Teeb meem siv Internet hauv cov neeg quav tshuaj nyob rau hauv kev kho mob hauv chaw kho mob pej xeem (2019)

Ntiaj teb J Psychiatry. 2019 Jun 10; 9 (3): 55-64.

Luam tawm hauv internet 2019 Jun 10. doi: 10.5498 / wjp.v9.i3.55

PMCID: PMC6560498

PMID: 31211113

Stefano Baroni, Donatella Marazziti, Federico Mucci, Elisa Diadema, Thiab Liliana Dell'Osso

Abstract

KEV PAB

Teeb meem siv Is Taws Nem (PIU) los yog kev siv tshuaj yeeb tiv thaiv hauv Internet tau raug lees paub tias yog kev coj cwj pwm ntawm cov neeg saib xyuas ntau dhau los tswj hwm tsis zoo, yaum, lossis tus cwj pwm hais txog kev siv koos pis tawj thiab siv Is Taws Nem uas ua rau muaj kev tsis zoo lossis ua rau muaj kev quav yeeb tshuaj.

AIM

Txheeb xyuas qhov tseeb thiab nthuav dav ntawm kev siv Is Taws Nem thiab kev tsim txom hauv ib pawg neeg quav yeeb tshuaj los ntawm Yav Qab Teb Ltalis, los ntawm cov lus nug tshwj xeeb ["Questionario sull'Utilizzo delle Nuove Tecnologie" (QUNT)].

METHODS

Txhua qhov kev kawm (183) yog cov neeg haus luam yeeb hnyav, yuav luag 50% ntawm lawv tau siv tshuaj yeeb (heroin) thiab / lossis tshuaj tiv thaiv opioid, 30% cawv, 10% cannabis, 8% yeeb, thiab 5% yog cov siv polydrug. Yuav luag 10% ntawm cov tib neeg kuj tau txais kev cuam tshuam los ntawm kev twv txiaj.

KEV SIV

Lub sijhawm siv online yog ntau dua 4 teev ib hnub nyob rau hauv tag nrho cov qauv, nrog qhov tsis txaus ntseeg hauv cov txiv neej. Cov neeg siv yeeb dawb thiab cov neeg haus luam yeeb tau siv sijhawm ntau dua 6 teev nyob hauv online, ntau dua li opioid thiab kev quav dej quav cawv. Kev faib tawm ntawm QUNT yam tsis txawv hauv ob hom neeg. Cov neeg siv yeeb dawb tau pom cov qhab nia siab dua ntawm "kev tswj tsis tau", "kev saib duab liab qab", thiab "kev quav mus rau kev sib raug zoo", rau cov nyhuv ntawm cov tshuaj yeeb dej caw. Ntxiv mus, 15 tawm ntawm tag nrho cov neeg siv 17 cocaine yog cov tub twv txiaj pathological. Kev sib raug zoo thiab cov lus tshaj tawm tau raug pom nyob ntawm qee qhov QUNT yam thiab lub cev qhov ntsuas.

XAUS

Cov kev tshawb pom no qhia tau tias PIU tsis tshua hnyav rau cov neeg uas haus tshuaj sedative, xws li heroin / opioids thiab cawv, dua li hauv cov ncauj lus noj tshuaj. Hloov pauv, nws yuav raug siv los ua "txhawb" zog hauv cov neeg siv yeeb dawb thiab cannabis. Kev cuam tshuam los ntawm kev ua phem ntawm cov tshuaj raug tsim txom tau sau tseg rau qhov muaj peev xwm sib deev ntsig txog QUNT cov khoom sib txawv. Peb tau pom ib qho kev tiv thaiv "kev tiv thaiv" ntawm kev sib raug zoo thiab / lossis nyob ua ke nrog tus khub, vim tias cov ncauj lus qhia pom tias cov qhab nia poob qis ntawm cov khoom sib txawv ntau dua li cov kev kawm lossis cov nyob ib leeg. Cov kev sib raug zoo ntawm lub sijhawm siv online (thiab muaj feem cuam tshuam txog kev ua neej nyob sib luag) thiab lub cev kev qhia tawm ntawm lub cev yuav qhia tias kev siv Is Taws Nem tej zaum yuav ua rau muaj kev nce phaus thiab rog dhau ntawm cov neeg hluas thiab cov hluas thoob ntiaj teb. Peb qhov kev tshawb pom tseem qhia meej txog qhov tsis zoo ntawm cov neeg quav yeeb quav tshuaj uas siv tshuaj tiv thaiv, tsis yog siv tshuaj tiv thaiv, rau lwm yam kev coj cwj pwm, xws li kev twv txiaj.

keywords: Is Taws Nem, Teeb Meem Siv Is Taws Nem, Kev Coj Tus Cwj Pwm, Kev Quav Yeeb Tshuaj, Chaw Rov Rov Qab Los

Core taub: Txoj kev tshawb fawb no tau tshawb xyuas cov yam ntxwv ntawm Kev Siv Is Taws Nem thiab teeb meem siv Is Taws Nem (PIU) hauv kev quav yeeb tshuaj los ntawm kev nug tshwj xeeb. Qhov kev tshawb pom tau qhia tias PIU muaj ntau nyob rau hauv kev kawm siv yeeb dawb thiab cannabis dua li ntawm cov ncauj lus opioids lossis haus cawv, thiab cuam tshuam los ntawm kab mob kev twv txiaj. Qhov no qhia txog qhov muaj lub luag haujlwm ntawm cov tshuaj txhawb nqa mus rau kev txhim kho tus cwj pwm kev quav. Cov kev sib raug zoo ntawm lub sijhawm siv online thiab lub cev hnyav qhia tau tias kev siv Is Taws Nem tej zaum yuav yog ib qho ua rau txhawb qhov hnyav nce thiab rog dhau. Kev tiv thaiv kev quav yeeb tshuaj yuav tsum ua tib zoo txiav txim siab PIU, uas tam sim no sawv cev rau kev kis thoob ntiaj teb.

