Adolescentologia Giornale Italiano di Adolescentologia e medicina dell'adolescenza

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Adolescentologia
Giornale Italiano di Adolescentologia e medicina dell’adolescenza
Giornale di cultura scientifica ed educativa per la salute dell’adolescente
:
Fondato nel 1992 da Giuseppe R.Brera
Direttore responsabile Giuseppe R.Brera
Direttore editoriale Vito Galante
Comitato scientifico e di redazione
Luciano Berti, Giuseppe R. Brera, Vito Galante, Luigi Gargantini, Patrizia Marchetti, Vincenzo Ovallesco, Mariangela Porta,
Assunto Quadrio, Ettore Ruberti
Organo del Dipartimento di Adolescentologia dell’Università Ambrosiana e
della Società Italiana di Adolescentologia e Medicina dell’Adolescenza
e della World Federation and Society of Adolescentology (WFSA-Italia)
www.adolescentologia.it
www.unambro.it
Nuova Serie-Edizione trimestrale dell’Università Ambrosiana, Milano -
Abbonamenti: 100 euro-4 numeri- gratuito per i soci- Scuole 1 euro/ studente con licenza distribuzione-
Numeri Speciali 50 euro richiedere abbonamento a dipedit@unambro.it
Autorizzazione del Tribunale di Milano n° 374- 1992

Giornale Italiano di Adolescentologia e Medicina dell’Adolescenza 2019: (5) 1-2 :31-49
©Copyright 2019 Adolescentologia Giornale Italiano di Adolescentologia e Medicina dell’Adolescenza
The “Mercury Syndrome” or the smartphone addiction
Giuseppe R. Brera
1
Summary
Different investigation scales like SAS ( Smartphone addiction scale), SAPS (Smartphone Addiction Proneness Scale),
e la KS-scale. (The Korean self-reporting internet addiction short-form scale ), gives evidence to the existence of a mass of
adolescents and young people smartphone addicted. The prevalence rate is comprehended between 20-30% of users, with a
significant difference between males and females who result more addicted. A range between 500- 750 milion of persons out
of 2 bilion and half smartphone users, comprehends people who are smartphone and/or internet or internet game addicts
or heavy users. At neurological level these addictions are associated to an extended structural and functional impairment of
the orbitofrontal cortex, dorsolateral prefrontal cortex, anterior right and posterior cingulate cortex, temporo-parietal
junction, right auditory cortex to right motor cortex with a loss of gray and white brain substance. It results in a deficit of
cognitive discrimination, cognitive processing of perceptions and facial empathic expressions, cognitive control of behaviour
with enhancement of impulsivity, impairment of the deep task directed attention and working memory. At neurochemical
level in the anterior cingulate cortex there is an alteration of the Gaba/Glutamate ratio in favour of Gaba that means the
functional loss of integration and regulation of the cognitive neural and emotional network. The finding of the reduced
striatal dopamine receptors in Internet addiction and the abnormal dopamine regulation of the pre-frontal cortex, gives
evidence of the heavy users’ necessity of emotional rewards, with the impairment of the cognitive control of emotions, due
to lesions of the anterior cingulate cortex with errors in the facial emotion interpretation. In the addicted persons it could
provoke aggressive uncontrolled behaviours because of impulsivity due to an altered function of the frontal-striatal network
that is correlated to impulsivity. It is the neurological basis of the ADHD most frequent disorder in the smartphone addicted
persons . At the affective level the smartphone heavy user persons more frequently show clinical and sub-clinical depression
that is associated with low self-esteem that they want to compensate with the social networks use. Males seem more
submitted to such dynamic than females who use social networks for self-positive reinforcements and are more frequently
addicted. It is consistent with the BAS score enhancement. Depression in heavy smartphone users finds its neurological basis
on the loss of the frontal-limbic impairment of functions and it relates to the loss of the anterior cingulate cortex
connectivity. At the cognitive level these subjects show a general impairment of higher cognitive functions: attention, tas k
directed concentration, working memory and coherent reactions to environmental stimuli because of the loss of the cognitive
skill to discriminate and interpret these. Every day multitasking internet users exhibit a poorer control over attention and
more errors on a task directed behaviour, because of the impairment of the ability to ignore distractions that interfere with
task completion that is associated with an higher electric pre-frontal activity, confirming the findings of a difficulty in the
cognitive control and cognitive processing. This functional deficit in the frequent multimedia multitasking, has been
associated with a grey matter lost in the anterior cingulate cortex, confirming the relation of the functional loss with
structural brain lesions in regions necessary to attention and emotional integration. The sub-cortical balance of interactions,
the loss of cognitive ability to interpret in the right way the interpersonal and symbolic relationship with the environment
and the enhancement of impulsivity , with the necessity of a reinforcement to compensate depression, explains findings that
show the necessity of these subjects to look for a more immediate reward than to wait for a delayed one and behavioural
violent acting-out. They look for instant gratification also of impulsive aggression and sexual drives. This peculiarity is
mediated by individual differences in impulsivity but not in reward/sensation seeking. Academic achievements in multi-
tasking users are damaged because of the impairment of task directed attention and the cognitive control of executive
behaviour also because of vulnerability to distractor inputs. It is also caused by a deficit of working memory and explicit
learning that allows the maintaining of a goal representation and the memory of cognitive processes to join it. These subjects
show only more skills to adapt a starting attention to different tasks at the same time without the ability to concentrate for
realizing one of these.
1
President of the Italian Society of Adolescence Medicine and WFSA - Director of the Milan School of Medicine

