Mobile phone addiction not only poses potential adverse effects on the effective implementation of educational and teaching activities, but also exerts a detrimental influence on students' mental health. Negative life events have been identified as a significant contributing factor to mobile phone addiction among vocational college students. Although prior research has investigated the relationship between life events and problematic mobile phone use, this study represents the first comprehensive examination of the sequential mediating roles of perceived stress and psychological resilience in the association between negative life events and mobile phone addiction. This investigation not only extends the application of stress-coping theory within the domain of digital behavior addiction, but also offers novel empirical insights and potential intervention strategies for understanding the psychological vulnerability and adaptive mechanisms involved in the development of mobile phone addiction among vocational college students. The present study investigates the relationship between perceived stress and psychological resilience in the context of negative life events and mobile phone addiction, as well as the underlying mechanisms that mediate this association. Data collection was carried out among 587 vocational college students in Nanchang City, Jiujiang City, and Fuzhou City of Jiangxi Province, using the Self-Rated Life Events Scale for Adolescents, the Perceived Stress Scale, the Psychological Resilience Scale, and the Mobile Phone Addiction Questionnaire. The findings are: (1) Mobile phone addiction is widespread among vocational college students, and the level of mobile phone addiction does not show significant differences in factors such as gender and place of origin. (2) Negative life events among vocational college students are positively associated with mobile phone addiction. (3) Perceived stress and psychological resilience play an independent mediating role and a chain mediating role between negative life events experienced by vocational college students and mobile phone addiction behaviors. The mediating effect includes three paths: negative life events → perceived stress → mobile phone addiction (effect size: 0.200), negative life events → psychological resilience → mobile phone addiction (effect size: 0.047), and negative life events → perceived stress → psychological resilience → mobile phone addiction (effect size: 0.024). This study highlights that negative life events are directly associated with mobile phone addiction among vocational college students, and also are indirectly associated with the degree of mobile phone addiction among vocational college students through the mediating effects of perceived stress and psychological resilience. The research results provide an important theoretical basis for higher vocational colleges to deeply understand the psychological causes of students' mobile phone addiction, which is conducive to optimizing the content of mental health education in schools and strengthening stress management training and psychological resilience cultivation in a targeted manner. It provides scientific support for educators to design stratified intervention plans and prevent problematic mobile phone usage behaviors, and also offers a powerful practical reference for promoting the formulation of digital health promotion policies for vocational college students and creating a positive and healthy campus network environment.
In Brazil, ultra-processed food consumption has increased disproportionately among lower-income groups, and food insecurity has been linked to food addiction. Previous studies have examined income and food addiction separately as predictors of ultra-processed food intake. This study evaluated the joint contribution of household income and food addiction to ultra-processed food intake in Brazilian university students. A cross-sectional online study was conducted with 368 Brazilian university students aged 18-30 years. Ultra-processed food intake was assessed using a score based on the Nova classification, reflecting the number of ultra-processed food subgroups consumed on the previous day. Food addiction was measured with the modified Yale Food Addiction Scale 2.0 and operationalized as diagnostic severity (none, mild, moderate, severe) and symptom presence (zero vs. one or more symptoms). Household income was categorized into four classes (A-D/E). Associations were examined using negative binomial regression, with multivariable models adjusted for body mass index and additional models including gender, race, and perceived stress related to the COVID-19 pandemic. Lower household income was consistently associated with higher intake of ultra-processed foods. Compared with the highest income class, participants in income classes C and D/E showed expected intakes 39% and 42% higher, respectively. When food addiction was analyzed using diagnostic criteria, only the mild diagnosis group differed from the non-food addiction group, showing lower expected intake after adjustment for body mass index. In contrast, symptom-based analyses revealed that participants with one or more food addiction symptoms had an approximately 18% higher expected ultra-processed food intake than asymptomatic individuals. Lower income and symptom presence were particularly associated with consumption of ultra-processed foods that replace or accompany meals, as well as ultra-processed beverages. Household income and food addiction symptoms jointly influence ultra-processed food intake among Brazilian university students. Symptom-based measures appear more sensitive than diagnostic categories for identifying population-level vulnerability. These findings highlight the need for public policies that address both socioeconomic inequalities and addictive-like eating behaviors to reduce excessive ultra-processed food consumption.
