The work purpose was to examine the role physical and sexual abuse during childhood plays as risk factors for committing acts of sexual violence or child abuse once becoming adults.

We selected - from EBM literature published in the last ten years - the most significant studies, no neglecting previous studies also useful for a better comprehension about physical and sexual abuses suffered during childhood and their commission once adults.

To have been victims of physical and sexual violence during childhood predisposes to perpetrate similar behaviors. The family background seems to be the greatest risk factor for the development of such behaviors. This is demonstrated by studies of twins in which only one suffers sexual violence but both experience unfavorable outcomes like the examined. In particular, pedophiles are more exposed to sexual violence during childhood (73%) while rapist to physical and emotional abuse (68%, 70%), especially by parents (78%), but both share models of pathological attachment (anxious for pedophiles and avoiding for rapists).

Even if with different results, we can highlight how to be a victim of violence during childhood, especially in a family context characterized by physical or sexual violence, is one of the greatest risk factors in becoming an abuser. This evidence should be a major impetus to further researches, but mainly to act measures to safeguard the victims from the consequences of the trauma they suffered and from the development of future similar behavior.

Liaison Psychiatry facilitates the management of medical-psychiatric comorbidities.

To describe the activity of the Liaison Service, Maggiore della Carità General Hospital, Novara, Italy, from February 2006 to December 2011.

To evaluate the referral rate among different wards.

Patients referred for psychiatric consultation were analysed by means of a logistic regression model.

1794 patients overall were involved. The referral rate was 1,60%, with a decrease in 2011. The highest frequency was in Radiotherapy and Hematology (14.71%). Reasons for consulting were: management problems (38%), assessment of a positive psychiatric history (37%), depression (32%), differential diagnosis between organic and psychiatric diseases (19%). Interventions for differential diagnosis and management problems significantly increased in 2010 and 2011 respectively. Radiotherapy and Haematology Wards were characterised by a higher referral rate for psychiatric history or depression (53%; 55%), Surgery showed fewer requests for depression (20%). The consultant suggested interviews or drug administration to 91% and 69% of patients respectively; interventions on the hospital staff and on the family in 34% and in 16% of cases. We observed an increase in interventions on hospital staff (49%) since 2006 and the use of interviews increased (96%) since 2010. Radiotherapy and Hematology were characterized by a greater use of interviews (95%), interventions on staff (43%) and family members (22%).

The referral rate is consistent with literature. Differences among Wards as far as the use of liaison psychiatry is concerned are discussed.

Physical abuse means the non-accidental infliction of physical injury on or physical mistreatment of a child. Incidence, forms and degree of child physical abuse vary greatly depending on many variables such as geographical area, general awareness, culture, religion, economic status and others factors.

This study highlights occurrences of child physical abuses in Kurdish families from to medical students’ reports.

To know the rate of phsycial abuse in Kurdish families and address the related characteristics.

The total of 432 medical students in Kurdistan Region/Erbil/Iraq, anonymously answered a set questions about the occurrence of child abuse in their families, their attitudes and opinions towards the issue, the perpetrators and their motives, with physical, psychological, and low sequelae etc.

Two-thirds of students believed that child physical abuse is a real concern in Kurdish families.

One-thirds of students reported occurrence of child physical abuses sometime in their families.

To them, most perpetrators of the abuse were from paternal more than maternal side; from other males, rather than other females in the extended family. And they were associated with subsequent adult victimization (both psychological and physical).

Childhood physical abuse is relatively common in Kurdish families, and is associated with a wide variety of psychological symptoms.

More emphasis on raising the public awareness about impact of child abuse is crucial, in terms of demonstrating its psychological consequences like building a more fragile adult personality, and a lot of other untoward consequences.

To explore safety, tolerability, treatment response and hospitalizations in adult patients with schizophrenia treated with long-acting injectable risperidone (RLAI) or oral antipsychotic standard of care (oAP) in routine clinical practice.

Prospective one-year open-label non-interventional study exploring flexible doses of RLAI and oAPs. Primary outcome was the number of hospitalizations from baseline to endpoint. Additional outcomes were changes in the Clinical Global Impression of Schizophrenia (CGI-SCH), patient functioning (Global Assessment of Functioning) and treatmentemergent adverse events (TEAEs).

