Gambling is a deeply rooted cultural activity in the Philippines as a form of recreation, and a a significant portion of the population engages in gambling activities, however, specific data on the prevalence of Gambling Disorder is are limited due to the lack of comprehensive studies. Psychiatric admissions specifically with Gambling Disorder remain relatively less studied and under-investigated.

This study aims to determine the profile of patients admitted for Gambling Disorder admitted to a tertiary psychiatric facility in the Philippines from 2016-2025, to describe the demographic characteristics, types of gambling, and the associated factors with the addiction.

The study involved a retrospective review of medical charts, focused on sociodemographic factors, prior psychiatric admissions, and family history of substance use and related disorders, as well as clinical profiles including co-morbid psychiatric disorders. Descriptive statistical methods were used to analyze the findings.

48 patients were diagnosed with Gambling Disorder were admitted to the psychiatric facility between 2016 and 2025. The number of admissions increased in recent years from 2023-2025. Most patients were male (89.6%), mainly between 21 and 50 years old. A majority were married (52.1%) or single (43.8%), and more than half had completed college education (56.3%). Casino gambling was the most common form of gambling 64.6%, followed by online gaming at 33.3%. Many patients had co-morbid psychiatric conditions, with Mood disorders affecting 79.2% and Substance-related disorders present in 62.5%. Substance use involved methamphetamine, alcohol, cannabis, benzodiazepines, and opioids, while 35.4% reported use of multiple substances. Additional co-morbidities included Psychotic disorders (12.5%), Personality disorders (12.5%), and Neurodevelopmental disorders (14.6%). Almost half of the patients (45.8%) had previous psychiatric admissions, and 27.1% had a family history of substance-related disorders.

A significant proportion of patients with Gambling Disorder had co-morbid psychiatric conditions highlighting the complex clinical profile of these patients, which emphasizes the need for comprehensive and integrated treatment approaches. These findings suggest that Gambling Disorder is an emerging public health issue in the Philippines that requires targeted intervention, increased awareness, and specialized services within psychiatric care settings. Further studies could investigate long-term outcomes and treatment approaches for this population.

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Tobacco use remains a major public health concern among adolescents, with growing evidence linking it not only to physical harm but also to mental health challenges. While e-cigarettes and other tobacco products are increasingly popular among youth, less is known about how patterns of multiple product use relate to anxiety, depression, self-esteem, and digital behaviors.

To determine the association between the use of many tobacco products and mental health disorders among Tunisian High School Students.

A cross-sectional study was carried out in the urban area of Sousse, Tunisia, during the 2018/2019 school year. A representative sample of high school students attending public institutions was recruited. Data were collected using a self-administered structured questionnaire that captured sociodemographic information and mental health outcomes (including depression, anxiety, self-esteem, alexithymia, and problematic use of video games and Facebook), assessed through validated Arabic scales. Statistical analyses were performed using SPSS software, version 20. We created clustering groups by adding each one-tobacco product (Cigarette, e-cigarette , and Waterpipe) to obtain 4 aggregations from 0 to 3.

A total of 1,342 students participated (63.2% female; mean age 17.5 ± 1.4 years). The prevalence of tobacco use was 16.5%. We found that 83.5% of the studied population were nontobacco users, 2.7% had the maximum number of poly-tobacco use, 8.1% were single users, and 5.7% were dual users. The proportion of anxiety decreased significantly (0.002) with the number of tobacco products used. The high school students who did not use any tobacco products were more likely to have anxiety, with 86.9% compared to students using 3 products (50%). Yet, students who used 2 or 3 tobacco products presented a problematic use of videogames (33.3% and 27.6% respectively), significantly higher than those who used none or one product (10.5% and 21.7% respectively). Users of three products were more likely to be depressed, have low self-esteem, and have a problematic use of Facebook. However, the associations were nonsignificant

Using multiple tobacco products among adolescents was associated with disorders in mental health and digital behaviors. While causality cannot be inferred from this cross-sectional study, the findings underscore the need for preventive programs that address both substance use and emerging digital risks. Future longitudinal research is warranted to clarify these relationships and guide effective interventions.

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Adolescence is a critical developmental stage often marked by the initiation of risk behaviors and the emergence of psychological difficulties. Tobacco, alcohol, and drug use remain major public health concerns worldwide. In contrast, behavioral addictions such as problematic Internet use and excessive video gaming are increasingly recognized as threats to adolescent health. In parallel, emotional and mental health challenges, including depression, anxiety, alexithymia, and low self-esteem, contribute to impaired well-being and long-term vulnerability.

To determine the prevalence of addictive behaviors and mental health among Tunisian high school students.