This study aimed to examine the serial mediating roles of perceived social support and life satisfaction in the relationship between religiosity and online gambling addiction within the framework of Conservation of Resources (COR) theory. A total of 771 individuals (34.4% female, 65.6% male) aged between 18 and 69 years (M = 31.98, SD = 10.42) participated in the study. Data were collected using the Religiosity Scale, the Internet Gambling Addiction Scale, the Multidimensional Scale of Perceived Social Support, and the Satisfaction with Life Scale. Correlation analyses indicated that online gambling addiction was negatively associated with religiosity, perceived social support, and life satisfaction, whereas positive relationships were found among religiosity, social support, and life satisfaction. Serial mediation analysis was conducted using PROCESS Macro Model 6. The results revealed that religiosity showed a significant negative total association with online gambling addiction; however, this direct association became non-significant when mediators were included in the model. Perceived social support and life satisfaction both significantly mediated this relationship, and the serial mediation pathway was also found to be significant. The findings suggest that higher religiosity is associated with lower levels of online gambling addiction through greater perceived social support and life satisfaction. Consistent with COR theory, the results indicate that the accumulation of social and psychological resources may be associated with lower vulnerability to behavioral addictions. The study contributes to the literature by offering a resource-based and process-oriented explanation of the relationship between religiosity and online gambling addiction and provides implications for prevention and intervention programs.
This study investigates the relationship between life stress (LS) and Internet addiction (IA) among college students, focusing on the mediating role of loneliness (LL) and the moderating role of physical exercise (PE). A moderated mediation model was developed based on stress-coping theory and self-regulation theory. A survey was conducted with 409 college students from various regions, and statistical analyses were performed using SPSS 28.0 and Process 4.1. (1) Life stress, loneliness, and Internet addiction were significantly positively correlated, whereas physical exercise exhibited a significant negative correlation with all three variables; (2) Loneliness served as a partial mediator in the relationship between life stress and Internet addiction, with a mediating effect value of 0.248, representing 40.7% of the total effect; (3) Physical exercise negatively moderated the relationships between life stress and Internet addiction (β = -0.366, p < 0.01), life stress and loneliness (β = -0.348, p < 0.01), and loneliness and Internet addiction (β = -0.341, p < 0.01). Life stress and loneliness are identified as risk factors for Internet addiction among college students, while physical exercise emerges as an effective intervention strategy.
Adolescents are increasingly exposed to climate-related content in digital environments; however, the psychological mechanisms underlying eco-anxiety in the context of problematic digital engagement remain insufficiently understood. This study examined the association between digital addiction and eco-anxiety and explored the mediating role of hopelessness in this relationship. The sample consisted of 3,561 high school students in Türkiye (56.4% female). Participants completed the Digital Addiction Scale for Teenagers, the Eco-Anxiety Scale-High School Form, and the Beck Hopelessness Scale. Associations among variables were examined using correlation analysis, and the mediating role of hopelessness was tested using a regression-based approach with bootstrapping. Digital addiction was weakly associated with eco-anxiety but showed a stronger association with hopelessness, while hopelessness was positively related to eco-anxiety. In the mediation analysis, digital addiction was associated with higher hopelessness, and hopelessness was associated with higher eco-anxiety. When hopelessness was included in the model, the direct effect of digital addiction on eco-anxiety became non-significant, while the indirect effect remained significant, indicating full mediation. These findings suggest that digital addiction may contribute to eco-anxiety primarily by increasing future-oriented pessimism and a diminished sense of control among adolescents. Eco-anxiety also differed across several socio-demographic and digital exposure variables. From a conceptual perspective, eco-anxiety appears to emerge not only as a response to environmental threat awareness but also as a psychological experience shaped by cognitive and emotional vulnerabilities within digital contexts. However, the cross-sectional design of the study limits causal interpretations of the findings. Addressing future-oriented pessimism and perceived inefficacy, alongside strengthening digital media literacy and climate-related coping resources, may support adolescent psychological wellbeing in digitally mediated environments.
