Egypt is one of the most famous endemic areas for hepatitis C virus. Drug use in Egypt is rising exponentially. Drug use is always considered one of the main risk factors for HCV.

To assess the effect the route of drug use on the incidence of HCV in the Egyptian population.

To study the effects of opiates (tramadol and heroin) use and the route of intake on the incidence of HCV infection among addicts treated in Mamoura mental state hospital, Alexandria, Egypt.

This is a cross-sectional study on drug dependence patients visiting the out patient clinic for addiction in Elmamora Hospital.

Subjects were divided into two groups.

Group I: Control group.

Twenty non-addict volunteers.

Group II: Cases groups (comprising 60 subjects)

This group will be divided into three sub-groups each contains 20 cases.

Group IIa: consuming tramadol.

Group IIb: consuming tramadol and heroin by injection.

Group IIc: consuming tramadol and heroin by inhalation.

All studied groups were subjected to:.

1. detailed history taking, urine screening tests for drugs of abuse, liver functions tests and HCV screening.

The study showed deterioration in liver function tests in the heroin and tramadol use groups compared to the tramadol only use.

There was a statistical significant difference in the incidence of HCV infection in the heroin injection group (85%) compared to 35% in the heroin non injector users and only 5% in tramadol users had HCV positive.

Heroin injection showed the highest risk for both liver function deterioration and HCV infection.

The authors have not supplied their declaration of competing interest.

Despite different treatment approaches many drug addicted patients continue to use drugs during and after treatment.

Personality traits are considered risk factors for drug use, and, in turn, the psychoactive substances impact individuals’ traits.

To describe the sample of 186 opioid addicted patients entered hospital treatment and assessing the differences in personality traits between abstinent and non-abstinent after one year.

A cohort of 186 patients consecutively admitted to the detoxification unit was investigated. The research interview, the Big Five Inventory (BFI), the Treatment Outcomes Profile (TOP) were administered during the first week of admission to the detoxification unit. Urine test was administered on the day of admission and at each follow-up point in combination with the TOP (after three, six and twelve months). Illicit drugs abstinence during one year after intake was selected as a treatment outcome measure.

Twelve months after admission 82 (44.9%) patients abstained completely. Agreeable patients remain in treatment longer (r = 0.20, P = 0.07). Extraversion and openness are negatively correlated with abstinence after six and twelve months (r = –0.15, P = 0.041; r = –0.15, P = 0.044). Neuroticism is in negative correlation with duration of treatment (r = –0.20, P = 0.006). Patients who are less open to new experiences are more likely to abstain from drugs 6 months after admission (r = –0.17, P = 0.021).

Personality measured with BFI correlates with treatment outcome poorly. At the same time personality could have an important role in responding to treatment, but personality traits could be at the same time protective as well as risk factors.

The authors have not supplied their declaration of competing interest.

Studies have shown high association between trauma exposure in childhood and adulthood, post-traumatic stress disorder (PTSD) and substance use disorder (SUD). Women seeking treatment for SUD are more likely to have histories of sexual and physical abuse.

To study the effect of gender difference on the history of traumatic experiences and the mental health problems of the SUD patients.

Cross-sectional comparative study was conducted at the Addiction Treatment Center at El Maamoura psychiatric hospital. Two hundred adult inpatients were recruited and assessed using a structured interview questionnaire to collect sociodemographic data, substance-use history, and medical and psychiatric history. The semi structured psychiatric interview was applied, and psychometric assessment was performed using Arabic version of Trauma History Screen (THS) for assessment of trauma exposure, and the Arabic version of the Post-traumatic Stress Disorder Checklist, civilian version (PCL-C) for assessment of current PTSD.

One hundred and fifty-six were males (78.0%), 44 were females (22.0%). Females were significantly more likely to be exposed to sexual abuse at childhood (P = 0.002) and adulthood (P = 0.050), score higher on PCL-C (P = 0.002), to have major depressive disorder (MDD) (P = 0.028), and have suicidal plans and attempts (P = 0.001).

