{"id":403356,"global_id":"medizinonline.com\/it\/?id=403356","global_id_lineage":["medizinonline.com\/it\/?id=403356"],"author":"17389","status":"publish","date":"2024-09-23 23:03:33","date_utc":"2024-09-23 21:03:33","modified":"2024-09-23 23:03:33","modified_utc":"2024-09-23 21:03:33","url":"https:\/\/medizinonline.com\/it\/event\/28-forum-wirbelsaulenchirurgie-der-akademie-der-dwg-ggmbh\/","rest_url":"https:\/\/medizinonline.com\/it\/wp-json\/tribe\/events\/v1\/events\/403356","title":"28. Forum Wirbels\u00e4ulenchirurgie der Akademie der DWG gGmbH","description":"","excerpt":"","slug":"28-forum-wirbelsaulenchirurgie-der-akademie-der-dwg-ggmbh","image":false,"all_day":true,"start_date":"2025-01-16 00:00:00","start_date_details":{"year":"2025","month":"01","day":"16","hour":"00","minutes":"00","seconds":"00"},"end_date":"2025-01-18 23:59:59","end_date_details":{"year":"2025","month":"01","day":"18","hour":"23","minutes":"59","seconds":"59"},"utc_start_date":"2025-01-15 23:00:00","utc_start_date_details":{"year":"2025","month":"01","day":"15","hour":"23","minutes":"00","seconds":"00"},"utc_end_date":"2025-01-18 22:59:59","utc_end_date_details":{"year":"2025","month":"01","day":"18","hour":"22","minutes":"59","seconds":"59"},"timezone":"Europe\/Zurich","timezone_abbr":"CET","cost":"","cost_details":{"currency_symbol":"","currency_code":"","currency_position":"prefix","values":[]},"website":"https:\/\/forum-wirbelsaeulenchirurgie.de","show_map":true,"show_map_link":true,"hide_from_listings":false,"sticky":true,"featured":true,"categories":[{"name":"Chirurgie","slug":"chirurgie","term_group":0,"term_taxonomy_id":89,"taxonomy":"tribe_events_cat","description":"","parent":0,"count":126,"filter":"raw","id":89,"urls":{"self":"https:\/\/medizinonline.com\/it\/wp-json\/tribe\/events\/v1\/categories\/89","collection":"https:\/\/medizinonline.com\/it\/wp-json\/tribe\/events\/v1\/categories"}},{"name":"General practice","slug":"general-practice","term_group":0,"term_taxonomy_id":90,"taxonomy":"tribe_events_cat","description":"","parent":0,"count":748,"filter":"raw","id":90,"urls":{"self":"https:\/\/medizinonline.com\/it\/wp-json\/tribe\/events\/v1\/categories\/90","collection":"https:\/\/medizinonline.com\/it\/wp-json\/tribe\/events\/v1\/categories"}},{"name":"Neurology","slug":"neurology","term_group":0,"term_taxonomy_id":107,"taxonomy":"tribe_events_cat","description":"","parent":0,"count":161,"filter":"raw","id":107,"urls":{"self":"https:\/\/medizinonline.com\/it\/wp-json\/tribe\/events\/v1\/categories\/107","collection":"https:\/\/medizinonline.com\/it\/wp-json\/tribe\/events\/v1\/categories"}},{"name":"Orthopedics","slug":"orthopedics","term_group":0,"term_taxonomy_id":109,"taxonomy":"tribe_events_cat","description":"","parent":0,"count":84,"filter":"raw","id":109,"urls":{"self":"https:\/\/medizinonline.com\/it\/wp-json\/tribe\/events\/v1\/categories\/109","collection":"https:\/\/medizinonline.com\/it\/wp-json\/tribe\/events\/v1\/categories"}},{"name":"Pharmacology","slug":"pharmacology","term_group":0,"term_taxonomy_id":110,"taxonomy":"tribe_events_cat","description":"","parent":0,"count":614,"filter":"raw","id":110,"urls":{"self":"https:\/\/medizinonline.com\/it\/wp-json\/tribe\/events\/v1\/categories\/110","collection":"https:\/\/medizinonline.com\/it\/wp-json\/tribe\/events\/v1\/categories"}}],"tags":[{"name":"Featured","slug":"featured","term_group":0,"term_taxonomy_id":77250,"taxonomy":"post_tag","description":"","parent":0,"count":351,"filter":"raw","id":77250,"urls":{"self":"https:\/\/medizinonline.com\/it\/wp-json\/tribe\/events\/v1\/tags\/77250","collection":"https:\/\/medizinonline.com\/it\/wp-json\/tribe\/events\/v1\/tags"}},{"name":"Featured Home","slug":"featured-home","term_group":0,"term_taxonomy_id":116,"taxonomy":"post_tag","description":"","parent":0,"count":351,"filter":"raw","id":116,"urls":{"self":"https:\/\/medizinonline.com\/it\/wp-json\/tribe\/events\/v1\/tags\/116","collection":"https:\/\/medizinonline.com\/it\/wp-json\/tribe\/events\/v1\/tags"}}],"venue":{"id":2302,"author":"4","status":"publish","date":"2013-10-16 00:00:00","date_utc":"2013-10-15 22:00:00","modified":"2023-01-07 03:21:16","modified_utc":"2023-01-07 02:21:16","url":"https:\/\/medizinonline.com\/fr\/la-cyberaddiction-nous-entoure\/","venue":"La \u00abCyberaddiction\u00bb nous entoure","description":"

