bluuebunny/crossref_metadata_2025 huggingface dataset:
Substance use relapse associated with Iowa gambling task performances in polysubstance dependent alcoholics
Authors: De Wilde B. , Sabbe B. , Hulstijn W. , Dom G.
Published: May 2011

Introduction

Polysubstance dependent alcoholics (PSA) show a high risk of relapse. Decision-making deficits might be predictive of relapse so that high-risk relapse PSA are easily identified and novel more effective treatment interventions can be found.

Objectives

To evaluate the effect of decision-making as measured by neurocognitive measures like the Iowa Gambling Task (IGT) and the Delay Discounting Task (DDT) on short-term relapse in PSA. The possible confounding effects of personality disorders (PD) are also examined.

Methods

Forty-one PSA following an inpatient addiction treatment were questioned about their substance use. After two weeks of stable abstinence they performed self-report questionnaires (Barratt Impulsiveness Scale - Sensitivity to Punishment and Sensitivity to Reward Questionnaires) and neurocognitive measures of decision-making (DDT - IGT). Thirty-seven PSA were retrieved three months after treatment completion and questioned about their current substance use. Thirty-one healthy controls (HC) were also asked to perform the self-report questionnaires and neurocognitive measures.

Results

All PSA showed decision-making deficits in comparison to the HC. Abstinence was associated with better IGT performances, an older age at onset, and a greater likelihood of a cluster C PD.

Conclusion

IGT performances but not DDT performances are associated with short-term relapse in PSA. It is assumed that the processes involved in the DDT are more important to the initiation of the addiction while the processes involved in the IGT are more important to the maintenance of and the relapse in the addiction.
Impulsivity measures do not predict relapse in pathological gamblers
Authors: De Wilde B. , Sabbe B. , Hulstijn W. , Dom G.
Published: May 2011

Background and objectives

Pathological gamblers (PG) are often compared to substance dependent patients. Analogous to research into relapse into chemical addictions, a longitudinal outcome design was created to evaluate the impact of impulsivity measures on one-year relapse of pathological gamblers.

Methods

Twenty-two PG without comorbid substance use disorders and 31 healthy controls (HC) were compared on measures of impulsivity (Baratt Impulsiveness Scale, Delay Discounting Task, Iowa Gambling Task, Sensitivity to Punishment and Sensitivity to Reward Questionnaires, Stroop Color Word Task). The associations between these impulsivity measures and one-year relapse of pathological gambling were examined.

Results

PG_Abstainers (N = 9) had a later age of onset and gambled for a shorter period than PG_Non-abstainers (N = 13). The PG groups did not differ in impulsivity measures. Healthy controls and PG differed on the Barratt Impulsiveness Scale and the Stroop Color Word Task, but not on the other impulsivity measures.

Discussion

The present data show that PG are not always impulsive and that gambling histories, rather than impulsivity measures, predict one-year relapse.
The black box of the therapeutic community for addiction clarified by means of mentalisation theory: A participant observation study
Authors: Debaere V. , Vanheule S.
Published: May 2011

Drug free Therapeutic Communities (TC’s) for addiction developed outside the medical and mental health care. Although these programs have proven to be effective, the why and how of the treatment process stays misunderstood. This ‘Black Box of the TC's’ threatens their continued existence and has led to a call for qualitative research.

To investigate the treatment process, the first author fully immersed herself in the Belgian TC ‘Trempoline’ for 3 weeks. The full participation strongly affected research possibilities: record equipment was taken away and the exigent day’s schedule left few moments to note.

Paradoxically, such frustrating experience proved to be an integral part of the treatment process. The data-set was analyzed with thematic analysis.

This resulted in a model consisting of 5 main themes which clarifies how the TC-program (themes 2 and 4) influences its residents (themes 1, 3, 5) (see figure 1).

The frustrating but at the same time holding environment reactivates the residents’ drowned emotional life. By applying symbolization-tools they learn to deal with the increasing tension in a mentalised way instead of acting out their discontent.

We conclude that a TC tackles the disruptive affect-regulation in people suffering from addiction by triggering and developing their mentalisation process.
Comorbidity of substance use disorder and schizophrenia and mood disorders
Authors: Delafariban M.
Published: May 2011

Individuals with a severe mental illness and substance use disorders tend to have medical and social problems and those who have either disorder alone. Nevertheless, little attention has been paid to the discovery of effective methods of modifying substance use in the mentally ill.

The purpose of this study was to examine the prevalence of substance use in schizophrenia and mood disorders.

Methods & materials

In a cross-sectional descriptive study, patients meeting DSM-IV criteria for schizophrenia(n = 30) and mood disorder (n = 30) randomly selected in two psychiatric hospital in Shiraz, Iran, and a control group (30) randomly selected in normal population without history of psychiatric disorders; completed questionnaire for substance use.

Results

Results showed %40 of patients with schizophrenia, %36.6 of subjects with mood disorders and % 36.6 of control group had substance use disorder.

