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Odette MM, Porucznik CA, Gren LH, Garland EL. Alcohol consumption and opioid craving among chronic pain patients prescribed long-term opioid therapy. Addict Behav 2024; 150:107911. [PMID: 38039857 DOI: 10.1016/j.addbeh.2023.107911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/15/2023] [Accepted: 11/12/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Concurrent use of alcohol with opioids is common among chronic pain patients, heightening the risk for disordered opioid use and overdose, yet the relationship between alcohol consumption and opioid craving among chronic pain patients remains largely unexplored. Here we examined the relationship between alcohol consumption and opioid craving among chronic pain patients on long-term opioid therapy. METHODS A cross-sectional study was conducted with 335 chronic pain patients on long-term opioid therapy. Participants completed the Timeline Followback to assess alcohol consumption, as well as measures of opioid craving, pain severity, and pain interference. Linear regression analyses examined the relationship between alcohol consumption and opioid craving, controlling for pain severity, pain interference, and opioid misuse severity. RESULTS Alcohol consumption (total number of drinks and amount consumed in one sitting) was positively associated with opioid craving (p < 0.001 and p = 0.005, respectively). Pain severity did not predict opioid craving. The relationship between alcohol consumption and opioid craving remained significant after controlling for pain severity, pain interference, and opioid misuse severity. CONCLUSION Alcohol consumption is linked with more severe opioid craving among chronic pain patients prescribed long-term opioid therapy. Patients receiving opioid analgesics should be carefully screened for co-use of alcohol.
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Affiliation(s)
- Madeleine M Odette
- Department of Family & Preventative Medicine Division of Public Health, The Spencer Fox Eccles School of Medicine at the University of Utah, United States; Center on Mindfulness and Integrative Health Intervention Development, University of Utah, United States; College of Social Work, University of Utah, 395 South 1500 East, University of Utah, Salt Lake City, UT 84112, United States
| | - Christina A Porucznik
- Department of Family & Preventative Medicine Division of Public Health, The Spencer Fox Eccles School of Medicine at the University of Utah, United States
| | - Lisa H Gren
- Department of Family & Preventative Medicine Division of Public Health, The Spencer Fox Eccles School of Medicine at the University of Utah, United States
| | - Eric L Garland
- Center on Mindfulness and Integrative Health Intervention Development, University of Utah, United States; College of Social Work, University of Utah, 395 South 1500 East, University of Utah, Salt Lake City, UT 84112, United States.
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2
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Stamatovich SN, Simons RM, Simons JS. Anhedonia and impulsivity in college alcohol use: A path analysis. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-11. [PMID: 37722885 DOI: 10.1080/07448481.2023.2249116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 08/09/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE Alcohol use is a substantial problem among college students and has several negative consequences. The current study examined the associations between anhedonia and alcohol use and related problems via impulsive behavior (e.g., negative urgency, sensation seeking). We parsed anhedonia into four specific facets: consummatory, anticipatory, recreational, and social anhedonia. PARTICIPANTS Six hundred and forty college students aged 18-25 were included in the final analysis. METHOD Data were collected via Amazon Mechanical Turk. Self-report inventories assessing for anhedonia, alcohol use, impulsive behavior, and depressed mood were utilized. RESULTS Recreational consummatory anhedonia was negatively associated with alcohol use and alcohol-related problems through negative urgency. Recreational consummatory anhedonia also had significant negative associations with alcohol consumption via sensation seeking. Further, social anticipatory anhedonia was positively associated with alcohol use and related problems via negative urgency. CONCLUSIONS This study highlights important associations between anhedonia, impulsivity, and alcohol use and related problems.
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Affiliation(s)
- Sydney N Stamatovich
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
| | - Raluca M Simons
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
| | - Jeffrey S Simons
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
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Hamid MS, Abo Hamza E, Hussain Z, AlAhmadi A. The Association Between Internet Gaming Disorder and Sensation Seeking Among Arab Adolescents. Front Psychiatry 2022; 13:905553. [PMID: 35911214 PMCID: PMC9334920 DOI: 10.3389/fpsyt.2022.905553] [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: 03/27/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
Research on internet gaming disorder (IGD) has increased considerably over the last decade. Although most IGD research has focused on Western or South Asian samples, it is critical to understand and assess this disorder among other populations. The present study investigated the association between IGD and sensation seeking among Arab adolescents. An online survey consisting of the short internet gaming disorder short scale (IGDSS) and brief sensation seeking scale (B-SSS) was completed by 260 participants (mean age = 14.61, SD = 2.43). The results showed that sensation seeking behaviours were associated with higher gaming hours and greater chances of exhibiting IGD. The findings support the current perspective of understanding this disorder from a disease framework as it highlights the relevance of behavioural components in gaming addiction. Importantly, the results will further aid the development of reliable diagnosis and efficacious treatments within clinical practices.
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Affiliation(s)
| | - Eid Abo Hamza
- College of Humanities and Sciences, Ajman University, Ajman, United Arab Emirates
- Faculty of Education, Tanta University, Tanta, Egypt
| | - Zaheer Hussain
- School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Aisha AlAhmadi
- Department of Psychological Sciences, Qatar University, Doha, Qatar
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Kim E, Gooding DC, Lee TY. Validation of the Korean Version of the Anticipatory and Consummatory Interpersonal Pleasure Scale in Non-help-seeking Individuals. Front Psychol 2022; 13:859234. [PMID: 35572241 PMCID: PMC9099351 DOI: 10.3389/fpsyg.2022.859234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
The Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS) is a psychometric instrument that has been used to indirectly measure social anhedonia in many cross-cultural contexts, such as in Western (US), European (French, Spanish), Eastern (Chinese), and Israeli samples. However, little is known about the psychometric properties of the ACIPS in Korean samples. The primary goal of this study was to validate the Korean version of the ACIPS among non-help-seeking individuals. The sample consisted of 307 adult individuals who had no current or prior psychiatric history. Participants were administered the ACIPS, along with the Behavioral Inhibition and Behavioral Activation Scales (BIS/BAS) and Beck Depression Inventory (BDI). We examined the association of the total ACIPS scores with the other measures. The ACIPS showed good internal consistency. We also explored the factor structure of the Korean translation of the ACIPS using principal component analysis with Promax rotation and Kaiser normalization. Factor analysis yielded a three-factor structure that accounted for 58.8% of the variance. The three-factor model included the following subdomains: interactions involving close relationships, casual interactions, and interactions involving family members. Total BAS and BIS scores were significantly associated with total ACIPS scores, while BDI scores were inversely associated with total ACIPS scores. The current research indicates that the Korean version of the ACIPS is a useful and valid scale. Future directions include using the Korean translation of the ACIPS to elucidate the varying degrees of hedonic capacity in psychiatric patients.
