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Bai W, Feng Y, Sha S, Zhang Q, Cheung T, Zhang D, Su Z, Ng CH, Xiang YT. Comparison of Hypomanic Symptoms Between Bipolar I and Bipolar II Disorders: A Network Perspective. Front Psychiatry 2022; 13:881414. [PMID: 35633807 PMCID: PMC9135060 DOI: 10.3389/fpsyt.2022.881414] [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: 02/22/2022] [Accepted: 04/04/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Hypomanic symptoms between bipolar-I disorder (BD-I) and bipolar-II disorder (BD-II) are often indistinguishable in clinical practice. This study compared the network structure of hypomanic symptoms between patients with BD-I and BD-II. METHODS The 32-item Hypomania Checklist (HCL-32) was used to assess hypomanic symptoms. Network model was generated in BD-I and BD-II patients. Centrality index of strength was used to quantify the importance of each symptom in the network. The Network Comparison Test (NCT) was used to assess the differences in hypomanic symptoms between BD-I and BD-II patients. RESULTS Altogether, 423 patients with BD (BD-I: 191 and BD-II: 232) were included. The most central symptom was HCL17 "I am more flirtatious and/or am more sexually active" (strength BD-I = 5.21) and HCL12 "I have more ideas, I am more creative" (strength BD-II = 6.84) in BD-I and BD-II samples, respectively. The results of NCT showed that four nodes (HCL12 "I have more ideas, I am more creative," HCL17 "I am more flirtatious and/or am more sexually active," HCL23 "My thoughts jump from topic to topic," and HCL31 "I drink more alcohol") were significantly different between the BD-I and BD-II samples. Two edges (HCL3 "I am more self-confident"-HCL17 "I am more flirtatious and/or am more sexually active," and HCL10 "I am physically more active (sport, etc.)"-HCL24 "I do things more quickly and/or more easily") were significantly stronger in BD-I compared to BD-II patients. CONCLUSION The network structure of hypomanic symptoms is different between BD-I and BD-II patients. Interventions targeting the respective central symptoms and edges should be developed for BD-I and BD-II separately.
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Affiliation(s)
- Wei Bai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences, Institute of Translational Medicine, University of Macau, Macao, Macao SAR, China.,Center for Cognition and Brain Sciences, University of Macau, Macao, Macao SAR, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao, Macao SAR, China
| | - Yuan Feng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & The Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Sha Sha
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & The Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & The Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Teris Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Dexing Zhang
- Faculty of Medicine, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences, Institute of Translational Medicine, University of Macau, Macao, Macao SAR, China.,Center for Cognition and Brain Sciences, University of Macau, Macao, Macao SAR, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao, Macao SAR, China
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Adult Gambling Problems and Histories of Mental Health and Substance Use: Findings from a Prospective Multi-Wave Australian Cohort Study. J Clin Med 2021; 10:jcm10071406. [PMID: 33915774 PMCID: PMC8037618 DOI: 10.3390/jcm10071406] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 01/08/2023] Open
Abstract
Little is known about the cumulative effect of adolescent and young adult mental health difficulties and substance use problems on gambling behaviour in adulthood. We use data from one of Australia's longest running studies of social and emotional development to examine the extent to which: (1) mental health symptoms (depressive and anxiety symptoms) and substance use (weekly binge drinking, tobacco, and cannabis use) from adolescence (13-18 years) into young adulthood (19-28 years) predict gambling problems in adulthood (31-32 years); and (2) risk relationships differ by sex. Analyses were based on responses from 1365 adolescent and young adult participants, spanning seven waves of data collection (1998-2014). Persistent adolescent to young adult binge drinking, tobacco use and cannabis use predicted gambling at age 31-32 years (OR = 2.30-3.42). Binge drinking and tobacco use in young adulthood also predicted gambling at age 31-32 years (OR = 2.04-2.54). Prior mental health symptoms were not associated with gambling and no risk relationships differed by sex. Findings suggest that gambling problems in adulthood may be related to the earlier development of other addictive behaviours, and that interventions targeting substance use from adolescence to young adulthood may confer additional gains in preventing later gambling behaviours.
