Drug and alcohol addiction is a leading cause of raising health care cost and has adverse effect on peoples health, social and occupational functioning.

The purpose of this study was to investigate the prevalence of substance induced psychosis and mood disorders in adolescent population, and to determine what type of substance causing the presentation.

Child psychiatry consults in the emergency department at Royal Alexandra Hospital, Edmonton, Canada during October, November, and December, 2007.

Age was 12 to 17 years both sexes. Presenting complaints were either psychosis or mood symptoms. The diagnosis of substance induced disorder was made according to the DSM IV TR. Urine toxicology screen were obtained before discharge from Emergency department for cannabis, amphetamine, and cocaine. Blood test for ETOH was performed.

Total number of subjects was 27 patients. 70.37% presented with substance induced mood disorder, 29.62% with substance induced psychosis. For patients with psychosis (8, one was excluded, untested urine) 28.57% the urine test was positive for amphetamine, 42.85% marijuana, 14.28% cocaine, 14.28% negative test. For patients with mood disorder (19, 6 was excluded, untested urine) 76.92% urine was negative for substances, 15.30% blood was positive for ETOH, 7.69% urine was positive for cannabis.

In this preliminary data, a trend that substance induced mood disorder is more prevalent than substance induced psychosis. Substance is more to cause psychosis than mood disorder. Cannabis use is more than amphetamine and cocaine to produce psychosis. ETOH use is more than Cannabis to produce mood symptoms.

The incidence of substance use, abuse and dependence seem to be increasing (1). It is probable that underlying mental illness, may reinforce individual's continuing substance indulgence (2), and If not intervened early, the consequence of this not only affects individual health, but also poses the threat of them procreating future sufferers.

To detect mental illness at an early stage, in young adults with drug indulging behavior, and early intervention could be attempted.

A pilot project has been undertaken, for young adults (16-20 years) with concurrent disorder providing integrated intensive treatment program for six months. 12 patients were enrolled the study and 8 patients completed the study. A questionnaire has been devised to detect the probable existence of concurrent disorders. Assessment in all tridimensional spheres and intervened concurrently by the multidisciplinary team members. The outcome measures with the patients and the personnel were assessed by an independent assessor. The sensitivity and specificity of the devised questionnaire, has been measured.

There is significant correlation between underlying mental illness with drug indulgence and specific drug preference with type of mental illness have been elicited. The outcome measures along with the sensitivity and specificity of the questionnaire have been found significantly positive.

It seems that the integrated treatment program is quite effective although resource consuming.

Small sample and limited duration which needs further replication.

In Tunisia and in most Muslim countries, alcohol consumption has remained taboo. The aim of our study was to determine the prevalence of alcohol abuse and alcohol dependence in an adult primary care population and to compare gender prevalences and characteristics.

This is a cross-sectional prevalence survey conducted in the district of Sousse from June to November 2006. Thirty primary care centers have been randomly selected. The sample was composed of 2576 subjects aged 18 years and more. Participants were interviewed by psychiatrists and medical trainers using the Composite International Diagnostic Interview, which was translated into the Tunisian dialect and validated.

Females represented 78% of the whole sample. The lifetime prevalence rates of alcohol abuse and alcohol dependence were respectively 2,9% and 0,7%. The lifetime prevalences in the male subgroup were 12,9% for alcohol abuse and 3% for alcohol dependence. Only one case of alcohol abuse was found in the female subgroup.

The related alcohol disorders among the men of our study are as frequent as among occidental ones. The related alcohol disorders among women were unexpectedly very low. However, a similar result was reported in an other study conducted in the United Arabic Emirates. This gender alcohol use discrepancy, found in our study, led to two main interrogations. The first one concerning the usefulness of the alcohol disorder structured interviews among Arabic women and the second concerning the Arabic women beliefs about alcohol consumption (Is it a result of religious thoughts or a deny?).

Prolonged alcohol abuse as a chronic disease may increase inflammation and lead to hepatic disorders. Liver fibrosis results from chronic damage to the liver in conjunction with the accumulation of ECM proteins, which is characteristic of most types of chronic liver diseases. The main cause of liver fibrosis include alcohol abuse. The pathological features of hepatic cirrhosis induced by ethanol and other factors are similar. Monocyte chemotactic protein - 1 (MCP-1) is a protein related to inflammation and fibrosis.

The aim of this study was to assess of MCP-1in serum of alcohol dependent women.

Study group consisted of 40 inpatients treated in Inpatients Clinic in Toruń. Mean age of females in the study group was 43+/-7 yrs, duration of alcohol dependence 8+/-6 yrs. Control group consisted of 35 healthy women. Monocyte chemotactic protein - 1 (MCP-1) in the serum was determined by ELISA, serum AST and ALT on automatic analyzer.