L\u2019usage excessif d\u2019Internet a \u00e9t\u00e9 tr\u00e8s m\u00e9diatis\u00e9 ces derni\u00e8res ann\u00e9es et a donn\u00e9 lieu \u00e0 un champ de recherche en progression. Sa reconnaissance comme trouble de sant\u00e9 n\u2019est cependant pas encore acquise. Toutefois, sa similitude avec des troubles existants et ses cons\u00e9quences sur la vie de l\u2019individu en font un sujet de pr\u00e9occupation des pouvoirs publics et de strat\u00e9gies de pr\u00e9vention aupr\u00e8s des jeunes notamment. Le m\u00e9decin g\u00e9n\u00e9raliste a une place pr\u00e9pond\u00e9rante pour d\u00e9celer ce trouble et adresser le patient vers un sp\u00e9cialiste.<\/strong><\/p>\n

<\/p>\n

Les nouvelles technologies de la communication et Internet ont fait \u00e9merger un nouveau genre de trouble appel\u00e9 \u00abUsage Probl\u00e9matique d\u2019Internet\u00bb (UPI) ou \u00abCyberaddiction\u00bb. A l\u2019instar de tout nouveau trouble de la sant\u00e9, il pose la question de sa r\u00e9alit\u00e9 clinique, de son origine, de ses m\u00e9canismes, de sa pr\u00e9valence et de sa similitude avec des troubles connus. S\u2019agissant de comportements humains, le risque de consid\u00e9rer comme pathologique un certain nombre de conduites est un \u00e9cueil qu\u2019il s\u2019agit d\u2019\u00e9viter en se basant sur des faits scientifiques.<\/p>\n

De quoi parle-t-on?<\/h2>\n

La cyberaddiction se r\u00e9f\u00e8re \u00e0 l\u2019usage excessif d\u2019Internet ou de certaines applications informatiques. Elle comprendrait le jeu vid\u00e9o excessif, les pr\u00e9occupations obs\u00e9dantes et compulsions sexuelles et l\u2019usage excessif des r\u00e9seaux sociaux [1]. L\u2019ensemble de ces troubles ayant en commun dans leur expression clinique (a) un usage excessif associ\u00e9 \u00e0 une perte de contr\u00f4le et une n\u00e9gligence des activit\u00e9s quotidiennes, (b) des sympt\u00f4mes de manque comme l\u2019irritabilit\u00e9 et la tension interne, (c) un ph\u00e9nom\u00e8ne de tol\u00e9rance avec un besoin accru de temps pass\u00e9 sur Internet ou d\u2019outils informatiques performants, et (d) des cons\u00e9quences n\u00e9gatives sur les sph\u00e8res priv\u00e9e et sociale comme le mensonge \u00e0 l\u2019entourage, l\u2019asth\u00e9nie ou l\u2019isolement social [1]. La question de l\u2019appartenance de l\u2019UPI \u00e0 une entit\u00e9 nosographique fait d\u00e9bat et n\u2019est \u00e0 ce jour pas tranch\u00e9e. La piste de l\u2019addiction reste la plus pertinente au regard des similitudes cliniques et neurobiologiques retrouv\u00e9es (Tabl. 1).<\/strong> L\u2019addiction \u00e0 Internet bien que non r\u00e9pertori\u00e9e dans le DSM-V fait l\u2019objet d\u2019un commentaire qui demande \u00e0 ce que plus d\u2019\u00e9tudes valid\u00e9es soient r\u00e9alis\u00e9es sur le sujet avant de l\u2019int\u00e9grer \u00e0 la cat\u00e9gorie des \u00abaddictions et troubles associ\u00e9s\u00bb [2].<\/p>\n

