The authors have not supplied their declaration of competing interest.

Sexual dysfunction (SD) is defined as the deterioration of sexual response cycles caused by anatomic, physiologic or psychologic reasons.

We believe that SD is closely related to self-esteem and childhood trauma (CT).

In this study, the level of self-esteem and CT in patients diagnosed with SD vs. controls are aimed to be compared. In addition, relationship between complaints of SD self-esteem and CT variable subgroups are planned to be investigated.

Twenty-four patients visited Prof. Dr. Mazhar Osman Psychiatric Hospital with matching defined criteria and 24 control counterparts statistically matching were taken sociodemographic data form, Rosenberg Self-esteem Scale (RSS) and Childhood Trauma Questionnaire (CTQ-28) was applied.

CTQ-28 averages and RSS variables which are sensitivity to criticism, depressive mood, psychosomatic symptoms, feeling threatened in interpersonal relationships, degree to participate in discussions, relationship with father were higher in patients with SD (P < 0.05). Considering the relationship between complaints of SD and CTQ-28 subscales, physical abuse, emotional abuse, physical neglect, emotional neglect averages of patients were observed significantly different rooted by genitopelvic pain/penetration disorder and premature ejaculation and in emotional neglect by premature ejaculation and low libido combination (P < 0.05).

In literature, there are many studies that show CT leads to SD and several studies state that self-esteem is affected in patients with SD [1]. CT must be considered and determined in the goal of treatment of SD.

The authors have not supplied their declaration of competing interest.

Researches showed comorbidity of sleep disorders and mental disorders.

The current study aimed to evaluate depression and anxiety and their relationship with insomnia, nightmare and demographic variables in the medical students of Qazvin University of Medical Sciences in 2015.

The study population included 253 medical students with the age range of 18–35 years. Data were gathered using Beck depression inventory, Kettle anxiety, and insomnia and nightmare questionnaires and were analyzed by proper statistical methods.

Among the participants, 126 (49.6%) subjects had depression and 108 (42.5%) anxiety. The prevalence of depression and anxiety among the subjects with lower family income was significantly higher (Chi2 = 6.75, P = 0.03 for depression and Х2 = 27.99, P < 0.05 for anxiety). There was a close relationship between depression with sleep-onset difficulty, difficulty in awakening and daily sleep attacks, and also between anxiety with sleep-onset difficulty and daily tiredness (P < 0.05). In addition, there was a close relationship between depression and anxiety with nightmare; 16.2% of the subjects with depression and 26.5% of the ones with anxiety experienced nightmares.

Results showed a relationship between nightmare, insomnia and level of family income with increasing depression and anxiety in the medical students; hence, due to the importance of medicine in human life, it is necessary to evaluate the mental health of medical students, identify and solve the relative problems such as anxiety, depression and related symptoms such as insomnia and nightmare in them.

The author has not supplied his/her declaration of competing interest.

Insomnia is a highly prevalent complaint, largely associated with mental disease. Clinical evidence classifies insomnia in 2 subtypes: with sleep misperception (WSM) and without sleep misperception (wSM). That presents distinctive pathophysiologic pathways and different public health implications.

Describe the main differences between primary insomnia WSM and wSM regarding:

– clinical features;

– diagnosis;

– management;

– implications.

We conducted a systematic review. PubMed, Embase and PsycInfo were searched from 2000–2016. The reference lists of systematic reviews, narrative synthesis and some important articles were included. Following the inclusion criteria, we selected 25 studies from 59 articles.

The prevalence of sleep-state misperception in primary insomniacs (total sleep time > 6.5 h and sleep efficiency > 85%) is around 26%. Insomniacs with normal sleep duration showed a profile of high depression and anxiety and low ego strength, whereas insomniacs with short sleep duration showed a profile of a medical disorder.

Cortical hyperarousal is higher in insomniacs and could be related to an alteration in sleep protection mechanisms. The sleep architecture was relatively normal for the WSM comparing with the group wSM. Risk of cardiometabolic, neurocognitive morbidity and mortality, and responses to treatment are different between these two insomnia phenotypes. Patients with short sleep duration may respond better to biological treatments, whereas insomnia with normal sleep duration may respond primarily to psychological therapies.