We conducted a cross-sectional study in the urban area of the Sousse governorate in Tunisia during the 2018/2019 school year. We selected a representative sample of high school students enrolled in public educational institutions in Sousse. Data collection was performed through a self-administered structured questionnaire, which gathered information on sociodemographic characteristics, lifestyle behaviors, and mental health disorders (Depression, Anxiety, Self-esteem, Alexithymia, Problematic use of Video Games and Facebook) using validated Arabic version scales. Statistical analysis was carried out using the SPSS program (version 20).

We enrolled a total of 1342 high school students in our study, of whom, 63.2% were female with a mean age of 17.5±1.44 years. The prevalence of tobacco use was 16.5%. E-Cigarettes were the most used tobacco product among high school students, with a prevalence of 11.1%, and 27% of adolescents acknowledged having smoked at least once in their lifetime. The prevalence of drug use and alcohol use was 9% and 6.1% respectively. Boys were more likely to use drugs than girls (11.9% vs. 7.4%, p = 0.005). The prevalence of Facebook and Video game addiction was 28.3% and 13% respectively. Boys were more likely to be addicted to video games than girls (24.1% vs. 6.8%, p < 0.001). Girls were more likely to be addicted to Facebook (18.3% vs. 34.0%, p < 0.001). A notable proportion of adolescents (66.8%) manifested signs of alexithymia, 11.4% of the participants presented severe depression, and 39% of students reported experiencing low or very low levels of self-esteem. More than half of the participants (67%) demonstrated symptoms of anxiety disorders.

These findings highlight the substantial burden of risk behaviors and mental health problems among adolescents, with notable gender differences across several domains. The high prevalence of tobacco experimentation, alcohol and drug use, digital addictions, emotional difficulties, and physical inactivity underscores the urgent for integrated prevention and intervention strategies targeting both behavioral and psychological well-being in this vulnerable population.

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Psychoactive substance use (PSU) is a growing concern among university students, particularly those in medical schools who face high academic and emotional demands. Peer influence, stress, and lifestyle factors contribute significantly to this behavior. Such use may impair mental health, cognitive function, and academic achievement.

This study aimed to assess the prevalence, and the impact of psychoactive substance use among medical students at the Faculty of Medicine of Sousse (FMSo), Tunisia.

A cross-sectional analytical study was conducted among FMSo students during the academic year 2023-2024. Data were collected via an online questionnaire that assessed sociodemographic characteristics, lifestyle habits (such as physical activity), and psychoactive substance use (tobacco, alcohol, illicit drugs). Academic performance was measured using self-reported overall grade averages. Univariate and multivariate analyses were performed to determine the association between PSU and academic performance.

Among 1,529 eligible students, 701 completed the survey (response rate: 45.8%), with a female majority (69%). The median age was 22 years [IQR: 21–24]. Most participants came from urban areas (60.2%) and were single (94.2%). Seventy percent reported engaging in physical activity (either occasionally or regularly). Most of the students (47.4%) achieved moderate performance (12-13.99/20). The overall prevalence of PSU among students was 28.4%, including 19.6% for tobacco, 5.4% for alcohol, and 3.4% for illicit drugs. PSU was significantly associated with poor academic performance (p < 0.001). Tobacco smoking also showed a significant negative impact on academic success (p < 0.001). In the final multivariate model, PSU remained an independent predictor of lower academic performance (β = - 1.597, p < 0.001).

Psychoactive substance use is independently associated with reduced academic performance among medical students. Comprehensive prevention strategies focusing on stress reduction, mental health support, and healthy lifestyle promotion are essential to improve students’ well-being and academic success.

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Background: Video gaming is a global phenomenon increasingly recognized in mental health research, with potential for both adaptive and maladaptive outcomes. While gaming disorder (GD) has been integrated into the ICD-11, the psychological heterogeneity of players remains understudied, particularly in women and non-binary gamers and across diverse game genres.

Aims This study investigates the association of mental health, relational contexts, and gaming characteristics with psychological profiles of gamers, focusing on emotional regulation and motivations for play. A central contribution of this study is its inclusivity: it integrates women and non-binary participants and considers all types of video games, addressing gaps in existing literature often limited to male samples or specific genres.

An international sample of 5,255 gamers (49.9% men, 43.2% women, 9.3% non-binary; aged 16–69, M = 25.6, SD = 6.46) from 112 countries completed validated measures of emotion regulation (DERS-SF), gaming motivation (GMI), mental health (CORE-SFB), attachment (ECR-RS), social interactions, and gaming habits. Latent profile analysis identified four psychological profiles, followed by multinomial logistic regressions to assess associations with mental health, social-relational, and gaming-related covariates.

Four profiles were identified: avoidant (older players, low distress, secure attachment, offline socialization), engaged (largest group, secure attachment, active social integration of gaming), relational (insecure attachment, emotional regulation difficulties, selective online engagement), and dysregulated (younger players, high distress, substance use, online preference). Dysregulated and relational profiles were linked to insecure attachment and mental health problems, while engaged and avoidant profiles reflected secure attachment and adaptive functioning.

