Search Results (938)

The use of opioids for cancer-related pain is essential but poses significant challenges due to the risk of misuse and the development of opioid use disorder (OUD). This review takes a multidisciplinary perspective based on the current scientific literature to analyze the pharmacological mechanisms, classification, and therapeutic roles of opioids in oncology. Key risk factors for opioid misuse—including psychiatric comorbidities, prior substance use, and insufficient clinical monitoring—are discussed in conjunction with validated tools for pain assessment and international guidelines. The review emphasizes the importance of integrating toxicological, pharmacological, physiological, and public health perspectives to promote rational opioid use. Pharmacogenetic variability is explored as a determinant of treatment response and addiction risk, underscoring the value of personalized medicine. Evidence-based strategies such as early screening, psychosocial interventions, and the use of buprenorphine-naloxone are presented as effective measures for managing OUD in cancer patients. Ultimately, this work advocates for safe, patient-centered opioid prescribing practices that ensure effective pain relief without compromising safety or quality of life. Full article

The diagnosis of opioid use disorder (OUD) is prevalent due to increased prescribing of opioids. Long-term oxycodone self-administration can lead to addiction-like behavioral responses in rats. Herein, we sought to identify molecular pathways consequent to long-term exposure to oxycodone self-administration. Towards that end, we used male Sprague Dawley rats that self-administered oxycodone for 20 days according to short-(ShA, 3 h) and long-access (LgA, 9 h) paradigms. LgA rats escalated their oxycodone intake and developed into 2 phenotypes, labeled Long-access High (LgA-H) and Long-access Low (LgA-L) rats, based on their escalation. RNA sequencing analysis revealed the LgA-H has significantly different DEGs in comparison to other groups. DAVID analysis revealed the participation of LgA-H DEGs in potassium transport. RT-PCR analysis of striatal samples validated the increased levels of potassium channels. Since these increases correlated with oxycodone intake, we believe potassium channels are potential targets for the treatment of oxycodone use disorder Full article

Background/Objectives: The consumption of opioids is a public health problem that significantly affects quality of life. In Spain, 7585 people are enrolled in the Methadone Maintenance Programme (MMP), which is an effective intervention with a low adherence rate. In this study, factors associated with the quality of life of MMP users, especially perceived social support and treatment adherence, were analysed. We hypothesised that low levels of adherence and social support would be associated with poorer quality of life. Methods: This was a cross-sectional observational study with an analytical approach. Quality of life (WHOQoL-BREF), perceived social support (DUKE-UNC-11), and treatment adherence (MMAS-8) among MMP users were studied, and data on sociodemographic and clinical characteristics were collected through ad hoc questionnaires and a review of electronic medical records. Linear and logistic regression models were used. Results: A total of 70 individuals were included in this study. The mean age was 56.9 years, and 83% of the participants were male. The perceived quality of life was low in the four domains evaluated (range of 47.4–48.2). A total of 38.57% of the participants had low perceived social support. Treatment adherence was low or moderate in 77.1% of the participants. Greater perceived social support was associated with better quality of life in all domains (p < 0.05). Quality of social life was negatively associated with the use of nonbenzodiazepine neuroleptics and HIV status. Treatment adherence was lower in insulin therapy users. Conclusions: Social support is a key determinant of the quality of life of MMP users. Health policies should promote social support networks as a strategy to improve the well-being of this population. Full article

Food addiction is characterized by compulsive consumption and impaired control over highly palatable foods, with neurobiological mechanisms analogous to substance use disorders. The Yale Food Addiction Scale 2.0 (YFAS 2.0) is the most widely used instrument to assess these symptoms; however, its psychometric properties have not been validated in Mexican adults. This study aimed to perform the cross-cultural adaptation of the YFAS 2.0 and validate its psychometric properties for the identification of food addiction in the Mexican adult population. A cross-sectional study was conducted in 500 Mexican adults aged 20 years or older. Participants completed the cross-culturally adapted YFAS 2.0. Exploratory and hierarchical factor analyses were conducted. Reliability was assessed using Cronbach’s alpha and omega coefficients, and model fit was evaluated through global fit indices. The scale showed high internal consistency (α = 0.88; ωt = 0.87; ωh = 0.89). The Kaiser–Meyer–Olkin index was 0.815 and Bartlett’s test was significant (χ² = 4367.88; df = 595; p < 0.001). Exploratory factor analysis supported a unidimensional structure, with the first factor explaining 21.3% of the total variance. In the hierarchical model, all items loaded substantially onto the general factor. Fit indices indicated excellent model fit (CFI = 0.99; TLI = 0.98; RMSEA = 0.001; RMR = 0.004). The YFAS 2.0 is a valid and reliable instrument for identifying food addiction symptoms in Mexican adults. It may be useful in clinical practice and research on eating disorders. Full article

