Posttraumatic stress disorder and substance use disorder is an important comorbidity in terms of its prevalence, clinical impact, and treatment challenges. To date, interventions for this comorbidity have been solely professionally led.

In this pilot study, we sought to evaluate the impact of a peer-led model, using Seeking Safety (SS; Najavits, 2002), which is the most evidence-based intervention thus far for the comorbidity. We adapted it for peer-led use to help make it accessible and safe for this modality.

Eighteen women in residential substance abuse treatment participated. The 25 SS topics were conducted twice weekly. They were assessed at baseline and end of treatment, with some measures also collected at monthly interims.

Results showed decreases in trauma-related symptoms (Trauma Symptom Checklist-40 total scale and all subscales, i.e., dissociation, sexual problems, depression, sleep problems, anxiety, and sexual abuse); self-compassion (the Self-Compassion Scale subscales self-judgment, isolation, and overidentified); the Brief Symptom Inventory (total and all nine subscales); and a measure of use of SS coping skills (total score). Also, ratings of fidelity to SS was very high (on the SS Adherence Scale), as was satisfaction with SS.

Limitations of the study and areas for future research development are discussed.

Addiction Serious health, safety and economy of nations would be analyzed. And the increasing tendency to consume drugs is one of the great social problems. Lazarus based theory of behavior in an article in confronting stress are two processes: problem oriented process in which a person with a problem that the real reason he has been facing turbulence and the process is exciting circuit based on the person trying to adjust their emotional responses to.

This descriptive study - the unity, in which 230 undergraduate students participated Tehran University that cluster sampling were selected were studied. Tools used, coping strategies Cavrer, sensation seeking, and attachment styles Arnett was Simpson. Data obtained by the correlation coefficient and multivariate analysis of variance analysis were statistically analyzed.

Pearson correlation showed that the intensity components (r = 0 / 18), recent (r = 0 / 70) and the excitement of pro (r = 0 / 12) in the field of substance abuse is significant and positive relationship

The use of problem oriented coping strategies to increase individual attitudes towards drug abuse is more negative and also between attachment styles and substance abuse trends and significant positive relationship exists.

Drug users have an increased rate of developing physical health problems, such as Hepatitis, HIV, skin infection, tuberculosis, lymphatic system, and tissue and vein damage. The nature of drug use makes it difficult to integrate IV drug users into a managed care system and monitoring of their physical health is difficult to achieve. An audit was conducted in a suburban population in the west midland region of the United Kingdom, where intravenous drug use is prevalent. The first part of the audit highlighted that despite increased morbidity in this population, physical health monitoring was incomplete, inaccurate and sometimes completely lacking. Recommendations were made, which included attaching a pro-forma to the assessment form, to enhance accurate and complete documentation of physical health monitoring.

To determine whether the recommendations are being followed. To re-establish the detection rate of medical co morbidity in IDUs.

30 injecting drug users have randomly been selected from the computer database. Case notes of these patients are being checked for quality of documentation, and whether the pro-forma for physical health monitoring is being completed. Drug workers will be contacted to verify the findings.

Previous results have shown that 80% of patients had some documentation, 20% had good quality health documentation and 60% was found to meet standards. We will expect to see an improvement in these figures, and 100% completion of the pro-formas.

Physical health monitoring is vital in this patient population and means to improve this should be employed globally.

It is difficult to distinguish between posttraumatic and idiopathic psychotic disorders. After a traumatic brain injury, the incidence of psychotic symptoms is between 5–20%, with an average duration of 4 years. Delusions and auditory hallucinations are more frequent than negative and catathoniform symptoms. Despite the lack of strong scientific evidence, antipsychotic treatment seems the best choice, although there is a bigger risk of adverse effects. The prognosis does not seem to be related to the severity of the injury.

We intend to illustrate the daily clinical practice, in which we find patients with important comorbidities, difficult differential diagnosis and therapeutic challenges.

