Massively multiplayer online role-playing games: comparing characteristics of addict vs non-addict online recruited gamers in a French adult population

<p>Abstract</p> <p>Background</p> <p>Massively Multiplayer Online Role-Playing Games (MMORPGs) are a very popular and enjoyable leisure activity, and there is a lack of international validated instruments to assess excessive gaming. With the growing number of gamers worldwide, adverse effects (isolation, hospitalizations, excessive use, etc.) are observed in a minority of gamers, which is a concern for society and for the scientific community. In the present study, we focused on screening gamers at potential risk of MMORPG addiction.</p> <p>Methods</p> <p>In this exploratory study, we focused on characteristics, online habits and problematic overuse in adult MMORPG gamers. In addition to socio-demographical data and gamer behavioral patterns, 3 different instruments for screening addiction were used in French MMORPG gamers recruited online over 10 consecutive months: the substance dependence criteria for the Diagnostic and Statistical Manual of Mental Disorder, fourth revised edition (DSM-IV-TR) that has been adapted for MMORPG (DAS), the qualitative Goldberg Internet Addiction Disorder scale (GIAD) and the quantitative Orman Internet Stress Scale (ISS). For all scales, a score above a specific threshold defined positivity.</p> <p>Results</p> <p>The 448 participating adult gamers were mainly young adult university graduates living alone in urban areas. Participants showed high rates of both Internet addiction (44.2% for GIAD, 32.6% for ISS) and DAS positivity (27.5%). Compared to the DAS negative group, DAS positive gamers reported significantly higher rates of tolerance phenomenon (increased amount of time in online gaming to obtain the desired effect) and declared significantly more social, financial (OR: 4.85), marital (OR: 4.61), family (OR: 4.69) and/or professional difficulties (OR: 4.42) since they started online gaming. Furthermore, these gamers self-reported significantly higher rates (3 times more) of irritability, daytime sleepiness, sleep deprivation due to play, low mood and emotional changes since online gaming onset.</p> <p>Conclusions</p> <p>The DAS appeared to be a good first-line instrument to screen MMORPG addiction in online gamers. This study found high MMORPG addiction rates, and self-reported adverse symptoms in important aspects of life, including mood and sleep. This confirms the need to set up relevant prevention programs against online game overuse.</p

[Pharmacogenetics of depression in elderly patients]

International audienceDepression is one of the leading causes of disability and is efficiently treated by antidepressant pharmacotherapy. Pharmacological treatment is still hampered by a delayed time of onset of clinical improvement and a series of side effects. In elderly, it is complicated by an increased risk of adverse drug events, associated with age-related physiological changes, individual variability in drug metabolism mainly related to polymedication, concurrent diseases and diet. Then every physician would like to predict these impairments and to prescribe a "tailored" treatment based on individual characteristics. One of the tools for this tailored medication is the use of pharmacogenetics, leading to an evaluation of the human genome implications in the treatment response (efficacy, time of onset and adverse events). Some candidate-genes have already been identified, showing encouraging results, but only a few studies focus on depressed old subjects. The existing studies have analyzed the polymorphism of the metabolizing enzyme gene CYP2D6 and the serotonin transporter genes implications. The results are promising but more researches are necessary to include pharmacogenetic studies in the clinical practice

Predictors of remission to antidepressants in late-life depression: a systematic review

International audienc

Smoking-cessation for patients with acute psychiatric illness

Context: Legal measures forbidding smoking in public places- as hospitals, conducted to a rising preoccupation for smoking cessation in psychiatric patients. But, little is known about the efficient way to proceed with in-patients in acute phase of psychiatric disorders. The aim of this paper is to expose a way to integrate smoking-cessation in psychiatric care, called Smoking Cessation Program (SCP); and the encouraging results on smoking reduction on 31 in-patients. Methods: SCP consisted on a cognitive and behavioural, motivational, and nicotinic replacement intensive program, integrated in psychiatric care. Results: SCP showed efficacy on cigarette consumption at short and medium- term (50% of initial value at 6 months), with a parallel decrease of anxiety and depressive symptoms in psychiatric heavy smokers. Conclusion: SCP is an interesting way to help psychiatric patients to reduce smoking without worsening their psychiatric symptoms. Studies with greater samples are needed to confirm those results and generaliz

Ectoparasitosis or Ekbom syndrome?: A case report

International audienc

Does hospitalisation affect hypnotic and anxiolytic drug prescribing?

International audienceOBJECTIVE: The aim of this study was to measure the impact of hospitalisation on hypnotic and anxiolytic (HA) drug prescription, during and after hospitalisation. METHOD: A descriptive study was carried out over three periods: before, during and after hospitalisation (three-month follow-up), examining the presence or absence of HA treatment at each stage. The HA drug list studied was selected using the World Health Organisation (WHO) Anatomical Therapeutic and Chemical (ATC) classification system. Trained final-year pharmacy students asked a series of structured questions during hospitalisation and postal questionnaires were sent to included patients one and three months after discharge. All the in-patient departments in the University Hospital of Besançon-France-were included, except units with pre-, peri-, and post-operative HA treatments. All in-patients present in the selected units on February 12, 2003, aged over 18, who gave their consent and were considered able to answer by the nursing team, were finally included. MAIN OUTCOME MEASURE: An eight-branch descriptive model, including the three study periods with two states (presence or absence of HA treatment) at each stage. RESULTS: A total of 260 in-patients were included, and a further 112 (43%) completed the whole study (alive, non re-hospitalised, one- and three- months post discharge response). 48% (n = 260), 64% (n = 260) and 58% (n = 112) of the included patients had sleep disorder complaints respectively before, during and after hospitalisation. HA usage increased when comparing pre- and during hospitalisation (33% vs. 51%; n = 112; p < 0.0001) and decreased when comparing during hospitalisation and post-discharge (51% vs. 43%; n = 112; p < 0.0001). The descriptive model showed an overall persistence of treatment induced by hospital stay in 5.35% of the patients. CONCLUSION: Hospital appeared to have a significant impact on delayed HA use in the French general population. Our results should incite hospital prescribers to transversally reconsider the whole sleep disorder treatment strategy in hospital settings, from improving patient's accommodation conditions, to working out a consensus on the justification of prescription of HA and precising the exact place of nursing team in sleep disorders management