Cannabis Use and Dependence among French Schizophrenic Inpatients.

BACKGROUND: To assess the prevalence of cannabis use and dependence in a population of schizophrenic inpatients and to compare schizophrenics with and without cannabis consumption. METHODS: One hundred one schizophrenic patients were examined during their first week of hospitalization. They answered the PANNS scale of schizophrenia, the CAGE and the Fagerström questionnaire, and the DSM-IV-TR criteria for cannabis, alcohol, opiates, and nicotine use dependence were checked. We also assessed socio-demographic characteristics, the motive of cannabis consumption, and the number of cannabis joints and alcoholic drinks taken. RESULTS: The prevalence of cannabis consumption was 33.6% among schizophrenic inpatients. Schizophrenics consuming cannabis were younger than non-schizophrenics (33.3 vs. 44.7 years p < 0.0001), more often male (77 vs. 54%, p = 0.02) and had been hospitalized for the first time in psychiatry earlier (24.3 vs. 31.3 p = 0.003). Eighty-eight percent of cannabis consumers were dependent on cannabis. They were more often dependent on opiates (17 vs. 0%) and alcohol (32 vs. 7.4%, p = 0.001) and presented compulsive buying more often (48 vs. 27%, p = 0.04). Logistic regression revealed that factors associated to cannabis consumption among schizophrenics were cannabis dependence, male gender, pathological gambling, opiate dependence, number of joints smoked each day, and compulsive buying. CONCLUSION: 33.6% of the schizophrenic patients hospitalized in psychiatry consume cannabis and most of them are dependent on cannabis and alcohol. Hospitalization in psychiatry may provide an opportunity to systematically identify a dependence disorder and to offer appropriate information and treatment.

An Investigation of Factors Increasing the Risk of Aggressive Behavior among Schizophrenic Inpatients.

AIM OF THE STUDY: This study tried to identify risk factors of aggressive behavior in a population of schizophrenic inpatients. We tested the association between aggressive behavior and socio-demographic characteristics, addictive disorders, history of suicide attempt, and sexual violence, impulsivity, and sensation seeking. METHODS: All consecutive schizophrenic inpatients (100) were assessed during 6 months. Aggressive behavior was quantified with a standardized scale, the Overt Aggression Scale (OAS). We studied socio-demographic characteristics and the history of suicide attempt and sexual violence with a specific standardized questionnaire. Addictive disorders were identified with the Fagerström and CAGE questionnaires and with the DSM-IV-R diagnostic criteria for nicotine, alcohol, cannabis opiates, and cocaine abuse and dependence disorders. Lastly, we studied sensation seeking with the Zuckerman scale and impulsivity with the Barratt scale. RESULTS: Linear regression identified four factors associated with aggressive behavior: male gender (odd ratio = 12.8), history of sexual violence (odd ratio = 3.6), Fagerström score (odd ratio = 1.3), number of cigarettes smoked each day (odd ratio = 1.16). Patients with nicotine use or dependence had significantly higher levels of OAS scores. This difference was not observed between patients with or without alcohol dependence. OAS scores were correlated to the number of cigarettes smoked each day and to Fagerström scores. Patients with a higher level of sensation seeking and impulsivity also had higher OAS scores. CONCLUSION: A typical schizophrenic patient at risk of showing aggressive behavior is a man, who smokes and presents a history of sexual violence.

Brief report: coronary heart disease: an unknown association to pathological gambling.

Pathological gamblers (PG), because of their high level of stress, depression, and alcohol or nicotine consumption may be overexposed to coronary heart disease (CHD). To test this association, we assessed pathological gambling (DSM-IV-TR criteria and South Oaks Gambling Screen scale) among 73 patients hospitalized in cardiology for CHD and 61 in-patients from the same department hospitalized for a non-coronary disorder. We found six cases of PG (8.2%) and one case of problem gambling in the CHD group versus no case in the non-coronary group (p = 0.01). Pathological gambling was not associated to a higher level of alcohol or nicotine consumption neither to a higher level of sensation-seeking.

