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      Moderating effect of alexithymia between problem gambling and psychotic experiences in university students

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          Abstract

          Background

          Most of the young individuals with problem gambling (PG) or psychotic experiences (PEs) are less prone to seek medical help. Therefore, community-based studies investigating the relationship between these entities in non-clinical young people across a continuum of severity are warranted. To this end, the present study proposes to advance knowledge on the mechanisms that potentially underlie the association between PG and PEs, by examining the role of a potential moderator, i.e. alexithymia, in this relationship.

          Methods

          A total of 399 participants enrolled in this study (mean age = 21.58 ± 3.20 years) participated in an online cross-sectional survey. The South Oaks Gambling Screen (SOGS), the Prodromal Questionnaire-Brief (PQ-B), and the Toronto alexithymia scale (TAS-20) were used.

          Results

          Thirty-three (8.3%) participants had problem-gambling, whereas 13 (3.3%) were probable pathological gamblers. Moderation analysis results adjusted over confounders (age, household crowding index, marital status, personal history of mental disorder, other illegal drug use) showed that the interaction PG by alexithymia ( p = .018) was significantly associated with PEs scores. At moderate (Beta = 1.93) and high (Beta = 3.38) levels of alexithymia, more PG was significantly associated with more PEs scores.

          Conclusion

          Findings suggest that GP may have a different impact on PEs depending on the individual’s level of alexithymia. As such, both alexithymia and gambling behavior should be considered in the clinical assessment of young people who present with PEs, which can help in implementing more tailored and individualized treatment plans.

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          Most cited references74

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          Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies

          Promotion of good mental health, prevention, and early intervention before/at the onset of mental disorders improve outcomes. However, the range and peak ages at onset for mental disorders are not fully established. To provide robust, global epidemiological estimates of age at onset for mental disorders, we conducted a PRISMA/MOOSE-compliant systematic review with meta-analysis of birth cohort/cross-sectional/cohort studies, representative of the general population, reporting age at onset for any ICD/DSM-mental disorders, identified in PubMed/Web of Science (up to 16/05/2020) (PROSPERO:CRD42019143015). Co-primary outcomes were the proportion of individuals with onset of mental disorders before age 14, 18, 25, and peak age at onset, for any mental disorder and across International Classification of Diseases 11 diagnostic blocks. Median age at onset of specific disorders was additionally investigated. Across 192 studies (n = 708,561) included, the proportion of individuals with onset of any mental disorders before the ages of 14, 18, 25 were 34.6%, 48.4%, 62.5%, and peak age was 14.5 years (k = 14, median = 18, interquartile range (IQR) = 11–34). For diagnostic blocks, the proportion of individuals with onset of disorder before the age of 14, 18, 25 and peak age were as follows: neurodevelopmental disorders: 61.5%, 83.2%, 95.8%, 5.5 years (k = 21, median=12, IQR = 7–16), anxiety/fear-related disorders: 38.1%, 51.8%, 73.3%, 5.5 years (k = 73, median = 17, IQR = 9–25), obsessive-compulsive/related disorders: 24.6%, 45.1%, 64.0%, 14.5 years (k = 20, median = 19, IQR = 14–29), feeding/eating disorders/problems: 15.8%, 48.1%, 82.4%, 15.5 years (k = 11, median = 18, IQR = 15–23), conditions specifically associated with stress disorders: 16.9%, 27.6%, 43.1%, 15.5 years (k = 16, median = 30, IQR = 17–48), substance use disorders/addictive behaviours: 2.9%, 15.2%, 48.8%, 19.5 years (k = 58, median = 25, IQR = 20–41), schizophrenia-spectrum disorders/primary psychotic states: 3%, 12.3%, 47.8%, 20.5 years (k = 36, median = 25, IQR = 20–34), personality disorders/related traits: 1.9%, 9.6%, 47.7%, 20.5 years (k = 6, median = 25, IQR = 20–33), and mood disorders: 2.5%, 11.5%, 34.5%, 20.5 years (k = 79, median = 31, IQR = 21–46). No significant difference emerged by sex, or definition of age of onset. Median age at onset for specific mental disorders mapped on a time continuum, from phobias/separation anxiety/autism spectrum disorder/attention deficit hyperactivity disorder/social anxiety (8-13 years) to anorexia nervosa/bulimia nervosa/obsessive-compulsive/binge eating/cannabis use disorders (17-22 years), followed by schizophrenia, personality, panic and alcohol use disorders (25-27 years), and finally post-traumatic/depressive/generalized anxiety/bipolar/acute and transient psychotic disorders (30-35 years), with overlap among groups and no significant clustering. These results inform the timing of good mental health promotion/preventive/early intervention, updating the current mental health system structured around a child/adult service schism at age 18.
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            Problem gambling worldwide: An update and systematic review of empirical research (2000–2015)