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3
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Dowling NA, Merkouris SS, Dias S, Rodda SN, Manning V, Youssef GJ, Lubman DI, Volberg RA. The diagnostic accuracy of brief screening instruments for problem gambling: A systematic review and meta-analysis. Clin Psychol Rev 2019; 74:101784. [PMID: 31759246 DOI: 10.1016/j.cpr.2019.101784] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 10/22/2019] [Accepted: 10/26/2019] [Indexed: 02/06/2023]
Abstract
Non-gambling specialist services, such as primary care, alcohol and other drug use, and mental health services, are well placed to enhance the identification of people with gambling problems and offer appropriate generalist first level interventions or referral. Given time and resource demands, many of these clinical services may only have the capacity to administer very short screening instruments. This systematic review was conducted to provide a resource for health service providers and researchers in identifying the most accurate brief (1-5 item) screening instruments to identify problem and at-risk gambling for their specific purposes and populations. A systematic search of peer-reviewed and grey literature from 1990 to 2019 identified 25 articles for inclusion. Meta-analysis revealed five of the 20 available instruments met criteria for satisfactory diagnostic accuracy in detecting both problem and at-risk gambling: Brief Problem Gambling Screen (BPGS-2), NODS-CLiP, Problem Gambling Severity Index-Short Form (PGSI-SF), NODS-PERC, and NODS-CLiP2. Of these, the NODS-CLiP and NODS-PERC have the largest volume of diagnostic data. The Lie/Bet Questionnaire and One-Item Screen are also promising shorter options. Because these conclusions are drawn from a relatively limited evidence base, future studies evaluating the diagnostic accuracy of existing brief instruments across settings, age groups, and timeframes are needed.
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Affiliation(s)
- N A Dowling
- School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia; Melbourne Graduate School of Education, University of Melbourne, Kwong Lee Dow Building, 234 Queensberry Street, Parkville, VIC 3053, Australia.
| | - S S Merkouris
- School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia
| | - S Dias
- School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia
| | - S N Rodda
- School of Population Health, Faculty of Medical and Health Sciences, 216 Morrin Road, Auckland 1142, New Zealand.
| | - V Manning
- Eastern Health Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Level 2, 5 Arnold Street, Box Hil, 3128 Melbourne, Victoria, Australia; Turning Point, Eastern Health, 110 Church Street, Richmond 3121, VIC, Australia
| | - G J Youssef
- School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Road, Parkville 3052, Victoria, Australia
| | - D I Lubman
- Eastern Health Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Level 2, 5 Arnold Street, Box Hil, 3128 Melbourne, Victoria, Australia; Turning Point, Eastern Health, 110 Church Street, Richmond 3121, VIC, Australia
| | - R A Volberg
- School of Public Health and Health Sciences, University of Massachusetts, 715 N. Pleasant Street, Amherst, MA 01003, USA.
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The Reciprocal Association between Problem Gambling and Mental Health Symptoms/Substance Use: Cross-Lagged Path Modelling of Longitudinal Cohort Data. J Clin Med 2019; 8:jcm8111888. [PMID: 31698740 PMCID: PMC6912817 DOI: 10.3390/jcm8111888] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 10/29/2019] [Accepted: 10/30/2019] [Indexed: 02/01/2023] Open
Abstract
To date, studies have highlighted cross-sectional and unidirectional prospective relationships between problem gambling and mental health symptoms or substance use. The current study aims to: (1) examine the reciprocal relationships between problem gambling and mental health symptoms (depression, generalized anxiety)/substance use variables (hazardous alcohol use, daily tobacco use, and drug use) using cross-lagged path models in a prospective general population cohort sample; and (2) determine whether these associations are moderated by age and gender. This study involved secondary data analysis from 1109 respondents who provided data during Wave 2 or 3 (12-months apart) of the Tasmanian Longitudinal Gambling Study (Australia). Depression (odds ratio (OR) = 2.164) and generalized anxiety (OR = 2.300) at Wave 2 were found to have cross-lagged associations with the subsequent development of any-risk gambling (low-risk, moderate-risk, or problem gambling) at Wave 3. Hazardous alcohol use, daily tobacco use, and drug use at Wave 2 were not associated with the development of any-risk gambling at Wave 3. Any-risk gambling at Wave 2 was not associated with the subsequent development of any mental health symptoms or substance use variables at Wave 3. Age and gender failed to be significant moderators in the associations between any-risk gambling and mental health symptoms or substance use variables. Future longitudinal and event-level research is required to further substantiate these prospective relationships, with a view to developing targeted preventions and interventions.