Mental health problems including depression, eating disorders and anxiety disorders are associated with extensive social media use. The literature has examined the relationship between social anxiety and social media addiction; however, there is a lack of studies conducted in clinical patient populations. This study aimed to investigate the role of metacognitions related to social media addiction in individuals diagnosed with social anxiety disorder (SAD). In this cross-sectional case-control study, 99 participants aged 18-65 years with social anxiety disorder and 113 control participants were recruited. One control participant with missing BSMAS data was excluded from all analyses, including sociodemographic comparisons; therefore, the final analytic sample included 99 SAD participants and 112 control participants without current psychiatric disorder. The SCID-5 was administered to participants in the SAD group to confirm the diagnosis of social anxiety disorder and to control participants to screen for current psychiatric disorders. No current psychiatric disorder was identified among control participants at the time of assessment. After written informed consent was obtained, all participants completed the Bergen Social Media Addiction Scale (BSMAS), Liebowitz Social Anxiety Scale (LSAS), and Metacognitions Questionnaire-30 (MCQ-30). SMA prevalence did not differ significantly between participants with SAD and control participants without current psychiatric disorder (52.5% vs. 46.4%; χ²=0.781, p = 0.377; φ = 0.06). Within the SAD group, SMA was associated with higher negative metacognitive beliefs, particularly uncontrollability of worry and the need to control thoughts, and BSMAS severity correlated with these metacognitive domains. Among participants meeting the operational SMA criterion, those with SAD showed higher MCQ-30 uncontrollability of worry scores than control participants. Sensitivity analyses using an alternative BSMAS threshold showed the same overall pattern (see Table 8). SMA prevalence was comparable between participants with SAD and control participants without current psychiatric disorder; however, within SAD, problematic social media use was associated with negative metacognitive beliefs. These cross-sectional findings suggest that metacognitive beliefs may be treatment-relevant correlates of problematic social media use in SAD; longitudinal and interventional studies are needed.
Youth addiction often unfolds within landscapes of neglect, yet adult accounts of these histories are commonly gathered through one-off interviews or clinical assessments. This study examined how adults in stable recovery narrate adolescent alcohol and other drug use and associated neglect through handwritten diary-style writing, and what such writing contributes methodologically to qualitative inquiry across time. This paper reports a secondary analysis of community-generated qualitative materials produced through the SIDINL peer-support and mental health recovery network. The available corpus comprised n = 14 handwritten diary-style texts and then participants took part in a participant-led co-reading conversation. Four cases (n = 4) were selected for in-depth vignette-based analysis based on explicit consent for secondary analysis and quotation, sufficient narrative density/legibility of written material, completion of co-reading discussion, and feasibility of de-identification. Data were analyzed using case-centered narrative summaries and reflexive thematic analysis, attending to both content and material features of handwriting. The analysis foregrounded three recurring patterns. (1) "No one was watching": participants described moving through unsupervised spaces where adults were absent or silent; substance use was framed as both relief and proof of invisibility, and neglect appeared as both wound and perceived freedom from scrutiny. (2) "My body on the page": writers portrayed the body as a site of self-neglect and communication, describing hunger, injury, dirt, ignored symptoms, and hygiene or clothing as shields that kept others away or signaled distress that others did not read. (3) "Writing from after": letter and then/now formats staged dialogue between youth and adult selves, redistributing responsibility for neglect across families, institutions, and self while also acknowledging harms caused during use. Handwritten diary-style writing, paired with participant-led co-reading, generated temporally layered narratives of youth addiction and neglect that extend beyond single interview recall. The approach positions writing as an active practice of identity reconstruction in recovery and offers a practical method for qualitative substance-use research where control over disclosure and careful attention to shame, stigma, and omission of care are essential.
While life-course research has emphasized the role of early-life adversity in shaping substance use trajectories, less attention has been paid to developmentally normative yet emotionally salient experiences, such as adolescent romantic breakups (ARBs). This study examined associations between ARBs and substance use patterns (alcohol, tobacco, and cannabis) and addiction-related risk among emerging adults in the Delhi National Capital Region, independent of adverse childhood experiences (ACEs). This cross-sectional study included 1468 college-going young adults aged 18-25 years. ARB was defined as experiencing a romantic breakup before age 18. Substance use and addiction-related risk were assessed using the WHO ASSIST. ARB was associated with higher odds of lifetime alcohol use (adjusted OR [aOR] = 2.55), frequent alcohol use (aOR = 4.77), and alcohol-related addiction risk (aOR = 3.59). Similar associations were observed for tobacco (lifetime use aOR = 2.97; addiction risk aOR = 3.13) and cannabis, particularly for frequent use (aOR = 6.27). These associations remained significant after adjustment for ACEs. However, correlations between substance use and addiction risk were comparable among participants with and without ARB. ARB may be an overlooked but important factor associated with substance use initiation and escalation in emerging adulthood, alongside other factors, including mental health.