The clinical characteristics of patients with sleep-state misperception differed from those without this condition. Available research related to these conditions is expanding rapidly, but many questions remain unanswered.

The authors have not supplied their declaration of competing interest.

In Korean culture, co-sleeping of parents and children are quite common, which is different from the Western culture where solitary sleeping of children is preferred. In this study, we evaluate the sleep environment factors that effect on children sleep disorder, and parent's parenting stress and mental health.

Surveys were conducted to 115 participating parents of preschool children sleeping behaviour lecture. Seventy-one completed surveys were analyzed for the study. The mean age of target children was 53 ± 23 months. Parents’ mental health was evaluated by using several forms such as Insomnia Severity Index, Korean-Parenting Stress Index short form, and The Patient Health Questionnaire-9. Children's sleeping environment and quality were assessed by Child Sleep Habit Questionnaire and Sleep environment survey.

Pearson correlation analysis (P < 0.05) was conducted to evaluate the relationship between the sleep disorder of children, and the parent's parenting stress and mental health. Analyzing the data through the partial least square path modeling, co-sharing would have negative effect; bed-sharing could have negative effect on the depressing emotion of parents (P = 0.065). Solitary sleeping of children could have positive effect on parent's mental health (P < 0.01).

Preschool children's sleeping disorder occurs more often in co-sleeping children with parents than solitary sleeping children. Parents’ parenting stress is related to the parent's age and depression, further related to the children sleeping disorder and their sleep environment. Although, it is difficult to generalize the exact cause, evaluation and improvement of children's sleep environment would help to reduce the parent's parenting stress.

The authors have not supplied their declaration of competing interest.

In our current practice, we do not see many cases of somnambulism in adults. We do not have much information about their treatment and outcome. In difficult cases, some clinicians try to use benzodiazepines, which decrease slow-wave sleep. More recent reports suggest the use of zolpidem.

Sleepwalking disorder consists of a sequence of complex behaviours that are initiated in the first third of the night during deep NREM (stage III and IV) sleep. The architecture of normal sleep is impaired. In important cases - with dangerous behaviour – we need treatment.

Trazodone is an antidepressant with sedative effect due to H1 and α1 receptors blockade. Trazodone can rewrite the bad sleep architecture of depressive patients with insomnia and improve sleep in such cases. For these reasons, we try to use trazodone in somnambulism.

We had two case studies (males, 24 and 22 old), diagnosed with NREM arousal disorder, sleepwalking type, according to DSM-5. Both patients were treated with trazodone 50 mg/day, up-titrated with 50 mg/day every three days. The target used dose was 150 mg/day because this is the most sedative.

Somnambulism disappeared in both cases after the first dose of trazodone. We treated three month both patients and then down-titrated and stopped the treatment. After one year from stopping the treatment, the patients had not new episodes of somnambulism.

Trazodone has the power to rewrite, in those cases, the sleep architecture of somnambulism. This action is due to blockade the brain's arousal histamine and adrenaline systems.

Speaker honoraria from Angelini Pharmaceuticals Romania.

Suicide is a serious public health problem, being the second leading cause of death among 15–29-year-olds. Many risk factors have been associated with suicidal behavior, such as psychiatric disorders, family history of suicide, loss of a close friend/relative, physical/sexual abuse, lack of support network, or sleep disturbances where nightmares and insomnia have been consistently reported to increase the risk of suicidal behaviors.

To conduct a systematic review to examine the association between short sleep duration and suicidal behaviour (suicide ideation/attempt/suicide).

This is a systematic review of published research articles in the electronic database PubMed in the last 10 years. The query “sleep” or “sleep disorders” and “suicide” was used. Studies that assessed the relation between sleep duration and suicidal behaviour, with a well-defined index for sleep disorders and with an outcome measure of suicidal behavior were included.

