bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Methadone Therapy on Changing of Positive and Negative Mood Affect in Addicted People
Authors: Amiri S.J. Mosavi , Homayuoni A. , Amiri S. Soleimani , Nikpour G.A. , Khanmohammadi A.
Published: March 2009

Aim:

The study aimed to investigate effects of drug named methadone in treating of addicted on changing of positive and negative mood affect.

Method:

19 addicted people were randomly selected and before methadone therapy with a pretest, Watson’s Positive Affect and Negative Affect (PANAS) was administered on them. One month later after methadone therapy, again Watson’s Positive Affect and Negative Affect (PANAS) was administered on them. PANAS assesses: Interest, Distress, Powerfulness, Fear, Enthusiasm, Proud, Agitation, Nervous, Panic. Data was analyzed with independent T test.

Results:

Findings showed significant differences between PANAS components. Methadone therapy increase interest, powerfulness, enthusiasm, proud, and decreased distress, agitation, panic. But there is not any differences between fear and nervous in pre and post test.

Discussion:

The findings indicated using methadone drug in addition to reduce physical symptoms can reduce significantly mental problems in addicted and can be regarded a proficient drug for treating of addiction.
Comparison of Clinical Characteristics of Opium Induced and Independent Major Depressive Disorder
Authors: Mowla A.
Published: March 2009

Objective:

Psychiatric disorders and among them depression are common in substance dependant patients. The aim of this study is to compare the clinical characteristics of those that appear to have substance induced depression and those that have independent majordepression.

Method:

184 independent and 187 opium induced (OID) depressed male patients that met the DSM-IV criteria for major depressive disorder were randomly selected. Standard demographic data, including age, marital, employment and education status were collected. The primary measure of depressive signs and symptoms was Hamilton Depression Scale (HAMD-21).The two groups were compared with each other for the HAMD total and subscales scores.

Results:

The two groups were matched regarding age, educational level and marital status. Opium induced depressed patients were more severely depressed and motor retarded and also they had more social and occupational problems. Gastrointestinal, sexual and somatic complaints were more common among them too. MDD patients had better insight than the other group.

Conclusion:

The results demonstrate that it ispossible to differentiate between substance-induced andindependent depression. Such differentiation mightbe important for establishing prognosis and optimal treatment.
Is the Capacity of Forming Abstract Concepts Affected by Cocaine Use? Application of Wisconsin Test in a Prospective Study
Authors: Mangado E. Ochoa , Madoz-Gúrpide A.
Published: March 2009

Cocaine causes cognitive impairment. This affectation becomes evident by failures on several neuropsychological tests. Wisconsin cards test analyzes the capacity for forming abstract concepts. The utility of this test to demonstrate cognitive impairment in cocaine addicts is not fully proved.

Objetive:

Evaluate the utility of Wisconsin test for the detection of errors in the capacity of forming abstracts concepts in chronic cocaine users.

Experiment and method:

An observational, prospective, cohorts study was carried out, with a control group (n=27). The case subjects (n=24) are patients with cocaine dependence. The patients underwent the Wisconsin cards sorting test, in the 64 cards version.

Results:

Among the different results obtained we could remark the differences on the number of errors (mostly the perseverative ones, which would be showing difficulties for finding alternatives and proposals for problems resolutions, more noticeable in the cases group than in the control group) and on the number of conceptual level answers, which shows the comprehension of the basic classification principles, and it would be affected as well in the cocaine users group in comparison with the control group.

Conclusions:

These results would show a higher difficulty finding alternatives and different proposals when solving problems in the cases group; as well as on the comprehension of basic classification principles.

According to the estimations offered on the Test's manual, we demonstrate the existence of cognitive impairment on the cases group, although it is not a severe damage, but could be labelled as medium-mild damage.

(Proyecto MSC-2005/465 financiado por DGPNSD)
Family Burden in Alcohol Dependence
Authors: Paparrigopoulos T. , Tzavellas E. , Karaiskos D. , Stefanis N. , Mourikis I. , Stahtea X. , Liappas J.
Published: March 2009

Objective:

There are no published data on how family burden changes over time in alcoholism. We present 6-month follow-up data on the burden of families of alcohol dependent individuals.

Methods:

The sample comprised 87 caregivers (63 females, 24 males) of alcohol dependent individuals who completed a 4-6 week inpatient alcohol detoxification in the Specialized Drug and Alcohol Addiction Clinic at the Eginition Hospital, Athens University Medical School. During hospitalization, a brief supportive intervention for the relatives took place. After detoxification all participants were followed-up as outpatients for a 6-month period in an affiliated service. Burden and psychopathology of caregivers were assessed with the Burden of Care Scale, and the General Health Questionnaire (GHQ-28). T-tests for paired samples were used for comparisons between different time points (admission-discharge-six months). A logistic regression model was used to identify factors which influence relatives’ relief.

Results:

Caregivers exhibited high scores of burden in terms of financial, household, interpersonal relations and parental roles at admission; mild psychopathological symptoms were also recorded. By the end of detoxification scores significantly decreased in most relatives (admission vs. discharge, p< .000); this improvement was determined by the patients’ soberness.

