strategies for BD-BA comorbidity are rather limited; only one randomized controlled trial that fulfilled inclusion criteria was identified. Methodological heterogeneity in terms of design and results among studies was found. BD-BA commonly co-occurs although there is a need for rigorous studies. Routine screening and adequate assessment may be helpful in BD patients to identify individuals at risk for BA and to effectively manage the complex consequences associated with BA-BD comorbidity.
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Affiliation(s)
- C Varo
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A Murru
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - E Salagre
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Jiménez
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Solé
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - L Montejo
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom
| | - I Grande
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A Martínez-Arán
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Vieta
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - M Reinares
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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18
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Martinotti G, Chillemi E, Lupi M, Risio LD, Pettorruso M, Giannantonio MD. Gambling disorder and bilateral transcranial direct current stimulation: A case report. J Behav Addict 2018; 7:834-837. [PMID: 30264605 PMCID: PMC6426396 DOI: 10.1556/2006.7.2018.85] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Gambling disorder (GD) is a major public health concern with currently no validated and efficacious treatments approved. In this single case study, we report the short- and long-term effect of bilateral transcranial direct current stimulation (tDCS) of dorsolateral prefrontal cortex (DLPFC) on craving and impulse control in a subject with GD. METHODS The patient is a 26-year-old Caucasian male with an 8-year history of GD as well as alcohol and cocaine misuse. Treatment consisted of twice-a-day stimulation for 10 days. According to the literature, both the left (to control craving) and the right (to control emotional impulses) DLPFC were stimulated. Patients subsequently received tDCS once a week for 3 months and then once every 2 weeks for another 3 months. RESULTS After 10 days of treatment, the subject reported improved psychiatric symptoms (depression, anxiety, and impulsivity), as well as reduced gambling craving symptom severity. After 3 and 6 months of treatment, the clinical picture further improved. DISCUSSION This is the first report of tDCS effectiveness in a single case study of GD. Therapeutic effects, both on the addictive behavior and on psychiatric comorbid symptomatology, were lasting and continued over 6 months of tDCS maintenance treatment. Future case-control studies are required to test the efficacy of this tool in patients with GD.
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Affiliation(s)
- Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy,Department of Pharmacy, Pharmacology, Clinical Science, University of Hertfordshire, Herts, UK
| | | | - Matteo Lupi
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy,Corresponding author: Matteo Lupi, MD; Department of Neuroscience and Imaging, University “G. d’Annunzio”, Via dei Vestini 33, 66100, Chieti, Italy; Phone: +39 3385302482; Fax: +39 08713555887; E-mail:
| | - Luisa De Risio
- Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario “A.Gemelli”, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy
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19
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Kristensen M, Nierenberg AA, Østergaard SD. Face and predictive validity of the ClockΔ19 mouse as an animal model for bipolar disorder: a systematic review. Mol Psychiatry 2018; 23:70-80. [PMID: 29112195 DOI: 10.1038/mp.2017.192] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 07/13/2017] [Accepted: 07/17/2017] [Indexed: 02/07/2023]
Abstract
Mice carrying the circadian locomotor output cycles Kaput delta 19 N-ethyl-N-nitrosoure (ENU) mutation (ClockΔ19) are used as an animal model for bipolar disorder (BD). We aimed to systematically review the face validity (phenotypical and pathophysiological resemblance with BD) and predictive validity (responsiveness to treatments used in BD) of this model in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. We carried out a systematic search of the databases PubMed and Embase, combining search terms covering BD and ClockΔ19. The 22 studies included in the review (from a total of 1281 identified records) show that the behavioral phenotype of the ClockΔ19 mouse is characterized by hyperactivity, decreased anxiety-like behavior, decreased depression-like behavior and increased preference for rewarding stimuli. This is highly consistent with mania in humans. Moreover, the ClockΔ19 mouse exhibits rapid mood cycling (a manic-like phenotype during the day followed by euthymia at night), which is consistent with BD. Chronic administration of lithium, a drug with well established mood-stabilizing effect in humans with BD, reverses the majority of the bipolar-like traits and most of the neurobiological abnormalities observed in the ClockΔ19 mouse. In conclusion, the ClockΔ19 mouse has substantial face validity as an animal model for BD. The predictive validity of the ClockΔ19 mouse has primarily been investigated via studies using lithium challenge. Therefore, further studies are needed to determine how the ClockΔ19 mouse responds to other mood-stabilizing treatments of BD such as valproate, lamotrigine, carbamazepine, oxcarbazepine, antipsychotics, electroconvulsive therapy and various light interventions.