Using a case-report format, we describe a 26 year old patient with the following diagnostics: traumatic brain injury with secondary psychotic symptoms versus schizophrenia; alcohol abuse; cannabis dependence; pathologic gambling. We summarize complementary explorations, therapeutic management and evolution.

Along three years of follow up there is a preponderance of negative symptoms. Positive symptom exacerbations also occur, in coincidence with an increase of cannabis consumption. Due to lack of compliance, long acting antipsychotics are prescribed. Motivational Interview is used for the drug use disorders and the treatment compliance, achieving the goal of reducing cannabis consumption.

Daily clinical practice brings us highly complex cases in which a multidisciplinary approach is very important. This particular case shows the differential diagnose difficulties between posttraumatic and idiopathic psychosis, and the troubles of clinical and therapeutical management in the dual pathology field.

Early started clinical investigation of tobacco dependence in adolescents promotes the physicians with the opportunity to choose the adequate therapy approches.

The aim of the study was to disclose the meaning of both clinico-psychopathological and character traits of smoking adolescents in organizing special antinicotine programs.

85 adolescents, middle age 16,1, regular smoking period more, then 1 year. All the adolescents had special clinical signs of tobacco dependence (TD): easy-going adaptation to nicotine intoxication; fast growth of smoking intensity, 1 cigarette per day; the craving for tobacco symptoms (impossibility to control the mental ideas of smoking, soma to-vegetative disturbances, high level of irritation, attention deficit).The character traits of heavy smoking adolescents were complicated (according DSM-IV) and included schizo-hysteric, schizo-epileptoid origin (gr.1,2, Fig.1). Character traits were strongly associated with intensity of ideatory component of TD and irritation level.

Heavy smoking adolescents need special therapy including both personality and TD approaches - bio-feed-back, psychotherapy, antinicotine drugs.

Severity drinking and alcohol dependent individuals have high rates of co-occurring somatic disorders. Many papers show close relationship between alcoholism and liver damage or liver disease. There occur high blood pression, diabetes. According the treatment proposal, patients with co-occur somatic problems seem less compliant with treatment and more drop out of treatment at all.

The purpose of this paper was to show high implication of somatic disorders among severity drinking patients and alcohol dependent patients.

We observed 34 male patients, age between 35- 60, who treated in our clinic for one year, on Department of Alcoholism. We used the medical data, history of illness, psychiatric and neurological examination during treatment and complete blood count. All the patients verified diagnosis of alcoholism and excluded other mental illness according the criteria ICD-X.

All of 34 male patients (100%) show raised level of Gamma-glytamyl transpeptidase (GGT),19 patients (55,88%) with high blood pressure, 9 patients (26,47%) verified Type 2 (non-insulin-dependent) diabetes mellitus, 3 patients(8,82%) with Type 1 (insulin-dependent) diabetes mellitus and 5 patients (14,70%) drop-out in the middle of treatment(solving problem with somatic disorders and less of motivation).

Alcoholism, alcohol-dependency and severity drinking show more linking with somatic problems and somatic disorders as well. In recent clinical work many different specialist may confirm somatic aspect as a big role in alcoholism, like note that patients with some somatic problem seek more likely to seek treatment than the others alcoholics.

Patients’ compliance to illicit drugs addiction's treatment, is a limiting factor for the effectiveness of these patients’ treatment.

The aim of this research was to study the pharmacological therapy and its side effects, in patients undergoing addiction treatment.

This study selected 31 patients with mean age of 33,61 ± 1,90 years old enrolled in a public mental health service with psychotic disorder related to the use of cocaine, crack an alcohol.

Patients under this study were addicted to alcohol (61,29%), cocaine, crack or the association of both (38,71%).

Effects related to the use of cocaine were delirium/hallucination (50%), cardiovascular effects (27,76%), psychomotor agitation (11,12%). (No effects reported 11,10%).

Patient-reported, crack-related effects were delirium and hallucination (50%), cardiovascular effects (37,50%). (No effects reported 12,50%).