Females with substance use disorder are more likely to be victims of sexual trauma, to develop Post-traumatic stress disorder and to have more complicated psychiatric comorbidities than their male counterparts.

The authors have not supplied their declaration of competing interest.

Turkish version of the UPPS Impulsive Behavior Scale was previously validated in a sample of psychiatric inpatients. The aim of the present study was to evaluate psychometric properties of the sensation seeking subscale of this scale in a sample of inpatients with alcohol use disorder.

Participants (n = 190) were evaluated with the sensation seeking subscale of UPPS Impulsive Behavior Scale.

Sensation seeking subscale had two factors, which together accounted for 63.80% of total variance. As similar with original subscale internal consistency for the sensation seeking (coefficient α=0.859), factor 1 (α=0.862) and factor 2 (α=0.755) examined by Cronbach's alpa, were high. Factor 1 (r = 0.894) and factor 2 (r = 0.863) were highly correlated with total score, whereas moderately correlated (r = 0.544) with each other. Test-retest correlation for sensation seeking (n = 120) was mild (r = 0.460). Test-retest correlation for factor 1 was moderate (r = 0.518) and for factor 2 was mild (r = 0.431).

These findings support the Turkish versions of the sensation seeking subscale of the UPPS has good psychometric properties among inpatients with alcohol use disorder.

The authors have not supplied their declaration of competing interest.

The aim of the present study was to evaluate relationship of impulsivity with severity of ADHD symptoms while controlling the effects of anxiety and depression in a sample of inpatients with alcohol use disorder.

Participants included 190 inpatients with alcohol use disorder. Participants were evaluated with the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory (BDI), the Short Form Barratt Impulsiveness Scale (BIS-11-SF) and the Adult ADHD Self-Report Scale (ASRS).

Impulsivity predicted both severity of ADHD symptoms and inattentive and hyperactive/impulsive dimensions, even after controlling the effects of depression and anxiety in linear regression models. Types of negative affect that predicted dimensions of ADHD differed; similar with severity of ADHD symptoms, depression and trait anxiety also predicted inattentive dimension, whereas trait and state anxiety predicted hyperactive/impulsive dimension.

Impulsivity is related with severity of ADHD symptoms and dimensions of ADHD although negative affect that is related with dimensions may differ.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Mechanical restraint is a therapeutic procedure commonly applied in acute units in response to psychomotor agitation. Its frequency is between 21 and 59% of patients admitted. These patients represent a risk to both themselves and for health workers. There is a myth that patients with substance use disorder (SUD) are more aggressive and require more forceful measures. There are not clinical studies that compared if there are differences of the frequency of mechanical restrain in patients with SUD.

The aim of this study is to explore the differences of frequency of mechanical restraint on patients with SUD in the psychiatry acute and dual pathology units and others psychiatric diagnostics.

We reviewed retrospectively the informatics record of all the mechanical restraints made and the total discharges of the three acute care units and dual disorders of Neuropsychiatry and Addictions Institute (INAD) of the Parc de Salut Mar de Barcelona, between January 2012 and January 2015. For every discharge the presence of at least one mechanical restraint and the DSM-IV diagnostic were coded. Then was calculated the frequency and proportion of mechanical retrains in every diagnostic group.

The number of discharges analyzed was 4659 from which 838 had an episode of mechanical restraint. The 37% of patients with SUD of cocaine had an episode of mechanical restrain. The patients with SUD of alcohol only the 4%, and there no one case on patients with SUD of Cannabis. Thirty percent of patients with schizophrenia and 28% of bipolar disorder.

L. Galindo is a Rio-Hortega-fellowship-(ISC-III;CM14/00111).

The authors have not supplied their declaration of competing interest.

Smoking is an addictive and chronic disease. Twenty-four percent of the Spanish population in 2012 smoked daily.

To evaluate a smoking cessation program in a Primary Care Center.