Conclusion

These data suggest that schizophrenia and mood disorders can lead to substance use disorders. Also, in our study high rate of substance use in control group is an alarm. Since substance is caused by and can cause psychiatric disorders and substance use can effect various aspects of social life.
Alcohol misuse in a population of suicide attempters
Authors: Delavenne H. , Got B. , Garcia F.D. , Baguet A. , Thibaut F.
Published: May 2011

Introduction

Alcohol misuse could be a treatable risk factor for suicidal behaviour, which is seldom approached in the emergency room.

Objective

This study aimed to evaluate the impact of alcohol misuse in an interventional follow up program of patients immediately after a suicidal attempt.

Methods

Transversal study based on a post hoc analyse of a controlled randomized study done. Epidemiological data and the impact of alcohol misuse were evaluated in relation to suicidal relapse, in compliance for the treatment and in the evolution of Beck’s scores of depression. The study took place in the Rouen University Hospital and lasted for 2 years.

Results

A total of 228 patients, 50 (22.2%) men and 173 (78.8%) women were included. The group with alcohol misuse was composed of 31 (13.9%) patients, and the group without alcohol misuse was composed of 192 (86.9%) patients. The group with alcohol misuse had a lower employment level (n = 16, 51.6%) versus (n = 54, 28.1%) p = 0.009 and was older (mean age 41+/−12 years) than the group without alcohol misuse (mean age 31+/−13 years), p = 0.05. The group with alcohol misuse was composed of 15 (48.4%) of men, compared to 35 (18.2%) of men in the group without alcohol misuse, p = 0.0005. No statistical differences were found for evolution of the depression’s score obtained with the Beck’s scale, nor for the compliance, nor for the suicidal relapse.

Conclusion

Our conclusions are limited by age and sex difference among alcoholic and non alcoholic groups.
Mephenesin dependence: A case series
Authors: Djezzar S. , Vorspan F. , Chataigner D. , Burin E. , Garnier R. , Lépine J.-P.
Published: May 2011

Introduction

Mephenesin is a central muscle relaxant, acting through a depression of the activity of some neurones in the caudate nucleus. It was proposed as a potential treatment of alcohol withdrawal syndrome in the 50s. This over the counter medicine is now mainly prescribed to treat spasticity or as an adjunctive treatment of painful muscle spasm. We know little about this substance except that side effects are venous thrombosis, haemolysis or cutaneous intolerance. Yet, no case of abuse or dependence has been reported.

Aims

To report a series of 5 clinical cases in patients who developed abuse or dependence to mephenesin.

Methods

We performed a systematic search in data bases of both Paris addictovigilance and poison centres from 1999 to 2010. Clinical details were obtained from clinicians when possible. A literature search was also performed to describe mephenesin mechanisms of actions that could be implied.

Results

Three (3) women et 2 men aged 35 to 52 years (m : 43.6) were identified as abusing mephenesin, among which 4 patients had a full DSM IV criteria of dependence. All had a previous history of abuse or substance dependence (alcohol, heroin, codeine, ketamine…).The average mephenesin daily intake was 13 g (9 to 24 g) when the maximum recommended dosage is 3 gr/d. In one case, a withdrawal syndrome was observed (tremor, aggressiveness).

Conclusion

Mephenesin may be abused by patients with previous risk factors, especially a personal history of alcohol dependence.
Spice plants induced psychosis-case presentation
Authors: Nagy H. , Buftea L. , Domokos L. , Mihai A.
Published: May 2011

Spice shops, selling ethnobotanical plants like Salvia divinorum, Mitragina speciosa, Amanita muscaria and others, have become very numerous in Romania, first of all because they are legal, second of all because more and more young people are tempted to experiment new sensations. These plants can cause different psychiatric illnesses and associating theme with alcohol or drugs can also be fatal.

Our objective was to present the case of a 25 year old male patient consulted at emergency service, and admitted in our department, presenting psychomotor agitation, anxiety and the specific elements of a psychotic episode, delusions and hallucinations, after smoking a cigarette with sage and night-shade.

The symptomatology remitted rapidly, after approximately 12 hours, revealing the complications of psychoactive substance use.

Conclusions

This case shows the importance of knowledge of psychiatrists concerning the psychoactive substances of ethnobotanical plants, because of their legality and easy procuration possibility. We consider that the role of psychiatrists in mediatizing the side effects of these plants is very important.
Recovery of cortical functioning in abstinent alcohol dependent patients? Prefrontal brain oxygenation during verbal fluency at different phases during withdrawal
Authors: Dresler T. , Schecklmann M. , Ernst L.H. , Pohla C. , Warrings B. , Fischer M. , Polak T. , Fallgatter A.J.
Published: May 2011

Introduction/objectives

Neurotoxic effects of alcohol consumption are well-known. There is plenty of literature on frontal lobe impairment on the behavioral and structural brain imaging level. However, only few functional imaging studies investigated altered neural patterns and even less abstinence-related neural recovery. Here, we investigated if frontal lobe activity tends to normalize in patients that remain successfully abstinent.

Methods

In a cross-sectional design three patient groups (acute withdrawal, detoxified, abstinent) and healthy controls (each n = 20) performed a phonological and semantical verbal fluency task (VFT) while brain activity was measured with near-infrared spectroscopy (NIRS).

