Effects of Exercise on Depression, Anxiety, Cognitive Control, Craving, Physical Fitness and Quality of Life in Methamphetamine-Dependent Patients

Forced Wheel Running Pre-Conditioning Diminishes Reward Learning Induced by Methamphetamine: Involvement of Orexin 1 Receptor in the Hippocampus

Methamphetamine (METH) is a highly addictive drug that leads to neurobehavioral changes related to the brain's reward circuit. Orexin and orexinergic receptors, found in crucial brain areas involved in reward processing, may play a significant role in reward mechanisms and addiction. Studies have shown that physical exercise can be an effective non-pharmacological approach to controlling drug use but limited research explores its role as pre-conditioning to prevent dependency on narcotics. In this study, 48 male Wistar rats were assigned into six groups: exercise training+saline (EX-SA), exercise training+METH 1mg/kg (EX-METH1), exercise training + METH 2mg/kg (EX-METH2), control+saline (CON), control+METH 1mg/kg (CON-METH1), control+METH 2mg/kg (CON-METH2). The pre-conditioning groups underwent forced wheel-running training (five days a week, at 65% Vmax) for eight weeks. Following pre-conditioning with exercise training, the METH groups received intraperitoneal (IP) METH injections using the conditioned place preference (CPP) model. After the post-test, the animals were dissected, and hippocampal tissue was collected to measure orexin receptor1 (OXR1) expression levels. The results showed that long-term, moderate-intensity forced exercise pre-conditioning prevented METH-induced CPP. However, CPP was observed only in the EX-METH2 group, receiving a double dose of the drug. Molecular analysis also revealed a significant increase in OXR1 expression in the hippocampus following METH injections, while physical exercise caused suppression in OXR1 increment. Seemingly, prior exercise influences this pathway and effectively prevents conditioning to METH, probably through OXR1, indicating an adaptation in the mesolimbic reward pathway that helps protect against METH addiction.

Effects of acute aerobic exercise on emotional memory formation in individuals with methamphetamine use disorder: Encoding vs consolidation

OBJECTIVE

This study investigates the effects of acute aerobic exercise on the encoding and consolidation processes of emotional memory in individuals with methamphetamine use disorder (MUD).

METHODS

A within-subject cross-over design was utilized for both experiments. In Experiment 1, thirty-two participants engaged in 30 min of moderate-to-high intensity (70 %-80 % of predicted HRmax) aerobic exercise and a sedentary task before completing a learning task. Following a 50-min interval, participants completed a recognition task. In Experiment 2, thirty-six participants first completed the learning task, then engaged in a 30-min session of moderate-to-high intensity aerobic exercise or a sedentary task. After a 20-min interval, participants undertook the recognition task. The recognition task assessed participants' accuracy in identifying old and new images, reaction times for recognition judgments, and confidence ratings.

RESULTS

In Experiment 1, participants in the aerobic exercise condition exhibited significantly higher discrimination index d' for neutral emotion images compared to those in the sedentary condition. Additionally, they demonstrated a significantly lower response bias index β for positive and neutral emotion images. Furthermore, participants in the aerobic exercise condition displayed significantly longer reaction times for both METH-related and negative images compared to those in the sedentary condition. In Experiment 2, no significant differences were observed in discrimination index d', response bias index β, and reaction times between the two task conditions.

CONCLUSION

This study reveals a significant impact of acute aerobic exercise on specific phases of emotional memory in individuals with MUD, particularly in enhancing encoding abilities. As a non-pharmacological intervention, exercise demonstrates the potential to alleviate addiction-related cognitive deficits and reduce the risk of relapse. The research further supports the prospect of integrating physical exercise into the treatment of substance use disorders, highlighting its critical role in promoting cognitive function recovery and overall therapeutic outcomes.

Enhanced brain network flexibility by physical exercise in female methamphetamine users

Methamphetamine (MA) abuse is increasing worldwide, and evidence indicates that MA causes degraded cognitive functions such as executive function, attention, and flexibility. Recent studies have shown that regular physical exercise can ameliorate the disturbed functions. However, the potential functional network alterations resulting from physical exercise have not been extensively studied in female MA users. We collaborated with a drug rehabilitation center for this study to investigate changes in brain activity and network dynamics after two types of acute and long-term exercise interventions based on 64-channel electroencephalogram recordings of seventy-nine female MA users, who were randomly divided into three groups: control group (CG), dancing group (DG) and bicycling group (BG). Over a 12-week period, we observed a clear drop in the rate of brain activity in the exercise groups, especially in the frontal and temporal regions in the DG and the frontal and occipital regions in the BG, indicating that exercise might suppress hyperactivity and that different exercise types have distinct impacts on brain networks. Importantly, both exercise groups demonstrated enhancements in brain flexibility and network connectivity entropy, particularly after the acute intervention. Besides, a significantly negative correlation was found between Δattentional bias and Δbrain flexibility after acute intervention in both DG and BG. Analysis strongly suggested that exercise programs can reshape patient brains into a highly energy-efficient state with a lower activity rate but higher information communication capacity and more plasticity for potential cognitive functions. These results may shed light on the potential therapeutic effects of exercise interventions for MA users.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11571-022-09848-5.

Behavior Change Techniques in Physical Activity Interventions Targeting Overweight and Obese Children and Adolescents: A Systematic Review

Substantial evidence globally confirms the benefits of physical activity (PA) interventions for the physical and mental health of overweight and obese children and adolescents. However, current research has yet to determine which behavior change techniques (BCTs) are most effective in PA interventions for this population. This systematic review aims to evaluate the application of BCTs in PA interventions for overweight and obese children and adolescents and to identify the most effective BCTs using the promise ratio. Five electronic databases (PubMed, Embase, Cochrane Central, Web of Science, and PsycINFO) were searched up to 31 May 2024, to identify intervention studies meeting the eligibility criteria for promoting PA in the target population. Thirteen studies were included (nine randomized controlled trials and four quasi-experimental studies). The quality of the included studies was assessed using a revised version of the Cochrane Risk of Bias tool and the Risk of Bias in Non-randomized Studies tool. Among the 24 BCTs implemented, the most frequently applied were goal setting (behavior), instruction on how to perform the behavior, feedback on behavior, and self-monitoring of behavior. Action planning, social support, and material incentives showed the most significant potential to promote PA. These findings provide valuable insights for designing future PA interventions for this group, with the potential to improve health outcomes and enhance PA participation among obese children and adolescents.