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Affiliation(s)
- Eunhye Kim
- Department of Psychiatry, Yangsan Hospital, Pusan National University, Yangsan, South Korea
| | - Diane C. Gooding
- PATHS Laboratory, Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, United States
| | - Tae Young Lee
- Department of Psychiatry, Yangsan Hospital, Pusan National University, Yangsan, South Korea
- Research Institute for Convergence of Biomedical Science and Technology, Yangsan Hospital, Pusan National University, Yangsan, South Korea
- *Correspondence: Tae Young Lee,
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Lau JH, Jeyagurunathan A, Shafie S, Chang S, Samari E, Cetty L, Verma S, Tang C, Subramaniam M. The factor structure of the Barratt Impulsiveness Scale (BIS-11) and correlates of impulsivity among outpatients with schizophrenia and other psychotic disorders in Singapore. BMC Psychiatry 2022; 22:226. [PMID: 35361174 PMCID: PMC8968701 DOI: 10.1186/s12888-022-03870-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 03/21/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Impulsivity has been linked to risky behaviours amongst patients with schizophrenia or other psychotic disorders. However, there is a dearth of studies examining impulsivity amongst this population in Singapore. Moreover, to date, scales to measure impulsivity have not been validated in this population. The present study seeks to examine the underlying factor structure of the Barratt Impulsiveness Scale (BIS-11) and explore sociodemographic and clinical correlates of impulsivity within this group. METHODS Confirmatory factor analyses (CFA) were conducted to test factor structures of the BIS-11 proposed in extant literature. However, due to poor fit statistics, the sample (n = 397) was split into two groups, with Exploratory Factor Analyses (EFA) conducted in the first subgroup (n = 200). The final model of the EFA was then tested within the second subgroup (n = 197) with CFA. Multivariable linear regressions were conducted to examine sociodemographic and clinical correlates of each underlying factor. RESULTS CFA indicated a three-factor structure amongst 16-items of the BIS-11 with acceptable fit: i) Non-planning impulsivity (5-items; α = 0.94), ii) Motor impulsiveness (6-items α = 0.84), and iii) Lack of self-control (5-items, α = 0.85). Lower education was associated with higher non-planning impulsivity. While age, ethnicity, marital status, and general psychiatric symptom severity were significant correlates of motor impulsiveness, problematic alcohol use and general psychiatric symptom severity were related to a greater lack of self-control. CONCLUSION Factor structures of the BIS-11 suggested by extant literature were not applicable, and we propose an alternative factor structure for BIS-11. Significant correlates of impulsivity are highlighted, and avenues for future research are suggested.
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Affiliation(s)
- Jue Hua Lau
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Saleha Shafie
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Sherilyn Chang
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Ellaisha Samari
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Laxman Cetty
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Swapna Verma
- grid.414752.10000 0004 0469 9592Medical Board, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Charmaine Tang
- grid.414752.10000 0004 0469 9592Department of Early Psychosis Intervention, Institute of Mental Health Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Mythily Subramaniam
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
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Lyu J, Zhang J, Hennessy DA. Characteristics and Risk Factors for Suicide in People with Schizophrenia in Comparison to Those without Schizophrenia. Psychiatry Res 2021; 304:114166. [PMID: 34388512 DOI: 10.1016/j.psychres.2021.114166] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Little research has been conducted that compares suicide cases with and without schizophrenia. The aim of the present study was to identify demographic, personal, social, relational, and psychological characteristics among suicides identified posthumously with schizophrenia compared to those without. METHODS The DSM-IV was used to independently assess the presence of schizophrenia among suicide cases by two psychiatrists. Data on risk factors was collected through a psychological autopsy method, which included structured interviews of two informants for each suicide case (a family member and a close friend). Interview questions included demographic characteristics, suicide risk factors, the Beck Hopelessness Scale, Dickman's Impulsivity Inventory, the Spielberger State-Trait Anxiety Inventory, the Hamilton Depression Scale and the Duke Social Support Inventory. RESULTS The prevalence of schizophrenia was 9.69% among suicide cases in this sample. The schizophrenia suicide group was more likely to be female, older, in poorer physical health, suffer from chronic disease, suffer other psychological disorders, and have a family history of psychological disorders compared to those not diagnosed schizophrenia. Other important risk factors included more frequent past suicide attempts, increased levels of depression and anxiety, lower levels of impulsivity, lower help seeking from friends, and lower social interaction social support. CONCLUSIONS There is a notable link between schizophrenia and suicide in China. Identification of social, personal, relational, and psychological risk factors could beneficially guide attempts to improve future preventive measures against suicide among those with schizophrenia in China.
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Affiliation(s)
- Juncheng Lyu
- Weifang Medical University School of Public Health, China
| | - Jie Zhang
- Shandong University Center for Suicide Prevention Research, China; State University of New York College at Buffalo Department of Sociology, USA.
| | - Dwight A Hennessy
- State University of New York College at Buffalo Department of Psychology, USA
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Oh H, Jang SK, Lee HS, Lee EB, Choi KH. Personality Traits in Individuals with the Dual Diagnosis of Psychosis and Substance Use Disorders: A Comprehensive Review and Meta-Analysis. J Dual Diagn 2021; 17:34-51. [PMID: 33404373 DOI: 10.1080/15504263.2020.1839827] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Substance abuse comorbidity is highly prevalent and is linked to detrimental outcomes in individuals with psychotic disorder, but the role of personality traits as the underlying mechanism is being increasingly underscored. This study aimed to profile temperamental risks of comorbid substance use disorder in psychotic disorders by performing meta-analyses on personality trait differences between psychotic disorders with comorbidity (dual diagnosis; DD) and without it (psychotic disorders; PSD). Methods: A systematic review of English articles using PubMed, MEDLINE, Scopus, Google Scholar, and ProQuest Dissertation and Theses. Only original empirical studies including participants with diagnosis of psychotic disorders based on structured diagnostic interviews, with and without substance use disorder evaluated with reliable and valid tests were included. Articles were independently extracted by two authors using predefined data fields, including study quality indicators. All pooled analyses were based on random-effect models. Thirteen studies (N = 885) met our inclusion criteria. All effect-size estimates were calculated based on means and standard deviations of included measures. Separate effect size estimates were obtained for four traits in the UPPS model (negative urgency, low premeditation, low perseverance, sensation seeking), four traits in the HS model (unconscientious disinhibition, negative affect, disagreeable disinhibition, positive affect) and trait anhedonia. Results: Negative urgency (four studies with 262 participants; ES = 0.59; 95% confidence interval [CI] [0.34, 0.84]), low premeditation (five studies with 349 participants; ES = 0.60; 95% CI [0.39, 0.80]), sensation seeking (seven studies with 550 participants; ES = 0.63; 95% CI [0.17, 1.09]) and unconscientious disinhibition (five studies with 291 participants; ES = 0.36; 95% CI [0.13, 0.59]) were elevated in DD than PSD. Heterogeneity of sensation seeking was significant (I2 = 86.2%). Conclusions: The findings of the current meta-analysis highlight a unique profile of impulsive and externalizing trait personality domains pertaining to DD. The study emphasizes the importance of emotion regulation interventions targeting impulsivity or negative affect (i.e. negative urgency, low premeditation) in substance abuse comorbidity patients.