Of the 522 references founded, 33 articles met the inclusion criteria (1 review, 1 qualitative and 31 quantitative studies). An association between short sleep duration and suicidal behaviour was found in most of the studies with children/adolescents and adult samples. However, this relation was not verified in the research into the elderly.

The results point to a significant association between short sleep time and the presence of suicidal behaviours, for both adults and children/adolescents. The effect of short sleep duration seems to be more consistent with suicidal ideation, but not for attempts, needing further studies to highlight the importance of this link between sleep duration and suicide.

The authors have not supplied their declaration of competing interest.

Several epidemiological studies have been conducted to document the prevalence and correlates of insomnia. Most of them confirm their high prevalence in the general population, and a gender difference in the risk for insomnia.

To study the role of gender in the relationship between personality (perfectionism and neuroticism) and insomnia ([IG] insomnia group, [ISG] insomnia symptoms group, and [GSG] good sleepers group).

A total of 549 college students (80.1% females) filled in the MPS (Frost et al., 1990; Hewitt and Flett, 1991), EPI (Barton et al., 1992, 1995), and a self-reported questionnaire to assess insomnia symptoms.

No differences were found between female and male samples, concerning the dimension of perfectionism – doubts about actions. The IG and the ISG showed higher levels of doubts about actions than the GSG. However, only in female sample the IG and the ISG showed higher levels of concern over mistakes in comparison with the GSG. In males, no significant differences between the sleep groups were found, in which respects concern over mistakes. The level of extroversion was higher in the GSG, but only in male sample. In females, there were no significant differences between the sleep groups in relation to extroversion.

No gender differences were found for the role of doubts about actions in insomnia. Only in females, the dimension – concern over mistakes is important in insomnia, and only in males the dimension – extroversion is important to have a good sleep. These results warrant further research.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Multiple sclerosis (MS) is the commonest chronic autoimmune demyelinating and inflammatory disease of the CNS, afflicting both body and mind. Typical symptoms are fatigue, paraesthesia and depression, along with cognitive impairments. Whereas there is extant research on fatigue, depression, and cognitive impairment of patients with MS during the clinical course, no research focused on sleep, psychological functioning, and physical activity (PA) at the moment of the diagnose. The aims of the present study were therefore to assess possible state markers of mental toughness (MT) as a dimension of psychological functioning, sleep disturbances (SD), PA among patients at the moment of the diagnose, and to compare these data with those of healthy adolescents and healthy young adults.

A total of 23 patients with recently diagnosed MS (M = 32.31 years), 23 healthy adolescents (M = 17.43 years), and 25 healthy young adults (M = 20.72 years) took part in the study. They completed questionnaires covering socio-demographic data, MT, SD, and PA.

Patients with MS reported similar MT traits as adolescents, and an equal amount of moderate PA and SD as young adults. Further, patients reported a lower level of vigorous PA, compared to healthy adolescents and young adults.

Compared to healthy adolescents and young adults, patients at the moment of the diagnose of MS reported similar MT traits, SD and moderate PA. The pattern of results suggests that at the moment of the diagnose MS is not predictable by poor MT, poor sleep, and decreased level of moderate PA.

The authors have not supplied their declaration of competing interest.

Nowadays, 30% of the Spanish population suffers from some form of sleep disorder, occupying much of the visits to a psychiatrist. Sleep disorders are not a serious condition by itself, but have serious implications in daily life: physical exhaustion, poor performance, daytime sleepiness. Insomnia is a most common sleep disorder, however, hypersomnia must also be considered due to the limitations that it causes.

By the description of case report, we will carry out a review of the syndrome Kleine Levine.

Case report.

A case of Kleine–Levin syndrome in a 23-year-old male is described. The episodic disorder was characterized by excessive sleep, voracious appetite, hyper-sexuality, irritability and memory loss. Among its history, he included a psychotic episode in childhood and an episode of behavioral disorder caused by a stressful situation. His partner refers a similar episode of hypersomnia last year that was self-limiting in 15 days and he did not go to the doctor. Patients often act normal between episodes. Remission was spontaneous. Prospects, for organic aetiology, differential diagnosis. However, arises additional tests (analytical, brain CT, EEG…) resulted no pathological. Patient fulfilled the criteria for KLS, but due to the rarity of the disorder he was previously diagnosed as psychosis not otherwise specified.

