The role and implications of digital solutions in

drug/behavioral disorders

A perspectiveRoberto Mollica

Conclusions 1Web-based self-help interventions supplemented by briefchat counseling are an effective alternative to face-to-facetreatment and can reach a group of cannabis users who differin their use and sociodemographic characteristics from thosewho enter outpatient addiction treatment.

Conclusions 2For cocaine users with low dependence severity, a fullyautomated Web-based cognitive behavioral self-helpintervention is a feasible alternative with limited effectivenessin outpatient treatment services. However, this type ofintervention may attract specific user groups that are rarelyreached by existing outpatient treatment and may help themto control their cocaine consumption anonymously.

OPPORTUNITÀ DIGITALI

CARATTERISTICHE• Malattia cronica recidivante prevenibile• Esordio molto precoce (adolescenti,

giovani adulti)• Conseguenze psico socio sanitarie

OPPORTUNITÀ• Soggetti già «digitali» e «connessi»• Suscettibili a interventi preventivi

precoci• Plasticità cerebrale come risorsa per il

recupero

Sensazionigratificanti

Controllo comportamenti

DIPENDENZA E SPESSORE CORTICALE

DIPENDENZA E SPESSORE CORTICALE

A compilation of epigenetic influences on humans.

Epigenetics establishes a scientific basis for how

external factors and the environment can shape an

individual both physically and mentally.

EXPOSOMA ED EPIGENETICA

EXPOSOMA

GENOMA

EREDITARIETÀ

EXPOSOMA

BEHAVOMA

MODIFICAZIONI

EPIGENETICHE

ESPRESSIONI

FENOTIPICHE

BENESSERE

PATOLOGIA

Dev Psychopathol. 2013 November ; 25(4 0 2): 1279–1291. doi:10.1017/S0954579413000618.

…to advance our understanding of epigenetics both as amechanism by which the environment can contribute to thedevelopment of psychiatric disorders and as an avenue formore effective intervention and treatment strategies.

EPIGENETICA E COMPORTAMENTO

EPIGENETICA AND SNC

Control Stress (21 d) Stress (21 d) + ADs

Gemelli omozigoti possono avere differentesviluppo cerebrale se esposti a stimoli diversi

EPIGENETICA, SNC E NEUROSCIENZE

L’apprendimento è unostimolo esterno chedetermina modificazioniepigenetiche favorenti losviluppo morfologico efunzionale dell’encefaloattraverso un aumentodelle connessioni tracellule nervose (spinedendritiche).Con metodiche dineuroimaging è ormaipossibile evidenziare talimodificazioni funzionalie morfologiche.

EPIGENETICA, SNC E NEUROSCIENZE

Giocatori Controlli

Goudriaan, et al, 2009 (Addiction Biology)

craving

vincita

perdita

De Ruiter et al., 2009

We also assessed emotional statusmood at random during the day viasmartphone, following the EcologicalMomentary Assessment principles. Themethod provides great opportunities tocollect various responses such as moodand stress level.

ECOLOGICAL MOMENTARY ASSESSMENT

ECOLOGICAL MOMENTARY ASSESSMENT

ECOLOGICAL MOMENTARY ASSESSMENT

ConclusioniEMI basato sulla tecnologia mobile può essereeffetivamente implementato come intervento peruna varietà di comportamenti a ricaduta sanitaria esintomi fisici e psicologici. La futura ricerca dovrebbeintegrare le capacità di inquadramento e interventodella tecnologia mobile per creare dinamicamente eindividualmente EMI su misura che sianoecologicamente sensibili e adattabili.

ECOLOGICAL MOMENTARY INTERVENTIONS

ECOLOGICAL MOMENTARY INTERVENTIONS

ECOLOGICAL MOMENTARY INTERVENTIONS

DIPENDENZE COMPORTAMENTALI

REVISIONE DEI COMPORTAMENTI

Interventi principali delle tecniche di terapia cognitiva. Serpelloni G., 2012

Lo scopo delle terapie cognitivo-comportamentalideve essere quello di identificare e tentare dicambiare le distorsioni cognitive del giocatored’azzardo patologico agendo su due fronti: quellocognitivo e quello comportamentale.

ConclusionsThese data suggest that CBT4CBT is aneffective adjunct to standard outpatienttreatment for substance dependence and mayprovide an important means of making CBT,an empirically validated treatment, morebroadly available.

SUPPORTI DIGITALI E CBT

Web-based treatment interventionsare a viable supplement to face-to-face substance abuse treatment forthe majority of substance usersentering treatment and their deliverysystems may increase accessibility ofinterventions that are effective fortreatment of the majority ofsubstance use disorders

TRATTAMENTI SU WEB

TRATTAMENTI SU WEB

Planned behaviour

SERIOUS GAMES E COMPORTAMENTO

PROSPETTIVE

PROSPETTIVE

THE TRIPLE AIM FRAMEWORK FOR POPULATION HEALTH MANAGEMENT

(source: Institute for Healthcare Improvement (IHI)

PROSPETTIVE

PROSPETTIVE

PROSPETTIVE

PROSPETTIVE

PROSPETTIVE

PROSPETTIVE

GAME Me

ADVANCE

SYSTEM FOR

SELF CARE

GAMING

Besides technology considerations,any initiative must include a culturalshift by both providers and patients.David YeagerThe Challenges of Population Health Management For The Record - Vol. 28 No. 2 P. 22 - February 2016

CONCLUSIONI

PERSONALEITA 7.000

R LOMB 800

PAZIENTIITA 130.000

R LOMB 20.000

Roberto Mollica

…A PROPOSITO DI DIVARIO DIGITALE…