The involvement of affective temperaments in the field of addiction and addictive conducts has been studied very little, despite the interest that this approach can have in the study and understanding of this disorder etiopathogeny.

We conducted a cross-sectional descriptive study of 60 Tunisian addicts who consulted the Tunisian Association for Information and Orientation on AIDS and CHEMS center during the period between 01 January and June 30, 2013. The dependence diagnosis was selected according to the DSM IV-TR criteria. We used the Tunisian validated version of the TEMPS-A for the evaluation of affective temperaments.

Our population was predominantly male in 96.7% of cases. The average age of our sample was 33.13 years old. The most frequent temperaments found in our population were hyperthymic temperament with an overall prevalence of 68.3% and a score of 12.78±4.4 and cyclothymic temperament with a prevalence of 58.3% and a score of 11.52±4.7. The essential reasons for substance abuse initiation were looking for novelty/thrills among the hyperthymic, the struggle against conflicts among those with depressive temperament, and anxiolysis in anxious addicts. We noted that alcohol and cannabis consumers had higher average scores in anxiety and cyclothymic temperaments. Heroin and cocaine consumers had higher scores in hyperthymic temperament. This temperament was significantly correlated with polydrug use (p = 0.005).

The study of affective temperaments is a necessary and critical step in the management, prognosis and prevention of substance abuse.

Assessment the ocular movements (saccades) in opioid addicted subjects in the dependence of the time of substitution treatment.

Eighty-eight patients from the substitution program were examined (mean age 39±7.7 years, mean daily dose of methadone: 71.9±(33.4) mg) The study included 55 subjects treated with methadone from one year to three years and subjects treated with methadone from three to seven years. The examination was conducted twice: before and about 1,5 hours after the administration of a therapeutic dose of methadone. Performed Latency Task (LT) with Saccadometr diagnostic system.

The statistical analysis shows that the mean duration after the administration of methadone in the subjects treated with methadone from one year to three years was statistically significantly increased (p=0,0001) but in the subjects treated with methadone from three to seven years was no statistically significant difference (p=0,0524). No statistically significant differences were found in other parameters of the test.

The results indicate a change in the dynamics of saccade after methadone administration in subjects treated with methadone from one year to three years compared to the subjects treated with methadone from three to seven years.

In Tunisia, the number of drug addicts seems toincrease and this addiction is considered as a complex psychiatric disorderwith a chronic relapsing course.

to describe the socio-demographic and clinicalprofile of drug addict patients.

This consisted on a cross-sectional and descriptive study. Data were collected from the files of 30 men hospitalized at the drug abuse prevention center ‘ATUPRET ‘of Sfax in Tunisia, during the month of September and October 2014.

The average age of patients was 33,6 years (19-59 years). They were single in 66.7%. Their school leveldidn’t exceed the secondary one in 80% of cases and they didn’t have any occupation in 30% ofcases. Theaverage age of onsetof drug use was21.3 years (14-52years) and the average duration of drug use was 11.9 years (1-43 years). Curiosity was the most commonly reported reasonfor initiating drug use (36, 7%). It was commonly a polytoxicomania (63%). The most widely used substances were cannabis (56, 7%) and subutex (46,7%). Nearly half of subutex addictsused to shoot it (42, 3%) and the average daily dose was 5, 28 mg. A comorbide affective disorder was found in16.7% of addict patients.

A young single men with no profession and a limitededucational attainment, such is the profile most frequently encountered amongdrug addicts in our study. Those social characteristics and the presence ofunderlying affective disorders should be considered in the management of suchpatients.

There is an increasing demand for treatment for dependence on different psychiatric medication like benzodiazepines. The goal is to determine the user's profile that is attended in a mental health center.

We obtained a sample of 30 users, divided into two groups: A) main drug benzodiazepines, B) primary drug others.

Sociodemographic, psychiatric and drug use variables are collected, making a descriptive retrospective analysis, using means for quantitative variables and proportions for categorical variables.

Group A is composed mainly of women (63.6%) of average age 46 years, and the group B of males (75%) with slightly higher average age (48 years). In group A and B the average level of education is primary/secondary education. Overall, they do not work and are single, having more pensioners and separated in group B.

