Heroin use has been associated with increased impulsive behavior. Overdose (OD) is a common cause of death among in opioide users, but majority of them report a history of non fatal OD. The aim of this study has been to observe the role of impulsivity among heroin users, as a prominent factor which can lead to non-fatal OD.

Sixty patients, heroin users (30 male and 30 female), were separated in two groups- first with positive history of non fatal OD and intravenous administration opoides and second without history of OD and same addiction pattern. Control group was formed of 30 heroin users reported non fatal OD and with intranasal administration opioides.The psychometric inventory- Barrat Impulsivity Scale (BIS 11), Dickman Impulsivity Inventory (DII), and Sensation Seeking Scale (SSS) were also administrated to patients with Hamilton Depression Rating Scale (HAMD).

The results have demonstrated significantly higher mean scores on Barrat and Dickman scale, compared with control. Separated analyses of variance conducted on Motor Barrat Subscale and Dysfunctional impulsives on Dickman Inventory revealed significant correlation in mean scores (p< 0.01).The important relationship between seeking for sensation and motor impulsivity was shown.There is no relevant diference detected on HAMD compared to control.

Chronic abuse of illicit drugs, such as heroin, produces significant deficit in executive control functions.These findings suggests that impulsivity could be associated with increase risk of non- fatal overdose.

Alcohol use by students is a major public health problem, leading to the Secondhand Effects - decrease in academic performance, injuries, blackouts etc.

To determine the extent of alcohol use on academic performance of university students.

Participants (n=46, mean age - 21 yrs) received the AUDIT questionnaire and other alcohol related questions. Grade Point Average and the effectiveness to sit for examinations of all participants from the 1st to 6th semesters of university education were used as objective criteria for problems related with alcohol use. The Pearson χ2 and Student's t-tests were employed for analysis of results. The probability value for significance was set at p< 0.05.

Alcohol and non-alcohol users were 41.3% and 58.7% respectively. Among alcohol users, the average quantity of alcohol used by one person per month was 37ml of absolute ethanol. A 10.9 - 11.4% higher rate of academic performance was noted among the non-alcohol users only in the 3rd, 4th and 5th, 6th semesters. The cases of injuries and blackouts were higher among the alcohol users by approximately 35 times. About 75% of all drinkers reported alcohol use only during their university education. The dose-time response effect of alcohol use on cademic performance was also proven.

A variety of inconsistencies in the pattern of alcohol use exists between male and female genders.

To examine the differences in the rate alcohol use and related problems in the general students’ population in Minsk, Belarus.

A total of 465 males (mean age of 21yrs) and 1030 females (mean age of 20.5yrs) were administered standardized anonymous AUDIT questionnaire. The cut-off point on the AUDIT was set at 8. Statistical analysis: All data analyses were performed using SPSS 16.0 version for Windows; the Pearson criteria and t-test. The probability value for significance was set at p< 0.05. All volumes of alcohol are in values of pure ethanol.

All in all, 85.7% males and 88.5% females were alcohol users. On the average, the total monthly quantities of alcohol use by the males and females were 131.3ml and 100.9ml respectively. Problem drinkers were 33.7% males and 10.1% females.

Even though the rate of alcohol use for the males and females was approximately the same, the percentage of related problems was significantly higher among the male population. Also, the quantity of alcohol use was higher among the males. The present study confirms that alcohol related problems are higher among males, compared to females.

Participation in social, cultural, and physical activities positively influences perceptions of health and quality of life. Few have studied how substance abuse influences patients’ participation in social, cultural and physical activities.

We examined patterns of past, recent and future (desired) activities of patients being admitted to substance abuse treatment at a Norwegian university hospital.

A questionnaire was developed specifically for the self-reporting of social, cultural, and physical activities. Psychiatric diagnoses including substance use diagnoses and other clinical and demographic data were also obtained. Data were analysed with descriptive and comparative analyses, including ANOVA.

78 patients responded (71%), 23 women, 55 men. Mean age was 38. 71% had a diagnosis of mental and behavioural disorders due to psychoactive substance use, while some had personality disorders (8.9%) or schizophrenia (3.6%). The total amount of activities had dropped significantly compared to before the respondents started abusing substances, and the drop was particularly pronounced for physical activities (Figure).

Changes in activities

Most expressed an interest in increasing their social, cultural, and physical activities.

The total amount of social, cultural, and physical activities falls markedly after starting substance abuse. Helping patients regain positive activities may improve subjective health and quality of life.

The hypothalamus plays an important role in regulating stress, reward and motivated behaviours. Central to this is the orexin (hypocretin) system, which is a key player in regulating these processes. The orexin system reflects an established functional dichotomy, where reward-mediated pathways are regulated by the anatomically distinct lateral hypothalamic orexin neurons; and stress is regulated by the orexin neurons located in the perifornical area.

