A commonly carried genetic variant in the delta opioid receptor gene,OPRD1, is associated with smaller regional brain volumes: Replication in elderly and young populations

Delta opioid receptors are implicated in a variety of psychiatric and neurological disorders. These receptors play a key role in the reinforcing properties of drugs of abuse, and polymorphisms in OPRD1 (the gene encoding delta opioid receptors) are associated with drug addiction. Delta opioid receptors are also involved in protecting neurons against hypoxic and ischemic stress. Here, we first examined a large sample of 738 elderly participants with neuroimaging and genetic data from the Alzheimer's Disease Neuroimaging Initiative. We hypothesized that common variants in OPRD1 would be associated with differences in brain structure, particularly in regions relevant to addictive and neurodegenerative disorders. One very common variant (rs678849) predicted differences in regional brain volumes. We replicated the association of this single‐nucleotide polymorphism with regional tissue volumes in a large sample of young participants in the Queensland Twin Imaging study. Although the same allele was associated with reduced volumes in both cohorts, the brain regions affected differed between the two samples. In healthy elderly, exploratory analyses suggested that the genotype associated with reduced brain volumes in both cohorts may also predict cerebrospinal fluid levels of neurodegenerative biomarkers, but this requires confirmation. If opiate receptor genetic variants are related to individual differences in brain structure, genotyping of these variants may be helpful when designing clinical trials targeting delta opioid receptors to treat neurological disorders. Hum Brain Mapp 35:1226–1236, 2014. © 2013 Wiley Periodicals, Inc.     

Internet use and addiction among Finnish Adolescents (15–19 years)

This study investigates Internet use among Finnish adolescents (n = 475) combining qualitative and quantitative research. Internet use was evaluated using the Internet Addiction Test (Young, 1998a, Young, 1998b). The data was divided into three parts according to the test scores: normal users (14.3%), mild over-users (61.5%), and moderate or serious over-users (24.2%). The most common reason for use was having fun. While half the students reported disadvantages associated with their use, further qualitative analysis revealed that students with serious overuse did not report any harm caused by using the Internet. As disadvantages of using the Internet, students reported that it is time-consuming and causes mental, social, and physical harm and poor school attendance. Four factors of Internet addiction were found, and for two of them, a statistical difference between females and males was found.     

Attachment and family functioning in patients with Internet addiction

Objective

Although the Internet is used effectively in many areas of life, some users experience problems because of over-use due to a lack of control. The diagnostic criteria for Internet addiction include disruptions in family relationships, but adequate data on the attachment styles and family functioning associated with this condition are limited. This study aimed to investigate the attachment styles and family functioning of patients with Internet addiction.

Method

The sample included 30 male patients consecutively admitted to the Bak?rköy Mental Health and Research Hospital Internet Addiction Outpatient Clinic, who were diagnosed in clinical interviews as having Internet addiction according to Young’s (1998) criteria. Thirty healthy males who were matched with the experimental group in terms of sociodemographic characteristics were included as control subjects. Both groups provided sociodemographic data and completed the Beck Depression Inventory (BDI), the Experiences in Close Relationships Questionnaire-r (ECR-r) and the Family Assessment Device (FAD).

Results

Patients with Internet addiction had higher BDI scores (P< .001) and higher attachment anxiety subscores on ECR-r (P< .001) compared with those in the control group. Patients with Internet addiction evaluated their family functioning as more negative and reported problems in every aspect addressed by the FAD. Scores on the FAD behaviour control, affective responsiveness, and problem-solving subscales (P< .05) and on the FAD communication, roles, and general functioning subscales (P< .001) were significantly higher in the patient compared with the control group.

Conclusion

Patients with Internet addiction have more anxious attachment styles as well as prominent disruptions in family functioning. Thus, it may be important to evaluate the attachment styles and family functioning of patients with Internet addiction. Indeed, comprehensive treatment approaches including other family members may make important contributions to treatment success.     