Observational, prospective study. We describe an individualized smoking cessation in Plaza del Ejército Health Center (Valladolid). Inclusion criteria: active smoker, ≥ 18 years old and belonging to the Health Center. Exclusion: severe mental illness. Included patients from November 2013 until January2014. Ended in July 2014. Four Medical residents participated, we present the results of one of them. During the first consultation motivational interviewing was conducted, physical examination and treatment was prescribed (cognitive behavioral therapy or drug treatment: varenicline). In subsequent consultations interview and follow-up. Variables: age, gender, pack-years, nicotine dependence (Fagerstrom) and Prochaska and DiClemente phase, weight, treatment used, dropout rate and final withdrawal of snuff.

Eleven patients, mean age 48.18 (13.61), 7 (63.6) women. Comorbidity: 6 (54.5) anxious-depressive pathology, 1 (9.1) dysthymia, 2 (18.2) endocrine pathology and 1 (9.1) respiratory disease. Four (36.4) showed high dependency and 2 (18.2) extreme. Media packages 20.50/year (19,20). Seven (63.6) were in action phase of Prochaska and DiClemente and 2 (18.2) in preparation. Visits range: 1-11. The average was 4.55 (3.64). Three (27.27) patients attended only the first visit. Four (36.4) achieved complete abstinence, 3 (27.27) met maintenance phase. One (9.1) reduced consumption in half. Patients gained average 0.5 kg (2.47).

The results are similar to those reported in other series. Modest dropout rate. No pharmacological treatment was used due to high coexistence of comorbidities, the only patient who used varenicline suffered insomnia. Average age and media packages were superior to other series.

The authors have not supplied their declaration of competing interest.

Smoking cessation has long been associated with weight gain and is one of the many reasons that smokers invoke for not giving up smoking. Many psychiatric medications are also associated with increased weight gain and metabolic syndrome. Unhealthy lifestyles reflect symptoms of illness with poor coping strategies and financial and social difficulties.

There are many reasons why smoking cessation may be viewed as much more difficult for psychiatric patients and weight gain is one of them.

To study how patients’ weight evolves during smoking reduction and cessation in a smoking reduction/cessation program in a psychiatric hospital.

To demystify weight gain as a significant problem in smoking reduction and cessation in this patient population.

Every patient entering the smoking reduction/cessation program is evaluated initially with regard to weight and BMI.

Patients’ weights are evaluated during the duration of the program for each patient as is smoking status.

We are still collecting data at this time.

There are three groups of patient according to weight changes during the program: those who gain weight, those who maintain the same weight (± 1 kg) and those who lose weight.

Most patients who gain weight end up recuperating their initial weight or are able to lose weight later.

Some patients had weight control issues and their fear of gaining weight led them to overcompensate leading to weight loss.

We have included interventions on healthy lifestyles that have aided patients in controlling their weight.

The authors have not supplied their declaration of competing interest.

To describe personality profile of drug users in relation to substance of choice.

To know personality dimension differences according to drug used.

Cloninger's TCI-R was administered to 218 patients in a dual diagnosis unit.

SPSS was applied.

Of the patients, 33.94% had personality disorder. Principal substances used were alcohol, cocaine and cannabis.

Most of drug users had normal scores in each dimension. No high scores were found in reward dependence, self-directedness and cooperativeness with any drug.

High scores were observed for novelty seeking in 42.9% of timulants users; for arm avoidance in a quarter of cocaine, alcohol and methadone users and for persistence in 18.2% of hypnotics users.

Low scores were observed for reward dependence in 45% of heroine and hypnotics users; for persistence in 50% of methadone and 32% of cocaine users; for self-directedness in most of types of drug users and for cooperativeness in up to 50% in heroine, hypnotics, stimulants and cocaine users.

Statistical significant differences were observed for cocaine use and high novelty seeking and low cooperation; for non cannabis use and high harm avoidance; for non anfetamine use and low scores in reward dependence; for opiate use and low self-directedness.

Most of patients had normal scores in the different dimensions.