Average serum AST was 32,88+/-32,95, ALT 29,76+/-24,48 (U/l). The concentration of MCP-1 was significantly higher in alcohol-dependent female group compared to healthy subjects (360,34ng/ml +/-273,95 vs 240,27ng/ml+/-178,31; p=0,030).

These results imply that prolonged alcohol abuse leads to increased concentrations of MCP-1 and may in consequence have impact on the pro-inflammatory state related to increased risk of liver fibrosis. Our results suggests that prolonged alcohol abuseas as chronic disease can be a factor of inflammation and lead to hepatic disorders.

The increasing attention given to dual diagnosis does not correlate with well defined and consensual therapeutic interventions. This issue is particularly evident in the case of comorbid severe personality disorders with clear indication for psychotherapy.

To report a case of comorbid borderline personality disorder and alcohol abuse disorder, underlining the impact of dysfunctional personality traits in a specific dangerous pattern of alcohol abuse. To present and discuss a combined psychotherapeutic and pharmocotherapeutic approaches in a dual diagnosis case.

Case study and review of the literature.

A 37 year old woman with a history of alcohol abuse and self-destructive behaviour was referred to an alcohol treatment unit. She had a personal history of childhood parental sexual abuse, alcohol abuse since adolescence and a high risk self-destructive behaviour. A brief psychotherapeutic intervention (weekly 4 months sessions) was started, along with treatment as usual (psychiatric consultation and psychopharmacological treatment). The psychotherapeutic intervention (Person-Centered therapy) focused on her relational difficulties, corresponding to her request - “dealing with unresolved issues in my life”. After the psychotherapeutic intervention, she was able to stop the episodes of alcohol abuse and to reorganize her life at several levels.

Choosing a psychotherapeutic and pharmacological approach for comorbid addiction disorder and personality disorder cases, presents difficulties due to lack of empirical evidence on dual diagnosis treatment. This case of combined psychotherapeutic and pharmacotherapeutic interventions had acknowledged success, in contrast to several prior treatment attempts focused mainly on the alcohol use disorder.

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.

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.

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

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).

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.

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.

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).

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.

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.

Aim of this randomised, parallel, placebo-controlled group trial was to compare oxcarbazepina and topiramate with placebo on alcohol drinking indices. Craving and psychiatric simptomatology have also been investigated.

This randomised, parallel, placebo-controlled psychopharmacology trial studied 60 patients, consecutively recruited, meeting clinical criteria for Alcohol Dependence (DSM-IV). After detoxification, subjects were assigned to flexible doses of oxcarbazepine (n=20), or topiramate (n=20) or placebo (n=20). Withdrawal symptomatology was determined by the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) and 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 symptoms were evaluated with the Symptom Check List 90 Revised (SCL-90 R).

Non-benzodiazepine anticonvulsants have been shown to be efficacious treatments for the prevention of alcohol relapse although the FDA has yet approved none of these agents. During the congress the main results of this study will be presented.

To our knowledge, this is the first randomised, parallel, placebo-controlled group study to evaluate the efficacy of oxcarbazepine and topiramate compared in alcohol dependent patients. The data of this pilot clinical study suggest and investigate a possible role for the anticonvulsants agents in the treatment of alcohol dependent patients.

Aims of this study were to investigate alexithymic traits and dissociative experiences in a sample of patients with Alcohol Use Disorders, the significance of this association and the possible correlation with temperamental and character personality traits.

Eighty patients with diagnosis of Alcohol Use Disorder (DSM-IV) were consecutively recruited and assessed with the Toronto Alexithymia Scale-20 (TAS-20), to evaluate the alexithymic traits, the Dissociative Experience Scale II (DES II), to investigate the possible presence of dissociative experiences, and the Temperament and Character Inventory - Revised (TCI-R) in order to define a personality profile.

The mean scores obtained by the experimental group in both the TAS-20 and DES II do not differ from those estimated during the validation procedure. Pearson's linear correlation between scores was found statistically significant (p < .05). Significant correlations with some personality dimensions have also been found.

According to some authors substances related disorders could be classified as “disturbs of emotional regulation”, an active process in which neurophysiological, motor-behavioural and cognitive-experiential systems are involved. The lack of connection or an inadequate development of these systems would result in the malfunction of the symbolic function and then in the inability for the subject to contain the tensions generated by internal needs and/or by environmental stimulations. Both alexithymia and dissociation may assume the form of defence mechanisms against the unbearable emotions. Finally, some personality factors may be involved both in the rise of dissociative states and in the alexithymic traits.

To identify the differences in the ASI-6 scores according to main substance of consumption among patients with drug use disorder who were included at the study of adaptation-validation of the Addiction Severity Index 6th version (ASI-6) into Spanish.

Multicentre, observational, longitudinal, prospective study. 186 substance dependent/abuser individuals were included. Assessments were made with the Spanish ASI-6.