Psychosis (73,08%), aggressive behavior (7,69%), abstinence syndrome (11,54%), were associated to the use of alcohol. (No side effects reported 7,69%)

The pharmacological treatment to these patients were typical neuroleptics (41,94%), atypical neuroleptics (22,58%), typical and atypical neuroleptics associated (29,03%), (No treatment 6,45%).

Side effects related to pharmacological treatment were extrapyramidal effects (56,24%), delirium/hallucination (43,74%), memory impairment (34,37%), anxiety(31,25%),attention deficit (21,87%), psychotic depression (12,50%), verbal communication deficit (3,12%).

These effects were treated with biperiden (58,34%), promethazine or benzodiazepines (25,00%). (No treatment was done in16,67%).

The use of neuroleptics in the treatment of psychotic disorders due to the use of illicit drugs should be evaluated. The side effects related to the neuroleptics must be carefully controlled in order to guarantee the patients' compliance to the treatment.

This study investigates how personality traits, social axioms and therapeutic orientations affect burnout of professionals who work in the area of addictions.

110 psychiatrists, social workers, and counselors participated in the study. They worked in Alcohol and Drugs Treatment and Rehabilitation Clinics. The professionals anonymously completed the following questioners: Social Axioms Survey (Leung et al., 2002), a modernized version of Therapeutic Attitudes Scale (Sandell et al., 2004), and Maslach Burnout Inventory - General Survey (Maslach & Jackson, 1986). Social Axioms Survey measured three basic beliefs regarding world functioning: social cynicism, reward for application, and religiosity. Therapeutic Attitudes Scale measured the professionals’ beliefs of what are the best ways to help the client. They related to three types of therapeutic orientations: cognitive-behavioral, psychodynamic, and systemic. Burnout Inventory measured three aspects of professional burnout: exhaustion, cynicism, and professional efficacy; however, since exhaustion and cynicism scales were highly correlated (r = 71), they were combined into one scale, called emotional weariness.

A stronger belief in social cynicism associated with a higher level of emotional weariness. In addition, a stronger systemic therapeutic orientation was associated with a lower level of emotional weariness. There was a positive relationship between the reward for application belief and the sense of professional efficacy. Therapeutic beliefs were not related to the sense of professional efficacy.

The results of this study may help to identify addiction area professionals who are prone to burnout and would allow the development of burnout prevention and coping programs.

Nutritional status is known to directly influence clinical outcome in patients hospitalized for acute illness (Stratton et al. 2006; Raslan et al. 2010) and the chances of them developing complication. (Lelovics et al., 2008). As patients at nutritional risk can be easily identified, screening for malnutrition, with a validated screening nutritional tool should be done as a routine in hospitalized patients. (Kyle et al.,2005; Raslan et al. 2010; Ben-Ishay et al. 2011)

To assess nutritional risk of alcoholic patients admitted for alcohol detoxification.

Screen nutritional risk of alcoholic patients using the Malnutrition Universal Screening Tool.

53% patients at presentation were rated as medium or high risk of malnutrition.

Malnutrition should be actively considered and screened for in alcoholic patients admitted for alcohol detoxification due to its high prevalence and benefits obtained from treatment.

1. 1. The number of smokers who quit was higher in the control group;

2. 2. The number of smokers who quit and maintained their decision was higher in the control group;

3. 3. The number of smokers that only reduced the number of daily cigarettes was higher in the study group.

Although the efficacy of the double approach was obvious for both groups, the smoker schizophrenic patients need longer assistance, but even if they only reduced the number of smoked cigarettes, their clinical evolution (psychotic symptoms, hospitalisations) improved.

A two-way conditioning relationship is developed between the maladaptative use of alcohol and the somatic pathology, influencing the prognosis in a negative sense. Somatic comorbidities represent vulnerability factors for the nosologic entity related to the use of alcohol.

