bluuebunny/crossref_metadata_2025 huggingface dataset:
Association analysis of imbalanced interhemispheric functional coordination and early therapeutic efficacy in major depressive disorder: Evidence from resting state fMRI
Authors: Hou Z. , Song X. , Jiang W. , Yue Y. , Yin Y. , Zhang Y. , Liu Y. , Yuan Y.
Published: May 2016

Introduction

Emerging evidences indicate that the alteration of interhemispheric functional coordination may be involved in the pathogenesis of major depressive disorder (MDD). In present study, we aim to explore the potential marker by using the voxel-mirrored homotopic connectivity (VMHC) approach, which may be contributing to predict the clinical prognosis in MDD.

Methods

Eighty-two MDD patients and 50 normal control (NC) subjects participated in this study. We divided the MDD group into unremitted and remitted group according to the reduction rate of Hamilton Rating Scale for Depression (HAMD) within 2 weeks.

Results

The study detected significantly decreased VMHC in bilateral precuneus (pCu), inferior temporal gyrus (ITG) and increased VMHC in middle frontal gyrus (MFG) and caudate nucleus when compared remitted depression (RD) group to unremitted depression (URD) group. Meanwhile, when compared with NC group, the URD group presented reduced VMHC in bilateral cerebellum anterior lobe, thalamus and postcentral gyrus. Furthermore, the VHMC in media frontal gyrus, postcentral gyrus and precentral gyrus were significantly decreased in RD group. Correlation analysis suggested that reduced VMHC in bilateral pCu was negatively correlated with the baseline HAMD score of URD (r = −0.325, P = 0.041). Receiver operating characteristic (ROC) curve indicated that three regional VMHC changes could identify depressed patient with poorer treatment response: ITG [area under curve (AUC) = 0.699, P = 0.002, 95% CI = 0.586–0.812], MFG (AUC = 0.692, P = 0.003, 95% CI = 0.580–0.805), pCu (AUC = 0.714, P = 0.001, 95% CI = 0.603–0.825).

Conclusion

The current study combined with previous evidence indicates that the subdued intrinsic interhemispheric functional connectivity might represents a novel neural trait involved in the pathophysiology of MDD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cryostimulation of whole body as a possible supportive biological approach in mild cognitive impairments
Authors: Rymaszewska J. , Szczesniak D. , Katarzyna U. , Elzbieta T. , Bartlomiej S.
Published: May 2016

Background

Limitations of available treatment methods of dementia imply constant need to search for new, supplementary therapy strategies. There is a consensus that vascular lesions, oxidative stress, inflammatory processes and abnormal neurotransmission are associated with dementia. Due to the anti-inflammatory (modification of pro-inflammatory cytokines concentration), antioxidative effect of cryogenic temperatures as well as the hormonal and lipid changes, they may play an important role in preventing or inhibiting pathophysiological processes.

Aim

To assess the influence of whole-body cryostimulation on cognitive functions of patients with MCI.

Methods

RCT design is used to examine the influence of whole-body cryotherapy (WBC) on people with mild cognitive impairments (MCI) with the evaluation of psychometric, somatic and laboratory parameters. Participants undergo 10 sessions each day of 2–3 min of WBC in experimental group (−110 till −160 °C) and placebo (−20 °C). The CDR, MoCA, TYM, DemTect and SLUMS scales are used among others at baseline and follow-up. Preliminary data of 7 volunteers (n = 7, 49–79 years old) were presented. Results on Fig. 1.

Discussion

Among obtained psychometric results show that all, except of one, patients significantly improved their scores after WBC. That is a very promising feedback for future evaluation of WBC effectiveness in prevention of dementia in patients with MCI.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical symptomatology and facial emotion recognition in schizophrenia: Which relationship?
Authors: Arous A. , Mrizak J. , Trabelsi R. , Aissa A. , Ben Ammar H. , El Hechmi Z.
Published: May 2016

Introduction

Patients with schizophrenia show impairments in social cognitive abilities, such as recognizing facial emotions. However, the relationships between specific deficits of emotion recognition and with clusters of psychotic remain unclear.

Objectives

To explore whether facial emotion recognition was associated with severity of symptoms and to which presentation of psychotic symptoms.

Methods

Facial emotion recognition (FER) were evaluated in 58 patients with stable schizophrenia with a newly validated FER task constructed from photographs of the face of a famous Tunisian actress representing the Ekman's six basic emotions (happiness, anger, disgust, sadness, fear, and surprise). Symptomatology evaluation comprised the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS) and the Clinical Global Impressions Scale Improvement and severity (CGI).

Results

Patients who failed to identify anger had significantly higher scores in hyperactivity item (P < 0.0001). The patients who had a difficulty to identify sadness had more grandiosity (P ≤ 0.002). The impairment in happiness recognition was correlated with hallucination (P = 0.007) and delusion (P = 0.024) items. Incapacity to identify fear was associated to lack of judgment and insight (P = 0.004).