The intent-to-treat analysis included 561 patients on RLAI and 522 patients on oAPs (44% female gender, mean age (±SD) 42.2±13.1 years). Demographics and baseline characteristics were comparable, yet RLAI-treated patients had higher disease severity, lower baseline functioning and more substance abuse. The number of hospitalizations did not differ between the two groups while median duration of hospitalization was significantly shorter with RLAI (12.3 vs 20.6 days). Positive, negative, cognitive symptoms, disease severity, patient functioning and medication satisfaction improved significantly better with RLAI than oAPs. The most frequently reported TEAEs (=2% in any group) for RLAI and oral APs were increase of body weight (5.0%; 5.6%), psychotic disorder (2.7%; 4.0%), schizophrenia (2.5%; 3.1%), anxiety (2.3%; 2.7%), insomnia (0.9%; 3.1%) and somnolence (0.4%; 2.5%), respectively.

This one-year non-interventional study supports results of recent randomized controlled trials that treatment with RLAI is associated with less days spent in hospital, better symptomatic and functional outcomes and higher patient satisfaction with medication compared to oral APs.

Delirium is a common complex syndrome with serious outcomes such as increased mortality, physical morbidity and length of hospitalization. There are similarities with symptoms of mental illnesses, which may lead to under-diagnosis of delirium in psychiatric patients. Thus in spite of the severity of delirium, it frequently goes unrecognised and hence is inadequately managed.

The literature about the incidence of delirium in psychiatric patients is sparse.

A description of the pattern of admission will help understand the clinical features of delirium.

To estimate the diagnostic incidence and describe the pattern of admission (inpatient, outpatient and emergency) of delirium in Danish psychiatric patients from 1994–2011.

Using a nationwide population-based mental health register to examine diagnoses of delirium from 1994–2011, where ICD-10 diagnostic criteria have been used. The delirium diagnoses include delirium unspecified, delirium superimposed on dementia and delirium due to alcohol or drug use or in a withdrawal state. The incidence rates were age-standardized and the statistical analyses performed with STATA.

Males dominate in all three groups of delirium diagnoses. The incidence rates of delirium unspecified in hospitalized patients have increased markedly, graph 1. The incidence rates of delirium in hospitalized dementia do not show the same increase.

Fig. 1

[graph 1]

The incidence rates of delirium unspecified in hospitalized psychiatric patients have increased.

The Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) is a severe adverse drug-induced reaction of delayed onset. It is characterized by a severe skin eruption, fever, hematologic abnormalities, and internal organ involvement, potentially life-threatening. His incidence ranges from 1 in 1000 to 1 in 10,000 drug exposures. More than 50 drugs have been reported to induce DRESS, however anticonvulsants account for one third of the drugs causing DRESS.

To Highlight to the knowledge of potential adverse effects of psychiatric drugs.

To describe and discuss a case report of DRESS Syndrome induced by Lamotrigine in a patient with bipolar disorder, using medline database.

The pathogenesis of DRESS syndrome is not fully understood. However, his death rate is up to 10%, what makes his recognition very important. From all the drugs that can cause DRESS, lamotrigine, used in psychiatry as mood stabilizer, is the second principal drug related to it, next to carbamazepine.

Although, this syndrome is mainly managed in non-psychiatric units, a psychiatrist must know the potential reactions to the drugs he uses. The psychiatrist must be able to warn the patient and to suspect of this clinical identity, in to order to a quicker and better managing of these cases. This subject is an example how psychiatry and medicine are linked and how important is a multidisciplinary approach of a psychiatric patient.

Obsessive compulsive disorder (OCD) is relatively more frequent in pregnancy (third trimester) -3,5%- and post partum - 4 to 9%. Puerperium is at risk for onset of OC disorder and OC personality disorder. Most common obsession are contamination (75%), aggressive (33.3%), and symmetry/exactness (33.3%), and the most common compulsions are cleaning/ washing (66.7%) and checking (58.3%). OC personality disorder is a risk factor for post partum onset of OCD.