Conclusions:

Alcohol dependence may have a considerable impact on family interaction as shown by the high scores of burden and mild psychopathology recorded in the caregivers. Our findings suggest that the relatives’ relief was dependent on the achievement of abstinence and the number of relapses. Therefore, a brief supportive intervention is recommended.
Patterns of Substance use in an Immgrant Population in Spain
Authors: Qureshi A. , Rutow N. , Visiers C. , Pedrini E. , Revollo H.W. , Collazos F. , Major X.
Published: March 2009

Aims:

The relationship between immigration and drug abuse and its treatment is complex and poorly understood. The objective of this study is to gain insight into patterns of drug use and service access and how they are influenced by social factors and the migratory process in a population of foreign born drug users in Barcelona, Spain.

Methods:

An interview protocol was developed for the study which examined drug use patterns, social and health factors, and treatment, and was administered to 118 foreign born users in harm reduction centers. 92% were male and 8% were female. 42% were from Eastern Europe, 35% were from the Magreb, 14% from the European Community, 6% from Subsaharan Africa and 3% from Latin America.

Results:

With migration opium use decreased whereas cocaine, heroin, and speedball increased, which also constitute the primary drug used by this sample. Social support was correlated with greater consumption of heroin, cocaine, and alcohol, whereas lower social stress was predictive of higher cannabis use. Hard drug use was predicted by illegal status and a lack of stable housing. Acculturation and acclturative stress were not found to be related to substance use. Treatment was positively evaluated, with no perception of lower quality of care.

Discussion:

Drug use patterns shift with the migratory process, and, it would appear, adapt to the dominant local ones. The unexpecting findings regarding social factors and acculturation and acculturative stress may indicate differences in the Spanish drug use context, and as such warrant further research.
Women Addiction (Alcohol and Opiates) and Defense Mechanism Style
Authors: Raketic D. , Kovacevic M. , Djuric T.
Published: March 2009

Very few researches concerning women addictions are done up to day. This paper tries to define basic similarities and differences in defense mechanisms used by women alcohol and opiate addicts.

Method:

Sample of alcohol and opiate female addicts (30 patients in each group) plus control group (30 women) with no psychiatric diagnosis were questioned with Defense Style Questionnaire - DSQ 40 (Andrews, Singh, Bond, 1993).

Results:

There were found no statistically relevant differences between two experimental and one control group concerning mature defense mechanism use. Significant differences were found in neurotic and immature defense mechanism use: alcohol addicts use prevalently neurotic mechanisms and immature mechanisms prevail among opiate addicts.

Conclusions:

In our research mostly used neurotic defense mechanisms by alcohol addicts were: pseudoaltruism, idealization, and undoing. The mostly used immature defense mechanisms among opiate addicts were: phantasy, isolation, devaluation, denial and splitting.
Physical and Mental Health in Severe Opioid Dependent Patients Within a Randomised Controlled Maintenance Treatment Trial
Authors: Reimer J. , Verthein U. , Karow A. , Schäfer I. , Naber D. , Haasen C.
Published: March 2009

Background:

Injection drug users (IDUs) frequently suffer from somatic and mental co-morbidity. The effects of different opioid maintenance protocols on these parameters have not been systematically studied yet.

Methods:

This study was conducted as a 12-month open-label multi-centre randomised controlled trial to test a heroin- vs. methadone based protocol.

Results:

515 patients were randomised to the heroin-assisted and 500 to the methadone-assisted treatment program. Baseline scores were as follows: OTI-HSS 19.0 (±5.2), BMI 22.6 (±3.5), pathologic electro-/echocardiogram 20.4% (n=582) / 13.9% (n=491), positive HBV-, HCV- and HIV-serology 65.7% (n=863) / 86.5% (n=855) / 9.2% (n=951), positive tuberculin test 9.1% (n=318), KPS 71.4 (±12.9), Global Severity Index (GSI; SCL-90-R) 69.2 (±10.6), GAF 53.6 (±11.7) (all parameters not significant between treatment groups). Improvement after 12 months of treatment differed significantly between treatment groups (heroin vs. methadone): OTI-HSS 8.1 (±5.2) vs. 10.6 (±6.4), BMI 24.5 (±4.3) vs. 23.7 (±4.1), KPS 78.2 (±12.8) vs. 74.2 (±13.3), GSI 58.6 (±13.7) vs. 62.0 (±13.2), GAF 63.0 (±13.3) vs. 56.2 (±15.0) (ANOVA, all p=.000). The frequency of pathologic echocardiograms after 12 months was significantly lower in the heroin compared to the methadone group. Within the heroin group, completers benefited stronger than drop-outs. The remaining parameters did not differ between baseline and 12 months and between treatment groups.

Conclusion:

Integration of severe injection drug users either in methadone or heroin assisted maintenance treatment has positive effects on most change sensitive physical and mental variables. In this patient group heroin assisted treatment showed superior results compared to methadone.
Children of Bacchus - withdrawal in the ER
Authors: Roque M. , Craveiro A.
Published: March 2009

Through the ages, Portugal's History, geography, industry and mysticism are intertwined with viniculture. Legends proclaim Lusus the founding father of its inhabitants, who answer to this day to the designation of "Lusos". Lusus was said to be a companion of Bacchus, the Roman God of Wine. Portugal was the 7th major alcohol consumer, according to data by the world Drink Trends 2005. Facing these numbers, it is fairly understood the morbidity and lethality potential of multi-organic diseases, neurologic entities, accidents, suicides, and familial disfunction. Alcoholic Delirium may be caused by alcohol withdrawal, or by a sudden increase in consumption, or phenomena where tolerance to alcohol is diminished. These complex states are affluent in symptomatology, which can evolve to critical life threatening stages.