In both groups, more than half have a history of affective disorders, often followed by anxiety disorders, with higher prevalence in group A (54.6% vs 36.8%), and personality disorders (77.3% and 75%).

In reference to group B, the primary drug of abuse is mostly alcohol. In general there is higher prevalence of nicotine dependence.

The profile of group A is a middle-aged woman who presents comorbidity with affective and personality disorders. The profile of group B is a middle-aged man, alcohol dependent, with earlier onset of use and with personality disorder.

Tramadol withdrawal symptoms are either natural (typical) or unnatural (atypical). In this context, psychotic symptoms as atypical Tramadol withdrawal symptoms have been rarely reported.

A case report and review of literature by a research on medline database. Key words: 'psychosis', 'psychotic symptoms', 'tramadol withdrawal', 'opiate withdrawal'

Mr. A. L. is 35 years-old man with a past medical history of alcohol dependence and cannabis abuse. He was admitted in 2012 for an alcoholic pancreatitis. Following this episode he began taking 650 mg/d of tramadol. He was put on Acetaminphen, clorazepate and paracetamol. When he started tapering Tramadol, he began experiencing auditory and cenesthetic hallucinations. He presented in our outpatient unit with restlessness, grandiosity thoughts, messianic delusions and sleeplessness. He was treated with antipsychotic medication and could stop taking Tramadol a week after his first consultation. After 8 days mental symptoms including hallucinations and delusions persisted. Therefore the diagnosis of Tramadol-induced Psychotic disorder with onset during withdrawal was the most likely diagnosis. Neurological examination was normal and brain CT scan showed no organic abnormalities.

There is evidence that only a few patients with tramadol dependency are susceptible to atypical withdrawal symptoms. Atypical withdrawal symptoms may include severe anxiety, panic attacks, unusual CNS symptoms such as confusion, delusion, derealization, depersonalization, paranoid thoughts, visual and auditory hallucinations. There have been some reports in the literature on psychotic episodes related to opiate withdrawal but only one previous case with Tramadol.

Trihexyphenidyl (THP) is an anti-Parkinson and anticholinergic drug, indicated in the treatment of parkinson disease, abnormal movements and parkinsonism induced by neuroleptic. The prophylactic use of anticholinergics in patients on neuroleptic treatment isn't recommended and may be justified only early in treatment. Howerver, in usual practice, the THP, is widely prescribed and used by patients. Recent observations suggest the existence of THP abuse linked to its hallucinogenic and euphoric effects.

to assess the tunisian psychiatrists perception on abuse and dependence potential of THP and their attitude toward this misuse.

A descriptive study among 100 tunisian psychiatrists (76: the public sector and 24: the private sector) who responded to a questionnaire, investigating the subject (dependence potential of THP, efficacy of THP, opinions about banning the THP from the tunisian pharmaceutical market).

87% of whole psychiatrists think that THP is associated with dependence potential. In the public sector, 77,63% of psychoatrists don't think that THP is more efficient than other anticholinergics and 78,94% agree to introduce other anticholinergic drugs in the hospital pharmacy. 3/4 of whole psychiatrists are for banning the THP from the national pharmaceutical market, espacially in the public sector, whose 80% of them approve the exclusion of THP from all public structures.

The majority of tunisian psychiatrists think that trihexyphenidyl is associated with a high risk of addiction. Many of them consider that banning THP and substitue it with other anticholinergics may be the solution. Is that really the best solution ?

Tramadol is an atypical, centrally acting, synthetic, analgesic. Its anti-nociceptive effects are mediated by a combination of μ-opioid agonist effects, and norepinephrine and serotonin reuptake inhibition. Initially, tramadol was said to have a low-abuse potential. However, its abuse liability and diversion were soon recognized, with several reports on physical dependence.

A case report and review of literature by a research on medline database. Key words: 'Tramadol”, 'opiate dependence”, 'tramadol withdrawal”, 'tramadol addiction”

Mr. L.M. is a 24 year-old man without past history of substance abuse. In 2012, he underwent leg surgery after gunshot wounds. He was started on Tramadol treatment for his pain. He progressively increased Tramadol dosage and was taking 250mg to 750mg intravenous injections per day. He tried several times to stop taking Tramadol but each time his developed nausea, muscle aching, dysphoric mood and insomnia. His withdrawal symptoms had bad impact on his daily life and resulted in family life breakdown.