Qu\u2019est-ce qui fait d\u2019Internet un facteur addictog\u00e8ne?<\/h2>\n

Pour rappel, dans les addictions aux substances ces derni\u00e8res (alcool, nicotine\u2026), stimulent le centre du renforcement (Noyau accumbens, aire tegmentale ventrale). Cette stimulation se fait de mani\u00e8re directe par les substances qui court-circuitent le processus naturel de l\u2019apprentissage (dont le centre du renforcement est la cl\u00e9) [3]. Il peut en d\u00e9couler une attribution trop importante \u00e0 la valeur de ces substances qui se traduit par un ensemble de comportements dits addictifs (p. ex. poursuite du comportement malgr\u00e9 les cons\u00e9quences n\u00e9gatives, perte de contr\u00f4le, automatisation du processus de consommation, etc.). Dans les addictions sans substance comme le jeu pathologique aux jeux de hasard et d\u2019argent (JHA) [2], il n\u2019y a pas de stimulation directe du centre du renforcement par un toxique mais par des r\u00e9compenses r\u00e9p\u00e9t\u00e9es (gain d\u2019argent) qui sont distribu\u00e9es d\u2019une mani\u00e8re renfor\u00e7atrice selon des sch\u00e9mas connus de conditionnement.<\/p>\n

Les activit\u00e9s en ligne comme les jeux vid\u00e9o de r\u00f4les massivement multi-joueurs (p. ex. World of Warcraft ou Dofus) font \u00e9galement appel \u00e0 ce principe de renforcement. Elles proposent des m\u00e9caniques de jeu utilisant des syst\u00e8mes de r\u00e9compense tr\u00e8s proche de ceux observ\u00e9 dans les JHA [4]. Par exemple, les joueurs gagnent des niveaux d\u2019exp\u00e9rience en tuant des monstres virtuels qui rapportent des r\u00e9compenses al\u00e9atoires selon des statistiques pr\u00e9programm\u00e9es. Cela rappelle les \u00abjackpot\u00bb des machines \u00e0 sous. Pour les r\u00e9seaux sociaux de type \u00abFacebook\u00bb, les r\u00e9compenses se retrouvent sous forme de \u00ablikes\u00bb qui sont des r\u00e9ponses positives des autres abonn\u00e9es \u00e0 une activit\u00e9 en ligne. On comprend donc que les facteurs d\u2019addiction dans les activit\u00e9s en ligne sont compos\u00e9s de renfor\u00e7ateurs sociaux et de r\u00e9compenses virtuelles.<\/p>\n

Il est important de souligner que le potentiel addictif des activit\u00e9s en ligne d\u00e9pend du type d\u2019activit\u00e9 et qu\u2019il est utile de le pr\u00e9ciser avec le patient. Ainsi parler d\u2019addiction \u00e0 internet est trop vague, il faut pr\u00e9ciser le type d\u2019activit\u00e9 (gaming, surfing, cybersexualit\u00e9). Il est aussi important de comprendre que certaines addictions existantes comme le jeu pathologique se pratiquent en ligne et que dans ce cas l\u2019Internet n\u2019est qu\u2019un vecteur facilitant l\u2019addiction.<\/p>\n

L\u2019UPI, trouble ou sympt\u00f4me?<\/h2>\n

La question de savoir si l\u2019usage probl\u00e9matique d\u2019Internet est primaire ou secondaire se pose souvent dans les articles critiques sur le sujet [5]. Ainsi certains estiment que l\u2019utilisation probl\u00e9matique d\u2019Internet n\u2019est que le sympt\u00f4me de pathologie psychiatrique existante (le d\u00e9pressif joue pour fuir la r\u00e9alit\u00e9, le phobique social pour \u00e9viter les contacts). D\u2019autre pensent qu\u2019au vu des facteurs addictifs sp\u00e9cifiques d\u00e9crits pr\u00e9c\u00e9demment le d\u00e9veloppement d\u2019une addiction primaire est possible. Il y a lieu de penser que les deux m\u00e9canismes sont possibles comme c\u2019est abondamment d\u00e9crit pour les addictions aux toxiques: L\u2019usage probl\u00e9matique d\u2019Internet est plus fr\u00e9quent chez les gens qui pr\u00e9sentent une fragilit\u00e9 psychique et d\u00e9velopper un usage probl\u00e9matique entra\u00eene des sympt\u00f4mes psychiques comme la d\u00e9pression.<\/p>\n

