Hu-Ming Chang

Reliable tools for assessing gambling symptom severity in gambling disorder (GD) are critical for both research and clinical intervention. The Gambling Symptom Assessment Scale (GSAS) is widely used but lacks validation in Chinese-speaking populations. Our study aimed to evaluate the psychometric properties of the Chinese version of GSAS (C-GSAS) among 186 treatment-seeking GD patients. Internal consistency was excellent (Cronbach’s α = 0.93), and exploratory factor analysis revealed a two-factor model: Cognitive-Preparatory and Emotional-Consequential Factors. Confirmatory factor analysis supported the two-factor structure with satisfactory model fit indices. Concurrent validity was established through significant correlations with the Chinese version of Problem Gambling Severity Index (β = 0.32, p < 0.01) and a Visual Analog Scale for gambling craving (β = 0.67, p < 0.01). The C-GSAS is a reliable and valid measure for assessing gambling severity in patients with GD.

Background: Alcohol use disorder (AUD) is associated with imbalanced bone turnover and psychological symptoms, but the relationship between bone and brain remains unclear. The study analyzed serum levels of a bone formation marker, procollagen type 1 N‐terminal propeptide (P1NP), and bone resorption marker, C‐terminal telopeptide of type I collagen (CTX‐1), in AUD patients before and after 2 weeks of alcohol withdrawal and investigated their correlation with psychological symptoms.Methods: Ninety patients with AUD and 117 healthy controls were recruited. P1NP and CTX‐1 levels were measured using Enzyme‐Linked Immunosorbent Assay. The Penn Alcohol Craving Scale (PACS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were assessed in the AUD group at baseline, week 1, and week 2 of withdrawal.Results: Baseline CTX‐1 levels, along with the CTX‐1/P1NP and P1NP/CTX‐1 ratio, were higher in the AUD group than controls. Over the 2‐week withdrawal, PACS, BDI, and BAI scores demonstrated significant reductions. P1NP (p < 0.001) and P1NP/CTX‐1 ratio increased (p < 0.001), while CTX‐1/P1NP ratio decreased (p < 0.001), indicating a propensity toward bone formation. Univariate analysis revealed that reductions in PACS, BDI, and BAI scores during withdrawal correlated with increased P1NP levels and decreased CTX‐1/P1NP ratios. However, multivariate analysis indicated that only PACS score reductions correlated with these changes.Conclusions: Bone metabolism shifted toward increased bone formation and decreased bone resorption during 2‐week alcohol withdrawal. The correlation between improvements in bone turnover markers and reduction in craving scores during withdrawal supports the concept of the bone‐brain axis.

Objective The Penn Alcohol Craving Scale (PACS) is a five-item, single-dimension questionnaire that is used to measure a patient’s alcohol craving. We sought to develop the Chinese version of the PACS (PACS-C) and assess its reliability and validity.Methods A total of 160 Taiwanese patients with alcohol use disorder were enrolled in this study. The internal consistency and concurrent validity of the PASC-C with the visual analogue scale (VAS) for craving, the Yale–Brown Obsessive Compulsive Scale for heavy drinking (YBOCS-hd), and the Severity of Alcohol Dependence Questionnaire (SADQ) were assessed. The test–retest reliability of the PASC-C was evaluated 1 day after the baseline measurements. Confirmatory factor analysis (CFA) was performed to examine the psychometric properties of the PACS-C.Results The PACS-C exhibited good internal consistency (Cronbach’s α=0.95) and test–retest reliability (r=0.97). This scale showed high correlations with the VAS (r=0.81) and YBOCS-hd (r=0.81 and 0.79 for the obsession and compulsion subscales, respectively), and moderate correlation with the SADQ-C (r=0.47). Furthermore, CFA results revealed that the PACS-C had good fit indices under various models.Conclusion The PACS-C appears to be a reliable and valid tool for assessing alcohol craving in patients with alcohol use disorder in Taiwan.

Aim: Although studies in Western countries have investigated the quality of life (QoL) of heroin users, limited research on this topic has been conducted in Asia. The present study assessed QoL in patients with heroin dependence receiving medications to treat opioid use disorder.Methods: We performed a cross‐sectional study of patients with heroin dependence receiving methadone and buprenorphine treatment. The demographic and substance use variables of patients receiving methadone and buprenorphine were compared. The Chinese Health Questionnaire (CHQ‐12), Obsessive Compulsive Drug Use Scale (OCDUS), and World Health Organization Quality of Life Short Form Taiwan version (WHOQOL‐BREF‐T) were administered to measure patient mental health problems, addiction severity, and QoL, respectively. Multivariate regression was used to identify the factors associated with QoL.Results: A total of 149 patients receiving methadone and 31 receiving buprenorphine completed the questionnaires. Individuals in the buprenorphine group were more likely to be married (p = 0.024) or employed (p = 0.024), have a higher educational level (p = 0.013), have lower drug craving (OCDUS: p = 0.035), or have higher QoL (WHOQOL‐BREF‐T: p = 0.004) than those in the methadone group. After adjustment for other variables, employment was positively associated with the physical, psychological, and environmental domains of QoL. Receiving buprenorphine treatment (p = 0.032) and longer treatment duration (p = 0.016) were associated with higher psychological QoL.Conclusion: Several factors were associated with QoL in patients with heroin dependence. Some measures may improve their QoL, such as reducing employment barriers, improving treatment adherence, or increasing accessibility to buprenorphine treatment.