TAW qHIA

Lub thev naus laus zis tshiab, thaum siv qhov tsim nyog, tsis pom zoo ua lub peev txheej uas tuaj yeem txhim kho tau ntau tus neeg lub neej. Is Taws Nem yog tej zaum ib qho kev hloov pauv loj tshaj plaws ntawm ob peb lub xyoo dhau los vim tias nws tau hloov txoj kev sib txuas lus, sib pauv cov ntaub ntawv, koom nrog cov xwm txheej hauv lub sijhawm ntau txhiab mais deb, thiab nrhiav tau yooj yim thiab ceev txhua yam ntaub ntawv [,]. Nyob rau hauv tib txoj kev, nws yuav tsum raug sau tseg tias kev siv kev tsis ncaj ncees siv Is Taws Nem yog qhov tseem ceeb, tshwj xeeb yog qhov chaw uas muaj kev cuam tshuam txog kev puas siab puas ntsws, qhov kev pheej hmoo tiag tiag rau cov ncauj lus mob hlwb, vim nws yuav dhau los ua teeb meem tawm ntawm nws txoj kev tswj hwm.

Tshwj xeeb, kev tsim txom siv Is Taws Nem piv txog kev txaus ntshai thiab kev txaus ntshai uas yuav ua rau muaj kev cuam tshuam loj rau kev sib raug zoo, puas siab puas ntsws, ua haujlwm, thiab kev xav ntawm tus kheej. Tshaj 15 xyoo dhau los, cov neeg siv Internet tau nce los ntawm 1000% [], raws li tau teev tseg los ntawm Is Taws Nem Qib Ntiaj Teb Stats, Pigdom, ib haiv neeg uas nthuav tawm txog kev siv Internet thoob ntiaj teb, cov pej xeem cov txheeb cais, thiab lwm yam teeb meem []. Tsis ceeb, vim li ntawd, kev kawm txog kev tsim txom hauv Is Taws Nem muaj qhov ua rau neeg ceeb. Qhov teeb meem no tseem tseem tsis tau to taub zoo, thiab kev tshawb fawb ntawm nws cov kev qhia tseem yog thaum pib [].

Kev siv Internet muaj teeb meem (PIU) lossis kev quav yeeb tshuaj hauv Internet yog kev coj tus cwj pwm [] uas txhais tau tias "siv Is Taws Nem uas tsim kev puas hlwb, kev sib raug zoo, tsev kawm ntawv, thiab / lossis kev ua haujlwm nyuaj nyob hauv tib neeg lub neej" [].

Cov ntawv nyeem ntau ntxiv ntawm PIU coj lub koom haum American Psychiatric Association kom suav nrog qhov Internet Gaming Kev Tsis Txaus Siab nyob rau ntu 3 ntawm Kev Tshuaj Ntsuam Xyuas thiab Cov Ntawv Qhia rau Cov Mob Puas Ntsoog (DSM-5), tab sis cov kev xav tam sim no yog xav tau ntau cov ntaub ntawv xav tau ua ntej muab nws tso rau hauv phau ntawv uas yog mob nrog qhov tsis muaj meej mom [-]. Hauv 2008, Thaiv [] tawm tswv yim plaub yam kev kuaj mob uas tseem ceeb rau kev soj ntsuam PIU uas yog kev coj cwj pwm, raws li hauv qab no: “Siv Internet ntau dhau ua rau xiam sij hawm; kev tshem tawm, suav nrog kev xav los ntawm kev npau taws, kev ntxhov siab thiab kev ntxhov siab thaum Internet nkag tsis tau; kev ua siab ntev, suav nrog kev xav tau cov khoom siv khoos phis tawm zoo dua, siv software ntau dua, lossis siv sijhawm ntau teev, thiab cov xwm txheej tsis zoo, suav nrog kev sib cav, dag, tsis kawm ntawv / ua haujlwm lossis kev kawm ua haujlwm, tsis muaj kev sib cais, thiab kev qaug zog].

Feem ntau, cov ntsiab lus PIU tsis paub tias lawv muaj teeb meem [-] uas yuav ua rau tsev neeg, tsev kawm ntawv, haujlwm, lossis lub neej txom nyem zuj zus] lossis ua rau muaj kev tshem tawm hauv lub zej zog [,] thiab tseem tua tus kheej [,-]. Ntau cov kev tshawb fawb tau sau txog cov txiaj ntsig tsis zoo ntawm PIU, tab sis cov ntawv nyeem tsis cuam tshuam qhov kev xav ntawm lub cwj pwm ntawm tus cwj pwm no [,]. Tshwj xeeb, nws tsis meej txog PIU yuav tsum tau cais raws li hom kev coj cwj pwm phem [], lub siab tswj lub cev tsis ncaj ncees, lub subtype ntawm obsessive-compulsive tsis meej [-], lossis txoj kev tsis ncaj nruab nrog daws kev ntxhov siab [-].

Cov tsos mob tshwm sim ntawm PIU zoo ib yam li cov kev siv tshuaj yeeb dej cawv (SUDs) raws li DSM-5 [] suav nrog tus cwj pwm tsis txaus ntseeg thiab kev xav [,], kev nqhis, kev txhawj xeeb ntau dhau ntawm cov haujlwm Internet, thiab kev tsis muaj peev xwm txo qis siv [,]. Qee cov kws tshawb nrhiav tau ua ib qho kev sib txuam nrog kev coj tus cwj pwm, suav nrog kev twv txiaj [,]. Ib zaug ntxiv, cov kev tshawb fawb txog neurobiological qhia tau tias PIU koom nrog SUD ob peb lub neurobiological yam ntxwv [,-]. Txawm hais tias PIU tau pom muaj ntau zaus comorbid nrog lwm cov kev puas siab puas ntsws [], cov ntawv nyeem ntawm kev sib raug zoo ntawm PIU thiab SUDs yog meager.

Tib yam muaj tseeb rau cov ntaub ntawv ntawm PIU kev nthuav dav thiab tus yam ntxwv hauv peb lub tebchaws. Vim li no, txoj kev tshawb fawb tam sim no txhawm rau tshawb xyuas cov xwm txheej no hauv cov neeg tsis sib haum xeeb uas yog los ntawm cov tib neeg ua raws cov txheej txheem tshuaj rau kev quav yeeb tshuaj hauv cov chaw pej xeem (Servizio Tossicodipendenze, SERT) los ntawm cov lus nug hu ua "Questionario sull'Utilizzo delle Nuove Tecnologie" (QUNT) uas peb tau tsim rau lub hom phiaj no.

COV NTAUB NTAWV THIAB KEV HLOOV

Kev ntsuas tus kheej daim ntawv nug tus kheej

Ib qho kev sib tham sib platform thiab lub vas sab (http://dronet.araneus.it/questionario) ntawm cov thev naus laus zis tshiab tau tsim los ntawm ib tus neeg sab nraud. Lub chaw tso cai nkag mus rau daim ntawv ntsuas tus kheej cov lus nug tsuas yog ntawm hauv Internet.