Objective:

The authors’ aim is to present a clinical case of Delirium by alcoholic withdrawal.

Methods:

The authors undertake a revision of this topic in the literature and clinical files review.

Conclusions:

Delirium is not uncommon in Portuguese emergency rooms, though often misdiagnosed. The knowledge tools should be shared by other specialities besides Psychiatry or Liaison Mental Health for treatment may be life-saving. After crisis, the treatment should proceed, based on maintaining abstinence by medication and therapy.
The Role of Family and Psychoticism in Poly-toxicomania
Authors: Sapic R. , Krivokapic Z.
Published: March 2009

Abuse of psychoactive substances, according to its spreading shows epidemic character. Drug addicts are mainly young adults, between 15 and 25 years old, have a predisposition to all kind of addiction, acting in public, without hiding their addiction and very often acting in crime way.

The aim of this research is to examine the stage of addict delinquency, his family functionality and the level of psychoticism as person disintegration phenomenon. Three groups were examined: poly toxicoman, psychotic patients and health control group, with use of General questionnaire, GRADIR scale for family functional examination and DELTA scale for grading the grade of psychoticism, as a person disintegration phenomenon.

The results showed high level of delinquency among addicts and addict family showed dysfunction. The results showed high level of delinquency among drug addicts and their families are dysfunctional. They are not so defect in emotional exchange as in structure, which is disorder amplification factor leading to addiction. It could be that, if family was more structured and organized, they would not end up as drug addicts.

Psychoticism has components of autism, apathy, aggressiveness, asociality. This disorder in cognitive processing, confirmed by DELTA test, showed higher psychoticism dimensions: general executive functions (GEI), schizotypal personality disorder (SHD), paranoia (P) and depression (D), as significant factors for addict development and for the longtime stabile abstinence, which is hard to gain.

Pilot study abstinent retesting, one year after the treatment, confirmed their behavior altered (improved results on DELTA scale of psychoticism).
Characteristics of Sexual Functioning of Alcoholics
Authors: Krivokapic Z. , Sapic R.
Published: March 2009

Consequences of the alcohol illness are evident on psychic, physical and social plan. Sexual behaviour is also changed. Our research aimed at complex recognition of sexual functioning, usual behaviour in all revealing spheres, normal aspects: dreams, imagining, masturbation, foreplay, coitus and sexual attitudes. 200 persons were sample in this research: 100 alcohol addicts and 100 persons of the control group. Following results were obtained:

•

dreams of sexual contents are rare both with addicts and other population, but significantly larger percent of alcoholics has “wet or orgasmic” dreams,

•

day-dreaming is less noticed with alcoholics, meaning that the need for raising sexual vigilance is reduced,

•

alcoholics masturbate more, they start to masturbate in later stage,

•

addicts rarely have foreplay and its duration is shorter, as a consequence of disturbed intimacy and impossibility of total harmony and exchange with a partner,

•

alcoholics have less sexual intercourses and feel different during them

•

there are no great differences in opinions about sex,

•

structural personal characteristics also have effect on sexual behaviour and alcoholism. Alcoholics have certain personal characteristics that clearly define them and which, because of their nature, influence addiction development and sexual behaviour.

We can conclude from the research that a tendency in behaviour is evidenced, and for which can be said that it is "pattern of sexual functioning of alcoholics". Except difficulties in genital response, "pattern" refers to emotional component, meaning closeness or a level of intimacy with partner, as well as modification of "normal” sexual aspects.
Internet-based Screening and Intervention for Alcohol- and Drug- related Problems
Authors: Sinadinovic K. , Berman A.H. , Wennberg P. , Hasson D.
Published: March 2009

Background:

Swedish accommodation to EU-policy has weakened state control over the alcohol supply as well as increased the inflow of drugs. Limiting alcohol and drug consumption must thus occur through reducing demand. As the Internet is virtually a universal phenomenon, influencing alcohol and drug behaviors via an Internet-based service is therefore a natural next step. A new Swedish website for self-screening via the AUDIT- and DUDIT-questionnaires is eScreen (www.escreen.se).

Method:

Self-screening via eScreen generates user feedback and treatment recommendations. In-depth self-report is possible using the Alcohol-E and DUDIT-E. Site users can follow their progress over time in diagrams showing personal risk level as well as by writing a personal electronic diary.

Results:

During the first 18 months, 2492 user-accounts were registered, evenly distributed between genders. With regard to selection bias, approximately 65% of adult site users over 18 report harmful alcohol consumption, compared to 63% of female and 51% of male adolescent users. Screening suggests that 11% of female and 16% of male adult users are dependent on illicit drugs; for adolescents the rates are virtually identical. These results will be compared to rates from an ongoing general Swedish population study.

