A cross-sectional study: Nitrous oxide abuse in Parisian medical students.

BACKGROUND AND OBJECTIVES: Nitrous oxide (N2 O) has euphoric properties, which are associated with an alarming increasing misuse. A lack of data exists regarding medical students. The objectives are: (i) evaluate the prevalence of N2 O use and N2 O use disorder (NUD) among French medical students, (ii) assess whether education about addictions has an impact on consumption, (iii) draw up clinical profiles of N2 O users with or without NUD, (iv) identify factors associated with use and NUD. METHODS: A cross-sectional study among medical students at Université de Paris, using an online questionnaire. RESULTS: Out of the 981 medical students (29% of the total medical students) who completed the questionnaire, 80% had used N2 O. 19% had a mild use disorder, 4% moderate, and 1% severe. N2 O use was significantly associated with the use of poppers (p < .0005), alcohol (p < .0005), and cocaine (p = .004). Factors significantly associated with NUD were alcohol use disorder (p = .017), male gender (p = .006), and being part of a student association (p = .0130). DISCUSSION AND CONCLUSION: This survey shows a high prevalence of N2 O use and NUD among medical students. It could be explained by the N2 O pharmacokinetic profile or by a perception of "harmlessness." We also identified associated risk factors that may be useful to better identify and treat students seeking help. SCIENTIFIC SIGNIFICANCE: This is the first study to evaluate the use of this product among medical students. The evaluation of factors impacting use and dependence is also new in this population, which is at risk of misuse of substances.

MDMA Use by Paris Medical Students: Prevalence and Characteristics.

BACKGROUND: 3,4-Methylenedioxy-N-methylamphetamine (MDMA) is increasing being used by youth in Europe and in France, but characteristics of its use are unknown. Objectives: The aim was to characterize MDMA use in a sample of French medical students. Methods: Cross-sectional study of Paris VII medical students (N = 592) with an online self-reporting questionnaire. Results: 592 students completed the online questionnaire. 21.5% (n = 127) had experimented with MDMA. Use of MDMA was associated with male sex (p < 0.001), older age (p < 0.001), left the parent's home (p < 0.01), and belonging to a fraternity (p < 0.05). Most experimenters (90.7%) used MDMA in a club or during a music festival. Among users, 42.5% used it more than once a year and less than once a month. During the use, users drank alcohol (90.6%), smoked tobacco (70.9%), smoked cannabis (42.0%) or used cocaine (20.5%). In the days after the use, some smoked tobacco (40.9%), smoked cannabis (29.1%), drank alcohol (22.0%), used cocaine (1.6%) and also took benzodiazepines (5.5%). According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, criteria, the prevalence of MDMA use disorder was 8.5% in our sample and 40.9% among MDMA users. As compared with students who never experienced MDMA, fewer users thought that occasional intake could be dangerous (66.9% vs 83.9%, p < 0.001) and that MDMA could be addictive (74.0% vs 90.3%, p < 0.001). Conclusions: Other studies focusing on drug consumption among students are necessary to define specific public health strategies of prevention and harmful reduction.

Compulsive buying in Paris psychology students: Assessment of DSM-5 personality trait domains.

Compulsive buying is associated with significant psychiatric comorbidity, such as personality disorders. Few studies have focused on the dimensional model of personality disorders in compulsive buying. We aimed to assess the eventual presence of personality dysfunctions in compulsive buying according to the Diagnostic and Statistical Manual of Mental Disorder, 5th edition (DSM-5) dimensional conception of personality disorders. We screened online compulsive buying (QABB), characterized purchasing behavior and explored DSM-5 personality trait domains (Personality Inventory for DSM-5-Brief Form [PID-5-BF]) in 233 Paris psychology students using an online self-reporting questionnaire. The prevalence of compulsive buying among students was 7.7% (n = 18). The favorite items purchased by compulsive buyers were clothing and cosmetic products. Three mean trait domain scores were significantly higher for CB+ than CB- students: negative affect, detachment and disinhibition. Our findings suggest that compulsive buyers distinctively feature pathological DSM-5 dimensional personality trait domains.

Suicide attempters examined in a Parisian Emergency Department: Contrasting characteristics associated with multiple suicide attempts or with the motive to die.