Results

First, for the phonological condition patients in the acute withdrawal phase and also detoxified patients showed less fluency-related frontal lobe activation compared to controls despite equal performance. Second, significant linear trend effects from withdrawal patients over detoxified and abstinent patients up to healthy controls indicated more normal activation patterns in the abstinent group that did not differ from the controls. In the detoxified group brain activation increased with time since detoxification.

Conclusions

Our results support the assumption of an increase in frontal brain activity from alcohol dependency over abstinence up to normal functioning. Longitudinal studies are needed to further elucidate recovery processes in alcohol dependency.
Drug-abusing offenders with co-morbid mental disorders:gender differences in problem severity, treatment participation, and recidivism
Authors: Du J. , Zhao M. , Hser Y.-I.
Published: May 2011

Introduction

Individuals with co-occurring disorders have higher levels of psychological distress and poorer psychosocial functioning, as compared with individuals with substance dependence only. Studies identified substance abuse as a risk factor, which increases the likelihood that an individual with mental disorders may become violent.

Objectives

To examine the gender differences in drug-related problems and predictors of recidivism among a sample of 1,444 offenders with co-morbid drug abuse and mental disorders participating in California's Proposition 36.

Methods

Characteristics and problem severity in multiple key life areas were assessed at intake using Addiction Severity Index, and drug treatment participation, mental health diagnoses and arrests were based on official records.

Results

Women demonstrated greater problem severity than men in family relationships, health, psychological health, and sexual and physical abuse history. Men on the other hand had greater criminal history, high rates of attention disorder, and psychotic disorder. Logistic regression analyses showing that for the combined sample, male, young age, cocaine use (relative to methamphetamine), drug abuse severity, methadone treatment, arrest history and fewer prior treatment history were associated with higher recidivism at 12-month follow-up; lower education, cocaine use, and arrest history were related to women's recidivism, while young age, outpatient treatment, and arrest history were predictors of men's recidivism.

Conclusions

Although the specific type of mental disorder did not seem to be predictive of recidivism, the high rates of mental health disorder and arrest of this population is problematic. Intervention strategies taking into consideration gender-specific problems and needs can improve outcomes for both.
Education in drug addicts (Yasouj-Iran): A cross-sectional study
Authors: Fararouei M. , Shirazi K.K. , Abasi A. , Estakhrian Haghighi R.
Published: May 2011

Introduction

Drug addiction is one of the most common social disorders in Iran. It is estimated that about 2 million Iranian are addicted and the number is rising.

Aims

This study is done to investigate the educational history and its related issues of addicted participants.

Methods

Participants are a convenience sample of 71 drug addicted males who came to one of the 17 addiction treatment centers in Yasouj- Iran. Data were collected via a self administered questionnaire.

Results

Patients were all male, age from 19 to 50 years old. Only 1.4% (one patient) was illiterate, and 10.1% had university degrees. 59.9% did not started (1.4%) or finished (58.5%) their national compulsory educational program. Addiction was reported as the main reason for withdrawing from school (19.6%). More than 73% of the participants had educational difficulties (e.g. failed subject) and 74% used to be aggressive during their study period. More than 46% were under 18 years old (33.3% under 16) when they used drugs for the first time. School was the place of the first use of drug for 6.1% of the participants.

Discussion

Educational issues seem to be a common problem for the drug addicted participants. This is due to either addiction itself or educational problems can be considered as indicators for later attempt for using drugs or more precisely addiction. It would be reasonable to do further work to find out more specific educational difficulties which can predict later risk for addiction.
Playing violent games, internet café visits and degree of daily schedule disruption predict internet addiction in a sample of greek young internet café users
Authors: Frangos C.C. , Fragkos K.C. , Piperopoulou A.N.
Published: May 2011

Aim

To estimate the percentage and risk factors of Internet addiction (IA) at Greek Internet cafés.

Methods

We used a questionnaire including questions on demographics, Internet use duration, Internet applications and sites visited, degree of Internet use influence on daily schedule and social relations, psychosocial characteristics of users and Young's IA Test (48 items overall). Our randomly selected sample included Internet café users in Athens and other big Greek cities. The sample size was 686 people (74%/26% M/F) and 12%, 70% and 18% were between 7–14, 15–25 and 26–45 years old respectively.

Results

Cronbach's alpha ranged from 0.79 to 0.90 for all 6 sections of our questionnaire. The prevalence of IA among Internet café visitors was 20.8% (16.0% men, 4.8% women). IA was significantly associated to Internet use duration per day, Internet Café visits number per week, number of hours playing at Internet cafés per visit, duration playing violent games (e.g. Counter-Strike, Quake, Assassin), duration visiting Facebook and MySpace, and degree of Internet use influence on daily schedule, social relations and psychological attitudes (p < 0.01). Binary logistic regression showed that significant predictive factors of IA were the length of time playing violent games [ORCounter-Strike = 23.6 (95% CI 1.2 − 40.1); ORAssassin = 10.9 (95% CI 1.5 − 43.2)], visiting Facebook [OR = 41.9 (95% CI 19.7 − 87.5)], and deterioration of social relations (p = 0.009).

