bluuebunny/crossref_metadata_2025 huggingface dataset:
Racial disparities in treatment service utilization among U.S. adolescent substance abusers with criminal justice system involvement
Authors: Jin J. , Fuller C. , Liu X. , Fan B. , Ukonu N.A. , Wu P.
Published: May 2011

Introduction

Previous studies have shown that African American youth are over-represented in the Criminal Justice System (CJS). Substance use problems are common among those with CJS involvement. However, less is known regarding racial disparities, among youth with CJS involvement, in receiving substance use treatment services.

Objective

To examine racial disparities with regard to receiving treatment services for substance use related problems, among youth with (CJS) involvement.

Methods

Data were obtained from the 2006–2008 United States National Survey on Drug Use and Health (NSDUH) in USA. Among White and African American adolescents (Ages 12–17) with recent CJS involvement and who met criteria for alcohol or illicit drug abuse or dependence (N = 602), racial differences in receiving treatment services for substance use problems were examined. Multiple logistic regression analyses were performed to identify predictors of service access among the adolescents, to see if the racial disparity could be explained by individual-level, family-level, and criminal justice system involvement factors.

Results

While 31.2% of White adolescent substance abusers with CJS involvement had received treatment for substance use related problems, only 11.6% of their African American counterparts had received such treatment (P = 0.0005). Multiple logistic regression analyses showed that access to treatment services can be predicted by substance use related delinquent behaviors, but that racial disparities in treatment still exist after adjusting for these factors (AOR = 0.24, 95%CI = (0.09,0.59), P = 0.0027).

Conclusions

There is an urgent need to reduce racial disparities in receiving substance use treatment among U.S. youth with CJS involvement.
Social context of marijuana use among the young population: Case of Serbia
Authors: Jugovic A. , Sarajlija M. , Sarajlija A.
Published: May 2011

Introduction

Global socio-cultural and family context of Serbian society intensifies risks of marijuana use (MU).

Objectives

Prevalence of MU in young population in Serbia and identification of family factors related to increased risk of MU.

Aim

Five indicators were examined: prevalence of MU, age of first MU, MU during one month before survey, motives for MU, family factors of risk for MU.

Method

The study included 2987 participants aged between 16 and 35 years from different parts of Serbia. Collection of data was conducted in April 2007. Participants completed self-administered anonymous questionnaires (modified YOUTH RISK BEHAVIOUR SURVEY) that consisted of sociodemographic characteristics and experiences related to MU.

Results

The prevalence of lifetime MU among participants was 32%. First use was reported by 14% to occur at the age of sixteen or younger. During one month before survey 10% of participants had smoked marijuana. Risk of MU in regular cigarette smokers is two-fold higher than in non-smokers. Key motives for MU are curiosity (59%), achieving “good mood” (12%), persuasion by persons of the same age (11%), the emotional crisis (8,5%). Alcoholism of both parents and family dysfunctionality - especially physical and verbal conflicts between parents - were related to significantly higher risk of marijuana use.

Conclusion

Early use of marijuana, history of family disorganization, parental alcoholism and conflicts were identified as factors significantly related to increased risk of marijuana use among young population in Serbia.
What factors influence use of dental health services by substance users?
Authors: Kemm J. , Holland R. , Rumball D.
Published: May 2011

Introduction

Several studies show that despite poor oral health substance users fail to access dental care. This was confirmed locally by audit in 2005; 63% (n = 82) were not registered with a dentist and 72% had dental problems, of whom 83% were not receiving treatment.

Objectives

To examine issues affecting substance users use of dental services.

Aims

To identify factors influencing whether substance users visit the dentist, in particular whether having a ‘regular’ dentist is important. Secondly, to compare this with perceptions of dental care staff.

Methods

A cross sectional survey was conducted across Norfolk & Waveney Mental Health Trust's Alcohol and Drugs Service and Norwich dental practices. 87 substance users participated, half of Norwich dentists (n = 67) and 66 reception staff from Norwich dental practices.

Results

Participants reported high levels of dental problems, most commonly toothache (71%). Those having a dentist they normally saw were more likely to have visited the dentist in the previous year (X2 = 14.06, p < 0.01). The most common reasons for not receiving treatment were difficulty finding a dentist, difficulty keeping appointments and few available appointments. Dental staff acknowledged similar dental problems, but were more likely to think lack of motivation caused non-attendance. Drug use, substitute prescribing or duration in treatment did not influence frequency of dental visits. Dentists hi-lighted remuneration issues for providing services to substance users.

Conclusions

Having a ‘regular’ dentist could improve use of dental services. Examining capacity and revisiting payments for this group under the new dental contract could improve treatment rates.
The effects of liffe skills training on mediating factors of drag use among adolescents (student) at risk
Authors: Khademi Ashkzari M. , Ahmadi Gatab T.
Published: May 2011

Introduction

Adolescence and its importance in the growth and spread of risky behavior theorists and researchers Mvrdtvjh Humanities is located. Among the risky behaviors of substance abuse behaviors in adolescence and early adulthood is still one of the most common problems are communities.

Aims

The purpose of the present research was to study the effects of life skills training on reducing individual risk factors of drug abuse among secondary school students.