Tib lub sijhawm, cov lus nug ntawm tus kheej-kev ntsuas tus kheej xa mus rau acronym QUNT tau tsim. Lub QUNT muaj ob ntu, ib qho rau cov ntaub ntawv qhia txog cov pej xeem thiab lwm qhov muaj 101 cov khoom (Daim Ntawv Ntxiv 1). Plaub caug tsib ntawm tag nrho cov khoom 101 tau tsib qhov lus teb tau, raws li Likert tsib-ntu teev nrog 1 qhia tias "tsis muaj tseeb" thiab 5 taw qhia "yeej muaj tseeb"; peb cov khoom yog cov lus nug xaiv teb tau ntau; kaum tau tsom ntsoov rau kev siv "kev xa xov tam sim ntawd" (nrog tsib cov lus teb tau, raws li Likert tsib-ntu teev nrog 1 qhia tias "tsis muaj tseeb" thiab 5 taw qhia "tseeb kiag"), thiab 42 cov khoom ntawm kev siv "kev sib raug zoo tes hauj lwm ”(kev xa ntawv tam: Whatsapp, Telegram, Skype, thiab kev sib raug zoo: Facebook, Twitter thiab Instagram) (nrog tsib cov lus teb tau, raws li Likert tsib-ntu teev nrog 1 qhia tias“ tsis muaj tseeb ”thiab 5 qhia tias“ muaj tseeb tag ” )). Qhov khoom #101 yeej yog ib lo lus nug ntawm kev txaus siab / nqi hluav taws xob lossis tsis yog nrog kev nug. Cov khoom txiav txim siab ntawm qhov muaj feem cuam tshuam tau tau muab tso ua ke txhawm rau txhawm rau txheeb xyuas cov laj thawj ua raws ib tug priori cov txheej txheem ntxiv los ntawm cov ntaub ntawv muaj nyob hauv cov ntawv xov xwm scientific [,,]. Tej yam zoo li no yog “siv sijhawm nyob online” (yam 2, 3, 4, 5, 6, 7, 25, 33), “thim kev sib raug zoo” (yam 8, 10, 18, 22, 30, 35), “tsis suav nrog qhov tseeb ”(Nqe 11, 13, 24),“ tswj tsis tau lwm tus ”(nqe 19, 20, 32, 36),“ kev saib duab liab qab ”(nqe 26, 27),“ mob siab ntsws ”(yam 40, 41, 42, 43) ), thiab “kev quav rau kev sib raug zoo” (49, 50, 51, 52, 53, 54, 55, 56, 57). Qhov "kev quav rau kev tes hauj lwm" tau raug muab faib ntxiv rau cov teeb meem hauv qab no: "Kev quav rau Facebook" (yam 61-75), "kev quav rau Twitter" (yam khoom 76-86), thiab "kev quav rau Instagram" (yam 86-97). Cov qhab nias tau suav tau xam raws li qhov tawm ntawm cov qhab nia tau hauv txhua yam muab faib los ntawm qhov siab tshaj plaws ua feem pua. Peb tsim cov lus teb 4 (nruab nrab ntawm 4 thiab 6 teev / teev) lossis 5 (> 6 teev / teev) ntawm nqe 2 “siv sijhawm online”. Raws li cov lus txiav tawm los txheeb xyuas qhov muaj, raws li qhov tsim nyog lossis muaj tseeb / PIU, hauv kev pom zoo nrog cov ntaub ntawv tam sim no, txawm tias muaj kev sib cav []. Tsis muaj kev tawm tau qhia kom paub cov neeg koom uas nws tsis lees paub lawv tau lees paub.

Cov txheej txheem sau cov txheej txheem

Cov ntawv txuas rau QUNT tau sib txuas lus rau cov chaw haujlwm uas saib xyuas cov neeg sab nraud cov kev pabcuam rau cov neeg quav yeeb tshuaj, SERTs, nyob hauv thaj chaw Calabria, txhawm rau thov lawv cov neeg mob sau rau. hauv daim ntawv nug kev raws li kev yeem. Qhov kev tshawb pom tam sim no tau pom zoo los ntawm Pab Pawg Saib Xyuas Kev Ncaj Ncees ntawm Pisa University.

Kev Tshawb Fawb Tsom

Lub ywj pheej t-ib daim ntawv thov raug muab coj los piv rau cov qhab nia nruab nrab ntawm cov qhab-nees ntawm cov hauv paus ntawm cov hloov pauv: pw ua ke (M / F); ib (muaj / tsis nyob nyob uake (yog / tsis muaj). Ib-txoj kev txheeb xyuas ntawm kev sib txawv ua raws los ntawm Bonferroni lub xeem rau tom qab ua haujlwm tau siv los ntsuas qhov sib piv ntawm kev ntsuas lub cev ntawm lub cev (BMI) pawg. Tus χ2 kev tsom xam raug siv los piv rau yam hloov pauv ntawm pawg. Txhua qhov txheeb cais tau nqa tawm los ntawm Cov Ntawv Pob rau Lub Neej Kev Tshawb Fawb (SPSS), version 22 (Armonk, NY, Tebchaws Asmeskas) [].

KEV SIV

Cov yam ntxwv ntawm kev kawm cov pej xeem

Cov lus nug xa rov qab tus lej 183, ntawm uas 148 (80.87%) yog los ntawm cov txiv neej thiab 35 (19.13%) yog los ntawm cov poj niam, tawm ntawm tag nrho cov 1500 kev caw. Feem ntau ntawm cov ncauj lus kawm (86, 47%) tau ua tiav 8 xyoo ntawm tsev kawm, 73 (39.9%) cov tsev kawm theem siab, 14 (7.7%) 5 xyoo ntawm thawj lub tsev kawm ntawv, thiab 10 (5.5%) tau kawm tiav. Cuaj caum-ob (50.3%) cov ntsiab lus yog ib leeg, 64 (14.8%) tau sib yuav, thiab 27 (14.8%) tau koom nrog kev sib hlub. Qhov txhais tau ntev ntawm kev mus koom ntawm cov chaw txais kev pabcuam pejxeem yog nyob nruab nrab ntawm 1 thiab 60 mo (txhais tau tias ± kev txawv txav (SD): 32 ± 20).