To analyse current experimental literature on the role of orexin in the regulation of both stress and addiction

PubMed - searched with MeSH term “orexin” or “hypocretin”, with additional terms; “addiction”, “stress”, “relapse”.

The orexin neurons of the lateral hypothalamus act on the mesolimbic dopamine pathway, activating it directly, to produce its reward-seeking behavioural effects. The orexin neurons of perifornical area however mediate the response to stress, by increasing arousal, locomotor activity, and cardiovascular responses. But, via the activation of the hypothalamic-pituitary axis (HPA), it can also mediate effects on the mesolimbic dopamine pathway, in particular the ventral tegmental area (VTA), and cause reward-seeking behaviour as well. Additionally neurons containing corticotrophin-releasing factor connect the HPA reciprocally with lateral hypothalamic orexin neurons.

The pathways by which they work through are now understood reasonably well, but there is still new evidence emerging all the time which is increasing our understanding of the whole system, and this will have major implications in how we can approach addiction and diseases where the reward pathways are continuously activated.

It is widely described in literature, the high comorbidity between drug misuse and psychiatric disorders. 85% of patients with serious mental disorders, use alcohol or tobacco and other drugs. In almost 50% of them consume alcohol and cannabis. If we consider just hospitalized patients, the prevalence varies between 12 and 50% of the cases.That is why in 2003 a multidisciplinary group was formed in order to study drug consumption at hospital and to establish a drug screening protocol to control this issue.The objective of the study is to explain the protocol introduced in 2003 and an example of its benefits specially in the reduction of cannabis consumption.

There was elected a multidisciplnary group formed by the hospital administrator, the laboratory technician, different psychiatrists and nurses. They designed the drug screening protocol that we show in this work.

As an example of the effectiveness of the protocol, we consider the evolution of cannabis misuse before and after protocol enforcement, looking for positive results in urine samples. In 2003, there were taken 2575 urine samples for cannabis screening and in the 35,22% of the cases the result was positive. On the other hand in 2009, 3656 urine samples were collected and just the 17.7% of the determinations were positive.

The design of a specific, serious, standarized drug screening protocol in a hospital permits to control and minimize drug misuse during inpatients' hospitalization.

In some different studies, a high prevalence of posttraumatic stress disorder (PTSD) has been found in patients with several mental illness (SMI): schizophrenia, schizoaffective and bipolar disorder.

Evaluate the prevalence and correlates of PTSD in a sample of patients with SMI.

Adult patients with schizophrenia, schizoaffective disorder or bipolar I disorder were enrolled.

Patients who score 3 or more in conceptual disorganisation, hallucinations and/or unusual contents of thinking and 4 in another item of the Brief Psychiatric Rating Scale (BPRS) were excluded.

• Sociodemographic data

• Traumatic Live Events Questionnarie. Kubany ang Hayne, 2001.

• Distressing Event Questionnaire. Kubany anb Haynes, 2001, related to PTSD diagnostic DSM-IV criteria.

• 102 patients were included.

• The diagnostic subgrup of SMI patients were: 40 bipolar disorder, 52 schizophrenia and 10 schizoaffective desorder.

• The prevalence of PTSD was found in 15.1%: Criterion B (reexperiencing) 34.4%, Criterion C (avoindance and numbing) 27.1%, Criterion D (hyperarousal) 27.1%.

• The PTSD was more prevalent in females: 21.7% versus 8.5% (p 0.074). Only in criterium of hyperarousal the differences of gender were significatives (p 0.02).

• There were no significative differences in dignostic subgrups (p 0.381).

• Patients with PTSD had some suicide attempt history in 64.3% versus in 35.7% the patients without PTSD (p 0.042).

The comorbidity of PTSD in SMI was found in a fifteen percent, and only three patients had been diagnostiqued.

PTSD is significantly related to history of suicide attempts in patients with SMI.

The relationship between psychiatric disorders and adolescent suicide is well established. The aim of the present study was to examine gender differences in suicidal behavior among adolescents.

A structured diagnostic interview (Mini International Neuropsychiatric Interview Kid (M.I.N.I. Kid)) was used to determine 25 psychiatric diagnoses defined by the DSM-IV and suicidal behavior (having any current suicidal ideations or suicide attempts). The study population consisted of adolescents (aged 11-18), who were consecutively, first time admitted patients with suicidal behavior (according to the M.I.N.I. Kid) into the Vadaskert Child Psychiatry Hospital, Budapest.