Epidemiologie<\/h2>\n

Il s\u2019agit d\u2019un ph\u00e9nom\u00e8ne qui prend de l\u2019ampleur notamment parmi les jeunes qui sont la population la plus \u00e9tudi\u00e9e \u00e0 l\u2019heure actuelle. La Cor\u00e9e du Sud et la Chine le consid\u00e8rent comme un trouble de sant\u00e9 publique parmi les plus s\u00e9rieux avec comme cons\u00e9quences les plus graves des cas de plusieurs d\u00e9c\u00e8s dans des cybercaf\u00e9s [6] et des meurtres li\u00e9s au jeu vid\u00e9o [7]. Un taux de 2,1% de jeunes sud-cor\u00e9ens \u00e2g\u00e9s de 6 \u00e0 19 ans et environ 10 millions d\u2019adolescents chinois [8] n\u00e9cessiteraient un traitement pour une addiction \u00e0 Internet [1].
\nLes freins \u00e0 une estimation juste de l\u2019ampleur du trouble sont multiples. Parmi eux: le d\u00e9ni, la honte, l\u2019absence d\u2019outils de screening standardis\u00e9s, le peu d\u2019\u00e9tudes en population adulte, les diff\u00e9rences culturelles et l\u2019absence d\u2019\u00e9tudes \u00e9pid\u00e9miologiques dans nombre de pays. Cela aboutit \u00e0 des marges de pr\u00e9valence tr\u00e8s larges (Tabl. 1)<\/strong> [9]. La pr\u00e9valence de l\u2019UPI en Suisse n\u2019est pas connue, mais le rapport de l\u2019Office F\u00e9d\u00e9ral de la sant\u00e9 Publique fait \u00e9tat de 2,3% d\u2019Internautes interrog\u00e9s \u00abd\u00e9pendants\u00bb (35 heures par semaine sur Internet) et de 3,7% autres \u00ab\u00e0 risque de d\u00e9pendance \u00bb (20 heures par semaine sur Internet) [10].<\/p>\n

A Gen\u00e8ve par exemple, entre 2007 et 2010, \u00adcinquante sept patients \u00e0 95% de sexe masculin, \u00e2g\u00e9s en moyenne de 24 ans (de 14 \u00e0 67 ans) ont consult\u00e9 pour UPI, et 16% d\u2019entre eux souffraient d\u2019autres addictions. Ces patients sont rest\u00e9s en soins en moyenne 19 semaines [11]. Les demandes viennent essentiellement de l\u2019entourage familial, social, ou scolaire, et ont doubl\u00e9 entre 2011 et 2012.<\/p>\n

<\/p>\n

D\u00e9pistage<\/h2>\n

Des \u00e9chelles valid\u00e9es en fran\u00e7ais existent comme l\u2019Internet Addiction Test qui comprend 20 items explorant des \u00e9l\u00e9ments comme la perte de contr\u00f4le ou les cons\u00e9quences n\u00e9gatives de l\u2019usage d\u2019Internet sur l\u2019individu [12]. Au cabinet m\u00e9dical, des questions simples \u00e0 poser sont celles de l\u2019utilisation des nouvelles technologies, la dur\u00e9e et les cons\u00e9quences per\u00e7ues par le patient ou son entourage de cette utilisation sur des champs importants de la vie.<\/p>\n

D\u00e9terminants de l\u2019UPI<\/h2>\n

Facteurs de risque individuels: <\/strong>Une majorit\u00e9 d\u2019Internautes utilisent ce vecteur sans risque pour leur sant\u00e9 et leur vie quotidienne. Ce qui constitue un facteur de risque pour la minorit\u00e9 d\u2019usagers excessifs d\u2019Internet a \u00e9t\u00e9 investigu\u00e9. Ainsi, quelques donn\u00e9es sugg\u00e8rent que le jeune \u00e2ge, le temps important pass\u00e9 sur Internet, le manque de support \u00e9motionnel et psychologique seraient des facteurs en lien avec l\u2019UPI chez des coll\u00e9giens europ\u00e9ens [13].<\/p>\n

Des \u00e9tudes d\u2019imagerie c\u00e9r\u00e9brale fonctionnelle ont retrouv\u00e9 des similitudes avec les addictions avec substance (une forte r\u00e9activit\u00e9 aux indices d\u2019Internet [14], une hypersensibilit\u00e9 \u00e0 la r\u00e9compense et une hypo sensibilit\u00e9 aux pertes [15]).<\/p>\n