Embodied cognition driven Qigong: a cross-sectional study and a pilot randomized controlled trial on managing depression and preventing relapse in substance dependence

Objective

Substance use disorders (SUDs) pose a significant challenge to public health systems worldwide, with persistent high relapse rates underscoring the urgency for innovative intervention strategies. This study embarked on a systematic exploration of the factors influencing relapse among individuals with SUDs, alongside the implementation of targeted Health Qigong intervention to mitigate these effects based on the embodied cognition.

Methods

In the cross-sectional survey, a total of 398 male substance users were recruited to complete the questionnaires assessing depression, self-esteem, resilience, and relapse inclination. Subsequently, 60 participants diagnosed with depression were selected for a Pilot RCT, randomly divided into an intervention group, which underwent a 12-week Health Qigong program designed to combat depression through embodied cognition principles, and a control group, which maintained their daily routines.

Results

Structural equation modeling demonstrated that depression not only had a direct effect on substance users' relapse, but also exerted an indirect effect through three paths: firstly, via the mediating role of self-esteem; secondly, via the mediating role of resilience; and thirdly, via the chain-mediated role of self-esteem and resilience. Two-factor mixed-design ANOVA showed that the 12-week targeted Health Qigong training not only mitigated depression in individuals with SUDs, but also enhanced self-esteem and mental resilience, and reducing the propensity for relapse.

Conclusion

This research identifies critical factors influencing relapse in individuals with SUDs and introduces a novel, non-pharmacological intervention that significantly diminishes relapse rates and enhances recovery outcomes. It highlights the importance of physical activity in promoting mental health improvement and integrates traditional Chinese exercises with contemporary psychological insights, offering a comprehensive approach to drug rehabilitation and the integration of cultural practices in holistic health interventions.

Optimal dose and type of exercise to improve cognitive function in patients with mild cognitive impairment: a systematic review and network meta-analysis of RCTs

Background

Mild cognitive impairment (MCI) represents a prodromal stage of dementia, characterized by cognitive decline exceeding that expected with normal aging. Exercise interventions have emerged as a promising approach to counter functional decline and enhance cognitive function in the elderly MCI population. However, the optimal exercise modalities and dosage (dose-response relationship) are understudied.

Objective

It aims to determine the most effective exercise modality for MCI patients by optimizing the dose-response relationship to ensure sufficient intensity to induce positive neurological adaptations.

Methods

A systematic search of electronic databases, including PubMed, Embase, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception to April 15, 2024. Studies evaluating the efficacy of exercise interventions in MCI participants were included. Primary outcomes of interest are global cognition and executive function. Random-effects models will be utilized for both pairwise and network meta-analysis.

Results

Following the application of specific inclusion and exclusion criteria, a total of 42 articles, encompassing 2832 participants, were chosen for inclusion in a network meta-analysis. The findings revealed that multi-component exercise demonstrated superior efficacy in mitigating the deterioration of global cognition, as evidenced by standard mean differences (SMDs) of 1.09 (95% CI: 0.68 to 1.51) compared to passive controls. Additionally, multi-component exercise exhibited a significant impact on executive function, with SMDs of 2.50 (95% CI: 0.88 to 4.12) when contrasted with passive controls. Our research has demonstrated that sessions lasting 30 minutes, occurring 3-4 times per week, with interventions lasting 12-24 weeks and an intensity of 60-85% of maximum heart rate, yield higher effect sizes in improving global cognition. However, sessions lasting 30-61 minutes, with interventions lasting 25 weeks or longer, show greater effectiveness in enhancing executive function.

Conclusion

A network meta-analysis identified multi-component exercise as the most effective intervention for improving global cognitive and executive function in patients with mild cognitive impairment. Notably, moderate-intensity exercise performed at least three times weekly appears beneficial, with evidence suggesting shorter sessions and higher frequencies may optimize cognitive outcomes.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO, identifier CRD42024534922.

Modeling the structural equations of the corona anxiety level based on psychological hardness and physical activities in the treatment staff of Ilam Province with the mediator role of professional identity

BACKGROUND

The increase in deaths due to COVID-19 has increased anxiety among the treatment staff. Therefore, the purpose of this research was to model the structural equations of the anxiety level of corona based on psychological hardness and physical activities in the treatment staff of Ilam province with the mediator role of professional identity.

MATERIALS AND METHODS

Based on the purpose, the method of this research is applied and based on how to obtain the data it is descriptive-correlational. The statistical population of the research includes all the treatment staff of Ilam province, with the number of 1900 people who were selected using Morgan's table, 320 people with the stratified sampling method as the sample. To collect the data, four standard questionnaires were used: Alipour et al. (2020) coronavirus anxiety questionnaire, Kiamarsi et al. (1998) psychological hardness, Baecke et al. (1982) physical activity, Hao et al. (2014) professional identity, and their validity and reliability were also confirmed. To analyze the data, from the indicators of descriptive statistics, Pearson's correlation coefficient test and structural equation model method (SEM) were used using SPSS and Amos software.

RESULTS

The results of the research showed that psychological hardness, physical activities, and professional identity have a significant and inverse effect on the anxiety caused by corona, and the mediator role of professional identity in the relationship between physical activities and corona anxiety was confirmed, but this role was not confirmed in the relationship between psychological hardness and corona anxiety.

CONCLUSION

To reduce the anxiety of the coronavirus in the treatment staff, the managers of the health and treatment centers of Ilam province should pay special attention to the employees' perceptions of psychological hardness, physical activities, and professional identity and provide them with the opportunity to create sports activities.

Mesenchymal stem cell-derived exosomes improve neurogenesis and cognitive function of mice with methamphetamine addiction: A novel treatment approach

BACKGROUND

Methamphetamine (METH) is a psychostimulant substance with highly addictive and neurotoxic effects, but no ideal treatment option exists to improve METH-induced neurocognitive deficits. Recently, mesenchymal stem cells (MSCs)-derived exosomes have raised many hopes for treating neurodegenerative sequela of brain disorders. This study aimed to determine the therapeutic potential of MSCs-derived exosomes on cognitive function and neurogenesis of METH-addicted rodents.

METHODS

Male BALB/c mice were subjected to chronic METH addiction, followed by intravenous administration of bone marrow MSCs-derived exosomes. Then, the spatial memory and recognition memory of animals were assessed by the Barnes maze and the novel object recognition test (NORT). The neurogenesis-related factors, including NeuN and DCX, and the expression of Iba-1, a microglial activation marker, were assessed in the hippocampus by immunofluorescence staining. Also, the expression of inflammatory cytokines, including TNF-α and NF-κB, were evaluated by western blotting.