Methods

In the first phase 636 secondary students at risk were selected by cluster random sampling and answered to risk factors and protective questionnaires. The data were analyzed by correlation coefficients and multi variable regression. The results indicated the following predictive factors: attitude, self- management, social empowerment, family and school ties.

Results

In the second phase based on the results of the first phase by pre- and post- test methods 80 secondary students were selected and divided to case and control groups at random. After performing pre-test for both groups, the case group attended 10 training section. After wards post- test was performed for both. The data analyzing using covariance (comparing post- tests regardless of the pre-test effect) indicated effectiveness af skills training on individual abuse factors. These factors showed significant difference comparing to control group after intervention.

Conclusions

Thus it can be concluded that training life skills in the high risk group can have positive effect on individual abuse variables and reduce the possibility of drug abuse in future among them.
Low emotional intelligence as a predictor of tendency to addiction
Authors: Khanmohammadi Otaghsara A.
Published: May 2011

Introduction & objectives

The study is to clarify role of emotional intelligent in addicted and nonaddicted people.

Method

80 addicted and 82 nonaddicted people were randomly selected and Schutte’s Self- Report Emotional Intelligence Test (SSREIT) administered on them. Data were analyzed with independent T formula.

Results

Results showed significant differences between components of emotional intelligent especially in regulation, expression and assessment of emotions between two groups.

Discussion

Findings indicates that applying of plans in the field of increasing emotional intelligent can help peolple with positive attitudes to addiction in order to manage the bad problems and event and as a result reduce tendency to addiction.
The « desire and automatism cue-reactivity questionnaire”
Authors: Khazaal Y. , Billieux J. , Zullino D.
Published: May 2011

Introduction

Alcohol misuse is associated to cue-reactivity phenomena leading to consummation following desire and/or automatic processes.

Objective

The objective of the present study is to create a scale (the Desire and Automatism alcohol cue-Reactivity Questionnaire: DARQ-Alcohol) in order to assess desire and automatic reactivity to cue-stimuli-related to alcohol.

Aims

The present study aims to preliminary assess reliability of the DARQ-Alcohol and its external validity.

Methods

To be included in the study, participants had to drink alcohol at least once per week. Participants had to assess 60 alcohol related picture (valence, arousal and dominance) and to complete the AUDIT and the DARQ-Alcohol.

Results

Eighty-nine participants (60 women) participated in the study. The reliability coefficients (Cronbach's alpha) calculated on DARQ-Alcohol were high both for the triggering of desire to drink (α=.88) and for the automatic proneness to drink (α=.90). Pearson's correlations were computed between (1) the three affective dimensions of the pictures, (2) the two dimensions of the ACRQ, (3) the total score on the AUDIT. Individuals who found the alcohol related pictures more pleasant, arousing and dominating have higher DARQ Alcohol automatic sub-score. DARQ Alcohol automatic sub-score is moderately related to the AUDIT score, whereas the DARQ Alcohol desire sub-score is less lightly correlated with the AUDIT score.

Conclusions

The DARQ Alcohol seems to be a useful scale allowing the distinction of automatic and desire-related cue-reactivity. Further studies on clinical sample are warranted to further validate the DARQ scale.
Experiences of opium dependents from performance of methadone centers
Authors: Kheradmand A. , Mahani N. Banazadeh
Published: May 2011

Introduction

To assess patients’ satisfaction and to evaluate methadone therapy program, it is important to understand the experiences of opium dependents during the treatment period in methadone centers and determine the quality of this program and revise standards based on that.

Aims

To describe the nature and structure of patients’ experiences during treatment in methadone centers.

Methods

This was a qualitative method using phenomenology. Sampling was purposive and the participants were selected from opium dependents referred to Kerman methadone centers during 2007. Sampling continued until data saturation and the sample size was 32. Colaizzi’s method was applied for data analysis.

Results

The findings of this study included 27 codes categorized in four main groups: experiences of structure, personnel, patients, and regulations. These four categories showed the main structure of experiences in methadone centers.

Conclusions

It is necessary to establish new centers or solve the problems of centers in near-by cities. The type of patients referring to the centers plays a role in treatment process. The regular presence of physicians and other personnel and their concerns and care for patients as well as longer working hours of the centers have roles in patients’ satisfaction and increase of consistency with treatment. Discussing the rules and regulations of the center with patients including the obligatory of daily reference to the center to obtain medicine and injections sound necessary. Also, it is necessary to find ways for solving problems of urine tests.
Stock market trading: Compulsive gambling and the underestimation of risk
Authors: Konstantaras K. , Piperopoulou A.N.
Published: May 2011

Introduction

Although gamblers and investors have been found to exhibit many common traits, no existing studies associate retail investors with an explicit addictive behavior, or account for the degree of addiction's influence on investors’ and gamblers’ risk attitude and risk perception.

Objectives

The study explores whether trading in the stock market is a potentially compulsive form of behavior. Furthermore, it explores the psychological risk perception versus economic risk taking of individuals engaged in active stock market trading and those in gambling, for various degrees of addiction.

Aim

The study aims to develop the profile of an addicted retail investor across demographic and risk variables.