Tramadol has long been considered to have a very low abuse potential. According to the US Food and Drug Administration, the rate of addiction was 1 in 100,000 during the last 18 months period of surveillance. Most of the cases had been in patients with a prior history of substance abuse. This case shows that Tramadol addiction may also occur in patients with no psychiatric or substance abuse history.

The aim of this study was to assess the differences in peak velocity of eye movements between alcohol-dependent and healthy controls.

Participants

Ninety-nine alcohol dependent patients were examined. Patients with oculomotor impairment were excluded. Thirty-eight healthy controls were matched to the affected cohort according to demographic characteristics.

Assessment

In this study we used the Saccadometer Advanced System (Advanced Clinical Instrumentation, Cambridge, UK). The eye movement measurements are automated and synchronized with stimuli presentation. The person conducting the experiment needs to ensure that the sensor is placed correctly and to give instructions to the test subject. The Saccadometer System does all other measurements and recordings of test data automatically. The study analyzed the peak velocity of eye movements of amplitude of 10 degrees and the deviations in peak velocity.

There was a statistically significant higher mean peak velocity of saccadic eye movements in alcohol-dependent individuals (440.82±86.33deg/s) when compared to healthy controls (411.39±86.33deg/s).

Greater asymmetry of mean peak velocity between right-sided and left-sided saccades was observed in the affected cohort when compared to the healthy test subjects.

There was a higher mean right-sided peak velocity (462.73±118.54deg/s) in the alcohol dependent subjects when compared to healthy controls (414.68±73.79deg/s) and also a higher mean of left-sided peak velocity (418.82±79.83deg/s) when compared to healthy controls (405.13±49.50deg/s).

It was found that alcohol dependence is associated with differences and significant increased asymmetry of peak velocity of eye movements.

The aim of this study was to assess the differences in saccadic latency (a measure of time delay experienced in eye movements) between alcohol-dependent and healthy controls.

Participants

Ninety-nine alcohol dependent patients were examined. Thirty-eight healthy controls were matched to the affected cohort according to demographic characteristics.

Assessment

In this study we used the Saccadometer Advanced System (Advanced Clinical Instrumentation, Cambridge, UK). The Saccadometer System allows quick and easy collection of saccadic responses within the shortest physiologically possible time (100 saccades in 5 min). The brevity of the testing routine minimizes any potential influence on the results due to fatigue in the test subjects. The eye movement measurements are automated and synchronised with stimuli presentation. This study analyzed saccadic latency and standard deviation of mean latency.

There was higher saccadic latency and standard deviation of mean latency in alcohol-dependent individuals (224.43±56.24 msec) when compared to healthy controls (187.84±25.65 msec). A marked asymmetry of standard deviation of mean latency between right-sided and left-sided saccades was observed in the affected cohort. There was an increased standard deviation of right-sided saccades mean latency (69.96 msec) in alcohol-dependent individuals when compared to healthy controls (30.93 msec) and also an increased standard deviation of left-sided saccades mean latency (59.33 msec) when compared to healthy controls (33.09 msec).

It was found that alcohol dependence is associated with impaired (longer time delay) saccadic reaction.

The people who seem to have less social support And suffer lack of multiple social supports are more likely at risk to drug abuse.

This research was an experimental with pre-test post-test design with randomly assigned 30 patients referred to drug addiction treatment centers in experimental and control groups. present aim at testing the effect of eight, 2- hour sessions of stress management training based on cognitive behavioral techniques. Subjects were tested at the beginning and at the end of the project with (SSQ).

Study findings showed that the subjects of experimental group that were under the intervention(training)compared with control group showed significantly better scores and test effectiveness.

Interventions based on cognitive – behavioral approaches, is effective treatment that it can alters behavioral and cognitive factors associated with substance abuse and be as an efficient model for the prevention of drug abuse and also after treatment.

Enucleation is a topic discussed in psychiatry which is a self-injury matter. Enucleation is observed as psychotic disorder due to substance abuse. In people with mental disorders who also have substance use leading to hallucinations and delusions, unusual eye evacuation were reported. In most cases, enucleation was done using sharp tools.

