Suchergebnisse

<b><i>Introduction:</i></b> Although sport activities have beneficial effects on health, excessive practice can lead to exercise addiction (EA), which can be associated with other addictive behaviors. However, results regarding the comorbidities between EA and alcohol use disorder (AUD) remain heterogeneous. This study aims to investigate the relationship between a proxy of AUD and different sport practices, more specifically focusing on EA. <b><i>Methods:</i></b> One thousand nine hundred eighty-five (<i>N</i> = 1,985) participants were recruited online and selected to represent the French adult population. Participants were asked to answer questions regarding sport activity, with the EA inventory questionnaire investigating EA, and alcohol consumption, with the CAGE questionnaire investigating a proxy of AUD (score ≥2). <b><i>Results:</i></b> AUD was associated with a higher risk of EA and with more time devoted to collective sports (such as football) and two-person sports (such as tennis). The risk of EA was higher for individual sports (such as running), and the risk of AUD seems to increase with the level of physical activity for collective sport but to decrease for individual sports. The type of sports partly but significantly mediated the relationship between AUD and EA. <b><i>Conclusions:</i></b> Results support the hypothesis that different types of sport have different risks for EA (individual sports being more concerned) and AUD (collective sports being more concerned). Results suggest that the type of sports may be a crucial variable to understand how physical activity can be a risk factor for alcohol disorders. The social dimension of collective sports should be further investigated to facilitate preventive approaches.

But : Le but de ce travail est de comparer les joueurs qui jouent à de tels jeux sur des sites comme les casinos ou les hippodromes (joueurs hors ligne) et ceux qui jouent en plus en ligne (joueurs mixtes) en traçant les profils de ces joueurs.
Méthode : 608 joueurs hors ligne et mixtes ont répondu à plusieurs questionnaires qui ont porté sur : 1) les données sociodémographiques (genre, âge, situation de famille, éducation) ; 2) les mesures de dépistage des usages problématiques des jeux de hasard et d'argent ; 3) la consommation d'alcool ; 4) les mesures d'anxiété et de dépression et 5) les mesures sociocognitives (distorsions cognitives et confiance en soi).
Résultats : L'échantillon, d'un âge moyen de 53.0 ans (de 17 à 76 ans ; E.T = 15,9) est composé majoritairement de femmes (femmes : 60 % ; hommes : 39 %) ; 55 % des personnes interrogées vivent en couple. Seulement 23,7 % (N = 144) des participants sont des joueurs mixtes. En ce qui concerne la consommation d'alcool, 31,5 % (N = 191) ont des conduites à risque ou problématiques ; au niveau du jeu 19,6 % (N = 109) sont considérés à risque modéré selon l'indice canadien de jeu excessif (ICJE, 2001), alors que 9 % (N = 55) sont des joueurs pathologiques probables. Les joueurs mixtes sont de façon significative plus jeunes, jouent plus, ont des scores à l'ICJE plus élevés, sont plus anxieux et ont une plus grande consommation d'alcool. Ils présentent également des distorsions cognitives plus intenses (contrôle prédictif), mais ont, en revanche, moins confiance en leur capacité d'arrêter de jouer que les joueurs hors ligne.
Conclusion : Une sévérité accrue au jeu pathologique et des distorsions cognitives plus intenses rendent la population des joueurs mixtes fragile. Quelques pistes d'intervention et de prévention seront proposées en guise de conclusion.

Abstract

Objective
Alcohol withdrawal syndrome (AWS) is a frequent and potentially life-threatening condition experienced in alcohol use disorder. Since hypomagnesemia is involved in AWS's severity, we conducted a multicenter double-blind randomized placebo-controlled trial to examine the efficacy of oral magnesium supplementation as an adjuvant therapy of AWS.


Material and Methods
Inpatients were recruited in six different centers if they had a baseline score higher than eight on the Revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar). The experimental treatment was magnesium lactate dehydrate, administrated three times per day providing a total of 426.6 mg per day and up to 15 days. The primary endpoint was the significant between-group difference of the CIWA-Ar total score change from baseline to 3 days later. The treatment group and baseline score were introduced as covariables in an analysis of covariance.


Results
A total of 98 inpatients were included {71.4% of men; mean age of 49.1 years [standard deviation (SD): 10.3]}. In the intention-to-treat population, the mean reduction of the CIWA-Ar score in the experimental group between baseline and 3 days later was 10.1 (SD: 5.2), whereas it was 9.2 (SD: 3.9) in the control group. The absolute difference of the adjusted mean in the experimental group compared with the control group was −0.69 (SD: 0.72), which did not correspond to a significant between-group difference (P = 0.34). Per-protocol analysis and sensitivity analyses also supported this result. Supplementary analyses found no significant difference regarding benzodiazepine consumption, magnesium blood concentration, and satisfaction to care.


Conclusions
The present study does not support the rationale of systematic oral magnesium supplementation in patients with AWS.

Brain disorders pose major challenges to medicine and treatment innovation. This is because their spectrum spans inflammatory, degenerative, traumatic/ischaemic, and neoplastic disease processes with a complex and often ill- understood aetiology. An improved genetic and genomic understanding of specific disease pathways offers new approaches to these challenges, but at present it is in its infancy. Here, we review different aspects of the challenges facing neuromedicine, give examples of where there are advances, and highlight challenges to be overcome. We see that some disorders such as Huntington's disease are the product of single gene mutations, whose discovery has been leading to the development of new targeted interventions. In the field of neurosurgery, the identification of a number of mutations allows an elaborated genetic analysis of brain tumours and opens the door to individualised therapies. Psychiatric disorders remain the area where progress is slow. Genetic analyses show that for major common disorders such as schizophrenia and depression there are no single gene alterations which offer options for targeted therapy development. However, new approaches are being developed to leverage genetic information to predict patients' responses to treatment. These recent developments hold promise for early diagnosis, follow-up with personalised treatments with adjusted therapeutic doses, predictable responses, reduced adverse drug reactions, and personal health planning. The scenario is promising but calls for increased support for curiosity-driven research into the mechanisms of normal brain functioning as well as challenging adaptations of health care and research infrastructures, encompassing legal frameworks for analysing large amounts of personal data, a flexible regulatory framework for correlating big data analyses in cooperative networks between academia and the drug development industry, and finally new strategies for brain banking in order to increase access to brain tissue samples. To make personalised medicine for brain disorders a reality, a joint effort between all relevant stakeholders - among which patients and patient organisations should play an important role - is required.

Background. Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care. Methods. The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions. Results. We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures. Conclusions. We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions. ; publishedVersion ; © The Author(s), 2020. Published by Cambridge University Press on behalf of the European Psychiatric Association This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background. Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care. Methods. The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions. Results. We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures. Conclusions. We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.