Conclusion

IA is frequent in Internet cafés, possibly due to an online gaming addiction affecting multiple aspects of a person's life.
Psychologic predictors and epidemiology of internet addiction among university students in greece
Authors: Frangos C.C. , Fragkos K.C.
Published: May 2011

Aim

To present the epidemiology and psychological predictors of Internet Addiction (IA) among Greek University students.

Methods

This random sample consisted of 3545 students, drawn from 24 higher education institutions (1618/1927 M/F, mean age 20.12 ± 2.4 years). The survey was conducted in the 4 Greek cities: Athens, Preveza, Thessaloniki and Amfissa.

Results

The prevalence rates of IA according to Young's Test in the four cities were: Athens (17.5%), Preveza (15.9%), Thessaloniki (19.3%), Amfissa (16.3%). There was a statistically significant association between location and IA (χ2 = 28.251, df = 3, p < 0.001), gender and IA for males and females (p < 0.001). We performed a t-test with the dependent variable S = sum of scores in the psychological features of loneliness, feeling abandoned, disappointed, aimless in life, and with low self-esteem; the grouping variable was IA. Results showed that the variable S was much lower for the non-addicted than for addicted students (t = 19.329, p < 0.005, df = 3085). Binary logistic regression was performed to assess the impact of psychological characteristics on the likelihood that respondents would be Internet Addicted. The model was statistically significant χ2(10, N = 3085) = 316.3, p < 0.001. The model classified correctly 85.1% of the cases. The strongest predictors of IA were the following: Loneliness (OR = 2.15, 95% CI = 1.67-2.71), feeling abandoned (OR = 1.63, 95% CI = 1.2-2.1), low self-esteem (OR = 1.72, 95% CI = 1.4-2.1) and fear of losing their job (OR = 1.36, 95% CI = 1.01-1.7).

Conclusion

Loneliness, helplessness, low self-esteem and fear of unemployment are the strongest predictors of IA among Greek university students.
Physical health monitoring among an injecting drug using population
Authors: George M. , Gupta R. , Parashar N.R. , Ravi P.
Published: May 2011

Introduction

Injecting drug users experience higher rates of death and poorer health than their non-injecting peers.

Accurate assessment of drug users physical health needs forms an essential precursor to treatment.

Aims

To determine the completeness of documentation and accuracy of medical evaluation for a sample of injecting drug users.

To establish the detection rate of medical co morbidity in injecting drug using patients.

Methods

20 injecting drug users were randomly selected from the computer database The case notes of each of these patients were then checked for any physical health documentation and the quality of the documentation.

The medical databases of the acute hospital were then checked to identify if these patients have presented there and the medical conditions with which they have presented.

The patients were then asked during their outpatient appointment about their physical health condition and the last time they have been checked by the GP.

Results

80% of the patients had some health related information’s documented in the notes. However when these were compared with the history from the patients during the follow up OP appointments and medical notes, only 20% of the notes had good quality health documentation. 60% was found to meet standards.

50% of the patients had an acute hospital presentation with drug related complication. Of these 20% was in the previous 1 year. In terms of GP contact, 25% had seen the GP within the last 6 months and another 40% within the previous 1 year
Treasure paranoia and met - Amphetamine abuse
Authors: Ghaffarinejad A.
Published: May 2011

Using met

Amphetamine is going to be speared among young people in recent decade in our region.

Cases of met

Amphetamine induced psychosis are frequently admitted in our psychiatric hospital in Kerman city (Located in south - east of Iran). Hallucinations and paranoid delusions are well - known symptoms of met - psychosis.

In this report we presented a 35 years old man with history of regular usage of drug in the past one year. He had persecutory delusions.

His paranoid symptoms were interesting from a point of view. He bought a second - hand car, one year prior to his illness’ and at the same time, he started using met - amphetamines, gradually he found small pieces of gold and diamonds in the car. He could find them anywhere in the car, so he had searched the car completely several times during nights. He collected a small box filled with severed small stones, glasses and other garbage and called them treasure, and claimed former owners of the car were following him and want to recapture the car, take the treasure and harm him. Paranoid symptoms are common in met - abuse but this type could be considered as a variant In this type patient had painful sensation of paranoid delusion, and in the same time he enjoied the feeling of being reach.
Medication use in a dual pathology program: Observational study
Authors: Grau L. , Daigre C. , Miquel L. , Barral C. , Gonzalvo B. , Fuste G. , Esteve O. , Rodriguez-Cintas L. , Martinez N. , Roncero C.
Published: May 2011

Introduction

Polyfarmacy is frequent in patients with dual diagnosis.

Aims

To quantify the number and describe the treatments prescribed in a cohort of outpatients with dual diagnosis.

Material and methods

A descriptive and transversal study was performed. Patients with dual diagnosis treated at an Outpatient Drug Treatment Center from January 2005 to December 2009 were included. Data from demographic, clinical and therapeutical variables were gathered once. The instruments used for the diagnosis were EuropASI y SCID-I. The number and type of prescript drugs were related with protocol variables.