This report describes a man suffering from psychosis after consuming hashish and has attempted to evacuate his eyes with his finger.

Given the increasing prevalence of hashish use by young people, and false beliefs about the use of hashish in order to withdraw other substances, preventive methods and education for young and vulnerable people are suggested.

Only a limited number of studies have examined the association of conversion disorder (CD) with depression and anxiety in adolescents. Furthermore, no data regarding the association of CD with anxiety sensitivity and perceived social support are available. This study aimed to assess the relationships among psychological characteristics and conversion symptoms in adolescents.

We assessed 50 outpatients, aged 8–18 years, who had been diagnosed with CD and members of a control group using the Child Depression Inventory (CDI), Screen for Child Anxiety-related Emotional Disorders (SCARED), Childhood Anxiety Sensitivity Index (CASI), and Multidimensional Scale of Perceived Social Support (MSPSS). Symptoms of CD were assessed using the Somatoform Dissociation Questionnaire (SDQ) and Children's Somatization Inventory (CSI).

Compared with controls, adolescents with CD scored higher on the CDI, SCARED, CASI total, CASI physical and cognitive subscales, and MSPSS total and MSPSS family subscale. Multiple regression analysis showed that CDI, CASI total, and CASI cognitive scores predicted the SDQ scores and that CDI and CASI total scores predicted the CSI scores of subjects.

This study suggest that adolescents with CD had poor psychosocial well-being, and depression and global AS and AS cognitive concerns may play a role in the development of conversion symptoms.

Literature describes important comorbidity rates between somatization and mood disorders. Furthermore, there are data suggesting an association between affective temperament and somatization traits in healthy subjects.

In the present observational study, we investigated affective temperaments and somatization aspects in clinical and healthy samples.

The study focused on differences between unipolar depressive inpatients (DEP) and controls (C).

We administered to 20 DEP and 20 C following questionnaires: Mini International Neuropsychiatric Interview (MINI), 17-item Self Rating Depression Scale (SDS), Hypomania check list 32(HCL-32), Self Rating Anxiety Scale (SAS), DCPR diagnostic criteria for psychosomatic research, Brief TEMPS-A, Modified Somatic Perception Questionnaire (MSPQ), Somatosensory Amplification Scale-SSAS. DEP and C were matched for age, sex and marital status.

About temperaments, ANOVA showed that DEP were more cyclothymic (p<0,0001), depressive (p<0,0002) and irritable (p<0,0425) (scores to Brief TEMPS-A) than C. In addition, in DEP, MSPQ scores (somatic perception scale) were higher than C (p<0,0001). Similar results were about SASS scores (somatosensory amplification scale). DEP present more frequently than C Type A Behavior Pattern (DCPR diagnosis) (CHI-SQUARE p <0,0601).

Our data suggest that DEP present an important affective temperamental dysregulation. Relative to somatization aspects, DEP show a greater vulnerability than C.

Anxiety symptoms have variable prevalence rate of 26.3% to 50.4% in schizophrenic patients compared to 28.8% for general population. Some atypical antipsychotics (Quetiapine, Olanzapine) are effective in reducing anxiety in patients with schizophrenia or schizoaffective disorders.

The purpose of this preliminary study was to compare the efficacy of typical and atypical antipsychotics in reducing anxiety in patients diagnosed with schizophrenia and schizoaffective disorder hospitalized in Arad between 2013- 2014.

Considering the treatment, 63subjects patients were divided in two groups: T1 (treated with Olanzapine, Quetiapine) and T2 (treated with Haloperidolum, Risperidone, Aripiprazol).

After treatment, the level of anxiety is reduced with significant improvement of total score of PANSS; the effect is higher in group T2 compared to T1. Before treatment, anxiety is positively correlated with total score of PANSSN (r=.285; p=0.010), PANSST (r=.260; p=0.040) and total score of HAM-D (r=.455; p<0.0001). Also the score of the YMRS is negatively correlated with negative items of PANSSN scale (r=-.321; p=0.010). The cognitive level (QI) was decreased post-treatment for both treatments, but T1 had had a higher effect on it.

Various treatments are successful in reducing anxiety in psychotic patients. This conclusion is confirm duet our results: in group T2 the treatment has a higher effect on anxiety and lower size effect on intelligence.