RESULTS

The results showed that BMSCs-exosomes improved the time spent in the target quadrant and correct-to-wrong relative time in the Barnes maze. Also, NORT's discrimination index (DI) and recognition index (RI) were improved following exosome therapy. Additionally, exosome therapy significantly increased the expression of NeuN and DCX in the hippocampus while decreasing the expression of inflammatory cytokines, including TNF-α and NF-κB. Besides, BMSC-exosomes down-regulated the expression of Iba-1.

CONCLUSION

Our findings indicate that BMSC-exosomes mitigated METH-caused cognitive dysfunction by improving neurogenesis and inhibiting neuroinflammation in the hippocampus.

Understanding physical exercise among individuals with substance use disorders using an integrated theoretical perspective of the health action process approach and theory of planned behavior

Introduction

Physical exercise is considered a useful non-pharmacological adjunctive treatment for promoting recovery from substance use disorders (SUD). However, adherence to physical exercise treatments is low, and little is known about what factors are associated with the initiation and maintenance of physical exercise behaviors. The aim of this study was to explore the psychosocial factors underlying these behaviors in individuals with SUD using an integrated theoretical model based on the health action process approach (HAPA) and the theory of planned behavior (TPB).

Methods

A total of 1,197 individuals with SUDs (aged 37.20 ± 8.62 years) were recruited from 10 compulsory isolation drug rehabilitation centers in Zhejiang Province via convenience sampling according to a set of inclusion criteria. Self-reported data were collected to assess task self-efficacy (TSE), maintenance self-efficacy (MSE), recovery self-efficacy (RSE), outcome expectations (OE), action planning (AP), coping planning (CP), social support (SS), subjective norms (SN), attitude behavior (AB), behavioral intention (BI), perceived behavioral control (PBC), risk perception (RP), exercise stage, and exercise behavior in this integrated model. ANOVA and structural equation modeling (SEM) were used to evaluate this model.

Results

One-way ANOVA revealed that the majority of the moderating variables were significantly different in the exercise phase. Further SEM showed that the model fit the data and revealed several important relationships. TSE, RP, SS, AB, and SN were indirectly associated with physical exercise behavior in individuals with SUD through the BI in the SUD initiation stage. In addition, PBC was directly related to physical exercise behavior in individuals with SUD. In the maintenance stage, MSE, AP, CP and exercise behavior were significantly related. Moreover, AP and CP were mediators of BI and MSE.

Conclusion

This study is the first attempt to integrate patterns of physical exercise behavior in individuals with SUD. The HAPA-TPB integration model provides a useful framework for identifying determinants of physical exercise behavioral intentions and behaviors in individuals with SUD and for explaining and predicting the initiation and maintenance of physical exercise behaviors in these individuals. Moreover, the model provides scientific guidance for the enhancement of physical exercise adherence in individuals with SUD.

Effects of Aerobic Exercise Combined With Attentional Bias Modification in the Care of Male Patients With a Methamphetamine Use Disorder

OBJECTIVE

It remains unclear which individual or combined strategies are most beneficial for methamphetamine use disorders (MUDs). We compared the effects of aerobic exercise, attentional bias modification, and combined intervention on male patients with MUD.

METHOD

One hundred male patients with MUD were randomly assigned to combined intervention, aerobic exercise, attentional bias modification, or control groups (25 patients per group). The 8-week intervention protocol included three 60-minute sessions of aerobic exercises per week. Primary outcomes included high- and low-frequency heart rate variability, executive function, and cardiorespiratory fitness measured by customized software, computerized tests, and the Harvard step test, respectively. Secondary outcomes included psychiatric symptoms, drug craving, training acceptability, and persistence.

RESULTS

Participant characteristics were matched between groups at baseline. Executive function, heart rate variability, cardiorespiratory fitness, drug craving, and most psychiatric symptoms had significant time-group interactions at posttest (p < .05, η2 = .08-.28). Compared with the attentional bias modification and control groups, the combined intervention and aerobic exercise groups improved significantly in executive function, heart rate variability, cardiorespiratory fitness, and most secondary outcomes. In addition, high-frequency heart rate variability and cardiorespiratory fitness in the aerobic exercise group were significantly higher than those in the combined intervention group.

CONCLUSIONS

Combination strategies showed comparable efficacy to aerobic exercise alone in improving executive function, psychiatric symptoms, and drug craving and significantly exceeded other conditions. For heart rate variability and cardiorespiratory fitness, aerobic exercise alone was the most effective. For acceptability and persistence, combination strategies were preferred over single-domain training and health education intervention.

The impact of aerobic exercise training on cognitive function and gut microbiota in methamphetamine-dependent individuals in the community

OBJECTIVE

This study aimed to investigate the impact and mechanism of gut microbiota on the enhancement of cognitive function in methamphetamine (MA)-dependent individuals during aerobic exercise training.

METHODS

A total of sixty-four MA-dependent individuals were randomly assigned to either an aerobic exercise training group (DK, n = 32) or a conventional rehabilitation group (CK, n = 32). After an eight-week intervention, the participants' working memory and inhibition ability were assessed using the Stroop paradigm and Go/NoGo paradigm, respectively. Gut microbiota composition was analyzed using high-throughput sequencing.

RESULTS

1) Eight weeks of aerobic exercise training significantly improved the working memory and inhibition ability of MA-dependent individuals (P < 0.05). 2) Following the intervention, the DK group exhibited significantly higher levels of Lactobacillus, Lactococcus lactis, Prevotellaceae, and Ruminococcaceae compared to the CK group. Conversely, the DK group demonstrated significantly lower levels of Desulfovibrio and Akkermansia compared to the CK group. Furthermore, the DK group showed significantly increased metabolic pathways associated with d-Glutaralate and d-Galactate Degradation, as well as the Alanine, aspartate, and glutamate metabolism pathway, compared to the control group. 3) Cognitive function related to MA addiction positively correlated with Bifidobacterium, Dialister, and Adlercreutzia, while negatively correlated with Enterobacteria, Bacillus cereus, Catabacter, and Akkermansia.

CONCLUSION

Aerobic exercise training enhances working memory and inhibition ability in MA-dependent individuals, thereby mitigating the detrimental effects of MA addiction on cognitive function. Additionally, analysis of gut microbiota suggests that the modulation of gut microbiota and associated metabolic pathways play a role in regulating the improvement of cognitive function in MA-dependent individuals through exercise.