Background/Objectives: In an increasingly pervasive digital environment, trait boredom has been identified as a key psychological factor in the onset and maintenance of problematic digital technology use. This systematic review aims to investigate the role of trait boredom in digital behavioral addictions, including problematic smartphone use, Internet and social media overuse, and gaming addiction, through theoretical models such as the I-PACE model and the Compensatory Internet Use Theory (CIUT). Methods: A systematic literature search was conducted across multiple scientific databases (PsycINFO, Web of Science, PubMed, and Scopus), yielding a total of 4603 records. Following the PRISMA guidelines after duplicate removal and screening based on title and abstract, 152 articles were assessed for full-text eligibility, and 28 studies met the predefined inclusion and exclusion criteria and were included in the final review. Results: Findings reveal that trait boredom functions as both a direct and indirect factor in problematic technology use. It serves as a mediator and moderator in the relationship between psychological vulnerabilities (e.g., depression, alexithymia, vulnerable narcissism) and dysfunctional digital behaviors. Furthermore, as an independent variable, it has an influence on technological variables through Fear of Missing Out (FoMO), loneliness, low self-regulation, and dysfunctional metacognitions, while protective factors such as mindfulness and attentional control mitigate its impact. Conclusions: Boredom represents a central psychological lever for understanding behavioral addictions in the digital age and should be considered a key target in preventive and therapeutic interventions focused on enhancing self-regulation and meaningful engagement with free time. Full article

Food addiction (FA) is an emerging psychiatric condition that presents behavioral and neurobiological similarities with other addictions, and its early identification is essential to prevent the development of more severe disorders. The aim of the present study was to determine the ability of anthropometric measures, eating habits, symptoms related to eating disorders (ED), and lifestyle features to predict the symptoms of food addiction. Methodology: A cross-sectional study was conducted in a sample of 702 university students (77.3% women; age: 22 ± 6 years). The Food Frequency Questionnaire (FFQ), the Yale Food Addiction Scale 2.0 (YFAS 2.0), the Eating Attitudes Test (EAT-26), anthropometric measurements, and a set of self-report questions on substance use, physical activity level, and other questions were administered. A total of 6.4% of participants presented symptoms compatible with food addiction, and 8.1% were at risk for ED. Additionally, 26.5% reported daily smoking, 70.6% consumed alcohol, 2.9% used illicit drugs, and 29.4% took medication; 35.3% did not engage in physical activity. Individuals with food addiction had higher BMI (p = 0.010), waist circumference (p = 0.001), and body fat (p < 0.001) values, and a higher risk of eating disorders (p = 0.010) compared to those without this condition. In the multivariate logistic model, non-dairy beverage consumption (such as coffee or alcohol), vitamin D deficiency, and waist circumference predicted food addiction symptoms (R²_Nagelkerke = 0.349). Indeed, the machine learning approaches confirmed the influence of these variables. Conclusions: The prediction models allowed an accurate prediction of FA in the university students; moreover, the individualized approach improved the identification of people with FA, involving complex dimensions of eating behavior, body composition, and potential nutritional deficits not previously studied. Full article

Opioid use disorder (OUD) is a chronic disease that remains difficult to treat, even with significant improvements in available medications. While current treatments work well for some, they often do not account for the unique needs of individual patients, leading to less-than-ideal results. Precision medicine offers a new path forward by tailoring treatments to fit each person’s genetic, psychological, and social needs. This review takes a close look at medications for OUD, including methadone, buprenorphine, and naltrexone, as well as long-acting options that may improve adherence and convenience. Beyond medications, the review highlights the importance of addressing mental health co-morbidities, trauma histories, and social factors like housing or support systems to create personalized care plans. The review also explores how emerging technologies, including artificial intelligence and digital health tools, can enhance how care is delivered. By identifying research gaps and challenges in implementing precision medicine into practice, this review emphasizes the potential to transform OUD treatment. A more individualized approach could improve outcomes, reduce relapse, and establish a new standard of care focused on recovery and patient well-being. Full article