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Dowling NA, Merkouris SS, Manning V, Volberg R, Lee SJ, Rodda SN, Lubman DI. Screening for problem gambling within mental health services: a comparison of the classification accuracy of brief instruments. Addiction 2018; 113:1088-1104. [PMID: 29274182 DOI: 10.1111/add.14150] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 10/22/2017] [Accepted: 12/14/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIMS Despite the over-representation of people with gambling problems in mental health populations, there is limited information available to guide the selection of brief screening instruments within mental health services. The primary aim was to compare the classification accuracy of nine brief problem gambling screening instruments (two to five items) with a reference standard among patients accessing mental health services. DESIGN The classification accuracy of nine brief screening instruments was compared with multiple cut-off scores on a reference standard. SETTING Eight mental health services in Victoria, Australia. PARTICIPANTS A total of 837 patients were recruited consecutively between June 2015 and January 2016. MEASUREMENTS The brief screening instruments were the Lie/Bet Questionnaire, Brief Problem Gambling Screen (BPGS) (two- to five-item versions), NODS-CLiP, NODS-CLiP2, Brief Biosocial Gambling Screen (BBGS) and NODS-PERC. The Problem Gambling Severity Index (PGSI) was the reference standard. FINDINGS The five-item BPGS was the only instrument displaying satisfactory classification accuracy in detecting any level of gambling problem (low-risk, moderate-risk or problem gambling) (sensitivity = 0.803, specificity = 0.982, diagnostic efficiency = 0.943). Several shorter instruments adequately detected both problem and moderate-risk, but not low-risk, gambling: two three-item instruments (NODS-CLiP, three-item BPGS) and two four-item instruments (NODS-PERC, four-item BPGS) (sensitivity = 0.854-0.966, specificity = 0.901-0.954, diagnostic efficiency = 0.908-0.941). The four-item instruments, however, did not provide any considerable advantage over the three-item instruments. Similarly, the very brief (two-item) instruments (Lie/Bet and two-item BPGS) adequately detected problem gambling (sensitivity = 0.811-0.868, specificity = 0.938-0.943, diagnostic efficiency = 0.933-0.934), but not moderate-risk or low-risk gambling. CONCLUSIONS The optimal brief screening instrument for mental health services wanting to screen for any level of gambling problem is the five-item Brief Problem Gambling Screen (BPGS). Services wanting to employ a shorter instrument or to screen only for more severe gambling problems (moderate-risk/problem gambling) can employ the NODS-CLiP or the three-item BPGS. Services that are only able to accommodate a very brief instrument can employ the Lie/Bet Questionnaire or the two-item BPGS.
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Affiliation(s)
- Nicki A Dowling
- School of Psychology, Deakin University, Geelong, Australia.,Melbourne Graduate School of Education, University of Melbourne, Australia
| | | | - Victorian Manning
- Turning Point, Eastern Health, Fitzroy, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Rachel Volberg
- School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Stuart J Lee
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne, Australia
| | - Simone N Rodda
- School of Psychology, Deakin University, Geelong, Australia.,Turning Point, Eastern Health, Fitzroy, Australia.,School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand
| | - Dan I Lubman
- Turning Point, Eastern Health, Fitzroy, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Australia
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Keough MT, Penniston TL, Vilhena-Churchill N, Michael Bagby R, Quilty LC. Depression symptoms and reasons for gambling sequentially mediate the associations between insecure attachment styles and problem gambling. Addict Behav 2018; 78:166-172. [PMID: 29175293 DOI: 10.1016/j.addbeh.2017.11.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 11/09/2017] [Accepted: 11/09/2017] [Indexed: 11/28/2022]
Abstract
One of the central pathways to problem gambling (PG) is gambling to cope with negative moods, which is a cardinal feature of depression. Insecure attachment styles are also etiologically related to depression; and, therefore, by extension, those who are insecurely attached may engage in excessive gambling behaviors to cope with depression. In this study, we aimed to evaluate this and to this end predicted that depression severity and coping motives for gambling would conjointly mediate the relations between insecure attachment styles and PG. Data came from a larger investigation of PG within mood disorders. Participants exhibited a lifetime depressive or bipolar disorder and endorsed a mood episode within the past ten years. Participants (N=275) completed self-report measures during a two-day assessment. Path analysis supported two main indirect effects. First, anxious attachment predicted elevated depression, which in turn predicted increased coping motives for gambling, which subsequently predicted greater PG severity. Second, this double mediational pathway was also observed for avoidant attachment. Results suggest that insecure attachment relates to PG via depressive symptoms and coping-related gambling motives. Mood symptoms and associated gambling motives are malleable and are promising targets of gambling interventions for insecurely attached individuals.