The hidden-zero effect in male individuals with opioid use disorder

Background: Explicitly expressing the hidden opportunity cost in intertemporal choice significantly reduces healthy participants' delay discounting - a phenomenon named the "hidden-zero effect," which is undetermined in individuals with substance use disorder (SUD).Objectives: This study aimed to determine whether the hidden-zero effect occurs among individuals with opioid use disorder (OUD) and the degree to which this effect differs between the OUD group and healthy controls.Methods: In two different experiments, Exp#1) 29 male individuals with OUD (13.5 ± 6.0 months abstinence) and 29 male controls performed an intertemporal choice task (ICT); Exp#2) 28 male individuals with OUD (17.5 ± 5.6 months abstinence) and 27 male controls performed a delay discounting task (DDT). The OUD group was recruited from a mandatory treatment, and controls from WeChat. There were two choice conditions in both two tasks: the hidden-zero (H0) condition (standard), and the explicit-zero (E0) condition (explicitly expressing opportunity cost).Results: Compared with the H0 condition, all participants' delay discounting was significantly decreased in the E0 condition (ps < .05, ηp2 = 0.254, 0.110). There was no significant difference in the changed degree between these two groups in either experiment (ps > .05). The delay discounting of the OUD group was significantly higher than that of controls only in Experiment 2 (p < .001, ηp2 = 0.376).Conclusion: This study extended the population in which the hidden-zero effect occurs to individuals with OUD. With respect to delay discounting, the hidden-zero effect benefit did not differ in OUD and control participants.

Effects of Acute Exercise on Affect, Anxiety, and Self-Esteem in Poly-Substance Dependent Inpatients

INTRODUCTION

Negative affect and anxiety frequently precede the onset of drug use in those with substance use disorder (SUD). Low self-esteem may increase the risk of relapse. We examined the short-term effects of exercise on affect, anxiety, and self-esteem in inpatients with poly-SUD.

METHODS

This is a multicenter randomized control trial (RCT) with a crossover design. Thirty-eight inpatients (37.3 ± 6.4 years; 84% male) from three clinics participated in 45 min of soccer, circuit training, and control condition (psychoeducation) in a random order. Positive and negative affect (PANAS), state anxiety (single item), and self-esteem (Rosenberg SE-scale) were measured immediately before, immediately after, 1-h, 2-h, and 4-h post-exercise. Heart rate and ratings of perceived exertion were taken. Effects were assessed using linear mixed effects models.

RESULTS

Compared to the control condition, there were significant post-exercise improvements in positive affect (β = 2.99, CI = 0.39: 5.58), self-esteem (β = 1.84, CI = 0.49: 3.20), and anxiety (β = -0.69, CI = -1.34: -0.04) after circuit training (shown) and soccer. Effects persisted 4-h post-exercise. Reductions in negative affect were observed 2-h (circuit training: β = -3.39, CI = -6.35: -1.51) and 4-h (soccer: β = -3.71, CI = -6.03: -1.39) post-exercise, respectively.

CONCLUSION

Moderately strenuous exercise undertaken in naturalistic settings may improve mental health symptoms in poly-SUD inpatients for up to 4-h post-exercise.

Challenges and future trends in wearable closed-loop neuromodulation to efficiently treat methamphetamine addiction

Achieving abstinence from drugs is a long journey and can be particularly challenging in the case of methamphetamine, which has a higher relapse rate than other drugs. Therefore, real-time monitoring of patients' physiological conditions before and when cravings arise to reduce the chance of relapse might help to improve clinical outcomes. Conventional treatments, such as behavior therapy and peer support, often cannot provide timely intervention, reducing the efficiency of these therapies. To more effectively treat methamphetamine addiction in real-time, we propose an intelligent closed-loop transcranial magnetic stimulation (TMS) neuromodulation system based on multimodal electroencephalogram-functional near-infrared spectroscopy (EEG-fNIRS) measurements. This review summarizes the essential modules required for a wearable system to treat addiction efficiently. First, the advantages of neuroimaging over conventional techniques such as analysis of sweat, saliva, or urine for addiction detection are discussed. The knowledge to implement wearable, compact, and user-friendly closed-loop systems with EEG and fNIRS are reviewed. The features of EEG and fNIRS signals in patients with methamphetamine use disorder are summarized. EEG biomarkers are categorized into frequency and time domain and topography-related parameters, whereas for fNIRS, hemoglobin concentration variation and functional connectivity of cortices are described. Following this, the applications of two commonly used neuromodulation technologies, transcranial direct current stimulation and TMS, in patients with methamphetamine use disorder are introduced. The challenges of implementing intelligent closed-loop TMS modulation based on multimodal EEG-fNIRS are summarized, followed by a discussion of potential research directions and the promising future of this approach, including potential applications to other substance use disorders.

Before and during the COVID-19 Pandemic, Physical Fitness Association with Mental Health among Higher Education Students: A Multi-Group Analysis Model

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), created a significant problem people's health around the world. The mental and physical health of entire populations has been negatively impacted due to the introduction of several restriction methods. Maintaining a specific physical activity and fitness level is crucial given the pandemic situation. The connection between physical fitness and mental health has recently received growing attention. In contrast to the message from physiological research, which lauds the general benefits of fitness for physical health, the corresponding psychological literature reveals a more complex relationship. This paper outlines the research evidence, focusing on the relationship between physical fitness and depression, anxiety, and stress before and during the COVID-19 pandemic. Data were obtained from 390 higher education students (measuring their perception before and during the pandemic). They were analyzed by a structural equation modeling multi-group analysis to detect the variance in the test relationship before and during the COVID-19 pandemic. Theoretical and empirical implications are also discussed.

Effects of Aerobic Exercise on Markers of Brain Injury in Methamphetamine-Dependent Individuals: A Randomized Controlled Trial

Objective: Drug dependence has become a major global public health problem. This study aimed to investigate the effects of moderate-intensity aerobic exercise on the blood−brain barrier and neurological damage in methamphetamine (MA)-dependent individuals. Methods: MA-dependent individuals (all males) were recruited and randomly divided into MA exercise group (MAE) and MA control group (MAC) by using random number table method. The MAE group underwent 12 weeks of moderate-intensity aerobic exercise, and the MAC group underwent conventional detoxification. The Neurofilament light chain (NfL), S100 calcium binding protein b (S100b), and Neuron-Specific Enolase (NSE) levels in the blood of MA-dependent individuals were measured before and after the exercise intervention. Results: After the exercise intervention was implemented, the amount of change in NfL in the plasma of the MAE (1.75 ± 1.40) group was significantly different from that of the MAC (0.60 ± 1.21) group (p < 0.01); the amount of change in NSE in the serum of the MAE [−1.51 (−3.99~0.31)] group was significantly different from that of the MAC [0.03 (−1.18~1.16)] group (p < 0.05); and the amount of change in S100b in the serum of the MAE [0.66 (0.40~0.95)] group was not significantly different from that of the MAC (0.60 (0.21~1.04)) group (p > 0.05). Conclusion: This study showed that 12 weeks of moderate-intensity aerobic exercise treatment significantly promoted the recovery of blood−brain barrier and neurological damage in MA-dependent patients compared with conventional withdrawal.

