bluuebunny/crossref_metadata_2025 huggingface dataset:
Who Gets how much Care in Psychiatric Outpatient Clinics and Why? [PW08-04]
Authors: Wedegaertner F. , Holler G. , Emrich H.M.
Published: March 2009

Aims:

German psychiatric outpatient clinics have been established to treat the sickest among outpatients. They receive a lump sum per patient and quarter. This reimbursement is currently under scrutiny, because it can act as a disincentive for the care-givers and to the disadvantage of the patients. It was the aim of this study to elucidate the connections between individual aspects and concerns of the patients and the amount of care administered.

Method:

Clients of one of the largest health insurers, who visited a preselected outpatient clinic were followed for six months (p=339). All treatment activities were logged individually. Relevant sociodemographic data, the diagnoses, the individual needs and idiosyncracies, the course of the symptoms and case history were noted. Associations between the factors and utilization were tested by ANOVA and multiple linear regression models.

Results:

The regression model with the best fit (r²=0,48, p< 0,001) included five variables. Lower utilization is associated with living in nursing home (ß=-0,378; p< 0,001), higher age (ß=-0,273; p< 0,001), legal incapacity (ß=-0,306,p=0,002) and lower social functioning (ß=-0,187; p=0,033); higher utilization with inpatient days prior to outpatient treatment (ß=0,168; p=0,015). Treatment aims, isolated functional deficits, diagnoses and graveness of symptoms did not have a significant influence.

Conclusions:

Outpatient clinics should address the needs of younger patients with the aspiration of an independent life despite of a grave psychiatric disorder. Treatments administered to nursing-home inhabitants are much less complex, although these patients are even sicker. A corresponding reallocation of financial resources is suggested.
Evidence Supporting the Historical Context for Current Views on Unmet need in Child and Adolescent Mental Health [PW08-05]
Authors: Wilkes T.C.R. , Cawthorpe D.
Published: March 2009

Objective:

In over 60 years little has changed in children's mental health and the flag waving continues: It is time for action in the trenches. It is imperative to focus health policy on the need to provide basic mental health succor to children and their families. A failure to alter the situation related to children's mental health will no doubt have catastrophic consequences for our society. We review the level of progress made in reforming regional mental health services since 2002.

Methods:

Using population-based representation of regional service utilization capacity permits comparison of regional, provincial and national rates of child and adolescent mental disorder.

Results:

Regional services in the last 6 years have served at most approximately 1% of the 0-18 year old population annually. This rate represents an increase from about 0.6% in 2002.

Conclusions:

Rationing the scant professional resources that exist to serve children's mental health will become increasingly difficult. For example, it is estimated that three percent of 0-18 year-olds are estimated to suffer a debilitating mental problem. Implication for policy are that our results point to service gaps in need of immediate policy development to meet basic needs of children. Several strategies are considered.
Improving the Diagnosis of Fibromyalgia (FM) in Europe: Identification of Factors that Aid in the Detection of FM [PW09-01]
Authors: Serra E. , Perrot S. , Guillemin I. , Barbosa C. Dias , Arnould B. , Baron R.
Published: March 2009

Aim:

Prior to facing the challenges of FM management, an initial diagnosis must be made. To guide general practitioners (GPs) in the early detection of FM in Europe, we developed an easy-to-use screening tool specific to FM.

Method:

A European multidisciplinary expert group was constituted with the aim of providing clinical expertise, defining methodology, and identifying key issues around the detection of FM. Three conceptual models describing factors that may contribute to the identification of FM patients were derived from; a) a comprehensive literature review, 2) clinician focus groups (N=6), and 3) face-to-face interviews with German, French, and English-speaking patients (N=29) conducting by psychologists to explore their attitudes and perceptions of the disease. A FM screening tool was developed in all three languages and tested for comprehension and applicability in FM-diagnosed and FM-suspected patients.

Results:

The models derived from the literature, clinician focus groups, and FM patient interviews showed high consistency. The resulting FM screening tool is comprised of 14 questions that describe patients’ pain, fatigue, associated symptoms, impact on everyday life, personal history, and attitudes towards their FM.

Conclusion:

Based on this qualitative study, the detection of FM is likely to require the assessment of multiple psychological factors in addition to symptoms, including patient reporting of personal history and patient behaviour. The quantitative validation of these findings is currently underway.
Neurobiological and Clinical Predictors of Impulsivity in Bulimia Nervosa [PW09-03]
Authors: Vaz Leal F.J. , Santos L. Rodríguez , Fuentes M.I. Ramos , Moreno M.J. Cardoso , Sánchez N. Fernández
Published: March 2009

Objective:

The main aim of this study was to analyze the association between a set of neurobiological/clinical factors and impulsivity in patients suffering from bulimia nervosa, as well as the capability of this factors to predict the severity of impulsivity.