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Affiliation(s)
- Matthew T Keough
- University of Manitoba, Department of Psychology, 190 Dysart Road, P314 Duff Roblin Building, Winnipeg, MB R3T 2N2, Canada.
| | - Trinda L Penniston
- University of Manitoba, Department of Psychology, 190 Dysart Road, P314 Duff Roblin Building, Winnipeg, MB R3T 2N2, Canada
| | - Natalie Vilhena-Churchill
- Altum Health, University Health Network, Krembil Discovery Tower, 399, Bathurst St., Toronto, Ontario M5T 2S8, Canada
| | - R Michael Bagby
- University of Toronto, Departments of Psychology and Psychiatry, 1265 Military Trail, Toronto, Ontario M1C 1A4, Canada
| | - Lena C Quilty
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, 100 Stokes Street, Bell Gateway Building, Toronto, Ontario M6J 1H4, Canada; University of Toronto, Department of Psychiatry, 250 College St., Toronto, Ontario M5T 1R8, Canada
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Subramaniam M, Mahesh MV, Peh CX, Tan J, Fauziana R, Satghare P, Gupta B, Gomathinayagam K, Chong SA. Hazardous alcohol use among patients with schizophrenia and depression. Alcohol 2017; 65:63-69. [PMID: 29084631 DOI: 10.1016/j.alcohol.2017.07.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 07/18/2017] [Accepted: 07/18/2017] [Indexed: 01/16/2023]
Abstract
AIMS The current study aimed to 1) report the prevalence of hazardous alcohol use in an outpatient population among those with schizophrenia and depressive disorders, 2) assess the sociodemographic and clinical correlates of hazardous alcohol use, 3) examine the association of hazardous alcohol use with severity of depression, anxiety and smoking, and 4) assess the association of hazardous alcohol use with quality of life. METHODS Three hundred ten outpatients seeking treatment at a tertiary psychiatric institute with a diagnosis of either schizophrenia spectrum disorder or depressive disorder were included in the study. Patients were assessed for hazardous alcohol use using the Alcohol Use Disorders Identification Test. Information on sociodemographic correlates, clinical history, severity of symptoms of depression and anxiety, as well as quality of life (QOL) was collected. RESULTS The overall prevalence of hazardous alcohol use among the sample was 12.6%. The prevalence of hazardous alcohol use among patients with depression and schizophrenia was 18.8% and 6.4%, respectively. Compared to those who were students, patients who were gainfully employed or unemployed were more likely to engage in hazardous alcohol use (Odds Ratio (OR) = 5.5 and 7.7, respectively). Patients with depression compared to those with schizophrenia (OR = 11.1) and those who were current smokers compared to those who had never smoked (OR = 14.5) were more likely to engage in hazardous alcohol use. Hazardous alcohol use was associated with lower QOL in the physical health domain (p = 0.002). CONCLUSION Given the significant prevalence of hazardous alcohol use in this population, routine screening for hazardous alcohol use and brief interventions could be an effective way of managing this comorbidity. There is a need to develop and evaluate culturally appropriate brief interventions based on patient preference in this setting.
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Manning V, Dowling N, Lee S, Rodda S, Garfield J, Volberg R, Kulkarni J, Lubman D. Problem gambling and substance use in patients attending community mental health services. J Behav Addict 2017; 6:678-688. [PMID: 29254361 PMCID: PMC6034952 DOI: 10.1556/2006.6.2017.077] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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
Background and aims Relatively little is known about co-occurring gambling problems and their overlap with other addictive behaviors among individuals attending mental health services. We aimed to determine rates of gambling and substance use problems in patients accessing mental health services in Victoria, Australia. Methods A total of 837 adult patients were surveyed about their gambling and administered standardized screening tools for problem gambling and harmful tobacco, alcohol, and drug use. Prevalence of gambling problems was estimated and regression models used to determine predictors of problem gambling. Results The gambling participation rate was 41.6% [95% CI = 38.2-44.9]. The Problem Gambling Severity Index identified 19.7% [CI = 17.0-22.4] as "non-problem gamblers," 7.2% [CI = 5.4-8.9] as "low-risk" gamblers, 8.4% [CI = 6.5-10.2] as "moderate-risk" gamblers, and 6.3% [CI = 4.7-8.0] as "problem gamblers." One-fifth (21.9%) of the sample and 52.6% of all gamblers were identified as either low-risk, moderate-risk, or problem gamblers (PGs). Patients classified as problem and moderate-risk gamblers had significantly elevated rates of nicotine and illicit drug dependence (p < .001) according to short screening tools. Current diagnosis of drug use (OR = 4.31 [CI = 1.98-9.37]), borderline personality (OR = 2.59 [CI = 1.13-5.94]), bipolar affective (OR = 2.01 [CI = 1.07-3.80]), and psychotic (OR = 1.83 [CI = 1.03-3.25]) disorders were significant predictors of problem gambling. Discussion and conclusions Patients were less likely to gamble, but eight times as likely to be classified as PG, relative to Victoria's adult general population. Elevated rates of harmful substance use among moderate-risk and PG suggest overlapping vulnerability to addictive behaviors. These findings suggest mental health services should embed routine screening into clinical practice, and train clinicians in the management of problem gambling.