Main substance of consumption: 57% alcohol, 19.9% cocaine and 19.4% opiates. Men were 77.4% vs. 81.1% vs. 83.3% (p n.s.), mean ages were 47.12 (SD 10.18) vs. 32.62 (SD 8.20) vs. 36.47 (SD 8.04) years (p< 0.001), and 25.5% vs. 64.9% vs. 55.6% were single (p< 0.001). The greatest severity was found in the Alcohol area in the case of alcohol users (56.86) and in the Family/Social Partner Problems area in the case of cocaine and the opiate users (50.43 and 51.22). Alcohol users had statistically significant greater severity than the other two groups in the Alcohol area (56.86 vs. 49.38 vs. 45.17, p< 0.001) and tended to have lower severity in the Legal area than cocaine users (46.78 vs. 48.43, p 0.079).

Cocaine users were the youngest and used to be single. The ASI-6 only differentiated in the severity of the Alcohol area. Further studies including a higher proportion of cocaine and opiate users are needed.

To describe the physical health profile of patients with drug use disorders who were included in the study of adaptation-validation of the Addiction Severity Index 6th version (ASI-6) into Spanish.

Multicentre, observational, longitudinal, prospective study. A total of 194 substance dependent/abuser individuals were included. Assessments were made with the Spanish ASI-6.

Men were 79.9%, mean ages were 41.08 (SD 11.64), 42.3% were single and 87.6% were acute patients. The severity score in the Physical Health area was 44.32 (SD 9.51). The most prevalent diseases were: 25.3% hepatitis, 11.9% had high blood pressure, 8.2% cirrhosis or hepatic disease, 6.7% epilepsy or convulsions and 5.7% tuberculoses. No statistically significant differences were found according to gender. Acute patients had statistically significant higher proportion of pregnant woman (2.3% vs. 0% p< 0.05) and lower proportion of diabetes (3.5% vs. 12.5% p= 0.05).

Patients with drug use disorders have a mild-moderate severity of physical health. Physical health is not influenced by gender, but it is by the clinical state.

Although alcohol-dependent smokers represent an important group for applying smoking interventions, sufficient pharmacotherapy has not been established in this high-risk group so far. Acetylcholinesterase-inhibitors inhibit the breakdown of Ach. The retention time of this neurotransmitter is prolonged and thereby the efficiency of cholinergic neurotransmission at nAChRs is enhanced. Thus, we suppose a possible substitution of neuronal nicotine effects.

In order to examine the effect of acetylcholinesterase-inhibitors on tobacco dependence, we performed clinical-pharmacological studies on alcohol and tobacco dependent patients who had already completed an alcohol detox. We investigated galantamine (with positive allosteric modulation, n=114, randomized placebo controlled over 24 weeks) and rivastigmine (without allosteric modulation, n=26, randomized, placebo controlled over 12 weeks) and assesses smoking behavior (diaries, FTND, CO measurements) as well as craving for tobacco (QSU) and alcohol (AUQ).

Galantamine (Diehl et al., 2006) as well as rivastigmine (Diehl et al., 2008) led to a significant smoking reduction (galantamine: -20% after 24 weeks, rivastigmine: -30% after 12 weeks) without compromising the alcohol abstinence. Patients taking rivastigmine also experienced a significant reduction of nicotine craving (-20%), without any other specific pharmacological or psychotherapeutical action to support the smoking cessation.

Our preliminary data indicate an effect of galantamine and rivastigmine on tobacco craving and consumption in alcohol dependent smokers. These pilot studies encourage further investigation of acetylcholinesterase-inhibitors as a promising treatment approach regarding tobacco dependence.

The prospective clinical study included 101 patients diagnosed in accordance with DSM IV criteria for AIPD. Patients were monitored for 3 months in hospital and outpatient conditions, according to specially designed protocol, which included MMSE, BPRS, CGI1-4 scales, and clock drawing test (CDT). Both the control and the experimental groups were treated with conventional therapy and in addition the experimental group treatment was supplemented with rivastigmine (3-12 mg/24 h).

The participants were in the same age range, predominantly male, with an similar average illness duration. Average daily rivastigmine dose was 9.76±2.014 mg. An average pretrial MMSE score was around 19, BPRS score was around 50, CGI1 score was around 4.6, and CDT score around 5. Statistically significant differences among the C and E group begin to show after 14th (in BPRS scores)and 28th day of therapy(in MMSE,CDT,and CGI1 scores) (p>0.1) and to become more apparently significant after two and three months of treatment (p>0.5).

MMSE and CDT scores are significantly higher, and BPRS, CGI1-3 scores significantly lower in rivastigmine group from 14th and 28thday of treatment. Rivastigmine has statistically significant effect in treatment of AIPD.

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

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.

1. a. The prevalence of Internet dependents was 7.9%.

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

3. 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.

4. 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).

5. 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.

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

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.

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.

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.

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).

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.