Methods

The South Oaks Gambling Screen (Lesieur & Blume, 1987), adapted for stock market trading, the financial part of the Risk Taking Scale and Risk Perception Scale (Weber et al., 2002) and a demographics questionnaire was completed by a sample (582 responses) of active investors, gamblers and a control group in Greece at three distinctive time periods.

Results

Results suggest that retail trading in the stock market exhibits significant incidence of compulsive behavior (11.2%) across diverse stock market environments, probably more for females. The decision to become an active investor or gambler entails greater risk friendliness. Pathologically addicted retail investors underestimate the risk of trading in the stock market. Demographics also play a critical role in risk perception and risk underestimation.

Conclusion

There is an apparent addiction problem between active retail investors that should be taken into account. Psychotherapeutic interventions are discussed.
Attitudes towards sex with alcoholics
Authors: Krivokapic Z.M. , Sapic R.V.
Published: May 2011

Attitude is defined as acquired disposition, readiness for a certain way of perception, thinking, emotional reacting and behaving. The formation of social attitudes is greatly in influence by a group (alcoholics group). Drinking alcohol also disrupts higher cognitive processes: abstraction, conceptualization, problem solving and influences on different opinions.

Our research concerned the impact of chronic alcohol use and membership to alcoholic group as a framework that influences attitudes towards sexuality. 200 persons were sample in this research: 100 alcohol addicts and 100 persons of the control group. The instrument used in this study was-Scale of attitudes toward sex.

Statistically significant difference was found in five attitudes:

–

Differences in two paragraphs point to some homosexual orientation. We can confidently say that this is a “latent homosexuality in an alcoholic”, it is possible that the difference arises because of the presence of homosexuals in the group of alcoholics, although the subjects did not say to have such orientation.

–

Some conservatism is present in the attitude drinkers to sexuality of the young, they argue that sexual experience can wait until more mature years.

–

Extramarital relationships are positively evaluated by the control group, while alcoholics show greater disapproval.

–

Alcoholics have the attitude that sexual arousal does not come with ease, unlike the control group.

–

They are more liberal about the social situation of people with HIV (a certain degree of identification with an estimated negative social group).

Results showed small difference in attitudes between alcoholics and nonalcoholic.
An Indian study of psychiatric comorbidity in alcohol dependence
Authors: Kumar P. , Bhatia M.S. , Mittal S. , Kumar V. , Tomar B.
Published: May 2011

Aim

To assess psychiatric comorbidity in patients of alcohol dependence.

Method

All the patients of alcohol dependence attending alcohol and drug de-addiction OPD and adult psychiatry OPD on specific days were screened. Those fulfilling the selection criteria were included in the study. A detailed evaluation was done for socio-demographic variables and history of drug using semi-structured proforma especially prepared for the study. Diagnosis of alcohol dependence was made according to DSM-IV-TR criteria. The patients were seen for co-morbid psychiatric illness by applying Structured Clinical Interview for DSM-IV-TR I & II (SCID I & II).

Results

Out of 37 patients 24 (64.8%) were found to have comorbid psychiatric illness. Axis I and Axis II comorbidity was found in 64.8% and 5.4% of the samples, respectively. Patients of cluster A & B personality were equally distributed in the sample. Patients with more than one comorbidity accounted for 37.8% of the sample.

Conclusion

Psychiatric comorbidity in alcohol dependence is very high, other substance in particular. Number of comorbid diagnoses in a person may as high as three.
Attentiveness functions in multiple drug abusers: Results of neuropsychological examinations
Authors: Kunert H.J. , Tuchtenhagen F.
Published: May 2011

Statement of the problem

So far, research on the long-term effects of chronic multiple drug abuse regarding specific neurocognitive function deficits has been only tentative. However, also regarding rehabilitation of mostly young long-time addicts, studies are urgently needed (e.g., ability to drive or operate machinery) which are directed at the typical abuse clusters (e.g., alcohol and cannabis) of subgroups in a heterogeneous cohort of drug users.

Method

A group of 750 drug users was examined and the cognitive function deficits in various attentiveness systems compared against the retrospectively detected drug use pattern. Type, extent and stability of drug use were folowed back for 10 years.

Results

The study subjects used drugs of different effects: While morphine was hardly associated with serious cognitive function deficits, with cannabis both the cumulative lifetime dosage and the duration of use correlated with subtle disorders of multimodal stimulus processing and control of eye movement. Cumulative use of alcohol also had a negative effect on the cognitive functions, particularly working memory and the frontal executive functions. The effect of amphetamines, methamphetamines and cocaine varied depending on which other drugs were used. Comorbidity (e.g., schizophrenia) also was important.

Discussion

These neurocognitive function disorders can lead to impairment of cognitive functions which may be needed professionally. The implications of these results for diagnosis and therapy of comorbid multiple drug users are discussed by means of cases.
Training of attentiveness in young schizophrenic patients with multiple drug abuse
Authors: Kunert H.J. , Goldberg Y. , Tuchtenhagen F.
Published: May 2011

Statement of the problem

Recent studies have conclusively proven the effectiveness of cognitive training in the context of psychiatric rehabilitation. Examinations on young schizophrenic multiple drug users are yet to be done, although it could be shown that most of these patients are likely to relapse, abandon therapy and show untreated social adaptation disorders if existing cognitive functional deficits are not treated appropriately.

