Neuronal plasticity and neurotrophic factors in drug responses

Neurotrophic factors, particularly brain-derived neurotrophic factor (BDNF) and other members of the neurotrophin family, are central mediators of the activity-dependent plasticity through which environmental experiences, such as sensory information are translated into the structure and function of neuronal networks. Synthesis, release and action of BDNF is regulated by neuronal activity and BDNF in turn leads to trophic effects such as formation, stabilization and potentiation of synapses through its high-affinity TrkB receptors. Several clinically available drugs activate neurotrophin signaling and neuronal plasticity. In particular, antidepressant drugs rapidly activate TrkB signaling and gradually increase BDNF expression, and the behavioral effects of antidepressants are mediated by and dependent on BDNF signaling through TrkB at least in rodents. These findings indicate that antidepressants, widely used drugs, effectively act as TrkB activators. They further imply that neuronal plasticity is a central mechanism in the action of antidepressant drugs. Indeed, it was recently discovered that antidepressants reactivate a state of plasticity in the adult cerebral cortex that closely resembles the enhanced plasticity normally observed during postnatal critical periods. This state of induced plasticity, known as iPlasticity, allows environmental stimuli to beneficially reorganize networks abnormally wired during early life. iPlasticity has been observed in cortical as well as subcortical networks and is induced by several pharmacological and non-pharmacological treatments. iPlasticity is a new pharmacological principle where drug treatment and rehabilitation cooperate; the drug acts permissively to enhance plasticity and rehabilitation provides activity to guide the appropriate wiring of the plastic network. Optimization of iPlastic drug treatment with novel means of rehabilitation may help improve the efficacy of available drug treatments and expand the use of currently existing drugs into new indications.Peer reviewe

The extent and type of gambling harms for concerned significant others : A cross-sectional population study in Finland

Aims: This study investigates the proportion of concerned significant others (CSOs) of problem gamblers at population level and describes the extent and type of gambling harms for CSOs. Methods: Cross-sectional random sample data (n = 4515) were collected in 2015. The data were weighted based on age, gender and residence. CSOs were identified using a question including seven options. Gambling harms were inquired using structured questions. Descriptive statistics and Chi-Squared and Fischer's exact tests were used. Results: Overall, the proportion of CSOs was 19.3%. Males had close friends with gambling problems more often than females, while females had family members with gambling problems more often than males. Of the CSOs, 59.5% had experienced one or more harms. Females experienced more harms than males. Typical harms were worry about health or well-being of close ones, emotional distress and problems in interpersonal relationships. CSOs with a problem gambler in the family, particularly a partner, child/children or mother, experienced harms more often than CSOs with a problem gambler as a close friend. Conclusions: Female gender was associated with a larger extent of harms. The extent of harms was greatest if the problem gambler was a family member; however, a substantial amount of harms were experienced when the problem gambler was a close friend. CSOs and their position in evaluating gambling harms in general should be acknowledged. Persons beyond the nuclear family and the harms they encounter should be better acknowledged in prevention and harm minimisation. Early identification and a clear referral path to tailored support in occupational, social and healthcare settings may be considered.Peer reviewe

How gambling motives are associated with socio-demographics and gambling behavior - A Finnish population study

Background and aims: The aims were to examine how socio-demographics and gambling behavior relate to both primary and additional gambling motives, and whether the gambling motives change during a one-year-period. Methods: The Finnish Gambling Harms Survey data was used. Gambling motives were measured with a categorical question. Gambling severity was measured using the Problem and Pathological Gambling Measure (PPGM). Using the first-wave data including only past-year gamblers (n = 5,684), five logistic regression models were utilized to explore the associations of gambling motives with socio-demographics and gambling behavior. The stability of gambling motives was assessed with McNemar's test using longitudinal data (n = 2,078). Results: Gambling for positive feeling was associated with younger age, high income, high gambling involvement and at-risk gambling. Monetary motive was associated with female gender, high gambling involvement, online or mixed-mode and at-risk gambling. Supporting worthy causes was associated with older age, monthly and weekly gambling, and land-based gambling. Socializing was associated with younger age and gambling occasionally on land-based venues with multiple game types. Finally, the motive to escape was intensified among 25-34-year-olds, homemakers, and those with high gambling involvement and at-risk or problem gambling. Gambling motives remained relatively stable for one year. Discussion and conclusions: Gender and age profiles varied in different motives. Positive feeling, socializing and escape motive was heightened among younger respondents while supporting worthy causes was heightened among the oldest. Women gambled for money more often than men. Escape motive was associated with problem gambling. Longer follow-up is needed to confirm the longitudinal results.Peer reviewe