We selected women during their admission for delivery (n = 61) and analyzed: sociodemographically and through administration of EPDS, BDI, BAI, WHOQOL and SCID II (comparing Obsessive-Compulsive patients [OC=32] with negative patients [NEG=11]). Time of recruitment: 2 weeks

Labor: Emergency cesarian OC (21,4%) vn NEG (10,3%)

Previous treatment: OC (outpatient department+ private psychiatrist+ psychologist) 11,1% vs NEG 0%; only Psychologist OC 16,7% vs NEG 6,3%

Past drug intake: Antidepressant OC 11,1% vs NEG 0%

Miscarriage: OC (22,2%) vs NEG (31,3%)

Previous Oestroprogestinic intake : OC (66,7%) vs NEG (81,3%)

Complication during pregnancy: OC (38,9%) vs NEG (21,9%)

Whoqol psychological: OC (22,05) vs NEG (23,66) p = 0,46; environment: OC (28,32) vs NEG (31,09) p=0,015; physical: OC (23,37) vs NEG (26,72) p=0,011

BAI: OC (14,58) vs NEG (5,75) p=0,0005

BDI: OC (5,63) vs NEG (1,72) p< 0,0001

The groups clearly differ. From a test analysis we can underline that OC feels less confident in their environment and perceives less Physical wellness. BAI and BDI are statistically different, even if OC scores small level of anxiety or depression.

The Night Eating Questionnaire (NEQ; Allison et al, 2008) is the only validated instrument to assess the Night Eating Syndrome. It is composed of 14 Likert items and it enables to rule out for sleep-related eating disorder.

To investigate the psychometric properties of the NEQ and to investigate its pattern of correlation with related variables in a sample of Portuguese overweight women.

The NEQ and the other self-report validated instruments to assess disordered eating, insomnia, daytime sleepiness, depressive symptoms and affect were administered to an outpatient sample of 276 women (Mean age=43.85±11.88; Mean BMI=32.82Kg/m2±5.43) attending a weight loss treatment consultation in a public hospital.

The NEQ Coronach a was .60. A four factors structure (variance explained=57.62%) was selected: Factor (F)1 “Nocturnal ingestions” (α=.81); F2 “Evening hiperfagia” (α=.57); F3 “Mood/Sleep” (α=.42) and F4 “Morning anorexia” (α=.24). From the 23 participants (8.6%) who snacks when get up in the middle of the night, 6 (26.1%) had “not at all/a little” awareness of their eating; 3 (13.0%) had “none at all/a little” control over their eating while up at the night. NEQ total score significantly (p< .01) correlated with disordered eating behaviors (r=.28), insomnia (.50), daytime sleepiness (.27), depressive symptoms (.40), negative affect (.39) and positive affect (-.16).

The Portuguese version of NEQ presents reasonable internal consistency. The factorial structure overlaps with the original almost completely. The pattern of correlations with relevant variables was as expected. The NEQ could be very useful to clinical and epidemiological purposes.

Co-occurring impairments of episodic-autobiographical memory and theory of mind were described in several psychiatric and neuropsychiatric disorders. Despite sophisticated elaborations in theoretical domains, the relationship between episodic-autobiographical memory and social cognition remains unelucidated.

This work’s objectives are establishing greater recognition of the possible contribution of episodic - autobiographical memory to social cognition, by resorting to data from developmental amnesia (a condition with onset in early childhood, caused by relatively selective bilateral damage to hippocampi).

We describe a young adult with amnesia with neurodevelopmental mechanisms.

The patient was investigated medically, psychiatrically, with extensive neuropsychological methods and with neuroimaging.

Neuroimaging revealed grossly reduced hippocampi volumes bilaterally. There was no evidence of pathology in the underlying parahippocampal region or other areas. Performance on tasks that tapped on various aspects of social cognition was non-uniform, ranging from within normal limits to moderate impairment.

According to our knowledge, this is among the first case reports about a comprehensive evaluation of social information processing in a patient with amnesia with neurodevelopmental mechanisms. This patient showed impairments in performance in some laboratory tasks for social cognition, but not in others. This suggests that various components of social cognition may have different neural correlates; their unraveling may aid understanding of when and how episodicautobiographical memory contributes to social cognition. This study also emphasizes the need to employ various tasks to assess social cognition in patients with amnesia, which go beyond traditional laboratory paradigms.

Cocaine users often experience transient psychotic symptoms following cocaine use (Smith et al. 2009). The severity of such psychotic symptoms is influenced by cocaine dose (Vorspan et al. 2011). Several authors observed a higher prevalence of childhood trauma in cocaine addicts than control subjects (Enoch et al. 2010).