Altogether 81 adolescents (46 girls (56.8%) and 35 boys (43.2%)) met the inclusion criteria. The most common psychiatric disorder of suicidal boys (n=35) was attention deficit hyperactivity disorder (ADHD) (n=17; 48.6%), followed by oppositional defiant disorder (ODD) (n=16; 45.7%) and generalized anxiety disorder (GAD) (n=13; 37.1%). Among girls (n=46) the most common psychiatric disorder was dysthimia (n=23; 50%), followed by GAD (n=22; 47.8%) and ODD (n=20; 43.5%).

This study examined an inpatient population with suicidal behavior, generalizations about outpatient and community samples cannot be made.

Based on the present study in adolescent suicide prevention, in both sexes professionals have to pay attention to externalization and internalization disorders as well. The striking finding is the very high prevalence of ADHD among suicidal boys. It's important to emphasizes the important role of GAD and ODD as risk factors of suicidal behavior in both sexes and dysthymia among suicidal girls.

Suicide is a leading cause of death in young people worldwide. Risk factors for suicidal behaviors and endophenotypes are partly heritable, and include variants in genes that drive stress diathesis in addition to, or by interaction with, certain adverse environments. Hypothalamic-Pituitary-Adrenal (HPA) axis genes are candidates for association with the dysregulated cortisol response to psychosocial stress that is observed in suicidal individuals. The role of HPA axis genetic variation will be explored in the context of varying “susceptibility” to suicidality after exposure to certain stressful life events.

A family-based association test was used on a case offspring-parent “trio” sample of 672 suicide attempt cases and their parents. Single nucleotide polymorphisms (SNP's) and/or haplotypes in CRHR1 were studied for interaction with age of exposure to physical and/or sexual assault, gender, and/or lifetime exposure to other types of stressful events.

Preliminary findings show interactions of certain CRHR1 SNP's with sexual and/or physical assault that are associated with suicide attempt, possibly using a violent method. Possible associations with candidate endophenotypes such as Cluster B personalities and early-onset major depression are under investigation.

Interactions of HPA axis genetic variants and stressful life events are consistent with a stress diathesis model of suicidal behavior, and may additionally influence the method and medical damage outcomes of suicide attempts, which may explain part of the diversity within this phenotype.

To provide information about psychiatric comorbidity and suicidal behavior in people with epilepsy compared to those without epilepsy from a community sample in Brazil.

An attempt was made to evaluate all 174 subjects with epilepsy (cases) identified in a previous community survey. For every case identified, an individual without epilepsy (control) and matched by sex and age was selected in the same neighborhood. A structured interview with validated psychiatric scales was performed. 153 cases and 154 controls were enrolled in the study.

People with epilepsy had more frequently anxiety (39.4% versus 23.8%, OR 2.1 [95% CI 1.2 - 3.5]; p=0.006), depression (24.4% versus 14.7%, OR 1.9 [95% CI 1.01 - 3.5]; p=0.04) and anger (55.6% versus 39.7%, OR 1.9 [95% CI 1.2 - 3.1]; p=0.008). They also reported more suicidal thoughts (36.7% versus 23.8%, OR 1.8 [95% CI 1.1 - 3.1]; p=0.02), plans (18.2% versus 3.3%, OR 2.0 [95% CI 1.0 - 4.0]; p=0.04) and attempts (12.1% versus 5.3%, OR 2.4 [95% CI 1.1 - 3.2], p=0.04) during life than controls.

These findings call attention for psychiatric comorbidity and suicidal behavior associated with epilepsy. Suicide risk assessment, mental evaluation and treatment may improve quality of life in epilepsy and ultimately prevent suicide.

1. 1. To assess how nurses evaluate their abilities to communicate to individuals who attempted suicide.

2. 2. To ascertain the attitude of nurses to the importance of the influence of communication with patients to their social rehabilitation.

3. 3. To determine, what kind of help nurses would appreciate to improve communication with patients with attempted suicide.

Original survey questionnaire, data analysis. Sample was selected by means of nonprobability - simple sampling method.

Study included a total number of 64 nurses working at the Hospital of Kaunas University of Medicine. Most of nurses evaluate their communication with suicidal individuals as positive: 80 percent believe they listen closely to their patients, 69 percent believe they pay enough attention, 69 percent talk to patients about their problems. 66 percent of nurses report the lack of information about psychological characteristics of suicidal patients, and 48 percent refer to the lack of experience in communication with such patients as the greatest problems in communication with individuals with attempted suicide. Also 52 percent emphasize lack of time and 34 percent mention reluctance of doctors to cooperate. 66 percent of nurses would like to undergo training containing these topics during lectures and seminars.

1. 1. Majority of nurses precisely determine suicide itself, however, causes of suicide are not so obvious.

2. 2. It is necessary to keep ongoing training of nursing staff on the topics of suicide prevention, treatment and rehabilitation.