Conclusions:

Internet-screening for alcohol and drug problems appeals to people with harmful alcohol and drug use. Low cost combined with the potential to reach many people could make Internet-based self-help services a cost-efficient self-help tool as well as a complement for patients in treatment for substance abuse.
Mental Disorders Following Delirium Tremens: Preliminary Data
Authors: Sivolap Y. , Damulin I. , Mendelevich S.
Published: March 2009

Symptoms of states following delirium tremens have not been adequately studied until now. We observed 24 alcoholic males aged from 29 to 62 years old (mean age 44 ± 11 years) in early period after delirium tremens. Post-psychotic period in nineteen cases was characterized by severe brain organic symptoms, including emotional disorders, cognitive dysfunction and alcoholic anosognosia. Emotional disorders included the prevalence of euphoric affect with light-heartedness in evaluation of their own health. Cognitive dysfunction included deceleration of thought, decrease of abstraction ability and logic thinking, difficulties in counting. Eleven patients had disturbances of short memory, which in 8 cases reach degree of fixative amnesia. Alcoholic anosognosia was closely related to emotional and cognitive disorders, including the loss of light-minded attitude to their disease and to the consequences of the psychosis. The severity of post-delirious disorders positively correlated with age of patients and the duration of alcohol abuse. Brain organic symptoms were more severe in patients with repeated psychosis. Post-delirious disorders gradually reduced in 11-28 (mean 18 ± 4) days after complete reduction of psychosis. Our findings suggest that these disturbances can be a benign equivalent of acute transient forms of Korsakoff disease. Development of post-psychotic brain organic symptoms, including euphoria, loss of critics and anosognosia, suggests adverse influence of delirium tremens on the clinical course and prognosis of the disease, but this assumption requires corroboration during further studies.
Cocaine Dependence Produce Psychiatric Symptoms - a Case Report
Authors: Stankovic M. , Vucetic-Arsic S. , Alcaz S. , Cvejic J.
Published: March 2009

Aim:

We want to present a polymorphic clinical features like: hallutinations, paranoid ideas, agitation and violence as a result of prolonged cocaine intranasal consumption.

Methods:

We exposed a 30-year old male patient with ICD-X diagnostic criteria for cocaine dependence (intranasal consumption) that treated in the outpatient unit of Special Hospital of Addicitons, Belgrade, Serbia from April to July 2008. We used the medical records, psychical examination, psychiatric interwievs, standard blood sampling and cocaine urine detections sample (positive).

Results:

Observations a specific and polymorphic clinical features with presence of psychotic symptoms after cocaine consumptions in our male patient, for the first time after 5 years of cocaine dependence: auditory hallucinations (two- voice speakers), paranoid persecution ideas and suspiciousness, agitation with appearance of vegetative symptomatology (palpitations, sweating, pupil dilatation), extremely violence behavior to other people, complete social reductions (“armed to the outside world”, refused any personal contact and isolated from friends and family, permanent outdoor checking). There was an intensive fear too and impaired judgment.

Conclusions:

Permanent cocaine consumption can result with produce a numerous of psychiatric symptoms and syndromes as our experience does. It is similar to the findings of other studies and papers reviewed. It is suppose that cocaine has numerous effects on important neurotransmitters in the brain, such as increase as well as the release of dopamine and it related with aggressiveness, hallucinations and other psychiatric symptoms.
Comorbid Substance Dependence and Posstraumatic Stress Disorder (PTSD) in a Brazilian Sample
Authors: Pulcherio G. , Strey M. Neves , Sarti P. , Fensterseifer D. , Pinent C.
Published: March 2009

Objective:

The present study investigated the demographic characteristics of a sample with posstraumatic stress disorder (PTSD) that seeking treatment for alcohol and others drugs dependence.

Methods:

Forty drug-addicted men participated of this study. All the subjects were psychiatric outpatients of IPPAD, Porto Alegre, Brazil. They were invited to play a part in a research. They completed the following instruments: Specific Traumatic Events Scale, Davidson Trauma Scale, Beck Depression Inventory, Sociodemographic characteristics. The Sociodemographic instrument had questions about the justice involvement. The measures were a self-report. SPSS 12.5 was used by the statistical analyses. Descriptive statistics include frequency, percents and means. Significance of 5%.

Results:

Twelve patients had PTSD. Aged 25 to 60 years; low income; 41,7% were married. About sixty seven per cent had some member on family with alcohol or other substance abused. The half patients (n=10) are used various psychoactive substances. 16,7% used alcohol only. The drugs more used were: alcohol (91,7%); tobacco (75,0%); cocaine (58,3%); marihuana (58,3%); Don't have related about the use of ecstasy and inhalants. The half of the sample related that was arrested due to drugs use.

Conclusions:

The literature shows that patients with Posstraumatic Stress Disorder have more drug use, interpersonal difficulties, legal problems, more relapses or worse prognostic when compared without PTSD. It's very important to determine the psychosocial characteristics of patients seeking treatment to ascertain if these characteristics reflect a group at risk for premature termination therapy.
Cognitive Functions, Impulsivity and Personality Traits in Alcohol Dependent Subjects
Authors: Struglia F. , Tomassini A. , Stratta P. , Spaziani D. , Rossi A.
Published: March 2009

The term ‘decision making’ indicates the aspects of executive functions related to the ability to modulate the reward and punishment perception, in order to operate advantageous choices.

Subjects with alcoholism exhibit poor decision making and high level of impulsivity.

This study assesses the relationship between decision making ability, as measured by Iowa Gambling Task (IGT), and impulsivity and others temperamental and character traits in a long-term abstinent alcohol dependent sample.