Describe cocaine induced psychosis and evaluate if it is associated with childhood trauma.

Define the population of cocaine users who experiment cocaine induced psychotic symptoms.

We did a transversal retrospective study. 100 outpatient cocaine users were evaluated with Scale for the Assessment of Positive Symptoms of Crack Induced Psychosis (SAPS-CIP) and Childhood Trauma Questionnaire (CTQ). Informations were obtained about lifetime cocaine use (age of onset, DSM IV dependence criteria, route of administration, daily dose, days of use per month).

We did not observe any link between SAPS-CIP and CTQ or CTQ and cocaine consumption. About cocaine consumption, more often patients took cocaine during the worst period, higher is the SAPS-CIP score. If patients are (or were) dependent to cocaine, they have higher scores on SAPS-CIP. Moreover, if patients took cocaine intravenously, they have higher scores on SAPS-CIP than if they took it by snorting, or smoking.

In the conditions of our study, childhood trauma isn’t a mediator for cocaine induced psychosis. About psychotic symptoms, they seem to be more severe among daily cocaine dependents who take it intravenously.

Adolescents and young adults are an understudied and often a misrepresented population in oncology research and practice.

The current study was designed to assess the impact of cancer on a sample of Portuguese young adults with cancer, regarding emotional distress, quality of life (QOL) and personal growth.

The specific aims of the present work are 1) to assess current emotional distress, QOL and personal growth of young adults with cancer, which are compared to those of a group of healthy controls, and 2) to assess current emotional distress, QOL and personal growth of young adults with cancer according to treatment status (patients or off treatment survivors).

A sample of 36 Portuguese young adults with cancer and 435 healthy controls was evaluated through four instruments: Socio-demographic and clinical questionnaire, Hospital Anxiety and Depression Scale (HADS), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30), and Personal Growth Subscale (PG) from the Psychological Well Being Scale.

Cancer patients scored lower than controls in the role, cognitive and social domains of QOL and in personal growth. Cancer patients scored lower than cancer survivors in the role domain of QOL and personal growth.

The cancer patients revealed QOL and personal growth difficulties, mainly those undergoing treatment. These issues need to be considered in the psychosocial intervention within adolescents and young adults’ oncology care.

To report a case of isoniazid-induced delirium.

A 56-year-old man affected by alcoholism and hepatic cirrhosis was admitted to hospital for a suspected pneumonia with pleural effusion and thickenings. A Mantoux skin test was positive. A core biopsy of the pleural nodules revealed a tubercular granulomatous pleuritis. An isoniazid, ethambutol and rifampicin therapy was then started. Subsequently the patient developed a state of delirium. A diagnostic work-up was carried out considering different hypothesis: hepatic encephalopathy was ruled out because of lack of response to appropriate treatment; negative encephalic CT scan, liquor examination and EEG excluded a tubercular involvement of the central nervous system or other neurologic etiologies. Haloperidol and delorazepam were administered under the suspicion of Wernicke-Korsakoff syndrome, without any benefit. Finally a toxic etiology was considered. Among isoniazid side effects psychosis is described, though rare. Isoniazid therapy was then stopped and substituted by moxifloxacin, with progressive improvement of the state of consciousness.

Cases of isoniazid-related psychiatric disorders reported include psychosis, obsessive-compulsive disorder and mood alterations. Two mechanisms are generally considered as responsible: pyridoxin deficiency and isoniazid toxicity, a molecule chemically near to iproniazid, a powerful monoamineoxidase inhibitors. This is the first report of a case of isoniazidinduced pure delirium, with all clinical features according to DSM-IV criteria. We also confirmed successful resolutions of symptoms only by discontinuation of therapy.

In the work-up of a state of delirium, when investigating the toxic hypothesis, clinicians should consider neuropsychiatric side effects of isoniazid.

Recovery is currently the guiding principle for mental health policies in English-speaking countries with growing influence internationally.

Recovery is defined not only by symptom reduction but mainly by opportunities for inclusion and success in social roles. Recovery means leading a meaningful life after and despite mental health problems and disabilities. Being a mother is an integral part of what constitutes a meaningful life for many women.

Peer support is an essential ingredient of recovery-oriented services and the evidence on its feasibility and positive impact is growing.