Hom kev quav tshuaj thiab / lossis yees kev quav

Cov tshuaj phem ntau tshaj plaws yog heroin lossis opioids (n = 88, 48.1%), cawv (n = 55, 30.1%), cannabis (n = 20, 9.8%), tshuaj yeeb (n = 17, 7.7%), thiab amphetamines (n = 3, 1.6%). Kev tsim txom polydrug (amphetamine, cannabis, cocaine, ecstasy) tau muaj nyob rau cuaj (4.9%) cov tib neeg, thaum kev tsis txaus siab ntawm kev twv txiaj tau tshawb pom hauv 18 (9.3%). Tag nrho cov ntsiab lus 183 yog cov neeg haus luam yeeb hnyav (Cov Lus ​(Table11).

rooj 1

Hom kev quav tshuaj thiab / lossis yees kev quav

n (%)
Tshuaj Qhiaj lossis opioids88 (48.1)
Haus dej cawv55 (30.1)
cannabis20 (9.8)
Cocaine17 (7.7)
Amphetamines3 (1.6)
Kev tsim txom polydrug9 (4.9)
Kev twvtxiaj kev twvtxiaj18 (9.3)
Cov neeg haus luam yeeb183 (100)

Lub smartphone tau pom tias yog lub cuab yeej siv tau los ntawm txhua qhov kev kawm kom nkag tau rau hauv Is Taws Nem. Lub sijhawm siv online yog zoo ib yam ntawm cov txiv neej thiab poj niam, 4.12 ± 2.9 h. Qhov xav tau, lub sijhawm siv online los ntawm 30% ntawm neeg muaj yeeb thiab 25% cov neeg siv cannabis tau nce siab dua (> 6 h) tshaj li ntawm lwm pab pawg.

QUNT yam tseem ceeb thiab tub los ntxhais

Kev faib tawm ntawm QUNT yam tsis txawv ntawm ob hom neeg; txawm li cas los xij, cov txiv neej siv cov cannabis tau qhia txog kev hloov rau cov qhab nias siab dua (txhais tau ± SD) ntawm cov ntsiab lus hauv qab no: "Kev tshem tawm hauv zej zog" (2.44 ± 0.38 vs 2.23 ± 0.39, P <0.001) thiab "abstraction los ntawm kev muaj tiag" (3.12 ± 1.74 vs 2.24 ± 0.46, P <0.001). Cov neeg siv yeeb dawb tau pom cov qhab nia siab dua lwm cov kev kawm ntawm qhov "tswj tsis tau tus kheej" (3.64 ± 1.12 vs 2.51 ± 0.36, P <0.001), "kev saib duab liab qab" (3.59 ± 1.44 vs 2.54 ± 0.41, P <0.001), thiab "kev quav rau kev tes hauj lwm" (3.22 ± 0.98 vs 2.66 ± 0.76, P <0.001) yam.

QUNT lwm yam thiab cuam tshuam rau kev sib raug zoo

Kev tsom xam ntawm qhov sib txawv hauv QUNT yam txog kev ua ib leeg (n = 92) los yog koom tes nrog kev hlub (n = 91) qhia tias ib qho kev kawm tau qhab nia siab dua ntawm cov ntsiab lus hauv qab no (txhais tau ± SD): "Lub sijhawm siv online" (2.95 ± 0.47 vs 2.17 ± 0.44, P <0.001); "Kev tshem tawm hauv zej zog" (1.40 ± 0.35 vs 1.34 ± 0.32, P <0.001); “Kev cais tawm ntawm kev muaj tiag” (1.90 ± 0.40 vs 1.56 ± 0.62, P <0.001); “Kev muaj yees rau saib duab liab qab” (3.12 ± 0.88 vs 1.99 ± 0.79, P <0.001); thiab "kev quav rau kev tes hauj lwm" (2.89 ± 1.08 vs 2.06 ± 0.33, P <0.001).

Qhov kev tshuaj ntsuam xyuas ntawm qhov sib txawv ntawm cov khub sib koom (72) lossis tsis nyob ua ke (17) nrog tus khub tau qhia qee qhov sib txawv. Cov ntsiab lus hauv qab no tau qhia cov qhab nia siab dua hauv cov ncauj lus uas tsis nyob nrog tus khub vs cov neeg uas nyob nrog tus khub: "Lub sijhawm siv online" (3.03 ± 0.53 vs 2.16 ± 0.76, P <0.001), "kev muaj yees rau saib duab liab qab" (3.15 ± 0.99 vs 2.33 ± 0.71, P <0.001), “mob siab ntsws” (3.42 ± 1.08 vs 2.96 ± 0.66, P <0.001), thiab "kev quav rau kev tes hauj lwm" (2.99 ± 0.91 vs 2.01 ± 0.44, P <0.001).

QUNT lwm yam thiab BMI

Tag nrho cov qauv tau muab cais tawm raws li BMI qhov tseem ceeb. Kaum tsib yam muaj BMI hauv qab 18.50 (cov rog hauv qab, UW), 69 nruab nrab ntawm 18.51 thiab 24.9 (qhov hnyav, NW), 60 nruab nrab ntawm 25 thiab 30 (rog dhau, OW), 26 nruab nrab ntawm 30.1 thiab 34.9 (thawj qhov kev rog, OB1), thiab 13 ntau dua 35 (qib ob ntawm kev rog, OB2). Cov qeb OB1 thiab OB2 tau muab tso ua ke nyob rau hauv qeb "Rog" (OB). Cov kev sib piv ntawm QUNT qhov sib piv cov qhab nia hauv plaub qhov BMI tau muab tshaj tawm hauv Table ​Table2,2, uas qhia tias qhov ntau dua ntawm BMI suav qhov ntau dua qhov qhab nia loj dua. Ntxiv mus, raws li qhia hauv daim duab ​Daim duab 1,1, raws li BMI tau nce qhov feem pua ​​ntawm tsib feem cuam tshuam, “siv sijhawm nyob online”, “thim kev sib raug zoo”, “tsis suav nrog qhov tseeb”, “tsis txaus siab”, thiab “quav rau kev sib raug zoo”, kuj tseem nce siab. Thaum kawg, kaum tsib ntawm tag nrho cov neeg siv yeeb dawb tseem yog cov kev twv txiaj txog kev twv txiaj (feem ntau yog cov twv txiaj hauv online) thiab tau qhia tias qhov qhab nia tau zoo dua ntawm "ludopathy" qhov tseem ceeb (3.20 X 0.45 vs 2.86 ± 0.51, P <0.001).

