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Abstract

The treatment of human immunodeficiency virus (HIV) with antiretroviral (ARV) medications has revolutionised the care for these patients. The dramatic increase in life expectancy has brought new challenges in treating diseases of aging in this cohort. Cardiovascular disease (CVD) is now a leading cause of morbidity and mortality with risk matched HIV-positive patients having double the risk of MI compared to HIV-negative patients. This enhanced risk is secondary to the interplay the virus (and accessory proteins), ARV medications and traditional risk factors. The culmination of these factors can lead to a hybrid metabolic syndrome characterised by heightened ectopic fat. Cardiovascular computed tomography (CT) is ideal for quantifying epicardial adipose tissue volumes, hepatosteatosis and cardiovascular disease burden. The CVD risk attributed to disease burden and plaque morphology is well established in general populations but is less clear in HIV populations. The purpose of this review article is to appraise the latest data on CVD development in HIV-positive patients and how the use of cardiovascular CT may be used to enhance risk prediction in this population. This may have important implications on individualised treatment decisions and risk reduction strategies which will improve the care of these patients.

Open access

Background

Internet gaming disorder (IGD) was introduced in the DSM-5 as a way of identifying and diagnosing problematic video game play. However, the use of the diagnosis is constrained, as it shares criteria with other addictive orders (e.g., pathological gambling).

Aims

Further work is required to better understand IGD. One potential avenue of investigation is IGD’s relationship to the primary reinforcing behavioral functions. This study explores the relationship between duration of video game play and the reinforcing behavioral functions that may motivate or maintain video gaming.

Methods

A total of 499 video game players began the online survey, with complete data from 453 participants (85% white and 28% female), were analyzed. Individuals were placed into five groups based on self-reported hours of video gaming per week, and completed the Video Game Functional Assessment – Revised (VGFA-R).

Results

The results demonstrated the escape and social attention function were significant in predicting duration of video game play, whereas sensory and tangible were not significant.

Conclusion

Future implications of the VGFA-R and behaviorally based research are discussed.

Open access
Orvosi Hetilap
Authors:
Attila Bokor
,
Erszébet Koszorús
,
Valentin Brodszky
,
Thomas D’Hooghe
,
WERF EndoCost Consortium
, and
János Rigó

Bevezetés: Az endometriosis az egyik leggyakoribb nőgyógyászati betegség, több mint 70 millió felnőtt és serdülő nőt érint világszerte. Célkitűzés: A szerzők az endometriosis diagnosztikus késedelmi idejének meghatározását, a sebészi, illetve kombinált műtéti kezelés hatékonyságának vizsgálatát, valamint a betegek életminőségének felmérését tűzték ki célul. Módszer: A beválogatási kritériumoknak megfelelő 240, endometriosisban szenvedő nőből 84 vett részt a retrospektív és prospektív kérdőíves felmérésben. Eredmények: A tünetek kezdetétől a diagnózisig átlagosan 3,9 év telt el. A tünetek fellépésekor a betegek 89%-a, a kezelést követő prospektíven vizsgált hónapokban 28%-a panaszkodott fájdalomról (p = 0,025). A sebészi kezelés és a műtéti terápiával kombinált konzervatív kezelés hatékonysága között nem találtak szignifikáns különbséget (p = 0,85). A munkahelyi teljesítmény csökkenéséről a betegek 47%-a, míg a személyes kapcsolatok kedvezőtlen alakulásáról a vizsgálatban részt vevők 40%-a számolt be. Az életminőségre standardizált életévveszteség egy év alatt 0,147 volt. Következtetések: Jelen felmérés az első hazai prospektív, az endometriosis életminőségre gyakorolt hatását vizsgáló tanulmány. A betegségre hosszú diagnosztikus késés jellemző. Az endometriosis jelentősen rontja az életminőséget, de adekvát kezeléssel a panaszok csökkenthetők. Orv. Hetil., 2013, 154, 1426–1434.

Open access
Journal of Behavioral Addictions
Authors:
William Van Gordon
,
Edo Shonin
,
Thomas J. Dunn
,
Javier Garcia-Campayo
,
Marcelo M. P. Demarzo
, and
Mark D. Griffiths

Background and aims

Workaholism is a form of behavioral addiction that can lead to reduced life and job satisfaction, anxiety, depression, burnout, work–family conflict, and impaired productivity. Given the number of people affected, there is a need for more targeted workaholism treatments. Findings from previous case studies successfully utilizing second-generation mindfulness-based interventions (SG-MBIs) for treating behavioral addiction suggest that SG-MBIs may be suitable for treating workaholism. This study conducted a controlled trial to investigate the effects of an SG-MBI known as meditation awareness training (MAT) on workaholism.