Facteurs environnementaux associ\u00e9s: <\/strong>Un environnement familial per\u00e7u comme probl\u00e9matique, peu de loisirs et de faibles performances scolaires auraient \u00e9t\u00e9 retrouv\u00e9s de fa\u00e7on plus fr\u00e9quente chez les adolescents souffrant d\u2019UPI [16, 17]. Des adultes souffrant de ce trouble rapporteraient un impact sur leur vie familiale, de couple, professionnelle, amicale, leurs loisirs, leur qualit\u00e9 de sommeil et leur \u00e9tat de sant\u00e9 [18, 19].<\/p>\n

Comorbidit\u00e9s psychiatriques: <\/strong>L\u2019anxi\u00e9t\u00e9, la d\u00e9pression (avec id\u00e9es suicidaires [20]) et le trouble d\u2019hyperactivit\u00e9 et de d\u00e9ficit d\u2019attention (THADA) sont les principales comorbidit\u00e9s retrouv\u00e9es chez les sujets souffrant d\u2019UPI [20]. Internet serait alors un moyen de recherche de support social, de fuite des difficult\u00e9s de la vie quotidienne et de retrouver un sentiment de maitrise [21]. De plus, des troubles addictifs lui ont \u00e9t\u00e9 fortement associ\u00e9s, avec une pr\u00e9valence dans la vie enti\u00e8re d\u2019abus de substances de 38% [22].<\/p>\n

Traitement<\/h2>\n

Psychoth\u00e9rapie:<\/strong> Du manque de d\u00e9finition d\u00e9finitive de l\u2019UPI d\u00e9coule un manque d\u2019\u00e9tudes de qualit\u00e9 sur les traitements psychoth\u00e9rapeutiques du trouble. On constate n\u00e9anmoins que les traitements propos\u00e9s se basent essentiellement sur les approches valid\u00e9es dans les addictions comme la th\u00e9rapie cognitive et comportementale [23], l\u2019approche motivationnelle, la pr\u00e9vention de rechute ou les approches syst\u00e9miques incluant les proches.<\/p>\n

Comme toutes probl\u00e9matiques comportementales, le contexte social et culturel joue un r\u00f4le majeur dans la fa\u00e7on d\u2019aborder le traitement du trouble. Les pays asiatiques et tout particuli\u00e8rement la Cor\u00e9e du sud et la Chine ont d\u00e9velopp\u00e9 des approches de type \u00abcamps de r\u00e9\u00e9ducation\u00bb avec l\u2019id\u00e9e d\u2019emp\u00eacher l\u2019acc\u00e8s aux nouvelles technologies et de favoriser le reprise d\u2019activit\u00e9 de groupe [24]. Si le concept de changer de milieu pour d\u00e9velopper d\u2019autres activit\u00e9s centr\u00e9es sur le sport, la discipline et les activit\u00e9s en groupe fait partie des alternatives propos\u00e9es aux patients, les risques de d\u00e9rives de tels solutions sont nombreux (violence, traumatisme).<\/p>\n

Pharmacoth\u00e9rapie: <\/strong>Outre le traitement pharmacologique des comorbidit\u00e9s psychiatriques existantes, quelques essais de traitements m\u00e9dicamenteux pour l\u2019UPI ont fait \u00e9tat de l\u2019efficacit\u00e9 de la Naltrexone dans un case report sur une addiction au sexe en ligne, de l\u2019efficacit\u00e9 du Citalopram (sans sup\u00e9riorit\u00e9 par rapport au placebo) sur un case report d\u2019UPI, et l\u2019efficacit\u00e9 du M\u00e9thylph\u00e9nidate sur l\u2019addiction aux jeux vid\u00e9o chez 62 enfants souffrant de THADA [25].<\/p>\n

Pr\u00e9vention<\/h2>\n

Comme dans les addictions classiques, une r\u00e9flexion sur le type de pr\u00e9vention doit avoir lieu. La pr\u00e9vention sur la personne doit identifier les individus \u00e0 risque, celle-ci passe par une d\u00e9tection dans le milieu scolaire et par la famille, il faut donc que les parents et les enseignants re\u00e7oivent de l\u2019information et de la formation aux nouvelles technologies. Une pr\u00e9vention de type structurelle (qui vise \u00e0 modifier les structures et l\u2019environnement des groupes cibles) doit poser la question de l\u2019acc\u00e8s aux nouvelles technologies \u2013 pour les jeunes notamment, des questions sur la pertinence de l\u2019utilisation de logiciels de contr\u00f4le parental, de la limitation des temps de connexion ou de la place de l\u2019ordinateur dans la maison (au salon plut\u00f4t que dans la chambre des enfants).<\/p>\n