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Affiliation(s)
- Hyeonju Oh
- Department of Psychology, Korea University, Seongbuk-gu, Republic of Korea
| | - Seon-Kyeong Jang
- Department of Psychology, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Hyeon-Seung Lee
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Eun-Byeol Lee
- Department of Psychology, Korea University, Seongbuk-gu, Republic of Korea
| | - Kee-Hong Choi
- Department of Psychology, Korea University, Seongbuk-gu, Republic of Korea
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8
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Kirschner M, Rabinowitz A, Singer N, Dagher A. From apathy to addiction: Insights from neurology and psychiatry. Prog Neuropsychopharmacol Biol Psychiatry 2020; 101:109926. [PMID: 32171904 DOI: 10.1016/j.pnpbp.2020.109926] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 03/11/2020] [Accepted: 03/11/2020] [Indexed: 12/21/2022]
Abstract
The tendency to engage in addictive behaviors has long been tied to the actions of the dopamine system. Early theories were based on the fact that all addictive drugs and behaviors (such as gambling) increase dopamine levels in the striatum, and the evidence that dopamine signaled reward or reward prediction error. However, with a changing emphasis of addiction away from purely pharmacological models that emphasize tolerance and withdrawal, towards one of behavioral dyscontrol, is there still a place for abnormal dopamine signaling in addiction? Here we recast the dopamine theory of addiction based on the idea that tonic dopamine may index a continuous phenotype that goes from apathy to impulsivity and compulsivity. Higher tonic dopamine signaling would make individuals vulnerable to drug reinforcement and cue-induced craving. We relate this to computational models of dopamine signaling, and review clinical and neuroimaging evidence from Parkinson's Disease, schizophrenia and bipolar disorder in support of this model.
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Affiliation(s)
- Matthias Kirschner
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
| | - Arielle Rabinowitz
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada
| | - Neomi Singer
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada
| | - Alain Dagher
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada.
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Río-Martínez L, Marquez-Arrico JE, Prat G, Adan A. Temperament and Character Profile and Its Clinical Correlates in Male Patients with Dual Schizophrenia. J Clin Med 2020; 9:jcm9061876. [PMID: 32560099 PMCID: PMC7356598 DOI: 10.3390/jcm9061876] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/07/2020] [Accepted: 06/12/2020] [Indexed: 02/07/2023] Open
Abstract
Personality traits are relevant in understanding substance use disorders (SUD) and schizophrenia (SZ), but few works have also included patients with dual schizophrenia (SZ+) and personality traits. We explored personality profile in a sample of 165 male patients under treatment, using the Temperament and Character Inventory-Revised. The participants were assigned to three groups of 55 patients each, according to previous diagnosis: SUD, SZ- and SZ+ (without/with SUD). We analyzed their clinical characteristics, relating them to personality dimensions. The SUD and SZ+ groups scored higher than SZ- in Novelty/Sensation Seeking. SZ- and SZ+ presented higher Harm Avoidance and lower Persistence than the SUD group. SZ+ patients showed the lowest levels of Self-directedness, while SZ- and SZ+ had higher scores in Self-transcendence than the SUD group. Several clinical characteristics were associated with personality dimensions depending on diagnosis, and remarkably so for psychiatric symptoms in the SZ- and SZ+ groups. The three groups had a maladaptive personality profile compared to general population. Our results point to different profiles for SUD versus SZ, while both profiles appear combined in the SZ+ group, with extreme scores in some traits. Thus, considering personality endophenotypes in SZ+ could help in designing individualized interventions for this group.
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Affiliation(s)
- Laura Río-Martínez
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebrón 171, 08035 Barcelona, Spain; (L.R.-M.); (J.E.M.-A.); (G.P.)
- Institute of Neurosciences, University of Barcelona, 08035 Barcelona, Spain
| | - Julia E. Marquez-Arrico
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebrón 171, 08035 Barcelona, Spain; (L.R.-M.); (J.E.M.-A.); (G.P.)
| | - Gemma Prat
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebrón 171, 08035 Barcelona, Spain; (L.R.-M.); (J.E.M.-A.); (G.P.)
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebrón 171, 08035 Barcelona, Spain; (L.R.-M.); (J.E.M.-A.); (G.P.)
- Institute of Neurosciences, University of Barcelona, 08035 Barcelona, Spain
- Correspondence: ; Tel.: +34-9331-25060
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10
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Schizophrénie et addictions : Étude exploratoire chez 106 patients suivis en consultation. ANNALES MEDICO-PSYCHOLOGIQUES 2020. [DOI: 10.1016/j.amp.2018.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Peritogiannis V, Manthopoulou T, Mavreas V. Long-term Benzodiazepine Treatment in Patients with Psychotic Disorders Attending a Mental Health Service in Rural Greece. J Neurosci Rural Pract 2019; 7:S26-S30. [PMID: 28163499 PMCID: PMC5244055 DOI: 10.4103/0976-3147.196447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Long-term benzodiazepine (BZD) treatment in patients with mental disorders is widespread in clinical practice, and this is also the case of patients with schizophrenia, although the evidence is weak and BZD prescription is discouraged by guidelines and medical authorities. Data on BZD prescription are usually derived from national or regional databases whereas information on the use of BZD by patients with schizophrenia and related psychoses in general population-based samples is limited. MATERIALS AND METHODS Information for 77 patients with psychotic disorders who were regularly attending follow-up appointments with the multidisciplinary Mobile Mental Health Unit of the prefectures of Ioannina and Thesprotia, Northwest Greece, during 1-year period (2015) was obtained from our database. RESULTS From the total of 77 engaged patients, 30 (39%) were regularly prescribed BZDs in the long term, as part of their treatment regimen. Prescribed BZDs were mostly diazepam and lorazepam, in 43.3% of cases each. The mean daily dose of these compounds was 13 mg and 3.77 mg, respectively. Statistical analysis showed a correlation of long-term BZD use with the history of alcohol/substance abuse. Most patients were receiving BZD continuously for several years, and the mean dose was steady within this interval. CONCLUSIONS A large proportion of patients with psychotic disorders were regularly prescribed BZD in long term. It appears that when BZDs are prescribed for some period in the course of a psychotic disorder, their use commonly exceeds the recommended interval and then becomes a regular part of the chronic treatment regimen. Future research should address the factors that may be related to the long-term BZD use by patients with psychotic disorders. Interventions for the reduction of regular BZD prescription should target the primary care setting and all those who treat first episode patients.
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Affiliation(s)
- Vaios Peritogiannis
- Mobile Mental Health Unit of the Prefectures of Ioannina and Thesprotia, Society for the Promotion of Mental Health in Epirus, Ioannina, Greece
| | - Thiresia Manthopoulou
- Mobile Mental Health Unit of the Prefectures of Ioannina and Thesprotia, Society for the Promotion of Mental Health in Epirus, Ioannina, Greece
| | - Venetsanos Mavreas
- Department of Psychiatry, University of Ioannina School of Medicine, Ioannina, Greece
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12
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Abdeen MS, Shaker NM, Elrassas HH, Hashim MA, Abo Zeid MY. Characteristics of the schizophrenia suicide attempts in comparison with the suicide attempts with other diagnosed psychiatric disorders: An Egyptian study. Int J Soc Psychiatry 2019; 65:368-377. [PMID: 31144567 DOI: 10.1177/0020764019852654] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND There has been much literature on schizophrenia, but little is known about the characteristic features of suicide attempts with schizophrenia in comparison with the suicide attempts with other diagnosed psychiatric disorders. AIMS The objective of this study was to clarify the specific characteristics and risk factors among suicide attempters with schizophrenia that differentiate them from other psychiatric disorders. METHODS Thirty-three suicide attempters diagnosed with schizophrenia and 87 suicide attempters with other psychiatric disorders were included. Suicide attempts seriousness were appraised by the Beck's Suicide Intent Scale (BSIS). Standardized scales were applied: Suicide Probability Scale (SPS) and Barratt Impulsiveness Scale, Version 11 (BIS-11). The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and The Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) based on the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) was applied to assess the psychiatric status of individuals. Demographic and clinical characteristics, method of suicide and suicide probability scores and impulsivity were compared among both groups (schizophrenia group and other psychiatric disorders group). RESULTS In total, 27.5% of suicide attempts suffered from schizophrenia. The current study found that having more past history of medical diseases, longer duration of illness, using more violent suicidal methods, and having less significant suicidal ideations were the significant factors that differentiated schizophrenia suicide attempts from those diagnosed with other psychiatric disorders. The schizophrenia group did not show more impulsivity or hostility than other psychiatric disorders group. CONCLUSION These results indicated that each group shows its unique characteristics. They give us new perspectives to prevent suicides in schizophrenia according to their different characteristics.