Conclusions

Deficits in recognition of specific facial emotions may reflect severity of psychiatric symptoms. They may be related to specific clusters of psychotic symptoms, which need to be confirmed in further studies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Are self-stigma and coping strategies interrelated in outpatients with schizophrenia spectrum disorders using the psychiatric medication? Cross-sectional study
Authors: Holubova M. , Prasko J. , Hruby R. , Latalova K. , Slepecky M. , Marackova M. , Kamaradova D. , Gubova T.
Published: May 2016

Introduction

Self-stigma is the maladaptive psychosocial phenomenon that can affect the patient's self-image, may lead to dysphoria, social isolation, reduced adherence and quality of life. Maladaptive coping strategies may adversely disturb the overall functioning of psychiatric patients.

Objectives

Thinking about coping strategies and self-stigma in practice may play a significant role in understanding patients with schizophrenia spectrum disorders, especially for mental health professionals. Focus on coping strategies could be a useful concept in supportive and educational therapy to help patients in using more adaptive coping strategies and decrease their self-stigma.

Aims

The aim of this study was to determine the relation between coping strategies and the self-stigma among outpatients with schizophrenia and related disorders.

Methods

Stress Coping Style Questionnaire (SVF-78), Internalized Stigma of Mental Illness (ISMI) and severity of the disorder (measured by Clinical Global Impression objective and subjective form) were assessed.

Results

One hundred and four patients suffering from schizophrenia (n = 67), schizoaffective disorder (n = 30), polymorphic psychotic disorder (n = 3), schizotypal disorder (n = 2) and delusional disorder (n = 2) were included in the study. The results showed that there was a high positive correlation between negative coping and self-stigma, and the negative correlation between positive strategies and the overall score of self-stigma. Stepwise regression analysis showed that negative coping (especially resignation), subjective severity SubjCGI and positive coping strategies (especially positive self-instruction) explains 52.8% of the overall score variance of self-stigma (Tables 1–3).

Conclusions

This study revealed that there is a connection between self-stigma and coping strategies in patients suffering from schizophrenia spectrum disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Maternal obstetric complications and intellectual functioning in patients with schizophrenia and their healthy siblings
Authors: Karakula-Juchnowicz H. , Juchnowicz D. , Krukow P. , Morylowska-Topolska J. , Pawezka J. , Flis M. , Markiewicz R. , Urbanska A.
Published: May 2016

Objectives

Intellectual functioning in schizophrenia has been associated with genetic vulnerability and obstetric complications.

Aims

The aim of this study was to assess:

– the incidence of complications during pregnancy, labor and delivery;

– the association of OCs with general intellectual ability in two groups: patients with schizophrenia and their healthy siblings.

Methods

Forty-two patients with schizophrenia according to DSM-IV and 43 their healthy siblings were included in the study and examined using MINI and WAIS-R. Their mothers were interviewed to gather data on OCs. The ‘midwife protocol’ of Parnas et al. was used to quantify the presence and entity of OCs.

Results

Asphyxia, mother's serious illness during pregnancy, premature delivery with weight < 2500 g, labor time > 48 h, infarcts in the placenta and eclampsia were statistically more frequent in schizophrenic group. OCs were more common in individuals with a family history. The two investigated groups were different in the following WAIS-R subtests: comprehension (P = 0.018), block design (P = 0.0001), digit symbol (P = 0.001), as well as in performance IQ and total IQ. In the patient group, correlations between OCs indexes and WAIS-R results include all intelligence quotients (verbal, performance, total IQ) and 5 WAIS-R subtests, while in the sibling group: verbal and total IQ and 2 subtests. The correlation between Vocabulary subtest and OCs was the strongest in both groups.

Conclusion

OCs may interact with genetic vulnerability to increase the risk of schizophrenia and have been associated with cognitive deficits in the patient group.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms and antipsychotic-induced metabolic disturbances in first-episode schizophrenia patients
Authors: Misiak B. , Łaczmański Ł. , Słoka K. , Szmida E. , Ślęzak R. , Piotrowski P. , Kiejna A. , Frydecka D.
Published: May 2016

Introduction

There is a scarcity of prospective studies addressing the influence of the methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms on antipsychotic-induced metabolic changes in first-episode schizophrenia (FES) patients.

Objectives

We aimed at investigating metabolic side effects of second-generation antipsychotics (SGAs) with respect to the MTHFR gene polymorphisms in FES patients.

Methods

Polymorphisms in the MTHFR gene (C677T and A1298C) were investigated with respect to changes in body mass index (BMI) and waist circumference (WC) together with serum levels of glucose, lipids, homocysteine, vitamin B12 and folate after 12 weeks of treatment with SGAs in 135 FES patients.