Method

Pre-post examinations were done on 80 schizophrenic drug users (mean age 26±4 years) to assess various attentiveness functions (i.e. alertness, crossmodal integration, divided attentiveness, flexibility, working memory, go nogo, visual scanning) before and after computerised attentiveness training (CURE therapy system, Siemens (NCSys)). Patient results were compared to those of a control group matched for age, education, illness characteristics and current medication which did not undergo cognitive training. Cognitive training lasted 10 weeks.

Results

Computerised attentiveness training led to significant (>30%) improvement in everyday attentiveness functions (tonic and phasic alertness, divided attentiveness), although some patient subgroups are different in their course of therapy.

Discussion

Training specific attentiveness functions helps improve rehabilitation of young schizophrenic patients with multiple drug abuse. Subgroup effects may also be of clinical relevance.
Connections between personality and the symptomatology of alcohol use disorder
Authors: Kurgyis E. , Andó B. , Rózsa S. , Szkaliczki A. , Demeter I. , Szikszay P. , Janka Z. , Álmos P.Z.
Published: May 2011

Introduction

Temperament and character factors and specific impulse control-related personality traits are connected to the developmental and clinical aspects of alcohol use disorder (AUD).

Objectives/aims

To reveal the underlying personality structure of individual differences in the symptom severity of AUD. Therefore temperament and character, impulsivity and aggression were assessed in relation to alcohol addiction severity.

Methods

Sixty-three patients with AUD were involved. Temperament and Character Inventory-Revised was used to quantify temperament and character dimensions. Impulsivity was assessed by the Barratt Impulsivity Scale-11 (BIS) and aggression by the Buss-Perry Aggression Questionnaire (BPAQ). To determine symptom severity of AUD the Severity of Alcohol Dependence Questionnaire (SADQ), the Alcohol Use Disorders Identification Test (AUDIT), the MacAndrew Alcoholism Scale-Revised (MAC-R) and the number of DSM-IV alcohol dependence symptoms were registered. To analyze the connections between symptom severity indicators and personality factors Pearson and Spearman correlation analysis were applied, p < 0.05 were considered significant.

Results

SADQ (r = 0.290), AUDIT (r = 0.345), MAC-R (r = 0.504) and the DSM-IV alcohol dependence symptoms (Spearman rho = 0.271) correlated positively with novelty-seeking temperament factor. SADQ (r = 0.262) and AUDIT (r = 0.293) scores correlated positively with BIS. Furthermore SADQ (r = 0.382), AUDIT (r = 0.318), MAC-R (r = 0.416) correlated positively with BPAQ.

Conclusions

Novelty-seeking, impulsivity and aggression as indicators of impulse control have different theoretical backgrounds but a common root. This study has revealed that the adverse consequences of lower impulse control can lead to more severe symptoms of AUD. These connections between impulse control and the symptomatology could contribute to a better understanding of the clinical complexity of AUD.
Tramadol dependence in the addiction unit of Baghdad: A cross sectional study
Authors: Lafta M.R.
Published: May 2011

Objective

Tramadol is one of the most prescribed centrally-acting analgesic in the world. It has been widely used in Iraq over the last few years. There are many contradicting studies about the potential risk of tramadol abuse in the world. In this piece of work we have tried to describe a group of patients referred to the main addiction unit in Baghdad with Tramadol Abuse.

Method

41 patients referred to the addiction unit in Ibn-Rushed Mental Teaching Hospital in Baghdad with Tramadol abuse problems, were screened, and 36 were included in this Cross Sectional study.

Results

78% were males & 22% were females. Their age were 16–57y(mean27y).90% of the sample were on Tramadol alone & 10% on polydrugs. About 92% of them were iatrogenic abusers. Most of the patients were without previous history of drug abuse. More than one fifth of the patients had at least one seizure. About one fifth of the sample were health professionals.

Conclusion

Tramadol is freely and widely used in Iraq. Tramadol has a clear risk of causing dependency syndrome and this has been nearly almost always iatrogenic in our study sample. Tramadol abuse seems to be a growing problem in Iraq.
Genetics of the androgen receptor influences craving of men in alcohol withdrawal
Authors: Lenz B. , Frieling H. , Kornhuber J. , Bleich S. , Hillemacher T.
Published: May 2011

Introduction

The clinical observation suggests a relation between alcoholism and dysregulation of the hypothalamus-pituitary-gonadal hormone axis. Chronic alcohol abuse leads to hypogonadism and sexual dysfunction. Testosterone and the genetics of the androgen receptor [AR] are related to impulsivity as well as appetite/hunger, both associated with addiction.

Aims

This study investigated whether the length of a CAG trinucleotide repeat within the coding region of the AR is associated with alcoholism in general and whether it is linked to craving during withdrawal. Moreover, we concentrated on finding possible mediators of the observed effects.

Methods

We included 112 male inpatients who were admitted for detoxification treatment and who were compared to 50 age-matched controls. To measure the extent of craving we used the Obsessive Compulsive Drinking Scale (OCDS) on the day of hospital admission. For laboratory analysis we used whole blood (genetics) and serum (protein quantification).