Among patients examined after a suicide attempt in a Parisian emergency department, we aimed to compare individual characteristics of i) first time and multiple suicide attempters, ii) attempters whose principal motive was "to die" and attempters who had any other motive. Information regarding sociodemographics, clinical characteristics, prior mental health care and outgoing referral was collected in 168 suicide attempters using a standardized form. Associations of these variables with suicide attempt repetition (yes or no) and with the motive underlying the attempt (to die or not) were examined using descriptive statistics and multivariable logistic regression models. Multiple attempters were more likely to have no occupation and to report previous mental health care: mental health follow-up, psychiatric medication or psychiatric hospitalization. The motive to die was not associated with the risk of multiple suicide attempts but related to past suicidal ideation and to some specific precipitating factors, including psychiatric disorder. Patients who intended to die were also more likely to be referred to inpatient than to outpatient psychiatric care. Multiple attempters and attempters who desire to die might represent two distinct high-risk groups regarding clinical characteristics and care pathways. They would probably not benefit from the same intervention strategies.

Impact of a computer-assisted Screening, Brief Intervention and Referral to Treatment on reducing alcohol consumption among patients with hazardous drinking disorder in hospital emergency departments. The randomized BREVALCO trial.

OBJECTIVE: To assess the impact of a computer-assisted Screening, Brief Intervention, and Referral to Treatment (SBIRT) on daily consumption of alcohol by patients with hazardous drinking disorder detected after systematic screening during their admission to an emergency department (ED). DESIGN: Two-arm, parallel group, multicentre, randomized controlled trial with a centralised computer-generated randomization procedure. SETTING: Four EDs in university hospitals located in the Paris area in France. PARTICIPANTS: Patients admitted in the ED for any reason, with hazardous drinking disorder detected after systematic screening (i.e., Alcohol Use Disorder Identification Test score ≥5 for women and 8 for men OR self-reported alcohol consumption by week ≥7 drinks for women and 14 for men). INTERVENTIONS: The experimental intervention was computer-assisted SBIRT and the comparator was a placebo-controlled intervention (i.e., a computer-assisted education program on nutrition). Interventions were administered in the ED and followed by phone reinforcements at 1 and 3 months. MAIN OUTCOME MEASURE: The primary outcome was the mean number of alcohol drinks per day in the previous week, at 12 months. Results From May 2005 to February 2011, 286 patients were randomized to the computer-assisted SBIRT and 286 to the comparator intervention. The two groups did not differ in the primary outcome, with an adjusted mean difference of 0.12 (95% confidence interval, -0.88 to 1.11). CONCLUSIONS: There was no additional benefit of the computer-assisted alcohol SBIRT as compared with the computer-assisted education program on nutrition among patients with hazardous drinking disorder detected by systematic screening during their admission to an ED.

Characteristics of online compulsive buying in Parisian students.

BACKGROUND: Online compulsive buying is a little-studied behavioral disorder. AIMS: To better understand its clinical aspects by focusing on (i) prevalence rate, (ii) correlation with other addictions, (iii) influence of means of access, (iv) motivations to shop to the internet and (v) financial and time-consuming consequences. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: 200 students in two different centers of Paris Diderot University - Paris VII. MEASUREMENTS: Brief self-questionnaires, to screen online compulsive buying, internet addiction, alcohol and tobacco use disorders, to rate frequency of online purchase by private-sale websites, by advertising banners, by mobile phone or to avoid stores, to rate motivations like "more discreet", "lonelier", "larger variety of products", "more immediate positive feelings", and "cheaper" and to assess the largest amount of online purchasing and the average proportion of monthly earnings, and time spent, both day and night. FINDINGS: Prevalence of online compulsive buying was 16.0%, while prevalence of internet addiction was 26.0%. We found no significant relationship with cyberdependence, alcohol or tobacco use disorders. Online compulsive buyers accessed more often shopping online by private-sale websites (56.2% vs 30.5%, p<0.0001) or by mobile phone (22.5% vs 7.9%, p=0.005) and preferred online shopping because of exhaustive offer (p<0.0001) and immediate positive feelings (p<0.0001). Online compulsive buyers spent significantly more money and more time in online shopping. CONCLUSION: Online compulsive buying seems to be a distinctive behavioral disorder with specific factors of loss of control and motivations, and overall financial and time-consuming impacts. More research is needed to better characterize it.