Ib cov ntaub ntawv sab nraud uas tuav ib daim duab, piav qhia, thiab lwm yam. Cov npe khoom siv yog WJP-9-55-g001.jpg

Sib piv ntawm cov qhab nia feem pua ​​ntawm qee yam QUNT thiab lub cev qhov ntsuas. A: Lub sijhawm siv online; B: Kev rho tawm; C: Kev rho tawm ntawm qhov tseeb; D: Ludopathy; E: Kev yees rau kev tes hauj lwm. BMI: Lub cev nyhav; UW: Kev hnyav; NW: Nqus hnyav; OW: Tshaj dhau; OB: Kev pham; QUNT: Questionario sull'Utilizzo delle Nuove Tecnologie.

rooj 2

Kev sib piv ntawm QUNT qhov sib piv cov qhab nia hauv plaub pawg BMI

yamUWNWOWOBFP tus nqiTom qab ua haujlwm sib piv: Tseem ceeb rau P <0.05
Siv sijhawm hauv online53.44 ± 13.6853.80 ± 13.1254.91 ± 12.7155.83 ± 14.103.870.009OW> UW
Kev rho tawm25.39 ± 6.3527.55 ± 7.6128.73 ± 8.9430.81 ± 10.149.910.001OW> UW; OB> UW; OB> NW
Kev cais tawm ntawm kev muaj tiag32.33 ± 10.0234.90 ± 10.1335.11 ± 12.9836.11 ± 13.442.690.045tsis muaj leej twg
Poob kev tswj tsis tau28,10 ± 9.1129.79 ± 10.1131.04 ± 12.4931.21 ± 10.871.951.98tsis muaj leej twg
Kev quav rau saib duab liab qab43.32 ± 12.2841.95 ± 13.7041.34 ± 11.0342.09 ± 13.451.550.250tsis muaj leej twg
Ludopathy33.26 ± 13.1736.23 ± 10.8539.88 ± 22.9141.16 ± 22.394.280.005OW> NW
Cov yees rau ntawv tam54.05 ± 18.3356.02 ± 16.4756.24 ± 18.3655.60 ± 17.091.720.197tsis muaj leej twg
Tus yees rau kev tes hauj lwm41.60 ± 12.6142.13 ± 13.1541.80 ± 12.1944.14 ± 18.901.810.187tsis muaj leej twg

QUNT: Questionario sull'Utilizzo delle Nuove Tecnologie; BMI: Txoj Kev Ntsuas Lub Cev; UW: Kev hnyav; NW: Nqus hnyav; OW: Tshaj dhau; OB: Kev pham.

SIB THAM

Cov kev kawm tam sim no qhia txog cov txiaj ntsig ntawm kev sib koom tes tshawb fawb txog qhov dav thiab cov yam ntxwv ntawm kev siv Is Taws Nem los ntawm cov thev naus laus zis tshiab (PCs, smartphones thiab ntsiav tshuaj), nrog rau PIU, nyob hauv cov kev kawm uas tau txais kev pabcuam ntawm kev rov ua haujlwm nyob hauv cov chaw pabcuam pejxeem hauv cov chaw cheeb tsam los ntawm yav qab teb Ltalis. Raws li peb txoj kev paub, qhov no yog thawj qhov kev tshawb nrhiav tau ua nyob rau hauv cov neeg laus txawv txav no, zoo li yav tas los tsuas yog cov piv txwv ntawm cov tub ntxhais hluas raug tshawb fawb [].

Muaj ntau lub ncauj lus tau txais kev caw los ntawm lawv cov kws kho mob hlwb / kws kho paj hlwb kom sau cov lus nug, uas yog QUNT, uas tau tsim los ntawm peb rau lub hom phiaj no. Qhov tseem ceeb ntawm QUNT, piv nrog cov siv nyob rau hauv kev tshawb fawb sib txawv, yog tias nws yog cov ncauj lus kom ntxaws heev txhawm rau ntsuas ntau yam ntawm cov tib neeg cov txiaj ntsig ntawm ob qho tib si siv Internet thiab PIU. Yam 2 "siv sijhawm nyob online" tau txiav txim siab tseem ceeb los txheeb xyuas qhov muaj peev xwm ntawm PIU thaum nws nyob nruab nrab ntawm 4 thiab 6 hr / d (teb 4), lossis ntawm PIU hnyav, thaum nws yog> 6 hr / d (teb 5) Cov.

Txog 10% ntawm cov ntsiab lus xa rov qab QUNTs tau muaj qhov muaj tseeb hauv qhov muaj tseeb rau kev txheeb cais cov ntsuas. Qhov no tuaj yeem ua rau tus cwj pwm sib txawv ntawm cov neeg quav yeeb tshuaj, tshwj xeeb tshaj yog cov kev mob ncua ntev uas sawv cev rau feem ntau ntawm peb tus qauv, thiab nws yuav qhia tau tias ob qho tib si qis rau kev koom tes tshawb fawb thiab ua raws li kev coj ua zoo li []. Cov khoom siv feem ntau (100% ntawm cov ncauj lus) kom nkag tau rau hauv Internet yog lub xov tooj smartphone. Muaj qhov muaj siab loj ntawm cov txiv neej dhau los ntawm poj niam, uas qhia txog kev faib tawm ntawm cov neeg sib deev hauv cov chaw pabcuam pejxeem hauv tebchaws Ltalis, hauv kev pom zoo nrog cov ntaub ntawv hauv tebchaws pom tias tus txiv neej sib piv: poj niam yog 4: 1 [].

Txhua qhov kev kawm yog cov haus luam yeeb hnyav, yuav luag 50% ntawm lawv tau siv tshuaj yeeb (heroin) thiab / lossis tshuaj tiv thaiv opioid, 30% cawv, 10% cannabis, 8% yeeb, thiab 5% yog cov siv polydrug. Tsuas yog peb lub ncauj lus qhia yog cov neeg siv tshuaj amphetamine thiab, yog li ntawd, tsis suav nrog hauv kev txheeb cais suav. Yuav luag 10% ntawm cov tib neeg kuj tau txais kev txom nyem los ntawm kev twv txiaj, thaum lub sijhawm muaj lwm cov kev puas siab puas ntsws tau tsim los ua ib qho kev cais tawm.