Peer support for mothers during pregnancy and the perinatal period has a long tradition in most societies. Examples of groupbased as well as individual peer support programs with direct contact or telephone based interventions have been described and evaluated mainly for breastfeeding and for the prevention of postpartum depression.

Recently, peer support programs especially designed for mothers with mental health problems have been developed. First experiences are encouraging. More research is needed and will include recovery-dimensions as outcome variables as well as qualitative and user-led designs. Areas of special interest in the development of recovery-oriented interventions are the need for ongoing support while children grow up, the prevention of unnecessary custody loss, issues of disclosure and assistance for children as supporting relatives.

Recovery-orientation and peer support offer new insights and new ways of support for mothers with mental health problems and disabilities.

Electroconvulsive therapy (ECT) is a medical treatment that is most effective for mood disorders.It has also been shown to be an effective form of treatment for schizophrenia. However, many unanswered questions remain regarding its role in the management of people with schizophrenia.

Evaluate the main indications of ECT in schizophrenia patients.

To investigate the efficacy of ECT in the treatment of schizophrenic patients, evaluating its effects in the short-term and the long-term, comparing ECT with pharmacotherapy, and assessing the effects of treatment and the main indications for use in patients with schizophrenia.

A systematic review of the literature was conducted for ECT and schizophrenia. Forty-nine articles from peerreviewed journals were identified.

The most common indication for using ECT for schizophrenia patients was to augment pharmacotherapy, while the most common accompanying symptoms were, in order, catatonia, aggression and suicide. Catatonic patients responded significantly better to ECT than patients with any other subtype of schizophrenia. The combination of ECT with pharmacotherapy can be useful for drug-resistant patients. The use of an ECT-risperidone combination or ECT-clozapine combination in patients non-responsive to prior pharmacotherapy was found to be most effective.

ECT, combined with pharmacotherapy, may be a viable option for a selected group of people with schizophrenia. In particular, the use of ECT is recommended for drug-resistant patients, for schizophrenic patients with catatonia, aggression or suicidal behavior, and when rapid global improvement and reduction of acute symptomatology is desired.

The Eating Disorder Examination Questionnaire (EDEQ; Fairburn & Beglin, 1994) is a widely used measure composed of 28 items derived from the EDE Interview. The questionnaire has been considered an adequate measure of eating related psychopathology, including with overweight samples. EDEQ also assesses frequencies of eating disordered behaviors in terms of the number of episodes in the past four weeks (6 items not contributing to scores).

To investigate reliability and factorial structure of the EDEQ in a large sample of Portuguese overweight women.

The EDEQ was administered to an outpatient sample of 276 women (Mean age = 43.85 ± 11.89; Mean BMI = 32.82 Kg/m2 ± 5.43) attending a weight loss treatment consultation in a public medical center.

The EDEQ Cronbach a was .88. All items contributed to the internal consistency. A three factors structure (variance explained = 50.37%) was selected: Factor (F) 1 “Weight and shape concern/dissatisfaction” (a = .91); F2 “Eating concern” (a = .71) and F3 “Restraint” (a = .63). The mean total score was 2.36 (± 1.07). The regular occurrence of overeating episodes, selfinduced vomiting, laxative misuse and excessive exercise was reported by 10%, 1.5%, 4.1%, and 8.9% of participants, respectively.

The EDEQ Portuguese version showed adequate psychometric properties in a sample of overweight women. Its factorial structure, mean scores and specific eating disorder behaviors frequencies are in accordance with other studies with obese participants. The EDEQ Portuguese version could be very useful to clinical and epidemiological purposes in a broad range of eating disturbances.

Alexithymia correlates with fundamental psychological traits of eating disorders in a complex causal model and high relapse rates which may be due to a lack of affect regulation. The literature does not reach definitive conclusions about the usefulness of this construct in the clinical field.

The purpose of this preliminary study was to evaluate the presence of alexithymia and its correlation with epidemiological variables, psychological characteristics, symptom severity, and general psychopathological dimensions.

A sample of 125 patients with eating disorders was recruited from outpatient care for eating disorders at the San Paolo Hospital in Milan. Patients were administered the following scales: the TAS20, SCL-90 and EDI-2.