L\u2019OFSP recommande un renforcement des ressources (p. ex. la confiance en soi, l\u2019augmentation de la tol\u00e9rance \u00e0 la frustration) et la transmission d\u2019une comp\u00e9tence m\u00e9diatique (Programme national \u00abProtection de la jeunesse face aux m\u00e9dias et comp\u00e9tences m\u00e9diatiques\u00bb men\u00e9 par l\u2019Office f\u00e9d\u00e9ral des assurances sociales). Il pr\u00e9conise que les atteintes et les signes d\u2019une \u00e9volution psychosociale perturb\u00e9e des enfants et adolescents doivent \u00eatre identifi\u00e9s \u00e0 un stade pr\u00e9coce pour que des mesures de soutien puissent \u00eatre rapidement engag\u00e9es (programme de mesures de la Conf\u00e9d\u00e9ration en vue de r\u00e9duire les probl\u00e8mes de drogue) [10].
\nConclusion pour la pratique<\/p>\n

    \n
  • L\u2019UPI n\u2019est pas encore cat\u00e9goris\u00e9 comme maladie.<\/li>\n
  • L\u2019UPI a un substrat anatomo-clinique similaire aux troubles addictifs.<\/li>\n
  • L\u2019UPI pr\u00e9sente des comorbidit\u00e9s psychiatriques et une suicidalit\u00e9 accrue.<\/li>\n
  • L\u2019UPI est associ\u00e9 \u00e0 un impact n\u00e9gatif sur la vie socio-professionnelle et sur l\u2019\u00e9tat de sant\u00e9.<\/li>\n
  • L\u2019UPI doit \u00eatre d\u00e9pist\u00e9 et adress\u00e9 pour un traitement psychoth\u00e9rapeutique au sp\u00e9cialiste.<\/li>\n<\/ul>\n

    Dr m\u00e9d. Sophia Achab
    \nProf. Dr m\u00e9d. Daniele Fabio Zullino
    \nDr m\u00e9d. Gabriel Thorens<\/strong><\/em><\/p>\n