Results

The 677TT genotype was associated with significantly higher BMI, WC and serum levels of triglycerides, as well as significantly lower folate levels at baseline. Additionally, the 677T allele was associated with significantly lower folate levels at baseline. The 677CC homozygotes had significantly higher increase in BMI and serum levels of triglycerides. The 677TT genotype predicted significantly higher increase in homocysteine levels and significantly higher decrease in folate levels. These associations were also significant in the allelic analysis. Only the patients with the 677T allele had significantly lower folate levels and significantly higher homocysteine levels at the follow-up. The 677T allele was also related to significantly lower increase in WC. The 1298CC homozygotes had significantly higher weight gain in the course of treatment with SGAs.

Conclusions

The MTHFR gene polymorphisms might predict antipsychotic-induced weight gain in FES patients. In addition, the MTHFR C677T polymorphism might be also predictive with respect to other metabolic adversities of SGAs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The incidence of hepatitis C virus infection among opiate drug users in Mamoura hospital patient in Alexandria, Egypt
Authors: Darwish S. , Sadek N. , Hoda H. , Bothaina M. , Farag I.
Published: May 2016

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Introduction

Egypt is one of the most famous endemic areas for hepatitis C virus. Drug use in Egypt is rising exponentially. Drug use is always considered one of the main risk factors for HCV.

Objectives

To assess the effect the route of drug use on the incidence of HCV in the Egyptian population.

Aim

To study the effects of opiates (tramadol and heroin) use and the route of intake on the incidence of HCV infection among addicts treated in Mamoura mental state hospital, Alexandria, Egypt.

Methods

This is a cross-sectional study on drug dependence patients visiting the out patient clinic for addiction in Elmamora Hospital.

Subjects were divided into two groups.

Group I: Control group.

Twenty non-addict volunteers.

Group II: Cases groups (comprising 60 subjects)

This group will be divided into three sub-groups each contains 20 cases.

Group IIa: consuming tramadol.

Group IIb: consuming tramadol and heroin by injection.

Group IIc: consuming tramadol and heroin by inhalation.

All studied groups were subjected to:.

1. detailed history taking, urine screening tests for drugs of abuse, liver functions tests and HCV screening.

Results

The study showed deterioration in liver function tests in the heroin and tramadol use groups compared to the tramadol only use.

There was a statistical significant difference in the incidence of HCV infection in the heroin injection group (85%) compared to 35% in the heroin non injector users and only 5% in tramadol users had HCV positive.

Conclusion

Heroin injection showed the highest risk for both liver function deterioration and HCV infection.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Gender difference in trauma exposure among a sample of egyptian patients with substance use disorder
Authors: Eldabah H. , Salama H. , Attia M. , Elkholy O.
Published: May 2016

Background

Studies have shown high association between trauma exposure in childhood and adulthood, post-traumatic stress disorder (PTSD) and substance use disorder (SUD). Women seeking treatment for SUD are more likely to have histories of sexual and physical abuse.

Aim

To study the effect of gender difference on the history of traumatic experiences and the mental health problems of the SUD patients.

Method

Cross-sectional comparative study was conducted at the Addiction Treatment Center at El Maamoura psychiatric hospital. Two hundred adult inpatients were recruited and assessed using a structured interview questionnaire to collect sociodemographic data, substance-use history, and medical and psychiatric history. The semi structured psychiatric interview was applied, and psychometric assessment was performed using Arabic version of Trauma History Screen (THS) for assessment of trauma exposure, and the Arabic version of the Post-traumatic Stress Disorder Checklist, civilian version (PCL-C) for assessment of current PTSD.

Results

One hundred and fifty-six were males (78.0%), 44 were females (22.0%). Females were significantly more likely to be exposed to sexual abuse at childhood (P = 0.002) and adulthood (P = 0.050), score higher on PCL-C (P = 0.002), to have major depressive disorder (MDD) (P = 0.028), and have suicidal plans and attempts (P = 0.001).

Conclusions

Females with substance use disorder are more likely to be victims of sexual trauma, to develop Post-traumatic stress disorder and to have more complicated psychiatric comorbidities than their male counterparts.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prevalence of substance use disorder among bipolar affective disorder
Authors: Gómez Sánchez-Lafuente C. , Reina Gonzalez R. , De Severac Cano A. , Mateos Carrasco E. , Moreno De Lara F. , Tilves Santiago I.
Published: May 2016

Introduction

High rates of substance abuse have been reported in the general population and users of mental health services. In our environment, relationship between substance abuse and manic phase has not been well characterized.

Aims

Determining the prevalence of active substance abuse among patients admitted to acute mental health unit at Virgen de la Victoria Hospital at Malaga, diagnosed with mania or hipomanía.

Methods

We analysed urine and blood seeking for ethanol, cannabis and other 11 substances in 140 patients previously diagnosed with bipolar disorder prior to their admission at the Hospital for mania or hipomanía phase.

Results

Thirty-seven percent of the patients were positive for drugs. Eighteen percent were positive for two or more drugs. Males had higher rates of abuse than females, except in MDMA and amphetamines. By subtypes, cannabis (37.2%) and ethanol (29.62%) were the most consumed drugs. In young age cohorts had higher rates of active substance abuse. Dual patients had longer average stays at hospital (2.6 days more) (Fig. 1).