These findings highlight the complex interplay of psychological, social, and gaming-related factors shaping player experiences. By including women, non-binary players, and all types of video games, this study provides one of the most inclusive examinations of gaming profiles to date, underscoring the need for gender-sensitive and context-aware prevention and intervention strategies in mental health.

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Students are expected to spend much of their time on their education and need to graduate with good academic results. Thus, academic failure is one of the most serious problems faced by a university student (US).

This study aimed to explore the prevalence of academic failure among US and its associated factors.

A cross-sectional study was conducted among university students at Sfax University, located in southern Tunisia, during the 2024–2025 academic year. A stratified three-stage cluster sampling method was employed to select a representative sample of US. Data collection was performed using an anonymous self-administered questionnaire. Academic failure was identified by an annual average < 10/20 during the last year.

A total of 1071 participants were included in the study, among whom 312 cases were males (29.1%), giving a male to female ratio of 0.41 . The median age of US was 22 [20-23] . There were 1028 US (96%) enrolled in public university and 1037 single US (96.8%). Of all, 61 US (5.7%) were living alone, 171 US (16%) had chronic disease, 160 US (14.9%) practiced physical activity, 920 US (85.9%) spent time on leisure activities and 378 US (35.3%) were frequently meeting their friends. Low monthly income was noted among 135 cases (12.6 %).

The prevalence of academic failure among US was 14% (n=150). Academic failure was statistically associated with male gender (OR=1.125;P=0.046), frequently meeting friends (OR=1.165;P=0.026), Alcohol comsumption (OR=1.133; P<0.001), Tobacco use (OR=1.125; P=0.009) and illicit drug use (OR= 1.035; P=0.049).

Academic failure among US was identified as a major concern, with substance use emerging as the primary associated factor. Early detection of academic difficulties and substance use could be crucial in preventing these issues.

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The use of tobacco and other substances remains a major public health concern affecting all age groups and generations. Young adulthood represents a peak period for the emergence of such behavioral problems, particularly among university students, including those in engineering.

This study aimed to explore the prevalence of substance use among engineering students (ES) in Sfax, Southern Tunisia and its associated factors.

It was a cross-sectional study conducted during the 2024-2025 academic year among ES of all levels. It was conducted in Sfax, South of Tunisia by using the stratified random sampling method. Data collection was performed using an anonymous self-administered questionnaire.

Overall, 302 ES were enrolled in the study. The median age was 23 years with an interquartile range (IQR)= [21-24 years]. There were 148 females (60.9%), giving a male to female ratio of 0.64. History of chronic disease was noted in 41 ES (13.6%). There were 33 ES (10.9%) having low monthly income and 53 ES (17.5%) lived in rural areas. Academic failure during the last year was noted among 38 ES (12.6 %). As for lifestyle behaviours, a total of 61 ES (14.9%) practised physical activity and 261 ES (86.4%) had leisure activities.

Prevalence of tobacco use, alcohol consumption and illicit drug use among ES were 23.5% (n=71), 16.2% (n=49) and 4.6% (n=14), respectively.

Prevalence of tobacco use was statistically associated with male gender (OR=3.407; p=<0.001), living in rural areas (OR =1.280; p=<0.001) and academic failure (OR=1.256; p=<0.001). In addition, it was statistically associated with alcohol consumption (OR =2.496; p=<0.001) and illicit drug use (OR =1.219; p=<0.001). Besides, having a leisure activity was statistically associated with lower prevalence of tobacco use among ES (OR=0.87; p=0.029).

A noteworthy finding was the high prevalence of both tobacco use and co-addictions among engineering students, with lifestyle behaviors and socioeconomic status identified as key predictors. These results emphasize the importance of implementing monitoring and support programs to address existing addictions and prevent the initiation of new substance use.

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Alcoholism is quite often combined with other mental illnesses. There are two aspects of the interaction between alcoholism and mental disorder: the influence of mental disorder on alcoholism, and the possible influence of alcohol on mental disorder.

The aim of the study was to analyse the specifics of alcohol use by patients with depression, assessment of the connection with ego identity.

77 patients (31.2% male, mean age 21.8±4.3) with depressive states (F31.3-4; F34.0; F21.3-4+F31.3-4; F60.X+F31.3-4).

Alcohol consumption was assessed using the ‘alcohol consumption’ scale of The questionnaire for diagnosing manifestations of psychological distress (Rasskazova, Sadovnichaja, 2022) was developed for research by E.G. Demenko (Demenko et al., 2018). Based on this scale, the subjects were divided into two subgroups: ‘No alcohol consumption’ (N=24) and ‘Alcohol consumption’ (N=53), that did not differ in terms of socio-demographic indicators.

