Journal of Clinical Medicine

Research

20 pages, 1408 KiB

Open AccessArticle

An International, Multidisciplinary Consensus Set of Patient-Centered Outcome Measures for Substance-Related and Addictive Disorders

by Nicola Black, Sophie Chung, Calvert Tisdale, Luz Sousa Fialho, Apinun Aramrattana, Sawitri Assanangkornchai, Alex Blaszczynski, Henrietta Bowden-Jones, Wim van den Brink, Adrian Brown, Qiana L. Brown, Linda B. Cottler, Maury Elsasser, Marica Ferri, Maria Florence, Ralitza Gueorguieva, Ryan Hampton, Suzie Hudson, Peter J. Kelly, Nicholas Lintzeris, Lynette Murphy, Abhijit Nadkarni, Joanne Neale, Daniel Rosen, Hans-Jürgen Rumpf, Brian Rush, Gabriel Segal, Gillian W. Shorter, Marta Torrens, Christopher Wait, Katherine Young and Michael Farrell Show full author list Hide full author list

J. Clin. Med. 2024, 13(7), 2154; https://doi.org/10.3390/jcm13072154 - 8 Apr 2024

Cited by 4 | Viewed by 3468

Abstract

Background: In 1990, the United States’ Institute of Medicine promoted the principles of outcomes monitoring in the alcohol and other drugs treatment field to improve the evidence synthesis and quality of research. While various national outcome measures have been developed and employed, no [...] Read more.

Background: In 1990, the United States’ Institute of Medicine promoted the principles of outcomes monitoring in the alcohol and other drugs treatment field to improve the evidence synthesis and quality of research. While various national outcome measures have been developed and employed, no global consensus on standard measurement has been agreed for addiction. It is thus timely to build an international consensus. Convened by the International Consortium for Health Outcomes Measurement (ICHOM), an international, multi-disciplinary working group reviewed the existing literature and reached consensus for a globally applicable minimum set of outcome measures for people who seek treatment for addiction. Methods: To this end, 26 addiction experts from 11 countries and 5 continents, including people with lived experience (n = 5; 19%), convened over 16 months (December 2018–March 2020) to develop recommendations for a minimum set of outcome measures. A structured, consensus-building, modified Delphi process was employed. Evidence-based proposals for the minimum set of measures were generated and discussed across eight videoconferences and in a subsequent structured online consultation. The resulting set was reviewed by 123 professionals and 34 people with lived experience internationally. Results: The final consensus-based recommendation includes alcohol, substance, and tobacco use disorders, as well as gambling and gaming disorders in people aged 12 years and older. Recommended outcome domains are frequency and quantity of addictive disorders, symptom burden, health-related quality of life, global functioning, psychosocial functioning, and overall physical and mental health and wellbeing. Standard case-mix (moderator) variables and measurement time points are also recommended. Conclusions: Use of consistent and meaningful outcome measurement facilitates carer–patient relations, shared decision-making, service improvement, benchmarking, and evidence synthesis for the evaluation of addiction treatment services and the dissemination of best practices. The consensus set of recommended outcomes is freely available for adoption in healthcare settings globally. Full article

(This article belongs to the Special Issue Addictive Disorders and Clinical Psychiatry—Part II)

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17 pages, 541 KiB

Open AccessEditor’s ChoiceArticle

Procrastination Mediates the Relationship between Problematic TikTok Use and Depression among Young Adults

by Aleksandra M. Rogowska and Aleksandra Cincio

J. Clin. Med. 2024, 13(5), 1247; https://doi.org/10.3390/jcm13051247 - 22 Feb 2024

Cited by 4 | Viewed by 9679

Abstract

Background: Although the prevalence of depression has increased significantly in recent years, especially in the young adult population, little is known about its causes and risk factors. The study aims to examine the mediating role of TikTok use in the relationships between procrastination [...] Read more.