Sleep disturbances are common in individuals with Internet gaming disorder (IGD), yet the neurobiological links between poor sleep quality and addictive symptoms remain unclear. The glymphatic system contributes to cerebrospinal fluid-interstitial fluid exchange and metabolic waste clearance, processes that are closely related to sleep physiology. Diffusion tensor image analysis along the perivascular space (DTI-ALPS) provides a non-invasive MRI-based marker related to glymphatic system function. In parallel, middle frontal gyrus (MFG)-centred functional connectivity may reflect prefrontal network alterations associated with cognitive control and addiction severity in IGD. The study included 30 individuals with IGD and 37 demographically matched healthy controls (HCs). All participants underwent diffusion tensor imaging and resting-state functional MRI. DTI-ALPS was used to assess glymphatic system-related function. Resting-state functional connectivity analysis was performed using the MFG as the seed region. Group differences in ALPS indices were tested while controlling for age, education years and mean framewise displacement. Within the IGD group, correlation analyses were conducted to examine associations among ALPS indices, PSQI scores, MFG-centred functional connectivity and IAT scores. Individuals with IGD showed significantly lower mean and left ALPS indices than HCs. The right ALPS index showed a non-significant trend towards reduction. Within the IGD group, higher PSQI scores were associated with lower mean, left and right ALPS indices, suggesting that poorer subjective sleep quality was related to reduced glymphatic system-related function. MFG-centred functional connectivity analysis showed increased connectivity mainly involving medial and superior frontal regions and decreased connectivity involving subcortical regions. Stronger MFG-centred functional connectivity was positively correlated with IAT scores, indicating an association with greater addiction severity. This study integrates DTI-ALPS and MFG-centred resting-state functional connectivity to examine sleep-related glymphatic alterations and prefrontal network changes in IGD. Lower ALPS indices were associated with poorer sleep quality, whereas stronger MFG-centred connectivity was associated with greater addiction severity. These findings support a potential sleep-glymphatic-prefrontal network framework for understanding IGD. Longitudinal and interventional studies are needed to clarify the directionality of these associations.
Objective: This study investigated current clinical practices, organizational barriers, and resource availability in managing dual diagnosis (co-occurring psychiatric and substance use disorders) among Italian psychiatrists in a healthcare system characterized by service fragmentation between mental health and addiction care. Methods: A structured, self-administered online questionnaire was distributed nationwide to Italian psychiatrists. The survey covered demographic characteristics; organizational aspects and service collaboration; pharmacological and nonpharmacological approaches; and perceived clinical challenges. Data were analyzed descriptively to identify practice patterns and priority intervention areas. Results: Seventy-nine psychiatrists participated from diverse settings (38% addiction services, 25% community mental health services, 14% hospitals, 15% other facilities). While 78% regularly treated dual diagnosis patients, only 38% reported structured protocols between mental health and addiction services. Collaboration was rated as only partially effective by 44%. Integrated treatment was preferred by 61%. The most commonly prescribed medications included mood stabilizers (94%), atypical antipsychotics (68%), anticraving agents (54%), and antidepressants (37%). For depression, trazodone (32%) and serotonergic antidepressants (25%) were used most. For psychosis, aripiprazole (47%) was predominant. Most clinicians (81%) combined pharmacotherapy with psychosocial interventions. Key barriers included insufficient training (67% highlighted need for specialized clinicians), poor service integration, and diagnostic uncertainty. Conclusions: Significant gaps persist in Italian dual diagnosis care despite clinical awareness. Urgent priorities include routine screening, clinician training, national guideline development, organizational reforms promoting service collaboration, and increased availability of structural resources, which was reported as insufficient by 61% of respondents. These improvements are essential for delivering timely, evidence-based, integrated care to this vulnerable population.
