In mammals, the suprachiasmatic nuclei of the hypothalamus contain the master circadian clock that coordinates the daily temporal organization of endogenous rhythms. The core oscillation is thought to be driven by several genes called “clock genes” for their crucial role in the clockwork. Eating disorders (EDs), such as anorexia nervosa (AN) and bulimia nervosa (BN), are characterized by a disruption of circadian feeding patterns, as well as by alterations in the circadian rhythms of endogenous hormones. Therefore, a possible role of the clock gene in the biological vulnerability to EDs may be suggested.

To explore this hypothesis we designed a case-control study study exploring the 3111T/C polymorphism of the CLOCK gene in patients with EDs. One hundred fifty one female Caucasian patients were enrolled into the study. Sixty of them met the DSM-IV diagnosis of AN and 91 met the DSM-IV diagnosis of BN purging. A group of 90 normal weight Caucasian healthy women were also recruited. We could not detect any significant association between the 3111T/C polymorphism of the CLOCK gene and AN or BN. Moreover, we found that the 3111T/C polymorphism of the CLOCK gene was significantly associated with minimum past BW in both AN and BN individuals, but not in healthy controls.

In conclusion, our present findings, although preliminary, suggest that the CLOCK 3111T/C SNP does not represent a major vulnerability factor for AN and BN, but seems to predispose ED patients to a more severe BW loss in the course of their illness.

Eating disorders (ED) is commonly referred to among women. Very few studies have been done focusing on male ED. A traditional point of view is that eating disorders are rare among men. This may be right in regard to anorexia nervosa; however clinical experiences and recent studies show that we should not disregard eating pathology among men.

In the present study, 5000 postal questionnaires were sent out in December 2005 to men 18-65 years in Norway. The total response rate was 41%.

The main aim of the present study was to calculate the lifetime, and point prevalences of eating disorders in the general male population in Norway. In addition, the relationship between eating disorders and physical activity has been studied.

Several studies have shown high prevalence of eating disorders among elite athletes. In particular, weight-related sports focusing on body and body shape have indicated high numbers. Studies including lower-level athletes have failed to find strong a relationship between amount of training (hours per week) and prevalence of eating disorders.

The aim of the present study was to study the relationship between eating disorders and physical activity among 1500 Norwegian women aged 18-65 years.

In addition, we wanted see whether the prevalence of eating disorders is higher among competitive athletes than among recreational athletes.

The Survey for eating disorders (SEDs, 37 questions), which assesses full DSM-IV diagnoses for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and eating disorders not otherwise specified (EDNOS) based on self-report, was used. In addition, the respondents answered specific questions related to different aspects of exercise and physical activity, such as hours of exercise, type of sport and competency level. As far as we know, no earlier studies on eating disorders and physical activity in general population have presented data to differentiate between competitive athletes and recreational athletes.

Preliminary analyzez indicate that women with AN exercised more than all the other ED groups, and the BN group also showed a high number of weekly physical activity. More results will be presented in March. The analyses are expected to shed some light over the discussion concerning sport as a risk group for eating disorders in relation to competition and level of performance.

The treatment of overweight and obesity has recently been given priority by the Norwegian Government. A research project has been started in the Central Norway Regional Health Authority which includes surgical treatment (gastric bypass), and non-surgical treatment.

The focus on eating disorders and comorbid psychiatric diagnoses has to some extent been ignored in this patient group. Important questions are: How will an eating disorder and/or other psychopathology affect treatment outcome? How should the follow up procedures be tailored in regard to psychopathological status?

The main aim of this study was to describe the prevalence of eating disorders in obese patients. In addition, data on depression, anxiety, quality of life, and personality will be presented in groups with and without and eating disorder.

The purpose of this preliminary study was to examine the share of women with incorrect eating behavior in the group of young women studying courses join with food technology. The 120 women studying food technology, human nutrition, and dietetics (“food” group) and 118 women from the humanistic study (philosophy and pedagogic courses) (“humanistic” group) aged 20-24 years were examined by the Eating Attitude Test, designed according to DSM-IV and adapted to the Polish conditions. It was obtained statistically significant differences between different profiles of the study. However in the “humanistic” group 12% had early anorexia symptoms, in the “food” group it was approximately 29%. It could be in accordance with literature data concern interest in food, cocking, dietetic etc. in anorectics. The purpose of this study was also to compare the some elements of quality of life women with and without incorrect eating attitude in “food” group. There were significant differences in the assessment of own body shape (incorrect), imaging of perfect body shape (too thin), physical activity (high), reaction on stress situations (withdraws and escapes usually), frequency of physical symptoms (headache and stomachache, irregular menstruation) as well as home conflicts especially with old sisters or mothers. The social position of respondents were not influenced on expression of early symptoms of anorexia. This study suggests that profile of university education could depend on incorrect eating attitudes and should be common to focus on the candidates to recognize early anorexia symptoms and prevent to express them.

