Alexithymia is the incapacity to identify and describe one's own feelings. Our study questions whether alexithymia is a constant personality “trait” or a “state” phenomenon occurring in addicted patients. Our hypothesis is that this may change with cognitive-behavioural psychotherapy.

96 patients (69 male and 27 female) suffering from multiple substance addictions defined by DSM-IV criteria participated in group cognitive-behavioural treatment sessions, for a period of 8 weeks. The patients did not have concurrent psychotic and organic cerebral diseases, withdrawal syndrome, and were abstinent from psychoactive and substitution medication. Each patient was evaluated at the beginning of the first and the last week of psychotherapy according to Schalling-Sifneos Personality Scale Revised, State-Anxiety Inventory of Spilberger, Hospital Anxiety and Depression Scale, Hopelessness Scale. Duration of the addiction, educational and social-economic states were analysed.

60% of patients (44% of female and 67% of male) were established as alexithymic. These patients showed the highest scores in all psychometric tests compared with non-alexithymic patients.

After cognitive-behavioural psychotherapy the majority of the patients improved their scores and only 30% of patients (22% of female and 33% of male) remained alexithymic. There are correlations between alexithymia and the severity of anxiety-depression manifestations, the duration of addiction, the educational and social-economic states.

Alexithymia is a “state” phenomenon within patients with substance addiction and can be improved with cognitive-behavioural psychotherapy.

It is very important to monitor and analyze statistics on the adverse consequences of alcohol abuse. In fact, there is already a tradition of using the alcohol consumption per capita level as an index of magnitude of alcohol-related problems.

Statistical data of narcological service reports turns out to be a unique source of information regarding the problem.

In the present paper we focused on the aggregate-level, beverage-specific effect of alcohol consumption on alcoholism and alcohol psychoses morbidity rate.

Trends in alcoholism and alcohol psychoses morbidity rate and beverage-specific level of alcohol consumption per capita from 1970 to 2005 in Belarus were analyzed employing ARIMA analysis in order to assess bivariate relationship between time series.

According to official statistics, alcohol psychoses rate increased 3.5 fold (from 6.8 to 23.7 per 100.000 of population) and alcoholism rate increased 6.0 fold (from 51.5 to 304.7 per 100.000 of population).

The results of analysis suggest close relationship between alcohol psychoses morbidity rate and total level of alcohol consumption per capita (r = 0.72; SE = 0.18), as well as strong spirits (vodka) consumption (r = 0.47; SE = 0.18).

The outcome of present study suggests that alcohol psychoses morbidity rate is considered to be reliable enough statistical index reflecting the level of alcohol-related problems in the society.

Different personality factors have been investigated in connection with addictive disorders such as pathological gambling. “Impulse control”, proposed as a dimension of personality in modern “Big Five” models, has been associated with pathological gambling. Pathological gamblers have a high prevalence of childhood attention-deficit/hyperactivity disorder (ADHD), which is also associated with high impulsivity. Based on a five-factor personality model, our objective was to compare different personality dimensions in a group of pathological gamblers with childhood ADHD history, a group of pathological gamblers without such history and a control group. Special emphasis was placed on the factor “emotional stability”, which includes the subdimensions “emotion control” and “impulse control”.

A sample of 30 pathological gamblers with childhood ADHD history (ADHD+PG group), 33 pathological gamblers without ADHD history (ADHD-PG group) and 42 control subjects were assessed using the Big Five Questionnaire (BFQ). The different BFQ dimensions and subdimensions were compared.

For the “emotional stability” factor, the T-scores obtained indicated statistically significant differences between groups (ADHD+PG group: 44.1; ADHD-PG group: 51.9; control group: 57.9; ANOVA, p<0.001). Scheffe´s post hoc analysis showed the ADHD+PG group to be less emotionally stable than both the ADHD-PG (p=0.002) and the control groups (p<0.001); the ADHD-PG group also scored lower on this “emotional stability” factor than the control group (p=0.015).

Pathological gamblers with a history of childhood ADHD exhibit differential personality traits. ADHD history is associated with a lower score on the “emotional stability” factor, which includes the subdimensions “emotion control” and “impulse control”.

