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All Journal Narra J Jurnal Kedokteran Meditek
Siste, Kristiana
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Efficacy of N-acetylcysteine and motivational enhancement therapy for nicotine addiction: A randomized clinical trial Nasrun, Martina WS.; Ginting, Tribowo T.; Siste, Kristiana; Pandelaki, Jacub; Kekalih, Aria; Louisa, Melva; Susanto, Agus D.; Utami, Diah S.; Tarigan, Immanuel N.; Trishna, Alya R.; Halim, Kelvin
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.2178

Abstract

N-acetylcysteine (NAC) is known to enhance neuroplasticity and help reduce smoking addiction by modulating brain metabolites. The use of magnetic resonance spectroscopy (MRS) in smokers receiving NAC as an adjuvant to motivational enhancement therapy (MET) represents a novel approach to understanding how this combination therapy influences brain chemistry. By utilizing MRS, the effectiveness of NAC can be quantitatively assessed by analyzing changes in smoking-affected brain metabolites. The aim of this study was to evaluate the efficacy of NAC combined with MET for nicotine addiction, using MRS to assess neurochemical alterations associated with treatment response. A stratified, randomized, parallel-group clinical trial was conducted, comparing NAC and MET combination to MET only among smokers. The study analyzed the effectiveness of NAC by evaluating glutamate-glutamine (Glx) to creatine ratio (Glx/creatine ratio) and N-acetylaspartate (NAA) to creatine ratio (NAA/creatine ratio) in the nucleus accumbens, bilateral cerebellum, medial prefrontal cortex, ventromedial prefrontal cortex, and bilateral precuneus. Our data indicated that the Glx/creatine ratios for the intervention versus control groups were as follows: nucleus accumbens (0.68 vs 0.43), bilateral cerebellum (0.68 vs 0.43), left medial prefrontal cortex (1.11 vs 0.82), ventromedial prefrontal cortex (0.32 vs 0.86), and bilateral precuneus (0.75 vs 0.58). The NAA/creatine ratios for the intervention versus control groups were as follows: nucleus accumbens (3.55 vs 8.35), bilateral cerebellum (7.82 vs 4.02), left medial prefrontal cortex (5.47 vs 5.20), ventromedial prefrontal cortex (3.55 vs 7.46), and bilateral precuneus (4.73 vs 4.00). Our analysis indicated that the Glx/creatine ratio was higher in the intervention group than in the control group in the medial prefrontal cortex (p=0.02), while the NAA/creatine ratio was higher in the intervention group than in the control group in the bilateral cerebellum (p<0.001). The reported side effects were mild to moderate discomfort and well-tolerated across both groups. These findings highlight the potential of NAC and MET combination in promoting neuroplasticity and supporting nicotine addiction treatment.
Hubungan Psikopatologi dan Mekanisme Koping dengan Internet Gaming Disorder (IGD) pada Populasi Dewasa di Indonesia Assandi, Pratiwi; Siste, Kristiana; Tobing, Heriani; Kusumaningrum, Profitasari
Jurnal Kedokteran Meditek Vol 31 No 4 (2025): JULI
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v31i4.3728

Abstract

Introduction: Psychopathology and maladaptive coping can contribute to Internet Gaming Disorder (IGD) in adults, threatening productivity and life. Purpose: This study aimed to explore the associations between psychopathology and coping mechanisms with IGD in Indonesian  adults. Methods: This cross-sectional study included 358 adults aged 18 to 59 who engaged in online gaming through consecutive sampling. Data were collected online using Symptoms Check List-90, Brief COPE, Ten-Item Internet Gaming Disorder Test, and sociodemographic questionnaire and were analyzed using chi-square, Kolmogorov Smirnov, Mann-Whitney, and logistic regression tests. Results: The IGD proportion was 16,5%. Psychopathology (somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobia, paranoia, and psychotic), coping mechanisms (active-coping, use of instrumental support, humor, use of emotional support, positive reframing, self-distraction, denial, substance use, behavioral disengagement, venting, and self-blame), age, marital status, gaming duration, and Multiplayer Online Battle Arena games were significantly associated with IGD (p<0,05). Gaming duration exceeding three hours per day (OR=3,220, CI=1,574-6,588), dysfunctional coping (OR=1,154, CI=1,067-1,248), and hostility (OR=7,231, CI=3,038-17,213) identified as risk factors, while venting (OR=0,727, CI=0,533-0,991) served as protective factor. Conclusion: Psychopathology and dysfunctional coping are associated with IGD. Education on related factors, early detection of psychopathology, and identification of coping mechanisms support comprehensive IGD management.
Co-Authors Agus D. Susanto Aria Kekalih Ginting, Tribowo T. Halim, Kelvin Kusumaningrum, Profitasari Melva Louisa Nasrun, Martina WS. Pandelaki, Jacub Pratiwi Assandi Tarigan, Immanuel N. Tobing, Heriani Trishna, Alya R. Utami, Diah S.