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Affiliation(s)
- M Kristensen
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - A A Nierenberg
- Bipolar Clinic and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - S D Østergaard
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark
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20
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Neural correlates of cognitive control in gambling disorder: a systematic review of fMRI studies. Neurosci Biobehav Rev 2017; 78:104-116. [DOI: 10.1016/j.neubiorev.2017.04.025] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 04/18/2017] [Accepted: 04/22/2017] [Indexed: 12/21/2022]
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21
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Montes KS, Weatherly JN. Differences in the Gambling Behavior of Online and Non-online Student Gamblers in a Controlled Laboratory Environment. J Gambl Stud 2017; 33:85-97. [PMID: 27106027 DOI: 10.1007/s10899-016-9613-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Although research suggests that approximately 1 in 4 college students report having gambled online, few laboratory-based studies have been conducted enlisting online student gamblers. Moreover, it is unclear the extent to which differences in gambling behavior exist between online and non-online student gamblers. The current study examined if online gamblers would play more hands, commit more errors, and wager more credits than non-online student gamblers in a controlled, laboratory environment. Online (n = 19) and non-online (n = 26) student gamblers played video poker in three separate sessions and the number of hands played, errors committed, and credits wagered were recorded. Results showed that online student gamblers played more hands and committed more errors playing video poker than non-online student gamblers. The results from the current study extend previous research by suggesting that online gamblers engage in potentially more deleterious gambling behavior (e.g., playing more hands and committing more errors) than non-online gamblers. Additional research is needed to examine differences in the gambling behavior of online and non-online gamblers in a controlled, laboratory environment.
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Affiliation(s)
- Kevin S Montes
- Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, 2650 Yale SE MSC 11-6280, Albuquerque, NM, 87106, USA.
| | - Jeffrey N Weatherly
- Psychology Department, University of North Dakota, Corwin-Larimore Hall, 319 Harvard St, P.O. Box 8380, Grand Forks, ND, 58202, USA
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22
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Granero R, Fernández-Aranda F, Baño M, Steward T, Mestre-Bach G, Del Pino-Gutiérrez A, Moragas L, Mallorquí-Bagué N, Aymamí N, Goméz-Peña M, Tárrega S, Menchón JM, Jiménez-Murcia S. Compulsive buying disorder clustering based on sex, age, onset and personality traits. Compr Psychiatry 2016; 68:1-10. [PMID: 27234176 DOI: 10.1016/j.comppsych.2016.03.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 03/09/2016] [Accepted: 03/14/2016] [Indexed: 01/17/2023] Open
Abstract
UNLABELLED In spite of the revived interest in compulsive buying disorder (CBD), its classification into the contemporary nosologic systems continues to be debated, and scarce studies have addressed heterogeneity in the clinical phenotype through methodologies based on a person-centered approach. OBJECTIVES To identify empirical clusters of CBD employing personality traits, as well as patients' sex, age and the age of CBD onset as indicators. METHODS An agglomerative hierarchical clustering method defining a combination of the Schwarz Bayesian Information Criterion and log-likelihood was used. RESULTS Three clusters were identified in a sample of n=110 patients attending a specialized CBD unit a) "male compulsive buyers" reported the highest prevalence of comorbid gambling disorder and the lowest levels of reward dependence; b) "female low-dysfunctional" mainly included employed women, with the highest level of education, the oldest age of onset, the lowest scores in harm avoidance and the highest levels of persistence, self-directedness and cooperativeness; and c) "female highly-dysfunctional" with the youngest age of onset, the highest levels of comorbid psychopathology and harm avoidance, and the lowest score in self-directedness. CONCLUSION Sociodemographic characteristics and personality traits can be used to determine CBD clusters which represent different clinical subtypes. These subtypes should be considered when developing assessment instruments, preventive programs and treatment interventions.