A high prevalence of childhood attention-deficit/hyperactivity disorder (ADHD) history has been found in alcoholic patients. Patients with this history have an earlier onset and greater intensity of alcohol use, more polysubstance use and a poorer prognosis. Our objective was to study differences in neuropsychological functioning in a group of alcoholic patients according to the presence or absence of a history of childhood ADHD.

A sample of 136 male alcoholic patients and 56 male control subjects were evaluated using the Continuous Performance Test (CPT); execution in both groups was compared. The sample of alcoholic patients was then divided into two subgroups according to the presence or absence of a history of childhood ADHD, namely the ADHD+ OH subgroup (61 patients with childhood ADHD history) and the ADHD- OH subgroup (75 patients without this history); CPT execution in these two subgroups was also compared.

The group of alcoholic patients made more omission (p=0.008) and commission (p=0.009) errors in the CPT than the control group. When comparing subgroups, ADHD+ OH patients made more omission and commission errors than ADHD- OH patients, although the differences did not reach statistical significance.

Alcoholic patients perform more poorly on the CPT than control subjects. In the sample of alcoholic patients, a history of childhood ADHD was not associated to significant differences in the execution of this test.

Smoking is an important health problem associated with different medical and psychiatric disorders. A high prevalence of smoking has been described in psychiatric patients. Our objective was to determine the prevalence of smoking in inpatients admitted to a psychiatric hospitalisation unit in a general hospital, and to study the possible differences in this prevalence according to the different psychiatric diagnoses.

A retrospective analysis of the medical records and discharge reports of the 659 patients admitted to our psychiatric hospitalisation unit during three consecutive years (2003-2005) was carried out.

At the time of their admission, 70.2% of our patients were smokers. This percentage reached 97.2% among patients with substance-use disorders (SUDs), and 95.5% among patients with dual diagnosis. However, only 48.6% of patients without concurrent SUDs were smokers; this difference reached statistical significance (p<0.001). According to psychiatric diagnosis, significant differences were also found regarding the percentage of smokers: 83.0% in schizophrenia, 80.0% in schizophreniform disorder, 70.7% in bipolar disorder, 29.3% in major depressive disorder and 56.8% in other disorders (p<0.001).

Although smoking prevalence among psychiatric patients is higher than in the general population, differences were found between the various psychiatric diagnoses. Thus, the prevalence of smoking was highest among psychotic patients and among those with concurrent use of other substances, whilst depressive patients had rates of smoking similar to those of the general population.

Alcohol and cocaine are frequently used together. Little is known about which factors are related with the development of either cocaine or alcohol dependence in dually users.

To determine variables associated with the risk fro the development of either cocaine or alcohol dependence in non-dependent drinkers with recreational cocaine use during a 4 year-follow-up period.

A prospective cohort study was performed to establish the risk factors associated with alcohol and cocaine dependence. Subjects recruited (N=336), from primary care centres. At baseline were classified as heavy drinkers and cocaine users (HD+Co, N=227) and alcohol abusers with cocaine use (AA+Co, N= 109).

At 4-year follow-up assessment, AA+Co subjects had higher rates of prevalence for cocaine (55% vs. 32%, p<0.001)) and alcohol dependence (97.5% vs. 58.2%, p<0.001) than HD+Co participants. Being alcohol abuser and single were eight and three times, respectively, more likely to develop cocaine dependence. When impulse control disorders or alcohol abuse occurred the odds ratio of developing alcohol dependence was 9 and 5.7 respectively. Also, alcohol abuse at baseline was associated with shortened time between onset of abuse and dependence for cocaine use disorders and for alcohol use disorders.

Alcohol abuse in heavy drinkers with recreational cocaine use predicted alcohol and cocaine dependence at follow-up. Our findings agree with previous findings supporting the relationship between impulsivity and risk for substance use disorders.

Impulsivity has been associated with alcohol dependence, but impulsivity in alcohol-dependent subjects has not been well characterized.

Using a variety of laboratory measures of impulsivity, we assessed whether alcohol-dependent patients (ADP) were more impulsive than control subjects, and the role of Cluster-B personality disorders in impulsivity measurements.

A cross-sectional patient survey with a community comparison group. Diagnoses were made using the Structured Interview for DSM-IV. Sustained attention and rapid-response impulsivity were assessed using the continuous performance test (CPT). Inhibitory control was measured by the stop-signal task (SST). Ability to delay reward task was assessed using differential reinforcement for low-rate responding (DRLR).