Lub sijhawm siv online yog qhov nce siab, ntau dua 4 hr / d hauv tag nrho cov qauv, nrog me ntsis, txawm tias nws tsis tseem ceeb ntawm cov txiv neej. Cov neeg siv yeeb dawb thiab cannabis siv nyiaj ntau dua 6 teev / teev online, pom ntau dua li opioid thiab dej cawv cov neeg ua phem. Yog li ntawd, tej zaum lawv tau cuam tshuam los ntawm PIU hnyav, raws li lub hom phiaj tau txhais los ntawm peb (teb 5 ntawm yam khoom 2) thiab cov ntaub ntawv luam tawm [,-]. Noj ua ke, cov kev tshawb pom tau qhia tias txawm tias PIU muaj peev xwm nyob hauv txhua pawg ntawm cov neeg quav, nws tsis tshua muaj ntau hauv kev noj tshuaj sedative, xws li heroin / opioids thiab cawv. Hloov pauv, nws yuav raug siv los ua "txhawb" zog hauv cov neeg siv yeeb dawb thiab cannabis. Qhov no tau txais kev txhawb nqa los ntawm qhov muaj peev xwm ntau dua ntawm cov kev twv txiaj ntawm cov neeg quav yeeb, nyob hauv kev pom zoo nrog cov ntaub ntawv luam tawm [-].

Kev tsom xam ntawm qhov faib tawm ntawm QUNT cov ntsiab lus qhia tsis muaj kev sib deev sib txawv thiab qhov sib txawv me ntsis ntawm cov qhab nia siab dua ntawm "kev tshem tawm" thiab "abstraction los ntawm kev muaj tiag" cov txiv neej. Qhov no yog qhov sib piv nrog cov kev tshawb fawb yav dhau los nqa tawm hauv cov kev kawm muaj kev noj qab haus huv uas qhia pom qhov sib txawv ntawm cov txiv neej thiab poj niam Cov lus piav qhia yuav yog kev cuam tshuam ntawm kev tsim txom cov tshuaj uas nyiam "tsawg dua" sib txawv sib deev []. Raws li muab piv nrog rau lwm pab pawg, neeg siv yeeb dawb tau pom cov qhab nia siab dua ntawm "kev tswj tsis tau", "kev saib duab liab qab", thiab "kev quav rau kev sib raug zoo". Qhov no tsis txaus ntseeg txog kev ua kom lub zog ntawm cov tshuaj no [].

Peb qhov kev tshawb pom tau lees paub txog "kev tiv thaiv" cuam tshuam los ntawm kev sib hlub sib raug zoo thiab / lossis nyob nrog tus khub [], raws li ib qho kev kawm lossis cov nyob ib leeg uas tsis muaj kev txhawb nqa tsev neeg tau qhia cov qhab nias siab dua rau ntawm cov khoom sib txawv, tshwj xeeb “siv sijhawm sijhawm online”, “sib pauv”, “cais tawm ntawm kev muaj tiag”, “quav rau duab liab qab”, thiab “yees rau kev sib raug zoo ”. Qhov no qhia meej meej tias Internet tau siv rau lub sijhawm dhau mus los yog kev ua si.

Tsis yog qhov xav tsis thoob, cov neeg uas siv sijhawm ntau hauv online, raws li qhia los ntawm cov qhab nia siab dua ntawm "sijhawm siv online", "tshem tawm kev sib raug zoo", "tsis xam los ntawm kev muaj tiag", thiab "quav rau kev sib raug zoo", muaj BMI siab dua. Yog li, kev siv ntau dhau hauv Is Taws Nem tuaj yeem suav tias yog lwm qhov ntxiv uas ua rau muaj kev coj ua tsis tau zoo [], thiab nws yuav muaj kev pheej hmoo tshwj xeeb tshaj yog nyob rau hauv cov neeg quav yeeb quav tshuaj uas twb muaj kev cuam tshuam ntau dhau los uas twb tau txais cov kab mob sib txawv []. Txo cov sijhawm pw tsaug zog thiab kev hloov circadian rhythms vim PIU yog lwm yam uas yuav ua rau muaj feem ntau ntawm cov khoom noj ntawm lub cev, kev kho mob, thiab kev puas hlwb [,,] nrog rau kev cuam tshuam ntawm kev ua haujlwm, tsev neeg, kev sib raug zoo, lossis kev kawm hauv tsev kawm ntawv [,].

Thaum kawg, feem ntau (15 tawm ntawm tag nrho 17) ntawm cov neeg siv yeeb siv tshuaj kuj tseem muaj kev twv txiaj txog kev twv txiaj (feem ntau yog cov neeg twv txiaj hauv online), thiab tau qhia cov qhab nia siab dua ntawm "ludopathy" qhov zoo tshaj. Qhov no yuav qhia qhov tshwj xeeb muaj qhov tsis zoo ntawm cov neeg quav tshuaj rau lwm hom kev quav, tshwj xeeb tshaj yog tias lawv siv cov tshuaj stimulants es tsis siv cov tshuaj sedative []. Peb txoj kev kawm muaj qee qhov kev txwv uas yuav tsum tau lees paub. Cov lus nug QUNT tsis tau raug kuaj pom, txawm hais tias qhov no tshwm sim heev hauv kev tshawb nrhiav hauv daim teb no [,-]. Feem ntau ntawm PIU raug nthuav tawm los ntawm ib yam khoom nkaus xwb, tab sis nws yog qhov sib dhos ntawm lub hom phiaj tseem ceeb ntawm kev tshawb fawb tshawb txog feem ntau ntawm cov yam ntxwv ntawm kev siv Is Taws Nem. Ib yam li ntawd, tsis muaj xov xwm sau txog cov kev ntxhov siab lossis ntxhov siab coj cwj pwm uas tam sim no tseem tab tom tshawb nrhiav.