Presence of comorbid personality disorder led us to consider the results with caution.

The authors have not supplied their declaration of competing interest.

Depression, anxiety and panic disorders are often encountered in chronic respiratory disorders, like chronic obstructive pulmonary disease (COPD), especially in severe disease stages with impaired quality of life.

To assess anxiety, depression and panic disorders among patients diagnosed with COPD and to correlate them with respiratory disease severity and quality of life.

We investigated the profile of anxiety, depression and panic attacks in relation to patients’ medical history, demographic data, smoking status, COPD staging and disease severity (estimated by CAT quality of life questionnaire, GOLD guideline staging).

A total of 60 COPD patients were enrolled. Smoking profile showed more intensive smoking in men (35.81 mean packs-years versus 24.38 in women). The COPD high-risk group type D was predominant, with severe dyspnea, decreased lung function, frequent exacerbations and low quality of life (mean CAT score: 21.75). Mean distribution of anxiety and depression symptoms among COPD subjects was corresponding to a 10.65 ± 3.54 SD anxiety score, respectively to 9.93 ± 3.80 SD depression score. Panic attacks were found in 43.3% of the patients.

Anxiety, depression and panic attacks were frequent findings among severe, unstable COPD patients. More carefully screening for anxiety, depression and panic attacks in this category of patients, thus adding a specific psychotherapeutic component to the COPD general treatment plan, would improve patients’ health benefits.

The authors have not supplied their declaration of competing interest.

Baclofen, a drug currently used in the treatment of spasticity, has been reported to be useful in reducing the intensity of withdrawal symptoms of substance use disorders of alcohol or other psychotropic drugs.

With our clinical case we aim to demonstrate that baclofen reduces severe withdrawal symptoms and also helps to achieve and maintain abstinence in severe cases, in agreement with the current literature.

We present a clinical case of a 68 year-old patient with alcohol use disorder since his childhood, with familiar antecedents, multiples relapses and associated organic pathology such as alcoholic polyneuropathy and Wernicke syndrome. We used to high doses of baclofen to reduce the craving and withdrawal symptoms. Additionally, we searched in PubMed for more case reports and for a systematic review of the efficacy and tolerability of baclofen.

We were able to demonstrate that high doses of baclofen can be useful in resistant cases of substance use disorders like alcoholism. For our case study, we obtained positive results with a large remission, in comparison with the previous detoxications, with doses up to 150 mg/day.

We conclude that baclofen is an interesting alternative for resistant cases, with a good outcome and tolerability, in complicated patients, with important organic repercussions.

The authors have not supplied their declaration of competing interest.

High rates of substance abuse have been reported in the general population and users of mental health services. In our environment, relationship between substance abuse and manic phase has not been well characterized.

Determining the prevalence of active substance abuse among patients admitted to acute mental health unit at Virgen de la Victoria Hospital at Malaga, diagnosed with mania or hipomanía.

We analysed urine and blood seeking for ethanol, cannabis and other 11 substances in 140 patients previously diagnosed with bipolar disorder prior to their admission at the Hospital for mania or hipomanía phase.

Thirty-seven percent of the patients were positive for drugs. Eighteen percent were positive for two or more drugs. Males had higher rates of abuse than females, except in MDMA and amphetamines. By subtypes, cannabis (37.2%) and ethanol (29.62%) were the most consumed drugs. In young age cohorts had higher rates of active substance abuse. Dual patients had longer average stays at hospital (2.6 days more) (Fig. 1).

Substance abuse is a major comorbidity in bipolar patients with manic phase. The active consumption of cannabis and ethanol especially emphasizes in men younger than 35 years.

We believe priority should be given to recognition and multidisclipinary approach to substance use disorders in bipolar patients. Bipolar patients with comorbid substance abuse may have a more severe course, and may be a preventable factor of new relapses. This rate could increase healthcare costs and worse quality of life of these patients.

The authors have not supplied their declaration of competing interest.