Conclusions

Substance abuse is a major comorbidity in bipolar patients with manic phase. The active consumption of cannabis and ethanol especially emphasizes in men younger than 35 years.

We believe priority should be given to recognition and multidisclipinary approach to substance use disorders in bipolar patients. Bipolar patients with comorbid substance abuse may have a more severe course, and may be a preventable factor of new relapses. This rate could increase healthcare costs and worse quality of life of these patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Alcohol consumption in 2049 patients with paranoia
Authors: Guerrero Jiménez M. , Carrillo de Albornoz Calahorro C.M. , Porras Segovia A. , Cervilla Ballesteros J.A.
Published: May 2016

Introduction

Epidemiological studies have reported associations between alcohol consumption or abuse and occurrence of delusional disorder (F.22) rather than in general population. Alcohol has not been described as the main cause of the delusional idea, but is an enhancer factor which would inhibit behavioral brake and executive function in prefrontal cortex facilitating the development of the existing delusional idea.

Hypothesis

We want to confirm this association in our influence area so this study aims to report compared frequency of alcoholism in DD versus a control group published in andalusian population.

Aims

To review the literature on the potential links between alcohol abuse and delusional disorder and this relationship in general population.

Results

This poster presents a brief but updated systematic literature review on the associations between DD and alcohol abuse. We will also present data from a relatively large case-mix of 2049 patients with the diagnosis of delusional disorder resulting from a thorough retrospective, medical-record based, assessment of patients attended in our clinical catchment area.

In our sample, alcohol abuse and other drugs consumption was significantly less common in Delusional Disorder than in other psychoses.

This result suggests that alcohol and other drugs consumption can be a greater importance parameter in other psychoses correlates than in delusional disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Predictors of quality of life in opiate-dependent individuals undergoing methadone maintenance treatment
Authors: Hornillos C. , Crespo M.
Published: May 2016

Introduction

Quality of Life (QoL) is an important outcome variable in Methadone Maintenance Treatment (MMT) for opiate dependence. Previous research has focused on demographic variables, treatment features, drug use and physical and mental health as possible predictors of QoL in this condition but interest in genuinely psychological variables (skills and personal repertoires) has been lacking. Experiential Avoidance (EA), the tendency to behave in order to decrease some kind of internal distress, has a strong relationship to psychological disorders and holds promise as a potential predictor of QoL.

Objectives

To identify predictors of QoL in clients undergoing MMT, taking into account psychological variables.

Aims

To see if EA is related to QoL in clients undergoing MMT.

Methods

Using a cross-sectional design, information was gathered from 48 opiate-dependent individuals undergoing MMT. Variables included were QoL (IDUQOL), severity of drug use, social adjustment and physical and mental health (ASI-6), emotional distress (HAD) and EA (AAQ and its version for substance-abusing individuals, AAQ-SA). Mean-comparison tests and correlation tests were carried out, and several variables were entered into a stepwise multiple regression analysis.

Results

Anxiety and EA were the only variables which made it into the regression model, accounting for 41.9% of variance of QoL.

Conclusions

Contrary to previous research, the predictors of QoL were psychological. It is the first time that EA is related to QoL in this population. Interventions should explicitly target EA and anxiety. Additional research should make use of longitudinal designs and take into account further psychological variables (emotion regulation, coping).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Torsades-de-Pointes Predisposing Risk Factors (TdPPRFs) in a cohort of patients maintained on high dose methadone – a clinical safety caseload analysis
Authors: Iosub R. , Hawkins S. , McCarville C. , Kennedy H. , Williams K. , Watson B.
Published: May 2016

Introduction

Methadone, a long-acting opioid agonist commonly used in the treatment of opiate dependence, has been reported to cause QTc interval prolongation, increasing the risk of a fatal cardiac arrhythmia – Torsades-de-Pointes (TdP). This effect seems to be attributable to methadone's inhibitory effect on the cardiac “hERG”-K+ ion channel and is dose-dependent. There is a lack of consensus regarding when to perform an ECG for patients on methadone.

Objectives

Identifying other TdPPRFs in a cohort of patients receiving ≥ 85 mg (high dose) methadone daily to inform local clinical safety guidelines.

Methods

Our outpatient caseload was filtered to select opiate-dependent patients receiving more than 85 mg methadone daily. Primary care summaries and laboratory results databases were analysed for the presence of other TdPPRFs: female sex a documented history of ECG abnormalities, electrolyte imbalance, liver or renal failure, and concomitant use of other QT prolonging medication or stimulants.

Results

Fourteen opiate-dependent patients (10.29% of patients on methadone) were maintained on ≥ 85 mg methadone daily. Gender distribution was F:M = 1:1.8; 64% misused illicit stimulants; 57% were prescribed other QTc prolonging medication and 29% had a documented history of liver/renal failure or electrolyte imbalance. Only 14% had previous ECGs documented in primary care summaries. Of patients on high dose methadone, 85.7% had at least one TdPPRFs present and 64.3% had at least two.