Background: Although the prevalence of depression has increased significantly in recent years, especially in the young adult population, little is known about its causes and risk factors. The study aims to examine the mediating role of TikTok use in the relationships between procrastination and depression in young adults. Methods: A sample of 448 adults, ranging in age from 18 to 35 years (M = 24.45, SD = 3.76), including 214 men (48%), participated in the study. The cross-sectional survey consists of a modified Bergen Facebook Addiction Scale (BFAS) to assess problematic TikTok use (PTTU), the Pure Procrastination Scale (PPS) for procrastination measurement, and the nine-item Patient Health Questionnaire (PHQ-9) for screening depression symptoms. Results: The independent samples t-test indicates that emerging adults (ages ranging between 18 and 25 years) have more severe depression symptoms than young adults (26–35 years old). Gender differences were not found for procrastination, PTTU, and depression symptoms. Positive correlations were found between procrastination, PTTU, and depression symptoms. PTTU plays a mediating role in the associations between procrastination and depression. Conclusions: Both procrastination and PTTU treatment should be prioritized in the prevention and intervention programs for improving mental health among young adults. Some effective therapeutic methods are recommended. Full article

(This article belongs to the Special Issue Addictive Disorders and Clinical Psychiatry—Part II)

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17 pages, 267 KiB

Open AccessArticle

Intensity of Psychoactive Substance Use Affects the Occurrence of Prodromal Symptoms of Psychosis

by Gniewko Więckiewicz, Iga Florczyk, Maciej Stokłosa, Marta Jurga, Piotr Gorczyca and Magdalena Kotlicka-Antczak

J. Clin. Med. 2024, 13(3), 760; https://doi.org/10.3390/jcm13030760 - 28 Jan 2024

Cited by 1 | Viewed by 1716

Abstract

Background: Psychosis is defined as a series of symptoms that impair the mind and lead to a kind of loss of reference to reality. Development of psychosis is usually preceded by the appearance of prodromal symptoms. Numerous attempts have been made to find [...] Read more.

Background: Psychosis is defined as a series of symptoms that impair the mind and lead to a kind of loss of reference to reality. Development of psychosis is usually preceded by the appearance of prodromal symptoms. Numerous attempts have been made to find out how psychoactive substances can influence the onset and development of psychotic disorders, but to date there are no studies that show a link between the onset of prodromal symptoms and the use of psychoactive substances. Methods: A survey consisting of epidemiological and demographic questions, the Drug Use Disorders Identification Test (DUDIT), and the Prodromal Questionnaire Brief Version (PQ-B) was conducted on social media among users of illegal psychoactive substances, covering 703 study participants. Results: A total of 39.8% of the respondents had been treated by a psychiatrist, and the most popular drugs used by respondents in their lifetime were tetrahydrocannabinol-containing products, MDMA, amphetamines, and LSD. A significant correlation was found between the DUDIT and the PQ-B values. Conclusions: Intensity of psychoactive substance use correlated positively with the risk of appearance and intensity of prodromal symptoms of psychosis. Early exposure to psychoactive substances increased the risk of heavy substance use in adulthood and led to more frequent prodromal states. Full article

(This article belongs to the Special Issue Addictive Disorders and Clinical Psychiatry—Part II)

12 pages, 251 KiB

Open AccessArticle

Using the Recovery Capital Model to Explore Barriers to and Facilitators of Recovery in Individuals with Substance Use Disorder, Psychiatric Comorbidity and Mild-to-Borderline Intellectual Disability: A Case Series

by Esther Pars, Joanne E. L. VanDerNagel, Boukje A. G. Dijkstra and Arnt F. A. Schellekens

J. Clin. Med. 2023, 12(18), 5914; https://doi.org/10.3390/jcm12185914 - 12 Sep 2023

Cited by 7 | Viewed by 2485

Abstract

Recovery capital (RC) encompasses the wide range of resources individuals can employ to recover from Substance Use Disorder (SUD). It consists of five subdomains: human, social, cultural, financial, and community RC. Negative recovery capital (NRC) represents the obstacles to recovery. Research on (N)RC [...] Read more.

Recovery capital (RC) encompasses the wide range of resources individuals can employ to recover from Substance Use Disorder (SUD). It consists of five subdomains: human, social, cultural, financial, and community RC. Negative recovery capital (NRC) represents the obstacles to recovery. Research on (N)RC in complex multimorbid populations is scarce. This study offers an initial exploration of the viability of (N)RC in three individuals with SUD, psychiatric comorbidities, and an intellectual disability (a triple diagnosis) in inpatient addiction treatment. We collected case file data, ranked recovery goals, and conducted follow-up interviews. The data were subjected to template analysis, using (N)RC domains as codes. All domains were prevalent and relevant, showing dynamic and reciprocal effects, influenced by critical life events acting as catalysts. Notably, during treatment, patients prioritized individual skill development despite challenges in other domains. RC emerges as a valuable concept for mapping recovery barriers and facilitators in individuals with a triple diagnosis, serving as an alternative to the medical model and complementing the biopsychosocial model. It provides a systematic framework to assess critical factors for recovery in complex cases and accordingly align interventions. Future studies should explore the intersections of NRC domains and the dynamic nature of (N)RC to enhance the understanding of the challenges faced by individuals with a triple diagnosis. Full article