Results

The study sample included 80 patients (71,6% men, average age 37,2 ± 9). Psychotic disorders (46.8%) and cocaine dependence/abuse (34.6%) were the most frequent comorbid psychiatric illnesses found. 40.8% of patients were polydrug users. The mean of prescript drugs was 3,06 ± 1,4 and only 14% of patients were on monotherapy. The frequency of drugs prescribed was: 68,4% antidepressant, 63,3% antipsychotic, 55,7% antiepileptic and 36,7% anxiolytic drugs. Older patients ( > 45years) took a major number of prescripted drugs (3,88 ± 1,1). Patients with psychotic disorders took the 43.9% of drugs prescripted (p = 0,042). Patients with benzodiazepine abuse took higher number of prescription drugs (5 ± 1,4;p = 0,003) compared with patients with other dependence or abuse.

Conclusions

Patients with dual diagnosis take high quantity of drugs. Older patients, diagnosis of psychosis and benzodiacepine abuse were related with polydrug prescription. Quantification of medication is recommended for treatment optimisation and avoiding yatrogenic.
P01-44-The e-mail as a potential therapeutic tool in patients with alcohol dependence: The patient's perspective
Authors: Ortega L. , Robles N. , Matrai S. , Gual A.
Published: May 2011

Introduction

The use of Internet-based communication tools has spread to multiple areas of life. E-mail is a fast and easy tool that can be used by the health care system to facilitate doctor-patient communication.

Objectives

To assess the use and value of the e-mail for communication between physician and patient, from patients’ perspective.

Aims

To evaluate the use of e-mail as a potential therapeutic tool in patients with alcohol dependence.

Methods

The sample included patients who reported to have an e-mail account at their first visit in Alcohol Unit (n = 44 of 238 patients seen during one year). 23 patients were given the contact e-mail of the Alcohol Unit, and were instructed to contact their physician, if needed, by e-mail. The rest of the sample (n = 21) could contact their physician only by phone. Six months later, the whole sample received an electronic survey measuring their satisfaction of the communication with the physician.

Results

57% patients who received the contact e-mail of the Alcohol Unit answered the survey (n = 13). Of those, 54% used e-mail to contact their physician. 71% found e-mail easy-to-use; 86% reported being satisfied with e-mail communication.

Conclusions

E-mail contact with physician was considered useful by most patients, although they report using also other contact methods, such as phone call.
Tobacco control strategies in psychiatric services in catalonia (Spain)
Authors: Ballbè M. , Nieva G. , Mondon S. , Pinet C. , Bruguera E. , Saltó E. , Fernández E. , Gual A. ,   Smoking and Mental Health Group
Published: May 2011

Introduction

Mortality and morbidity due to smoking in people with mental illnesses are higher than in the general population. However, smoking continues to be allowed in psychiatric premises of many countries despite being prohibited in workplaces including health care services.

Objective

To describe tobacco control strategies undertaken in psychiatric inpatient services and day centers in Catalonia.

Aims

To study tobacco control strategies in psychiatric services in order to identify unmet needs.

Methods

A cross-sectional study including all psychiatric services offering public service in Catalonia (n = 192). The managers answered an on-line questionnaire with 24 items grouped in four dimensions: staff's training & commitment, clinical intervention, management of smoking areas, and communication of smoke-free policies.

Results

186 of the managers (96.9%) responded to the questionnaire. Results showed low levels of implementation of tobacco control strategies, especially in the training and intervention dimensions. 41.0% of the services usually intervened in their patients’ tobacco use but an overall 65.9% didn’t have pharmacotherapy for smoking cessation available. 47.3% of the managers stated that their staff had not enough knowledge on smoking cessation interventions. 38.9% of the services had smoking indoor areas. Day Centers showed the lowest implementation of tobacco control measures while services belonging to the Network of Smoke-free Hospitals showed the highest implementation.

Conclusions

Current Spanish partial law has failed to promote a desirable tobacco control in psychiatric services. There is a need to extend tobacco control policies, specifically in terms of smoking intervention and training, together with a higher availability of resources.
Chronic cannabis use in morocco
Authors: Hami H. , Azzaoui F.-Z. , Mokhtari A. , Soulaymani A. , Skalli S. , Soulaymani R.
Published: May 2011

Introduction

In Morocco, as in other countries, the cannabis consumption by a great number of the population remains worrisome, in terms of its effects on “mental and physical” health and its social repercussions.

Objectives and aims

To determine the profile of the people poisoned by cannabis in Morocco in order to identify individuals and groups at high risk.

Methods

A retrospective study was conducted on chronic cannabis poisoning cases notified between 2000 and 2008 in the Morocco Poison Control Center.

Results

During the study period, three hundred and one regular users of cannabis (28 women and 273 men) were poisoned, constituting 34 cases on average per year. The clinical symptoms presented by victims are different, depending on the quantity of inhaled and absorbed psychoactive substances (especially THC) and the frequency and method of use. The average age of victims is 22 years. Among the 225 patients for whom the evolution is known, a 23-year-old man died. The rest of the patients’ condition has improved under gut decontamination.