SCL-90-R, Cambridge Depersonalisation Scale (CDS), Ammon Ich Structur Test (ISTA) measures personality traits formed as a result of early relationships with significant others, Constructive Thinking Index (CTI), Questions about the propensity for risky behavior (answers on a Likert scale) were used. Subgroups were compared using analysis of variance in SPSS.

The results showed that the group ‘Alcohol consumption’ had higher scores on the SCL-90R scales, dissociative phenomenology (CDS), categorical thinking (СТI), high level of destructive internal and external ego demarcation (ISTA) (see Tabl.). The ‘Alcohol consumption’ group also has a higher level of risk-taking behaviour (20% in the no-alcohol group versus 50% in the alcohol group).Table 1.

Comparison of subgroups without and with alcohol consumption

Alcohol consumption in mental illnesses is associated with higher rates of psychopathological symptoms, categorical thinking, and a tendency to risky behaviour. The data obtained suggest that a significant role is played by EGO- integration disturbance (rigid boundaries, destructive fear, pathological narcissism, destructive aggression), which are associated with higher rates of the alcohol consumption. Alcohol can be considered as a vulnerability factor for mental disorder, and alcohol can be used as an unproductive coping strategy in cases of severe psychological distress.

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Substance use disorders (SUD) and behavioral addictions constitute a complex group of affections with a high prevalence around the world and in Morocco. Their treatment hindered by the frequency of relapses. Virtual reality (VR) is a computer-generated simulation, using specific hardware, that allows users to feel present in a virtual environment through various sensory stimuli. Thanks to its unique ecological validity, VR has gotten a lot of interest as a potential solution to craving assessment, but also as a tool that may be used in cue exposure therapy (CET) and/or cognitive behavioral therapy (CBT).

This study aims to present an overview of the use of VR in the field of addiction.

The literature review was based on PubMed research using the key words: virtual reality, addictive, addiction, substance, alcohol, eating disorder, cocaine, cannabis, opioid, tobacco, nicotine, methamphetamine, gaming, gambling. Out of the 170 results initially found, 26 studies were included after screening.

Nicotine: significant signs of craving were induced by virtual smoking cues. Crushing virtual cigarettes was shown to reduce nicotine addiction, and virtual environment CET as a treatment method was better than classical pictures watching and as good as CBT.

Alcohol: VR systems were able to induce alcohol craving using both contextual and sensory alcohol-related cues. High levels of presence were reported thus proving ecological validity. There was a decrease in cue-elicited craving after virtual environment CET, with one study showing better results using VR CET than general cognitive therapy.

Methamphetamine: VR drug-related cues led to increased craving and skin conductance. VR based therapies are able to suppress cue-induced reactivity after multiple sessions.

Gaming: An increase in craving was observed when patients were exposed to game-related cues in a virtual environment. Similar results to CBT were reported with VR treatment.

Gambling: Casino-related cues were able to generate craving in gamblers. Multiple sessions based on repeated exposure and relaxation training led to a reduced urge to gamble.

Cannabis: Cannabis virtual environments caused a higher craving sensation than the neutral ones.

Cocaine: Significant increase in craving and heart rate during cocaine-related virtual scenes compared to baseline.

Eating disorders: Overall, VR CET showed better results than CBT in the treatment of bulimia nervosa and binge-eating disorder.

The studies reviewed in this work showed promising results and were able to prove that VR could be a powerful tool in the field of SUD thanks to its several benefits in both assessment and treatment. Future work involving researchers in both VR and SUD domains and associating it to other technologies could expand the future prospects of the virtual world.

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Psychiatric nurses face high occupational stress, frequently exposed to patient aggression and emotionally charged situations. These pressures may be associated with maladaptive coping strategies, including psychoactive substance use. Investigating these patterns can inform preventive interventions and support mental well-being.

To assess the prevalence of psychoactive substance use among psychiatric nurses in Tunisia and examine its association with coping strategies and psychological distress.

An exhaustive cross-sectional study including 237 psychiatric nurses was conducted from January 2024 to April 2024. Participants completed a self-administered questionnaire assessing the use of tobacco, alcohol, and cannabis , coping strategies via the Brief COPE inventory and psychological distress using the DASS-21 scale.

Substance use was reported by 21.9% (tobacco), 7.6% (alcohol), and 1.7% (cannabis). The most common coping strategies were religion (51.9%), planning (49.4%), and acceptance (47.3%). Avoidant coping strategies including denial, behavioral disengagement, and substance use ,were significantly associated with higher psychological distress (p < 0.05).

Younger nurses (<35 years) relied more on avoidant coping (38% vs. 21%) and reported higher substance use (tobacco 28% vs. 18%, alcohol 11% vs. 5%). Nurses with fewer than 10 years of experience also showed higher avoidant coping (36% vs. 20%) and substance use (tobacco 26% vs. 18%, alcohol 10% vs. 5%), identifying vulnerable subgroups for targeted interventions.

This study did not assess psychotropic use or addiction, which may be relevant due to their accessibility in psychiatric settings.