This case report aim to highlight that KLS though considered a rare disorder but not uncommon and lack of enough available research data is likely to be responsible for missed or erroneous diagnosis; thus we require more systematic studies regarding etiologies and treatment.

The authors have not supplied their declaration of competing interest.

Insomnia is the most common sleep disorder in the elderly. Its management must take into account the physiological changes associated with age, a higher frequency of comorbidities and polypharmacy.

To evaluate the management of insomnia in the elderly patients by general practitioners and to compare it with international recommendations.

We conducted a cross-sectional and descriptive study among general practitioners in Sfax over a period of two months (January and February 2016). We proposed to these doctors to participate in our study by sending to them a questionnaire in their emails, which they fill anonymously.

A total of 32 doctors responded to the questionnaire. Among them, 62.5% reported that they often or very often receive elderly consulting for insomnia. Before prescribing hypnotic drugs, 65.6% of practitioners reported that they often advise lifestyle and dietary rules. The most prescribed hypnotic classes were: benzodiazepines (BZD) 59.37%; antihistamines 59.37% and homeopathic treatments 56.25%. In the last prescription, the treatment period exceeded 30 days in 18.75%. As for the prescription of BZD, molecules with long half-life were used in 37.48% of cases, and the dosage was identical to adult in 34.4% of cases.

The prescription of hypnotic treatment in the elderly meets a logical approach to care, after an accurate diagnosis, taking into account psychiatric and somatic comorbidities, the precautions and contraindications. In this context, we have identified several shortcomings in the management of insomnia in the elderly in general practice. A multiplication of training on this subject is needed.

The authors have not supplied their declaration of competing interest.

The term “psychosis” is very broad. Substance users represent one group with particularly high rates of psychotic symptoms.

This review will present an update on cannabis and amphetamine-type Stimulant (ATS) and will try to differentiate and compare their associated psychotic features.

A systematic literature search was conducted from 1980 to date in the following databases: MEDLINE, PsycINFO and PubMed. Articles were included if they were highlighting substances induced psychoses, with particular emphasis on stimulants/amphetamine/methamphetamine and cannabis/marijuana induced psychoses, schizophrenia-spectrum disorder or schizophrenia.

There are many differences between these two substances regarding source, neurobiological processes, average latency periods before developing psychosis, clinical features as compared to schizophrenia, risk of using drugs and developing psychosis and drugs use and development of schizophrenia and urine screening test. With the recent proposals to regulate cannabis use, a further investigation of the association of this use with psychosis is required.

Our search elicited many studies of one substance and its association with psychosis but few comparative studies across substances. Yet in our opinion, these comparisons could shed further insight on the development of psychotic features.

The author has not supplied his/her declaration of competing interest.

The care to the alcohol and/or other drugs’ user focuses on the logic of care for extended clinical and harm reduction, under the focus of the user and his family co-responsibility towards treatment.

This study aimed to understand the concept of self-care developed by drug users.

It is about a descriptive exploratory study with a qualitative approach. It was conducted in a center of psycho-social attention (CPSA), in Recife, Pernambuco, Brazil. The study participants were alcohol and/or other drugs users, over the age of 18 years, both sexes and were in treatment in the mentioned service in morning, afternoon and evening shifts. Data collection occurred in consultation records and individual interviews for the sample characterization, and three operating group sessions, one per shift, guided by the question: “what is self-care for you?” The interviews and sessions were audio-recorded, transcribed and submitted to analysis by ALCESTE software.

It was noted that self-care was conceptualized by the drug users from different points of view. For some, self-care is to self-protect, for others it means taking medications. The family, religion and CPSA were identified as a support network for the self-care maintenance. Furthermore, the self-care was related to the desire to recover losses.

This study provided the understanding improvement of the self-care concept, supporting the care practice for the interventions planning, targeting the co-responsibility of the alcohol and/or other drugs users.