Conclusions

These results demonstrate an increased rate of TdPPRFs in this patient group and highlight the importance of ECG monitoring which ideally should be offered to patients receiving even lower doses of methadone.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neurobiological basis of mutual influence of stress burden and alcohol addiction: Review of data
Authors: Korostiy V. , Markova M. , Kozhyna H. , Gaponov K. , Lytvynenko V.
Published: May 2016

Introduction

The current situation in Ukraine is characterized by multitude social-stress factors, resulting in an increase in alcohol consumption and alcohol addiction, which arises as a mechanism to compensate the adverse mental stress and different variant of chronic stress disorder.

Objective

Substantiate the neurobiological basis of mutual influence of stress burden and alcohol addiction.

Aim

To study the biochemical mechanisms that underlie the vicious circle of stress and alcohol addiction.

Methods

Studies the features of hypothalamic-pituitary-adrenal (HPA) axis under stress and alcohol available in Medline, Institute for Scientific Information Databases (Science citation index expanded and Social sciences citation index), EMBASE, and Cochrane Library were identified and reviewed.

Results

Alcohol, just like stress, affects the HPA axis, changing the reaction of its parts and, by reducing the production of cortisol, which produces in response to stress and prolongs subjective experiences of nervous tension caused by stress. Stress, through the output of cortisol, reduces the effect of alcohol leads to a desire to further alcohol abuse. The system includes elements of the extended amygdala, which have as reinforcement and stress reactivity. Central nucleus amygdala plays a leading role in the reinforcing effects of pharmacological agents with narcogene potential and performs persuasive role in the activation of hypothalamic reinforcement mechanisms. This allows us to consider neurohormonal system, including the amygdala, hypothalamus, pituitary and adrenal glands as structural and functional basis of formation depending on various narcogene, primarily alcohol.

Conclusions

Dysregulation of the HPA axis is a neurobiological basis of mutual influence of stress burden and alcohol addiction.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Nalmefene and alcohol use disorder. Evaluation of clinical cases at a treatment centre for drug addicts
Authors: Fernández Mayo L. , Baño Rodrigo D. , Barbero García E. , Agujetas Rodríguez M.
Published: May 2016

Introduction

Alcohol abuse causes dopamine release in the mesolimbic system, which activates the reward circuit. This is linked to an interdependent opioid, serotonergic and endocannabinoid system. Nalmefene is a modulator of the endogenous opioid system, with antagonistic effect on mu and delta receptors, and a partial agonist activity kappa. This means that reduces the reinforcing effects of alcohol consumption through the cortical-mesolimbic system. Therefore, when a patient takes nalmefene, the satisfaction obtained when he drinks is lower, which increases the possibility to have more control over drinking.

The efficacy of nalmefene was evaluated in two profiles of patients: 1. No abstinence in alcohol dependence disorder and continuous relapses, 2. Cocaine dependence disorder associated to alcohol abuse.

Objectives

Improving the quality of life and compliance rates due to the difficulties of following a strict treatment to achieve the abstinence. Furthermore, in cases of patients with cocaine dependence disorder and alcohol abuse, the objective is to avoid cocaine use by reducing previous alcohol consumption.

Conclusion

nalmefene offers the possibility of treating the addiction from a new perspective. Our current clinical experience has been able to treat subjects with conventional treatments failures and those who need to achieve the necessary control to reduce cocaine use.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The role of personality traits in initiating and maintaining addictive behavior
Authors: Manea M. , Savu B.
Published: May 2016

Introduction

It is well known that certain personality traits are more linked to drug abuse than others. Psychiatrists are more likely to emphasize the importance of impulsivity in the connection with substance disorders but in the following study we found an important percentage of patients that have a substance abuse were linked to anxiety through impulsiveness as a personality trait.

Objectives

Most youths admitted for a substance abuse are highly impulsive. Our quest was to differentiate what component of impulsivity was more frequently linked to a substance use disorder.

Methods

In the study were included 50 patients admitted in the 3rd Psychiatric Clinic, Substance Dependences Department, Cluj-Napoca. For the identification of the drug abused we used the multitest screening kit in correlation with the results from the Forensic Medicine Institute of Cluj-Napoca. Each patient completed the Barratt Impulsivity Scale and the Swedish Universities Scales of Personality.

Results

High scores on BIS-11 strongly correlated with attentional impulsiveness (Pearson's r correlation = .838) which means high inattention and cognitive instability this being linked with anxiety disorders. Cognitive Instability was correlated with Psychic Trait Anxiety (r = 0.29) and Motor Impulsiveness with Somatic Trait Anxiety (r = 0.3). Normal 0 false false false EN-US X-NONE X-NONE.