Methods:

The Impulsive Behaviors Scale (IBS), the Diagnostic Interview for Bordeline Patients - Revised (DIB-R), the Beck Depression Inventory (BDI), the Millon Multiaxial Clinical Inventory (MMCI-II) and the Family Environment Scale (FES) were applied to 70 female patients with DSM-IV BN (purging subtype). Twenty-four hour urinary excretion of norepinephrine (NE), 3-methoxy-4-hydroxyphenylglycol (MHPG), serotonin (5-HT), 5-hydroxi-indol-acetic acid (5-HIAA), dopamine (DA), homovallinic acid (HVA), and morning serum cortisol levels before and after the administration of 1 mg of dexamethasone were determined.

Results:

Impulsivity was associated to lower levels of urinary 5-HT and 5-HIAA, borderline features, and lower family expressed emotion.

Conclusions:

The consideration of impulsivity as a core clinical feature in patients with bulimia nervosa could lead us to identify clinical subtypes of patients, with specific clinical profiles and specific treatment needs.
How to Improve the Visibility of Research in the Countries from the ‘scientific Periphery’: A ‘case Study’ [PW10-01]
Authors: Kulenovic A. Dzubur , Puljak L. , Ivanis A. , Vukojevic K. , Zaletel-Kragelj L. , Donev D.
Published: March 2009

Case history and symptoms:

Small number of prestigious scientific journals publishes most of the world's scientific information. Although scientists in developing countries represent 25% of the world's scientific community national journals from this "scientific periphery" are poorly visible: the Science Citation Index (SCI) included less than 2% of these journals in 1995.

Clinical presentation:

A vicious cycle of inadequacy for these journals: small number and poor quality of manuscripts submitted, inadequate review process, and imperfect English prevents them from reaching higher visibility and eventually escaping form anonymity. Key problems seem to be poorly designed and unoriginal research, lack of knowledge of research methods and data presentation.

Treatment:

1.

Teaching principles of scientific research in medical schools.

2.

Author-friendly editorial policy - a procedure where most of the articles received are pre-reviewed intramurally and improved by providing guidance to the authors, before being sent out for extramural review.

3.

Proactive board of editors - who seek interesting research and encourage researchers to communicate their results.

4.

Networking regional collaboration.

Treatment outcome:

In the case of Croatian Medical Journal (CMJ) that followed and partly developed the "treatment" described, such policy resulted in significant formal success - inclusion of CMJ in the most selective international indexing databases (MEDLINE, Current Contents and Web of Science), open access status, decent visibility and attention of researches (impact factor 1.2). The original, active and efficacious approach of the editors of CMJ will be analyzed in this presentation.
MEDED - a Novel Interactive Manual to Enhance Psychopharmacologic Care in Children and Adolescents [PW10-02]
Authors: Kutcher S.
Published: March 2009

Child and Adolescent psychopharmacology is a complex yet frequently necessary psychiatric intervention that requires the participation of the patient, the family, other caregivers, other health providers as well as physicians. Provision of up to date information about and education in the use of psychotropics is an essential component of good psychopharmacologic treatment. To date there have been no methods of addressing these needs within a collaborative care framework that meets the interests of all parties and optimizes the application of best available knowledge in the clinical care of child and adoelscents with mental disorders. MEDED (C) was developed by a group of pharmacists and child psychiatrists as an innovative tool to meet this need. It has been extensively evaluated in a variety of clinical settings in Canada with substantial positive results. This presentation will review the novel collaborative approach to pharmacotherapy that MEDED supports, the process of MEDED development, the contents of MEDED and research on its use to date. Clinicians and program directors will have the opportunity to learn how to obtain further information abot the use of this tool.
Family Characteristics and Children's Preschool Trajectories of Disruptive Behaviours
Authors: Carbonneau R. , Liu X. , Boivin M. , Tremblay R.
Published: March 2009

Aim:

The aim of this study was to investigate the association between parental characteristics and parental practices and the trajectories of Disruptive Behaviours (DBs) during early childhood.

Method:

Trajectories of DBs - Hyperactivity, Oppositional behaviour and Physical Aggression - were assessed based on annual mother interviews from 17 to 60 months for a Canadian population-representative birth cohort (N=2057).

Results:

Frequency of DBs increased from 17 to 41 months and then tended to decline. Parental characteristics and parental practices were both associated with chronic trajectories of DBs.

Conclusion:

Early childhood is a critical period to prevent later DBs during school years that leads to psychosocial maladjustment during adolescence and adulthood.
Systematic Review of National and International Guidelines on ADHD
Authors: de Seixas M.D. , Müller U.
Published: March 2009

Introduction:

ADHD is a well-established neurodevelopmental disorder affecting a significant population across the lifespan. Driven by the need to provide adequate clinical care, several national and international medical societies have published guidelines on ADHD. Our objectives were to compare the recommendations set out by these guidelines and their methodological quality.

Methods:

To meet the inclusion criteria the guidelines had to be published by national or international medical societies or governmental bodies and focus on diagnosis or management of ADHD. To assess their methodological quality we used the Appraisal of Guidelines for Research & Evaluation (AGREE) instrument.

Results:

We identified 13 guidelines on diagnosis and/or management of ADHD meeting our inclusion criteria. They represented the recommendations from 9 different bodies from 4 different countries and 1 European group. All guidelines made recommendations on both diagnosis and treatment. Seven made recommendations concerning children and adolescents, four are about ADHD in adulthood and two made brief comments on specific aspects of treatment in adulthood. All groups have used DSM-IV criteria but differed on their assessment recommendations to varying degrees. All of them recommended stimulants as the core of pharmacological treatment. Only one (NICE 2008) recommends specifically methylphenidate as the first-line treatment.