Anhedonia in obsessive-compulsive disorder: Beyond comorbid depression

Obsessive-compulsive disorder (OCD) has been linked to reward dysfunctions, highlighting a possible role of anhedonia in OCD. Surprisingly, anhedonia in OCD has never been evaluated. Moreover, although nicotine typically has anti-anhedonic effects, anecdotal reports suggest low prevalence rates of smoking in OCD. To address these two phenomena, 113 individuals with OCD completed a battery of questionnaires assessing symptom severity, anhedonia, and smoking. 28.3% of the sample met criteria for clinically significant anhedonia, which correlated with Y-BOCS scores (r=0.44), even when controlling for depressive symptoms. 13.3% of the sample endorsed current smoking, a lower rate than seen in psychiatric disorders (40–90%) and the general adult population (19%). Results highlight high rates of anhedonia and yet reduced prevalence of smoking in OCD. In contrast to the known positive association between anhedonia and smoking, a negative association emerged. Future research is needed to address the unique interface between anhedonia and reward responsiveness in OCD. Potential clinical implications are discussed.     

Causes of metabolic syndrome and obesity-related co-morbidities Part 1: A composite unifying theory review of human-specific co-adaptations to brain energy consumption

One line summary

Metabolic syndrome and obesity-related co-morbidities are largely explained by co-adaptations to the energy use of the large human brain in the cortico-limbic-striatal and NRF2 systems.

The medical, research and general community is unable to effect significantly decreased rates of central obesity and related type II diabetes mellitus (TIIDM), cardiovascular disease (CVD) and cancer. All conditions seem to be linked by the concept of the metabolic syndrome (MetS), but the underlying causes are not known. MetS markers may have been mistaken for causes, thus many treatments are destined to be suboptimal.The current paper aims to critique current paradigms, give explanations for their persistence, and to return to first principles in an attempt to determine and clarify likely causes of MetS and obesity related comorbidities. A wide literature has been mined, study concepts analysed and the basics of human evolution and new biochemistry reviewed. A plausible, multifaceted composite unifying theory is formulated.The basis of the theory is that the proportionately large, energy-demanding human brain may have driven co-adaptive mechanisms to provide, or conserve, energy for the brain. A ‘dual system’ is proposed. 1) The enlarged, complex cortico-limbic-striatal system increases dietary energy by developing strong neural self-reward/motivation pathways for the acquisition of energy dense food, and (2) the nuclear factor-erythroid 2-related factor 2 (NRF2) cellular protection system amplifies antioxidant, antitoxicant and repair activity by employing plant chemicals, becoming highly energy efficient in humans.The still-evolving, complex human cortico-limbic-striatal system generates strong behavioural drives for energy dense food procurement, including motivating agricultural technologies and social system development. Addiction to such foods, leading to neglect of nutritious but less appetizing ‘common or garden’ food, appears to have occurred. Insufficient consumption of food micronutrients prevents optimal human NRF2 function. Inefficient oxidation of excess energy forces central and non-adipose cells to store excess toxic lipid. Oxidative stress and metabolic inflammation, or metaflammation, allow susceptibility to infectious, degenerative atherosclerotic cardiovascular, autoimmune, neurodegenerative and dysplastic diseases.Other relevant human-specific co-adaptations are examined, and encompass the unusual ability to store fat, certain vitamin pathways, the generalised but flexible intestine and microbiota, and slow development and longevity.This theory has significant past and future corollaries, which are explored in a separate article by McGill, A-T, in Archives of Public Health, 72: 31.     

Failings of the disease model of addiction

Colloquially, addiction ranges in meaning from addiction to good deeds to addiction to substances of abuse. Especially during the last four decades, ‘addiction’ in this extreme pejorative meaning has been portrayed alternatively as a disease or a sin, and has been subject to social and moral sanctions. In an open society of free individuals such a coercion cannot be justified unless the condition is defined precisely by the simultaneous attributes of severe psychotoxicity, severe withdrawal symptoms, and recurrence tied to the loss of self-control and individual volition. Still, these attributes are open-ended, and an explicit metric of severity at which they may trigger social objection has not been clarified. As a consequence, ‘addiction’ allegations are left to elicit emotional, subjective, and value-laden responses ready to be exploited. A clamorous example is the claim by US officials that cigarette smoking is equal to the abuse of heroin or cocaine. An unequivocal definition of ‘addiction’ may restore some sense of proportion to official normative intervention. © 1996 John Wiley & Sons, Ltd.     