Most psychiatric nurses employ adaptive coping strategies, yet a minority use psychoactive substances linked to avoidant coping and higher psychological distress. Younger and less experienced nurses are particularly at risk. Findings support institutional measures, adaptive coping training, and early identification of at-risk staff. Future longitudinal studies are needed to explore these associations further.

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Early use of psychoactive substances constitutes a major factor of social vulnerability. It often precedes school, professional, and family disruptions, fostering isolation, precariousness, and exclusion from healthcare systems. This phenomenon, still underexplored in the Moroccan context, raises concerns for prevention and support programs.

To analyze the social and professional consequences of early substance use among young adults hospitalized for substance use disorder, and to identify potential levers for collective action.

A retrospective, descriptive, and analytical study conducted among patients hospitalized in the addiction unit of the Arrazi University Hospital. Data were collected using a structured questionnaire assessing age of first use, consumption profile (polysubstance use, relapses), and social impacts (job loss, isolation, precariousness, family breakdown, legal history).

Subjects who started early present a higher risk of social disaffiliation. The accumulation of comorbidities, relapses, and economic vulnerabilities reinforces social exclusion. The influence of family context and living environment is particularly significant.

Early addictions must be recognized as a major societal challenge. Collective responses, combining integrated prevention, community support, and reintegration assistance, are necessary to break the cycle of exclusion.

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Social support plays a central role in the recovery of individuals with substance use disorders (SUDs). It not only enhances treatment adherence but also helps sustain connections, reinforce motivation, and foster a sense of belonging. Yet, the ways in which gender norms influence the reception and provision of support within therapeutic communities (TCs) in Brazil remain under-explored.

To understand how individuals with SUDs perceive and experience social support during treatment in TCs, considering gender influences and the role of family and community ties in their care trajectories.

This is a qualitative exploratory study. A focus group was conducted with six participants (three men, including one trans man, and three women, including one trans woman) in a TC in an inland region of São Paulo state, Brazil. Discussions were audio-recorded, transcribed, and subjected to thematic content analysis.

Three primary themes emerged: (1) Emotional and instrumental support: Affectionate encouragement, attentive listening, and everyday presence were valued as fundamental, while lack of understanding by family members weakened support; (2) Family and institutional networks: When family ties were fragile, bonds forged in the TC and in social assistance networks assumed a central role in maintaining treatment motivation; (3) Gender norms: Men reported difficulties expressing vulnerability and seeking help, whereas women emphasized the importance of affective ties and acceptance from family and peers. These differences affected how support was accessed and incorporated into recovery pathways.

In TCs, social support emerges at the intersection of affective, institutional, and gendered dimensions. Recognizing the influence of gender norms is essential to foster equitable access to emotional support. We argue that policies and practices should strengthen family and institutional networks while creating environments that validate vulnerability and emotional expression among men, women, and trans people in treatment.

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Gambling disorder(GD) lacks approved pharmacotherapies and current psychological treatments face adherence and effectiveness limitations. Deep repetitive transcranial magnetic stimulation (dTMS) with the H7 coil targets medial prefrontal and anterior cingulate circuits implicated in impulsivity and compulsivity yet has not been tested for GD in a rigorous sham-controlled trial. We describe the COMET-7 protocol.

To evaluate the efficacy, safety and tolerability of high-frequency H7-coil dTMS for GD versus sham. Secondary objectives: to identify clinical/psychological predictors and heart-rate variability (HRV) correlates of response, and to estimate economic impact of this treatment.

Single-centre, prospective, double-blind, parallel-group, randomised, sham-controlled trial with concealed allocation and blinded outcome assessment at the University Psychiatric Clinic Sveti Ivan. Men aged 18–64 years with ICD-10 F63.0 GD, right-handed, entering treatment are eligible. Key exclusions include psychosis, recent substance use disorders (except nicotine) and major neurological disease. Participants will be randomised 1:1 by minimisation (Pocock–Simon) on prespecified factors. The active arm receives FDA-pattern H7-coil dTMS: 20 Hz, 2-s trains, 20-s inter-train, 2,000 pulses/session at 100 % motor threshold, five sessions/week for five weeks plus four sessions in week six (total 58,000 pulses); the sham arm receives device-matched sham. All patients continue standard multidisciplinary care, held constant across arms. Outcomes are assessed at baseline and six weeks; selected measures are monitored weekly. The primary endpoint is change in Gambling Symptom Assessment Scale (G-SAS). Secondary endpoints include craving (GUS, VAS), PG-YBOCS, PGSI, SOGS, abstinence, depressive and anxiety symptoms (BDI-II, BAI), quality of life (QOLI), HRV parameters, and adverse events. The intention-to-treat analysis tests the group×time interaction using mixed-model ANCOVA with prespecified covariates. Sensitivity analyses include per-protocol and robust models. Missing outcomes in ITT are handled under a conservative no-effect assumption; covariate missingness is multiply imputed. Target sample size is 60 (30 per arm) to detect a moderate effect with 80 % power, allowing 15 % attrition. The trial will be registered on ISRCTN; ethics approval will be obtained before enrolment

This abstract reports the registered design, eligibility, intervention, endpoints, analysis plan and sample size to enable appraisal and replication.