Cue-reactivity and impaired inhibitory control represent well-established mechanisms contributing to substance use relapse, which, in turn, increases the risk of criminal reoffending in forensic populations whose offending behavior is closely linked to substance use. In Germany, such individuals may be mandated to custodial addiction treatment under Section 64 of the Criminal Code (§ 64 StGB). To date, it remains largely unexplored whether inhibitory control deficits under substance-cue exposure relate more directly to indicators of criminal recidivism risk in forensic addiction populations. The present work addresses this gap by examining the relationship between cue-induced inhibitory control and a validated proxy of reoffending risk. Fifty-one abstinent male forensic patients (24 with alcohol use disorder (AUD), 27 with other substance use disorders (SUD)) undergoing treatment under Section 64 completed two Go/NoGo tasks assessing inhibitory control under alcohol-related and neutral stimulus conditions. Controlling for relevant covariates, inhibitory performance (adjusted d ' ) was used to predict scores on Factor 2 of the Psychopathy Checklist: Screening Version (PCL:SV). Among patients with AUD, weaker inhibitory control in the alcohol-cued condition was strongly associated with higher PCL:SV Factor 2 scores (β = -0.79, p = .004), whereas no such association emerged for the neutral condition or for patients with other SUDs. These findings suggest a context-specific link between cue-elicited inhibitory deficits and criminogenic risk in forensic patients with AUD. Cue-related inhibitory impairments may represent a key cognitive mechanism connecting substance use to criminal (re-)engagement. If replicated longitudinally, such measures may inform future approaches to risk assessment and intervention in forensic addiction treatment.
Transcranial direct current stimulation (tDCS) is a viable non-invasive approach to counter nicotine addiction. This systematic review and meta-analysis aim to investigate the effects of tDCS on smoking behaviours in Nicotine Use Disorder (NUD) and explore neuroimaging findings related to these effects. Systematic review following PRISMA guidelines shortlisted 21 studies. Primary outcome measures were effects of tDCS vs sham on smoking (i) craving, (ii) consumption and (iii)accompanying neuroimaging results. Random effects meta-analysis was conducted on 6 comparisons for smoking craving and 13 comparisons for smoking consumption. Anodal and cathodal stimulations were evaluated as moderator variables via meta-regression. Five studies with neuroimaging data supporting tDCS effects on smoking behaviours were reviewed. GRADE methodology was applied to assess evidence quality. Compared to sham, tDCS produced a small reduction in nicotine craving (Hedges' g = -0.26, 95%CI (-0.51, -0.01)) with moderate certainty, and moderate reduction in consumption (Hedges' g = -0.48, 95%CI [-0.79, -0.17],) with low certainty; all within the first day post-stimulation. Moderator analyses did not identify specific electrode placements that effectively reduce nicotine craving or intake. Five studies evaluated tDCS effects on smoking behaviours with neuroimaging support namely fMRI, fNIRS and EEG, providing additional insights to neurobiology of nicotine addiction. Current evidence indicates that tDCS may be associated with changes in craving and consumption in NUD. Further research is required to establish efficacy, identify key moderators, and integrate neuroimaging to explore tDCS effects in smoking cessation.
Over the last decades alcohol intake has decreased among the Swedish men but been on the rise among the women, thus leading to an increased risk of alcohol dependence (AD) and related consequences among the Swedish women. The aim of this study was therefore to compare the mortality between women with AD and population-matched controls. Data were retrieved from the medical records of 2,037 women with AD at the Addiction Centre in Malmö in 1970-2013 and followed up until 2019. They were matched by sex, age, and calendar year with a control group from the general population in Region Skåne. For persons who died during follow-up, death certificates were obtained from the national registers to obtain time and cause of death. The mortality was compared between the groups as observed vs. expected, cumulative survival was assessed by comparing the survival rates of the women with AD to those of the control group. The cumulative survival was calculated as observed compared to expected. The cumulative survival and standardized life expectancy were significantly reduced for the women with alcohol dependence compared to the matched controls; T1/2 = 21 vs. 11, p < 0.05 and OR 1.9 CI 1.73-2.02, respectively. More women with alcohol addiction passed away due to accidental and intended causes of death (15.5% vs. 2.8%, p < 0.05). Their cause-specific mortality was significantly increased for mental health disorders, respiratory and digestive diseases, but significantly lower for cardiovascular and cancer diseases. This study showed that the mortality among Swedish women with long term alcohol dependence was significantly increased, thereby suggesting a need for a special focus on this group.