Discussion:

Most of the diagnostic and treatment recommendations are consistent across the guidelines with few but important exceptions. This may reflect differences of service provision and target audiences. Convergent recommendation of psychostimulant treatment and differences with respect to psychosocial interventions reflect the strength (and weakness) of underlying evidence.
Clinical and Neuropsychological Profile in a Sample of Brazilian Children with Attention Deficit Hyperactivity Disorders (ADHD)
Authors: Rizzutti S. , Sinnes E.G. , Coelho L.F. , Freitas L. , Pinheiro D. , Palma S.M. , Miranda M.C. , Muszkat M. , Bueno O.F.A.
Published: March 2009

The main objective of this study was to analyse the clinical and neuropsychological profile of a sample of Brazilian children with ADHD, in order to contribute for diagnostic procedures. Participants were 150 children aged 7 to 14 with complaints of attention difficulties and/or hyperactivity. They were assessed by a multidisciplinary team with a battery of neuropsychological tests.

Results:

75 children (55 male) fulfilled the criteria for ADHD: 35 of inattentive type, 28 of combined type and 12 hyperactive/impulsive. In addition, 33 (44%) of the children had comorbities. Children with higher scores for hyperactivity and impulsivity showed low performance in these working memory measures than those with other types. In the Conners’ Continuous Performance Test (CPT), a higher rate of omissions was found in the inattentive group. Children with comorbidity of oppositional desafiant disorder presented lower ISI and Hit RT scores in addition to higher rates of omission.

Conclusion:

This study suggests that neuropsychological profile in children with ADHD is associated to specific differences in working memory performance and also in specific measures of the CPT. In addition, better defined tests, involving not only attention and motor planning may determine different neuropsychological profiles and, consequently, different approaches in cognitive rehabilitation.
Children and Computers use: Social, Psychological and Academic Consequences
Authors: Chele G. , Chirita V. , Chirita R. , Stefanescu C.
Published: March 2009

Numerous surveys have attempted to measure how frequently children use the computer at home. Few studies and inconsistent findings render uncertain whether using the computer has any influence on children's social outcomes. The only available review of this research concluded that there is no evidence that computer use is directly related to any psychological outcomes. Although benefits of computer use have been observed, they typically depend on a variety of factors (e.g., subject matter). The only cognitive outcome for which benefits have been consistently observed is visual-spatial skills. Computer gaming contributes to visual-spatial skills, at least when these skills are assessed immediately following the computer activity.

Objective:

The need for information about the effects of computers on their users also increases. The purpose of this study is to investigate how computers are use by children and adolescents. The second goal is to explore the beneficial and harmful effects of computers use on children's mental and physical health.

Methodology:

The studied group of samples comprised 69 subjects, aged between 13 and 18 years, who answered to a questionnaire. The parents of children answered too another questionnaire whit same subject.

Results and conlusions:

The results were obtained about computers use and identification pathological use. Some the children spend much time to computers, 4% more five hours/day. 41% of the parents believe that the usage computers are favorable to developmental children's mental and physical health and 49% of the parents don't believe that. We find approximately 3,5% of cases with pathological use.
The Fagerström Test for Nicotine Dependence in Lithuanian Adult Smokers
Authors: Dambrauskiene K. , Adomaitiene V. , Klumbiene J. , Petkeviciene J. , Veryga A.
Published: March 2009

Nicotine dependence meets the criteria for a psychiatric diagnosis, and has been referred to as “the most prevalent, most deadly, most costly, yet most treatable of all psychiatric disorders”. Fagerström test for nicotine dependence is an instrument often used to assess nicotine dependence. In the last decade, the importance of the level of nicotine dependence and difficulties in cessation has been acknowledged. Therefore it is important to know the level of nicotine dependence for choosing nicotine replacement as a function of dose.

Objective:

The aim of the study was to evaluate nicotine dependence among Lithuanian adult smokers, according to gender, age, and former quit attempts.

Methods:

The study analyses data of Lithuanian adult population health behavior surveys, performed in period of 1994- 2006. For every survey the national random sample of 3000 inhabitants aged 20-64 was taken from the National Population Register. The study material was collected through mailed questionnaires covering smoking habits. Nicotine dependence was assessed with Fagerström test for nicotine dependence (FTND).

Results:

Among Lithuanian regular smokers aged 20-64 in both genders dominated low level of nicotine dependence (56, 9 % of smokers). High level of nicotine dependence was observed in 2, 4 % of smokers. The men presented higher dependence on nicotine than women. Older smokers presented higher dependence on nicotine than young smokers.
Lorazepam, Tiapride and Pregabalin in Alcohol Withdrawal: A Multicenter, Randomised, Comparison Trial
Authors: Martinotti G. , Di Nicola M. , Tedeschi D. , Frustaci A. , De Filippis R. , Mazza M. , Pedullà C. , Pozzi G. , Janiri L.
Published: March 2009

Introduction:

In this multicenter, randomised, single-blind, parellel group, comparison trial we aimed to investigate the efficacy of lorazepam, tiapride and pregabalin in alcohol withdrawal. Craving and psychiatric symptoms improvements were the secondary endpoints.