COMET-7 will provide the first double-blind, sham-controlled evidence on H7-coil dTMS for GD. By integrating clinical measures with HRV and economic evaluation, the study is designed to inform mechanistic understanding, patient selection and health-policy decisions regarding neuromodulation for behavioural addictions.

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Strength, vitality, and aggression are central elements of cultural masculinity, often linked to testosterone. Anabolic-androgenic steroid (AAS) use alters circulating sex hormones in both the short and long term, with potential consequences for identity, behavior, and mental health. Yet, the role of sex hormones in men’s health and psychosocial functioning is often oversimplified and few have systematically examined these associations.

To investigate associations between AAS use, well-being, symptoms of male aging, masculinity norms, aggression, and sex hormone levels in midlife male weightlifters.

This ongoing study examines health and well-being in weightlifters with current, past, or no history of AAS use. Participants (mean age ∼45 years) completed questionnaires assessing masculinity norms (Conformity to Masculine Norms Inventory–30), aggression (Buss–Perry Aggression Questionnaire - Short Form), well-being (WHO-5), and aging-related symptoms (Aging Males’ Symptoms scale). Blood samples were analyzed for testosterone (T), free testosterone index (FTI), follicle-stimulating hormone (FSH), sex hormone-binding globulin (SHBG), luteinizing hormone (LH), and estradiol. Based on self-reported history, participants were stratified into four groups: weightlifting controls (WLC, n=44), current AAS users (n=31), past AAS users (n=24), and past AAS users on testosterone replacement therapy (TRT, n=13). Correlations and group comparisons explored associations between hormones, masculinity, aggression, well-being, and aging symptoms.

Preliminary analyses revealed associations between hormonal markers and psychosocial measures, alongside several non-significant findings. Past AAS users reported lower quality of life and more aging symptoms compared to all other groups (p < .01–.05). Groups did not differ significantly on aggression, but all AAS groups scored higher than WLC on masculinity norms (p <.01). Low T and FTI were associated with more aging symptoms, while in WLC, SHBG levels correlated positively with well-being. Several CMNI subscale findings confirmed classical stereotypes: endorsement of casual sexual activity and multiple partners (playboy subscale), power over women, and career pursuit were all positively associated with T, FTI, and estradiol. No relations were seen for aggression and hormonal markers.

Preliminary findings suggest that AAS history and hormonal status are linked to well-being, aging symptoms, and masculine norms in midlife men. Aggression showed no hormonal associations, whereas specific masculinity dimensions did, reflecting cultural stereotypes. The results highlight the complex interplay of biological and psychosocial factors in men’s health and warrant cautious interpretation and further study.

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Substance Use Disorders (SUDs) represent a persistent global psychiatric and public health burden, often exacerbated by stigma, fragmented care pathways, and limited integration of psychosocial dimensions in treatment. Traditional biomedical approaches frequently overlook the central role of empathy, which is fundamental in psychiatric practice. Empathy allows clinicians to reframe addiction beyond moral or stigmatizing narratives, to recognize patients’ lived experiences, and to incorporate dimensions such as pleasure and quality of life (QoL) into recovery processes. Despite its importance, empathy remains insufficiently emphasized in undergraduate and postgraduate medical education.

This review explores how empathy-centered education during medical school and psychiatric residency can shape clinician attitudes, strengthen therapeutic alliance, and contribute to better recovery trajectories and QoL outcomes for individuals with SUDs.

A narrative review of peer-reviewed literature was conducted, focusing on medical education, residency training, and addiction psychiatry. Educational strategies reviewed included reflective practice sessions, patient storytelling, exposure to recovery narratives, supervised empathy workshops, and integration of structured curricula promoting person-centered care.

Evidence shows that empathy-focused training improves clinical competence, communication, and stigma reduction. Medical students and residents exposed to empathy-based teaching reported enhanced motivation for compassionate practice and greater willingness to address complex psychosocial factors. Addressing pleasure as part of recovery, when approached empathetically, was associated with improved patient engagement, adherence, and QoL. Conversely, lack of empathy correlated with patient dissatisfaction, disengagement, and weaker therapeutic alliances.

Embedding empathy training across all stages of medical and psychiatric education is essential to bridge the gap between technical knowledge and humanistic care. Empathy not only mitigates stigma but also reframes addiction as a multifaceted condition, supporting recovery, resilience, and enhanced QoL for patients with SUDs.