Conclusions

The influence of consumption of the increasingly high doses of cannabis on the quality of life of young people justifies a public information, particularly young people for better prevention of using of this psychoactive product.
Medical assisted treatment of opioid dependence with suboxone method as prevention of social excluding young people
Authors: Hasanović M. , Pajević I. , Kuldija A. , Delić A. , Sutović A.
Published: May 2011

Introduction

The most modern medically assisted method of substitution treatment of opiate dependants with Buprenorphine+Naloxone (Suboxone) has been implemented in Department of Psychiatry in Tuzla from 27 July 2009. Suboxone offers possibility for achievement of prompt and effective results of detoxification and weaning of opiates in outpatient treatment. Treated opiate dependants become “clear minded”, qualified for the all professional and social activities, what improves significantly quality of family and social relationship. With this, the treatment in the institutions can be avoided, therefore it prevents social excluding of treated individuals.

Aim

To present medical assisted treatment of opiate dependence with substitution medicament Suboxone in Bosnia and Herzegovina, with which we may prevent social excluding of young opiate dependants.

Methodology

With presentation of clinical vignettes, authors described how opiate dependants with social hazardous behavior avoided social excluding after they were included in the Suboxone maintenance treatment program.

Results

All exemplars described with clinical vignettes showed that opiate dependants previously had open doubts in efficacy of this particular treatment, and after only three days they surprised with positive effects of Suboxone. Also they are very satisfied with life quality during treatment. Family members of dependant person show satisfaction with achieved efficacy of Suboxone.

Conclusion

Medically assisted treatment of opiate dependence with Suboxone is implementing outpatient with involvement of close family members who are not drug dependant, it brings back “clear mind” to treated addicts, it does not stigmatize but it re-socialize and in that way it preventing social excluding of young opiate dependants.
Social, cultural and historical aspects of prevention of alcoholism in northeast bosnia and herzegovina
Authors: Hasanović M. , Pajević I.
Published: May 2011

Introduction

Although the harmful effects of alcohol have long been observed, organized social measures for the prevention of excessive consumption of alcoholic beverages were taken relatively late.

Aim

To present an historical overview of development of social, cultural aspects of alcoholism prevention in northeast Bosnia.

Methodology

The authors provide a historical overview of societal and professional institutions that fight against alcoholism in the area of northeast Bosnia and Herzegovina (BH) following the definition of the World Health Organization, that alcoholism is illness and alcoholic is a patient.

Results

Teetotaler societies in BH began with the establishment and work at the late 19th and early twentieth century. Through the period before World War II, between the two world wars, the national liberation struggle period from 1941 to 1945, and the post-war socialist enthusiasm to the last war from 1992 to 1995 there were different levels of organizing struggle against alcoholism with different impact on the development of mental health protection of alcoholics and their families. During the 1992–95 war, due to high trauma of veteran and civilian population, a number of posttraumatic effects appeared, which lead to people seeking release in self-medication by alcohol abuse, worsening the issues of alcoholism and its aftermaths.

Conclusion

After the tragic war 1992–95, many of the socio-political relations and the issue of functional organization of health is redefined, this resulted in search for new formulas of successful dealing with very serious drinking problem in the postwar situation in the region of Tuzla Canton (northeast Bosnia).
Silence in the family about the abuse of heroin and its effect on the initiation of treatment
Authors: Hasanović M. , Kuldija A. , Pajević I. , Delić A. , Sutović A. , Kravić N.
Published: May 2011

Introduction

Adolescents often experience their addictive experiences hidden from parents. Treatment begins when problems arise that adolescents cannt solve it alone.

Aim

To asses correlation between duration of silence about heroin addiction experience and certain epidemiological data collected with the Pompidou form.

Methods

The authors analyzed the group of 77 heroin addicts aged 26.4 ± 5.6 years, who were treated at the Department of Psychiatry Tuzla in the period 2006–2009 year. Pompidou standardized form was used for collecting the necessary data.

Results

We found that the heroin addicts began to take the first drug of 17.2 ± 3.9 years, parents were informed about it 2.8 ± 1.3 years later. The duration of silence was positively associated with age of addicts (ρ = 0515, P > 0.001), length of addictive experience (ρ = 0463, P < 0.001), parent's divorce (ρ = 0432, P < 0.001), previous conflict with law (ρ = 0255, P = 0.028), powerty in the family (ρ = 0236, P = 0.045) and previous treatment (ρ = 0354, P = 0.002). On the other hand, it was negatively associated with living in community with other addicts (ρ = -0 363, P = 0.001), intravenous heroin use (ρ = -0 345, P = 0.003), detected hepatitis B (ρ = -0 262, P = 0.002), owning their own children (ρ = -0.280, P = 0.016) and with years of completed education of father (ρ = -0 245, P = 0.008) and of mother (ρ = -0 246, P = 0.036).

Conclusion

Silence about heroin addiction was positively associated with age of addicts, duration of addiction, parent's divorce, with trouble with law, with poverty in family, and previous treatment. Silence is negatively associated with living with other addicts, intravenous use, hepatitis B, owning children, and more years of parent's completed education.
P01-50-Kratom and alcohol dependence: Clinical symptoms, withdrawal treatment and pharmacological mechanisms- A case report
Authors: Havemann-Reinecke U.
Published: May 2011

Aim

1.