Methods:

One-hundred-nine alcohol dependent subjects (DSM-IV) were detoxified and subsequently randomised into three groups, respectively receiving 200-400 mg of tiapride (TIA; mean dosage 300 mg), 2-5 mg of lorazepam (LOR; mean dosage 3 mg) and 150-450 mg of pregabalin (PRE; mean dosage 280 mg). Withdrawal symptomatology was determined by the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar), whereas the level of craving for alcohol was evaluated by a 10-cm Visual Analogue Scale (VAS) and the Italian -version of the Obsessive and Compulsive Drinking Scale (OCDS). Psychiatric symptomatology was evaluated by the Symptom Check List 90 Revised (SCL-90 R).

Results:

All the three medications have shown efficacy on reducing alcohol drinking indices, craving scores and withdrawal symptomatology. The reduction observed in the PRE group was significantly higher than those in the LOR and TIA groups. In terms of safety and tolerability, all the compounds were generally well-tolerated. Only one patient has reported an epileptic episode during the treatment with tiapride.

Discussion:

Results from this study globally place the three medications at the same range of efficacy, with the PRE group reporting an higher reduction of withdrawal symptoms. Another point in favour of the employment of pregabalin was represented by a better outcome in those patients reporting a comorbid psychiatric disorder.
Internet Dependence in College Students from Greece
Authors: Frangos C.C. , Frangos C.C.
Published: March 2009

Aims:

We intended to study the trends of Internet dependence (ID) and to detect possible associations among Greek college students.

Methods:

646 college students (300 males and 346 females), mean age 20.5 years, from the Technological Educational Institute of Athens, were randomly selected. The students completed special questionnaires which contained questions on their demographics, Young's Addiction Scale (1996), and Lin and Tsai's (2002) Sensation Seeking scale.

Results:

a.

The prevalence of Internet dependents was 7.9%.

b.

There are more boys (32) Internet addicts than girls (19).

c.

There is a significant relationship between ID and gender (p < 0.01), average mark in last semester (p < 0.001), and daily use of Internet (p < 0.001). 11% of internet dependent students use the Internet more than 10h per day compare to 1.6% of non-dependent students.

d.

Internet dependent students have used for more average time per week than non-dependent students online games (p < 0.01), blogs, chat rooms, and forums (p < 0.001).

e.

Nine (9) factors accounted for 54.467% of the total variance in questions concerning ID, sensation seeking, and relations with others. The three most prominent factors were related problems to internet use, family, and school, compulsive use and withdrawal symptoms and depression.

f.

There is a substantial correlation between Internet addiction and alcoholism, smoking, and substance taking (p < 0.005).

Conclusion:

Internet addicted students are more prone to experience loneliness, withdrawal, depression and rejection from others. Internet over-use affects academic performance and is associated with substance consumption.
Tobacco Smoking and Motivation to Quit in Psychiatric Patients
Authors: Ganhão I. , Gonçalves E. , Paixão A. , Trigo M.
Published: March 2009

Introduction:

Smoking is a major health risk in the population in general with significantly increased morbility/mortality with severe consequences on the quality of life and tremendous economic burden on society. It is well known that psychiatric patients have an even higher prevalence of smoking, of heavy smokers and of other risk factors that contribute to the same illnesses.

Non-smoking campaigns/smoking restrictions have flourished and it appears that more people are quitting or seriously contemplating the idea. When once, many non-smokers tolerated smokers, today the stigma associated with smoking is undeniable. Psychiatric patients, already greatly stigmatized, risk even becoming more so. Furthermore, smoking cessation programs and interventions frequently are not available, exclude many psychiatric patients and/or are ill-adapted to the special needs in this patient population.

Aim:

To establish the prevalence of smoking, quantity of tobacco smoked, other factors of dependence by psychiatric diagnosis in a portuguese psychiatric hospital.

Establish the motivation of these patients to seek help by professionals and motivation to quit.

Methods:

Application of questionnaires including Fagerstrom's Modified Questionnaire to patients under care by one team of a Psychaitric hospital in Lisbon, Portugal (CHPL - Sector A).

Discussion and conclusions:

The study is under way therefore, there are no valid conclusions yet.