Methods

Male and female adults suffering from workaholism (n = 73) were allocated to MAT or a waiting-list control group. Assessments were performed at pre-, post-, and 3-month follow-up phases.

Results

MAT participants demonstrated significant and sustained improvements over control-group participants in workaholism symptomatology, job satisfaction, work engagement, work duration, and psychological distress. Furthermore, compared to the control group, MAT participants demonstrated a significant reduction in hours spent working but without a decline in job performance.

Discussion and conclusions

MAT may be a suitable intervention for treating workaholism. Further controlled intervention studies investigating the effects of SG-MBIs on workaholism are warranted.

Open access
Journal of Behavioral Addictions
Authors:
Thomas McLaughlin
,
Kenneth Blum
,
Bruce Steinberg
,
Edward J. Modestino
,
Lyle Fried
,
David Baron
,
David Siwicki
,
Eric R. Braverman
, and
Rajendra D. Badgaiyan

Background

Addictive-like behaviors (e.g., hoarding and shopping) may be the result of the cumulative effects of dopaminergic and other neurotransmitter genetic variants as well as elevated stress levels. We, therefore, propose that dopamine homeostasis may be the preferred goal in combating such challenging and unwanted behaviors, when simple dopaminergic activation through potent agonists may not provide any resolution.

Case presentation

C.J. is a 38-year-old, single, female, living with her mother. She has a history of substance use disorder as well as attention deficit hyperactivity disorder, inattentive type. She had been stable on buprenorphine/naloxone combination and amphetamine, dextroamphetamine mixed salts for many years when unexpectedly she lost her job for oversleeping and not calling into work. KB200z (a pro-dopamine compound) was added to her regimen for complaints of low drive and motivation. After taking this nutraceutical for 4 weeks, she noticed a marked improvement in her mental status and many behaviors. She noted that her shopping and hoarding addictions had appreciably decreased. Furthermore, her lifelong history of terrifying lucid dreams was eliminated. Finally, she felt more in control; her locus of control shifted from external to more internal.

Discussion

The hypothesis is that C.J.’s reported, behavioral, and psychological benefits resulted from the pro-dopamine-regulating effect of KB220Z across the brain reward system.

Conclusions

This effect, we surmise, could be the result of a new dopamine balance, across C.J.’s brain reward system. Dopamine homeostasis is an effect of KB220Z seen in both animal and human placebo-controlled fMRI experiments.

Open access
Journal of Psychedelic Studies
Authors:
John M. Clifton
,
Annabelle M. Belcher
,
Aaron D. Greenblatt
,
Christopher M. Welsh
,
Thomas O. Cole
, and
Alan K. Davis

Abstract

Background and aims

There is growing evidence that psilocybin, a serotonergic psychedelic substance, may be useful in the treatment of substance use disorders. However, there is a lack of data on the beliefs and attitudes towards psilocybin amongst Black individuals diagnosed with Opioid Use Disorder (OUD). This study characterized psilocybin use patterns and perception of risk amongst a cohort of Black individuals diagnosed with OUD.

Methods

Using a convenience sampling approach, patients were recruited from an urban methadone treatment program and paid five dollars to complete an anonymous phone-based survey.

Results

Twenty-eight patients participated (mean age 53.8; N = 28; 35.7% female). Most (N = 23; 82.1%) had “heard of” psilocybin mushrooms before taking the survey, but only five (N = 5; 17.8%) had ever used them. More than 80% perceived a risk or were “unsure” of the risk for sixteen of the seventeen items queried about psilocybin. Approximately half (N = 15; 53.6%) were willing to try therapy incorporating psilocybin and half (N = 14; 50%) said they would be more likely to try if it were FDA approved for OUD. Most (N = 18; 64.3%) preferred to stay on methadone treatment alone, 32.1% (N = 9) wanted to try treatment with both psilocybin and methadone, and only one participant opted for psilocybin treatment without methadone.

Conclusion

Many Black individuals with Opioid Use Disorder perceive psilocybin as dangerous and may be hesitant to try psilocybin treatment. Culturally informed treatment models, educational interventions and community outreach programs should be developed to increase racial/ethnic minority representation in psilocybin research and treatment.