To present selfmedication of alcohol dependence related withdrawal symptoms with the plant powder kratom of Mitragynosa speciosa and treatment of kratom withdrawal symptoms.

2.

Pharmocological mechanisms of kratom.

1.

A alcohol and kratom dependent patient used kratom (15 g/d) to limit alcohol dependence related withdrawal symptoms and was admitted for withdrawal treatment. Kratom and urine was analysed by GCMS, withdrawal symptoms by Opioid Withdrawal Scale (OWS), sleep by Pittsburgh sleep quality index (PSQI), mood by MADRS. Medical treatment was done with doxepine with one additional diazepam dos.

2.

3H-DAMGO radioligand binding assay of kratom, mitragynine and paynantheine with morphine transfected HEK 293 cells.

Results

GCMS-urine screening on day 1: mitragynine, paynantheine, on day 3: monochlorbenzodiazepine, doxepine. The patient benefits regarding sleep quality and quantity (PSQI day 6 (12), day 20 (6) and mental symptoms (MADRS on day 6 (18) and on day 20 (5). The OWS Score shifts from 17 (day 1) to 2 (day 14). The blood pressure and heart rate decrease from 150/90 and 100/bpm (day 2) to 100/70 and 64/bpm (day 14). The GCMS analysis of kratom showed five indolalcaloids: mitragynine, 7-hydroxymitragynine, paynantheine, speciogynine, speciofoline, and unspecific plant contents. The 3H-DAMGO-radioligand-bindungsassay of kratom-powder showed 350-fold less affinity to μ-opiatereceptor than morphine.

Conclusion

The patient's selfmedication with kratom prevented alcohol withdrawal symptoms most probably by action on μ-opioidreceptors. 15 g of kratom seems to be equivalent to 45 mg of morphine. Withdrawl treatment with doxepine (and diazepam) clearly prevented withdrawal symptoms of dependence of kratom and alcohol.
P01-51-Impulsivity and decision making measured in cocaine addicts in France
Authors: He X. , Bloch V. , Brousse G. , Vorspan F. , Lépine J.-P.
Published: May 2011

Introduction

Impulsivity and decision making are impaired in cocaine addicts. However, most studies were performed in the USA.

Objectives

To assess impulsivity and decision making in a sample of French cocaine addicts.

Methods

Subjects

40 current cocaine addicts and 21 control subjects with no history of drug abuse were compared using the Barratt Impulsiveness Scale (BIS) and Iowa Gambling Task (IGT). Subjects from the cocaine addicted group were evaluated for cocaine craving with the Obessive Compulsive Cocaine Scale (OCCS), and for their pattern of use. Statistical analysis: The mean scores of impulsivity and decision making were compared in the two groups (Mann-Whitney U test). In the group of 40 cocaine addicts, clinical factors that could be associated with high impulsivity and poor decision making scores were tested (Spearman’ s rho, Chi-square and Mann-Whitney U tests).

Result

Compared to controls, cocaine addicts had a higher impulsivity score (BIS: 72 ± 11 vs 57 ± 8, U = 138, p < .001) and had more disadvantageous choices on the decision making test (IGT) (advantageous minus disadvantageous choices -4 ± 19 vs 24 ± 35, U = 234, p = .005). There was a significant correlation between high impulsivity scores on the BIS and high cocaine craving as well as heavy cocaine use (more than 4 times a week). No correlation was found between poor decision making and high craving or frequent cocaine use.

Discussion

The discrepancy between impulsivity and poor decision making in cocaine addicts is discussed.
The effect of right-sided prefrontal HF-rTMS on alcohol craving: Preliminary results
Authors: Herremans S. , Vanderbruggen N. , Zeeuws D. , Santermans L. , Baeken C.
Published: May 2011

Introduction

Repetitive transcranial magnetic stimulation (rTMS) affects neuronal circuits and neurotransmitter systems in the brain. Recent data suggest that this application could diminish ‘craving’ in patients with alcohol dependence.

Objectives and aims

Given these preliminary data, we examined whether one high frequency (HF)- rTMS session over the right dorsolateral prefrontal cortex (DLPFC) would reduce alcohol craving in alcohol dependent patients in their natural habitat.

Methods

After detoxification during hospitalization, 22 current alcohol dependent inpatients were included (8 female, 14 male; age = 49.95 ± 8.82y).

We used a sham-controlled between-subjects design where after randomization patients received under MRI guidance one right-sided DLPFC active HF-rTMS session or sham. In each high-frequency (20 Hz) stimulation session, patients received 1560 pulses at 110 % MT. The obsessive-compulsive drinking scale (OCDS) was collected at baseline, just before and just after the stimulation session on Friday after detoxification and on the three consecutive days following stimulation in patient's natural habitat.

Results

Although the OCDS total score significantly decreased after the detoxification period, one sham-controlled stimulation session did not affect immediate craving measurements. Furthermore, no significant group differences were observed on OCDS total scores when patients were in their natural habitat.