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Affiliation(s)
- Victoria Manning
- Turning Point, Eastern Health, Melbourne, VIC, Australia,Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia,Corresponding author: Victoria Manning; Turning Point, Eastern Health, 110 Church Street, Richmond 3121, VIC, Australia; Phone: +61 3 8413 8413; Fax: +61 3 9416 3420; E-mail:
| | - Nicki. A. Dowling
- School of Psychology, Deakin University, Geelong, VIC, Australia,Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia
| | - Stuart Lee
- Monash Alfred Psychiatry Research Centre, Alfred Health and Monash University Central Clinical School, Melbourne, VIC, Australia
| | - Simone Rodda
- Turning Point, Eastern Health, Melbourne, VIC, Australia,School of Psychology, Deakin University, Geelong, VIC, Australia,School of Population Health, University of Auckland, Auckland, New Zealand
| | - Joshua Benjamin Bernard Garfield
- Turning Point, Eastern Health, Melbourne, VIC, Australia,Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Rachel Volberg
- School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre, Alfred Health and Monash University Central Clinical School, Melbourne, VIC, Australia
| | - Dan Ian Lubman
- Turning Point, Eastern Health, Melbourne, VIC, Australia,Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
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Yakovenko I, Hodgins DC. A scoping review of co-morbidity in individuals with disordered gambling. INTERNATIONAL GAMBLING STUDIES 2017. [DOI: 10.1080/14459795.2017.1364400] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Igor Yakovenko
- School of Public Health, University of Alberta, Edmonton, Canada
| | - David C. Hodgins
- School of Public Health, University of Alberta, Edmonton, Canada
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Nehlin C, Arinell H, Dyster-Aas J, Jess K. Alcohol Habits and Health Care Use in Patients with Psychiatric Disorders. J Dual Diagn 2017; 13:247-253. [PMID: 28665254 DOI: 10.1080/15504263.2017.1347307] [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] [Indexed: 10/19/2022]
Abstract
OBJECTIVE It is common for persons with psychiatric disorders to also have alcohol problems. Studies in the general population as well as in clinical samples have found hazardous or harmful alcohol habits to be particularly prevalent in the presence of psychiatric disorders. This study sought to explore the relationships between drinking habits and health care utilization (psychiatric as well as general medical) in persons seeking psychiatric treatment and to investigate the associations among age, sex, and type or number of diagnoses and health care use and costs. For the planning of targeted interventions, we also sought to identify subgroups with a high prevalence of hazardous drinking habits. METHODS From a psychiatric clinic for affective disorders at a university hospital in Sweden, patients who had been screened for hazardous drinking (N = 609) were selected. Patients with primary psychosis or substance use disorder receive treatment at other clinics and did not participate. Medical records data were grouped and compared. The International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) was used for diagnoses and the Alcohol Use Disorders Identification Test for screening. Patients were grouped by drinking habits and sex, age, and diagnosis group, and their psychiatric as well as general medical health care use was compared. RESULTS Abstainers used psychiatric care more than all other drinking groups (p < .001). Psychiatric health care costs were higher in abstainers and low-risk drinkers (1.64 to 1). No differences in general medical care could be identified between drinking groups. Specific subgroups with higher rates of hazardous drinking could not be identified (44% of all males and 34% of all females reported such habits). Inconclusive results from previous research are most likely due to different methods used to classify drinking problems. CONCLUSIONS Abstainers and low-risk drinkers used psychiatric health care to a higher cost than the other drinking groups. Possible explanations are discussed from a clinical and scientific perspective. This study clarifies the need for uniform measures when classifying alcohol use in studies of relationships between alcohol use and health care use. There is also a need to separate former drinkers from abstainers in future studies.