Background/Objectives: Muscle dysmorphia (MD), a subtype of body dysmorphic disorder, is prevalent among males who engage in the non-medical use of anabolic–androgenic steroids (AASs) and performance-enhancing drugs (PEDs). These individuals often experience severe psychopathology, including mood instability, compulsivity, and a distorted body image. Despite its clinical severity, no randomized controlled trials (RCTs) have evaluated structured psychological treatments in this subgroup. This study aimed to assess the efficacy of a manualized cognitive behavioral therapy (CBT) protocol in reducing MD symptoms and associated psychological distress among male steroid users. Results: Participants in the CBT group showed significant reductions in MD symptoms from the baseline to post-treatment (MDDI: p < 0.001, d = 1.12), with gains sustained at follow-up. Large effect sizes were also observed in secondary outcomes including depressive symptoms (PHQ-9: d = 0.98), psychological distress (K10: d = 0.93), disordered eating (EDE-Q: d = 0.74), and exercise addiction (EAI: d = 1.07). No significant changes were observed in the control group. Significant group × time interactions were found for all outcomes (all p < 0.01), indicating CBT’s specific efficacy. Discussion: This study provides the first RCT evidence that CBT significantly reduces both core MD symptoms and steroid-related psychopathology in men engaged in AAS/PED misuse. Improvements extended to mood, body image perception, and compulsive exercise behaviors. These findings support CBT’s transdiagnostic applicability in addressing both the cognitive–behavioral and affective dimensions of MD. Materials and Methods: In this parallel-group, open-label RCT, 59 male gym-goers with DSM-5-TR diagnoses of MD and a history of AAS/PED use were randomized to either a 12-week CBT intervention (n = 30) or a waitlist control group (n = 29). CBT sessions were delivered weekly online and targeted distorted muscularity beliefs, compulsive behaviors, and emotional dysregulation. Primary and secondary outcomes—Muscle Dysmorphic Disorder Inventory (MDDI), PHQ-9, K10, EDE-Q, EAI, and BIG—were assessed at the baseline, post-treatment, and 3-month follow-up. A repeated-measures ANOVA and paired t-tests were used to analyze time × group interactions. Conclusions: CBT offers an effective, scalable intervention for individuals with muscle dysmorphia complicated by anabolic steroid use. It promotes broad psychological improvement and may serve as a first-line treatment option in high-risk male fitness populations. Future studies should examine long-term outcomes and investigate implementation in diverse clinical and cultural contexts. Full article

Background and Objective: Obesity is currently one of the major challenges in medicine. Research indicates that assessing eating habits can contribute significantly to the development of more effective treatment. This study aims to validate the Eating Behaviors Assessment for Obesity (EBA-O) in a sample of Spanish adults with overweight or obesity. Methods: This cross-sectional study included 384 participants. To evaluate the structure, reliability, and measurement invariance of the Spanish EBA-O, we conducted a confirmatory factor analysis (CFA), calculated McDonald’s omega for reliability, and carried out a hierarchical sequence of multigroup CFAs. Two-way MANOVA was used to assess the effects of sex and body mass index (BMI) categories on EBA-O scores. Results: CFA supported a second-order five-factor structure for the EBA-O, demonstrating excellent fit indices. It respected the configural, metric, and scalar invariance. The Spanish version of the EBA-O exhibited significant correlations with measures of binge eating, food addiction, and eating disorder psychopathology. Internal consistency was high (ω = 0.80). Significant effects of sex and BMI were observed across EBA-O subscales. Conclusions: The EBA-O appears to be a valid, reliable, and easy-to-use instrument for assessing eating behaviors among Spanish-speaking individuals with overweight or obesity. Its strong psychometric properties support its use in both clinical settings and research, enhancing the development of tailored interventions for this population. Full article