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Affiliation(s)
- Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/ Monforte de Lemos, 3-5, Pabellón 11 - Planta 0, 28029, Madrid, Spain; Department of Psychobiology and Methodology of Health Science, Autonomous University of Barcelona, C/ Fortuna Edificio B, 08193, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/ Monforte de Lemos, 3-5, Pabellón 11 - Planta 0, 28029, Madrid, Spain; Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/ Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Campus de Bellvitge - Pavelló de Govern, Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Marta Baño
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/ Monforte de Lemos, 3-5, Pabellón 11 - Planta 0, 28029, Madrid, Spain; Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/ Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Trevor Steward
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/ Monforte de Lemos, 3-5, Pabellón 11 - Planta 0, 28029, Madrid, Spain; Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/ Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Gemma Mestre-Bach
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/ Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- Nursing Department of Mental Health, Public Health, Maternal and Child Health, Nursing School, University of Barcelona, Campus de Bellvitge - Pavelló de Govern, Feixa Llarga s/n, 08907, Hospitalet del Llobregat, Barcelona, Spain
| | - Laura Moragas
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/ Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Núria Mallorquí-Bagué
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/ Monforte de Lemos, 3-5, Pabellón 11 - Planta 0, 28029, Madrid, Spain; Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/ Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Neus Aymamí
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/ Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Mónica Goméz-Peña
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/ Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Salomé Tárrega
- Department of Psychobiology and Methodology of Health Science, Autonomous University of Barcelona, C/ Fortuna Edificio B, 08193, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain
| | - José M Menchón
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/ Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Campus de Bellvitge - Pavelló de Govern, Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain; Ciber de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Pabellón 11 - Planta 0, 28029, Madrid, Spain
| | - Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/ Monforte de Lemos, 3-5, Pabellón 11 - Planta 0, 28029, Madrid, Spain; Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/ Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Campus de Bellvitge - Pavelló de Govern, Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain.
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23
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Pettorruso M, Fasano A, De Risio L, Ricciardi L, Di Nicola M, Martinotti G, Janiri L, Bentivoglio AR. Punding in non-demented Parkinson's disease patients: Relationship with psychiatric and addiction spectrum comorbidity. J Neurol Sci 2016; 362:344-7. [DOI: 10.1016/j.jns.2016.02.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 12/06/2015] [Accepted: 02/07/2016] [Indexed: 12/28/2022]
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The role of comorbidities in duration of untreated illness for bipolar spectrum disorders. J Affect Disord 2015; 188:319-23. [PMID: 26408989 DOI: 10.1016/j.jad.2015.09.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 09/02/2015] [Accepted: 09/05/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Growing interest has been given to the construct of Duration of untreated illness (DUI) on the outcome of bipolar disorder (BD), due to its potentially modifiable nature. The aim of this study was to identify possible clinical correlates of DUI in a sample of BD patients. METHOD 119 BD spectrum patients included. DUI rate was calculated and dichotomized into short DUI and long DUI subgroups, cut-off 24 months. These subgroups were compared for socio-demographic and clinical variables. Significant results were included into direct logistic regressions to assess their impact on the likelihood of presenting with long DUI. RESULTS Mean DUI±SD was 75.6±98.3 months. Short DUI subgroup comprised 56 (47.1%), long DUI 60 (52.9%) patients. Age at onset of BD was lower in the long DUI subgroup (p=0.021), illness duration longer (p=0.011). Long DUI subgroup showed significantly more comorbidity with Axis I (p=0.002) and personality disorders (p=0.017), less interepisodic recovery (p<0.001) and less Manic Predominant Polarity (p=0.009). Direct logistic regression as a full model was significant, correctly classifying 76.7% of cases. A unique statistically significant contribution was made by: Manic Predominant Polarity, Personality Disorder Comorbidity, and Total Changes in Medications. LIMITATIONS Partial retrospective data, cross sectional study. CONCLUSIONS DUI was longer than 24 months in half of the sample. Psychotic /Manic onset contributed to a quick diagnostic classification. Personality disorders in depressed patients could delay a correct diagnosis of BD, factors associated with an increased likelihood of BD must be considered. More research on personality disorder comorbidities is needed.