Assessment of the correlation between the clinical forms of alcoholism, presence of somatic pathology and prognosis of basic disorder.

In a 12 years retrospective study, with 644 patients diagnosed with alcohol induced addiction disorder, the presence of somatic comorbidities was monitored. The data obtained was statistically analysed and was correlated with the disorder's clinical characteristics related to the use of alcohol. The classes and doses of psychotropic substances used in the alcohol therapy were evaluated as well.

The marked modifications of the hepatic constants with rates three times over the normal values (18,12%) were correlated with the cognitive deterioration (17,44%) end the presence of psychotic elements (27,32%). The hepatic and renal pathology showed significant percentages in limiting the necessary therapeutic doses.

Somatic comorbidity can be a predictive for certain clinical forms of the alcohol related disorder. The prognostics of the addiction disorder is influenced by the presence of somatic disorders, both through the intensity and type of psychic symptomatology and through the limitation of therapeutical approach imposed by the presence of somatic pathology.

Alcohol is legally accessible and widely used in Taiwan, but few studies have addressed alcohol-drinking problems in hospital settings.

To explore (1) the prevalence and risk factors for hazardous alcohol-drinking problems and (2) previous assessments and interventions for alcohol-drinking problems among a general Chinese patient population.

Self-report data were collected from 484 patients at five randomly selected hospitals.

The prevalence of hazardous alcohol-drinking problems was 19.2%. Logistic regression analysis revealed that risk factors for hazardous drinking problems were being male, smoking, and chewing betel quid. Only 29.1% of participants were assessed for drinking problems in the past year. Only 38.7% of participants with drinking problems had received a drinking intervention in the past year.

Alcohol problems in Taiwanese general hospitals are insufficiently assessed and targeted with interventions. Targeting high-risk groups and integrating psychiatric healthcare teams in general hospitals are important to prevent patients’ drinking problems.

The perception of the dependence symptoms is a key factor on the treatment seeking process by people who suffer from it, and its understanding is a relevant health issue. On the other hand, there are adjuvant factors that should be recognized by the physician, such as the symbolic meanings of the mother-children relationship, given that psycho-cultural meanings of motherhood can reshape the lives of women addicted to tobacco.

To discuss experienced psychological meanings attributed by mothers who have sought treatment, considering the condition of being caregivers of their children.

Qualitative study conducted with an intentional sample of 13 tobacco dependent women seeking formal treatment; in-depth semi-structured interviews.

The diagnostic criteria on substance dependence were spontaneously reported by the participants. They show a certain motivation to seek treatment, not always clearly said. It is relevant that mothers do not focus on the objectivity of the existence of your child or your maternal condition, but talk about motherhood as a representation of the self-image. Mothers create within themselves the idea that they are good role models for their children. They try to preserve the image of an idealized mother, installed according to standards when they were children.

The interviewees have a proper understanding on the seeking treatment process and seem to evaluate subjectively and carefully the distress related to the dependence tobacco. Their condition of being a mother, however, can be subtly touched by the physician, after establishing a relationship of mutual confidence.

To evaluate the efficacy of naltrexone in patients with dual diagnosis- alcohol dependence and personality disorder.

A group of 24 patients, mean age 38.7, admitted in our department for alcohol dependence, were also diagnosed with axis II pathology. The diagnosis of personality disorder was based upon Structured Clinical Interview for DSM IV Disorder (SCID -II) and clinical psychiatric evaluation. Patients received naltrexone 50 mg/day, after the initial detoxification period. Patients were monitored using Inventory of Drug Taking Situations- alcohol focused version (IDTS), Global Assessment of Functioning (GAF) and Clinical Global Impressions (CGI-S/I). These measurements were applied every week during the first month and every 4 weeks for another 5 months.