The Saini-Hodgins Addiction Risk Potential of Games (SHARP-G) is a recently developed instrument designed to assess the addictive potential of video games based on their structural characteristics. While the novel instrument is highly valuable, its applicability may pose several challenges. In this work, we introduce the SHARP-G-R, a revised version featuring modifications of selected items and an overall simplification of language to improve clarity and accessibility. This updated iteration enhances the interpretability of the items, removes those with limited empirical support, and introduces new items that capture additional relevant features that may contribute to the addictive potential of games. The commentary outlines all modifications made and provides a detailed rationale for each of them. By refining the instrument, the authors aim to contribute to the discourse on the role of game design in the development and maintenance of gaming-related harms, highlighting the ethical responsibilities of the gaming industry in fostering safer gaming environments.
Optimal hepatitis C virus (HCV) screening is required to prevent transmission and progression to advanced liver disease and to meet global elimination targets. While administrative health data can highlight trends in testing and treatment, additional information is required to understand barriers in the care cascade. We conducted a real-world analysis documenting the care cascade and the effectiveness of HCV antibody (Ab) screening modalities across different community and clinical settings. This was a cross-sectional study of individuals who completed HCV Ab testing at participating centers in Ontario, Canada, between May 2010 and June 2023. Among 61 605 individuals tested, the prevalence of HCV Ab was 13.6% and highest among individuals aged 35-44 years (23.2%) and individuals tested at addiction clinics (41.0%). Among those with an HCV Ab-positive result, 79.7% ever completed RNA testing of whom 57.3% were RNA positive. Among those with an RNA-positive result, 65.0% attended a follow-up appointment. Among those who attended their appointment, 94.0% initiated treatment (61.1% of the RNA-positive), 77.4% of those who started had documented treatment completion (47.3% of the RNA-positive), and 59.6% of those who completed treatment had documented sustained virologic response 12 weeks after treatment (28.2% of the RNA-positive). The Ab testing modality was closely related to test setting, and primary care was the most effective at linkage to care. While there was some attrition from HCV Ab positivity to RNA testing, treatment initiation was higher compared with administrative data. These results highlight the benefits of multiple testing modalities and matching the optimal Ab testing modality to the setting, with strong pathways for linkage to care.
The widespread adoption of smartphones, while bringing considerable convenience, has also given rise to issues such as smartphone addiction, nomophobia, and fear of missing out (FoMO). In the healthcare field, particularly within the nursing profession, excessive smartphone use has been linked to frequent work interruptions, delays in critical tasks, lapses in concentration, and even clinical errors, all of which seriously undermine the quality of nursing care-a domain where work immersion serves as a core indicator. However, there remains a notable research gap in integrating nomophobia, fear of missing out and work immersion within the nursing population, especially through symptom-level network analysis. This study aimed to (1) identify central symptoms within the nomophobia-fear of missing out-work immersion symptom network, and (2) detect the bridging pathways that link these symptom clusters. A total of 479 nurses were recruited via snowball sampling. Data were collected using the Nomophobia Questionnaire, the Fear of Missing Out Scale, and the Work-Related Flow Inventory. Symptom networks were estimated using the EBICglasso model. Centrality and bridge centrality indices were computed to identify the most influential symptoms within the network and the most influential links between symptom clusters, respectively. N2 (Giving up convenience) is the most central symptom; N1 (Not being able to access information) and F2 (Fear of Missing Information) are key bridging symptoms, whereas work immersion serves as a significant protective factor. The insights from this study clarify the interconnected psychological mechanisms linking nomophobia and fear of missing out to reduced work immersion among nurses. This understanding not only highlights critical intervention points but also supports the formulation of evidence-based institutional guidelines. Consequently, we recommend that healthcare organisations adopt tailored policies, dedicated training programs, and enhanced environmental support measures aimed at safeguarding nurse welfare and optimising professional efficacy. Not applicable.