Gambling participation, gambling habits, gambling-related harm, and opinions on gambling advertising in Finland in 2016

Background: This report is an overview of results from the 2016 Finnish Gambling Harms Survey covering the population and clinical perspectives. It summarises the main findings on gambling participation, gambling habits, gambling-related harm, and opinions on gambling advertising. Methods: The population sample (n = 7186) was collected from three regions and the clinical sample (n = 119) in a gambling help clinic. Results: Frequency of gambling in the population sample was characteristically once a week, while in the clinical sample it was daily. Men gambled more often than women only in the population sample. The most common gambling environments were kiosks, grocery stores or supermarkets, and home. The most typical gambling-related harms were financial or emotional/psychological harms; the amount of experienced harm was considerable among the clinical sample. The clinical sample also perceived gambling advertising as obtrusive and as a driving force for gambling. Conclusions: The results of the clinical sample imply that when gambling gets out of hand, the distinctions between gamblers' habits diminish and become more streamlined, focusing on gambling per se - doing it often, and in greater varieties (different game types). There is a heightened need to monitor gambling and gambling-related harm at the population level, especially amongst heavy consumers, in order to understand what type of external factors pertaining to policy and governance may contribute to the shift from recreational to problem gambling.Peer reviewe

The relationship between gambling expenditure, socio-demographics, health-related correlates and gambling behavioura cross-sectional population-based survey in Finland

AimsTo investigate gambling expenditure and its relationship with socio-demographics, health-related correlates and past-year gambling behaviour. DesignCross-sectional population survey. SettingPopulation-based survey in Finland. ParticipantsFinnish people aged 15-74years drawn randomly from the Population Information System. The participants in this study were past-year gamblers with gambling expenditure data available (n = 3251, 1418 women and 1833 men). MeasurementsExpenditure shares, means of weekly gambling expenditure (WGE, Euro) and monthly gambling expenditure as a percentage of net income (MGE/NI, %) were calculated. The correlates used were perceived health, smoking, mental health [Mental Health Inventory (MHI)-5], alcohol use [Alcohol Use Disorders Identification Test (AUDIT)-C], game types, gambling frequency, gambling mode and gambling severity [South Oaks Gambling Screen (SOGS)]. FindingsGender (men versus women) was found to be associated significantly with gambling expenditure, with exp = 1.40, 95% confidence interval (CI) = 1.29, 1.52 and P ConclusionsIn Finland, male gender is associated significantly with both weekly gambling expenditure and monthly gambling expenditure related to net income. People in Finland with lower incomes contribute proportionally more of their income to gambling compared with middle- and high-income groups.Peer reviewe

At-risk and problem gambling among adolescents : a convenience sample of first-year junior high school students in Finland

Background: Adolescent gambling and substance use are viewed as a public health concern internationally. The early onset age of gambling is a known risk factor for developing gambling problems later in life. The aims of this study are: to evaluate the internal consistency reliability, factorial validity and classification accuracy of the Finnish version of DSM-IV-Multiple Response-Juvenile (DSM-IV-MR-J) criteria measuring at-risk/problem gambling (ARPG); to examine gender differences in gambling participation, ARPG and substance use among first-year junior high school students; and to investigate the association of gambling and gaming (video game playing) participation, substance use and social variables with ARPG. Methods: This study examined 988 adolescents (mean age 13.4 years) at 11 public schools in Finland between October-December 2013. The response rate was 91.6%. Chi-squared test and binary logistic regression analysis were used. Results: 'Illegal acts' was the most endorsed and sensitive, but the least specific criteria identifying ARPG. During the past year, 51.6% of the respondents had gambled, 7.9% were identified as at-risk/problem gamblers (DSM-IV-MR-J score >= 2), 8.0% had smoked and 8.9% had been drinking for intoxication, and the first three were significantly more common among boys than girls. The odds ratio of being a male past-year at-risk/problem gambler was 2.27, 5.78 for gambling often or sometimes, 2.42 for video game playing weekly or more often and 6.23 for having peer gamblers. Conclusions: Overall, the Finnish version of the DSM-IV-MR-J had acceptable internal consistency reliability and factorial validity. None of the DSM-IV-MR-J criteria were accurate enough to screen ARPG per se. ARPG past-year prevalence was relatively high with males gambling more than females. ARPG was as common as drinking alcohol for intoxication and smoking. Peer gambling was strongly associated with ARPG. Efficient strategies to minimise the risks of gambling problems, tools for prevention and identification of ARPG among the underage are needed.Peer reviewe

