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Abnormalities in reward circuit function are considered a core feature of addiction. Yet, it is still largely unknown whether these abnormalities stem from chronic drug use, a genetic predisposition, or both.
In the present study, we investigated this issue using a large sample of adolescent children by applying structural equation modeling to examine the effects of several dopaminergic polymorphisms of the D1 and D2 receptor type on the reward function of the ventral striatum (VS) and orbital frontal cortex (OFC), and whether this relationship predicted the propensity to engage in early alcohol misuse behaviors at 14 years of age and again at 16 years of age.
The results demonstrated a regional specificity with which the functional polymorphism rs686 of the D1 dopamine receptor (DRD1) gene and Taq1A of the ANKK1 gene influenced medial and lateral OFC activation during reward anticipation, respectively. Importantly, our path model revealed a significant indirect relationship between the rs686 of the DRD1 gene and early onset of alcohol misuse through a medial OFC × VS interaction.
These findings highlight the role of D1 and D2 in adjusting reward-related activations within the mesocorticolimbic circuitry, as well as in the susceptibility to early onset of alcohol misuse.
In order to support service planning of the youth program of the East of Montreal Health and Social Services Board, and potentially of the other twenty-five programs across the Quebec province, our hospital-based Health Technology Assessment (HTA) unit was asked to bring evidence of the effective interventions for five most common mental disorders in children and young populations, namely anxio-depressive disorders, attention deficit and hyperactivity disorder, oppositional and conduct disorders, substance abuse disorders, and suicide attempts.
A review of reviews was conducted for the five disorders in young populations aged 6 to 25 years. This was based exclusively on systematic reviews and meta-analysis of a minimum two randomized-controlled trials. The review was completed with examples of Quebec's good practices in youth mental health gathered from personal research experience of clinical researchers involved in the project. The project involved collaboration with three other hospital units and provincial HTA agencies.
No review supporting screening and early detection for the five disorders was identified. Prevention, however, was better covered in the literature, and a clear distinction was made between universal, targeted and indicated interventions. In general, targeted and indicated prevention interventions were effective in the case of anxio-depressive (1) and substance use disorders, while universal prevention strategies seemed to reduce suicide attempts and suicide ideation (2). Effective treatments also exist for these mental disorders. In general, psychotherapies dominated for anxio-depressive and substance use disorders; parental skills dominated in oppositional disorders, whilst pharmacological treatment dominated in attention deficit and hyperactivity disorder (3). Evidence was limited for suicide attempts. The overview of Quebec's good practices allowed identification of interventions or practices already in use in the province.
The review summarized effective interventions for five most common mental disorders in young populations. It also permitted to identify several research gaps, and therefore research recommendations were formulated for the province's health research agency.
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