Certainly it will be possible to confirm high levels of smoking tobacco in this patient population. Hopefully, we may also conclude that there is the desire to change smoking habits making cessation programs a needed and welcomed intervention in psychiatric settings.
Maintenance Programs for Treatment of Heroin Addicts in Post-war Bosnia and Herzegovina
Authors: Hasanović M. , Pajević I.
Published: March 2009

Methadone maintenance program in Bosnia-Herzegovina (BH) has been introduced in Sarajevo for the first time in 1989 year. During the war years 1992-95, only sporadic cases of drug addicts, because of overdosing or because of toxic psychotic states were treated. Number of addicts increased in BH, especially after the war, and needed adequate solution of the problem as well as use of the experiences from the other countries that faced us before, "epidemy" of addictions. One of the solutions for harm reduction caused by use of opioid substances, primarily heroin, was use of methadone, which is a good replacement pharmacological. After opening the Unit for drug addiction in year 2000 in Sarajevo, the methadone program of detoxifying and maintenance was re-established in 2002. Nowadays in BH high-threshold methadone program is used in five centres, in accordance with the criteria for European guides for methadone therapy. In addition to the subject of methadone programs, there are serious preparations for the use of Suboxone (Buprenorphine+Naloxone) in BH. The basic component of medicine (Buprenorphine) was placed on the essential list of the World Health Organisation (WHO) in September 2005. In BH, this drug was registered 18.12.2007 year. At the Clinic for Psychiatry in Tuzla, the establishing of Suboxone maintenance program was planned for the autumn of 2008.
Temperament and Character Inventory Dimensions in Alcohol Dependency
Authors: Karadag F. , Saatcioglu O. , Ure I. , Ayhan A. , Tellioglu N. , Ozdemir F. , Akdeniz F. , Tezcan A.E.
Published: March 2009

Aim:

The aim of this study is to evaluate the differences in dimensions of temperament between alcohol dependent inpatients and healthy control subjects.

Method:

The study is consisted of 77 alcohol-dependent patients according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition and 80 healthy control subjects. Cloninger's Temperament and Character Inventory (TCI), Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) scale and semi structured sociodemographic form were applied to the subjects after detoxification period.

Results:

Age and education level were similar rates in both alcohol dependent (mean age= 43.7 ± 10.1 and education level= 9.0 ± 4.2) and healthy control subjects (mean age: 42.5 ± 11.8 and education level: 10.2 ± 3.8). Alcohol-dependent patients were characterized by higher Novelty-Seeking (p=0.006) and Harm Avoidance (p=0.002) than non-psychiatric control subjects. Also, subjects suffering from Alcohol-dependence exhibited significantly more depressive (p=0.003), anxious (p=0.001), irritable (p=0.004) and cyclothymic (p=0.001) temperament. Novelty-Seeking [95% C.I = 1.08 (1.07-1.16)] and cyclothymic temperament [95% C.I = 1.13 (1.03-1.23)] were predictors of alcohol dependency.

Conclusion:

Novelty seeking and harm avoidance were significantly higher in the patients than in the healthy subjects. Novelty-Seeking and cyclothymic temperament were predictors for alcohol dependency. It seems to be important to consider TCI dimensions and affective temperaments in planning the treatment and maybe in preventing of alcohol dependence.
The Survey of Effective Factors in the Re-addiction After Quitting in Ardabil
Authors: Molaei B. , Hejazi S. , Karimollahi M. , Mohammadi M.A.
Published: March 2009

Background and objectives:

Addiction is one of the most terrible disasters that has struck the young people in our country and has destroyed many of our economic and human resources. This study was done to determine the effective factors in the re-addiction after quitting in Ardabil.

Methods and materials:

This study was a descriptive study in which the subjects have been addicts referring to the governmental and nongovernmental drug treating centers in Ardabil. 380 addicts were chosen on the basis of sampling. The instrument was a questionnaire of two parts. The first part consists of 16 questions about demographic factors and the second part with 39 questions was about the factors that caused re-addiction. The questionnaire had a content validity and its reliability was determined by the test-retest method.

Results:

The results show that 50.5% of the subjects ranged between 30 to 50 years. less than 89.2% city residents, 32.6% opium addicts and 34.5% had quit at least twice, and 64.7% of them had started again after 2 months, 50.6% of the addicts had mental disorders. Chi-square statistical analyses showed that there is significant relationship between personal, social, economic and family-related factors with re-addiction.

Conclusion:

It can be concluded that the combination of personal, social, economic and family-related factors play a very important role in re-addiction. So it is recommended that for re-addiction prevention all dimensions of the addicts have to be taken into consideration when they are quitting.
In Vivo Evidence for Long-term CNS Toxicity Associated with Chronic Binge use of Methamphetamine
Authors: Kim D.
Published: March 2009

Purpose:

Methamphetamine has strong addictive characteristics and is a potent neurotoxin. We use Single PhotonEmission Computed Tomography (SPECT) to study brain perfusion in persons who were formerly chronic binge users of methamphetamine and who at the time of imaging had abstained from methamphetamine use for anaverage of 2 years.

Methods:

Members of the methamphetamine group were 20 men who had previously injected methamphetamine intravenously for over 30 months and who were now abstinent for a minimum of 9 months and for an average of 2 years. Controls were 12 healthy men who had never injected methamphetamine. Images were obtained 40 minutes after intravenous injection of 1110 MBq of Tc-99m ECD using a dual-head gamma camera (ECAM plus; Siemens).

Results:

The mean global count was significantly decreased in methamphetamine group compared with that of control group (p < 0.0001). After global normalization, rCBF in methamphetamine user group compared with the control group was significantly disproportionately reduced in the striatum, thalamus, cingulum, mesiodorsal prefrontal cortex, and pons. Furthermore, normalized rCBF was strongly intercorrelated across all regions where disproportionate hypoperfusion was identified, including striatum and thalamus (r=0.90), thalamus and cingulum (r=0.91), thalamus and pons(r=0.89), and striatum and pons (r=0.94).

