Compulsive sexual behavior: A review of the literature

Background and aims Compulsive sexual behavior (CSB) is a common disorder featuring repetitive, intrusive and distressing sexual thoughts, urges and behaviors that negatively affect many aspects of an individual’s life. This article reviews the clinical characteristics of CSB, cognitive aspects of the behaviors, and treatment options. Methods We reviewed the literature regarding the clinical aspects of CSB and treatment approaches. Results The literature review of the clinical aspects of CSB demonstrates that there is likely a substantial heterogeneity within the disorder. In addition, the treatment literature lacks sufficient evidence-based approaches to develop a clear treatment algorithm. Conclusions Although discussed in the psychological literature for years, CSB continues to defy easy categorization within mental health. Further research needs to be completed to understand where CSB falls within the psychiatric nosology

Neurocognitive findings in compulsive sexual behavior: A preliminary study

Background and aims Compulsive sexual behavior (CSB) is a common behavior affecting 3–6% of the population, characterized by repetitive and intrusive sexual urges or behaviors that typically cause negative social and emotional consequences. Methods For this small pilot study on neurological data, we compared 13 individuals with CSB and gender- matched healthy controls on diagnostic assessments and computerized neurocognitive testing. Results No significant differences were found between the groups. Conclusions These data contradict a common hypothesis that CSB is cognitively different from those without psychiatric comorbidities as well as previous research on impulse control disorders and alcohol dependence. Further research is needed to better understand and classify CSB based on these findings

Hallucinogen Use is Associated with Mental Health and Addictive Problems and Impulsivity in University Students.

Background:This study examined the prevalence of hallucinogen use in a large sample of university students and its associations with mental health issues. Methods:9,449 students received a 156-item anonymous online survey, which assessed the use of hallucinogens (ever or past year), alcohol and drug use, mental health issues, and impulsive and compulsive traits. Group differences were characterized using statistical tests (p values reported uncorrected, but only regarded as significant if surviving Bonferroni correction). Results:3,525 university students (57.7% female) responded to the survey. The prevalence of past 12-month hallucinogen use in the sample was 4.7%, with an additional 6.4% reporting having used more than 12 months ago. Hallucinogen use was associated with the use of multiple other drugs (e.g., alcohol, opiates) (each p<0.001), mental health problems (p<0.001), risky sexual behavior (p<0.001), low self-esteem (p=0.004), and impulsivity traits (p<0.001) but not compulsivity. Effect sizes were small to medium. Conclusion:Past use of hallucinogens was reported in 11.1%, and was associated with a variety of mental health and drug use problems. Clinicians should be aware that use of hallucinogens is common and mental health problems are more likely in those who use hallucinogens. This study indicates the need for longitudinal research into the negative effects of hallucinogen use on brain function and mental health, especially in young people. Such research should address the extent to which impulsive traits predispose to various substance use problems, versus the direct effects of hallucinogens (and other substances) on mental health

Impact of ADHD symptoms on clinical and cognitive aspects of problem gambling.

BACKGROUND: Problem gambling is common across cultures, and has been conceptualized in terms of impulsivity. While elevated rates of attention deficit hyperactivity disorder (ADHD) have been observed in problem gamblers, the relationship between these two conditions, and other dissociable forms of impulsivity, has received little research attention. METHODS: N=126 non-treatment seeking young adults with problem gambling were recruited from the community, and were grouped according to the presence or absence of probable current ADHD. Clinical and cognitive measures pertaining to impulsivity were collected via detailed psychiatric assessment, questionnaires, and computerized neuropsychological tests. These variables were compared between groups. RESULTS: Probable current ADHD was identified in 21.4% of the sample, and was associated with earlier age at onset of gambling behaviors, higher Barratt impulsivity scores (all three subscales), greater caffeine intake, worse response inhibition (Stop-Signal Test), and impaired decision-making (greater proportion of points gambled, Cambridge Gamble Test). Problem gamblers with and without ADHD did not differ on demographic characteristics or the rate of other psychiatric disorders, depression scores, nicotine and alcohol consumption, and body mass index. No significant group differences were found for general response speed, working memory, or executive planning. CONCLUSIONS: ADHD is common in young adults with dysfunctional gambling behaviors and is associated with elevated questionnaire and cognitive based measures of impulsivity, along with heightened caffeine use. Future work should study the causal nature between these factors and the treatment implications of these findings.This work was supported by a Center of Excellence in Gambling Research grant from the National Center for Responsible Gaming (USA) to Dr. Grant. Dr. Chamberlain's involvement in this research was supported by a grant from the Academy of Medical Sciences (AMS, UK).This is the author accepted manuscript. The final version is available from Elsevier via http://dx.doi.org/10.1016/j.comppsych.2014.10.01

A preliminary comparison of cannabis use in subsyndromal gamblers: select neurocognitive and behavioral differences based on use.