An accurate assessment of alcohol consumption is essential for identifying at-risk individuals and informing prevention and intervention strategies. The present study aimed to validate the Italian version of the Alcohol Use Questionnaire (AUQ), a self-report instrument designed to assess both general alcohol intake and binge drinking patterns. A sample of 378 Italian participants (54.5% female; M_age = 26.76 years, SD = 8.44) completed the AUQ along with additional measures assessing binge eating and psychological vulnerabilities related to addiction. Confirmatory factor analysis supported a bifactor model reflecting two distinct but related dimensions: general intake and binge drinking. Network analysis highlighted the central role of perceived frequency of intoxication within the structure of alcohol-related behaviors. Both AUQ indices showed good internal consistency and significant associations with external variables, particularly impulsivity, dissociation, and affect dysregulation, supporting construct validity. The Italian AUQ emerges as a valid and reliable tool for assessing alcohol use patterns and may be useful in both research and clinical practice. Full article

Current technological development has made the Internet and new technologies increasingly present in people’s lives, expanding their opportunities but also potentially posing risks for dysfunctional use. This study aims to identify psychopathological factors associated with dysfunctional ICT use, extending the evidence beyond the well-established relationships with mood disorders to include personality disorders (i.e., cluster C in particular). A total of 711 participants (75.70% female; Mage = 28.33 years, SD = 12.30) took part in the data collection. Firstly, the results showed positive correlations between higher levels of addictive patterns for the Internet, social networks, smartphones and applications, and video games and higher levels of borderline symptoms as assessed by the Borderline Symptom List 23—Short Version. Moreover, scores reflecting high addictive patterns also positively correlated with general narcissistic traits as indicated by the total score of the Narcissistic Personality Inventory 13—Short Version and those specifically described by its Entitlement/Exploitativeness dimension, as well as with higher levels of almost all the personality traits assessed by the Personality Inventory for DSM 5—Brief Form (i.e., negative affectivity, detachment, disinhibition, and psychoticism). These findings broaden the still scarce body of evidence on the relationship between personality disorders and dysfunctional ICT use, which, however, needs to be further explored. Full article

Background: Food addiction (FA) is an emerging construct that mirrors the behavioral and neurobiological characteristics of substance use disorders. Despite growing interest, its association with specific psychiatric disorders among bariatric patients remains understudied. Objective: Our aim was to examine the prevalence and strength of associations between FA and seven major psychiatric disorders in individuals who underwent bariatric surgery. Methods: In a sample of 100 post-bariatric patients referred for psychiatric evaluation, FA was assessed using the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), and psychiatric disorders were diagnosed using the Mini International Neuropsychiatric Interview (MINI). Logistic regression models were used to estimate adjusted odds ratios (aORs) for the association between FA and each psychiatric disorder, controlling for sex, age, body mass index (BMI), employment status, the number of children, clinical comorbidities, physical activity, family psychiatric history, and region of residence. Results: FA was present in 51% of the sample. Descriptive analyses revealed a significantly higher prevalence of major depressive disorder, panic disorder, generalized anxiety disorder, social anxiety disorder, agoraphobia, obsessive–compulsive disorder, and bulimia nervosa among individuals with FA. Multivariate models showed robust associations between FA and bulimia nervosa (aOR = 19.42, p < 0.05), generalized anxiety disorder (aOR = 2.88, p < 0.05), obsessive–compulsive disorder (aOR = 6.64, p < 0.05), agoraphobia (aOR = 3.14, p < 0.05), social anxiety disorder (aOR = 4.28, p < 0.05) and major depressive disorder (aOR = 2.79, p < 0.05). Conclusions: FA is strongly associated with a range of psychiatric comorbidities in post-bariatric patients, reinforcing the need for comprehensive mental health screening in this population. These findings underscore the potential role of FA as a clinical marker for stratified risk assessment, supporting more personalized approaches to mental health monitoring and intervention following bariatric surgery. Full article