Empathy, Medical Education, Residency, Addiction, Quality of Life

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Migrants and refugees are frequently exposed to traumatic experiences, resulting in high prevalence of post-traumatic stress disorder (PTSD). PTSD and substance use disorders (SUD) commonly co-occur, creating a challenging clinical presentation with important treatment implications. While this association is well established in the general population, less is known in migrants.

This literature review examined the association between post-traumatic symptoms and substance use among migrant individuals, aiming to clarify whether migration-related experiences confer specific risks for SUD.

A systematic literature search was conducted in PubMed, Web of Science, and Scopus, covering publications from 2005 to 2025. The association between substance use and post-traumatic symptoms in migrant populations was examined in peer-reviewed observational studies.

While findings were mixed, the results largely suggest a significant association between PTSD and substance use in migrants. In studies comparing migrants and non-migrants, PTSD was consistently linked to an increased risk of SUD in both groups. The association appeared weaker in migrants overall, but when SUD was present, post-traumatic symptoms tended to be more severe than in non-migrants. Cross-sectional studies showed heterogeneous associations between post-traumatic symptoms and substance use. Moreover, some studies reported an association between the severity of post-traumatic symptoms and substance use in migrants.

Preliminary evidence suggests that PTSD and substance use disorders co-occur in migrant populations, although the strength of this association varies across study designs, populations, and substances. Interpretation is limited by small sample sizes, the reliance on cross-sectional designs, and substantial heterogeneity across studies. Further research is needed to clarify the mechanisms linking PTSD and SUD in migrant populations, with particular attention to improved control of confounders and the use of more homogeneous samples.

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The use of psychoactive substances including tabacco among young people represents a growing public health concern. This population is particularly vulnerable due to academic pressure, social transition and increased autonomy, which may contribute to risky consumption behaviors. Understanding the prevalence and contributing risk factors is crucial for developing targeted prevention and support strategies among this population.

To assess the prevalence and risk factors associated with tobacco use among nursing students at a private institute in Tunisia.

A cross-sectional analytical study was conducted involving 300 nursing students at a private higher education institute in Tunisia. Data were collected using a questionnaire, and tobacco dependence was assessed using Fagerström Test.

The study included 300 nursing students, predominantly female (63%), with most participants aged 20–21 years (49%). All respondents were single, and the majority (96%) had not repeated an academic year. Over half (54.3%) lived with their families. Overall, 33.7% of students reported having used addictive substances, with tobacco being the most commonly used (31.7%). Among tobacco users, 55.7% showed signs of probable dependence, while 12.6% reported occasional use. The average consumption was 5.05 cigarettes per day. Univariate analysis identified significant associations with tobacco use. Age was positively correlated with tobacco consumption (r=0.413, p<0.001). Male students were significantly more likely to smoke than females (25.7% vs. 6%, p<0.001). Academic level was not significantly associated (p=0.516), though a slight decrease in prevalence was observed across academic years. Notably, all students who had repeated a year reported smoking (p<0.001). Place of residence was not significantly associated with tobacco use (p=0.264). Multivariate analysis confirmed strong associations between tobacco use, age (OR ranged from 2.8 to 3.0), male sex, and year repetition, while first-year students were less likely to smoke (OR=0.48). These findings highlight age, sex, and academic status as key factors associated with tobacco use in this population.

Tobacco use is prevalent among nursing students, with a concerning proportion showing signs of probable dependence. Age, male gender, and academic repetition emerged as significant risk factors. These findings highlight the need for targeted prevention strategies within university settings to reduce the initiation and progression of tobacco use in this vulnerable population.

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Alcohol consumption among young adults constitutes a major public health concern, given its association with a range of adverse health, academic, and social outcomes. This population is particularly susceptible to hazardous drinking behaviors due to several factors. A comprehensive understanding of its prevalence and contributing risk factors is essential for informing evidence-based prevention strategies and targeted interventions within this demographic.

To assess the prevalence and risk factors associated with alcohol use among nursing students at a private institute in Tunisia.

A cross-sectional analytical study was conducted involving 300 nursing students at a private higher education institute in Tunisia. Data were collected using a questionnaire, and alcohol dependence was assessed using CAGE-DETA test.

The study included 300 nursing students, predominantly female (63%), with most participants aged 20–21 years (49%). All respondents were single, and the majority (96%) had not repeated an academic year. Over half (54.3%) lived with their families. 33.7% of participants reported having used psychoactive substances, with alcohol being the most common after tabacco (28%). About 57.1% of students showed potentially risky or high alcohol consumption, while 42.9% reported low or no use. The mean consumption score was 1.79, indicating moderate overall use, with a subset at risk of misuse. Several influencing factors were identified. Alcohol use increased significantly with age (r = 0.259, p < 0.001) and was more prevalent among males (20%) than females (8%) (p < 0.001). Although academic level was not significant (p = 0.452), first-year students showed higher consumption (10.7%). Repeating a year showed a marginal association (p = 0.102). Students living away from family reported higher use (16% vs. 12%, p = 0.014). Multivariate analysis shows age and male sex are significant predictors of alcohol consumption. Older students and males are more likely to consume alcohol, while females have a lower likelihood (OR = 0.138). Place of residence shows a non-significant trend toward affecting consumption.