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Affiliation(s)
| | | | - Hanan Hany Elrassas
- Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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13
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Oberlin BG, Ramer NE, Bates SM, Shen YI, Myslinski JS, Kareken DA, Cyders MA. Quantifying Behavioral Sensation Seeking With the Aroma Choice Task. Assessment 2019; 27:873-886. [PMID: 31353921 DOI: 10.1177/1073191119864659] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Our goal was to develop a behavioral measure of sensation seeking (SS). The Aroma Choice Task (ACT) assesses preference for an intense, novel, varied, and risky (exciting) option versus a mild, safe (boring) option using real-time odorant delivery. A total of 147 healthy young adults completed 40 binary choice trials. We examined (1) intensity and pleasantness of odorants, (2) stability of responding, (3) association with SS self-report, and (4) association with self-reported illicit drug use. Participants' preference for the "exciting" option versus the safe option was significantly associated with self-reported SS (p < .001) and illicit drug use (p = .041). Odorant ratings comported with their intended intensity. The ACT showed good internal, convergent, and criterion validity. We propose that the ACT might permit more objective SS assessment for investigating the biological bases of psychiatric conditions marked by high SS, particularly addiction. The ACT measures SS behaviorally, mitigating some self-report challenges and enabling real-time assessment, for example, for functional magnetic resonance imaging (fMRI).
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Affiliation(s)
- Brandon G Oberlin
- Indiana University School of Medicine, Indianapolis, IN, USA.,Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Nolan E Ramer
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Sage M Bates
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Yitong I Shen
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jeremy S Myslinski
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - David A Kareken
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Melissa A Cyders
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
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Ethridge P, Sandre A, Dirks MA, Weinberg A. Past-year relational victimization is associated with a blunted neural response to rewards in emerging adults. Soc Cogn Affect Neurosci 2018; 13:1259-1267. [PMID: 30307568 PMCID: PMC6277819 DOI: 10.1093/scan/nsy091] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 10/01/2018] [Accepted: 10/07/2018] [Indexed: 12/16/2022] Open
Abstract
Anhedonia is associated with multiple forms of psychopathology, yet relatively, little is known about how anhedonia develops. Emerging evidence suggests that anhedonia is the result of interactions between life stress and the brain's reward systems, and that social stress, in particular, may drive these processes. One potent form of social stress is peer victimization, but very little research has focused on peer victimization beyond adolescence, and even less has examined the associations between peer victimization and neural response to rewards. The present study sought to identify associations between past-year history of peer victimization and neural response to rewards in emerging adults (N = 61). Relational and physical forms of victimization were assessed separately since these distinct types of social stress have different trajectories across development and different associations with psychopathology. Reward sensitivity was indexed with the event-related potential component known as the reward positivity, which was elicited using a forced-choice monetary reward guessing task. Results demonstrated that past-year relational, but not physical, victimization was associated with a blunted neural response to rewards. These findings provide insight into one potential mechanism in the etiology of anhedonia, which may, in turn, help us to better identify pathways to multiple psychopathologies.
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Affiliation(s)
- Paige Ethridge
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Aislinn Sandre
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Melanie A Dirks
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Anna Weinberg
- Department of Psychology, McGill University, Montreal, QC, Canada
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15
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Jepsen JRM, Rydkjaer J, Fagerlund B, Pagsberg AK, Jespersen RAF, Glenthøj BY, Oranje B. Overlapping and disease specific trait, response, and reflection impulsivity in adolescents with first-episode schizophrenia spectrum disorders or attention-deficit/hyperactivity disorder. Psychol Med 2018; 48:604-616. [PMID: 28712363 DOI: 10.1017/s0033291717001921] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Schizophrenia and attention-deficit/hyperactivity disorder (ADHD) are developmental disorders with shared clinical characteristics such as cognitive impairments and impulsivity. Impulsivity is a core feature of ADHD and an important factor in aggression, violence, and substance use in schizophrenia. Based on the hypothesis that schizophrenia and ADHD represent a continuum of neurodevelopmental impairments, the aim was to identify overlapping and disease specific forms of impulsivity. METHODS Adolescents between 12 and 17 years of age were assessed with the Schedule for Affective Disorders and Schizophrenia for School-aged Children - Present and Lifetime Version. Subjects with early-onset, first-episode schizophrenia spectrum disorders (EOS) (N = 29) or ADHD (N = 29) and healthy controls (N = 45) were compared on two performance measures (Information Sampling Task, Stop Signal Task) and a subjective personality trait measure of impulsivity (Barratt Impulsiveness Scale, Version 11 (BIS-11)). RESULTS Significantly increased reflection impulsivity was observed in ADHD but not in the EOS group. No significant response inhibition deficits (stop signal reaction time) were found in the two clinical groups. The ADHD and the EOS group showed significantly increased motor, attentional, and non-planning subtraits of impulsivity. CONCLUSIONS Impaired pre-decisional information gathering appeared to be specific for ADHD while the information gathering was not significantly reduced in subjects with EOS. Neither the ADHD nor EOS group showed impaired response inhibition but shared increased personality subtraits of attentional, non-planning, and motor impulsivity although the latter was significantly more pronounced in ADHD. These increased subtraits of impulsivity may reflect diagnostic non-specific neurodevelopmental impairments in ADHD and EOS in adolescence.
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Affiliation(s)
- J R M Jepsen
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR),Mental Health Centre Glostrup,University of Copenhagen,Glostrup,Denmark
| | - J Rydkjaer
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR),Mental Health Centre Glostrup,University of Copenhagen,Glostrup,Denmark
| | - B Fagerlund
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR),Mental Health Centre Glostrup,University of Copenhagen,Glostrup,Denmark
| | - A K Pagsberg
- Child and Adolescent Mental Health Center,Mental Health Services,Capital Region of Denmark,Copenhagen,Denmark
| | - R Av F Jespersen
- Department of Child and Adolescent Psychiatry,Landssjúkrahusid (National Hospital),Torshavn,Faroe Islands
| | - B Y Glenthøj
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR),Mental Health Centre Glostrup,University of Copenhagen,Glostrup,Denmark
| | - B Oranje
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR),Mental Health Centre Glostrup,University of Copenhagen,Glostrup,Denmark
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16
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Problem and Pathological Gambling in Schizophrenia: Exploring Links with Substance Use and Impulsivity. J Gambl Stud 2018; 34:673-688. [DOI: 10.1007/s10899-018-9757-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Ho BC, Barry AB, Koeppel JA. Impulsivity in unaffected adolescent biological relatives of schizophrenia patients. J Psychiatr Res 2018; 97:47-53. [PMID: 29175297 PMCID: PMC5742548 DOI: 10.1016/j.jpsychires.2017.11.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/03/2017] [Accepted: 11/17/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Although schizophrenia is not a prototypic impulse-control disorder, patients report more impulsive behaviors, have higher rates of substance use, and show dysfunction in brain circuits that underlie impulsivity. We investigate impulsivity in unaffected biological relatives of schizophrenia patients to further understand the relationships between schizophrenia risk and impulse control during adolescence. METHOD Group differences in impulsivity (UPPS-P Impulsive Behavior Scale and delay discounting) were tested in 210 adolescents contrasting 39 first- and 53 second-degree biological relatives of schizophrenia patients, and 118 subjects with no schizophrenia family history (NSFH). RESULTS Compared to NSFH adolescents and to second-degree relatives, first-degree relatives of schizophrenia patients had increased impulsivity-related behaviors (higher UPPS-P Perseverance, Positive Urgency and Premeditation subscale scores) and greater preference for immediate rewards (smaller AUC and larger discounting constant). Second-degree relatives did not differ significantly from NSFH adolescents on self-report impulsive behaviors or on measures of impulsive decision-making. These group differences remained even after careful consideration of potential confounding factors. CONCLUSION Impulsivity is associated with schizophrenia risk, and its severity increases with greater familial relatedness to the schizophrenia proband. Additional studies are needed to understand the role impulsivity may play in mediating schizophrenia susceptibility during adolescence.