    Bibliographie:<\/p>\n

      \n
    1. Block JJ: Issues for DSM-V: internet addiction. Am J Psychiatry 2008; 165(3): 306-307.<\/li>\n
    2. DSM-V [www.dsm5.org\/Pages\/Default.aspx]<\/li>\n
    3. Koob GF, Volkow ND: Neurocircuitry of addiction. Neuro\u00adpsychopharmacology 2010; 35(1): 217-238.<\/li>\n
    4. Thorens G, Zullino D: Une meilleure appr\u00e9hension du concept de cyberaddiction. Illustr\u00e9 par le potentiel addictog\u00e8ne des jeux de r\u00f4le massivement multijoueurs en ligne. Schweizer Archiv f\u00fcr Neurologie und Psychiatrie 2011; 162(6): 232-238.<\/li>\n
    5. Kuss DJ, Griffiths MD: Internet Gaming Addiction: A Systematic Review of Empirical Research. Int J Mental Health Addict 2012; 10(2): 278-296.<\/li>\n
    6. Choi YH: Advancement of IT and seriousness of youth Internet addiction. In: International Symposium on the Counseling and Treatment of Youth Internet Addiction. Edited by Commission NY. Seoul Korea 2007; 20.<\/li>\n
    7. Koh YS: Development and application of K-Scale as diagnostic scale for Korean Internet addiction, in: International Symposium on the Counseling and Treatment of Youth Internet Addiction. Edited by Commission NY. Seoul Korea 2007; 294.<\/li>\n
    8. Ahn DH: Korean policy on treatment and rehabilitation for adolescents\u2019 Internet addiction, in: International Symposium on the Counseling and Treatment of Youth Internet Addiction. Edited by Commission NY. Seoul Korea 2007; 49.<\/li>\n
    9. Kormas G, et al.: Risk factors and psychosocial characteristics of potential problematic and problematic internet use among adolescents: a cross-sectional study. BMC Public Health 2011; 11: 595.<\/li>\n
    10. Rapport d’experts OFSP, Dangers potentiels d\u2019Internet et des jeux en ligne, Editor: OFSP 2012.<\/li>\n
    11. Thorens G, et al.: A retrospective study of treatment and evolution of self-identified Internet problematic users in a specialized behavioral addiction outpatient clinic. Journal of Behavioral Addictions, in press 2013.<\/li>\n
    12. Khazaal Y, et al.: French validation of the internet addiction test. Cyberpsychology & Behavior: The Impact of the Internet, Multimedia and Virtual Reality on Behavior and Society 2008; 11(6): 703-706.<\/li>\n
    13. Durkee T, et al.: Prevalence of pathological internet use among adolescents in Europe: demographic and social factors. Addiction 2012; 107(12): 2210-2222.<\/li>\n
    14. Ko CH, et al.: Brain activities associated with gaming urge of online gaming addiction. J Psychiatr Res 2009; 43(7): 739-747.<\/li>\n
    15. Dong G, Huang J, Du X: Enhanced reward sensitivity and decreased loss sensitivity in Internet addicts: an fMRI study during a guessing task. J Psychiatr Res 2011; 45(11): 1525-1529.<\/li>\n
    16. Huang H, Leung L: Instant messaging addiction among teenagers in China: shyness, alienation, and academic performance decrement. Cyberpsychol Behav 2009; 12(6): 675-679.<\/li>\n
    17. Tsitsika A, et al.: Determinants of Internet addiction among adolescents: a case-control study. ScientificWorldJournal 2011; 11: 866-874.<\/li>\n
    18. Achab S, et al.: Massively multiplayer online role-playing games: comparing characteristics of addict vs non-addict online recruited gamers in a French adult population. BMC Psychiatry 2011; 11: 144.<\/li>\n
    19. Bergmark KH, Bergmark A, Findahl O: Extensive internet involvement–addiction or emerging lifestyle? Int J Environ Res Public Health 2011; 8(12): 4488-4501.<\/li>\n
    20. Carli V, et al.: The association between pathological internet use and comorbid psychopathology: a systematic review. Psychopathology 2013; 46(1): 1-13.<\/li>\n
    21. Ko CH, et al.: The association between Internet addiction and psychiatric disorder: a review of the literature. Eur Psychiatry 2012; 27(1): 1-8.<\/li>\n
    22. Grant RW, et al.: Internet use among primary care patients with type 2 diabetes: the generation and education gap. J Gen Intern Med 2005; 20(5): 470-473.<\/li>\n
    23. Du YS, Jiang WQ, Vance A: Longer term effect of randomized, controlled group cognitive behavioural therapy for Internet addiction in adolescent students in Shanghai. Australian and New Zealand Journal of Psychiatry 2010; 44(2): 129-134.<\/li>\n
    24. Chulmo K, et al.: Internet-Addicted Kids and South Korean Government Efforts: Boot-Camp Case. CyberPsychology, Behavior & Social Networking 2011; 14(6): 391-394.<\/li>\n
    25. Achab S, Bertolini M, Karila L: Developing Pharmacotherapy for cyberaddictions? The Open addiction Journal 2012; 5: 20-23.<\/li>\n<\/ol>","slug":"la-cyberaddiction-nous-entoure","image":{"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail.jpg","id":2300,"extension":"jpg","width":767,"height":294,"filesize":36533,"sizes":{"thumbnail":{"width":320,"height":240,"mime-type":"image\/jpeg","filesize":11192,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-320x240.jpg"},"cnvs-small":{"width":80,"height":80,"mime-type":"image\/jpeg","filesize":2165,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-80x80.jpg"},"cnvs-thumbnail":{"width":300,"height":225,"mime-type":"image\/jpeg","filesize":10494,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-300x225.jpg"},"pk-small":{"width":80,"height":80,"mime-type":"image\/jpeg","filesize":2165,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-80x80.jpg"},"pk-thumbnail":{"width":300,"height":225,"mime-type":"image\/jpeg","filesize":10494,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-300x225.jpg"},"csco-120":{"width":120,"height":46,"mime-type":"image\/jpeg","filesize":1962,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-120x46.jpg"},"csco-120-landscape":{"width":120,"height":90,"mime-type":"image\/jpeg","filesize":3179,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-120x90.jpg"},"csco-120-portrait":{"width":120,"height":160,"mime-type":"image\/jpeg","filesize":3948,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-120x160.jpg"},"csco-120-square":{"width":120,"height":120,"mime-type":"image\/jpeg","filesize":3631,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-120x120.jpg"},"csco-90":{"width":90,"height":34,"mime-type":"image\/jpeg","filesize":1578,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-90x34.jpg"},"csco-90-landscape":{"width":90,"height":68,"mime-type":"image\/jpeg","filesize":2363,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-90x68.jpg"},"csco-90-portrait":{"width":90,"height":120,"mime-type":"image\/jpeg","filesize":2946,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-90x120.jpg"},"csco-90-square":{"width":90,"height":90,"mime-type":"image\/jpeg","filesize":2615,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-90x90.jpg"},"csco-320":{"width":320,"height":123,"mime-type":"image\/jpeg","filesize":6608,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-320x123.jpg"},"csco-320-landscape":{"width":320,"height":240,"mime-type":"image\/jpeg","filesize":11192,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-320x240.jpg"},"csco-320-portrait":{"width":320,"height":294,"mime-type":"image\/jpeg","filesize":12581,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-320x294.jpg"},"csco-320-square":{"width":320,"height":294,"mime-type":"image\/jpeg","filesize":12581,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-320x294.jpg"},"csco-560":{"width":560,"height":215,"mime-type":"image\/jpeg","filesize":14031,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-560x215.jpg"},"csco-560-landscape":{"width":560,"height":294,"mime-type":"image\/jpeg","filesize":20143,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-560x294.jpg"},"csco-560-portrait":{"width":560,"height":294,"mime-type":"image\/jpeg","filesize":20143,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-560x294.jpg"},"csco-560-square":{"width":560,"height":294,"mime-type":"image\/jpeg","filesize":20143,"url":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail-560x294.jpg"}}},"json_ld":{"@type":"Place","name":"La \u00abCyberaddiction\u00bb nous entoure","description":"<p>L\u2019usage excessif d\u2019Internet a \u00e9t\u00e9 tr\u00e8s m\u00e9diatis\u00e9 ces derni\u00e8res ann\u00e9es et a donn\u00e9 lieu \u00e0 un champ de recherche en progression. Sa reconnaissance comme trouble de sant\u00e9 n\u2019est cependant pas…<\/p>\\n","image":"https:\/\/medizinonline.com\/wp-content\/uploads\/2014\/11\/e-mail.jpg","url":"","address":{"@type":"PostalAddress"},"telephone":"","sameAs":""},"show_map":true,"show_map_link":true,"global_id":"medizinonline.com\/it\/?id=2302","global_id_lineage":["medizinonline.com\/it\/?id=2302"]},"organizer":[{"id":347813,"author":"4","status":"publish","date":"2013-03-15 00:00:00","date_utc":"2013-03-14 23:00:00","modified":"2013-03-15 00:00:00","modified_utc":"2013-03-14 23:00:00","url":"https:\/\/medizinonline.com\/it\/gestione-della-trombosi-e-dellembolia-polmonare\/","organizer":"Gestione della trombosi e dell’embolia polmonare","description":"

