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According to the ICD-11 (World Health Organization, 2019), substance use disorders include disorders that result from a single occasion or repeated use of substances (both legal and illegal) that have psychoactive properties; all drugs that are taken in excess have in common direct activation of the brain reward system, which is involved in the reinforcement of behaviours and the production of memories. They produce such an intense activation of the reward system that normal activities may be neglected. Instead of achieving reward system activation through adaptive behaviours, drugs of abuse directly activate the reward pathways. The pharmacological mechanisms by which each class of drugs produces reward are different, but the drugs typically activate the system and produce feelings of pleasure, often referred to as a ‘high’ (American Psychiatric Association, 2013). This chapter will cover all substance use in people with intellectual disability, whether it is a problem, and alternative treatments.
Objective laws of emotional disorder formation, their frequency along with clinic and psychopathological structure have been poorly studied until now.3 groups of patients have been observed: 200 people with alcohol addiction, 180 people with opioid addiction, and 90 people with psychostimulant addiction.
Objectives
All these have influenced our research which goal is to study patients’ emotional state at the stages of psychosocial rehabilitation.
Methods
Signs of psychological and physical addiction, specific personality disorders and decrease in social functioning level have been found for all of the observed patients. Psychodiagnostic research (performed according to Hamilton, Spielberger and Hanin, Buss-Durkee methods) has shown significant increase of depression and anxiety parameters, as well as aggression level for all the patients.
Results
Psychosocial rehabilitation system has been formed and created according to the results of the research. It is built based on a stepwise multimodal principle, including social deprivation, individual and group psychotherapy, craft therapy with an outcome to self-organizing psychotherapeutic groups.
Conclusions
Emotional sphere state normalization occurred during the process of participation in the system. According to catamnesis data of 1 to 2 years, the developed system efficiency is: 72.00 % for patients with alcohol addiction, 64.00 % for patients with opioid addiction, 51.00 % for patients with psychostimulant addiction.
The aim of the present study was to explore and compare the caffeine intake, intoxication, withdrawal and dependence prevalence in Italian psychiatric patients and healthy subjects.
Materials and methods
Three hundred and sixty-nine out- and inpatients, suffering from different psychiatric disorders, and 104 healthy subjects were included in the study. They were assessed by the SCID and by a structured interview for caffeine intoxication and withdrawal and for substance dependence applied to caffeine use.
Results
Patients and healthy subjects did not differ in terms of current caffeine intake (mg/day, mean ± SD: 281 ± 325 vs. 288 ± 148, respectively), while the maximum lifetime intake of caffeine was significantly higher in the first group (mg/day, mean SD: 630 ± 549 vs. 504 ± 344, respectively; F = 4.897, p = .03) where it was significantly related to the CGI severity item scores (rho = .107; p = .04). In both patients and healthy subjects, a lower age was related to a higher current caffeine intake, while both current and maximum lifetime caffeine intake in the healthy subjects were significantly higher in men than in women. The patients suffering from eating disorders reported higher current caffeine intake than those with anxiety or mood disorders. The prevalence of dependence and intoxication was significantly higher in the patients than in the healthy subjects, without inter-group differences. Healthy subjects showed a trend towards a higher prevalence of withdrawal.
Conclusions
Our study highlights the need that a more accurate attention should be paid to the caffeine use which seems to be strongly, although generically, related to different psychiatric disorders.
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