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25
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Bussu A, Detotto C. The bidirectional relationship between gambling and addictive substances. INTERNATIONAL GAMBLING STUDIES 2015. [DOI: 10.1080/14459795.2015.1042493] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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26
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Di Nicola M, Tedeschi D, De Risio L, Pettorruso M, Martinotti G, Ruggeri F, Swierkosz-Lenart K, Guglielmo R, Callea A, Ruggeri G, Pozzi G, Di Giannantonio M, Janiri L. Co-occurrence of alcohol use disorder and behavioral addictions: relevance of impulsivity and craving. Drug Alcohol Depend 2015; 148:118-25. [PMID: 25630963 DOI: 10.1016/j.drugalcdep.2014.12.028] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Revised: 12/20/2014] [Accepted: 12/22/2014] [Indexed: 12/24/2022]
Abstract
PURPOSE The aims of the study were to evaluate the occurrence of behavioral addictions (BAs) in alcohol use disorder (AUD) subjects and to investigate the role of impulsivity, personality dimensions and craving. METHODS 95 AUD outpatients (DSM-5) and 140 homogeneous controls were assessed with diagnostic criteria and specific tests for gambling disorder, compulsive buying, sexual, internet and physical exercise addictions, as well as with the Barratt Impulsiveness Scale (BIS-11) and Temperamental and Character Inventory-Revised (TCI-R). The Obsessive Compulsive Drinking Scale (OCDS) and Visual Analogue Scale for craving (VASc) were also administered to the AUD sample. RESULTS 28.4% (n=27) of AUD subjects had at least one BA, as compared to 15% (n=21) of controls (χ(2)=6.27; p=.014). In AUD subjects, direct correlations between BIS-11 and Compulsive Buying Scale (CBS), Internet Addiction Disorder test (IAD), Exercise Addiction Inventory-Short Form (EAI-SF) scores (p<.01), between OCDS obsessive and CBS and VASc and CBS, IAD scores (p<.003), were found. BIS-11 (t=-2.36; p=.020), OCDS obsessive (Z=-4.13; p<.001), OCDS compulsive (Z=-2.12; p=.034) and VASc (Z=-4.94; p<.001) scores were higher in AUD subjects with co-occurring BAs. The occurrence of BAs was associated with higher impulsivity traits (BIS-11 scores; OR=1.08; p=.012) and higher craving levels (VASc scores; OR=2.48; p<.001). CONCLUSIONS Our findings emphasize a significant rate of co-occurrence of BAs in AUD. High levels of impulsivity and craving for alcohol seem to be associated with other addictive behaviors.
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Affiliation(s)
- Marco Di Nicola
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy; University Consortium Humanitas, Via della Conciliazione 22, 00193 Rome, Italy.
| | - Daniela Tedeschi
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Luisa De Risio
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Mauro Pettorruso
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Giovanni Martinotti
- Department of Neuroscience and Imaging, Institute of Psychiatry, "G. d'Annunzio" University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Filippo Ruggeri
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Kevin Swierkosz-Lenart
- Centre Neuchâtelois de Psychiatrie, République et Canton de Neuchâtel, Site de Préfargier, 2074 Marin-Epagnier, Switzerland
| | - Riccardo Guglielmo
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Antonino Callea
- Science of Education, LUMSA University, Borgo Sant'Angelo, 13, 00193 Rome, Italy
| | - Giuseppe Ruggeri
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Gino Pozzi
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience and Imaging, Institute of Psychiatry, "G. d'Annunzio" University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Luigi Janiri
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy; University Consortium Humanitas, Via della Conciliazione 22, 00193 Rome, Italy
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Targeting the glutamatergic system to treat pathological gambling: current evidence and future perspectives. BIOMED RESEARCH INTERNATIONAL 2014; 2014:109786. [PMID: 25013755 PMCID: PMC4075088 DOI: 10.1155/2014/109786] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 05/22/2014] [Indexed: 12/14/2022]
Abstract
Pathological gambling or gambling disorder has been defined by the DSM-5 as a behavioral addiction. To date, its pathophysiology is not completely understood and there is no FDA-approved treatment for gambling disorders. Glutamate is the principal excitatory neurotransmitter in the nervous system and it has been recently involved in the pathophysiology of addictive behaviors. In this paper, we review the current literature on a class of drugs that act as modulating glutamate system in PG. A total of 19 studies have been included, according to inclusion and exclusion criteria. Clinical trial and case series using glutamatergic drugs (N-acetylcysteine, memantine, amantadine, topiramate, acamprosate, baclofen, gabapentin, pregabalin, and modafinil) will be presented to elucidate the effectiveness on gambling behaviors and on the related clinical dimensions (craving, withdrawal, and cognitive symptoms) in PG patients. The results have been discussed to gain more insight in the pathophysiology and treatment of PG. In conclusion, manipulation of glutamatergic neurotransmission appears to be promising in developing improved therapeutic agents for the treatment of gambling disorders. Further studies are required. Finally, we propose future directions and challenges in this research area.