Epidemiological studies have reported associations between alcohol consumption or abuse and occurrence of delusional disorder (F.22) rather than in general population. Alcohol has not been described as the main cause of the delusional idea, but is an enhancer factor which would inhibit behavioral brake and executive function in prefrontal cortex facilitating the development of the existing delusional idea.

We want to confirm this association in our influence area so this study aims to report compared frequency of alcoholism in DD versus a control group published in andalusian population.

To review the literature on the potential links between alcohol abuse and delusional disorder and this relationship in general population.

This poster presents a brief but updated systematic literature review on the associations between DD and alcohol abuse. We will also present data from a relatively large case-mix of 2049 patients with the diagnosis of delusional disorder resulting from a thorough retrospective, medical-record based, assessment of patients attended in our clinical catchment area.

In our sample, alcohol abuse and other drugs consumption was significantly less common in Delusional Disorder than in other psychoses.

This result suggests that alcohol and other drugs consumption can be a greater importance parameter in other psychoses correlates than in delusional disorder.

The authors have not supplied their declaration of competing interest.

Substance related disorders is a problem of global concern because of the high prevalence and costs for patients and society. In one of the latest surveys, 52% of the American population reported being current alcohol drinkers and 6.3% admitted being heavy drinkers. In addition, 9.4% are illicit drug users, being marijuana the most commonly used.

To determine whether there is a relation between the substance of abuse and the demographic characteristics, medical and psychiatric comorbidities of patients with substance use disorder.

This correlational study examined data of 218 patients with substance use disorder (DSM-5), that consulted at the Addiction Unit of “Red de Salud, Pontificia Universidad Católica de Chile”, between April 2012 and September 2015. Data included: demographics, medical and psychiatric history, laboratory and imaging tests.

Out of all the patients, 57% suffered from alcohol use disorder, whereas 21% abused of marijuana, 20% of cocaine and 8% of benzodiazepines. There was a correlation between alcohol use disorder and being over 40 years of age, being separated and having higher educational studies. For marijuana, being under 40 years of age, being single and having no medical comorbidities. For cocaine, not being single. For benzodiazepines, being over 40 years of age, being separated and having medical comorbidities. All of these correlations were statistically significant.

These results emphasize on the complexity of these patients and on the important contrast created between age, marital status, level of education and prevalence of comorbidity depending on the abused substance.

The authors have not supplied their declaration of competing interest.

Over the past two decades the prescription of opioid analgesics has increased with a subsequent escalating in prescription opioid misuse. It is estimated that 4.5 million (2.5%) of the United States of America population abuse of pain relievers; opioids are among the most commonly.

In Chile there are few reports about the prevalence of opioid use disorder.

The aim of this study is to describe the demographic characteristics, medical and psychiatric comorbidity of patients that suffer from opioid addiction.

This transversal study examined data of 7 patients with opioid use disorder (OUD; DSM-5) that consulted at the addiction unit of “Red de Salud, Pontificia Universidad Católica de Chile”, between November 2013 and October 2015. Data included: demographics, medical and psychiatric history, laboratory and imaging tests.

Of all the patients, 57% were men, 25 to 67 years of age, 43% between 35-40 years; 57% were married; 57% had completed studies at university. 43% had also alcohol use disorder, 28% marijuana, 28% cocaine and 28% benzodiazepines than in most cases began before OUD. In addition; 57% had medical comorbidity among which stand out obesity (17%), osteoarthritis (17%) and chronic low back pain (17%). Eighty-three percent require hospitalization. Twenty-eight percent had abnormal liver tests and one patient had positive hepatitis B core antibody. Opioids used were: morphine(14%), codeine (43%), tramadol (42%).

These results emphasize on the misuse of prescription opioids analgesics, the complexity of patients with OUD and the prevalence of other substance use disorder that precedes and accompany OUD.

The authors have not supplied their declaration of competing interest.