Results

The group of patients (21.6 ± 3.7 repeats) did not differ significantly from the control group (21.3 ± 3.3 repeats, p = 0.632) in terms of the number of CAG repeats. We found a significant negative correlation for the AR repeat length regarding OCDS-to (R2 = 0.053, p = 0.016) and OCDS-obs (R2 = 0.058, p = 0.011). Carrying out a path analysis of the mediating effect of leptin on the association between the number of CAG repeats of the AR and alcohol craving we found that direct effects (r = −0.144) accounted for 60% and indirect leptin-mediated effects (r = −0.096) for 40% of the total effect.

Conclusions

Today, the impact of the sexual hormone axis seems to be underestimated in alcoholism.
ADHD in alcoholism: A real problem?
Authors: Lligoña Garreta A. , Lligoña A. , Roncero C. , Ortega L. , Daigre C. , Walther M. , Navarro E. , Jimenez T. , Gual T. , Casas M.
Published: May 2011

Introduction

Attention deficit hyperactivity disorder (ADHD) is a risk factor for drug. Prevalence rates between 15 and 30% had been previously found in this population.

Objective

To identify the real the prevalence of ADHD in alcoholics and to find/test/ evaluate? a new type of screening (ASRS) for the initial diagnosis of ADHD in alcoholics.

Method

312 patients from an outpatient clinic for alcoholism were recruited during 1 year. All patients completed the ASRS: Adult Self-Report Scale. DSM IV criteria were used for other psychiatric diagnoses.

Results

•

312 patients (66.3% (207) men) filled out the ASRS of which 13.5% (42) were positive.

•

Alcohol consumption: 69% for more than 1 month, 17% less than a month and 14% with active consumption.

•

27.6% (86) had another psychiatric diagnosis from which 69% were ASRS positive. ASRS positive patients present a major risk of having another mental disorder. OR = 8.3 (4,1 - 17,1, c2 = 0,77, p = 0,001).

•

Other drugs: 70.5% consume other drugs. 76% of them are ASRS positive. 27.6% consumed illegal substances, 47.6% of them being ASRS positive (c2 = 9.77, p = 0,002). ASRS positive patient have more average substance abuse (including tobacco): 1.02 DT: 0.87 versus 0.72, 7 DT: 0.04 (z -2.21, p.027).

Conclusions

•

ASRS detected 13.5% of ADHD diagnosis in alcoholics.

•

Patients with positive screening present more substance abuse and more risk of psychiatric comorbidity.
Influence of alexithymia, self-concept and health locus of control on alcohol consumption of young Portuguese
Authors: Lopes R.
Published: May 2011

Portugal still holds a leading place in the per capita consumption of alcohol at a world level, with high mortality rates due to hepatic cirrhosis, high indexes of road/work killings, besides a vast range of physical and mental, family and occupational health problems caused by alcohol. The narrow connection between juvenile/academic events and alcohol consumption makes youngsters vulnerable to this consumption.

A descriptive-correlational and transversal study was conducted with a 552 students’ sample of the Nursing degree aiming to determine some psychological characteristics that might influence/predict alcohol use/abuse in youngsters: alexithymia, self-concept and health control locus. The data collection instrument comprehended: Graffar Social Classification; Toronto Alexithymia Scale (TAS20), What Do I Think Of Health, Self-Concept Clinical Inventory (SCCI) and Alcohol Involvement Scale (AIS).

Male gender is related to alcohol involvement (rho = −0.276; p = .000), revealing that 35% of the male gender and 7% of the female are normally drinkers with problems.

Externally oriented thought (F3-TAS20) (rho = .084; p = .048), the impulsiveness (F4-SCCI) (rho = .119; p = .005) and the external control locus (rho = .118; p = .005) are correlated to the involvement with alcohol.

Hierarchic multiple regression revealed as behaviour predictor variables of that involvement: gender (3.8%; p = .000), impulsiveness (1.4%; p = .005) and self-efficiency with inverse relation (F2-SCCI) (1.0%; p = .015).

It is concluded that the choice of preventive strategies must be focused in actions that facilitate personal and social development, that promote personal and social skills, culminating in a freedom of choice by healthy behaviours and life-styles, diminishing the risk of PLA.
Caffeine related disorders: learning from our patients
Authors: Makela A.
Published: May 2011

Introduction

Caffeine is sometimes used to maintain alertness and performance enhancement. Caffeine can induce psychosis in healthy patients as well as exacerbate psychotic symptoms in patients with psychotic disorders. One patient, a 22 year old man in the United States of America, with a past psychiatric history significant for childhood trauma presented to the emergency department in acute distress secondary to racing thoughts, formication, persecutory auditory hallucinations, visual hallucinations, delusions of control, paranoia and high risk behaviors after five straight nights without sleep.

Objectives

Behavioral health professionals will be able to recognize symptoms of caffeine intoxication, compare different presentations of caffeine intoxication and identify caffeine related disorders per DSMIV-TR. They will also be able to examine the complex factors, including use of caffeinated energy drinks, which contributed to the admission of this patient to an inpatient psychiatric unit for stabilization of acute psychotic symptoms.