Past-year gambling behaviour among patients receiving opioid substitution treatment

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BMC Public Health Gambling expenditure by game type among weekly gamblers in Finland

Background: Excessive expenditure and financial harms are core features of problem gambling. There are various forms of gambling and their nature varies. The aim was to measure gambling expenditure by game type while controlling for demographics and other gambling participation factors. A further aim was to find out how each game type was associated with gambling expenditure when the number of game types played is adjusted for. Methods: Using data from the 2015 Finnish Gambling survey on adult gamblers (n = 3555), multiple log-linear regression was used to examine the effects of demographics, gambling participation, and engaging in different game types on weekly gambling expenditure (WGE) and relative gambling expenditure (RGE). Background: Excessive expenditure and financial harms are core features of problem gambling. There are various forms of gambling and their nature varies. The aim was to measure gambling expenditure by game type while controlling for demographics and other gambling participation factors. A further aim was to find out how each game type was associated with gambling expenditure when the number of game types played is adjusted for. Conclusions: It seems that overall gambling frequency is the strongest indicator of high gambling expenditure. Our results showed that different game types had different effect sizes on gambling expenditure. Weekly gambling on horse races and non-monopoly games had the greatest increasing effect on expenditure. However, different game types also varied based on their popularity. The extent of potential harms caused by high expenditure therefore also varies on the population level. Based on our results, future prevention and harm minimization efforts should be tailored to different game types for greater effectiveness.Peer reviewe

Gender- and age-stratified analyses of gambling disorder in Finland between 2011 and 2020 based on administrative registers

Aim: Prevalence studies on gambling have largely relied on survey samples. Little is known about the diagnosed prevalence of gambling disorder (GD) based on register data. This study examines the annual prevalence rate of GD between 2011 and 2020 among Finns by gender and age. Methods: Aggregated data on the diagnosis of GD (corresponding to pathological gambling, code F63.0 in the ICD-10) were retrieved from the following national registers: Register of Primary Health Care Visits, and Care Register for Health Care, including specialised outpatient and inpatient health care, and inpatient Care Register for Social Welfare. Primary and secondary diagnoses of adults were included. Average population during a calendar year (4,282,714-4,460,177 individuals) was utilised to calculate annual prevalence. Results: The annual prevalence of diagnosed GD in the population increased from 0.005% (n = 196) to 0.018% (n = 804) within nine years. In 2011, the annual prevalence rate was 0.006% for men and 0.003% for women, compared to rates in 2020 of 0.025% and 0.011%. Gender discrepancy was relatively stable across years: 27.2-33.8% of the diagnoses were for women. The prevalence of GD varied between age groups within genders. GD was most prevalent among 18-44-year-olds. The prevalence rates increased the most among 30-44-year-old women. Conclusion: The extremely low prevalence rate of GD implies that the problem remains under-diagnosed, yet, it has increased among all age groups across genders, except for women aged 60 years or older. Active efforts are needed to increase awareness of GD among both primary and specialised healthcare professionals and the public for better recognition and early detection.Peer reviewe

Teacher Awareness and Attitudes Regarding Adolescent Risk Behaviours : a Sample of Finnish Middle and High School Teachers

Empirical evidence has shown that youth gamble on both regulated and unregulated games, despite legislative prohibitions. This study assesses middle and high school teachers' awareness and attitudes regarding adolescent gambling and other potentially high-risk behaviours in Finland. A convenience sample of teachers (N = 157) from 13 provinces participated in the survey. The results suggest that teachers in Finland were more knowledgeable of the age limits of other adolescent high-risk behaviours than the legal age for gambling. Teachers were somewhat familiar with the behaviours and consequences associated with adolescent gambling. All other risk behaviours were perceived as being more important than gambling. Teachers' awareness about gambling prevention material in Finnish schools was limited. Results suggest that initiatives are required to enhance teachers' knowledge of adolescent problem gambling and its harmful short- and long-term consequences. School policies and guidelines including gambling behavior should be implemented in middle and high schools globally.Peer reviewe