A final sample of 253 males with alcohol-dependence recruited from two alcoholism treatment centres was compared with a matched non-substance-abusing comparison group (n=96).

Patients with alcohol dependence were more impulsive across all behavioural tasks. Alcohol-dependent subjects without personality disorders showed lower efficiency in DRLR than control subjects. Patients with Cluster-B personality disorder performed worse in inhibitory control, but subjects with borderline personality disorder in particular demonstrated increased rates of omission and commission errors in CPT. Inability to delay gratification was associated with antisocial personality disorder.

Our findings support the suggestion of two paradigms in alcohol dependence. The first, based on inability to delay gratification, might be a vulnerability marker for alcohol dependence. The second was related to inhibitory control, and might be specific for antisocial and borderline personality disorders.

Current trends that integrate neuroscience, attachement theory and clinical psychiatry suggest that traumatic attachments are imprinted into the developing limbic and autonomic nervous systems of the early maturing right brain. On the other hand addiction is caused by long lasting changes in brain function as a result of pharmacological insult (repeated drug use), genetic disposition and environmental association made with drug use (learning).

From our clinical work it is known that experience of any sort of attachement abuse is not uncommon in alcohol addiction. Issues of violence and sexual abuse in early personal history deeply influence not only partners' relationship, the capacity for intimacy and mutual trust, but also parental function and cooperation. Attachement traumas in addicted patient were supposed to be very resistant in treatment because of mutual reinforcement of both problems (early trauma experience and addiction): such patients were prone to relapse in addiction treatment either because detached traumatic experiences become a source of long lasting manipulation of addicted patient for retaining the “right for drinking” either because of seriously comorbide disorders without appropriate pharmacological treatment.

In our clinical experience, we found attachement trauma psychotherapeutically accessible only after period of stable sobriety and secondly, that routine combination of intensive psycho- and pharmacotherapy gives an optimistic attitude in treatment which is illustrated by clinical vignettes.

youths almost use alcohol or drugs the first time under peer pressure and they want to be accepted and be a part of the group.Using the alcohol they behavior have changed. Alcohol also caused the problems with friendship, family/parents, school, community, law, etc.

the sample of 20 youth patients (15 male and 5 female) under the age of 16 – 25 were conducted between January – June 2006. on the Department of alcoholism in the Institute on addictions,Belgrade. Data were collected from patient's history of illness,clinical protocols and psychiatric interviews including the criteria of alcohol abuse and adolescence crisis according to ICD – X.

to show that alcohol abuse in adolescence period is not just a developmental course, but more serious problem with consequences on behavior and social relationships.

1. 1) to take the other drugs (canabinoides, Ecstasy, sedatives): 11 patients (55%);

2. 2) marked fall in academic: 9 patients(45%);

3. 3) family problem: 20 patients (100%);

4. 4) auto destructive behavior: 7 patients (35%);

5. 5) behavior changes (aggressive,hostile,etc.) : 13 patients (65%);

6. 6) problem with law: 8 patients (40%);

7. 7) risky behavior (unprotected sex): 17 patients(85%).

this study shows that developmental transitions, such as puberty and increasing independence, have been associated with alcohol abuse. Just being an adolescent may be a key risk factor for drinking dangerously and consequential alcohol-related problems.

alcohol is the widespread among youths and the drug of choice. Many young people are experiencing the aversive symptoms as consequences of drinking too much, at too early of age. Research shows that many alcohol dependent patients start to drink at very young age as a binge drinkers. New research shows that the serious drinking problems typically associated with middle age actually begin to appear much earlier, during young adulthood and period of adolescence.

data were collected from medical history,psychiatric and clinical records. The 150 male patients were treated for alcohol dependent on the Department of alcoholism (DA) in Institute of addictions,Belgrade, between May 2005- 2006,including the criteria of alcohol dependent according to ICD – X.

the study shows does adolescence binge drinking may lead to alcohol dependent at middle age and alcoholism at all.

the total of 150 male patients with alcohol dependent at presence, 90 patients (60%) were experiencing of binge drinking before age of 15; 50 patients (33,3%) at age of 15 – 20; 10 patients (6,66%) at age of 20>.

the most of treated and observed male patients on DA who were binge drinking in young adulthood period are alcohol dependent at present and diagnosis verifications by the criteria from ICD-X. Youth and teenage drinking problem may lead to be a pathway for serious adult problem – alcohol dependent and alcoholism, as a developmental and behavior framework.