Conclusions

The underrecognized anxiety disorders in young adults whom are admitted for an addictive disorder prefrontal cortex is known to be the source of both impulsivity and could be linked to anxiety as well (valence asymmetry hypothesis). Normal 0 false false false EN-US X-NONE X-NONE.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Behavioral disorders and new psychoactive substances abuse, a French case series
Authors: Marillier M. , Batisse A. , Chevallier C. , Djezzar S.
Published: May 2016

Introduction

Range of drugs has largely increased the past few years, especially with the emergence of the New Psychoactive Substances (NPS) sold online. In front of serious risks they cause on human health, they are more and more regulated by the law.

Objectives

To describe cases of extreme behavioral disorders and highlight risks of potential forensic complications linked to these consumptions.

Methods

We present a case series of serious auto or hetero-aggressive behavioral disorders related to NPS abuse and notified to the Parisian addictovigilance center.

Results

Twenty cases were identified between 2010 and 2015. Users were exclusively men, with mean age of 35.5 years (min: 20, max: 51). Synthetic cathinones are the predominant class of reported NPS (65%). An association between NPS and sexuality is found in 60% of cases (12); among them cathinones are used by 11 men. We observed 6 deaths among which, 5 were associated to sexual practice. Two cases of consumptions of cathinones induced torture and barbarian acts. Concerning aggressive behavioral disorders, we quote 3 cases of hetero-aggressivity (one by stab wound and 2 others developed an hypersexuality ± exhibitionism) and 9 cases of auto-aggressivity characterized by genital mutilations (1), defenestration (3), suicidal attempt (3), and acute psychiatric disorder with endangering life (2). Only four cases have been confirmed by toxicological analysis.

Conclusion

Behavioral disorders inducing forensics complications exist with NPS and particularly with cathinones. The problematic is certainly undervalued. A collaboration between addictovigilance and forensic services has to be improved.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Zolpidem abuse: About a case
Authors: Sellami R. , Messedi N. , Feki I. , Baati I. , Zahaf A. , Masmoudi J.
Published: May 2016

Objective

Zolpidem is a non-benzodiazepine hypnotic drug for treatment of insomnia and is generally believed that is a safe medication. Therefore has been introduced as a lower potential agent for dependency and abusive effects however its safety and dependence potential are of great concern.

Case report

A 63 years old male patient had consulted a general physician in January 2015 for his insomnia. He started on zolpidem 10 mg at bedtime. Over the next few months he had gradually increased the dose as he found the prescribed dose to be having no significant effect. After abrupt discontinuation of zolpidem, he presented to a center for drug users “AIDE ET ECOUTE” with severe anxiety, impatience, loss of energy, insomnia, irritability, headaches, and increased craving for higher dosage of zolpidem. There was no history of any other substance abuse and he was diagnosed simultaneously a case of zolpidem dependence and major depressive disorder.

Conclusions

Zolpidem has a potency to be abused with high risk of dependency and withdrawal syndromes particularly among elderly patients with comorbid anxiety and depressive disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The “Endless Trip”: Psychopathology and psychopharmacology in the Hallucinogen Persisting Perception Disorder (HPPD)
Authors: Orsolini L. , Valchera A. , Papanti D. , Vecchiotti R. , De Berardis D.
Published: May 2016

Introduction

Hallucinogen Persisting Perception Disorder (HPPD) is a syndrome characterized by prolonged or reoccurring perceptual symptoms, reminiscent of acute hallucinogen effects. HPPD was associated with a broader range of LSD (lysergic acid diethylamide)-like substances, including cannabis, MDMA (methylenedioxymethamphetamine), psilocybin, mescaline and other psychostimulants. Symptomatology mainly comprises visual disorders (i.e., geometric pseudo-hallucinations, halos, flashes of colours/lights, motion-perception deficits, afterimages, micropsy, more acute awareness of floaters, etc.), even though depressive symptoms and thought disorders may be comorbidly present.

Objective

Although HPPD was firstly described in 1954, it was definitely established as a syndrome in 2000 with the revised forth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). However, neuronal substrate, risk factors, aetiology and pathogenesis of HPPD remains still unknown and under investigation. Furthermore, there are still open questions about its pharmacological targets.

Aims

A critical review on psychopathological bases, etiological hypothesis and psychopharmacological approaches towards HPPD was here provided.

Methods

A systematic literature search on PubMed/Medline, GoogleScholar and Scopus databases without time restrictions, by using a specific set of keywords was here carried out. In addition, a case report was here described.