Noj ua ke, peb cov txiaj ntsig tau hais tias kev siv ntau dhau los ntawm Is Taws Nem siv ntawm lub xov tooj smartphones yog qhov muaj ntau yam hauv cov neeg quav yeeb tshuaj, raws li qhia los ntawm lawv lub sijhawm siv online, thiab tias PIU muaj ntau heev rau cov neeg no, tshwj xeeb tshaj yog nyob rau hauv kev noj yeeb dawb thiab cannabis. Cov kev sib raug zoo ntawm lub sijhawm siv online (thiab cuam tshuam txog kev ua neej nyob sedentary) thiab BMI qhia tias kev siv Is Taws Nem tej zaum yuav ua rau muaj qhov hnyav ntxiv thiab rog dhau ntawm cov neeg hluas thiab cov neeg laus thoob plaws ntiaj teb [,]. Peb qhov kev tshawb pom xav qhia txog qhov phom sij ntawm cov neeg quav, feem ntau yog tias lawv siv cov tshuaj stimulant es tsis siv tshuaj tiv thaiv kab mob, tsis yog rau lwm yam kev ua kom zoo nkauj xwb, tabsis tseem cuam tshuam rau kev coj cwj pwm, xws li PIU lossis kev twv txiaj. Kev tiv thaiv kev quav yeeb tshuaj yuav tsum tau saib mus rau qhov tshiab, thiab tseem tsis tau tshawb nrhiav, qhov chaw ntawm kev coj tus cwj pwm, tshwj xeeb tshaj yog PIU uas niaj hnub no sawv cev rau kev sib kis thoob ntiaj teb [,-].

PHAAJ HIGHLIGHTS

Tshawb nrhiav tom qab

Teeb meem siv Is Taws Nem (PIU) yog ib qhov tshiab ntawm txoj kev coj tus cwj pwm uas tshwm sim los ntawm kev siv Is Taws Nem ntau heev uas dhau los ua qhov teeb meem thoob ntiaj teb. Txawm hais tias tsis muaj kev pom zoo rau cov kev kuaj mob meej meej, PIU raug suav hais tias yog kev coj cwj pwm sib koom nrog kev quav tshuaj yeeb dej caw (SUDs) thiab lwm yam kev quav tshuaj yeeb tshuaj nyob rau ntau lub yeeb yam thiab tej zaum neurobiological nyob rau hauv-pinnings.

Kev tshawb nrhiav txug

Hmoov tsis zoo, tsis muaj xov xwm txog kev nthuav dav ntawm PIU nrawm rau kev quav yeeb tshuaj, txawm hais tias muaj pov thawj tau muab, tias cov tib neeg no yuav cuam tshuam los ntawm kev siv polydrug thiab tseem los ntawm kev coj cwj pwm, zoo li yog tias muaj ib lossis ntau tus neeg quav yeeb tshuaj yuav sawv cev ib qho kev tsis ruaj khov ntawm kev ua tsis zoo ntawm cov duab hauv chaw kho mob los ntawm qhov pib ntawm lwm yam kev cuam tshuam no.

Tshawb nrhiav hom phiaj

Kev tshawb nrhiav ntawm qhov muaj tshwm sim thiab kev nthuav dav ntawm PIU nrad cov neeg quav yeeb tshuaj nyob hauv kev kho mob hauv cov chaw nruab ntug yuav tso cai rau kev siv cov kev kho mob tshwj xeeb los tiv thaiv qhov pib ntawm lwm yam kev quav yeeb tshuaj uas tuaj yeem ua rau cuam tshuam cov duab hauv chaw soj ntsuam thiab kev kho kom rov zoo.

Tshawb fawb txoj kev

Cov lus nug tshwj xeeb uas yuav tau sau hauv online, yog li lub npe hu ua Questionario sull'Utilizzo delle Nuove Tecnologie (QUNT), tau tsim los tshawb txog kev nthuav dav thiab yam ntxwv ntawm kev siv Is Taws Nem thiab PIU. Lub QUNT muaj ob ntu, ib qho rau cov ntaub ntawv qhia txog cov pej xeem thiab lwm qhov muaj 101 cov khoom tau muab faib ua pawg raws li tsim raws li ib tug priori cov txheej txheem extrapolated los ntawm cov ntaub ntawv muaj nyob hauv cov ntawv nyeem scientific. Txhua hom kawm uas tuaj yeem koom rau hauv txoj kev tshawb no (n = 183) tshaj tawm tias QUNT tau muaj txiaj ntsig thiab muaj kev zoo siab rau nws. Cov qhab nias tau suav tau xam raws li qhov tawm ntawm cov qhab nia tau hauv txhua yam muab faib los ntawm qhov siab tshaj plaws hauv qhov feem pua. Peb xaiv cov lus teb 4 (nruab nrab ntawm 4 thiab 6 teev / teev), thiab cov lus teb 5 (> 6 teev / d) ntawm nqe 2 “siv sijhawm online”. Txhawm rau txhawm rau txheeb xyuas qhov ntsuas lub cev lub cev (ntsiab lus rau, ntsig txog, qhov ua tau lossis qee yam (thiab loj heev) muaj PIU.

Tshawb nrhiav tau

Lub sijhawm siv online yog ntau dua 4 hr / d hauv tag nrho cov qauv, nrog me ntsis, txawm hais tias tsis tseem ceeb, nthuav dav ntawm cov neeg kawm. Cov neeg siv yeeb dawb thiab cov neeg haus luam yeeb tau siv sijhawm ntau dua 6 teev hauv online, siv ntau dua opioid thiab cov neeg haus cawv. Qhov faib tawm ntawm QUNT yam tsis txawv hauv ob hom poj niam thiab txiv neej. Cov neeg siv yeeb dawb tau pom cov qhab nia siab dua ntawm "kev tswj tsis tau", "yees kev siv yees", thiab "kev quav mus rau kev sib raug zoo", tej zaum vim muaj cov teebmeem ntawm cov tshuaj no. Ntxiv mus, 15 tawm ntawm tag nrho cov neeg siv 17 neeg quav yeeb kuj tseem yog cov twv txiaj pathological. Kev sib raug zoo thiab cov lus pom tau zoo kuj tau pom ntawm qee yam QUNT thiab kev ntsuas lub cev (BMI). Cov txiaj ntsig tau no, thaum qhia pom tias PIU nquag dhau los ntawm kev tsim txom cov neeg quav yeeb tshuaj, xav kom coj mus ua dua piv txwv hauv cov qauv loj dua los ntawm lwm lub tebchaws. Txawm li cas los xij, lawv hais txog qhov kev pheej hmoo ntawm kev coj tus cwj pwm hauv kev quav yeeb tshuaj, ib qho teeb meem uas yuav tsum tau coj mus thaum npaj kev tiv thaiv thiab cuam tshuam-gies.