Computer and Internet use by children and adolescents is widespread and begins at an early age. They commonly use computers for playing games, completing school assignments, email, and connecting to the Internet. On-line, the most frequent activities are school work, email, games, and finding information. We investigated factors that influence adolescents' engagement in risky Internet behavior, in particular the factors relating to development identity.

All the students, aged between 15 to 18 years old, come from 7 high schools of Iasi. The authors examined the online construction of identity at 283 teenagers, who had been involved in an online activities and completed a survey to assess relationships among development identity and (a) amount of Internet use (with the identification of a possible computer addiction), (b) the interference of excessive use with school grades and social life;

Results indicated that the following factors were found to be predictors of adolescents development: frequency of Internet use, frequency of chatting, parental rules, type of personal information given out, amount of inappropriate messages received, whether inappropriate websites have been visited, and type of internet advice heard.

Our results showed a significant positive correlation between measures of Internet use and time spent online for the Internet. Implications for and development as impacted by social support networks, are discussed. Finally, Internet use was associated with identity status. These results suggest that the Internet may be an important aid for teenager as they searched for an young identity.

Police and ambulance personnel are widely believed to have a high prevalence of excessive alcohol consumption. However, the empirical basis for this assumption is scant or non-existent. We assessed the association of alcohol use with burnout and job stress, with ‘drinking to cope’ and neuroticism as two possibly moderating factors in two occupations, the police- and ambulance services.

A comprehensive nationwide questionnaire survey of police (n = 2665) and ambulance personnel (n = 1180) in operational duty. The questionnaire encompassed the Alcohol Use Disorders Identification Test (AUDIT), the Maslach Burnout Inventory, the Job Stress Survey, and the Basic Character Inventory (BCI). A series of multiple linear regression analyses were conducted to examine relationships among the variables.

With a modified AUDIT score of 6 or more, the prevalence for men was 17.7% (police) vs. 16.6% (ambulance personnel). The prevalence for women was 9.1% vs. 7.4%, respectively. Personnel who were male, younger, and with higher levels of neuroticism reported higher levels of alcohol problems. ‘Drinking to cope’ was most strongly associated with higher levels of alcohol problems (standardized beta = 0.29, p < 0.001), and was found to moderate the effect of depersonalization and gender.

The prevalence of hazardous drinking was moderate in both groups. However, among those personnel who drank to reduce stress, males and those experiencing higher levels of depersonalization may be at increased risk of developing alcohol-related problems.

To evaluate the effect of quetiapine for the treatment of insomnia in addictive pathologies.

Observational retrospective chart review of patients with diagnoses of substance addiction and insomnia (DSM-IV-TR) and who received quetiapine for the treatment of their sleep disorder. In and outpatients were included. Outcome was measured with the Spiegel Sleep Questionnaire (SSQ). Patients' compliance and adverse events were also collected.

53 clinical histories were reviewed. 73.6% were males and mean age was 31 years. Heroine (65.4%) was the most frequent drug of use followed by cocaine (19.2%). Mean dose of quetiapine was 62.4 mg/day (SD:35.9). 73.6% completed the treatment with quetiapine for 60 days. Initial severity of insomnia was 2.42±0.61 (mean; SD) as measured by the SSQ global score (n=42), improving to 4.07±0.69 (p<0.0001) after quetiapine treatment. All items of the questionnaire improved significantly (p<0.0015). The greatest improvement in sleep occurred in the first week of treatment (p<0.001). Compliance was >90% in 71.8% of patients. The most frequent side effect was dry mouth (34%).

Quetiapine at low doses showed benefits on sleep in drug dependence subjects suffering from insomnia as measured by SSQ. Quetiapine was associated with a fast onset of response and maintenance of effect up to 60 days

Comorbidity between drug misuse and mental disorders affects negatively in the prognosis of psychistric illness, so it´s important to guarantee drug abstinence at least during hospitalization. This is even more significant in a medium stay unit because patients are more serious and resistant to treatment.