Results and conclusions

Pharmacological and clinical issues are here considered and practical psychopharmacological recommendations and clinical guidelines here suggested.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cerebellar atrophy supporting diagnosis of alcohol dependence: A case report
Authors: Reyes F. Pavez , Sánchez M. , Moral E. , Terradillos M. , López N. , Roca M. , García A. , Russo J.
Published: May 2016

Chronic use of alcohol is a known cause of cerebellar atrophy. This finding could be a valuable diagnosis support when there are not other information sources. In this case report, we describe a 65-year-old male patient who was referred from primary care to specialized consultation because a depressive syndrome it was unresponsive to treatment with desvenlafaxine and lorazepam. In psychopathological exploration we found overvalued ideas of suffering some kind of injury and damage by the family, which oriented the diagnostic hypothesis of delusional disorder with secondary mood symptoms, although the clinical suspicion of abuse of alcohol was proposed as a differential diagnosis. The continuing minimization and denial of consumption by the patient as well as their reluctance to incorporate an external informant made that the workup was a key element to elucidate the diagnosis. We found a discrete increase in transaminases, gamma glutamyl transferase and alkaline phosphatase. Magnetic resonance imaging showed cerebellar atrophy (vermian and, in a lesser extent, in both hemispheres). Once the patient was confronted with these results, he agreed to disclose his problem, which fulfilled alcohol dependence criteria. After that, he accepted to initiate treatment and detoxification in a specialized unity.

Conclusions

Although psychiatric diagnosis is based on the clinical features and the exclusion of associated medical conditions, in this case the workup provided support to our clinical suspicion, favouring recognition of the problem and willingness to treatment by the patient.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Characteristics and outcome of methadone maintenance treatment (MMT) patients with depression
Authors: Peles E. , Sason A. , Malik E. , Schreiber S. , Adelson M.
Published: May 2016

Introduction

Comorbidity of depression and opioid addiction is highly prevalent, but their outcome in MMT is not consistent.

Objectives

To compare between depressed and non-depressed MMT patients.

Methods

Hamilton depression scale scores (taken during a psychiatric assessment) were studied among MMT patients on admission or during treatment (cutoff for depression > 18).

Results

A total of 498 MMT patients were studied. Depression proportion was 22.5%, and 23.2% among 263 who were studied on admission; the depressed vs. non-depressed on admission did not differ in female proportion (19.7% vs. 25.6%), age of admission (43.2 ± 10.4), opiate use onset (21.8 ± 6.3) and education years (9.5 ± 2.8), but had higher proportion of cocaine (55.7% vs. 35.1%, P = 0.005), and benzodiazepine abuse (73.8% vs. 58.4%, P = 0.04). Retention was high and similar (80.3 vs. 82.9% P = 0.7) and of those who stayed one year, cocaine and benzodiazepine were still higher among the depressed patients (cocaine: 43.8% vs. 23.2%, P = 0.03; BDZ: 61.2% vs. 40%, P = 0.01). Compared to the non-depressed, among all study group (n = 498) the depressed patients presented higher proportion of rape history (25% vs. 9.5%, P = 0.001), of suicide attempts (43.8% vs. 25%, P = 0.001) with only a trend of shorter cumulative retention in MMT of mean 9.4y (95% CI 7.8–10.7) vs. 11.5 (95% CI 10.5–12.5, P = 0.07).

Conclusion

Despite cocaine and benzodiazepine abuse on admission, depressed succeeded similarly to the non-depressed in the first year retention in treatment. Intervention is recommended since admission, as their long-term retention seems to be shorter, later on, and their ability to discontinue cocaine and benzodiazepine abuse is clearly hampered.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prevalence of substance use among Russian, Somali and Kurdish migrants in Finland: A population-based study
Authors: Salama E. , Niemelä S. , Castaneda A.
Published: May 2016

Introduction

Although substance use is a well-known public health risk factor, European population-based studies reporting the substance use among adult migrant populations are scarce.

Objectives

We aim to: (1) determine the prevalence of alcohol use, cigarette smoking and consumption cannabis and intravenous drugs in Russian, Somali and Kurdish migrants in Finland and compare them to those of the Finnish general population; (2) determine if socio-economic and migration-related factors are associated with substance use in migrants.

Methods

We used data primarily from the Finnish migrant health and well-being study. Alcohol use was measured with the AUDIT-C questionnaire, smoking habits and the lifetime cannabis and intravenous drug use were recorded. Age-adjusted prevalence rates were determined by ethnicity and sex. The associations between background factors and substance use were analysed using logistic regression analysis.

Results

The prevalence rate of risky drinking is lower and the proportion of abstainers is higher in migrants than in the general population. Current smoking is more common in Russian (31%, P < 0,05) and Kurdish (31%, P < 0,05) migrant men than in the general population (21%). Younger age was associated with risky drinking, socioeconomic disadvantage increased the odd for the daily smoking among migrants, and migration-related factors were associated with substance use.

Conclusions

Migrants report less substance use than the general population, but acculturation-related factors seem to be associated with higher levels of substance use among migrants. Substance use seems to be a gendered phenomenon in migrant populations in comparison to the general population, where lately the alcohol and tobacco consumption of women have been growing.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Causes of psychoactive substance use by cannabis users with schizophrenia
Authors: Simonienko K. , Kwiatkowski M. , Cwalina U. , Wygnal N. , Wilczynska K. , Konarzewska B. , Waszkiewicz N.
Published: May 2016

Introduction

Psychoactive substance use (PSU) in patients with schizophrenia can affect the course of the disease and causes many side effects. There is no clear evidence whether cannabis use can trigger the first episode of schizophrenia. The main causes of cannabis use in patients with schizophrenia are also still not defined.