Associations between the COMT rs4680 Gene Polymorphism and Personality Dimensions and Anxiety in Patients with a Diagnosis of Other Stimulants Dependence

BACKGROUND

Research on the hypodopaminergic hypothesis of addictions showed that hypodopaminergic activity in males predicted the number of drugs used and is associated with drug-seeking behavior. Variant alleles may cause hypodopaminergic functioning as a result of the reduced density of dopamine receptors, decreased response to dopamine, increased dopamine clearance or metabolism in the reward system. The catechol-O-methyltransferase (COMT) is involved in the metabolism of dopamine. Personality traits may mediate the genetic predisposition to substance use disorders additively by various motivations associated with reward-seeking and regulating negative emotions, and also relate to self-control and environment selection.

THE AIM OF THE STUDY

The aim of this study was to investigate the association of the rs4680 polymorphism of COMT with personality dimensions and anxiety in patients addicted to stimulants other than cocaine (F15 according to WHO ICD-10 nomenclature) in the case of examined patients amphetamine.

METHODS

The study was conducted among patients addicted to stimulants other than cocaine (amphetamine). The study group included 247 patients addicted to stimulants (amphetamine) and the control group comprised 280 healthy male volunteers. The real-time PCR method was used to carry out genetic tests; personality dimensions were assessed using the standardized NEO-FFI and state and trait anxiety were assessed with STAI. All analyses were performed using STATISTICA 13.

RESULTS

The results of the 2 × 3 factorial ANOVA showed a statistically significant effect of the combined factor COMT rs4680 genotype on the group of patients diagnosed with other stimulants dependence/control (F_2,252 = 3.11, p = 0.0465, η² = 0.024). Additionally, we observed that the results of the 2 × 3 factorial ANOVA showed a statistically significant influence of the combined factor COMT rs4680 on the genotype in the group of patients diagnosis with other stimulants dependence/control (F_2,252 = 6.16, p = 0.0024, η² = 0.047).

CONCLUSIONS

In our research, the polymorphism G/G COMT rs4680 genotype was associated with higher scores of STAI traits and STAI states in the patients dependent on amphetamine. In the control group we observed no such interactions.

Efecto del ejercicio físico sobre la aptitud física y estrés en pacientes por consumo de sustancias psicoactivas

El ejercicio físico (EF) regular tiene beneficios en la salud; además, es recomendado como estrategia útil en el tratamiento por consumo de sustancias psicoactivas (SPA). Se estudiaron diferencias y efecto del EF sobre la aptitud física y estrés en sujetos drogodependientes. El diseño pre-experimental pretest-postest con un solo grupo conformado por (n=4, Medad=22.0, DE=5.3), evaluados y elegibles según el autoreporte PAR-Q & YOU y el inventario IDARE. Los resultados mostraron que la resistencia muscular de miembros superiores e inferiores obtuvieron diferencias significativas (p< 0.03, y 0.00), aunque el tamaño del efecto no evidenció valores positivos (d = -1.79 y -6.00); la capacidad aeróbica, resistencia muscular abdominal y flexibilidad no reportaron significación estadística y el tamaño del efecto fue negativo; el estrés mostró diferencias significativas. Los hallazgos revelan que el EF puede generar cambios positivos en algunos componentes de la aptitud física en los pacientes. Se debe seguir investigando esta línea de trabajo. Regular physical activity (PE) has positive health effects, and it is also suggested as a helpful tactic in the management of psychoactive substance use (PAS). Study individuals who were drug addicted looked at differences and the impact of PE on stress and physical fitness. The pre-experimental pretest-posttest design included a single group of (n=4, Mage=22.0, SD=5.3) individuals who were evaluated and eligible based on the PAR-Q & YOU self-report and the IDARE inventory. The results showed that the muscular resistance of the upper and lower limbs had significant differences (p 0.03, and 0.00), but the effect size was negative (d = -1.79 and -6.00); aerobic capacity, abdominal muscular resistance, and flexibility did not show statistical significance, and the effect size was negative; stress showed significant differences. The findings show that PE can improve some aspects of physical fitness in patients. This area of research should be looked into further.  

A Randomized Controlled Trial Evaluating the Effect of Tai Chi on the Drug Craving in Women

This study was conducted in the purpose of investigating the effect of Tai Chi on drug craving for women with drug disorders. One hundred and twelve women were recruited from a drug rehabilitation center in China, and 47 and 48 were finally analyzed in the control group and exercise group, respectively. The exercise group underwent a 3-month Tai Chi training, whereas the control group experienced no exercise intervention during the same time period. The drug craving was measured by the visual analog scale. In data analysis, repeated-measures were utilized to test the differences between the control and exercise group over the course of the experiment time. The mean of the craving score significantly dropped from pre-test (control: mean = 5.38, SD = 3.04; exercise: mean = 4.68, SD = 2.93) to post-test (control: mean = 4.03, SD = 2.73; exercise: mean = 1.91, SD = 1.90) in both groups (control group: t = 3.84, df = 46, p < 0.001; exercise group: t = 5.941, df = 47, p < 0.001), with more decrease witnessed in the exercise group. Repeated-measures analysis with a Huynh-Feldt correction showed the significant effect of time (F = 27.383, p < 0.001) as well as the study group by time interaction (F = 3.52, p = 0.024). Tai Chi can ameliorate the drug craving in women and it could be a supportive treatment for drug addiction.