The authors have not supplied their declaration of competing interest.

To distinguish socio-cultural predictors of cannabinoid dependence of child population in Siberia.

Clinical verification of dependence, due to cannabinoid use in the age group “0–14 years” across 22 administrative territories of Siberia and the far east. Review, of statistical materials of regional narcological institutions.

Cannabinoid dependency in children has been revealed in 8 of 22 territories–intensive indices per 10,000 of the population of the matched age were in two territories–0.2, one territory–0.4, in two–0.7, and in three–2.1, 3.2, 14.0, respectively. In the related territories, the specific weight of cannabinoid dependence in total structure of substance dependence for population as a whole (children, adolescents, and adults) was as follows: 0.7%, 0.8%, 2.7%, 3.5%, 27.2%, 67.6% and 76.9%. Therefore, for those territories where ill children are under observation their number per 10,000 of the population is closely associated with structural size of addictions: high level of cannabinoid dependence, formed in the territory, is interrelated with greater number of children, dependent on cannabinoids in this territory. With account for made corrections it should be recognized that “saturation level” of the territories, in particular, with cannabinoids results in higher indices of substance dependence among child population.

It should be considered that calculation of intensive indices is conducted for the age group “0–14 years” while diagnosed age range includes children aged 9–14 years, therefore, real indices of dependence, with account for this hypothetical correction, are three times higher as a minimum.

The authors have not supplied their declaration of competing interest.

Hyper-sexuality is an increased sexual activity that causes stress the individual at social levels. There are studies that support the theory that neurophysiological abnormalities of individuals appear in this disorder and do not overlap with the alterations found in substance addictions. However, it is doubtful whether addiction to other substances can trigger behavior in the sexual sphere.

To report a case of abuse of alcohol as a trigger relapse in terms of sexual alterations in a patient diagnosed with alcohol abuse, stimulants dependence and hyper-sexuality.

Here we report a married gentleman in the fourth decade of his life that presents behavior and sexual activity level compatible with a case of hyper-sexuality. After conducting motivational interviews with the psychologist to aim a sustained abstinence of amphetamines and a lack of alterations on the sexual sphere, the patient achieved clinical stability over several years. However, it is referred for psychiatric consultation as he presented recently abusive alcohol consumption associated with Speed. He relapsed in the sexual sphere by increasing sexual desire and impulsiveness. It was decided to prescribe oral nalmefene (1 tablet daily) for two months and then stop treatment regularly (taken PRN in case of high risk situations). As a result, he has had sustained remission for over 6 months.

Although, there are studies suggesting that neurobiological changes among the pathologies described are different, the treatment of alcohol abuse can be beneficial in other diseases such as hyper-sexuality as disinhibition associated with alcohol intoxication.

The authors have not supplied their declaration of competing interest.

In the literature, few intoxications are related to scopolamine due to its presence in cocaine, heroin or even in counterfeit rohypnol tablets. Nonetheless, during summer 2016, several cases of non-fatal intoxication appeared in the region of Paris.

Demonstrate how clinical detection of rare toxic events are fostered by exchanges in close collaboration with different territorial level.

Improve the detection of short toxic epidemic.

Suspected cases of scopolamine poisoning notified to Parisian Addictovigilance centre were reported. Information shared through different levels of the alert process contributed to strengthen their assessment.

Seventeen cases of probable scopolamine poisoning among cocaine users were registered between the 6 and 24 of July. In the first 4 cases, toxicological analysis, of blood samples were scopolamine positive, with high concentration between 7 ng/mL and 25 ng/mL (usual therapeutic range: 0.1 to 1.1 ng/mL). A collected sample of this cocaine powder had a purity of 23.2%, with 15.2% of scopolamine. Half time of scopolamine is longer than half time of cocaine (3–8 hours versus 1–2 hours): this could explain why the observed effects lasted over 24 hours (8/17). Main clinical features were mydriasis (15/17), high blood pressure (12/17), tachycardia (13/17), behavioural disorder with agitation (13/17), hallucinations (5/17), and coma (8/17). Practitioner's responsiveness and the extensive information sharing [MM1] between regional and European level were congruent.

