既往阿片类物质成瘾者中罕见网络成瘾者

柏林–网络成瘾和药物成瘾并不象火腿和鸡蛋一样相依相伴，二者之间的关系更象油和水一样难以兼容。特拉维夫市Sourasky医学中心的Einat Peles博士在欧洲神经精神药理学会年会上报告了这项研究的结果，即已证实拉斯维加斯和特拉维夫市美沙酮维持治疗诊所的既往阿片类物质成瘾者中网络成瘾非常罕见。

这一结果完全出人意料，因为众所周知的是，药物成瘾者更易于发生其他成瘾行为。例如，在之前的一项研究中， Peles博士及其合作者发现美沙酮维持治疗与病理性赌博之间具有很强的相关性(Am. J. Orthopsychiatry 2010;80:311-6)。

在这项新的网络成瘾研究中，她报告了来自拉斯维加斯美沙酮维持诊所的未经选择的177例患者和来自特拉维夫市一家相似诊所的71例患者的结果。对所有患者，使用网络成瘾测试问卷进行评估。网络成瘾的定义为网络成瘾测试评分³80分。此外，使用流行病学研究抑郁量表（CES-D）评估患者的抑郁症状况，这是因为在一项荟萃分析中显示网络成瘾与抑郁症相关（Psychopathology 2013;46:1-13），Peles博士指出。

结果发现，248例研究参与者中无一符合网络成瘾的标准，6例患者（每个诊所各3例）偶尔或经常发生互联网使用造成的问题，对此定义的基础为20项问卷的评分为50-79分。拉斯维加斯队列中的23%和特拉维夫队列中的48%的患者甚至从未接触过互联网。尽管这两个位于不同城市的诊所的患者人群具有相当大的差异，但两个诊所既往接受美沙酮治疗的阿片类物质成瘾者中网络成瘾罕见的结果惊人一致。拉斯维加斯患者中大麻滥用的比例为特拉维夫患者人群的36倍，女性比例为其5倍。并且拉斯维加斯患者较特拉维夫患者年龄更大、教育水平更高且更多发生抑郁。在经过一番激烈争论后，未将网络成瘾纳入DSM-5认可的障碍。

该研究结论为，既往阿片类物质成瘾者中网络成瘾非常罕见。

该研究未接受任何商业资助。Peles博士披露无与该研究相关的利益冲突。

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By: BRUCE JANCIN, Internal Medicine News Digital Network

BERLIN – Internet addiction and drug addiction do not, as it turns out, go together like ham and eggs. It’s more like oil and water.

Indeed, Internet addiction proved rare among former opiate addicts in methadone maintenance treatment clinics, both in Las Vegas and Tel Aviv, Einat Peles, Ph.D., reported at the annual congress of the European College of Neuropsychopharmacology.

This finding was unexpected, because it’s known that drug addicts are predisposed to other addictive behaviors. For example, in a previous study, Dr. Peles and her coinvestigators documented a strong association between participation in methadone maintenance treatment and pathological gambling (Am. J. Orthopsychiatry 2010;80:311-6).

In the new Internet addiction study, she reported on 177 unselected patients from a Las Vegas methadone maintenance clinic and 71 others from a similar clinic in Tel Aviv. All were assessed using the Internet Addiction Test questionnaire. They also were evaluated for depression using the Center for Epidemiologic Studies Depression Scale (CES-D), since Internet addiction has been shown in a meta-analysis to be related to depression (Psychopathology 2013;46:1-13), noted Dr. Peles of the Tel Aviv Sourasky Medical Center.

None of the 248 study participants met the criteria for Internet addiction as defined by an Internet Addiction Test score of 80 or higher. Six patients – three from each clinic – were defined on the basis of a score of 50-79 on the 20-item questionnaire as having an occasional or frequent problems attributable to Internet use. And 23% of the Las Vegas cohort and 48% from Tel Aviv weren’t exposed to the Internet at all.

The unexpected rarity of Internet addiction among former opiate addicts in methadone treatment was consistent across the two clinics, even though the patient populations in the two cities were quite dissimilar. The Las Vegas patients were 36-fold more likely to be cannabis abusers and five times more likely to be women. They also were older, better educated, and more likely to be depressed than the Tel Aviv group.

After considerable debate, Internet addiction was not included as a recognized disorder in DSM-5.

The study was conducted free of commercial support. Dr. Peles reported having no financial conflicts regarding her study.