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Affiliation(s)
- Beng-Choon Ho
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
| | - Amy B Barry
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Julie A Koeppel
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
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18
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de Girolamo G, Buizza C, Sisti D, Ferrari C, Bulgari V, Iozzino L, Boero ME, Cristiano G, De Francesco A, Giobbio GM, Maggi P, Rossi G, Segalini B, Candini V. Monitoring and predicting the risk of violence in residential facilities. No difference between patients with history or with no history of violence. J Psychiatr Res 2016; 80:5-13. [PMID: 27253885 DOI: 10.1016/j.jpsychires.2016.05.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 05/11/2016] [Accepted: 05/20/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Most people with mental disorders are not violent. However, the lack of specific studies in this area and recent radical changes in Italy, including the closure of six Forensic Mental Hospitals, has prompted a more detailed investigation of patients with aggressive behaviour. AIMS To compare socio-demographic, clinical and treatment-related characteristics of long-term inpatients with a lifetime history of serious violence with controls; to identify predictors of verbal and physical aggressive behaviour during 1-year follow-up. METHODS In a prospective cohort study, patients living in Residential Facilities (RFs) with a lifetime history of serious violence were assessed with a large set of standardized instruments and compared to patients with no violent history. Patients were evaluated bi-monthly with MOAS in order to monitor any aggressive behaviour. RESULTS The sample included 139 inpatients, 82 violent and 57 control subjects; most patients were male. The bi-monthly monitoring during the 1-year follow-up did not show any statistically significant differences in aggressive behaviour rates between the two groups. The subscale explaining most of the MOAS total score was aggression against objects, although verbal aggression was the most common pattern. Furthermore, verbal aggression was significantly associated with aggression against objects and physical aggression. CONCLUSIONS Patients with a history of violence in RFs, where treatment and clinical supervision are available, do not show higher rates of aggressiveness compared to patients with no lifetime history of violence. Since verbal aggression is associated with more severe forms of aggression, prompt intervention is warranted to reduce the risk of escalation.
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Affiliation(s)
- Giovanni de Girolamo
- Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy
| | - Chiara Buizza
- Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Davide Sisti
- Institute of Biomathematics, University of Urbino, Italy
| | - Clarissa Ferrari
- Service of Statistics, Saint John of God Clinical Research Center, Brescia, Italy
| | - Viola Bulgari
- Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy; PhD School in Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Laura Iozzino
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Maria Elena Boero
- Rehabilitation Hospital Beata Vergine Della Consolata, Torino, Italy
| | | | | | - Gian Marco Giobbio
- Villa Sant'Ambrogio Hospital, Milan, Italy; Sacro Cuore di Gesù Center, Milan, Italy
| | | | - Giuseppe Rossi
- Psychiatric Unit, Saint John of God Clinical Research Center, Brescia, Italy
| | | | - Valentina Candini
- Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy; Department of General Psychology, University of Padova, Italy.
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Müller KW, Dreier M, Beutel ME, Wölfling K. Is Sensation Seeking a correlate of excessive behaviors and behavioral addictions? A detailed examination of patients with Gambling Disorder and Internet Addiction. Psychiatry Res 2016; 242:319-325. [PMID: 27322843 DOI: 10.1016/j.psychres.2016.06.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 06/02/2016] [Accepted: 06/05/2016] [Indexed: 01/14/2023]
Abstract
Sensation Seeking has repeatedly been related to substance use. Also, its role as a correlate of Gambling Disorder has been discussed although research has led to heterogeneous results. Likewise, first studies on Internet Addiction have indicated increased Sensation Seeking, to some extent contradicting clinical impression of patients suffering from internet addiction. We assessed Sensation Seeking in a clinical sample of n=251 patients with Gambling Disorder, n=243 patients with internet addiction, n=103 clients with excessive but not addictive internet use, and n=142 healthy controls. The clinical groups were further sub-divided according to the preferred type of addictive behavior (slot-machine gambling vs. high arousal gambling activities and internet gaming disorder vs. other internet-related addictive behaviors). Decreased scores in some subscales of Sensation Seeking were found among male patients compared to healthy controls with no differences between patients with Gambling Disorder and Internet Addiction. The type of preferred gambling or online activity was not related to differences in Sensation Seeking. Previous findings indicating only small associations between Sensation Seeking and Gambling Disorder were confirmed. Regarding Internet Addiction our results contradict findings from non-clinical samples. Sensation Seeking might be relevant in initiating contact to the health care system.
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Affiliation(s)
- K W Müller
- Department of Psychosomatic Medicine and Psychotherapy, Outpatient Clinic for Behavioural Addictions, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
| | - M Dreier
- Department of Psychosomatic Medicine and Psychotherapy, Outpatient Clinic for Behavioural Addictions, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
| | - M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, Outpatient Clinic for Behavioural Addictions, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
| | - K Wölfling
- Department of Psychosomatic Medicine and Psychotherapy, Outpatient Clinic for Behavioural Addictions, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
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Personality in patients with substance use disorders according to the co-occurring severe mental illness: A study using the alternative five factor model. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2016.03.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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21
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Temperament and character dimensions in male patients with substance use disorders: Differences relating to psychiatric comorbidity. Psychiatry Res 2016; 237:1-8. [PMID: 26921044 DOI: 10.1016/j.psychres.2016.01.061] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 01/25/2016] [Accepted: 01/25/2016] [Indexed: 11/22/2022]
Abstract
Previous research has not considered the influence of the Comorbid Mental Disorder (CMD) among Substance Use Disorders (SUD) patients. We explored the possible differences in personality dimensions among SUD patients taking into account their CMD (Schizophrenia, SZ; Bipolar Disorder, BD; Major Depressive Disorder, MDD); and elucidated clinical factors related to personality dimensions according to the CMD. The Temperament and Character Inventory Revised was used to assess a sample of 102 SUD male patients, considered in three groups according to their CMD: SUD+SZ (N=37), SUD+BD (N=30) and SUD+MDD (N=35). SUD+BD patients had the highest levels of Novelty Seeking and Persistence, SUD+SZ patients showed the highest levels of Harm Avoidance, and SUD+MDD patients reported a lower level of Self-transcendence. Novelty Seeking was positively associated with severity of addiction for SUD+BD; Harm Avoidance was positively associated with psychiatric symptoms for SUD+SZ; and the age of SUD onset was positively linked to Cooperativeness for SUD+BD and to Self-transcendence for SUD+MDD. The different personality characteristics associated to the type of CMD among SUD patients are related to several clinical variables. Interventions in these patients should be tailored according the personality traits that could influence treatment outcomes and patients' prognoses.