      In questo numero di CARDIOVASC, l’attenzione si concentra soprattutto sulla procedura relativa all’insorgenza di trombosi ed embolia polmonare.<\/strong><\/p>\n

      <\/p>\n

      La situazione attuale, con l’approvazione di diversi nuovi anticoagulanti per il trattamento delle malattie tromboemboliche, suggerisce che la gestione del tromboembolismo cambier\u00e0 nei prossimi mesi o anni. Pertanto, vorremmo presentarle alcuni punti pratici in tre diverse recensioni. Il Dr. med. Michael Baumann fa luce sulle possibilit\u00e0 e le difficolt\u00e0 che possono sorgere nel contesto di chiarire il tromboembolismo in termini di ipercoagulabilit\u00e0. L’accento \u00e8 posto sul fatto che tale valutazione ha senso se pu\u00f2 portare a un possibile cambiamento nella gestione clinica.Grande enfasi \u00e8 posta sugli aspetti pratici nel riconoscimento, nella diagnosi e nel trattamento delle embolie polmonari nel lavoro di Thomas Lehmann, MD. Questa panoramica mira a evidenziare le difficolt\u00e0 che devono essere considerate nel riconoscimento e nel trattamento dell’embolia polmonare nella fase pre-ospedaliera, per garantire il miglior esito possibile in questi pazienti.<\/p>\n

      Infine, il documento della dottoressa Nazanin S\u00e9dille-Mostafaie descrive le propriet\u00e0 e le indicazioni dei tre anticoagulanti orali recentemente approvati in Svizzera e sottolinea i possibili problemi rilevanti nell’uso di queste sostanze. Va notato che le nuove sostanze rappresentano un’alternativa efficace e sicura agli anticoagulanti precedentemente disponibili nelle indicazioni approvate. Ora le auguro una lettura spero entusiasmante.<\/p>\n

      Cordiali saluti<\/p>\n

      Prof. Dr. med. Wolfgang 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