(This article belongs to the Special Issue Addictive Disorders and Clinical Psychiatry—Part II)

Review

Jump to: Research, Other

36 pages, 1205 KiB

Open AccessReview

Efficacy of Transcranial Direct Current Stimulation (tDCS) on Neuropsychiatric Symptoms in Substance Use Disorder (SUD)—A Review and Insights into Possible Mechanisms of Action

by James Chmiel, Marta Stępień-Słodkowska and Irena Ramik-Mażewska

J. Clin. Med. 2025, 14(4), 1337; https://doi.org/10.3390/jcm14041337 - 18 Feb 2025

Viewed by 609

Abstract

Introduction: Substance use disorder (SUD) is a significant global clinical issue marked by the excessive consumption of alcohol, nicotine, and various psychoactive substances, leading to impaired social, cognitive, and occupational functioning. Individuals with SUD frequently experience depression and anxiety disorders, which exacerbate their [...] Read more.

Introduction: Substance use disorder (SUD) is a significant global clinical issue marked by the excessive consumption of alcohol, nicotine, and various psychoactive substances, leading to impaired social, cognitive, and occupational functioning. Individuals with SUD frequently experience depression and anxiety disorders, which exacerbate their prognosis and contribute to substantial health and social burdens. The pathophysiology of SUD and its associated conditions is multifaceted, involving multiple dysfunctions in the brain. This complexity underscores an urgent need for the development of noninvasive treatments that can directly target the brain. One of them is transcranial direct current stimulation (tDCS), an intensively studied technique for safely modulating cortical excitability. The aim of this study is to investigate the effectiveness of tDCS in treating symptoms of depression and anxiety in SUD. Methods: With an emphasis on the underlying mechanisms of action, this mechanistic review investigates the effectiveness of tDCS in treating anxiety and depression in SUD patients. Literature searches were conducted using the PubMed/Medline, ResearchGate, Cochrane, and Google Scholar databases. Results: The review identified 12 relevant studies. The results showed that left dorsolateral prefrontal cortex (DLPFC) stimulation is an effective treatment option for depression in SUD. In anxiety disorders, left and right DLPFC stimulation is effective, with better results observed with right DLPFC stimulation. However, the included studies differed in their methodology, sample characteristics, and measurement methods, which could have influenced the final results of the analysis. The central focus of this mechanistic review is to discuss the potential mechanisms of action of tDCS in treating depression and anxiety in SUD. These mechanisms include the modulation of brain networks, a reduction in neuroinflammation, an enhancement in neuroplasticity, and an increase in P300 amplitude. We also discuss the limitations of the included studies and propose ways to address them in future research. Conclusions: This review provides evidence that tDCS is an effective treatment option for anxiety and depression in SUD. Stimulation of the left DLPFC reduces symptoms of depression, while stimulation of the right DLPFC reduces symptoms of anxiety. However, future research is required to confirm these findings and to deepen our understanding of the mechanisms through which tDCS exerts its effects in this context. Neuroimaging methods (fMRI and EEG) and blood tests could be particularly useful. Full article

(This article belongs to the Special Issue Addictive Disorders and Clinical Psychiatry—Part II)

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19 pages, 473 KiB

Open AccessReview

The Effect of Transcranial Direct Current Stimulation (tDCS) on Cocaine Addiction: A Narrative Review

by James Chmiel, Justyna Chojdak-Łukasiewicz and Jerzy Leszek

J. Clin. Med. 2023, 12(20), 6511; https://doi.org/10.3390/jcm12206511 - 13 Oct 2023

Viewed by 2678

Abstract

Cocaine addiction is a significant problem worldwide. The development of addiction involves a reward system, which consists of certain brain regions like the ventral tegmental area, nucleus accumbens, and prefrontal cortex. Currently, there are no approved medications for treating cocaine dependence, so researchers [...] Read more.