Giornale Italiano di Adolescentologia e Medicina dell’Adolescenza 2019: (5) 1-2 :31-49
©Copyright 2019 Adolescentologia Giornale Italiano di Adolescentologia e Medicina dell’Adolescenza
The brain and psychological lesions caused by the smartphone heavy use, the internet addiction, the internet game
addiction that gives evidence to a worrying world pandemic, allows to identify a new clinical syndrome that could be called “
the Mercury syndrome” characterized by a diagnosed smartphone addiction, the frontal-temporal and anterior cingulate
cortex lesions and loss of functions like task directed attention, working and long term memory, alterations in executing
behaviours and academic performances, depression, anxiety, sleep disorders, impulsivity . This syndrome could lead to a
pandemic of neurodegenerative disorders like frontal-temporal dementia and Parkinson disease, characterized by atrophy in
the anterior cingulate cortex, fronto-insula, striatum, and amygdala, and loss of the dopaminergic network due to the loss of
dopamine receptors, as has been seen in smartphone and internet addicts. At the phenomenological level the Mercury
syndrome allows to identify a mass of hundred millions of people who lost and are losing the introspective , making meaning
and historical memory skills with an impairment or absence of critical , philosophical , religious and moral thinking with a
lifestyle oriented only to warrant an impulsive gratification of drives and desires for compensating depression also in a violent
way . These serious problems call for a necessity to preventive actions addressed to fight an uncritical social adaptation easily
controlled and influenced by political and financial powers , marketing and mass media. The goal of heavy smartphone users
is to appear and communicate “on real time” own emotions, requesting for a confirmation by others with an existence
centered on an external locus of control. The socio-political consequences of this human mass decerebration are extremely
worrying and present a great risk for the world survival, because of the opposition to a real democracy where healthy
cognitive and affective people could arrive to political power, in opposition to unhealthy people without possibilities of
introspective, moral, philosophical thinking who, with the internet based consensus, could control the political power and
arrive to it, supported by a journalism made by the same quality people. This phenomenon presents more complex inducing
causes, “in primis” spiritual, emotional , unconscious factors that support marketing , financial, political social control ,
through the Internet and media manipulation of minds, corresponding to a great threat for the humanity physical and
spiritual survival : the being a human person.
Paper published in Italian