Adulterated street drugs can lead to short toxic epidemic which could be unnoticed. Emerging event should require careful assessment with linkage between risk assessors and risk managers.

The authors have not supplied their declaration of competing interest.

This study was performed with the aims of determining the perceptions of nursing staff in psychiatric hospitals regarding the causes and treatment of substance addiction as well as their attitudes towards people with substance abuse problems.

This study was carried out with 389 nurses working at 5 state psychiatry hospitals in Turkey. In this study, demographic questionnaire, the causes of drug abuse scale (CADAS), drug abuse scale (CUDAS), attitudes scale (AS), and a demographic questionnaire were used. Independent sample t-test, variance, correlation, and linear regression analyses were used.

In this study, 82.8% of the nurses were female, and the mean age was 33.79 ± 7.58. We found that the demographic characteristics of the nurses did not affect their perception regarding the causes of addiction and treatment (P > 0.05); but it did have an effect upon their attitude towards people with substance use problem (P < 0.05). Also, it was established that there was a negative relationship between their perception regarding causes of substance misuse and their attitude towards a person with substance use problem; and a positive relationship between their perception regarding substance misuse treatment and their attitude towards the person with substance use problem (P < 0.05).

Nursing staff working in psychiatric hospitals in Turkey have the perception that a person takes substances in order to “cope with problems”and for reasons pertaining to his/her “social environment”. Nursing staff tends to indicate a negative attitude towards persons with substance abuse problems, such distancing themselves socially from the patients.

The authors have not supplied their declaration of competing interest.

There is no unequivocal estimation of influence of synthetic cannabinoids on health of the users, their influence on neurocognitive functions and their correction with use of microwave resonance therapy (MRT).

To evaluate dynamics of pathological craving and neurocognitive functions in patients with dependence on synthetic cannabinoids during use of MRT.

Thirty-two patients (main group with dependence on synthetic cannabinoids with MRT) and 38 patients (control group with medication and without MRT) were examined. Craving was evaluated with “Drug Craving Scale”; efficiency with CGI. For evaluation of psychophysiological functions we used methods: “number square”, ‘balance-tranquility’, “verbal memory”, “linear visual estimation”, “exclusion of the word”.

After therapy, stopping of symptoms of pathological craving was observed in the main group as 29.6% as more than in control group, improvement according to CGI as 37.1% as more than in control one. The evaluation of neurocognitive indicators was conducted. Attention: in the main group improved by 11 ± 1.3 points; in control one by 7 ± 3.1 points. Level of activation: in the main group decreased by 16 ± 2.9 points; in control one by 9 ± 3.5 points. Memory in the main group improved by 3 ± 0.21; in control one by 2 ± 0.3 points. Perception: in the main group improved by 1.5 ± 0.2; in control one by 0.8 ± 0.12 points. Thought: in the main group improved by 14.0 ± 1.6; in control one by 6.4 ± 1.1 points. Thus, it was shown that during use of MRT both perception and processing of information, improve in complicated conditions, reduction of pathological craving accelerates.

The authors have not supplied their declaration of competing interest.

Amphetamine abuse has become a serious health concern worldwide, and this holds also true for Iran.

Investigating psychological and socio-demographic dimensions to predict amphetamine-abuse.

Hundred amphetamine abusers and 100 healthy controls took part in this cross-sectional study. Participants completed questionnaires covering socio-demographic and psychological dimensions.

Compared to healthy controls, amphetamine abusers reported more insecure and ambivalent attachment styles, higher novelty-seeking and risky behaviour, less current social support and stable relationships, and lower emotional competencies. No differences were found for socio-demographic dimensions.

Results from this cross-sectional study underscore that amphetamine abuse was related to poor social relationships, poor emotional competencies and higher risky behaviour. The cross-sectional nature of the study, however, does preclude any conclusions about the causal direction of amphetamine abuse and poor interactional behavior.

The authors have not supplied their declaration of competing interest.