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Affiliation(s)
- Christina Nehlin
- a Department of Neuroscience, Psychiatry , Uppsala University , Uppsala , Sweden.,b Division of Psychiatry , Uppsala University Hospital , Uppsala , Sweden
| | - Hans Arinell
- a Department of Neuroscience, Psychiatry , Uppsala University , Uppsala , Sweden
| | - Johan Dyster-Aas
- a Department of Neuroscience, Psychiatry , Uppsala University , Uppsala , Sweden.,b Division of Psychiatry , Uppsala University Hospital , Uppsala , Sweden
| | - Kari Jess
- c School of Education, Health & Social Studies , Dalarna University , Falun , Sweden
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11
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Smith C, Myles H, Galletly C. Developing a metformin prescribing tool for use in adults with mental illness to reduce medication-related weight gain and cardiovascular risk. Australas Psychiatry 2017; 25:387-390. [PMID: 28747113 DOI: 10.1177/1039856217695704] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES There is considerable evidence that metformin reduces weight gain associated with antipsychotic medication. The aim of this study was to develop an easy-to-use metformin prescribing tool in order to enable clinicians to prescribe metformin safely and confidently. METHODS The authors undertook a survey of clinicians and reviewed the published literature and existing guidelines concerning the use of metformin to reduce weight gain in adults with mental illness. RESULTS A metformin prescribing tool was devised based on the literature, national cardiovascular and diabetes guidelines and Australian metformin prescribing recommendations. The metformin prescribing tool guides clinicians through the considerations required for appropriate selection of the target patient population and safe prescription of metformin. CONCLUSIONS A novel, easy-to-use, one-page reference has been developed for busy clinicians that can be laminated and displayed in consulting rooms and psychiatric inpatient units to address weight gain and obesity associated with antipsychotic medications in people with mental illness.
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Affiliation(s)
- Cassie Smith
- Psychiatry Registrar, Northern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Hannah Myles
- Psychiatry Registrar, Country Health SA, Mental Health; The University of Adelaide, Adelaide, SA, Australia
| | - Cherrie Galletly
- Regional Director of Training, Northern Adelaide Local Health Network, Adelaide, SA, and; Discipline of Psychiatry, School of Medicine, The University of Adelaide, Adelaide, SA, and; Ramsay Health Care (SA) Mental Health Services, Adelaide, SA, Australia
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12
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Dwyer R, Fraser S. Engendering drug problems: Materialising gender in the DUDIT and other screening and diagnostic ‘apparatuses’. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017. [DOI: 10.1016/j.drugpo.2017.05.049] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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13
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Del Pino-Gutiérrez A, Fernández-Aranda F, Granero R, Tárrega S, Valdepérez A, Agüera Z, Håkansson A, Sauvaget A, Aymamí N, Gómez-Peña M, Moragas L, Baño M, Honrubia M, Menchón JM, Jiménez-Murcia S. Impact of alcohol consumption on clinical aspects of gambling disorder. Int J Ment Health Nurs 2017; 26:121-128. [PMID: 26952336 DOI: 10.1111/inm.12221] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 11/26/2015] [Accepted: 01/03/2016] [Indexed: 11/27/2022]
Abstract
Similarities between gambling disorder and substance use disorders have been extensively described. To date, however, few studies using large clinical samples have been carried out that reliably assess the relationship between different levels of alcohol consumption and gambling disorders. The present study aimed to assess the impact of baseline alcohol consumption levels on the clinical profile in a large sample of treatment-seeking individuals. Nine hundred and fifty-one consecutive outpatients diagnosed with gambling disorder according to DSM-IV criteria were compared after being included in three alcohol consumption groups (low risk, abuse and risk of dependence) based on their total raw scores on the AUDIT questionnaire. Results showed a high prevalence of risk of alcohol dependence in GD patients who were immigrants, unemployed, and had a low level of education. A positive linear trend was also found between alcohol consumption level and the prevalence of other current and life-time comorbid mental disorders, and for the presence of drug abuse. Statistically significant differences were found between the three alcohol consumption groups in terms of the evolution and severity of the gambling disorder, self-directedness personality trait, and levels of general psychopathology, hostility and paranoid ideation. In conclusion, the results showed an association between increased alcohol consumption and greater dysfunction.
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Affiliation(s)
- Amparo Del Pino-Gutiérrez
- Nursing Department of Mental Health, Public Health, Maternal and Child Health, The Nursing School of the University of Barcelona, Barcelona, Spain.,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Barcelona, Spain.,Departament of Clinical Sciences, School of Medicine, University of Barcelona, Spain
| | - Roser Granero
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Barcelona, Spain.,Department of Psychobiology and Methodology, Autonomous University of Barcelona, Spain
| | - Salomé Tárrega
- Department of Psychobiology and Methodology, Autonomous University of Barcelona, Spain
| | - Ana Valdepérez
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Zaida Agüera
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Barcelona, Spain
| | - Anders Håkansson
- Division of Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Anne Sauvaget
- Addictology and Psychiatry Department, Nantes University Hospital, France
| | - Neus Aymamí
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Marta Baño
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - María Honrubia
- Nursing Department of Mental Health, Public Health, Maternal and Child Health, The Nursing School of the University of Barcelona, Barcelona, Spain
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Departament of Clinical Sciences, School of Medicine, University of Barcelona, Spain.,CIBER Mental Health (CIBERSAM), Institute of Health Carlos III, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Barcelona, Spain.,Departament of Clinical Sciences, School of Medicine, University of Barcelona, Spain
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Abstract
This paper summarizes the degree to which different forms of legal gambling contribute to Problem and Pathological Gambling (PPG) in Canada. Legal gambling activities were compared using meta-analysis of publicly available data concerning Canada's legal gambling industry. The majority of revenues in the decade spanning 2002-2012 were drawn from Video Lottery Terminals and casino slot machines. Population surveys indicated that three quarters of Canadians reported some form of past-year gambling participation, but most did not play Electronic Gambling Machines. Annual revenues divided by estimated numbers of participants in various gambling activities showed that Video Lottery players spent more money on average than did participants in other forms of gambling. The relative risk of PPG was higher among Video Lottery players than it was for other common forms of gambling. Results from a community study of frequent Video Lottery players showed that the risk of frequent players reporting symptoms of PPG was elevated if they reported playing weekly, spending $50 or more per session, or playing for more than an hour per session. These studies provide converging evidence that Video Lottery is more hazardous to consumers than other forms of gambling that are commonly practised in Canada.