Conclusions:

Binge use of methamphetamine produces long-term changes in global and regional blood flow producing a pattern of hypoperfusion that resembles patterns reported previously for persons with atypical Parkinson disease. These findings suggest that methamphetamine abusers may be at increased risk for neurodegenerative diseases later in life.
Prevalence and Course of Substance Use in Pregnancy
Authors: Kumar M. , Crome I.
Published: March 2009

The prevalence of substance use among pregnant women varies widely. The reported prevalence varies between 0.2 and 15% for alcohol, between 1.8% and 15% for cannabis, and between 0.3% and 9.5% for cocaine. The reported prevalence of opiate use during pregnancy ranges from 1.6% to 8.5%. The prevalence varies widely because of differences in the methods of assessment, gestational period of assessment and population characteristics. There is clear evidence that substance use in this population is an issue of real and serious concern. Most pregnant women stop or reduce their substance use during pregnancy and this might be an opportune moment for detection and treatment.

We report the prevalence of smoking, drinking and illicit substance use among 420 women attending for 20 week antenatal ultrasound scan in a UK University Hospital is reported. Routine antenatal recording of substance use among this population is compared with a focused interview and objective measurements for substance use. Change in use of substances in relation to pregnancy is also reported.
Computer-assisted Self-infusion of Ethanol (case): New Outcome Measures may Contain Unseful Information
Authors: Mick I. , O’Connor S. , Vitvitsky V. , Plawecki M.H. , Mann K.F. , Zimmermann U.S.
Published: March 2009

Oral alcohol self-administration studies limit the range of arterial blood alcohol concentrations (aBAC) due to the combination of IRB-constraints on the maximum aBAC allowed and substantial variability in idiosyncratic enteral absorption. 25 healthy young adults participated in a preliminary assessment of the influence of familial alcoholism on alcohol self-administration using CASE. CASE automates the i.v. infusion of 6% ethanol, using an individualized kinetic model to achieve identical incremental aBAC in all subjects.

In two CASE sessions, the subject was instructed to request infused “drinks” in order to emulate his/her perceptions of alcohol effects obtained at a weekend party. Conventional outcome measures all correlated closely with each other, so we evaluated the basic shape of the time course of aBAC achieved and the latency to peak aBAC (Tpk).

Tpk correlated with maximum aBAC on the 1st (p= 0.029), but not 2nd session. Further, Tpk did not correlate with mean aBAC on either day, but did correlate well with the number of drink requests on both days (p< 0.001). In 33 out of 47 experiments, subjects achieved and maintained stable plateaus of aBAC for at least 30 minutes during the self-infusion. Both latency to peak aBAC and the shape of the subject’s preferred time course of aBAC may represent informative new ways of examining styles of alcohol self-administration of alcohol using CASE. The additions may enrich studies of the influence of factors such as familial alcoholism on the vulnerability for alcohol future alcohol dependence.
Cognitive Dysfunctions in Patients with Alcohol Dependence
Authors: Nowakowska K. , Jabłkowska K. , Adamiak G. , Borkowska A.
Published: March 2009

Background and aim:

Alcohol dependence is a chronic disease connected with disorders of the brain. The aim of this study was to assess cognitive frontal cortex functions in patients with alcohol dependence after discontinuation of alcohol use and after at least, one year of abstinence.

Methods:

106 patients (28 females, 78 males), aged 26 - 57 (mean 43±7,5) years with alcohol dependence were evaluated. In 53 subjects, an assessment was performed seven to ten days after discontinuation of alcohol drinking and in 53 subjects after at least one-year of abstinence. The control group consisted of 53 healthy persons, matched for age, sex and education to patients from the experimental group. The intensity of alcohol addiction was assessed, using SADD and MAST scales. Neuropsychological assessment included frontal tests: Wisconsin Card Sorting Test (WCST), N-back Test, TMT A&B, Stroop Test 1&2 and Verbal Fluency Test (FAS).

Results:

Significant disturbances of working memory and executive functions were noted in patients with alcohol dependence (with short-term and long-term abstinence), in comparison to healthy subjects. No significant differences were observed between the patients with short-term and long-term abstinence on the performance on neuropsychological tests, except better results of TMT B, WCST- the percent of non-perseverance errors and WCST - the percent of reactions compliant with logical concept obtained by the patients with long-term abstinence.

Conclusions:

The results obtained indicate core and enduring working memory deficits, connected with prefrontal cortex impairment in patients with alcohol addiction, independent from the duration of the abstinence.

Acknowledgements:

This research was supported by grant 502-16-685 Medical University of Lodz.
Does Gender have any Effect on the Neurophycological Damage in Cocaine Addicts? [P01-60]
Authors: Mangado E. Ochoa , Madoz-Gúrpide A. , Vadillo E. Salvador
Published: March 2009

Records:

Taking into account the differences on the basal cognitive performance, pattern of drug use, and the influence of menstrual cycle on cerebral blood flow and neuronal lost, it is expected to find differences on the neuropsychological damage resulting of chronic cocaine use according to the patient's gender.

