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Background and Aims: Amphetamines are the second most commonly used class of illicit drugs. We aimed to produce pooled estimates of mortality risks among people with regular or dependent use of amphetamines, with a focus upon all-cause mortality as well as specific causes of death., Design: Systematic review and meta-analysis of cohorts of people with problematic use or dependence on amphetamines with data on all-cause or cause-specific mortality., Setting and Participants: Of 4240 papers, 30 were eligible, reporting on 25 cohorts that measured all-cause mortality, drug poisoning, suicide, accidental injuries, homicide and cardiovascular mortality. Cohorts (n = 35-74 139) were in North America, several Nordic countries and Asia Pacific., Measurement: Titles/abstracts were independently screened by one reviewer and excluded those reviewed by a second reviewer. Full-text screening was by two reviewers with discrepancies resolved via a third reviewer. We extracted data on crude mortality rates (CMR) per 100 person-years (py), standardized mortality ratios (SMRs). We imputed SMRs where possible if not reported by study authors. We also calculated mortality relative risks. Data were pooled using random-effects models; potential reasons for heterogeneity were explored using subgroup analyses and meta-regressions., Findings: Twenty-three cohorts contributed data for the pooled all-cause CMR: 1.14 per 100 py [95% confidence interval (CI) = 0.92-1.42]. Pooled cause-specific mortality rates were: drug poisoning, 0.14 per 100 py (95% CI = 0.06-0.34); cardiovascular disease, 0.13 per 100 py (95% CI = 0.06-0.29); suicide, 0.20 per 100 py (95% CI = 0.07-0.55); accidental injury, 0.20 per 100 py (95% CI = 0.08-0.47) and homicide, 0.03 per 100 py (95% CI = 0.02-0.06). There was substantial heterogeneity for all pooled CMR estimates except homicide. The pooled all-cause SMR was 6.83 (95% CI = 5.27-8.84). Pooled cause-specific SMRS were: poisoning, 24.70 (95% CI = 16.67, 36.58); homicide, 11.90 (95% CI = 7.82-18.12); suicide, 12.20 (95% CI = 4.89-30.47); cardiovascular disease, 5.12 (95% CI = 3.74-7.00) and accidental injury, 5.12 (95% CI = 2.88-9.08)., Conclusions: People with regular or dependent amphetamine use are at elevated risk of a range of causes of mortality compared with people without regular or dependent amphetamine use., (© 2019 Society for the Study of Addiction.)

Aims: For the first time, the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) introduces non-substance addictions as psychiatric diagnoses. The aims of this paper are to (i) present the main controversies surrounding the decision to include internet gaming disorder, but not internet addiction more globally, as a non-substance addiction in the research appendix of the DSM-5, and (ii) discuss the meaning behind the DSM-5 criteria for internet gaming disorder. The paper also proposes a common method for assessing internet gaming disorder. Although the need for common diagnostic criteria is not debated, the existence of multiple instruments reflect the divergence of opinions in the field regarding how best to diagnose this condition., Methods: We convened international experts from European, North and South American, Asian and Australasian countries to discuss and achieve consensus about assessing internet gaming disorder as defined within DSM-5., Results: We describe the intended meaning behind each of the nine DSM-5 criteria for internet gaming disorder and present a single item that best reflects each criterion, translated into the 10 main languages of countries in which research on this condition has been conducted., Conclusions: Using results from this cross-cultural collaboration, we outline important research directions for understanding and assessing internet gaming disorder. As this field moves forward, it is critical that researchers and clinicians around the world begin to apply a common methodology; this report is the first to achieve an international consensus related to the assessment of internet gaming disorder., (© 2014 Society for the Study of Addiction.)