30 abstinent alcohol dependent subjects, referred to Drug Addiction Unit of National Health Service of L'Aquila were assessed using IGT, the Barratt Impulsiveness Scale 11-item version (BIS-11) and the Temperament and Character Inventory - 125 items (TCI-125). The mean age was 44.53 (8.66 SD) years and educational level was 9.03 years (2.52).

15 control subjects were recruited from general population and assessed with IGT only (age 41.38±11.10; educational level 12.23±3.44).

The clinical and the control samples significantly differ in their performance on the IGT, the former making disadvantageous choices in the task leading to lower scores. We found only a significant correlation between IGT total score and the BIS factor Non-Planning Impulsivity.

The alcoholic subjects, although in a abstinent status, show difficulties to learn the task strategies and/or earn from experience to orient toward an advantageous choice pattern, supporting the hypothesis of a decision making impairment.

The lack of correlation with impulsivity factors and personality traits supports the results of other studies concluding that, at dimensional level, decision making abilities may be a distinct construct.
The Vincent Van Gogh Model in the Treatment of Adolescents with Dual Diagnoses
Authors: Coetzee M. , Tuinier S.
Published: March 2009

Treatment of adolescents with addiction and comorbid disorders is notoriously difficult. In clinival practice one or the other diagnoses remain unnoticed and untreated. The reason for this the unfortunate focus on just one identifiable disorder. The resulting treatment remains suboptimal because state of the art evidence based parallel treatment programs for adolescents with dual diagnosis have not been adequately developed and implemented. In addition the long term development of psychopathology in adolescents due to addiction is unclear and needs to be elucidated. Addiction can lead to psychopathology of different kinds, such: as anxiety disorders, mood disorders, bipolar disorders and psychoses or the look-alikes. The opposite is also true: ADHD combined with a conduct disorder leads to addiction. Post traumatic stress disorder, bipolar disorder and antisocial personality disorder are alle associated with increased rates of substance abuse or addiction.

What is missing is an integrated continuity of care program with seamless transferral from ambulant to clinic to independent living to aftercare. This program will be affiliated with other caresystems in the community such as child and family services, juvenile justice and multisystemic therapy (MST). The adolescent is in a critical developmental stage of attaining a healthy personal identity. Keywords are: continuity of care, parallel treatment and long term intensive inpatient treatment of recalcitrant patients.

The role of expressive therapies, motivational enhancement therapy (MET) and cognitive behavioral therapy is emphasized. Several new exciting medications are avalilable and will be used in individual treatment strategies.
Neuropsychology in the Differential Diagnosis of Dual Pathology: Schizophrenia and Drugs Abuse/Dependence
Authors: Vargas M.L. , Lopez S. , del Brio A.M. , Fernandez M.L. , Franco M.A.
Published: March 2009

Aims:

Dual diagnosis of schizophrenic disorders and drug abuse/dependence are increasing due to more frequent use of cannabis and cocaine. It is important to differentiate between primary schizophrenia with associate drug abuse/dependence and drug-induced psychosis. The objective is to detect neuropsychological differences between drug users and non-users in schizophrenia patients, which could be used as diagnostic tools.

Method:

We conduct one case-control study on 12 schizophrenia out-patients (10 male) with vital history of drug abuse/dependence (mainly cannabis and cocaine) and one control group of 18 schizophrenia out-patients (12 male) who never used illegal drugs (global age mean: 32.8 years; SD:7.2). It was applied one neuropsychological battery sensitive to the neuropsychological deficit frequent in schizophrenia: WAIS-III, BADS, WCST, Colour Trails, Trail Making A and B, BVRT, California Verbal Learning Test (spanish version: TAVEC). Variables was summarized determining Z values and principal components. It was constructed one Logistic Regression Model to determinate the better predicting model of drug use state.

Results:

The resultant model included two predictors: WAIS Perceptive Organization Index and Trails Component. The prediction formula for Ln Odd Ratio of drug abuse/dependence group is: -13.83 + 1.09 (Trails Z score) + 0.16 (WAIS Perceptive Organization Index). It explains for 63% of the variance (p = 0.001). The ROC curve for using in diagnose was constructed.

Conclusion:

Neuropsychological diagnosis can contribute to the differential diagnosis of schizophrenia in dual pathology. The better functioning in visual-spatial tasks increases the probability of psychosis related with drugs use.
New Potential Molecular Targets for Cannabis Addition
Authors: Vieira-Coelho M. , Azevedo J. , Esteves M.
Published: March 2009

Cannabis is considerer the most widely abused illicit drug in the world. The recent rising prevalence of cannabis use by young adults and increasing evidence of adverse health effects makes the search for new pharmacotherapy to reduce cannabis abuse extremely important. To date no medication has been approved for the treatment of cannabis addition.

This study reviews recent results with potential interest for future pharmacological treatment of Cannabis dependence. Most of the relevant data obtained for treatment of cannabis dependence target the endocannabinoid or the central cholinergic systems, both involved and interact in brain systems implicated drug reinforcement. In laboratory animals blockade of cannabinoids CB1 receptors reverses central effects of cannabinoids. Rimonabant is a selective, orally active, cannabinoid CB1 receptor antagonist (inverse agonist) that has been shown in animals to modulate cannabinoid signaling in brain reward circuit. In humans, it has been shown that rimonabant, single or repeated oral doses blocked psychological and physiological effects of smoked marijuana (1). Although psychiatric adverse side affects like depression were reported with rimonabant, this compound was already been approved for treatment of obesity and metabolic syndrome. Very recently, blockade of α7 nicotinic receptors was shown to reverse abuse-related behavioral and neurochemical effects of cannabinoids in rats (2).