Alcohol consumption is prevalent among college students. These findings underscore the need for targeted prevention strategies addressing high-risk groups, particularly younger male students and those living away from family, to reduce harmful alcohol consumption in university settings.

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Cannabis use among young adults has become a growing public health concern in recent years. This age group is particularly susceptible due to several factors contributing to experimentation and regular use. As perceptions of cannabis risk decline and accessibility rises, understanding the prevalence and underlying risk factors is essential for informing effective prevention strategies and support interventions tailored to this population.

To assess the prevalence and risk factors associated with cannabis use among nursing students at a private institute in Tunisia.

A cross-sectional analytical study was conducted involving 300 nursing students at a private higher education institute in Tunisia. Data were collected using a questionnaire, and cannabis dependence was assessed using CAST Test.

The study included 300 nursing students, predominantly female (63%), with most participants aged 20–21 years (49%). All were single, and the majority (96%) had not repeated an academic year. Over half (54.3%) lived with their families. Among the students surveyed, 33.7% reported having used at least one addictive substance, while 66.3% had never used any. Cannabis use was reported by 14% of students. Among cannabis users, 57.1% showed signs of probable dependence, while 42.9% reported occasional or low use. The average cannabis use score was 7.14, suggesting a trend toward frequent use and a higher risk of dependence. Cannabis use was not significantly associated with age (p = 0.135), but significant differences were found by sex (p < 0.001), with higher use among males (10%) than females (4%). Academic level was also significant (p = 0.002), with decreasing prevalence from first (8%) to third year (3.3%). Repeating a year was associated with use (p = 0.003), although proportions were similar (2%) between repeaters and non-repeaters. Living situation showed no significant effect (p = 0.133), but students living away from family reported slightly higher use (8% vs. 6%). Multivariate analysis confirmed sex as a key factor, with males more likely to use cannabis (OR = 0.215, 95% CI \[0.099–0.466]). Academic level also remained significant, with higher use in earlier years. The effect of sex was further confirmed in iteration 4 (OR = 0.175, 95% CI \[0.084–0.364]). Repeating a year showed a potential association (OR = 3.528, 95% CI \[0.940–13.243]), though not consistently significant.

Cannabis use among students is relatively common, with a notable proportion showing signs of dependence. These findings highlight the need for targeted prevention strategies focusing on younger male students.

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Patients with substance use disorders are not a monolith in their digital behaviors. The digital ecosystem presents a dual reality for this population, acting as both a potential vector of risk—through exposure to triggering content and drug market access—and a vital channel for support and health information. Understanding this complex relationship is crucial for modern addiction care.

This study aims to move beyond simple prevalence to create a descriptive typology, classifying patients based on how they use their smartphones in relation to their substance use.

This was a cross-sectional, descriptive, observational study conducted on a cohort of 60 outpatients with Substance Use Disorders, recruited from the Hope Department for Addiction Care at the Jbel Ouest Health Center. Each participant was invited to fill in a form composed of : A sociodemographic and clinical data collection form, a purpose-built questionnaire designed to explore digital behaviors related to smartphone and social media use, comprising nine closed and semi-open questions and the translated and validated Literary Arabic version of the Smartphone Addiction Scale – Short Version (SAS-SV).Data was collected and analyzed using IBM SPSS Statistics software, version 27.

The sample (N=60) was predominantly male (n=56, 93.3%) and single (n=46, 76.7%). The participants’ ages ranged from 18 to 52 years, with a mean age of 29.0 (SD = 8.72). Most participants had a secondary education level (n=44, 73.3%) and were day labourers (n=20, 33.3%) or unemployed (n=14, 23.3%). Over one-third of participants (n=23, 38.3%) met the criteria for smartphone addiction according to the SAS-SV scale.

The analysis of digital behaviors revealed a clear typology among patients. The largest group was the “Help Seekers” (40%, n=24), who primarily used their smartphones to search for treatment information and online support. A significant portion were “Passive Consumers” (15%, n=9), exposed to drug-related content but not engaging further. Smaller groups included “Active Actors” (5%, n=3), who used their phones for transactions and dedicated forums, and “Neutral” users (10%, n=6), who reported none of these behaviors. Data was missing for 30% (n=18) of the sample.

This patient-centered typology reveals distinct patterns of digital behavior, suggesting different motivations and risks. Classifying patients into these archetypes can help clinicians personalize interventions, from providing targeted psychoeducation for Passive Consumers to offering safe technology alternatives for Help Seekers and more stringent monitoring for Active Actors.

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