The literature on suicidal behaviour among immigrants is scarce and little has been written from a comparative perspective.

The aim was to investigate whether suicide attempts are more common among immigrants than among their hosts, to map the differences between different immigrant groupings, and to analyse whether suicidal behaviours among immigrants and the populations of their countries of origin are related.

Data on suicide attempts (27,000 person-cases) originated from the WHO/EURO Multicentre Study on Suicidal Behaviour. Suicide attempt rates were calculated for each group. The immigrant groups were compared at each Center and across Centers. The completed-suicide rates of the home countries were compared to attempted-suicide rates in the immigrant groups using rank correlations.

Twenty-seven of the 56 immigrant groups showed significantly higher suicide attempt rates than their hosts. Also, they tended to have similar rates across different Centers. There was a significant correlation between the country-of-origin suicide rate and the immigrant-group suicide attempt rate among those born there. However, Chileans, Iranians, Moroccans and Turks displayed high suicide-attempt rates as immigrants despite low suicide rates in the home countries.

The similarity of the groups’ rates across Centers, and that of the suicidal behaviour in the countries of origin and among immigrants suggests strong continuity, which may be interpreted in cultural or genetic terms. The generally higher rates among immigrants in each Center and across Centers point to the influence of acculturative factors. Additional investigation into the specific characteristics of immigrant suicide attempters is needed.

interconsultation mode of observation from the emergency service is a subtype of demand related in large part with suicide attempts. the initial priority is to ensure the absence of organic complications resulting from suicide attempts, so it is usual in the course of 24 hours is appropriate to the request for psychiatric assessment

description of demographic and clinical profile associated with suicide attempts treated in the emergency department

are selected interconsultations motivated suicide attempts over 4 consecutive months in the emergency department of a tertiary hospital. the results were analyzed using SPSS 14

is selected from all those applications that relate to suicide attempts, resulting in a sample of 48 patients. the percentage of sex femininity is 73% and the average age is 38 years. respect to outstanding personal psychiatric history of affective disorders with 74%, substance abuse accounts for 37% and 10% psychotic history. 52% had made previous suicide attempts of low lethality and in 6% serious previous attempts. regarding the method used highlights with a 57% intake of drugs and second toxic and ingestion of alcohol and drugs.

evidenced a higher prevalence in female suicide attempts and low lethality, both of previous attempts like those presented today. only 10% of cases, held an admission to a psychiatric inpatient unit. the relationship with affective disorders, as well as with substance abuse is widely recognized in the literature

Around thirty of cases of public self-immolation occurred in Czechoslovakia, Poland and Lithuania between 1968 and 1972 in the background of protest movement against the Soviet ledinvasion. Rather than an act of a political protest, in a moment of absurdity of the existence, or a rational solution aimed to finish a desperate life situation, could a self-immolation also testify a suicidal behaviour and a failure of adaptation mechanisms of the victims concomitant a mental disorder?

We have selected and studied four most mediated cases of this period. Press articles available in English, French and Czech, biographical writings and czech archived data concerning Palach J. R. Kalanta, J. Zajic and R. Siwiec allowed us to retrospectively analyse the circumstances of the acting out, their apparent or hidden motivations and identify their suicidal risk factors.

All the four victims were men, young single students, aged between 18 and 21 years, excepted from R. Siwiec, aged 60 years. None had a psychiatric history or abuse of alcohol. All four, in the opposition of the communist system, were surrounded by a supporting family background. The public character of their act highlights the opposition against a totalitarian system and is questionning the possible intentionality of their behavior or the identification process of the young adults in post-adolescence.

Immolation by fire of Soviet opponents in Central Europe should be revised in the light of the likely depression and narcissistic vulnerabilities of these subjects.

Due to the inresed rate of depression and suicide the problem of correlation between suicidal behavior and symptoms of agitated depression became extremly important. In outpatient settings health professionals tend to underestimate clinical features indicated the increased suicide risk in patients with agitated depression. Inaccurate diagnosis and treatment plan frequently are suggested. Furthermore, agitated depression may occur in healthy person without previous psychiatric history, who has never applied to psychiatrist.In our study we aimed to verify the clinical features of agitated depression, which intensify suicidal trends leading to completed suicide.

From 477 patients with agitated depression we selected 126, who presented high risk of suicide and studded them by using Mood Anxiety Inventory (Greenberger D, Padesky CA (1995). Mind Over Mood. New York: Guildford Press).

On the bases of the structural-dynamic analyses we determine seven clinical variations of agitated-depression with prominent affective, cognitive, psychomotor, somato-algetic and behavioral symptoms.

The most dangerous types with regards of suicidal behavior appeared to be senesthopathic and algetic types and agitated depression with depersonalization and derealization.