Objetive:

To know about the influence of the gender factor on the neurophycological damage as a result of chronic use of cocaine.

Experiment and method:

Using a neurophicological assessment battrery (digit (WAIS-III), Trail Making, Card's, Zoo's (BADS), and Wisconsin Card test), we compare the performance between males (N= 19) and females (N= 5). This assessment is part of a wider observatory prospective study with a control group, to study neurophycology damage caused by the cronic consumption of cocaine (Proyect MSC-2005/465 (DGPNSD).

Results:

The mean age on our sample is 36.0 years (ds: 6.3); mean of schooling time was 8.4 years. 83.3% consume cocaine daily, but only 12.5% injected intravenously. The average of daily cocaine consumption is 1.5 gr (ds: 1.3). 87.5% use also other illegal substances.

No statistically significant differences were found between the two groups in any of the tests applied. The adjustment was made considering different patterns of drug use, schooling time and other variables. In the others analysis of the same tests in the group control neither did no find any different evidence in gender factor.

Conclusions:

Differences according to gender could not be found. On the statistical adjustment, pattern of cocaine use and previous cognitive function were considered.
Staff and Patient Attitudes and Issues Related to the Implementaion of a Comprehensive Smoking Ban in a Psychiatic Facility
Authors: Scharf D.L. , Zahn E. , Reddon J.R. , Els C.
Published: March 2009

Aims:

The purpose of the study was to evaluate issues related to the implementation of a smoking ban with the aim of improving programs to help patients reduce or quit smoking.

Method:

At a 410 bed pyschiatric facility, 73 staff and 68 patients completed separate surveys regarding their attitudes towards a smoke-free policy banning all indoor smoking and smoking on the grounds.

Results:

55.2% of patient respondents smoked cigarettes and 42% of participants who smoked have either reduced tobacco consumption or have quit. Changes in quality of life that were found to be significant were mood, eating habits, outlook on life, and level of restlessness, anxiety, stress, and concentration. Comfort level and alertness did not change significantly. These symptoms are all associated with nicotine withdrawal. Nicotine replacement therapy (NRT) was percieved as being effective in relieving nicotine withdrawal symptoms. Over half of the patients have not discussed tobacco use with a health care professional. Staff expressed mixed attitudes towards the ban and the use of NRTs. Concerns were raised over patients smoking while using NRT in fear of the patient recieving too much nicotine.

Conclusion:

Given that the deleterious health consequences of smoking are well known and given the high prevalence of smoking in the psychiatric population, extraordinary efforts are required to significantly reduce tobacco consumption. The implication of this research is that education on tobacco reduction options ought to be provided to staff as well as patients. Efforts to reduce tobacco usuage must be incorporated into standard patient care.
Alcohol and Youth
Authors: Spremo M.
Published: March 2009

Introduction:

In adolescence alcohol can become considerable psychological stimulus, and its more regularly consuming will be the first step in making psychological and later physical dependence as well.

Method:

The aim is to establish the freqsuency of misuse of alcohol among the youth and some of risk factors which precipitate that kind of behaviour.

610 secondary school pupils (360 females and 250 males), aged 14 - 18, in Banja Luka were sampled. Selfreported Questionnaire of Risk Behaviour by K. Berg-Kelly (2000) was used.

Results:

61,4% of those sampled consum alcohol with different frequency; from every day to few times a year, from that 29,7% females in relation to 30,5% males, and there is statistically considerable difference (x2=75373, p=0,000). From that number 39,3% drink alone, 43% testees drink within a family and from that 2% drink few times a week, and 28,5% few times a year. 25,7% of these sampled had experience in drinking. Parents allow drinking in 41,5% testees in relation to 58,5% who are not allowed to drink, so there is statistically cosiderable difference (x2=33997, p=0,000).

Conclusion:

The results should be used as a support to measures of prevention from selling alcohol to youth and establishing stronger supervision on spending money as well.
Demographic Characteristics of Patients with Comorbid Drug Dependende and Posstraumatic Stress Disorder
Authors: Strey M. Neves , Pulcherio G. , Sarti P. , Fensterseifer D. , Pinent C.
Published: March 2009

Objective:

The present study is investigating posttraumatic stress disorder among male with substance dependence in treatment.

Methods:

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

Results:

Overall the patients 30% had PTSD. The patients with PTSD had more family members with abuse or drugs dependence (66,7% versus 54,5%), related more exposure trauma (6,3 versus 4), when compared without PTSD. The PTSD patients punctuated more symptoms in Davidson Trauma Scale (12,8 versus 4,8). Punctuated more frequency and severity of symptoms’, mainly, hypercitability. The more frequent trauma was mugged or threatened with a weapon, 84,1%.