Background/Objectives: Substance use disorders, particularly opioid addiction, continue to pose a major global health and toxicological challenge. Morphine dependence represents a significant problem in both clinical practice and preclinical research, particularly in modeling the pharmacodynamics of withdrawal. Rodent models remain indispensable for investigating the neurotoxicological effects of chronic opioid exposure and withdrawal. However, conventional behavioral assessments rely on manual observation, limiting objectivity, reproducibility, and scalability—critical constraints in modern drug toxicity evaluation. This study introduces MWB_Analyzer, an automated and high-throughput system designed to quantitatively and objectively assess morphine withdrawal behaviors in rats. The goal is to enhance toxicological assessments of CNS-active substances through robust, scalable behavioral phenotyping. Methods: MWB_Analyzer integrates optimized multi-angle video capture, real-time signal processing, and machine learning-driven behavioral classification. An improved YOLO-based architecture was developed for the accurate detection and categorization of withdrawal-associated behaviors in video frames, while a parallel pipeline processed audio signals. The system incorporates behavior-specific duration thresholds to isolate pharmacologically and toxicologically relevant behavioral events. Experimental animals were assigned to high-dose, low-dose, and control groups. Withdrawal was induced and monitored under standardized toxicological protocols. Results: MWB_Analyzer achieved over 95% reduction in redundant frame processing, markedly improving computational efficiency. It demonstrated high classification accuracy: >94% for video-based behaviors (93% on edge devices) and >92% for audio-based events. The use of behavioral thresholds enabled sensitive differentiation between dosage groups, revealing clear dose–response relationships and supporting its application in neuropharmacological and neurotoxicological profiling. Conclusions: MWB_Analyzer offers a robust, reproducible, and objective platform for the automated evaluation of opioid withdrawal syndromes in rodent models. It enhances throughput, precision, and standardization in addiction research. Importantly, this tool supports toxicological investigations of CNS drug effects, preclinical pharmacokinetic and pharmacodynamic evaluations, drug safety profiling, and regulatory assessment of novel opioid and CNS-active therapeutics. Full article

Alcohol is a prevalent psychoactive substance and a risk factor for developing injuries and non-communicable diseases, representing a significant health and economic burden. Alcohol involves numerous molecular pathways. Its metabolism is regulated by alcohol dehydrogenases and aldehyde dehydrogenases; it also stimulates cholinergic interneurons, increasing the sensitivity of 5-HT3 receptors, while chronic alcohol consumption alters the mesolimbic dopaminergic system involved in reward processing. The treatment of alcohol use disorder (AUD) is essential to manage complex patients, following an evidence-based approach. The aim of this narrative review is to provide a clear and practical summary to support and assist healthcare professionals in the Italian context. Approved pharmacological treatments for AUD include oral naltrexone and acamprosate, sodium oxybate, disulfiram, and nalmefene. Off-label therapies include baclofen, topiramate, gabapentin, pregabalin, ondansetron, and cytisine. A more informed clinical and practical approach that understands the altered neuronal signaling pathways is essential for offering effective, efficient, appropriate, and safe therapeutic algorithms for complex patients with alcohol use disorder. A comprehensive framework should include integrated treatments with a personalized approach. Full article

Internet addiction among adolescents has emerged as a significant global health issue, contributing to social isolation, academic difficulties, and emotional disorders, with excessive use of social networks further intensifying these challenges. This study evaluated the effectiveness of an educational intervention grounded in the Theory of Planned Behavior (TPB) in reducing Internet addiction and enhancing academic performance among adolescent girls in southern Iran. A randomized controlled trial was conducted with 370 female students aged 15–16 years, selected through two-stage cluster random sampling and divided equally into intervention and control groups. The intervention group participated in a five-week TPB-based program, incorporating lectures, group discussions, and parent–teacher meetings, while the control group received unrelated health education. Data were collected using the Yang Internet Addiction Test (IAT), a TPB-based questionnaire, and academic performance scores (grade point average, GPA) before and after the intervention. A repeated measures ANOVA revealed significant improvements in attitudes, subjective norms, perceived behavioral control, and intentions to reduce Internet use (p < 0.001). Internet addiction scores significantly declined, and GPA improved in the intervention group compared to the control group (p < 0.001, Cohen’s d = 0.950). The findings support TPB-based interventions as effective tools for reducing Internet addiction and improving academic outcomes among adolescents. This study was registered with the Iranian Registry of Clinical Trials (IRCT20131014015015N18). Full article