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Pathological Gambling Associated With Aripiprazole or Dopamine Replacement Therapy: Do Patients Share the Same Features? A Review. J Clin Psychopharmacol 2016; 36:63-70. [PMID: 26658263 PMCID: PMC4700874 DOI: 10.1097/jcp.0000000000000444] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND In the last 10 years, dopamine replacement therapy (DRT) has become a well-known risk factor for developing an impulse control disorder, such as gambling disorder (GD). Another medication, aripiprazole (ARI), has been more recently identified as another risk factor. Dopamine replacement therapy and ARI share a dopamine agonist action. Our work aimed at comparing patients with PG according to their treatment with DRT or ARI. METHODS Two methods were combined-a systematic review concentrated on case reports and the analysis of a French disordered gamblers cohort focused on patients using ARI or DRT at inclusion. RESULTS We reported 48 cases of GD possibly due to DRT and 17 cases of GD possibly due to ARI. Because of their standardized assessment, only the EVALJEU patients could be compared. Two clinical patterns emerged. Patients in the ARI group were young, impulsive, and high novelty seekers and had a history of substance misuse. Their first gambling experience occurred during adolescence. Conversely, patients in the DRT group were old, and they began gambling late in life. They showed low levels of gambling-related cognition. CONCLUSIONS Patients in the ARI group seemed to be more severe pathological gamblers than patients in the DRT group. Aripiprazole is a partial D2 receptor agonist, whereas DRT includes full D2 receptor agonist. The trigger mechanism of PG development is complex and cannot only be attributed only to the pharmacodynamic effects of dopaminergic drugs. Indeed, individual vulnerability factors and environmental factors need to be considered.
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Núñez C, Stephan-Otto C, Cuevas-Esteban J, Maria Haro J, Huerta-Ramos E, Ochoa S, Usall J, Brébion G. Effects of caffeine intake and smoking on neurocognition in schizophrenia. Psychiatry Res 2015; 230:924-31. [PMID: 26614014 DOI: 10.1016/j.psychres.2015.11.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 10/30/2015] [Accepted: 11/15/2015] [Indexed: 02/09/2023]
Abstract
Although most studies support the beneficial effects of caffeine on neurocognition, its effects have never been assessed in psychiatric patients. In addition, results from studies in smokers are contradictory. Moreover, there are no data available about the neurocognitive effects of caffeine and tobacco together. We explored the concomitant effects of regular caffeine and tobacco intake on neurocognition in 52 schizophrenic patients and 61 healthy controls. Verbal fluency, processing speed, and working, visual and verbal memory were assessed. For each measurement, two tasks with two levels of complexity were administered. Our results showed that caffeine intake had beneficial effects on male schizophrenic patients only in complex tasks requiring deeper cognitive processing (semantic fluency, cognitive speed, working memory, and visual memory). Female patients and controls were unaffected. In contrast, smoking had a negative effect on male, but not on female, schizophrenic patients in semantic fluency. The effects of smoking in controls were inconsistent. In conclusion, our data showed, for the first time, beneficial effects of caffeine intake on neurocognition in male schizophrenic patients. These data suggest that further research of therapeutics based on caffeine is needed, as this could be beneficial for schizophrenic patients. In contrast, smoking appears to be detrimental.
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Affiliation(s)
- Christian Núñez
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat (Barcelona), C/Doctor Antoni Pujadas, 42, 08830 Sant Boi de Llobregat, Spain.
| | - Christian Stephan-Otto
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat (Barcelona), C/Doctor Antoni Pujadas, 42, 08830 Sant Boi de Llobregat, Spain
| | - Jorge Cuevas-Esteban
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat (Barcelona), C/Doctor Antoni Pujadas, 42, 08830 Sant Boi de Llobregat, Spain
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat (Barcelona), C/Doctor Antoni Pujadas, 42, 08830 Sant Boi de Llobregat, Spain
| | - Elena Huerta-Ramos
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat (Barcelona), C/Doctor Antoni Pujadas, 42, 08830 Sant Boi de Llobregat, Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat (Barcelona), C/Doctor Antoni Pujadas, 42, 08830 Sant Boi de Llobregat, Spain
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat (Barcelona), C/Doctor Antoni Pujadas, 42, 08830 Sant Boi de Llobregat, Spain
| | - Gildas Brébion
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat (Barcelona), C/Doctor Antoni Pujadas, 42, 08830 Sant Boi de Llobregat, Spain
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Fernández-Mondragón S, Adan A. Personality in male patients with substance use disorder and/or severe mental illness. Psychiatry Res 2015; 228:488-94. [PMID: 26144586 DOI: 10.1016/j.psychres.2015.05.059] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 04/23/2015] [Accepted: 05/25/2015] [Indexed: 10/23/2022]
Abstract
Dual diagnosis (DD) is the coexistence of a substance use disorder (SUD) and severe mental illness (SMI). The aim of this study is to determine for the first time if a specific personality pattern exists for DD patients compared to those who only have SUD or SMI. The sample was composed of 102 male, 34 patients in each group (DD, SUD and SMI). DD and SMI groups included 20 schizophrenic and 14 depressed patients respectively. Cloninger's TCI-R was administered together with a structured interview of sociodemographic and clinical characteristics. All the temperament dimensions and Self-directedness provided differences among groups. The DD and SUD showed significant higher scores in Novelty Seeking regarding SMI, whereas for Harm Avoidance the SUD subjects scored lower with respect to the DD and SMI group. Persistence was significant lower for the DD and SMI groups compared to the SUD patients. The DD obtained low significant scores in Reward Dependence in relation to the SUD and Self-directedness in relation to the SUD and SMI. Our data highlight the presence of a different personality profiles among DD, SUD and SMI disorders. Taking into account the patients' personality can benefit the clinical course and minimize the DD impact.
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Affiliation(s)
- Susana Fernández-Mondragón
- Department of Psychiatry and Clinical Psychobiology, School of Psychology, University of Barcelona, Barcelona, Spain
| | - Ana Adan
- Department of Psychiatry and Clinical Psychobiology, School of Psychology, University of Barcelona, Barcelona, Spain; Institute for Brain, Cognition and Behavior (IR3C), Barcelona, Spain.