Conclusions

Although the right DLPFC was targeted under MRI guidance, our preliminary results indicate that one sham-controlled HF-rTMS session does not affect craving in recently detoxified alcohol dependent patients. Besides the limited number of patients it could be possible that only one stimulation session could be insufficient to have a subjective effect on craving.
The role of personality traits and religious orientation and tendency to addiction: Comparison between addicted and nonaddicted people
Authors: Homayouni A.
Published: May 2011

Introduction & objectives

Since the introduction of DSM-III Third Edition in 1980,there has been a growing interest in the study of patients with substance use disorders (SUD). The driving force behind this field has been, and still is, the high clinical pessimism about the prognosis, and the difficulties in the clinical management of the characteristics of diagnosed patients. Also religion and to be religious can play an important role in human’s individual and social life. The religion can be entered in many aspects of human behavior and can affect on their behavior and reduce probably of abnormal functions. So the study was aimed to investigate personality traits and religious orientation in two groups of addicted and nonaddicted people.

Methods

109 addicted people were randomly selected and compared with 109 nonaddicted people. Participants were asked to fill out Revised NEO Personality Inventory (NEO-FFM PI-R) and self-report questionnaire of Alport's E/I religious orientation. Mean scores were compared with T independent tests.

Results

Analysis of means indicated significant differences among tow group. Compared to nonaddicted, addicted scored higher on Neuroticism, Openness to experience and External religious orientation, and lower on Extroversion, Agreeableness and Conscientiousness.

Conclusions

Based on results it is suggested that evaluating with reliable measures and with more attentions to intrinsic religious orientation related to personality traits can help the psychiatrists and psychologists to diagnose the cause of tendency to addiction and also reduce the psychological problems that is related with addiction before and in during drug treatment and can reduce duration of treatment and enhance efficacy of treatment methods.
The management of relapse in an outpatient program for heroin user by administration of naltrexone
Authors: Iliopoulou L. , Koutras V. , Komninou K. , Fidi E. , Gonta S. , Basogianni V.
Published: May 2011

Introduction

The Counseling Center for Combating Drug Abuse offers an outpatient drug psychotherapeutic program, on an individual basis. Naltrexone is prescribed to selected heroin addicted users as part of this program.

Objectives

Relapse is one of the most challenging problems.

Aims

Detection of factors which engage in the therapeutic process and hinder successful therapy leads to a better design of the therapeutic plan.

Methods

Administration of naltrexone aims at retention in therapy and avoidance of relapse. The program's design focuses on the right selection of users, and the therapist's suitability. Family or people in the user's environment engage actively in the observation of ingestion. Naltrexone administration continues for several months after stabilization and at least until user changes his attitude towards drug use. Relapse is considered as a stage of the withdrawal procedure. Manipulation focuses on user's rehabilitation in therapy. Therapist, user and family concentrate on factors which fostered relapse (parallel drug use, association with active users, co-morbidity, personal and family difficulties), and set new goals.

Results

Development of a therapeutic alliance between therapist and addicted patient is one of the stronger predictors of treatment retention and success. Effective manipulation of the factors which foster relapse may lead to successful therapy.

Conclusions

Relapse must be seen not as a failure, but as a demanding stage of the procedure. Goal readjustment, and focusing on previously unresolved problems, may lead to an ultimate successful therapeutic outcome, and develop trust in naltrexone programs which are considered as particularly effective in open withdrawal programs.
Relationship between impulsiveness and depressive symptoms in alcohol-dependent patients
Authors: Jakubczyk A. , Brower K. , Klimkiewicz A. , Serafin P. , Nowosad I. , Wnorowska A. , Sławińska A. , Sadowska J. , Wojnar M.
Published: May 2011

Introduction

Impulsiveness is considered to be an important symptom of many psychiatric disorders and is often treated as one of the diagnostic criteria. Relationship between impulsivity and severity of depressive symptoms in alcohol-dependent individuals hasn’t been investigated yet, although both are considered to be important risk factors of relapse.

Objectives

The aim of this study was to analyze relationships between depressive symptoms and level of behavioral as well as cognitive impulsiveness among alcohol-dependent patients.

Methods

By means of Barratt's Impulsiveness Scale and stop-signal task the level of impulsivity among 304 alcohol-dependent patients was measured. Stop-signal task was used as an independent, manipulation-free method of estimating the level of behavioral impulsiveness, and the Barratt's Impulsiveness Scale - as a self report measure of global as well as cognitive impulsivity. Patients were asked to fill in a questionnaire to asses depressive symptoms (BDI, BHS).

Results

The statistical analysis revealed significant association between impulsiveness and severity of depressive symptoms. Individuals with higher scores in BDI scale were more impulsive in Barratt Impulsiveness Scale (r = 0,473; p < 0,0005), whereas patients with higher scores in BHS appeared to be more impulsive in both: stop-signal task (r = 0,21; p = 0,001) and BIS (r = 0,281; p < 0,0005). Depressive symptoms in both measures correlated most with indicators of attention impulsivity in BIS (r = 0,541; p < 0,0005 for BDI and r = 0,312; p < 0,0005 for BHS).

Conclusion

High level of impulsiveness may be treated as an element of depressive disorder in alcohol dependent patients.