Concluding the literature on early recognition and early diagnostics in addictions we may take as an ascertained fact that early recognition of addiction is an utmost important condition of successful treatment: the earlier the valid diagnosis, the better the prognosis. But in early recognition as well as in early diagnostics we are confronted with various problems that are difficult to solve. Examples of this are the almost entire lack of widely accepted early diagnostic criteria, the diagnostic uncertainty in the transient area between health and illness resulting in the risk of false positive and false negative valuations, the instability of diagnostic criteria - and all that in connection with the stigmatization caused by the diagnosis of addiction. To make matters worse, early recognition usually is the task of people not trained in the field of addiction (e.g. non-psychiatric-medical professionals, nurses, social workers, probation-officers and judical officers, teachers, priests, relatives, employees, frie4nds, etc.). To cut the Gordian knot of early recognition, first, we need the development of valid and reliable criteria for early diagnosis of addiction; second, a close multi-professional cooperation and the development of liaison institutions with intensive and extensive educational activities; and last not least, the establishment of a “pentalogue” between all groups closely involved in prevention activities as psychiatrists, patients, relatives, industry representatives, and politicians. In the first three parts of the course after a short general introduction the various definitory and diagnostic approaches including modern dimensional diagnostics and their value in clinical practice will be discussed. Research on the pathogenesis of addictions showed that addictive disorders are caused by complex interactions of various mental, physical and social factors. But addictions cannot be longer reduced to psychopathological manifestations once established and therefore persisting. The addictive behaviour is a dynamic process which only persists if disorder maintaining factors become active. These disorder maintaining factors are not necessarily corresponding with the addiction's predisposing and triggering factors. As addictions represent nosological nonspecific syndromes with a multi-factorial pathogenesis modern integrative treatment approaches (including psycho-pharmacological, psychotherapeutic and socio-therapeutic methods) have to be based on an early multidimensional differential-diagnosis of all the predisposing, triggering, and disorder maintaining factors. In this context the disorder maintaining factors provide the basis for effective, pathogenesis-oriented treatment of the actual symptomatology, whereas the predisposing and triggering factors provide informations for planning prophylactic long-term treatment. The main focus of fourth part of the course is dedicated to the manifold problems concerning multi-professional approaches in the management of patients with addiction disorders in general and in the field of early recognition of addiction in particular. The final part of the course will focus on various involuntary (and sometimes even unexpected) side-effects of early recognition of addictions (e.g. effects of stigmatization) and the possible solutions of the manifold problems we are confronted with in early diagnostics.