Open access
Journal of Behavioral Addictions
Authors:
John B. Saunders
,
Wei Hao
,
Jiang Long
,
Daniel L. King
,
Karl Mann
,
Mira Fauth-Bühler
,
Hans-Jürgen Rumpf
,
Henrietta Bowden-Jones
,
Afarin Rahimi-Movaghar
,
Thomas Chung
,
Elda Chan
,
Norharlina Bahar
,
Sophia Achab
,
Hae Kook Lee
,
Marc Potenza
,
Nancy Petry
,
Daniel Spritzer
,
Atul Ambekar
,
Jeffrey Derevensky
,
Mark D. Griffiths
,
Halley M. Pontes
,
Daria Kuss
,
Susumu Higuchi
,
Satoko Mihara
,
Sawitri Assangangkornchai
,
Manoj Sharma
,
Ahmad El Kashef
,
Patrick Ip
,
Michael Farrell
,
Emanuele Scafato
,
Natacha Carragher
, and
Vladimir Poznyak

Online gaming has greatly increased in popularity in recent years, and with this has come a multiplicity of problems due to excessive involvement in gaming. Gaming disorder, both online and offline, has been defined for the first time in the draft of 11th revision of the International Classification of Diseases (ICD-11). National surveys have shown prevalence rates of gaming disorder/addiction of 10%–15% among young people in several Asian countries and of 1%–10% in their counterparts in some Western countries. Several diseases related to excessive gaming are now recognized, and clinics are being established to respond to individual, family, and community concerns, but many cases remain hidden. Gaming disorder shares many features with addictions due to psychoactive substances and with gambling disorder, and functional neuroimaging shows that similar areas of the brain are activated. Governments and health agencies worldwide are seeking for the effects of online gaming to be addressed, and for preventive approaches to be developed. Central to this effort is a need to delineate the nature of the problem, which is the purpose of the definitions in the draft of ICD-11.

Open access

Including gaming disorder in the ICD-11: The need to do so from a clinical and public health perspective

Commentary on: A weak scientific basis for gaming disorder: Let us err on the side of caution (van Rooij et al., 2018)

Journal of Behavioral Addictions
Authors:
Hans-Jürgen Rumpf
,
Sophia Achab
,
Joël Billieux
,
Henrietta Bowden-Jones
,
Natacha Carragher
,
Zsolt Demetrovics
,
Susumu Higuchi
,
Daniel L. King
,
Karl Mann
,
Marc Potenza
,
John B. Saunders
,
Max Abbott
,
Atul Ambekar
,
Osman Tolga Aricak
,
Sawitri Assanangkornchai
,
Norharlina Bahar
,
Guilherme Borges
,
Matthias Brand
,
Elda Mei-Lo Chan
,
Thomas Chung
,
Jeff Derevensky
,
Ahmad El Kashef
,
Michael Farrell
,
Naomi A. Fineberg
,
Claudia Gandin
,
Douglas A. Gentile
,
Mark D. Griffiths
,
Anna E. Goudriaan
,
Marie Grall-Bronnec
,
Wei Hao
,
David C. Hodgins
,
Patrick Ip
,
Orsolya Király
,
Hae Kook Lee
,
Daria Kuss
,
Jeroen S. Lemmens
,
Jiang Long
,
Olatz Lopez-Fernandez
,
Satoko Mihara
,
Nancy M. Petry
,
Halley M. Pontes
,
Afarin Rahimi-Movaghar
,
Florian Rehbein
,
Jürgen Rehm
,
Emanuele Scafato
,
Manoi Sharma
,
Daniel Spritzer
,
Dan J. Stein
,
Philip Tam
,
Aviv Weinstein
,
Hans-Ulrich Wittchen
,
Klaus Wölfling
,
Daniele Zullino
, and
Vladimir Poznyak

The proposed introduction of gaming disorder (GD) in the 11th revision of the International Classification of Diseases (ICD-11) developed by the World Health Organization (WHO) has led to a lively debate over the past year. Besides the broad support for the decision in the academic press, a recent publication by van Rooij et al. (2018) repeated the criticism raised against the inclusion of GD in ICD-11 by Aarseth et al. (2017). We argue that this group of researchers fails to recognize the clinical and public health considerations, which support the WHO perspective. It is important to recognize a range of biases that may influence this debate; in particular, the gaming industry may wish to diminish its responsibility by claiming that GD is not a public health problem, a position which maybe supported by arguments from scholars based in media psychology, computer games research, communication science, and related disciplines. However, just as with any other disease or disorder in the ICD-11, the decision whether or not to include GD is based on clinical evidence and public health needs. Therefore, we reiterate our conclusion that including GD reflects the essence of the ICD and will facilitate treatment and prevention for those who need it.

Open access