In February 2003, a multidisciplinary group was formed to evaluate the situation of drug use in a psychiatric hospital and a drug screening protocol was then created.

We evaluate if with the protocol, drug use decreases during hospitalization in a medium stay unit in a psychiatric hospital.

It is compared drug use (positive results in urine samples) from 2000 to 2002 (before protocol: urine samples collected when there´s drug misuse suspicion) with the period after the protocol was enforced (from 2003 to 2006). In the protocol urine samples are collected when there´s a past misuse history, consumption suspicion, randomly and every time they leave for home.

It is proved that drug use decreases during hospitalization since the new protocol came into force.

The introduction and exhaustive completion of a protocol designed to decrease drug misuse in a psychiatric hospitalization unit, provokes a high reduction of drug use, so we think it´s convenient to generalize this kind of measures.

Research on personality and substance use has shown that some traits of personality might be involved in the onset and later development of addictions. According to Gray's Reinforcement Sensitivity Theory (RST; Gray, 1981), there are two basic brain systems that control behaviour and emotions (Corr, 2004): the Behavioural Inhibition System (BIS) and the Behavioural Activation System (BAS). It has been suggested that high levels of BAS sensitivity predispose psychopathological conditions that are characterized by a pathological engagement in approach behaviours, such as alcohol and drug abuse (Franken, Muris, Georgieva, 2006)

The aim of the present research was to analyse individual differences in the BIS and BAS in a sample of cocaine dependent patients in comparison to a non-clinical population group.

To carry on this study a number of BIS/BAS related scales were administered in a sample of 30 cocaine dependent patients and in a non-consumers control group of 30 participants recruited from general population.

Cocaine addict patients showed higher BAS scores, specifically in Sensitivity to Reward, Non-planning Impulsivity, Motor Impulsivity and Cognitive Impulsivity in comparison to the control group. Moreover, the Disinhibition scale, of the Sensation Seeking Scale, a measure also related to BAS activity, predicted age of onset of cocaine consumption.

These results suggest that BAS might be a vulnerability factor of cocaine misuse, while BIS might be a protector factor.

The objective of the present study was to compare the effects of the administration of mirtazapine, venlafaxine, topiramate and amisulpride as detoxification adjuncts, on anxiety and depressive symptoms and global functioning in a sample of alcohol dependent subjects

Four age-matched groups, comprising 25 subjects each, were treated with psychotherapy and adjunctive venlafaxine, mirtazapine, topiramate, or amisulpride. The Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale and the Global Assessment Scale were administered at the beginning and at the end of a 4-6 week detoxification period for the assessment of psychopathology. ANOVAs were used for comparisons between groups.

he results were: Venlafaxine: HARS=37.90±4.49, HDRS=41.52±3.47, GAS=46.00±5.07; Mirtazapine: HARS=36.02±8.41, HDRS=41.39±5.02, GAS=7.00±5.61; Topiramate: HARS=37.35±3.49, HDRS=41.00±3.16, GAS=46.50±4.00; Amisulpride: HARS=37.46±3.06, HDRS=40.82± 1.94, GAS=47.48±3.67 (ANOVA, NS). By the end of the detoxification period psychopathology significantly subsided in all four groups. However this reduction was more marked in the mirtazapine treatment group: Venlafaxine: HARS=7.44±3.36, HDRS=8.28±3.45, GAS=83,43±6,27; Mirtazapine: HARS=4.78±4.0, HDRS=3.71±3.45, GAS=86.15±7.57; Topiramate: HARS=9.55±1.25, HDRS=9.65±2.89, GAS=82.65±4.75; Amisulpride: HARS:4.72±3.44, HDRS=6.53±3.42, GAS=82.53±6.37. Thus, the mirtazapine augmentation group differed significantly from the venlafaxine group (p<.000), the topiramate group (p=.002), and the amisulpride group (p=.014).

Moderate to severe anxiety and depressive symptoms with concomitant low functioning were present in all subjects before treatment. Following 4-6 weeks of alcohol detoxification using various medications (venlafaxine, mirtazapine, topiramate, amisulpride) these symptoms subsided and reached normal levels in all study groups. However, in our study, mirtazapine appeared to be more efficient than the other medications in reducing psychopathology and improving global functioning.