Prevalence of exercise dependence and other behavioral addictions among clients of a Parisian fitness room.

AIM OF THE STUDY: Exercise dependence is an inadequate pattern of exercise leading to clinically significant negative consequences. Subjects present loss of control of their physical activity, tolerance, and withdrawal symptoms when they do not practice sport. We studied the prevalence of exercise dependence among clients of a Parisian fitness room. We also assessed alcohol and nicotine use disorders, 2 other "socially tolerated" behavioral addictions (compulsive buying and Internet addiction), and 2 disorders related to anxiety focused on the body (bulimia and hypochondria). METHOD: All clients of the fitness room 18 years and older were invited to participate in the study. Three hundred subjects were included; 125 (42%) presented diagnostic criteria of exercise dependence. Unsurprisingly, exercise dependents spent more hours each day in the fitness center practicing (2.1 vs 1.5 hours per day). They went to the fitness center more often each week (3.5 vs 2.9 days per week). Exercise addicts smoked less; alcohol consumption was equivalent in both groups. Compulsive buying was significantly more frequent in exercise dependents (63% vs 38%), which means they scored higher in the compulsive buying scale (5.4 vs 4.1). Prevalence of hypochondria was equivalent in both groups, but scores in the Whiteley Index of Hypochondria were higher (4.1 vs 3) in the exercise-dependent group. Bulimia was significantly more frequent among exercise dependents (70% vs 47%), who also presented a higher number of bulimic episodes each week (2.5 vs 1.3). Subjects with exercise dependence spent more time on their computer each day (3.9 vs 2.4 hours per day). We found no difference regarding time spent using Internet, the number of e-mails sent or received, and their time at speaking on a cellular phone. CONCLUSION: Our results lead to systematically study the addictive relation to exercise among regular clients of the fitness rooms. Exercise addicts are exposed to negative consequences for their excess of physical activity. Exercise addiction is also associated to compulsive buying, bulimia, and, in a lesser extent, hypochondria.

Prevalence of compulsive buying among customers of a Parisian general store.

Compulsive buying is defined by the presence of repetitive impulsive and excessive buying, leading to personal and family distress. The objective of this study is to assess the prevalence of compulsive buying among "normal consumers" and to describe the specificities in the buying style of compulsive buyers. We tried to answer several questions. (1) Does compulsive buying occur more often during sales or periods of sales campaigns? (2) Is compulsive buying more impulsive and unplanned than normal buying? (3) Are compulsive buyers more "affectively" involved in their purchases (preference for specific brands they have a narcissistic relationship with, tendency to consider purchases as exceptional special occasions)? (4)Do women who buy compulsively use shopping Web sites and the Internet in general more than controls? We interviewed 200 women successively entering Les Galeries Lafayette, a famous Parisian department store. We diagnosed compulsive buying with standardized criteria and a specific rating scale. All subjects answered an additional questionnaire assessing their buying behavior. We also rated their duration of connection to the Web, the number of e-mails sent and received, and the time spent speaking on a cellular phone. Prevalence of compulsive buying was 32.5%. The proportion of married women was lower among compulsive buyers (66%) than in controls (85%). Compulsive buyers do not seek sales more than controls. Their decision to buy is more often made during their stay in the shop (48% vs 24%, chi(2) = 117, P < .001). Women buying compulsively consider more often their purchases as opportunities not to be passed by (33.7% vs 23.1%, P = .006). They have a higher tendency to use items less than expected (23.4% vs 14.4% in the control group, P < .001). They more often make purchases to impress others (6.5% vs 2.5%, P = .04) and consider more often their purchases as personally gratifying (44% vs 23%, P < .001). Their connections to online shopping sites are longer and more frequent. They spend significantly more time than controls speaking on their cellular phones.