The results indicate that 38% of the sample were alexithymic, an underestimation when compared to literature; different types of ED did not differ in alexithymia scores. The TAS20 did not correlate with the epidemiological variables. Diagnoses of Axis II disorders predicted the presence of alexithymia, suggesting that it may contribute to affective dysregulation found in personality disorders. The TAS20 further correlated with EDI-2, in particular with the subscales relating to the body and the relational aspects, and with the level of general psychopathology on the SCL-90, indicating that alexithymia may be a dimension that extends across nosographies in disorders of affective dysregulation.

In Psychiatry there is a controversial discussion about the use of coercion in general. Against this background the question, by which factors physical restraint rates can be influenced is of foremost importance.

In early 2008 we determined that those patients from the Geropsychiatry unit were most affected by physical restraints.

With the aim, to decrease physical restraint rates, a new concept of care was implemented in the Geropsychiatry unit. It included changes to staffing structure and staffing levels.

We performed a pre-post study (pre: 1st half of 2008, post I: 1st half of 2009, post II: 1st half of 2010, post III: 1st half of 2011). The evaluation focused on the criteria “staff number”, “physical restraint rates” and “fall rates”. The information value of the results is limited due to the used study design.

There were no significant changes regarding the socio-demographic and performance data. The number of registered nurses (pre: 100%; post III: 122%) and assistant staff (pre: 100%; post III: 142) in real time increased by a total of 52 working hours per day on average. There were a significant decrease of the ratio of physically restrained patients (pre: 0.19; post III: 0.08; p < 0.0005), the total duration of restraint (pre: 3162 h; post III: 781 h; p < 0.0001), a reduction regarding further restraint criteria and insignificant changes in fall rates.

The results emphasize that changes to staffing levels can influence physical restraint rates. More and highquality research is needed.

In Brazil there is a great demand for evaluation of the capacity to exercise civil rights of mentally ill patients, aiming their judicial interdiction as a protective measure. In Rio de Janeiro, the Public Attorney Office counts with a seven psychiatrists team, that among other functions, will evaluate the civil capacity of individuals, giving the district attorneys a technical psychiatric background to decide whether, or not, to demand a judicial interdiction.

Analyze five case reports in which district attorneys have demanded a civil capacity evaluation.

This is a serial cases study of five patients, where each individual was assessed. The final psychiatric diagnosis was obtained with a psychiatric evaluation of the patients, the examination of their records or relatives interview.

The five patients, each with a different diagnosis, were assessed individually. The civil incapacity is not an absolute state, but a relative situation, and the reasons and circumstances are important elements in forensic evaluation.

Interdiction is not always the best, or even the most convenient solution to social, economic and legal problems occasioned by the absence or loss of insight or self-determination caused by disability or mental illness. It is vital to characterize the absence or loss of sense of judgment, self-determination or volition, and it is necessary to determine that such damage would be significant to the specific conditions of the familiar and socio-economic profile of each citizen.

The high prevalence of psychiatric comorbidity in drug dependent individuals is well known. However, there is limited literature available regarding the comorbidity of psychiatric disorders in drug addicts on methadone maintenance treatment (MMT).

To determine the comorbidity of mental disorders in patients on MMT.

The Symptom Checklist 90-Revised (SCL-90R) [1] was completed by 85 drug addicts (65 male and 20 female) on MMT. We recorded demographic data, duration of addiction, and duration of MMT.

The mean age of the sample was 42.0 ± 8.8 years old, the mean duration of substance use was 24.3 ± 8.2 years and the mean duration of MMT was 6.8 ± 4.1. The majority of participants (78.8%) were unemployed and 58.3% of them had no children. Participants scored higher on the depression, paranoid ideation, anxiety, hostility, somatization, interpersonal sensitivity and psychoticism SCL-90R sub-scales, with average scores >1 [2]. On the contrary, lower scores were recorded in the obsessive-compulsive and phobic anxiety sub-scales. The percentage of participants that reported abnormal scores for each sub-scale was as follows: 89.3% for depression, 83.3% for paranoid ideation, 74.7% for anxiety, 66.7% for hostility, 64.7% for somatization, 51.2% for psychoticism and 35.7% for phobic anxiety. No abnormal scores were recorded regarding obsessive-compulsive symptoms. Only 8.4% of participants did not score abnormally on any sub-scale.

Drug-addicted patients on MMT show a high comorbidity of psychiatric disorders. In particular, the likely presence of depressive and paranoid symptoms should be taken into serious account when deciding on a therapeutic strategy.