Quality of Life (QoL) is an important outcome variable in Methadone Maintenance Treatment (MMT) for opiate dependence. Previous research has focused on demographic variables, treatment features, drug use and physical and mental health as possible predictors of QoL in this condition but interest in genuinely psychological variables (skills and personal repertoires) has been lacking. Experiential Avoidance (EA), the tendency to behave in order to decrease some kind of internal distress, has a strong relationship to psychological disorders and holds promise as a potential predictor of QoL.

To identify predictors of QoL in clients undergoing MMT, taking into account psychological variables.

To see if EA is related to QoL in clients undergoing MMT.

Using a cross-sectional design, information was gathered from 48 opiate-dependent individuals undergoing MMT. Variables included were QoL (IDUQOL), severity of drug use, social adjustment and physical and mental health (ASI-6), emotional distress (HAD) and EA (AAQ and its version for substance-abusing individuals, AAQ-SA). Mean-comparison tests and correlation tests were carried out, and several variables were entered into a stepwise multiple regression analysis.

Anxiety and EA were the only variables which made it into the regression model, accounting for 41.9% of variance of QoL.

Contrary to previous research, the predictors of QoL were psychological. It is the first time that EA is related to QoL in this population. Interventions should explicitly target EA and anxiety. Additional research should make use of longitudinal designs and take into account further psychological variables (emotion regulation, coping).

The authors have not supplied their declaration of competing interest.

The association between previous trauma and the development of alcohol and substance misuse is well established, however, much of the research is focused on the association of PTSD with alcohol and substance misuse. This research will be focussing on trauma in general and its influence on the development of alcohol and substance misuse in women.

The main objective of this study was to investigate the relationship between previous traumatic events and the development of alcohol and substance misuse in women.

This was a retrospective case note study of 146 female patients from a UK based detoxification and rehabilitation centre. Trauma history from patient files were audited, with the trauma experienced being assigned a category.

Out of 146 women with alcohol and/or substance misuse, 132 (90%) had experienced a previous trauma. The types of trauma experienced include; domestic (53%), traumatic grief (36%), sexual abuse (35%), physical (15%), bullying (4%) and neglect (4%). These results show that women who suffer from alcohol/substance misuse are highly likely to have suffered a previous trauma.

The results from this study suggest that women who have suffered previous trauma are high risk for alcohol and substance misuse problems, therefore early intervention and a robust psychological support system should be provided to women who have a history of trauma. Furthermore in addition to addiction treatment and behaviour focused therapy already in place trauma focussed therapy may prove beneficial.

The authors have not supplied their declaration of competing interest.

Methadone, a long-acting opioid agonist commonly used in the treatment of opiate dependence, has been reported to cause QTc interval prolongation, increasing the risk of a fatal cardiac arrhythmia – Torsades-de-Pointes (TdP). This effect seems to be attributable to methadone's inhibitory effect on the cardiac “hERG”-K+ ion channel and is dose-dependent. There is a lack of consensus regarding when to perform an ECG for patients on methadone.

Identifying other TdPPRFs in a cohort of patients receiving ≥ 85 mg (high dose) methadone daily to inform local clinical safety guidelines.

Our outpatient caseload was filtered to select opiate-dependent patients receiving more than 85 mg methadone daily. Primary care summaries and laboratory results databases were analysed for the presence of other TdPPRFs: female sex a documented history of ECG abnormalities, electrolyte imbalance, liver or renal failure, and concomitant use of other QT prolonging medication or stimulants.

Fourteen opiate-dependent patients (10.29% of patients on methadone) were maintained on ≥ 85 mg methadone daily. Gender distribution was F:M = 1:1.8; 64% misused illicit stimulants; 57% were prescribed other QTc prolonging medication and 29% had a documented history of liver/renal failure or electrolyte imbalance. Only 14% had previous ECGs documented in primary care summaries. Of patients on high dose methadone, 85.7% had at least one TdPPRFs present and 64.3% had at least two.

These results demonstrate an increased rate of TdPPRFs in this patient group and highlight the importance of ECG monitoring which ideally should be offered to patients receiving even lower doses of methadone.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.