Cocaine addiction is a significant problem worldwide. The development of addiction involves a reward system, which consists of certain brain regions like the ventral tegmental area, nucleus accumbens, and prefrontal cortex. Currently, there are no approved medications for treating cocaine dependence, so researchers are actively searching for effective treatments that can impact the brain. One potential treatment under investigation is transcranial direct current stimulation (tDCS), a non-invasive method of stimulating the brain to modulate its activity. In this review, we explore the use of tDCS in treating cocaine addiction. We found nine relevant articles via a literature search, and the results indicate that applying tDCS to the right dorsolateral prefrontal cortex (DLPFC) holds promise for reducing drug cravings in individuals with cocaine addiction. The review also discusses the possible mechanisms by which tDCS works and provides recommendations for future research in this field. Full article

(This article belongs to the Special Issue Addictive Disorders and Clinical Psychiatry—Part II)

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13 pages, 308 KiB

Open AccessReview

Opioid Analgesics after Bariatric Surgery: A Scoping Review to Evaluate Physiological Risk Factors for Opioid-Related Harm

by Stephanie C. M. Wuyts, Bart Torensma, Arnt F. A. Schellekens and Cornelis (Kees) Kramers

J. Clin. Med. 2023, 12(13), 4296; https://doi.org/10.3390/jcm12134296 - 27 Jun 2023

Cited by 4 | Viewed by 2945

Abstract

The persisting use of opioids following bariatric surgery has emerged as a prevalent complication, heightening the probability of opioid-related harm (ORM), such as opioid-related fatalities and prescription opioid use disorder (OUD). A comprehensive review of PubMed literature from 1990 to 2023 was conducted [...] Read more.

The persisting use of opioids following bariatric surgery has emerged as a prevalent complication, heightening the probability of opioid-related harm (ORM), such as opioid-related fatalities and prescription opioid use disorder (OUD). A comprehensive review of PubMed literature from 1990 to 2023 was conducted to pinpoint physiological influences on postoperative ORM. As a result, we found that patients undertaking bariatric operations often exhibit an inherently higher risk for substance use disorders, likely attributable to genetic predisposition and related neurobiological changes that engender obesity and addiction-like tendencies. Furthermore, chronic pain is a common post-bariatric surgery complaint, and the surgical type impacts opioid needs, with increased long-term opioid use after surgeries. Additionally, the subjective nature of pain perception in patients with obesity can distort pain reporting and the corresponding opioid prescription both before and after surgery. Furthermore, the postoperative alterations to the gastrointestinal structure can affect the microbiome and opioid absorption rates, resulting in fluctuating systemic exposure to orally ingested opioids. The prospect of ORM development post-bariatric surgery appears amplified due to a preexisting susceptibility to addictive habits, surgically induced pain, modified gut–brain interaction and pain management and the changed pharmacokinetics post-surgery. Further research is warranted to clarify these potential risk variables for ORM, specifically OUD, in the bariatric population. Full article

(This article belongs to the Special Issue Addictive Disorders and Clinical Psychiatry—Part II)

Other

Jump to: Research, Review

13 pages, 487 KiB

Open AccessSystematic Review

Emotional Intelligence and Behavioural Addictions: A Systematic Review

by Roberta Biolcati, Zeynep Özal, Federica Ambrosini, Paola Villano, Laura Palareti and Giacomo Mancini

J. Clin. Med. 2025, 14(4), 1125; https://doi.org/10.3390/jcm14041125 - 10 Feb 2025

Viewed by 908

Abstract

Background: The role of emotional intelligence on the experience of behavioural addictions is a growing area of research interest. However, there are operationalisation issues in studying both emotional intelligence and behavioural addictions separately. This review aims to report on the existing literature of [...] Read more.

Background: The role of emotional intelligence on the experience of behavioural addictions is a growing area of research interest. However, there are operationalisation issues in studying both emotional intelligence and behavioural addictions separately. This review aims to report on the existing literature of studies exploring the relationship between these two concepts, and to identify gaps in research practice in order to inform future studies. Methods: A search, covering the date range of 2013–2024, conducted in five databases in August 2024 identified 43 articles, reported according to PRISMA 2020 guidelines. The findings are discussed under four subheadings: technology-related behavioural addiction, internet gaming disorder, eating disorders, and consumer behaviour and compulsive buying. Results: Overall, the results show that emotional intelligence is negatively correlated with behavioural addictions and plays both a moderating and mediating role in the associations between behavioural addictions and other negative outcomes such as suicidal ideation, rumination, fear of missing out, and depression. Conclusions: In addition to summarising studies and controversial discussions on emotional intelligence and behavioural addictions, this review suggests possible roadmaps to ensure more accurate research outcomes by highlighting the importance of theoretical and methodological distinctions between trait and ability models of emotional intelligence. Full article

(This article belongs to the Special Issue Addictive Disorders and Clinical Psychiatry—Part II)

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