At week 24, patients had an overall improved IDTS score (−45.2 points to baseline, p < 0.05), with greater improvements observed in areas like “physical discomfort” (p = .0463) and testing personal control (p = .0374). Cluster B personality disorders were associated with a better response in IDTS score and with a lower rate of relapses (p < 0.01) and missed treatment doses (p < 0.01). GAF values increased in the treatment group with 24.5 points, compared to baseline, with a non-significant trend in favor of cluster B and C personality disorders. CGI-I decreased from a mean value of 4.5 to 1.5 at week 20 and remained at the same value until the endpoint, without significant differences between clusters.

Naltrexone decreased significantly alcohol consumption in situations of “physical discomfort” and testing of personal control in patients with associated personality disorders.

It is spent research of 2500 students of higher educational institutions and 650 schoolboys in Donetsk and Kyiv with smoking questionnaire and the Fagerstrom Test for Nicotine Dependence.

The research was established that 15,4% of teenagers at the age from 12 till 16 years tried to smoke and 7,2% - smoke regularly.

Among pupils of 10–11 classes average degree of nicotinic dependence was diagnosed for 21,8% of young smokers, high degree - at 10,3%.

Despite high prevalence of smoking among teenagers the majority of boys (65,1%) and girls (64,8%) would like to refuse this bad habit and 77,4% from them tried to make it within last year.

Among student's youth smoke 57,8%. Weak dependence is found out in 32,7% person, moderated - at 49,5% and strong - at 12,3% of students. The reasons of occurrence of a habit to a tobacco smoking students name problems in educational activity (10,4%), curiosity (20,2%), desire to mature (22,7%), influence of the friends familiar, the nearest environment (48,4%).

The data obtained by us testifies to high prevalence of tobacco dependence among youth.

Pathological gambling is often considered a behavioral addiction. Attentional bias (AB) refers to the observation that substance-related cues tend to grab the attention of experienced substance users. The Dot Probe Task has been used to assess AB in individuals with substance addiction, however it has never been used to assess AB in PG.

The aims of the present study are assessing potential AB in PG using Dot Probe Task with exposures time that assess attentional maintenance checking the possible correlation of PG severity with degree of attentional bias.

PG sample was 23 subjects and Non Gamblers group (NG) was 21 subjects. To asses the severity of gambling we use the South Oaks Gambling Screen. We can define two types of reaction times to assess the AB: a) Congruence time: time the subject takes to detect the point when it appears on the hemi-screen replacing the cue picture. b) Non-congruence time: idem when replacing the neutral picture. The difference between these times is the AB index.

The PG had a congruence time significantly lower than the non-congruence time which indicates the presence of AB in this group. There were also differences between AB index in PG and NG sample, validating the Dot Probe task to detect AB. Moreover, there weren’t relation between the severity of the game and AB.

The study shows the presence of AB in PG at level of maintenance of attention (disengagement) and the validity of Dot Probe Task to detect AB in PG.

Pathological Gambling (PG) tends to be a heterogeneous disorder where patients differ with type and severity of gambling behaviour, psychiatric co-morbidity, family history, sex and age of onset. Age of disease onset in PG varies significantly, with many individuals having onset during childhood and adolescence and others in various stages of adulthood. Previous studies have demonstrated that age of onset is an important characteristic for a better understanding of the PG heterogeneity.

(1) To analyze differences in sociodemographic aspects between early-onset PG and non early-onset PG, (2) to study whether early-onset PG is associated with specific psychiatric diagnosis in axis I and II.

We used data from a large and nationally representative community sample of United States (US) adults, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). We selected age 25 years as a threshold for early-onset PG.

Individuals with early-onset PG were more likely to be male, never married, and young and to have a lower education level and individual income than non early-onset PGs. Early-onset PG were less likely to have mood disorder (OR = 0.42 (0.19 − 0.94)) and had non-significant higher odds of having substance and anxiety disorders than non early-onset. The odds of having Cluster B disorder were significantly higher among early-onset PGs than non early-onset PGs (OR = 4.11 (1,77 − 9.55)).

Our findings support that subgroups of Pathological Gambling defined by onset age have phenotypic differences.