Cortical thickness and related depressive symptoms in early abstinence from chronic methamphetamine use

Methamphetamine use is surging globally as a cause of morbidity and mortality. Treatment is typically sought in early abstinence, when craving and depressive symptoms are intense, contributing to relapse and poor outcomes. To advance an understanding of this problem and identify therapeutic targets, we conducted a retrospective analysis of brain structure in 89 adults with Methamphetamine Use Disorder who were in early abstinence and 89 healthy controls. Unlike most prior research, the participants did not significantly differ in age, sex and recent use of alcohol and tobacco (p-values ≥ 0.400). We analysed thickness across the entire cerebral cortex by fitting a general linear model to identify differences between groups. Follow-up regressions were performed to determine whether cortical thickness in regions showing group differences was related to craving, measured on a visual analogue scale, or to the Beck Depression Inventory score. Participants in early methamphetamine abstinence (M ± SD = 22.1 ± 25.6 days) exhibited thinner cortex in clusters within bilateral frontal, parietal, temporal, insular, and right cingulate cortices relative to controls (p-values < 0.001, corrected for multiple comparisons). Unlike craving (β = 0.007, p = 0.947), depressive symptoms were positively correlated with cortical thickness across clusters (β = 0.239, p = 0.030) and with thickness in the anterior cingulate cluster (β = 0.246, p = 0.027) in the methamphetamine-dependent group. Inasmuch as anterior cingulate pathology predicts response to antidepressants for Major Depressive Disorder, cingulate structure may also identify patients with Methamphetamine Use Disorder who can benefit from antidepressant medication.

Exercise modulates central and peripheral inflammatory responses and ameliorates methamphetamine-induced anxiety-like symptoms in mice

Anxiety-like symptoms are common symptoms of methamphetamine (METH) users, especially in the acute withdrawal period, which is an important factor for the high relapse rate during METH acute withdrawal. Exercise has been demonstrated to relieve anxiety-like symptoms during METH withdrawal, but the underlying mechanisms of this anti-anxiety effect are still unclear. Activated microglia and abnormal neuroinflammation play an important role in the pathogenesis of anxiety-like symptoms after METH withdrawal. Moreover, peripheral immune factors were also significantly associated with anxiety symptoms. However, the effects of treadmill exercise on microglial function and neuroinflammation in the striatum and hippocampus during acute METH withdrawal have not been reported. In the current study, we found severe peripheral immune dysfunction in METH users during acute withdrawal, which may in part contribute to anxiety symptoms during METH acute withdrawal. We also showed that 2 weeks of METH exposure induced anxiety-like symptoms in the acute withdrawal period. Additionally, METH exposure resulted in increased microglial activation and proinflammatory cytokines released in the mouse striatum and hippocampus during acute withdrawal. We next evaluated the effects of treadmill exercise in countering anxiety-like symptoms induced by METH acute withdrawal. The results showed that anxiety-like symptoms induced by acute METH withdrawal were attenuated by coadministration of treadmill exercise. In addition, treadmill exercise counteracted METH-induced microglial activation in the mouse striatum and various subregions of the hippocampus. Furthermore, treadmill exercise also reversed the increase in proinflammatory cytokines induced by acute METH withdrawal in the mouse striatum, hippocampus and serum. Our findings suggest that the anti-anxiety effect of treadmill exercise may be mediated by reducing microglial activation and regulating central and peripheral inflammatory responses.

Aerobic exercise as a promising nonpharmacological therapy for the treatment of substance use disorders

Despite the prevalence and public health impact of substance use disorders (SUDs), effective long-term treatments remain elusive. Aerobic exercise is a promising, nonpharmacological treatment currently under investigation as a strategy for preventing drug relapse. Aerobic exercise could be incorporated into the comprehensive treatment regimens for people with substance abuse disorders. Preclinical studies of SUD with animal models have shown that aerobic exercise diminishes drug-seeking behavior, which leads to relapse, in both male and female rats. Nevertheless, little is known regarding the effects of substance abuse-induced cellular and physiological adaptations believed to be responsible for drug-seeking behavior. Accordingly, the overall goal of this review is to provide a summary and an assessment of findings to date, highlighting evidence of the molecular and neurological effects of exercise on adaptations associated with SUD.

Aerobic Exercise Improves Methamphetamine-Induced Olfactory Dysfunction Through α-Synuclein Intervention in Male Mice

Methamphetamine (Meth) is a predominantly abused neurostimulant, and its abuse is often associated with multiple neurological symptoms. Olfaction, the sense of smell, is a highly neurotransmission-dependent physiological process; however, the effect of Meth on olfactory function and its underlying mechanisms remain largely unknown. This study aimed to explore the impact of Meth abuse on the olfactory system and the potential mechanisms. Chronic Meth abuse was induced by daily administration of Meth in male mice for 4 weeks, and we then systematically examined olfactory performance. Behavioral tests found that Meth-treated animals showed increased olfactory threshold, decreased olfactory sensitivity, reduced olfactory-dependent discrimination, and difficulty in seeking buried food. Notably, the increased deposition of α-synuclein (α-syn) in the olfactory bulb was detected. Adeno-associated virus (AAV)-mediated α-syn intervention therapy in the olfactory bulb significantly alleviated Meth-induced olfactory function impairment, and 8 weeks of aerobic exercise showed similar effects through the same principle of α-syn intervention. Notably, exercise-mediated reduction of α-syn inhibited abnormal firing activity and restored the inhibitory synaptic regulation of mitral cells in the olfactory bulb. These findings suggest the involvement of α-syn in the pathogenic mechanisms of Meth-induced olfactory dysfunction and shed light on the possible therapeutic applications of aerobic exercise in Meth-induced olfactory dysfunction.

A Systematic Review of Exercise Intervention Program for People With Substance Use Disorder

Addiction has been attributed to development of habit-based neural circuits that promote continued substance use despite a conscious wish to abstain. The goal of this study was to determine if physical exercise could serve as an alternative habit to replace habitual substance use, and whether this exercise intervention methods differed for opioid vs. amphetamine Dependents. A total of 14 randomized controlled experimental literatures on exercise intervention in people with opioid and amphetamine use disorder were screened, the 14 literature included 4 opioids and 10 amphetamines. From the 14 literature, the information of intervention program elements were counted, respectively. Independent sample t-test was used to compare the similarities and differences between the two intervention methods, and intervention mechanism of dependents were discussed. All rehabilitation exercises for opioid dependents use aerobic exercise, while most rehabilitation exercises for amphetamine dependents use aerobic exercise, and a few use aerobic and anaerobic mixed exercise. There is no significant difference in exercise time, exercise frequency and cycle between the two intervention schemes (P > 0.05). The rehabilitation indicators of opioid and amphetamine dependents generally include psychological indicators and physiological indicators, and most of the tests mainly focus on measuring psychological indicators such as mood and drug craving of dependents. The goal of exercise intervention for opioid and amphetamine dependents is similar, the first is to improve mood, reduce craving, improve sleep, and the second is to enhance physical fitness. In the treatment of Substance use disorder, exercise intervention can be used as an auxiliary treatment. Exercise intervention emphasizes low intensity and high frequency. Exercise intervention tends to cultivate long-term exercise habits or exercise lifestyle. Based on this "habit" mechanism, exercise can complete the substitution of material dependence.