Anorexia behaviours, without complete typical symptoms of anorexia nervosa, are becoming more often and often common reaction to stress in young women. Some authors are in the opinion that even in early onset of anorexia may diagnose micronutrient deficiency. Hair are simple diagnostic material to assess trace elements status. The occurrence of anorexia behaviours was assessed by Eating Disorders Questionnaire based on DSM-IV and adapted to the Polish conditions. The questionnaire was fulfilled by 73 women aged 22-24 years. About 30% of subjects showed anorexia behaviours (AN Group). Rest of the women created control group (CON Group). In the both of groups calcium, magnesium, zinc, copper and iron were measured by FAAS method. However, there were no significant differences between analysed groups in the hair calcium, magnesium and iron (respectively mean: 1900, 66, 30 μg/g); the level of hair zinc (p<0,001) and hair copper (p<0,05) was significantly higher in the CON Group than in the AN Group (respectively mean: Zn – 251 vs. 194 μg/g and Cu: 15 vs. 12 μg/g). These results confirm opinion about fast decreasing of some micronutrient during fasting. Zinc is very important trace elements have a great importance in the protein synthesis such as neurohormones, and the low level of this element could fortify appetite deficiency.

We are presenting a retrospective study of case series of patients with a DSM IV diagnosis of pathological gambling, treated during 2006 in our institute (n=10; male=9, female=1; mean age=35 years).

The youngest patient (20 years) was addicted to video games, two were addicted to poker machines, three to betting (football) and the rest had variations of a combined addiction (card games, lotto, roulette, poker machines, betting); all subjects were addicted to nicotine. The mean duration of pathological gambling was 11.5 years, with mean onset at 23.4 years of age.

We identified 2 subgroups: early onset subgroup (<18 years); 5 subjects, mean onset at 16.6 years, mean duration 9.5 years; 3 unmarried, 2 divorced subjects; lower education level (1 primary school, 4 secondary school), 1 subject in part-time employment, 3 subjects with poly drug abuse and later onset subgroup (>18 years); 5 subjects, mean onset at 30.2 years and mean duration 13 years; 3 married, 1 divorced, 1single; education level higher (2 secondary school, 2 college); 3 fully employed, 1 in part time employment, 1 retired; 1 subject with comorbid alcohol addiction. The subgroups differed in adherence to treatment, too, with all early onset subjects dropping out from the program after few days, while the late onset subjects adhered for at least several months to up to one year.

Our results suggest that pathological gambling may represent a spectrum disorder with different clinical characteristics and prognosis.

Comorbid pathology of brain in formation of associated forms with the second stage of alcoholism (A): with exogenous-organic brain impairment of traumatic (group I); hypertensive (II), cervicogenic (III) genesis and without comorbidity.

Group I: A is formed early in persons with premorbidely problematic social adaptation (62,2% - excitable traits of character). Dysphoria in intoxication and withdrawal syndrome (AWS) results in psychopath-like degradation with total social desadaptation. Astheno-explosive modality of dysphoria - quick exhaustibility of affective oscillations. Outside AWS - reactive lability, asthenic-subdepressive states with dysphoric, hysteric-excitable components, more seldom hypochondriac manifestations.

Group II: Later formation of A (26,7% - anxious personality). Psychosomatization of anxiety - neurocirculatory dystonia (NCD). Alcohol decreased level of anxiety and severity of NCD with subsequent fixing the ataractic motivation of ethanol intake. In structure of AWS anxious-phobic modality of dominating depressive disorders with cerebral-asthenic and cardiovascular manifestations of toxicogenic effects of ethanol modified development of torpid asthenic-depressive states (with cardiophobic and hypochondriac components) - formation of hypochondriac variant of remission. Clinical efficacy of antidepressant Paxil in comorbid anxious-depressive syndromes has been revealed.