In conclusion, besides cannabinoid CB1 receptor, the homomeric α7 nicotinic receptors are novel molecular targets in the development of new drugs for treatment of cannabis addition.
Influence of Ethanol on Apoptosis of Lymphocytes and Neutrophils
Authors: Zhernova E. , Vyalova N. , Ivanova S.
Published: March 2009

Objective of this study was researching the apoptosis of lymphocytes and neutrophils in alcoholic patients as compared with healthy individuals. 58 men with alcoholism were examined along with 22 healthy age-matched men. The content of cells expressing the Fas-receptor as apoptosis marker was studied by indirect immunofluorescent method. Also determination of apoptosis by morphological examination was performed.

The relative content of lymphocytes expressing receptors of readiness to Fas-dependent apoptosis in alcoholics (16,56±1,19%, p< 0,05) significantly exceeds the same index in healthy controls (11,63±0,31%, p< 0,05). Also influence of 0,5% of ethanol in vitro on expression of receptor CD95 was studied. In group of healthy donors there is statistically significant increase in a parameter apoptosis lymphocytes (17,00±0,85% and 11,63±0,31% accordingly, p< 0,05) and for alcoholics it is shown insignificant changes up to 20,05±1,72%. The percentage of lymphocytes with morphological characteristics of nuclear fragmentation in alcoholic patients was five as much in comparison with the corresponding indexes of healthy men (5,07±0,63% and 0,90±0,18%, p< 0,001 respectively). The percentage of neutrophils with morphological characteristics of nuclear fragmentation in alcoholic patients statistically increase in comparison with the corresponding indexes of healthy men (1,14±0,36%, and 0,42±0,14%, p< 0,05 respectively). Also the index of apoptosis realization was calculated. It has been found that the index of apoptosis realization in alcoholics (14,36±2,38%) significantly exceeds the same index in healthy controls (7,74±1,65%, p< 0,05).

According to the performed analysis it is possible to suppose that alcohol increases the readiness of lymphocytes and neutrophils to apoptosis.
Efficacy of a Drug Screening Protocol
Authors: Zallo E. , Torreblanca M. , Arroita A. , Euba O. , Sánchez N. , Barreiro A. , Merino R. , Pinilla E.
Published: March 2009

Aims:

Comorbidity between drug misuse and mental disorders affects negatively in the prognosis of psychiatric illness, so it’s important to guarantee drug abstinence during hospitalization.

The Hospital of Zamudio contains short and medium stay units. Patients are referred to medium stay units when disorders are more serious or the symptoms are resistant to treatment.

In February 2003, a multidisciplinary group was formed to evaluate the situation of drug use in a psychiatric hospital and a drug screening protocol was then created.

We evaluate if the enforcement of the protocol, has decreased drug use during hospitalization.

Methods:

It’s compared, retrospectively, drug use (positive results in urine samples) since the screening drug protocol was enforced (2003) to 2007. Urine samples are collected when there’s a past misuse history, consumption suspicion, randomly and every time the patient leave for home. It’s also compared the differences between short and medium stay units.

Results:

It’s proved that drug use decreases during hospitalization since the new protocol came into force in a medium stay unit. This drug protocol is not useful in a short stay unit.

Conclusions:

The introduction and completion of this protocol provokes a high reduction of drug use in a medium stay unit. This design seems not to be adequate to short stay units. Probably, collecting urine samples when patients came into a short unit gives false positive results because these patients don’t come from other hospitalization units as in the case of medium stay unit.
The Role of Beliefs and Expectancies in Adopting Health Behaviors by Pregnant Smokers
Authors: Zycinska J.
Published: March 2009

Objective:

The aim of the study was to explore the predictability of beliefs and expectancies concerning one’s own health and the health of the infant in electing health behaviors by pregnant smokers.

Methods:

The study comprised 442 women, mean age 28.33 (SD=4.54), in normal pregnancy. Among the subjects 10.4% were current smokers while 30.3% had quit the habit. The beliefs and expectancies were evaluated using own questionnaire. Health behaviors were assessed on the basis of the IZZ by Z. Juczyński, supplemented by specific pregnancy-related behaviors.

Results:

Pregnant non-smokers adopted significantly more health behaviors in comparison with pregnant smokers. The multiple regression analysis revealed the highest effectiveness of the applied model among pregnant smokers (55% of the explained variance). Predictors of increased pregnancy-related health behaviors were: expectancies concerning delivery, internal health locus of control and self-efficacy associated with quitting smoking. Surprisingly, the socioeconomic status and educational attainment as well as the level of nicotine addiction did not influence these behaviors. The study verified discontinuity patterns of the TTM.