Effects of moderate-intensity exercise on social health and physical and mental health of methamphetamine-dependent individuals: A randomized controlled trial

OBJECTIVE

Methamphetamine (MA)-dependent individuals' health problems are widespread and need to be solved urgently. Exercise is considered a potential treatment for MA dependents. The study aimed to determine the effects of a 12-week aerobic exercise on the social, physical, and mental health of MA-dependent individuals.

MATERIALS AND METHODS

Sixty MA-dependent individuals were randomly assigned into two groups. Subjects in the exercise group (n = 30) received an exercise intervention five days a week for 60 min each for 12 weeks. Subjects in the control group (n = 30) received regular corrective rehabilitation without exercise in the same setting. Outcome measures, including questionnaires [quality of life scale for drug addiction (QOL-DA), self-rating anxiety scale (SAS), self-rating depression scale (SDS), and Pittsburgh sleep quality index (PSQI)] and physical fitness, were arranged the day before the start of the intervention and the day after the end of the intervention. Two-factor repeated measures ANOVA was used to compare the treatment differences between the two groups.

RESULTS

After 12 weeks of the intervention period, social health was significantly improved in the exercise group (P < 0.01), and there was a statistically significant difference in mental health scores between exercise group and control group, with a greater impact in exercise group.(Psychology: P < 0.01; SAS: P < 0.01; SDS: P < 0.01; PSQI: P < 0.01), physical health improved in the exercise group, physiology (P < 0.01), symptom (P < 0.01), heart rate (P < 0.01), systolic blood pressure (P < 0.01), systolic blood pressure (P < 0.01), vital capacity (P < 0.05), grip (P < 0.01), vertical jump (P < 0.001), sit and reach (P < 0.01), 50-meter run (P < 0.01), and reaction time (P < 0.01).

CONCLUSION

Aerobic exercise intervention is an effective treatment for MA-dependent individuals, and the 12-week intervention improved the social, physical, and mental health of MA-dependent individuals. We recommend that future studies focus more on drug-dependent individuals' overall health status rather than just relapse.Clinical trial registration: [https://www.chictr.org.cn/hvshowproject.aspx?id=131048], identifier [ChiCTR2200055348].

Effects of aerobics training on anxiety, depression and sleep quality in perimenopausal women

OBJECTIVE

To investigate the effect of aerobics training on anxiety, depression and sleep disturbance in perimenopausal women.

MATERIALS AND METHODS

A total of 289 perimenopausal women with anxiety, depression or sleep disorder in Lishi district of Luliang city were treated with aerobics training. Self-rating anxiety scale, self-rating depression scale and Pittsburgh sleep scale were used to investigate the anxiety, depression and sleep status of perimenopausal women before and after intervention.

RESULTS

After aerobics training, the scores of self-rating anxiety scale, self-rating depression scale and Pittsburgh sleep questionnaire were 48.26 ± 6.47, 50.27 ± 6.54 and 10.64 ± 4.38, respectively. The levels of anxiety, depression and sleep disorder in 289 subjects were significantly lower than those before intervention (t = 3.865, 4.541, 5.596, P < 0.01). The remission rate of symptoms was significantly different in subjects with different frequency of spontaneous practice (P < 0.01), and the higher the number of spontaneous practice, the higher the remission rate of anxiety, depression and sleep disorders in subjects (P < 0.01).

CONCLUSION

aerobics training can effectively improve the anxiety and depression of perimenopausal women, improve sleep quality, the more frequency of practice, the more obvious the effect. It can be used as an intervention to improve the mental health level of perimenopausal women in terms of anxiety, depression and sleep quality in clinical promotion.

Effect of aerobic exercise on executive function in individuals with methamphetamine use disorder: Modulation by the autonomic nervous system

This study assessed the effects of aerobic exercise on cardiac autonomic nervous system function (based on heart rate variability [HRV]) and executive function among individuals with methamphetamine use disorder (MUD). We further examine the role of autonomic nervous system control in aerobic exercise (assessed via cardiopulmonary fitness) and executive function. A total of 330 individuals with MUD were randomly divided into exercise (n = 165) and control (n = 165) groups, who underwent eight-week aerobic exercise/health education program consisting of five 60 min sessions a week. The outcome measures included cardiopulmonary fitness, HRV time-domain and frequency-domain parameters, and executive function. Our statistical analyses comprised repeated-measures analyses of variance, correlation analyses, and mediation and moderation effect tests. The results indicated that aerobic exercise could simultaneously improve autonomic nervous system function and executive function among individuals with MUD. Moreover, the changes in cardiopulmonary fitness, high frequency HRV, and executive function were positively correlated. HRV did not significantly mediate the relationship between aerobic exercise and executive function; however, it did have a moderating effect, which was eliminated after adjusting for demographic and drug-use covariates. Among the covariates, age was the greatest confounder and was inversely proportional to cardiopulmonary function, HRV, and executive function. Cardiac autonomic nervous system function exerted a moderating, rather than a mediating, effect on the relationship between aerobic exercise and executive function. However, this potential effect was largely influenced by covariates, particularly age.

Krill Oil Alleviated Methamphetamine-Induced Memory Impairment via the MAPK Signaling Pathway and Dopaminergic Synapse Pathway

Methamphetamine (METH) abuse exerts severe harmful effects in multiple organs, especially the brain, and can induce cognitive dysfunction and memory deficits in humans. Krill oil is rich in polyunsaturated fatty acids, while its effect on METH-induced cognitive impairment and mental disorders, and the underlying mechanism remain unknown. The aim of the present study was to investigate the protective effect of krill oil on METH-induced memory deficits and to explore the molecular mechanisms by using an integrated strategy of bioinformatics analysis and experimental verification. METH-exposed mice were treated with or without krill oil. Learning and memory functions were evaluated by the Morris water maze. The drug–component–target network was constructed in combination with network pharmacology. The predicted hub genes and pathways were validated by the Western blot technique. With krill oil treatment, memory impairment induced by METH was significantly improved. 210 predicted targets constituted the drug–compound–target network by network pharmacology analysis. 20 hub genes such as DRD2, MAPK3, CREB, BDNF, and caspase-3 were filtered out as the underlying mechanisms of krill oil on improving memory deficits induced by METH. The KEGG pathway and GO enrichment analyses showed that the MAPK signaling pathway, cAMP signaling pathway, and dopaminergic synapse pathway were involved in the neuroprotective effects of krill oil. In the hippocampus, DRD2, cleaved caspase-3, and γ-H2AX expression levels were significantly increased in the METH group but decreased in the krill oil–treated group. Meanwhile, krill oil enhanced the expressions of p-PKA, p-ERK1/2, and p-CREB. Our findings suggested that krill oil improved METH-induced memory deficits, and this effect may occur via the MAPK signaling pathway and dopaminergic synapse pathways. The combination of network pharmacology approaches with experimental validation may offer a useful tool to characterize the molecular mechanism of multicomponent complexes.