Surgery operations of children causes serious anxiety for parents.

The study was designed to determine the factors increasing the severity of anxiety existing in the parents whose children will have an operation and what can be done to decrease it.

200 parents were asked to complete the social demographic data form, Beck Anxiety Inventory(BAI), State-Trait Anxiety Inventory(STAI) before the surgery.

Mothers had higher scores of BAI and Trait Anxiety. The BAI score of two year-old and older children's parents had greater value than the one year-old children's parents(p=0.020). The State Anxiety score of girls' family was found greater (p=0.049).

The State Anxiety score of the parents who are unlettered/graduated from primary school was greater than those who graduated from high school/college(p=0.026). The BAI scores of the parents with low occupational level/unemployed and housewives both were greater than those of the parents with average/high occupational levels(p=0.029). The BAI score of parents with large families was lower than the parents with nuclear/fragmented families(p=0.043). The BAI score of parents whose families hadn't have surgery before had greater values. The Trait Anxiety score of parents whose children had a, b,c types of surgery operations was smaller than d, e types(p=0.036).

It was found that the mothers and parents who have daughters, with low educational levels and low socioeconomic status have continuous anxiety. Therefore, parents need to be informed more about children's diseases, the type of the surgery operation and the technique of anesthesia in pre/postoperative term.

Individual ethnogenetic and psychophysiological characteristics influence on peculiarities of risk, incidence, diagnosis, and course of a number of diseases.

An investigation of ethnogenetic characteristics (on phenotypic variants (PhV)) was performed in comparison with psychophysiological parameters (temper structure, personality anxiety, and parameters of strength, stability and mobility of the nervous system (NS)) of 123 patients with neurotic disorders and 105 persons without them.

Patients with neurasthenia represented more often Alpine PhV (30.56%); patients with anxious disorders represented more often Dinaric (18.64%), Armenoid (11.86%), and Paleo-European (11.86%) PhVs; patients with somatoform disorder more often represented Alpine (28.57%), Atlanto-Baltic (21.43%), and Uralic (10.71%) PhVs. Among patients with neurotic disorders presence of PhVs, which were non-typical for the general population (Atlanto-Baltic and Armenoid PhVs), was also determined. Patients of Alpine PhV demonstrated a high rigidity (91.66%), personality anxiety (80.00%), reaction pace (83.33%), a moderate NS stability (46.34%), and a low NS mobility (48.00%), which were a prerequisite for neurasthenia formation. Patients of Atlanto-Baltic, Uralic, and Alpine PhVs predominantly showed a high rigidity (94.11%), a moderate extraversion (52.94%) and reaction pace (64.70%), a low NS activeness (76.74%) and stability (47.05%), which were associated with somatoform disorders. Patients of Dinaric, Armenoid, and Uralic PhVs demonstrated a high personality anxiety (78.75%), emotional excitability (84.61%), extraversion (69.23%), passivity (76.47%) and inertness (42.85%) of nervous processes, and a moderate NS stability (54.17%), which were factors of anxious disorders formation.

These data should be taking into account in diagnosis and treatment of neurotic disorders.

An increasing amount of chronic, prolonged forms of mental disorders stipulates an actuality of this problem and require development of diagnostic and therapeutic strategies directed on prevention and overcoming of resistance.

The aim of the investigation was to define clinical-psychopathological peculiarities of dissociative disorders with signs of resistance.

Fifty patients with dissociative disorders (including 30 with signs of resistance and 20 without signs of resistance) were examined. The clinical-psychopathological method including a clinical-phenomenological analysis of psychopathological symptoms was used with addition of the Symptom Check List-90-Revised (SCL-90-R) scale.

It was found out that resistant dissociative disorders were characterized with a prolonged onset of the disease (J (xij) = 0.37); a somatization of clinical manifestations with formation of permanent somatic symptoms in several systems of organism (J (xij) = 0.30); a comorbidity with somatic-neurological pathology (J (xij) = 0.49); a combination of hypochondriac, depressive, and phobic psychopathological syndromes (J (xij) = 0.22) accompanied by a steady limitative behavior (J (xij) = 0.30).

The results obtained are expedient to use as criteria for diagnosis and targets for treatment of resistant dissociative disorders.