There is still insuffi cient data whether problematic internet use (PIU) is linked with physical symptoms associated with mental disorders, particularly among student demographics. This study was conducted to determine whether problematic internet use (PIU) in adults is associated with physical symptoms linked to mental disorders. An anonymous online survey included the nine-item Problematic Internet Use Questionnaire (PIUQ-9) to measure PIU and the 15-item Patient Health Questionnaire (PHQ-15) to measure physical symptoms associated with mental disorders. Depression symptoms were measured with the Patient Health Questionnaire (PHQ-9) and anxiety symptoms with the seven-item General Anxiety Disorder (GAD-7) scale. The study included 207 students (mean age: 23 ± 3 years, 83.6% women). Signifi cant correlations were identifi ed between PIUQ-9 scores and physical symptoms. Multivariable regression analysis, adjusting for age, gender, and PHQ-9 and GAD-7 scores, revealed associations between PIU and physical symptoms: extremity/joint pain (β = 0.161, p = 0.019), sexual dysfunction (β = 0.145, p = 0.032), chest pain (β = 0.135, p = 0.047), and fatigue (β = 0.214, p = 0.005). High levels of PIU in young adults were associated with physical symptoms linked to mental disorders irrespective of age, sex, depression, and anxiety symptoms. (Neuropsychopharmacol Hung 2026; 28(2): 57-65) Keywords: internet addiction disorder, anxiety, depression, medically unexplained symptoms, mental disorders.
The nucleus accumbens (NAc) is a key component of the mesolimbic dopamine system that is implicated in several neuropsychiatric disorders. The NAc contains transcriptomically distinct medium spiny neuron (MSN) subtypes, but their spatial organization remains unclear. We generated a spatiomolecular atlas of the human NAc by integrating paired single-cell and spatial transcriptomics of postmortem NAc tissue. We identified transcriptionally unique cell populations and spatial domains (SpDs), including D1 islands composed of discrete MSN subtypes enriched for dopamine receptor D1 (DRD1) and OPRM1. We demonstrated continuous spatial gene expression gradients across the NAc and evolutionary conservation of spatial features. We also identified SpDs associated with risk for psychiatric and addiction-related traits and spatially mapped risk-associated ligand-receptor interactions. Finally, we predicted enrichment of drug-responsive transcriptional programs in both SpDs and cell types. Collectively, we provide a spatiomolecular framework for understanding the relevance of the human NAc in neuropsychiatric diseases.
Social workers regularly encounter clients affected by substance use disorders (SUD), yet training in evidence-based assessment and interventions remains limited. In Sweden, municipal social workers have statutory responsibility for SUD assessment, intervention planning and client follow-up which underscores the need for targeted professional education. This study aimed to: (i) describe social workers' baseline self-assessed competence in evidence-based practices for SUD and its associations with demographic and professional characteristics, and; (ii) examine knowledge gains associated with completion of an evidence-based educational intervention. A non-randomized pre-post design included 173 municipal social workers recruited from 64 municipalities across five cohorts (2021-2023). Baseline self-assessed competence was analyzed using ordinal logistic regression, and knowledge gains were assessed using module-specific pre-post items with paired t-tests with Cohen's d. Baseline competence was rated as low to moderate, with professional experience predicting higher perceived competence. Substantial baseline knowledge gaps were observed, particularly in evidence-based psychosocial interventions and use of digital technology in assessment and planning of treatment. Knowledge increased significantly across all modules after training completion (d = 0.26-1.41). The largest knowledge gains were for modules on use of technology in the assessment and treatment-planning, biopsychosocial interventions, research-informed use of the assessment tool Addiction Severity Index (ASI), and the professional role in assessment and care planning. Score variability decreased across several modules. Completion of an immersive, online, evidence-based training was associated with meaningful improvements in social workers' knowledge related to substance use assessment, intervention planning, and use of technology. Although causal inference is limited by the non-randomized single-group pre-post design, the findings support the potential of scalable educational interventions to address competence gaps in substance use services even in organizations with high caseloads, workforce turnover, and limited training opportunities.
This research studies the impact of improving access to treatment for substance use disorders by reducing wait times. Linked individual-level administrative data are used to estimate the impacts of wait times on patients' treatment service utilization and employment. Potential confounding is addressed using an instrumental variables strategy that exploits exogenous variation in wait times generated by local congestion in the healthcare system. We find that longer wait times lead to increased use of treatment services in the focal treatment episode, raised re-entry into subsequent treatment episodes, and lowered employment, consistent with patients' health deteriorating while waiting for treatment. Our calculations suggest that each dollar spent on reducing wait times yields a return of between six and seven dollars. These findings demonstrate that shortening wait times for treatment can significantly reduce the economic and social burdens of addiction.