Conclusions:

Programs intended for pregnant smokers should aim not only at cessation of smoking but also at improving life styles. The general transformation of cognitive variables related to this process is more important than the phases of health behavior change.
The Memory and Attention Test (MAT), an Adaptive, Computer-based Performance Test: Evaluation in Dementia, Mild Cognitive Impairment and Control Subjects
Authors: Adler G. , Bektas M. , Hoffmann P.
Published: March 2009

The Memory and Attention Test (MAT), a newly developed, adaptive, computer-based performance test was evaluated in a mixed group of patients with Alzheimer's dementia, subjects with mild cognitive impairment and control subjects at ages from 60 to 89 years.

By means of the MAT, working memory and short-term memory are assessed in the verbal, figural and episodic domains by means of six independent tests individually adjusted to the subjects level of performance on the basis of intermediate results. Sustained attention is also assessed.

For evaluation purposes, well established tests for the respective memory domains were applied. They were the Auditory Verbal and Learning Test (AVLT), the Benton Test, the delayed reproduction of the Taylor Figure, the subtests working memory and logical memory of the Wechsler Memory Scale (WMS) and the Alterskonzentrationstest (AKT), a test analogous to the d2 test, especially suited and standardized for older subjects. Acceptance of the MAT was assessed by means of a questionnaire developed for this purpose.

Computerized testing was commonly well accepted by the subjects. There were highly significant positive correlations between performance in the MAT domains and performance in the respective reference assessments. Thus, the MAT may be a useful diagnostic tool for the assessment of dementia patients. It may be applied for early diagnosis, assessment of progression of disease and demonstration of treatment effects, particularly for disease-modifying treatments in Alzheimer's disease. Standardization relating to age and and education as well as the provision of versions in various languages are under way.
The Memory and Attention Test (MAT): An Adaptive, Computer-based Performance Test for Early Recognition and Treatment Evaluation in Dementia
Authors: Adler G. , Bektas M. , Hoffmann P.
Published: March 2009

Performance tests in dementia usually aim at a differentiated and standardized assessment of memory. They may be applied for early diagnosis, assessment of progression and demonstration of treatment effects, particularly for disease-modifying treatments in Alzheimer's dementia.

The tests currently applied are subject to various limitations. The results obtained are contaminated by impairments in cognitive domains other than memory, because respective capabilities are a precondition for the assessment of memory by means of these tests. For instance, some tests for the assessment of visual memory imply a certain level of motor, constructional or executive capabilities. On the other hand, the memory tests available are usually not adaptive, i.e. they may not be individually adjusted to the level of performance. Adaptivity as a feature of a neuropsychological performance test requires sequence control based on intermediate results and may be realized by the implementation of the test on a computer. The handling and the design of the user surface have to be adapted to the requirements of older people.

In order to meet these demands, a computer-based adaptive memory and attention test, the MAT was developed. Working memory and short-term memory are assessed in the verbal, visual and episodic domains by six independent tests individually adjusted to the subjects level of performance on the basis of intermediate results. Sustained attention is also assessed. The single tests do not require constructional or executive abilities. Make-up and handling are adapted to the requirements of older people.
Beneficial Effects of Memantine in Every Day Medical Practice: Results from a Large Greek Observational Study
Authors: Stamouli S. , Tzanakaki M. , Laggis N. , Giatas S. , Georgiadis G. , Sestrini M.
Published: March 2009

Memantine, NMDA-R antagonist, is approved for the treatment of moderate-to-severe Alzheimer's disease (MMSE< 20) (AD). The purpose of this study was to evaluate the efficacy and safety of memantine when used in routine clinical practice.

The 6-months, observational, open-label, multicentre study in 202 specialist centers in Greece evaluated the efficacy of memantine using the MMSE and Instrumental Activities of Daily Living (IADL) scale at baseline, 3 and 6 months. Safety was evaluated by spontaneously reported adverse events (AEs). Statistical efficacy analyses were performed in the Intent-To-Treat (ITT) (at least one post-baseline evaluation) and Per Protocol (PP) datasets (evaluations at both 3 and 6 months).

The study included 2570 AD patients (age: 74.8±6.8, 54.6% women, baseline MMSE score: 18.0±5.0). 34.2% had received previous treatment with acetylocholinesterase inhibitors (AChEIs), while for 65.8% memantine was the first treatment option. At baseline 91.5% were prescribed memantine as monotherapy, the remainder also received AChEIs. During the 6 months of the study, 80.9% continued memantine monotherapy. MMSE score was significantly improved from baseline at 3 (17.9±5.1 vs 19.2±5.0, p< 0.001, repeated measures analysis of variance Hotelling's test, ITT) and 6 months (17.9±5.1 vs 19.7±5.1). At 6 months, 67% of the ITT population had improved their MMSE score and 18.6% had no change. 19 patients (0.7%) terminated the therapy prematurely due to AEs. AEs were reported in 182 (7.1%) patients: the most common was dizziness (1.45%). 8 (0.3%) of the AEs were severe.

These results in naturalistic settings support the excellent efficacy and tolerability profile of memantine.
Effects of Chinese Herb Danshen-Dahuang on Hippocampal Gene Expression of APP and PS1 in Rats with Alzheimer Disease
Authors: Han B. , Tang R. , Han D. , Wang F. , Zhao S. , Xu M.
Published: March 2009

Aims:

To investigate the effect of Chinese herb Danshen-Dahuang on learning and memory ability in rats with Alzheimer disease (AD) induced by D-galactose and AlCl3 and its possible mechanisms.