            Problem gambling has been identified as an emergent public health issue, and there is a need to identify gambling trends and to regularly update worldwide gambling prevalence rates. This paper aims to review recent research on adult gambling and problem gambling (since 2000) and then, in the context of a growing liberalization of the gambling market in the European Union, intends to provide a more detailed analysis of adult gambling behavior across European countries. A systematic literature search was carried out using academic databases, Internet, and governmental websites. Following this search and utilizing exclusion criteria, 69 studies on adult gambling prevalence were identified. These studies demonstrated that there are wide variations in past-year problem gambling rates across different countries in the world (0.12–5.8%) and in Europe (0.12–3.4%). However, it is difficult to directly compare studies due to different methodological procedures, instruments, cut-offs, and time frames. Despite the variability among instruments, some consistent results with regard to demographics were found. The findings highlight the need for continuous monitoring of problem gambling prevalence rates in order to examine the influence of cultural context on gambling patterns, assess the effectiveness of policies on gambling-related harms, and establish priorities for future research.
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              An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: on the pathway from proneness to persistence to dimensional expression across mental disorders.

              The psychosis-proneness-persistence-impairment model of psychotic disorder incorporates notions of both phenomenological and temporal continuity (persistence) of psychotic experiences (PE), but not structural continuity. Specific testable propositions of phenomenological continuity and persistence are identified. Method Propositions are tested by systematic reviews of the epidemiology of PE, persistence of PE and disorder outcomes, and meta-analyses (including Monte Carlo permutation sampling, MCPS) of reported rates and odds ratios (ORs). Estimates of the incidence and prevalence of PE obtained from 61 cohorts revealed a median annual incidence of 2.5% and a prevalence of 7.2%. Meta-analysis of risk factors identified age, minority or migrant status, income, education, employment, marital status, alcohol use, cannabis use, stress, urbanicity and family history of mental illness as important predictors of PE. The mode of assessment accounted for significant variance in the observed rates. Across cohorts, the probability of persistence was very strongly related to the rate of PE at baseline. Of those who report PE, ∼20% go on to experience persistent PE whereas for ∼80%, PE remit over time. Of those with baseline PE, 7.4% develop a psychotic disorder outcome. Compelling support is found for the phenomenological and temporal continuity between PE and psychotic disorder and for the fundamental proposition that this relationship is probabilistic. However, imprecision in epidemiological research design, measurement limitations and the epiphenomenological nature of PE invite further robust scrutiny of the continuity theory.
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                Author and article information

                Contributors
                feten.fekih@gmail.com
                souheilhallit@hotmail.com
                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                1471-244X
                3 January 2024
                3 January 2024
                2024
                : 24
                : 19
                Affiliations
                [1 ]GRID grid.414302.0, ISNI 0000 0004 0622 0397, The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, , Razi hospital, ; 2010 Manouba, Tunisia
                [2 ]Faculty of Medicine of Tunis, Tunis El Manar University, ( https://ror.org/029cgt552) Tunis, Tunisia
                [3 ]GRID grid.11899.38, ISNI 0000 0004 1937 0722, Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, , Universidade de Sao Paulo, ; Sao Paulo, SP, BR Brazil
                [4 ]Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico e Tecnológico, ( https://ror.org/03swz6y49) Sao Paulo, Brazil
                [5 ]School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, ( https://ror.org/05g06bh89) Jounieh, P.O. Box 446, Lebanon
                [6 ]Psychology Department, College of Humanities, Effat University, ( https://ror.org/02cnwgt19) 21478 Jeddah, Saudi Arabia
                [7 ]Applied Science Research Center, Applied Science Private University, ( https://ror.org/01ah6nb52) Amman, Jordan
                Article
                5472
                10.1186/s12888-023-05472-7
                10765704
                38172817
                8fd989d3-73bb-418a-9c85-c1e26970d2c4
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 25 September 2023
                : 20 December 2023
                Categories
                Research
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                © BioMed Central Ltd., part of Springer Nature 2024

                Clinical Psychology & Psychiatry
                gambling problem,psychotic experiences,alexithymia,students,moderation

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