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Affiliation(s)
- Vance Victor MacLaren
- Department of Psychology, Brandon University, 270 18th St., Brandon, MB, R7A-6A9, Canada.
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Keough MT, Wardell JD, Hendershot CS, Bagby RM, Quilty LC. Fun Seeking and Reward Responsiveness Moderate the Effect of the Behavioural Inhibition System on Coping-Motivated Problem Gambling. J Gambl Stud 2016; 33:769-782. [PMID: 27766465 DOI: 10.1007/s10899-016-9646-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Gray's Reinforcement Sensitivity Theory (RST) predicts that the Behavioral Inhibition System (BIS) may relate to coping-motivated problem gambling, given its central role in anxiety. Studies examining the BIS-problem gambling association, however, are mixed. The revised RST posits that the Behavioral Approach System (BAS) may moderate the effect of the BIS on coping-motivated problem gambling. A concurrently strong BAS may highlight the negatively reinforcing effects of gambling, which may strengthen coping motives and increase gambling-related harms. We examined these interactive effects to clarify the moderators and mediators of the negative reinforcement pathway to problem gambling. Data came from a larger investigation of problem gambling among individuals with mood disorders. All participants (N = 275) met criteria for a lifetime depressive or bipolar disorder. During a two-day assessment, participants completed a diagnostic assessment and self-reports. Mediated moderation path analysis showed positive indirect effects from the BIS to problem gambling via coping motives at high, but not at low, levels of BAS-Reward Responsiveness and BAS-Fun Seeking. Enhancement motives were also found to mediate the associations of BAS-Fun Seeking and BAS-Drive with problem gambling. Reward Responsiveness and Fun Seeking facets of the BAS may strengthen coping gambling motives within the mood disorders.
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Affiliation(s)
- Matthew T Keough
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 100 Stokes Street, Bell Gateway Building, Toronto, ON, M6J 1H4, Canada. .,Department of Psychology, Concordia University, 7141 Sherbrooke St. West, Montreal, QC, H4B 1R6, Canada.
| | - Jeffrey D Wardell
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 100 Stokes Street, Bell Gateway Building, Toronto, ON, M6J 1H4, Canada
| | - Christian S Hendershot
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 100 Stokes Street, Bell Gateway Building, Toronto, ON, M6J 1H4, Canada.,Departments of Psychology and Psychiatry, University of Toronto, 1265 Military Trail, Toronto, ON, M1C 1A4, Canada.,Department of Psychiatry, University of Toronto, 250 College St., Toronto, ON, M5T 1R8, Canada
| | - R Michael Bagby
- Departments of Psychology and Psychiatry, University of Toronto, 1265 Military Trail, Toronto, ON, M1C 1A4, Canada
| | - Lena C Quilty
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 100 Stokes Street, Bell Gateway Building, Toronto, ON, M6J 1H4, Canada.,Department of Psychiatry, University of Toronto, 250 College St., Toronto, ON, M5T 1R8, Canada
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16
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An Update on Gender Differences in the Characteristics Associated with Problem Gambling: a Systematic Review. CURRENT ADDICTION REPORTS 2016. [DOI: 10.1007/s40429-016-0106-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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17
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Öster C, Arinell H, Nehlin C. The Drinking Motives Questionnaire among Swedish psychiatric patients: An exploration of the four-factor structure. Drug Alcohol Rev 2016; 36:400-407. [PMID: 27288296 DOI: 10.1111/dar.12421] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 03/07/2016] [Accepted: 03/09/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS Alcohol use above hazardous limits is common among persons with psychiatric disorders, and there is limited knowledge about motives for drinking. The objective of this study was to explore the adequacy of the four-factor structure of drinking motives in an adult psychiatric outpatient population in Sweden by confirming the factor structure in the Drinking Motives Questionnaire (DMQ-R) and in alternative models. DESIGN AND METHODS In total, 371 patients responded to the DMQ-R along with the Alcohol Use Disorders Identification Test (AUDIT). AUDIT was used to assess frequency of alcohol consumption, number of drinks consumed on a typical occasion and binge drinking frequency. Confirmatory factor analysis was used to examine the construct validity of the