Conclusions:

Psychiatric comorbidity is common among addicted patients. Post-traumatic stress disorder (PTSD) is a highly symptomatic anxiety disorder of acute onset after a major distressing life-event. In clinical practice, patients suffering from drug addiction invariably report the occurrence of psychologically stressful episodes, with frequencies of PTSD ranging from 30% to 60%. Among patients suffering from alcohol or other drugs dependence, the prevalence of PTSD is estimated to range between 10% and 40%. Global response to treatment was achieved after the recognition and appropriate treatment of the latter condition, along with the combined approach to other comorbid disorders.
Sexual Dysfunction in Alcohoolism
Authors: Teixeira P. , Martins M.
Published: March 2009

The prevalence of sexual dysfunction in alcoholism is frequent and fluctuates between 3.2% and 64.4%, according different studies. The aim of this research is to study sexual dysfunction frequency in a sample of alcoholic patients who were undergoing treatment for this illness.

The study consists of an a questionnaire on sexual behaviour, with a sample of 80 individuals, 60 men and 20 women.

The authors conclude about the sexual dysfunction in different groups of alcoholic patients, in treatment in an inpatient and follow-up setting.
Clinicodynamical Characteristics of Panic Disorders in Alcohol-dependent Patients
Authors: Tsygankov D. , Terekhova D. , Agasaryan E.
Published: March 2009

The aim of this study was to examine clinicodynamical characteristics of clinical course of alcohol addiction and panic disorders. Patients (n = 214) with comorbidity of alcoholism and panic disorder were included in this study.

Defined and described were 4 clinical variants of associated course of these diseases that differ in formation order, cause-effect relations between alcohol abuse and panic disorder, clinical features and course of alcoholism and panic attacks, further development of double pathology.

The first group included patients with full abstinence from alcohol for no less than one year by reason of panic attacks during alcohol withdrawal syndrome. The second group consisted of patients whose panic attacks were followed by ingesting considerable doses of alcohol in order to release anxiety, which resulted in the bout of heavy drinking. Episodic paroxysmal alcohol ingestion was typical in patients from the third group. Ingestion of considerable doses of alcohol leaded to panic attacks, the following abstinence from alcohol (6 months in average) was based on fear of reiteration of panic disorder. The forth group included patients with panic attacks during clinical remission of alcohol addiction who used alcohol to ease the panic symptoms. This resulted in the heavy alcoholism recurrence.

The results of the study can serve as a basis for working out programs of differential therapy for above-mentioned patients.

The study is supported by the President's Grant Mκ-2670.2008.7.
Depressive Disorders in Alcohol use
Authors: Radut C. , Tiugan A.
Published: March 2009

Background:

The relationship between alcohol usage, depressive psychopathological board represent a reality in psychiatric practice. The neurobiochemical layers of the two psychic pathologies are inter-correlated.

The dopaminergic deficice, especially on the compensation path, for regulating the GABA-ergic and GLUTAMATE-ergic pathways, the serotoninergic and noradrenergic dysfunctions being present in both disorders.

The amygdalae's anatomical circuit with the compensation paths (ventral segment and accumbens nuclei) represents the neurobiological substratum of comorbidity.

Objective and methods:

A retrospective, observational, open study was carried out in the period 2005 - 2007 on a lot of 200 male patients aged between 19 and 65 years, admitted in the clinic with the diagnosis “addiction disorder”, established according to the DSM IV-R criteria.

Results:

An depressive board associated with addiction disorder was observed in 140 patients from the studied lot.

Conclusions:

The alcohol use is induced by an depressive pathology, as the patients use alcohol as an anxiolytic and sedative.

The depressive disorder overlapped on the symptomatology induced by alcohol use is frequently characterized by psychomotor restlessness and suicidal ideation.

The depressive pathology is developed from the beginning of the addiction disorder or at a very short time after establishing a diagnosis, especially in the young patients.
Association of ADH2 and ALDH2 Gene Polymorphisms with Alcohol Dependence: A Pilot Study from India
Authors: Prasad P. , Vaswani M.
Published: March 2009

Background:

Functional polymorphism in ADH2 and ALDH2 genes are considered most important among several genetic determinants of alcohol dependence (AD), a complex disorder.

Aims:

There is no report on the widely studied Arg47His and Glu487Lys polymorphisms from Indian alcohol dependent population. We, for the first time, report allelic and genotypic frequencies of Arg47His and Glu487Lys SNPs in North Indian alcohol dependent subjects.

Methods:

A total of n=174 alcohol dependent males, recruited using DSM IV criteria, were genotyped using PCR-RFLP method.

Results:

Data obtained from genetic analysis was correlated with clinical parameters using T test or Mann Whitney's U test. ADH2 gene polymorphism was found to be largely monomorphic with minor allele frequency (ADH2*2) < 0.001. For the ALDH2 Glu487Lys SNP, genotypic frequencies were 0.73 (2*1/*1), 0.16 (2*1/*2) and 0.11 (2*2/*2), with minor allele frequency (ALDH2*2) = 0.19. Various clinical parameters were found to be significantly associated with ALDH2 polymorphism.

Conclusions:

The highlight of the study is a clear association of ALDH2 gene polymorphism with delayed onset and shorter duration of alcohol consumption among ALDH2*2/*2 individuals. Our finding bolsters the protection conferring property of the ALDH2*2 allele of Glu487Lys SNP of ALDH2 gene.