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Pharmacological treatments in gambling disorder: a qualitative review. BIOMED RESEARCH INTERNATIONAL 2014; 2014:537306. [PMID: 24955359 PMCID: PMC4052082 DOI: 10.1155/2014/537306] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 04/23/2014] [Indexed: 12/17/2022]
Abstract
Gambling disorder (GD) is a psychiatric condition associated with both social and family costs; DSM-5 currently includes GD among addictive disorders. Despite the high burden of this condition, to date there are no treatment guidelines approved by Food and Drug Administration (FDA). Purpose of this paper is to offer a qualitative overview about the different pharmacologic agents used for the treatment of GD. Our analysis, conducted on a final selection of 75 scientific papers, demonstrates that a variety of pharmaceutical classes have been utilised, with different results. Published data, although limited by brief duration of the studies and small number of enrolled subjects, shows mixed evidence for serotonergic antidepressants, opioid antagonists, and mood stabilizers. Other compounds, such as glutamatergic agents and psychostimulants, deserve further studies.
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Pettorruso M, De Risio L, Di Nicola M, Martinotti G, Conte G, Janiri L. Allostasis as a conceptual framework linking bipolar disorder and addiction. Front Psychiatry 2014; 5:173. [PMID: 25520673 PMCID: PMC4253530 DOI: 10.3389/fpsyt.2014.00173] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 11/16/2014] [Indexed: 12/28/2022] Open
Abstract
Bipolar disorders (BDs) and addictions constitute reciprocal risk factors and are best considered under a unitary perspective. The concepts of allostasis and allostatic load (AL) may contribute to the understanding of the complex relationships between BD and addictive behaviors. Allostasis entails the safeguarding of reward function stability by recruitment of changes in the reward and stress system neurocircuitry and it may help to elucidate neurobiological underpinnings of vulnerability to addiction in BD patients. Conceptualizing BD as an illness involving the cumulative build-up of allostatic states, we hypothesize a progressive dysregulation of reward circuits clinically expressed as negative affective states (i.e., anhedonia). Such negative affective states may render BD patients more vulnerable to drug addiction, fostering a very rapid transition from occasional drug use to addiction, through mechanisms of negative reinforcement. The resulting addictive behavior-related ALs, in turn, may contribute to illness progression. This framework could have a heuristic value to enhance research on pathophysiology and treatment of BD and addiction comorbidity.
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Affiliation(s)
- Mauro Pettorruso
- Department of Neuroscience, Institute of Psychiatry and Clinical Psychology, Catholic University of Sacred Heart , Rome , Italy
| | - Luisa De Risio
- Department of Neuroscience, Institute of Psychiatry and Clinical Psychology, Catholic University of Sacred Heart , Rome , Italy
| | - Marco Di Nicola
- Department of Neuroscience, Institute of Psychiatry and Clinical Psychology, Catholic University of Sacred Heart , Rome , Italy
| | - Giovanni Martinotti
- Department of Neuroscience and Imaging, Institute of Psychiatry, "G. d'Annunzio" University of Chieti-Pescara , Chieti , Italy
| | - Gianluigi Conte
- Department of Neuroscience, Institute of Psychiatry and Clinical Psychology, Catholic University of Sacred Heart , Rome , Italy
| | - Luigi Janiri
- Department of Neuroscience, Institute of Psychiatry and Clinical Psychology, Catholic University of Sacred Heart , Rome , Italy
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