Aims

Educate behavioral health care providers and stimulate discussion of the use of caffeine in different patient populations.

Methods

Use case-based learning to achieve objectives and aims above.

Results

Caffeine use can result in the appearance of symptoms consistent with depression, anxiety and psychosis.

Conclusions

Psychiatric patients, as well as the general population, would benefit to receive education on caffeine consumption and overuse.
Use of anticonvulsant agents in the management of alcohol dependence
Authors: Mayor M. Marin , Alvarez J. Lopez , Perez M.D. Riaza , Perez A. Quintana , Valladolid G. Rubio
Published: May 2011

Background

Alcoholism is a chronic relapsing disorder characterized by compulsive drinking, alcohol seeking, loss of control over alcohol consumption, and impaired social and occupational functioning. Treatment of Alcohol Dependence (AD) comprises two steps, detoxification and relapse prevention (RP). Traditionally, long half-life benzodiazepines have been the most widely used agents for alcohol detoxification. On the other hand, disulfiram, naltrexone and acamprosate are the three drugs that have been approved for relapse prevention. In the last decades, nevertheless, there is a growing interest in the use of anticonvulsant drugs in the management of both, detoxification and relapse prevention of alcohol.

Aims

To review the different pharmacological strategies in which an anticonvulsant was used in the management of AD.

Method

We searched in MEDLINE and in the Cochrane Database System Review, selecting all studies from 1980 until present, in which a pharmacological intervention with anticonvulsant agents was made for alcohol detoxification or RP.

Results

The most tested anticonvulsant drugs are the classical Carbamazepine and Valproate. Both have demonstrated to be efficacious in Alcohol Withdrawal Syndrome and RP. However, the use of these agents has been limited by their hepatic and hematologic toxicity. Novel anticonvulsants such as Gabapentin, Pregabalin, Topiramate, Oxcarbazepine and Zonisamide have also been found to be effective, with the advantage of rapid onset of action, lower toxicity and fewer side effects.

Conclusions

Anticonvulsants are efficacious and safe agents in the management of AD. Further randomized, double-blind, placebo-controlled trials are warranted to increase the evidence of the use of these agents.
Harm reduction programs the opportunity for psychiatric and substance use treatment
Authors: Martínez-Luna N.
Published: May 2011

Introduction

At least one-half of patients in substance use treatment have been diagnosed with comorbid psychiatric disorders. High prevalence of severe mental disorders co-occurring with substance use have been described. Harm reduction refers to policies, programs and practices that aim to reduce the harms associated with the use of illegal drugs in people unable or unwilling to stop.

Objectives

To describe attendance and integration of patients with substance use disorders in a harm reduction program, to psychiatric treatment.

Aims

Find the importance and profitability of Harm Reduction Programs as an access door to psychiatric treatment in people with drug addiction.

Methods

Data was gathered from the first interview survey made to patients that contacted the Harm Reduction Program or attending the Outpatient Drug Clinic Vall d’Hebron in Barcelona between January 2005 until September 2010.

Results

A total of 348 patients (males = 71%, European community origin = 92%, mean age = 28,18 years). 63,8% of patients were under medical and psychiatric treatments, 55,4% attended the Methadone Maintenance Program, 7,4% other psychiatric treatments, and other treatments without specification 30,7%. The residential status was: 38% squatters, homeless 9,7%, hostel 3,4%, home 43%, lodging 2%, others 3%.

Conclusions

More than fifty percent of harm reduction program patient's were in a psychiatric treatment, it is an advantage that in the outpatient drug clinic of Vall d’Hebron both programs are included: harm reduction and psychiatric assessment. Access to integral treatment is important for people with drug problems, but many people with drug problems are unable or unwilling to get treatments.
Behavioural dependences in adolescents and young adults: results from an observational study
Authors: Martinotti G. , Villella C. , Di Nicola M. , Fanella F. , Conte G. , Janiri L.
Published: May 2011

Introduction

Our study aims to assess the prevalence of behavioural addictions in an adolescent populations, evaluating the effects of gender and age, and to assess the correlations and associations between different behavioural addictions.

Methods

A population of 2853 students (1142 F and 1711 M, mean age 16.7± 1.9) was assessed in order to evaluate the prevalence of behavioural dependences such as Pathological Gambling (PG), Compulsive Buying (CB), Exercise Addiction (EA), Internet Addiction (IA), and Work Addiction (WA). The South Oaks Gambling Screen-Revised Adolescent, the Compulsive Buying Scale, the Exercise Addiction Inventory, the Internet Addiction Test, and the Work Addiction Risk Test, were compiled anonymously by the students.

Results

Overall prevalence was 7.0% for PG, 11.3% for CB, 1.2% for IA, 7.6% for WA, 8.5% for EA. PG, and EA were more common among boys, while gender had no effect on the other conditions. CB was more common among younger ( < 18 years old) students. Each of these conditions showed a strong association with others, and the scores of all of these scales were correlated.