Objectives

Determine causes of PSU in cannabis users with schizophrenia.

Aims

The aim of this study was to find out the causes of PSU in patients with schizophrenia.

Methods

Thirty-five cannabis users with schizophrenia (28 males, 7 females) were asked to complete 15-item questionnaire about the reasons of psychoactive substance intake. Eighteen of them used also stimulants. Additional information if PSU or schizophrenia occurred first was also taken.

Results

The results indicated that regardless of stimulants use PSU occurred before schizophrenia in 83% of patients. Main reasons of substance intake were: need for relaxation (86%) which was more often in marihuana group (100%) than in marihuana and stimulants group (73.7%) and this difference was statistically significant (P = 0.049), curiosity (80%), self-regulation of well-being (74%), shyness, need for altered states of consciousness, expectation that psychoactive substances could help them in problem solving, relationships and sleep disorders (49–54%).

Conclusions

PSU usually occur before the first episode of schizophrenia. Anxiety, curiosity and looking for unprofessional help are the most common reasons. The results may indicate an increased need of psychoeducation and social support in many areas of life. Future research should be considered.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Changes in qualified detoxification treatment of inpatients with multiple substance use: Impacts on key figures, a pre-post-study in an open door unit in Saxony, Germany
Authors: Voigtlaender B.S. , Schneider J. , Groß H. , Barth T.
Published: May 2016

Introduction

Detoxification treatment of adults at younger ages suffering from polysubstance dependence on our department pursues an integrative therapeutic concept. In addition to addiction-specific, topic-centred group and talk therapy orientation also behavioural therapy elements are included: a penalty points system provides negative sign stimuli for undesirable behaviour.

Objectives

Since 2010, both rate of psychotic disorders and number of N-methylamphetamine consumers (P < 0.001) have been growing impressively while the proportion of repeated admissions amounted to > 55%. Dissatisfying trends were identified by longitudinal measurement, e.g. regarding ALOS, kind of discharge, bed occupancy.

Aims

Targeted changes in treatment were established in the 2nd half of 2014. In particular, the penalty point system was adapted towards less restrictive rules, combined with slightly reduced therapeutic intensity in order to come better on the disorder-related needs of the patients. Staffing level and structure remained stable.

Methods

Key figures including quality criteria and performance data such as LOS, kind of admission and discharge, service intensity, and bed occupancy were evaluated by a pre-post study (pre: 1st half of 2014, N = 76/post: 1st half of 2015, N = 77) using descriptive and test statistics.

Results

Socio-demographic patient data remained stable. Regarding selected key figures there were significant changes (LOS > 21 days: P < 0.05; bed occupancy: P < 0.001; therapeutic contacts < 25 min: P < 0.001) and positive trends, e.g. decreased ratio of non-regular discharges.

Conclusions

Our data suggest that punishment-oriented interventions impede addressing specific needs of inpatients with multiple substance use whereas more need-oriented interventions may lead to improvements. Further evaluation including patient satisfaction is indispensable.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relationship between severity of tobacco dependence and personality traits, insomnia and impulsivity in male and female individuals entering alcohol treatment
Authors: Wnorowska A. , Serafin P. , Topolewska-Wochowska A. , Klimkiewicz A. , Jakubczyk A. , Brower K. , Wojnar M.
Published: May 2016

Introduction

Tobacco dependence (TD) often coexists with alcohol dependence. Previous research documented that both biological and environmental factors influence simultaneous development of the two disorders. However, it has not been determined whether the same psychological and psychopathological factors affect TD in alcohol-dependent males and females.

Aim

The objective of the study was to assess risk factors for high severity of TD in alcohol-dependent individuals considering gender differences.

Methods

The study entailed two groups: male (n = 284) and female (n = 102) subjects entering alcohol addiction treatment programs in Warsaw, Poland. Standardized instruments were used to assess: severity of TD – Fagerstrom Test for Nicotine Dependence, personality traits – NEO-Five Factor Inventory to assess, consequences of drinking – Short Inventory of Problems, impulsivity – Barratt Impulsivity Scale, and Sleep Disorder Questionnaire-7 as a measure of insomnia.

Results

In the studied sample, current smokers comprised 79.1% (n = 225) of male and 79.4% (n = 81) of female participants. Multivariate regression model showed that high negative consequences of drinking (P = 0.001) and low NEO Openness score (P = 0.009) were associated with high risk of TD in female alcoholics (corr. R2 = 0.223; P < 0.0005). Bivariate analyses showed that TD was associated with impulsivity, openness, agreeableness and neuroticism in male alcohol-dependent subjects. Insomnia was the only significant predictor for high severity of TD in the males (corr. R2 = 0.068; P = 0.002).

Conclusions

Different factors contribute to severity of tobacco dependence in male and female alcohol-dependent individuals entering addiction treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.