Assessing the symptoms of Internet Gaming Disorder among college/university students: An international validation study of a self-report

The present study evaluated the psychometric properties of a self-report scale for assessing Internet Gaming Disorder (IGD) symptoms according to the DSM-5 and ICD-11 among 3270 college/university students (2095 [64.1%] females; age mean 21.6 [3.1] years) from different countries worldwide. Croatian, English, Polish, Portuguese, Serbian, Turkish, and Vietnamese versions of the scale were tested. The study showed that symptoms of IGD could be measured as a single underlying factor among college/university students. A nine item-symptom scale following DSM-5, and a short four-item scale representing the main ICD-11 symptoms, had sound internal consistency and construct validity. Three symptom-items were found non-invariant across the language samples (i.e., preoccupation with on-line gaming, loss of interests in previous hobbies and entertainment, and the use of gaming to relieve negative moods). This study provides initial evidence for assessing IGD symptoms among college/university students and will hopefully foster further research into gaming addiction in this population worldwide especially with taking into account language/cultural differences

The Exposome Paradigm to Understand the Environmental Origins of Mental Disorders

There is an active interest in understanding the relationship between mental disorders and modifiable and potentially preventable exposures. However, the complexity of the environment, involving many causal and noncausal pathways, makes research extremely challenging. To tackle these challenges, we have recently proposed the use of the exposome paradigm. The exposome represents the totality of exposures in a lifetime from conception onward. The framework offers a solution to handle the complexity of all "non-genetic" factors. The exposome approach has recently been adopted to construct an exposome score for schizophrenia (ES-SCZ). Findings demonstrate that ES-SCZ can be used for risk stratification, adjusting for cumulative environmental load in statistical testing, and collecting risk enriched cohorts. Increasing data availability will help improve ES-SCZ that can be used in staging models to enhance clinical characterization and outcome forecasting. Although an ES-SCZ already provides several practical benefits for research practice, the exposome paradigm offers much more. Agnostic exposure-wide analyses might be the first step to mapping the exposome of mental disorders. These analyses help distinguish genuine signals from selective reporting and uncover novel risk and resilience factors. The exposome approach will also increase our understanding of the differential impact of the environment on mental health across geographical settings and ethnic communities. We are in the early phases of exposome research in psychiatry; however, if successfully applied, exposome framework is poised to embrace complexity and enable advanced analytical solutions to harness ever-growing data to gain insight into the complex dynamic network of exposures

Estimating Aggregate Environmental Risk Score in Psychiatry: The Exposome Score for Schizophrenia

To understand the role of environment in the pathoetiology of psychosis spectrum disorders, research has thus far mainly investigated the effects of single exposures in isolation, such as the association between cannabis use and schizophrenia. However, this approach fails to acknowledge the complexity of the exposome, which represents the totality of the environment involving many exposures over an individual's lifetime. Therefore, contemporary research adopting the exposome paradigm has aimed at capturing the combined effect of different environmental exposures by utilizing an aggregate environmental vulnerability score for schizophrenia: the exposome score for schizophrenia. Here, we attempt to provide a comprehensive overview of studies applying the exposome score for schizophrenia. First, we describe several approaches estimating exposomic vulnerability for schizophrenia, which falls into three categories: simple environmental sum scores (sum of dichotomized exposures), meta-analysis-based environmental risk score (sum scores weighted by estimates from meta-analyses), and the exposome score (sum score weighted by estimates from an analysis in an independent training dataset). Studies show that the exposome score for schizophrenia that assumes interdependency of exposures performs better than scores that assume independence of exposures, such as the environmental sum score and the meta-analysis-based environmental risk score. Second, we discuss findings on the pluripotency of the exposome score for schizophrenia and summarize findings from gene-environment studies using the exposome score for schizophrenia. Finally, we discuss possible scientific, clinical, and population-based applications of exposome score for schizophrenia, as well as limitations and future directions for exposome research to understand the etiology of psychosis spectrum disorders

Ornidazole-induced liver damage: report of three cases and review of the literature

Metronidazole and ornidazole, synthetic nitroimidazole derivatives, are used in the treatment of infections caused by anaerobic bacteria and protozoa. The drugs are well tolerated and serious side effects are very rarely encountered. Hepatotoxicity is a rare side effect and hitherto only six cases have been reported. We describe three patients who developed hepatitis after ornidazole use and review the previously reported cases. All three cases used ornidazole in conventional doses and developed hepatitis and associated cholestasis. They improved 1 - 2 months after discontinuation. We concluded that nitroimidazole derivatives may cause hepatotoxic damage resembling acute cholestatic hepatitis. Early recognition and withdrawal of the drug may prevent further damage