OBJECTIVES: Cannabis and gambling are 2 common forms of impulsive behavior among young adults. Although both cannabis use and gambling have been associated with specific cognitive deficits on tasks related to decision making, no studies to date have examined the possible effects on neurocognition in those who simultaneously gamble and use cannabis. METHODS: To address this question, the present study analyzed 214 subsyndromal gamblers from a larger study on impulsivity. Of these subjects, 64 (29.9%) were current cannabis users (last use within the last 3 months) and 150 (70.1%) had no history of cannabis use in the last 3 months, along with 163 healthy controls. Participants were assessed on various cognitive and clinical measures, including measures for gambling severity and impulsivity. RESULTS: Subjects using cannabis had higher rates of current alcohol use disorders and more frequent gambling behavior per week. Gamblers who used cannabis also exhibited significantly greater scores on one measure of attentional impulsivity. Both gambling groups differed from healthy controls on all clinical and select neurocognitive variables, consistent with previous research. CONCLUSIONS: These results indicate that cannabis use in young adults who gamble is associated with nuanced behavioral differences, although causality could not be determined. Longitudinal research should examine cannabis use in subsyndromal gamblers over time to characterize whether these findings are causative.Dr. Grant has received research grants from NIMH, NIDA, National Center for Responsible Gaming, Forest, Transcept, Roche, and Psyadon Pharmaceuticals, and the University of South Florida. He receives yearly compensation from Springer Publishing for acting as Editor-in-Chief of the Journal of Gambling Studies and has received royalties from Oxford University Press, American Psychiatric Publishing, Inc., Norton Press, and McGraw Hill. Dr. Chamberlain has consulted for Cambridge Cognition, P1Vital, and Shire Pharmaceuticals; and has received speaker honoraria from Lilly. Mr. Leppink and Ms. Derbyshire report no financial relationships with commercial interests.This is the author accepted manuscript. The final version is available from Wolters Kluwer via http://dx.doi.org/10.1097/ADM.000000000000007

Effectiveness of Seasonal Influenza Vaccine against Pandemic (H1N1) 2009 Virus, Australia, 2010

To estimate effectiveness of seasonal trivalent and monovalent influenza vaccines against pandemic influenza A (H1N1) 2009 virus, we conducted a test-negative case–control study in Victoria, Australia, in 2010. Patients seen for influenza-like illness by general practitioners in a sentinel surveillance network during 2010 were tested for influenza; vaccination status was recorded. Case-patients had positive PCRs for pandemic (H1N1) 2009 virus, and controls had negative influenza test results. Of 319 eligible patients, test results for 139 (44%) were pandemic (H1N1) 2009 virus positive. Adjusted effectiveness of seasonal vaccine against pandemic (H1N1) 2009 virus was 79% (95% confidence interval 33%–93%); effectiveness of monovalent vaccine was 47% and not statistically significant. Vaccine effectiveness was higher among adults. Despite some limitations, this study indicates that the first seasonal trivalent influenza vaccine to include the pandemic (H1N1) 2009 virus strain provided significant protection against laboratory-confirmed pandemic (H1N1) 2009 infection

White matter tract integrity in treatment-resistant gambling disorder

Background Gambling disorder is a relatively common psychiatric disorder recently re-classified within the DSM-5 under the category of ‘substance-related and addictive disorders’. Aims To compare white matter integrity in patients with gambling disorder with healthy controls; to explore relationships between white matter integrity and disease severity in gambling disorder. Method In total, 16 participants with treatment-resistant gambling disorder and 15 healthy controls underwent magnetic resonance imaging (MRI). White matter integrity was analysed using tract-based spatial statistics. Results Gambling disorder was associated with reduced fractional anisotropy in the corpus callosum and superior longitudinal fasciculus. Fractional anisotropy in distributed white matter tracts elsewhere correlated positively with disease severity. Conclusions Reduced corpus callosum fractional anisotropy is suggestive of disorganised/damaged tracts in patients with gambling disorder, and this may represent a trait/vulnerability marker for the disorder. Future research should explore these measures in a larger sample, ideally incorporating a range of imaging markers (for example functional MRI) and enrolling unaffected first-degree relatives of patients.This research was supported by a grant from the National Center for Responsible Gaming to Dr. Grant, and by a grant from the Academy of Medical Sciences to Dr. Chamberlain (UK). Dr. Grant has received research grants from NIMH, National Center for Responsible Gaming, and Forest and Roche Pharmaceuticals Dr. Grant receives yearly compensation from Springer Publishing for acting as Editor-in-Chief of the Journal of Gambling Studies and has received royalties from Oxford University Press, American Psychiatric Publishing, Inc., Norton Press, and McGraw Hill. Dr. Chamberlain consults for Cambridge Cognition. Mr. Odlaug has received a research grant from the Trichotillomania Learning Center, consults for H. Lundbeck A/S, and has received royalties from Oxford University Press. Mr. Leppink and Ms. Derbyshire report no conflicts of interest.This is the author accepted manuscript. The final version is available from the Royal College of Psychiatrists via http://dx.doi.org/10.1192/bjp.bp.115.16550

Higher proportion of older influenza A(H1N1)pdm09 cases in Victoria, 2011

The influenza surveillance system in Victoria is comprised of several components, including a general practitioner sentinel surveillance system, surveillance for influenza-like illness (ILI) in consultations made by the Melbourne Medical Deputising Service, laboratory confirmed influenza notified to the Victorian Department of Health and strain typing performed by the World Health Organization Collaborating Centre for Reference and Research on Influenza. As measured by ILI from both the MMDS and GPSS, the 2011 influenza season in Victoria was mild compared to previous seasons and was not dominated by any type or subtype of influenza. There were 13 laboratory confirmed influenza outbreaks in 2011, nearly all of which were in aged care facilities. GPs continue to swab more patients, a trend started in 2009, with a significantly lower percent of these testing positive for influenza than previous years. The proportion of ILI and swabbed patients who were vaccinated was also significantly lower in 2011 than previously. Strain analysis undertaken by the WHO Collaborating Centre indicated a good antigenic match between the 2011 vaccine and circulating strains. The Victorian influenza surveillance system continues to provide a reliable, consistent system for monitoring the epidemiology of ILI and laboratory confirmed influenza in Victoria.VIDRL receives support for its influenza surveillance program from the Victorian Government Department of Health. The Melbourne WHO Collaborating Centre for Reference and Research on Influenza is supported by the Australian Government Department of Health and Ageing