Addiction on prescribed sedative-hypnotics

This paper reviews the conceptualization of addiction on prescribed sedative-hypnotics medications; its evolution, occurrence, characteristics and validity. Such addictive behaviour is often concurrent with severe anxiety and/or personality disorders and follows a dismal course. The rate of suicide is very high, particularly in health care personnel with access to lethal medications. The risk of developing this kind of addiction is miniscule, considering the mass exposure to these medications in the general population. Yet, moralizing arguments amplified by the media, as well as overzealous government interventions create unnecessary obstacles to proper and effective pharmacotherapy for morbid anxiety and insomnia. © 1996 John Wiley & Sons, Ltd.     

Classical conditioning in humans: nicotine as CS and alcohol as US

Animal studies suggest that drug effects can act as conditioned stimuli for various unconditioned stimuli including the effects of other drugs. The current study investigated drug-drug conditioning in human subjects. Sixteen subjects were given subcutaneous injections of either nicotine or saline before consumption of an alcoholic or soft drink in each of eight sessions. Across sessions the content of the injections was established as a reliable predictor of the alcoholic content of the drink. Physiological, subjective, and behavioural responses to the injections were used as indices of conditioning. Skin conductance measures obtained following the injections changed across trials in a way consistent with a conditioned response though patterns of change on cardiac inter-beat interval were less clear. However, neither behavioural nor subjective measures showed conditioning effects. In view of the number of variables studied the evidence for the development of conditioned responding on physiological measures must be suspected of being a type I error and is in need of replication. Subjects' reports revealed that nicotine and saline injections were difficult to discriminate. This would have weakened conditioning effects. Suggestions are made for improvements in the design of future studies of drug-drug conditioning in human subjects.     

Acupuncture for Internet addiction: A protocol for systematic review

Background:Internet addiction (IA) has become a global problem characterized by excessive use of the internet, compulsive, and deleterious personal behaviors. Acupuncture has gained more and more attention in the treatment of IA. However, evidence of its effectiveness is lacking. The purpose of this systematic review is to evaluate the efficacy and safety of acupuncture in the treatment of IA.Methods:The following databases will be searched from the inception to September 30, 2020: the Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Wan-fang database, Chinese Biomedical Literature Database, and Chinese Scientific Journal Database. The research on acupuncture and IA meets the screening criteria, and two independent reviewers performed citation screening, data extraction, and risk assessment of bias. We used Cochrane Review Manager 5.3 software for statistical analysis.Results:The findings will be published at scientific conferences or in a peer-reviewed journal. This study is based on the existing research, so there is no need for ethical approval.Conclusion:This systematic review provides evidence for the efficacy of acupuncture in treating IA disorder, and it is of great significance for effective clinical routine treatment of IA.Trial registration number:INPLASY 2020120099     

A comparison of fraud to fund gambling with fraud for other reasons

In order to compare the characteristics, including diagnosed mental disorder, of people who commit fraud offences to fund gambling with those who committed fraud for other reasons, we examined a complete series of reports prepared for legal proceedings by two of the authors from between January 2002 and June 2019. A total of 160 fraud offenders were located, of whom 48 (30%) reported offending to fund gambling. Females made up 47.5% of the total sample and 43.8% of the gamblers. Of the problem gambling group, 44% had diagnoses of anxiety or depression, 44% had substance use disorder, 17% had bipolar and other psychosis, and 38% reported childhood trauma. There were no significant differences in the frequencies of diagnosis of mental illness or previous criminal convictions compared to the non-gambling group. Two thirds reported only gambling on poker machines. Only 19% of gamblers reported seeking treatment prior to being charged.