Tshawb nrhiav kev txiav txim siab

Qhov kev tshawb pom tshiab ntawm txoj kev tshawb no yog sawv cev los ntawm feem pua ​​loj ntawm PIU nrad cov neeg quav yeeb tshuaj, tshwj xeeb tshaj yog tias lawv siv cocaine lossis cannabis. Qhov no qhia tau hais tias, txawm hais tias kev siv tshuaj phem hauv Is Taws Nem muaj nyob rau hauv txhua tus neeg quav yeeb tshuaj, PIU tsis tshua pom kev coj yam tshuaj sedative, xws li yeeb dawb / tshuaj tiv thaiv cawv thiab cawv, thaum nws yuav dhau los ua "kev txhawb nqa" tawm hauv cov neeg siv yeeb dawb thiab cannabis , raws li kev txhawb nqa los ntawm qhov muaj peev xwm tseem ceeb ntawm cov kab kev twv txiaj ntawm cov neeg quav yeeb yeeb. Ntxiv mus, PIU muaj ntau dua nyob hauv ib qho kev kawm lossis kawm ib leeg nyob ib leeg, qhov no ua rau pom kev tiv thaiv los ntawm kev hlub los yog kev sib raug zoo feem ntau tawm tsam qhov pib ntawm kev muaj yees. Cov uas tau siv sijhawm ntau nyob hauv online, raws li qhia los ntawm qhov qhab nia siab dua ntawm "siv sijhawm hauv online", "kev tshem tawm hauv zej zog", "tsis suav los ntawm kev muaj tiag", thiab "quav rau kev sib raug zoo", muaj BMI siab dua. Yog li, kev siv ntau hauv Is Taws Nem tuaj yeem suav tias yog lwm qhov ntxiv los ua kom muaj kev coj ua tsis zoo uas yuav muaj kev pheej hmoo tshwj xeeb rau cov neeg quav yeeb quav tshuaj, tej yam uas twb muaj feem ua rau muaj mob sib txawv. Txo cov sijhawm pw tsaug zog thiab cuam tshuam circadian rhythms vim PIU yog lwm yam uas yuav ua rau muaj qhov tshwm sim ntawm cov khoom noj hauv lub cev, kev kho mob, thiab kev puas siab puas ntsws nrog rau kev tsis taus ntawm kev ua haujlwm, tsev neeg, kev sib raug zoo lossis tsev kawm ntawv.

Tshawb nrhiav kev xam pom

Cov kev tshawb pom ntawm qhov kev tshawb nrhiav tam sim no qhia tau hais tias kev coj tus cwj pwm, xws li PIU, tuaj yeem siv dav polydrug, tshwj xeeb tshaj yog hauv cov ncauj lus uas noj cov tshuaj tiv thaiv lossis cannabis. Ib qho ntxiv, PIU yuav suav hais tias yog ib qho ntxiv los ua qhov tsis zoo hauv lub neej, twb ua tsis tau zoo ntawm cov neeg quav yeeb tshuaj, thaum txhawb kev coj tus cwj pwm tsis zoo thiab ua tsis zoo rau qee tus neeg lub npe. Cov kev tshawb fawb yav tom ntej yuav tsum tau coj mus rau qhov kev cuam tshuam ntawm PIU rau cov neeg quav yeeb tshuaj los ntawm cov kws qhia tshwj xeeb los ntsuas nws, txhawm rau tiv thaiv, tsis tsuas yog nws qhov kev cuam tshuam uas tsis zoo, tab sis kuj cuam tshuam nrog rau kev nthuav dav ntawm kev coj tus yam ntxwv.

Acknowledgements

Peb ua tsaug rau txhua tus thawj tswj kev tswj hwm ntawm SERT los ntawm Calabria rau lawv txoj kev koom tes zoo.

Tshooj ntawv

Cov Txheeb Xyuas Pawg Tuam Txhab Saib Xyuas Kev Tshawb Fawb: qhov kev tshawb fawb tau pom zoo los ntawm Pawg Tswj Kev Cai ntawm Pisa University.

Qhia cov lus pom zoo tso cai: Txoj kev tshawb no tau pom zoo los ntawm Pawg Neeg Saib Xyuas Kev Ncaj Ncees ntawm Pisa University, thiab cov neeg koom tau txiav txim siab los koom nrog nws nyob ntawm kev yeem thiab yam tsis qhia npe, yog li nws tsis tuaj yeem txheeb xyuas lawv.

Cov lus tsis sib haum-ntawm-cov lus txaus siab: Cov sau phau ntawv tsis muaj kev tsis sib haum xeeb ntawm kev txaus siab tshaj tawm.

Cov peev txheej sau: Cov ntawv caw sau

Saib-rov pib: Lub Plaub Hlis 26, 2018

Thawj qhov kev txiav txim siab: Lub Rau Hli 15, 2018

Tsab xov xwm hauv xovxwm: Lub Tsib Hlis 15, 2019

P-Tshawb Xyuas: Hosak L, Seeman MV S-Editor: Ji FF L-Editor: Filipodia E-Editor: Wang J

Hom tshwj xeeb: Lub siab ntsws

Lub teb chaws ntawm keeb kwm: Ltalis

Kev tshuaj xyuas-muab tso ua pawg

Qib A (Zoo heev): 0

Qeb B (Zoo heev): 0

Qeb C (Zoo): C, C

Qib D (Ncaj Ncees): 0

Qib E (Tsis zoo): 0

Cov Ntaub Ntawv Qhia Ntxiv

Stefano Baroni, Dipartimento di Medicina Clinica e Sperimentale, Ntu ntawm Psychiatry, Tsev Kawm Ntawv ntawm Pisa, Pisa 56100, Ltalis.

Donatella Marazziti, Dipartimento di Medicina Clinica e Sperimentale, Ntu ntawm Psychiatry, Tsev Kawm Ntawv ntawm Pisa, Pisa 56100, Ltalis. ti.ipinu.dem.ocisp@izzaramd ib.

Federico Mucci, Dipartimento di Medicina Clinica e Sperimentale, Ntu ntawm Psychiatry, Tsev Kawm Ntawv ntawm Pisa, Pisa 56100, Ltalis.

Elisa Diadema, Dipartimento di Medicina Clinica e Sperimentale, Ntu ntawm Psychiatry, Tsev Kawm Ntawv ntawm Pisa, Pisa 56100, Ltalis.

Liliana Dell'Osso, Dipartimento di Medicina Clinica e Sperimentale, Ntu ntawm Psychiatry, Tsev Kawm Ntawv ntawm Pisa, Pisa 56100, Ltalis.

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