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Peritogiannis V. Sensation/novelty seeking in psychotic disorders: A review of the literature. World J Psychiatry 2015; 5:79-87. [PMID: 25815257 PMCID: PMC4369552 DOI: 10.5498/wjp.v5.i1.79] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 12/31/2014] [Accepted: 01/19/2015] [Indexed: 02/05/2023] Open
Abstract
The evaluation of personality traits is important for the better understanding of the person suffering from psychosis and for treatment individualization. However literature on patients’ personality and character in such disorders is limited. The aim of this review was to summarize the literature on sensation/novelty seeking (SNS), a trait which is biologically based and highly heritable and is associated with dopamine activity, and refers to a person’s tendency to seek varied, novel, complex, and intense sensations and experiences. A total of 38 studies were included in this review, involving 2808 patients and 2039 healthy controls. There is consistent evidence that this trait is independently associated with alcohol and substance abuse in patients with schizophrenia and related disorders. The estimation of SNS would help clinicians to identify patients at risk for abuse. There is also some evidence that higher SNS levels may relate to medication non-adherence and seem to increase the risk of patients’ aggressive and violent behavior, but studies are scarce. SNS was found not to be related to suicidality, whereas in the fields of patients’ quality of life and psychopathology results are contradictory, but most studies show no possible association. Several studies suggest that SNS is lower in psychotic patients compared to controls, whereas most yield no differences. The evidence for this trait as a potential endophenotype of schizophrenia is weak. SNS may be implicated in psychotic disorders’ course and prognosis in several ways and should be always inquired for. This trait can be reliably measured with the use of easily applicable self-rated instruments, and patients’ accounts could inform clinicians when planning management and delivering individualized treatment.
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Fischer BA, McMahon RP, Kelly DL, Wehring HJ, Meyer WA, Feldman S, Carpenter WT, Gorelick DA. Risk-taking in schizophrenia and controls with and without cannabis dependence. Schizophr Res 2015; 161:471-7. [PMID: 25467541 PMCID: PMC4308438 DOI: 10.1016/j.schres.2014.11.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 11/05/2014] [Accepted: 11/09/2014] [Indexed: 11/13/2022]
Abstract
BACKGROUND Risk-based decision making is altered in people with schizophrenia and in people with cannabis use compared to healthy controls; the pattern of risk-assessment in people with co-occurring schizophrenia and cannabis dependence is poorly understood. This study examined measures of risk-taking and decision-making in people with and without schizophrenia and/or cannabis dependence. METHODS Participants with schizophrenia (n=24), cannabis dependence (n=23), schizophrenia and co-occurring cannabis dependence (n=18), and healthy controls (n=24) were recruited from the community via advertisements and completed a one-visit battery of symptom, risk-based decision making, gambling behavior, cognitive, and addiction assessments. This report presents self-assessments of self-mastery, optimism, impulsivity, and sensation seeking and a behavioral assessment of risk (Balloon Analog Risk Task [BART]). RESULTS On self-report measures, participants with schizophrenia and co-occurring cannabis dependence were intermediate between those with only cannabis dependence or only schizophrenia on ratings of self-mastery, sensation-seeking, and impulsivity. There were no group differences on ratings of optimism. Their behavior on the BART was most similar to participants with only cannabis dependence or healthy controls, rather than to participants with only schizophrenia. CONCLUSIONS People with schizophrenia and co-occurring cannabis dependence may represent a unique group in terms of risk-perception and risk-taking. This has implications for interventions designed to influence health behaviors such as motivational interviewing.
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Affiliation(s)
- Bernard A Fischer
- Veterans Affairs Capital Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Department of Veterans Affairs, Baltimore, MD, USA; Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Robert P McMahon
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Deanna L Kelly
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Heidi J Wehring
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Walter A Meyer
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Stephanie Feldman
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - William T Carpenter
- Veterans Affairs Capital Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Department of Veterans Affairs, Baltimore, MD, USA; Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - David A Gorelick
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
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Potvin S, Tikàsz A, Dinh-Williams LLA, Bourque J, Mendrek A. Cigarette Cravings, Impulsivity, and the Brain. Front Psychiatry 2015; 6:125. [PMID: 26441686 PMCID: PMC4562259 DOI: 10.3389/fpsyt.2015.00125] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Accepted: 08/26/2015] [Indexed: 12/28/2022] Open
Abstract
Craving is a core feature of tobacco use disorder as well as a significant predictor of smoking relapse. Studies have shown that appetitive smoking-related stimuli (e.g., someone smoking) trigger significant cravings in smokers impede their self-control capacities and promote drug seeking behavior. In this review, we begin by an overview of functional magnetic resonance imaging (fMRI) studies investigating the neural correlates of smokers to appetitive smoking cues. The literature reveals a complex and vastly distributed neuronal network underlying smokers' craving response that recruits regions involved in self-referential processing, planning/regulatory processes, emotional responding, attentional biases, and automatic conducts. We then selectively review important factors contributing to the heterogeneity of results that significantly limit the implications of these findings, namely between- (abstinence, smoking expectancies, and self-regulation) and within-studies factors (severity of smoking dependence, sex-differences, motivation to quit, and genetic factors). Remarkably, we found that little to no attention has been devoted to examine the influence of personality traits on the neural correlates of cigarette cravings in fMRI studies. Impulsivity has been linked with craving and relapse in substance and tobacco use, which prompted our research team to examine the influence of impulsivity on cigarette cravings in an fMRI study. We found that the influence of impulsivity on cigarette cravings was mediated by fronto-cingulate mechanisms. Given the high prevalence of cigarette smoking in several psychiatric disorders that are characterized by significant levels of impulsivity, we conclude by identifying psychiatric patients as a target population whose tobacco-smoking habits deserve further behavioral and neuro-imaging investigation.
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Affiliation(s)
- Stéphane Potvin
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal , Montreal, QC , Canada ; Department of Psychiatry, Faculty of Medicine, University of Montreal , Montreal, QC , Canada
| | - Andràs Tikàsz
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal , Montreal, QC , Canada ; Department of Psychiatry, Faculty of Medicine, University of Montreal , Montreal, QC , Canada
| | | | - Josiane Bourque
- Department of Psychiatry, Faculty of Medicine, University of Montreal , Montreal, QC , Canada ; Centre de Recherche de l'Hôpital Sainte-Justine , Montreal, QC , Canada
| | - Adrianna Mendrek
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal , Montreal, QC , Canada ; Department of Psychology, Bishop's University , Lennoxville, QC , Canada
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Harrison A, Mountford VA, Tchanturia K. Social anhedonia and work and social functioning in the acute and recovered phases of eating disorders. Psychiatry Res 2014; 218:187-94. [PMID: 24755042 DOI: 10.1016/j.psychres.2014.04.007] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 02/07/2014] [Accepted: 04/02/2014] [Indexed: 02/07/2023]
Abstract
Interpersonal difficulties are proposed to maintain eating disorders (EDs). This study explored whether social anhedonia (SA) was an additional social emotional maintenance factor which might also explain work/social problems in EDs. Additionally, the study explored SA and work and social adjustment in recovered participants. Women with anorexia nervosa (AN; n=105), bulimia nervosa (BN; n=46), recovered from AN (RAN; n=30) and non-ED controls (n=136) completed the Work and Social Adjustment Scale (WSAS) and the Revised Social Anhedonia Scale. ED participants reported greater SA and WSAS scores than non-ED controls; the RAN group reported an intermediate profile. AN participants had poorer work/social adjustment than BN participants. SA was associated with longer illness duration. SA, current severity (BMI) and lifetime severity (lowest adult BMI) significantly predicted work/social difficulties. Recovered participants scoring in the clinical range for SA experienced significantly greater work/social difficulties than recovered participants scoring outside the clinical range for SA. EDs are associated with clinical levels of SA and poor work/social functioning which reduce in recovery. SA may maintain the interpersonal functioning difficulties.