Group III: Intermediate tempo of alcoholism progression acceleration with obligation of diencephalic psychovegetative, psychosensory and severe psychoorganic cognitive disorders with asthenic, more seldom dysphoric variants of alteration of personality.

Comorbidely-conditioned variants of pathologically altered biological ground in associated forms of alcoholism broadens approaches to systemization of clinical polymorphism of affective disturbances with therapeutic strategies individuation.

The need for a specific therapeutic-rehabilitative group for cocaine addicted patients rises up both from the progressive increase of cocaine use in the general population and from peculiar personality traits and associated psychopathology of these clients. Moreover, it is difficult to mantain a compliance to therapy, because there are no specific anticraving or antidothic drugs for cocaine addiction.

Therefore our equipe developed a short integrated treatment (ten weeks), of “group concelling” and “psychodinamic group therapy” in association. The group is open and composed by a maximum of eight participants.

The novelties of this model are: (1) hospital setting, (2) a short duration and (3) synergy between two different approaches: Minnesota 12 steps model (one sessions weekly, held by a councellor on addiction), and a psychodinamic group therapy (one session weekly).

Main success is the retention of patinets in therapy for a long time. In twenty months (March 2005- October 2006), fourty cocaine-addicted patients started this program: only 30% of them dropped out, while 70% of patients completed the treatment. 64% of the latter where completely abstinent, while 36% relapsed during the therapy. All of them are still continuing some therapy at the moment: 46% individual psychotherapy, 25% individual psychotherapy and pharmacological therapy, 14% narcotics anonymous attendance, 11% N.A. groups and pharmacological therapy, 4% is in a T. C.

In the last six years an increasing number of patients seeking care for cocaine dependence entered the Day Hospital program at Catholic University medical school, with a milder variation in the number of opioid dependent patients. The number of cocaine dependent patients doubled year by year from 15 pts in 2003, through 32 in 2004, to 60 in 2005; preliminary data from 2006 seem to follow this trend. A minority of patients are addicted to other drugs. This outgrowth in cocaine addicted patients could be related both to a wider diffusion of cocaine related problems in the general population in Italy1 and to the institution of a specific program for cocaine related disorders in our service. The mean age of opioid dependent patients remained quite stable through years, with a slight increase from 32,1 years, with a standard deviation of 6,9 in 2001 to 33,5 with a SD of 7,0 in 2005. In the same years we observed a slight decrease in the mean age of cocaine patients, frome 36,2 years with a SD of 11,2 in 2001 to 32,8 with a SD of 6,8 in 2005. Both substances are most commonly abused by men: 83,1% of cocaine dependent and 79,2% of opioid dependent patients are male, while only 16,1% of cocaine and 20,1% of opioid dependent patients are female.

Since November 2005 our institute has been developing a group therapy program for pathological gamblers, alternating a counselling/rehabilitation and a group psychotherapy session each week. This program was presented to the press; all of our patients knew about it from the newspapers, except for one patient, who was addressed to our service by another specialist.

Up to November 2006 fifteen patients joined the program: they are all male, their mean age is 46,8 years old, with a standard deviation of 11,7; eight of them (53,3%) are married, two are divorced (13,3%), one is separated from his wife (6,7%), one has a stable relationship (6,7%), while three of them are free (20%). Their education is generally low: one of them (6,7%) completed only primary schools, eight of them have a lower intermediate education (53,3%), five completed upper intermediate schools (33,3%), only one got a degree (6,7%). Some patients have an associated psychopathology: four (26,7%) have a depressive disorder, three (20%) have a bipolar disorder II, three (20%) have a history of cocaine abuse, one (6,7%) has a mild cognitive impairment related to a Parkinson's Disease. Seven patients (46,7%) have gambling debts or legal problems related to gambling. The most popular games among patients were betting, lotto, slot machine, videopoker and in same cases card game.

The safe consumption rooms (DCRs) are integrated in programs to reduce drug-related harms. These places have developed since the mid-1980s, and now-a-days they exist in a lot of European countries, and also in Canada and Australia. The authors describe historic data as well as the main purposes, physical and human conditions, and typical users of DCRs, and make a review about studies concerning results and evaluation of their impact.

Arguments supporting and rejecting DCRs are presented and discussed. The particular case of Portugal is also mentioned, refering the law and the real actual situation. The authors support the idea that, while the benefits should not be exaggerated, these facilities can make a positive contribution to reducing drug-related harms in Portugal, in a future not so distant.