Discussion

In line with previous studies our results indicate that behavioural addictions are quite common among adolescents. The strong association between behavioural addictions stresses the concept that treatment for one of these conditions should involve assessment and treatment for the others.
Psychiatric morbidity among methadone maintenance therapy (MMT) clients in University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Authors: Masturah R. , Rusdi A.
Published: May 2011

Introduction

Psychiatric comorbidities are very prevalence among heroin dependents yet many MMT sites do not have specific mental health services tailored to this dual diagnosis group. The prevalence rates are ranging from 30–90% depending on settings and tools use to measure the psychiatric morbidity. Both substance use disorder and psychiatric disorder need simultaneos treatment in dual diagnosis population. Failure to address any of the condition may affect and complicate each other condition.

Objectives

To investigate the prevalence of psychiatric morbidity and their psychosocial correlates among heroin dependents seeking MMT treatment in UMMC.

Aims

To determine whether we need to suggest dual diagnosis services in MMT sites.

Methods

A cross sectional, face to face interview was conducted in UMMC from October to December 2008. We interview those stable MMT clients( > one month treatment) who are above 18 years old and consented and fulfilled diagnostic citeria for heroin dependence syndrome in according to DSM IV. MINI Neuropsychiatric Interview (MINI) was used to measure psychiatric morbidity among 100 MMT clients using convenience sampling. The data was analysed using SPSS 16.

Results

Nearly half of the 100 clients (57 %) have at least one psychiatric illness. The most common psychiatric morbidity are the Anti Social Personality, Major Depressive Disorder, Suicidality and Psychotic Disorder Lifetime.

Conclusions

The prevalence of psychiatric morbidity is high as compared to general population.

Our finding is comparable with other studies which show similar result. There is a need for specific intervention for this dual diagnosis group for more effective treatment.
The role of parents’ divorce in adolescents’ internet addiction
Authors: Domokos L. , Cretu C. , Nagy H. , Mihai A.
Published: May 2011

Internet addiction is an excessive, ingrained habit and a thoughtless on-line/offline computer usage which can be divided into three subgroups related with games, web pages with sexual contents or email and internet chat programs. The causal factors of this trouble are still debated.

Aims

The purpose of our study is to survey the habits of teenagers concerning the use of internet and furthermore to investigate the frequency of internet addiction and its predisposing factors.

Material and methods

We investigated the habits of high school students (n = 154) in the county of Mureş using questionnaires (Internet Addiction Test).

Results

Young people spend daily an average of 3 hours and 38 minutes in front of a computer. 45% of the boys spend daily more than two hours with computer games while 74, 53% of the girls chat daily. 3, 41% of the adolescents think that they spend a lot of time on the net and their learning and school problems are a result of this. 9,3% of the teenage boys spend daily more than 4 hours 20 minutes in front of a computer (weekly 30 hours), what is qualified as dependence according to the American specialists. There is a strong correlation between internet addiction and parents divorce.

Conclusions

The rate of young people addicted to internet gains considerable importance. Moreover this addiction is associated with other addictions so there would be a serious need for health education programs already in high schools.
Comorbidity of substance use and psychiatric disorders among inpatients of a General Hospital Psychiatric Unit
Authors: Pachi A. , Giotakis K. , Kostaras T. , Pavla A. , Christodoulaki A. , Pashalakis G. , Tselebis A. , Bratis D. , Karkanias A. , Moussas G.
Published: May 2011

Introduction

In substance – related disorders comorbidity refers to any preexisting or following psychological or psychiatric condition that influence the course and prognosis of a patient.

Objectives

To determine the extent of comorbid substance use and psychiatric disorders among hospitalized in a General Hospital Psychiatric Unit patients and reveal the implications of treatment in such a unit.

Method

All patients hospitalized during a year, were included in the study. Demographics, final diagnosis, substance of use and means of admission (voluntary or involuntary) were recorded.

Results

7.4% of the total of 339 inpatients met the diagnostic criteria of comorbid substance use disorders. Eleven of them were diagnosed with alcohol use disorder comorbidity, 7 with illicit drug use comorbidity and 7 with both legal and illicit drug use comorbidity. Among inpatients with comorbid use disorders male patients had a significantly higher percentage versus females (x2 p < 0.05). Mean age of inpatients with comorbidity was significantly less than the mean age of the sample (t-test p < 0.05). Duration of hospitalization for inpatients with comorbidity was 15.16 ± 12.4 days versus 21.2 ± 18.4 days for the rest of patients (t-test p < 0.05). Concerning the way of admission, 72% of inpatients with comorbid use disorders were involuntary admitted (x2 p < 0.05).

Conclusion

Concerning age, sex and means of admission patients with a psychiatric disorder and substance use disorder comorbidity seem to vary from the rest of inpatients. These parameters are probably associated with serious difficulties in therapeutic compliance and with increased hazard.
Agomelatine as adjunctive therapy in discontinuation of long-term benzodiazepine withdrawal
Authors: Müller H. , Schütz P. , Maler J.M. , Kornhuber J.
Published: May 2011

Agomelatine is a new antidepressive drug, that is successfully applied in therapy of insomnia and depression. Until now, there has been no report on its application as add-on medication in therapy for the withdrawl ob benzodiazepine.