Optimizing outpatient treatment outcomes among methamphetamine-using gay and bisexual men through a computerized depression intervention

INTRODUCTION

Depression is a common sequelae of frequent methamphetamine use, and may influence rates of engagement in sexual risk-taking among methamphetamine-using cisgender gay, bisexual, and other men who have sex with men (GBMSM). The study team hypothesized that layering a brief, computerized depression intervention (i.e., MoodGym; based on Cognitive Behavioral Therapy [CBT] and Interpersonal Therapy) on top of a long-running outpatient methamphetamine treatment program (based on CBT and Contingency Management) for GBMSM could optimize reductions in methamphetamine use and sexual risk-taking among program participants.

METHODS

This pilot study, which also included analysis of historical data, employed nearest-neighbor matching algorithms to match current pilot study participants (N = 39) to prior participants of an outpatient methamphetamine treatment program (N = 703) and employed treatment effects analyses to determine the observed effects of adding depression intervention content to GBMSM-specific methamphetamine treatment.

RESULTS

Pilot study participants who received the MoodGym intervention were significantly less likely to submit methamphetamine-metabolite positive urine samples (Adjusted Treatment Effect [ATE] = -0.72; p < 0.01), and evidenced significantly greater reductions in receptive condomless anal intercourse with non-primary partners in the past 30 days (ATE = -1.39; p < 0.05), relative to prior participants of the outpatient methamphetamine treatment program who did not receive depression intervention content.

CONCLUSION

Preliminary results suggest layering a brief computerized depression intervention onto outpatient methamphetamine treatment for GBMSM may optimize reductions in methamphetamine use and/or sexual risk-taking.

A Systematic Review of Prevention and Intervention Strategies for Smartphone Addiction in Students: Applicability During the COVID-19 Pandemic

"During this coronavirus (COVID-19) pandemic, smartphones play an important role in online classes, study, and entertainment. However, excessive use may lead to smartphone addiction (SPA). The incidence of SPA among students has increased with the spread of COVID-19 and threatens to impair home-based students’ learning efficiency and physical and mental health. This study aimed to provide a comprehensive overview of the latest achievements in SPA prevention and treatment, and a theoretical basis for future experimental research and clinical treatment, while considering their applicability during the current pandemic. We researched the core literature in Chinese, English, and Korean databases from 2000 to 2021; 3208 articles were identified. After reading the titles, abstracts, and full texts, 53 articles were selected. Research on SPA interventions was relatively limited; we identified six types of prevention and treatment measures: psychotherapies, cognitive training, behavioral intervention, application restriction, social intervention, and complementary and alternative medicine. They can be implemented by students, parents, or online experts. Future research should focus on developing early measures to identify and prevent SPA and enhance students’ change motivation."

The Role of Chinese Herbal Therapy in Methamphetamine Abuse and its Induced Psychiatric Symptoms

Repeated intake of methamphetamine (METH) leads to drug addiction, the inability to control intake, and strong drug cravings. It is also likely to cause psychiatric impairments, such as cognitive impairment, depression, and anxiety. Because the specific neurobiological mechanisms involved are complex and have not been fully and systematically elucidated, there is no established pharmacotherapy for METH abuse. Studies have found that a variety of Chinese herbal medicines have significant therapeutic effects on neuropsychiatric symptoms and have the advantage of multitarget comprehensive treatment. We conducted a systematic review, from neurobiological mechanisms to candidate Chinese herbal medicines, hoping to provide new perspectives and ideas for the prevention and treatment of METH abuse.

Anxiety disorders in patients with cardiopulmonary diseases: A brief review

This manuscript reviews the current literature involving clinical anxiety and cardiopulmonary disease, considers the hypothesized physiological mechanisms for anxiety, and discusses the use of exercise as a treatment for both anxiety and cardiopulmonary diseases. The literature summary consists of original investigations, meta-analysis, commentaries, and review publications in order to better understand the biological and psychological mechanisms for using exercise as treatment and to provide details specific to cardiopulmonary disease and anxiety management. A gap in the literature exists concerning the anxiolytic effects of exercise as a psychological and physical treatment in cardiopulmonary populations. The findings from this review support further investigation into the use of exercise to ameliorate the burden of anxiety in cardiopulmonary disease patients. This review evaluates the current literature surrounding cardiopulmonary disease and anxiety. A systematic literature search identified articles discussing the prevalence, association, and risk of anxiety in cardiopulmonary patients. Though depression is often studied in this population, recent investigation supports a need for further research regarding anxiety in cardiopulmonary patients. Treatment to manage patients' psychological profile can reduce exacerbations of known disease, reduce hospital readmission, and improve functional capacity, and overall quality of life.

Psychopathological Burden and Quality of Life in Substance Users During the COVID-19 Lockdown Period in Italy

BACKGROUND

Following the development of the COVID-19 pandemic, a rigid public health strategy of reduced social contact and shelter-in-place has been adopted by the Italian Government to reduce the spread of the virus. In this paper, we aim at evaluating the impact that the COVID-19 pandemic, and the relative containment measures, have had on a real-life sample of patients suffering from substance use disorders (SUDs) and/or behavioral addictions.

METHODS

An anonymous questionnaire was filled out by 153 addicted patients, both outpatients and residential inpatients, recruited across Italy and highly representative of the current Italian population suffering from addictions. Psychopathological burden (anxiety and depressive symptomatology, somatization, irritability, and post-traumatic symptoms), quality of life, and craving changes in daily habits were assessed.

RESULTS

In our sample, we found moderate rates of depression (22.9%), anxiety (30.1%), irritability (31.6%), and post-traumatic stress (5.4%) symptoms. Psychopathological burden was globally higher among residential patients. Reported levels of craving were generally low.

DISCUSSION

This study is the first attempt to collect Italian data regarding the effects of the rigid quarantine period, during the COVID-19 pandemic, on patients suffering from a SUD and/or behavioral addictions. The presence of a moderate psychopathological burden correlated to poor quality of life and low craving scores represented the main outcomes. Long-term studies, with follow-up after the end of the restrictive measures, should be considered to implement our findings.