DMQ-R and alternative models, including the short form, DMQ-R SF. RESULTS Fit statistics suggested that the original four-factor model had questionable fit (root mean square error of approximation [RMSEA] = 0.10, comparative fit index [CFI] = 0.89, standardised root mean square residual [SRMR] = 0.08). The model with the best fit indices was the DMQ-R SF (RMSEA = 0.07, CFI = 0.97, SRMR = 0.04). When using DMQ-R SF in further analyses enhancement, the most strongly endorsed motives were related to quantity and AUDIT sum score. Coping motives were most strongly related to AUDIT sum score, frequency and binge drinking. Social motives were only related to binge drinking, whereas conformity motives were not statistically associated with any motives. DISCUSSION AND CONCLUSIONS The study implies that the 12-item short form, DMQ-R SF, could be more appropriate than the original DMQ-R in this group. [Öster C, Arinell H, Nehlin C. The Drinking Motives Questionnaire among Swedish psychiatric patients: An exploration of the four-factor structure. Drug Alcohol Rev 2017;36:400-407].
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Affiliation(s)
- Caisa Öster
- Department of Neuroscience, Psychiatry, Uppsala University, Sweden.,Uppsala University Hospital, Sweden
| | - Hans Arinell
- Department of Neuroscience, Psychiatry, Uppsala University, Sweden
| | - Christina Nehlin
- Department of Neuroscience, Psychiatry, Uppsala University, Sweden.,Uppsala University Hospital, Sweden
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Tran NT, Clavarino A, Williams G, Najman JM. Gender differences in the prospective association between maternal alcohol consumption trajectories and young adult offspring's problem gambling at 30 years. ACTA ACUST UNITED AC 2016; 6:2. [PMID: 27630809 PMCID: PMC4998162 DOI: 10.1186/s40405-016-0010-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 03/31/2016] [Indexed: 11/16/2022]
Abstract
Although a large number of studies have examined the association between young adult’s alcohol consumption and their problem gambling behaviours, none of these studies address the prospective association between mother’s alcohol consumption and their young adult offspring’s problem gambling behaviours. Using data from a 30 year prospective pre-birth cohort study in Brisbane, Australia (n = 1691), our study examines whether different maternal alcohol consumption trajectories predict offspring’s risk of problem gambling behaviours and whether these associations differ by the young adults’ gender. Offspring’s level of problem gambling behaviours was assessed by the short version of the Canadian Problem Gambling Index, with about 10.6 % of young adults having some risk of problem gambling behaviours. Trajectories of maternal alcohol consumption were determined by group-based trajectory modelling over five time points. Our study found that mother’s alcohol consumption pattern fits into three drinking trajectory groups, namely abstainers (17.2 %), a low-stable drinkers group (64.6 %) and a moderate-escalating drinkers group (18.2 %). Multivariate logistic regression analyses showed that the moderate-escalating alcohol trajectory group is independently associated with a risk of their male young adult offspring having problem gambling behaviours at 30 years—even after adjustment for a range of potential confounding variables. Mothers who exhibit a persistent life course pattern of moderate-escalating drinking have male children who have a high risk of engaging in problem gambling behaviours. Offspring’s alcohol consumption partially mediated the association between maternal drinking trajectories and young adult’s risk of problem behaviours. High levels of maternal alcohol consumption may lead to male offspring antisocial behaviours. Programs intended to address problem gambling behaviours by young adults may need to focus on male group with a focus which specifically addresses family influences as these contribute to gambling behaviour.
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Affiliation(s)
- Nam T Tran
- School of Social Science, University of Queensland, St Lucia, Brisbane, QLD 4072 Australia ; Department of Sociology, Academy of Journalism and Communication, Hanoi, Vietnam
| | | | - Gail Williams
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Jake M Najman
- School of Social Science, University of Queensland, St Lucia, Brisbane, QLD 4072 Australia ; School of Public Health, University of Queensland, Brisbane, Australia ; Queensland Alcohol and Drug Research and Education Centre, Brisbane, Australia
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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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