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Affiliation(s)
- Amy Harrison
- King׳s College London, Institute of Psychiatry, Addiction Sciences Building, 4 Windsor Walk, London SE5 8AF, UK; Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK.
| | - Victoria A Mountford
- Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK
| | - Kate Tchanturia
- Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK; King׳s College London, Institute of Psychiatry, PO59, De Crespigny Park, London SE5 8AF, London, UK; Clinical Psychology, Illia State University, Kakutsa Cholokashvili Avenue 3/5, Tbilisi 0162, Georgia
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Lyu J, Zhang J. Characteristics of schizophrenia suicides compared with suicides by other diagnosed psychiatric disorders and those without a psychiatric disorder. Schizophr Res 2014; 155:59-65. [PMID: 24657011 PMCID: PMC4003875 DOI: 10.1016/j.schres.2014.02.018] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 02/22/2014] [Accepted: 02/26/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND There has been much literature on schizophrenia, but very little is known about the characteristics of suicides with schizophrenia in comparison with the suicides with other diagnosed psychiatric disorders and without psychiatric disorders. METHODS Thirty-eight suicides with schizophrenia, 150 suicides with other psychiatric disorder, and 204 suicides without a psychiatric disorder were entered in current study. Psychological autopsy (PA) was applied to collect information of the suicides. Social demographic factors and clinical characteristics of the suicides were measured. The well validated standard scales were applied: Beck Hopelessness Scale (BHS), Landerman's Social Support Scale (DSSI), Dickman's Impulsivity Inventory (DII), Spielberger State-Trait Anxiety Inventory (STAI) and Hamilton Depression Scale (HAMD). Suicide intents were appraised by the Beck Suicide Intent Scale (SIS). The SCID based on the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) was applied to assess the psychiatric status of individuals. Demographic characteristics, clinical characteristics, method of suicide and suicide intents of suicides were compared among the three groups (schizophrenia group, other psychiatric disorders group, and none psychiatric disorders group). RESULTS There were 9.7% of suicides who suffered schizophrenia. The current study found that being female was the risk factor for suicides with schizophrenia in rural China, which was opposite to the previous studies. The suicides with psychiatric disorder scored higher on hopelessness, anxiety, and depression, but lower on social support and impulsivity than suicides without psychiatric disorder. The suicides with psychiatric disorder were less impulsive than none psychiatric disorders group, too. The schizophrenia group did not show more violence than other psychiatric disorders group. CONCLUSIONS This research compared the demographic characteristics, clinical characteristics, method of suicide and suicide intents among the suicides with schizophrenia, with other diagnosed psychiatric disorder and without psychiatric disorders. The result indicated that each groups showed their unique characteristics, which gave us new viewpoints to control and prevent the prevalence of suicides according to their different characteristics.
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Affiliation(s)
- Juncheng Lyu
- Shandong University, School of Public Health Center for Suicide Prevention Research, China; Weifang Medical University, China
| | - Jie Zhang
- Shandong University, School of Public Health Center for Suicide Prevention Research, China; State University of New York College at Buffalo, Department of Sociology, USA.
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The assessment of interpersonal pleasure: introduction of the Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS) and preliminary findings. Psychiatry Res 2014; 215:237-43. [PMID: 24210182 DOI: 10.1016/j.psychres.2013.10.012] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 10/05/2013] [Accepted: 10/16/2013] [Indexed: 11/21/2022]
Abstract
Although several valid measures of pleasure and anhedonia exist, there is a relative paucity of measures that adequately assess pleasure for social interactions. The Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS) is a measure specifically designed to assess hedonic capacity for social and interpersonal pleasure. Various aspects of the validity and reliability of the ACIPS were examined in several ways. First, we assessed the factor structure as well as the internal consistency, convergent, and discriminant validity of the ACIPS in 496 young adults recruited from undergraduate classes. Second, we investigated the temporal stability of the measure by having a subset of the group return for retesting. Results from the factor analysis suggested a three-factor model. The ACIPS was found to be highly reliable in terms of internal consistency and test-retest stability. Further, the ACIPS correlated in a theoretically meaningful way with other measures of pleasure and affect. The current research indicates that the ACIPS is a reliable and valid questionnaire to assess hedonic capacity for social and interpersonal pleasure in nonclinical samples. Suggestions for further clinical and research applications using the ACIPS are offered.
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Abstract
Behavioral tendencies that might be captured through self-report measures may provide insight into personality features that are associated with substance addictions. Recently, impulsivity and related constructs, such as sensation-seeking, have been examined to help better understand their relationships with addictions. Here, we review recent findings that show links over developmental epochs between addictive behaviors and impulsivity, sensation-seeking, and other constructs that are theoretically linked. These findings have significant implications for generating improved treatments and interventions aimed at preventing the development of addictive disorders.
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Affiliation(s)
- Marci R Mitchell
- Department of Psychiatry, Yale University School of Medicine, 1 Church St, 7th floor, New Haven, CT 06510, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, 1 Church St, 7th floor, New Haven, CT 06510, USA
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Garfield JBB, Lubman DI, Yücel M. Anhedonia in substance use disorders: a systematic review of its nature, course and clinical correlates. Aust N Z J Psychiatry 2014; 48:36-51. [PMID: 24270310 DOI: 10.1177/0004867413508455] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE There is growing evidence that anhedonia is a commonly experienced symptom among substance-using populations. This systematic review synthesises findings across a range of substances to address questions regarding the time course of anhedonia, how anhedonia relates to other symptoms of substance dependence and whether it is similarly prevalent across all addictive drugs. METHOD A literature search was conducted on PubMed, PsycINFO and MEDLINE, yielding 32 studies that used self-report measures of anhedonia among participants with a history of a substance abuse, dependence or long-term daily use of addictive substances. RESULTS Findings from these studies indicate that anhedonia (1) is elevated in samples dependent on a range of substances; (2) typically appears as a consequence of substance abuse or dependence, and diminishes with abstinence; and (3) predicts increased drug cravings and the likelihood of relapse in those attempting abstinence. CONCLUSIONS The common experience of anhedonia in substance-dependent populations, and its relationship to relapse, emphasises the importance of developing therapeutic interventions that specifically target anhedonia in the treatment of all substance use disorders.
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Affiliation(s)
- Joshua B B Garfield
- 1Turning Point Alcohol & Drug Centre, Eastern Health and Monash University, Melbourne, Australia
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Vitacco MJ, Buckley PF. Substance Use Comorbidity in Patients with Schizophrenia. Psychiatr Ann 2013. [DOI: 10.3928/00485713-20131003-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Neural substrates underlying effort computation in schizophrenia. Neurosci Biobehav Rev 2013; 37:2649-65. [PMID: 24035741 DOI: 10.1016/j.neubiorev.2013.09.001] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 08/16/2013] [Accepted: 09/03/2013] [Indexed: 11/23/2022]
Abstract
The lack of initiative, drive or effort in patients with schizophrenia is linked to marked functional impairments. However, our assessment of effort and motivation is crude, relying on clinical rating scales based largely on patient recall. In order to better understand the neurobiology of effort in schizophrenia, we need more rigorous measurements of this construct. In the behavioural neuroscience literature, decades of work has been carried out developing various paradigms to examine the neural underpinnings of an animal's willingness to expend effort for a reward. Here, we shall review this literature on the nature of paradigms used in rodents to assess effort, as well as those used in humans. Next, the neurobiology of these effort-based decisions will be discussed. We shall then review what is known about effort in schizophrenia, and what might be inferred from experiments done in other human populations. Lastly, we shall discuss future directions of research that may assist in shedding light on the neurobiology of effort cost computations in schizophrenia.
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