Methods:

The AD model was produced by injecting D-galactose and AlCl3 intraperitoneally for 90 days. Since the 20th day of D-galactose and AlCl3 intraperitoneal injection, the rats in Danshen-Dahuang group had been treated with Danshen-Dahuang extraction by intragastric administration for 70 days. Subsequently,learning and memory ability of the mice was evaluated by Morris water maze and hippocampal gene expression of APP, PS1 was tested by reverse transcription polymerase chain reaction (RT-PCR).

Results:

Rats intragastric administration with Danshen-Dahuang, mice had shorter latency (P< 0.05) and less error times (P< 0.05) in water maze test compared with those in AD model group. At the same time, Danshen-Dahuang down regulated the expression of APP, PS1 mRNA (P< 0.05) in hippocampus.

Conclusions:

Danshen-Dahuang improves the learning and memory ability of AD rats, its mechanism may be related to the downregulated expression of APP, PS1 mRNA.
Interferon Gamma +874 T/A Gene Polymorphism is not a Risk Factor in the Pathogenesis of Alzheimer’s Disease
Authors: Juhász A. , Fehér Á. , Rimanóczy Á. , Kálmán J. , Janka Z.
Published: March 2009

Inflammatory processes seem to play a role in neurodegenerative diseases such as Alzheimer's disease (AD). Local inflammatory mechanisms can affect to neurotoxicity, interfere with beta amyloid expression and metabolism. The increased production of amyloid precursor protein eventually leads to the deposition of amyloid beta. Interferon (INF) gamma plays a pivotal role in the inflammatory processes.

The aim of this study was to evaluate the putative role of INF gamma +874 T/A polymorphism and its association with apolipoprotein E (ApoE) 4 allele in AD.

One hundred and eighty nine healthy controls (HC) and 191 patients with AD were involved in this study. The probable AD patients were diagnosed by NINCDS-ADRDA criteria. The DNA was extracted from whole peripheral blood. INF gamma +874 T/A and ApoE polymorphisms were assessed by the PCR based method.

ApoE 4 allele occurrence in AD was 27% compared to 9% in HC. There were no statistically significant differences in the distribution of INF gamma genotypes (AD: A/A:30.9%, T/A:46.1%, T/T:23.0%; HC: A/A:21.7%, T/A:54.5%, T/T:23.8%, p=0.110) or alleles. The INF gamma A/A genotype was more frequent in the presence of ApoE 4 allele in AD (13.6%) than in the HC (4.8%).

Our results confirm the role of ApoE 4 allele in AD. However, no association was found between the INF gamma +874 T /A polymorphism and AD. The simultaneous occurrence of ApoE 4 allele and one of the INF gamma genotypes presumably can not modify the risk for AD. (ETT 198/04/2006 and OTKA K 60589/2006).
Delusions and Hallucinations as First Symptoms of Frontotemporal Dementia: A Case Report of a 48-Year Old Male
Authors: Malta R. , Torres C. , Faria T. , Almeida S.
Published: March 2009

Frontotemporal dementia (FTD) generally has a presenile onset, behavioral manifestations dominate the clinical picture during which cognitive functions are still relatively intact. Therefore, particularly in the early stages of FTD it is difficult to differentiate this type of dementia from other types of dementia and psychiatric disorders.

Although most patients with frontotemporal dementia (FTD) present with neuropsychiatric symptoms, the frequency of psychotic symptoms, assumed to be rare, is still unclear possibly due to limited temporal-limbic involvement in this disorder. We report the case of a 48-year old man admitted in a psychiatric ward with delusions and hallucinations.

Significant behavior impairment was present related to social isolation and personality changes. Structural and functional neuroimaging methods disclosed asymmetric frontal and bitemporal damage, mainly on the left. Differential diagnosis consisted of psychotic disorders as well as one of the subtypes of the frontotemporal lobar degeneration group.
Proton Spectroscopy in Mild Cognitive Impairment
Authors: Montull C. , Mercader J.M. , Blesa R. , Peri J. , Bertomeu M.
Published: March 2009

Objectives:

To establish whether 1H - MRS aids early diagnosis of progression to Alzheimer's disease in patients with MCI.

Material and methods:

21 patients with MCI underwent 1H - MRS using a 1.5 T GE scanner. The voxel of interest was located in the posterior cingulate. NAA/Cr, mI/Cr and NAA/mI were evaluated. Patients with MCI were compared with a group of 15 patients at various stages of AD and with 11 normal controls. Patients with MCI were followed up for four years, though by the fourth year the number of patients had fallen to 7. All subjects underwent a neurological exploration and the MMSE and ADAS neuropsychological tests.

Results:

In the four-year longitudinal study, 78% of the MCI subjects progressed to AD. The 1H -MRS of these subjects differed from that of the normal controls but no significant differences appeared in the evolution. From the outset it was closer to that of the AD subjects, especially in terms of the high levels of mI/Cr. Before the clinical appearance of dementia a sudden increase in mI was observed.

MCI subjects showed an increase in mI/Cr and a fall in NAA/Cr, as well as an increase in mI/NAA (p< 0.005).

AD subjects presented a significant reduction in NAA/Cr (p< 0.05) compared with controls. The mI/Cr and the mI/NAA presented significant increases (p< 0.005) in AD.

Conclusion:

Though other studies are required, 1H -MRS appear to aid early diagnosis of AD in subjects with MCI.