We are reporting a case of a forty-year-old male patient who was treated with Agomelatine in lorazepam withdrawl therapy. He showed a considerabel reduction of craving as well as of insomnia and vegetative symptoms.

Therefore there is the question if the substance has its own anti-craving component and to what extent the melatonin-receptor profile is involved.
Investigation the role of personality factors as the predictors of tendency to addiction
Authors: Nikpour G.A.
Published: May 2011

Introduction & objectives

For better understanding of the effective factors in tendency to addiction the research aimed to test this question that are there specific personality characters that lead to addiction?

Methods

153 addicted people and 153 nonaddicted people were randomly selected and Mochioly’s Characterlogy Inventory (MCI) was administered on them. The inventory assess personality based on eight characters: sanguine, indifferent, nervous, indolent, indignant, passionate, sentimentee, amorphous.

Results

Findings showed addicted people are much more indifferent, sanguine and passionate than nonaddicted people.

Conclusions

In regard to people with these characters are much more at risk, they should be trained with special plans and be cared so that tendency to addiction in them decrease or control.
Childhood risk factors for substance use disorders in attention deficit hyperactivity disorder subjects
Authors: Nogueira M. , Bosch R. , Palomar G. , Corrales M. , Gómez N. , Ramos-Quiroga J.A. , Casas M. ,   Programa de Integral de Atención al TDAH en el Adulto
Published: May 2011

Introduction

Co-morbidity between Attention Deficit Hyperactivity Disorder (ADHD) and Substance Use Disorders (SUD) is considered to be about 25–50% in adults. Several studies show vulnerability factors to later SUD to be associated with childhood ADHD features, such as conduct problems, untreated ADHD and maltreatment.

Objectives

To define childhood ADHD associated factors that predispose to SUD.

Specifically, comorbidity with oppositional defiant disorder (ODD) and conduct disorder (CD), temperamental traits, academic failure, familial SUD history, childhood maltreatment and subtype, severity and age of treatment of ADHD symptoms.

Methods

A comparative study was carried out in a sample of ADHD adults from the Department of Psychiatry H.U. Vall d’Hebron. Both groups, ADHD and ADHD+SUD subjects underwent the following assessment protocol: Conners Adult ADHD Diagnostic Interview for DSM-IV (CAADID-I & II), Wender Utath Rating Scale (WURS), SCID-I, SCID-II and K-SDAS.

Results

The total sample (n = 305) consisted of 201 men (66%) with age between 18–61 years. Two groups were compared: 162 ADHD subjects and 143 ADHD+SUD subjects. The ADHD+SUD group had significantly higher rates of comorbidity with ODD and CD, temperamental traits (obstinacy, bad temper, impulsive behavior), maladaptive behaviors at school, familial SUD history, childhood maltreatment, and major severity of the childhood ADHD symptoms. Neither ADHD subtype nor the non-treatment of ADHD during childhood were associated with later SUD.

Conclusions

An important percentage of ADHD children develop a SUD during their lifespan. This study shows that there are childhood factors that are strongly associated with SUD in ADHD subjects.
Pattern of craving response among smokers exposed to virtual reality
Authors: Pericot-Valverde I. , García-Rodríguez O. , Cabas-Hoyos K.P. , Ferrer-García M. , Gutiérrez-Maldonado J.
Published: May 2011

Introduction

Tobacco craving is an intense desire to smoke. Cue-induced craving is considered the main responsible for relapse after smoking cessation. Cue Exposure Treatment (CET) consists of controlled and repeated exposure to stimuli associated with substance use in order to reduce craving associated.

Objective

To analyze the pattern of craving response of smokers exposed to Virtual Reality environments.

Methods

Forty-six smokers were exposed randomly to complex virtual scenes of 6 minutes long duration with smoking related cues that reproduce typical situations where people use to smokes. Craving was assessed before each exposure and 6 times during navigation with a visual analogic scale. For this secondary analysis the evolution of craving response were explored for the environments that produced the most and the least craving responses.

Results

In the environment that produced the highest craving level, the pattern of response remains similar after the second assessment during the exposure, that is, after two minutes. For the environment that trigger the lowest levels, the responses gradually increased during the exposure and the highest level appeared in the last craving assessment, after 6 minutes.

Conclusions

This study has several implications. In the first place, virtual reality environments are able to elicit craving. In the second, we found that differents patterns of craving response exist in response to VR environments. Furthermore, the results obtained in the present study may be useful for cessation programs that include CET, in which is it necessary to know the pattern of desire during the exposure.
Pathological gambling and comorbidities
Authors: Poppe H. , Dillinger B. , Lentner S.
Published: May 2011

Pathological gambling accumulates frequently in connection with other diseases. This is documented both by studies and clinical observations, whereby no causalities can be derived, which underlying disease led to further diseases. Nevertheless different studies show similar results that pathological gambling arises increased in connection with substance dependence, depressive disorders, obsessive compulsive disorders and also personality disorders. These results stated in the literature also reflect the clinical observations of the Anton Proksch Institute.

In the following presentation we will try to figure out the results of inpatients with the diagnosis pathological gambling, that were treated in the Anton Proksch Institute in the years 2008, 2009 and 2010. We find a range of comorbititys longing from substance abuse to personality disorders.