Although substance use is a well-known public health risk factor, European population-based studies reporting the substance use among adult migrant populations are scarce.

We aim to: (1) determine the prevalence of alcohol use, cigarette smoking and consumption cannabis and intravenous drugs in Russian, Somali and Kurdish migrants in Finland and compare them to those of the Finnish general population; (2) determine if socio-economic and migration-related factors are associated with substance use in migrants.

We used data primarily from the Finnish migrant health and well-being study. Alcohol use was measured with the AUDIT-C questionnaire, smoking habits and the lifetime cannabis and intravenous drug use were recorded. Age-adjusted prevalence rates were determined by ethnicity and sex. The associations between background factors and substance use were analysed using logistic regression analysis.

The prevalence rate of risky drinking is lower and the proportion of abstainers is higher in migrants than in the general population. Current smoking is more common in Russian (31%, P < 0,05) and Kurdish (31%, P < 0,05) migrant men than in the general population (21%). Younger age was associated with risky drinking, socioeconomic disadvantage increased the odd for the daily smoking among migrants, and migration-related factors were associated with substance use.

Migrants report less substance use than the general population, but acculturation-related factors seem to be associated with higher levels of substance use among migrants. Substance use seems to be a gendered phenomenon in migrant populations in comparison to the general population, where lately the alcohol and tobacco consumption of women have been growing.

The authors have not supplied their declaration of competing interest.

Clinical and social improvement after treatment with nalmefene in an alcoholic 41-year-old male, with history of dependence during 20 years.

Our patient had been abusing alcohol for almost 20 years with short breaks of abstinence (one month). Before treatment he made a consumption of 105 g of alcohol per day. Serological examination showed hepatic alterations (GGT 2115, ALT 229) and a low amount of platelets (61,000). He also had no other relevant medical history and other possible clinical diagnoses were excluded. After a week detoxification program and alcohol consumption cessation during one month, the analytical values drastically changed: ALT 35, GGT 275, platelets 222,000.

Nalmefene is an opioid system modulator with antagonist activity at the μ and δ receptors and partial agonist activity at the κ receptor. Nalmefene as-needed has been shown to reduce the total amount of alcohol consumption and number of heavy drinking days and to improve liver function. The aim of this treatment is centered in decreasing consumption rather than achieving a total abstinence.

Against other pharmacologic approaches such as disulfiram an acamprosate, the options that allow acute consumption help patients in controlling drinking rampage and make them realize they will be able to afford alcohol cessation.

The authors have not supplied their declaration of competing interest.

Traumatic brain injury (TBI) can result in a variety of neuropsychiatric disturbances ranging from subtle deficits to severe intellectual and emotional disturbances, including cognitive impairments, mood and psychotic disorders and behavioral disturbances. Alcohol use disorder (AUD) and TBI are closely related. The reward-mediated behaviors central to alcohol addiction seem to interact with the cognitive dysfunction of TBI. First, a significant proportion of patients with TBI have a history of alcohol abuse. Second, AUD might jeopardize TBI recovery and trigger or lower seizures threshold. Third, both AUD and TBI share a negative impact on mental functioning (from memory and cognitive performance to mood impairment). Finally, there is some limited and recent evidence that TBI can increase AUD in patients with no history of substance use prior to the injury, by disrupting incentive-motivation neurocircuitry.

We aim to present a 27-year-old Portuguese male patient without prior psychiatric history who developed AUD and epilepsy after TBI (from a work-related fall).

After 3 years of treatment, the patient's hasn’t achieved abstinence. His treatment included pharmacological therapy with mood stabilizers, flufenazine injections and naltrexone, psychotherapy and rehabilitative interventions.

Given the sparse knowledge about this dual diagnosis, the approach of AUD after TBI is still challenging and the best treatment remains to be determined. Monitoring alcohol consumption should be considered in all patients presenting with TBI.

The authors have not supplied their declaration of competing interest.

The aim of this study is to evaluate the use of both legal and illegal substances, and see the difference in consumption patterns that occur in both men and women.

Surveys have been conducted on consumer habits in the past year among 84 inmates (60 women and 24 men) at the prison Brians 1, interrogating both the consumption of illegal drugs and consumer recreational drugs and routes of administration. Data were analyzed using SPSS program.

A total of 57.1% had used illegal drugs. The most frequent was cannabis, with 54.8% (62.5% men and 51.7% women), followed by heroin, with 23.8% (29.2% in men and 21.7% in women) and cocaine, with 14.3% (20.8% in men and 11.7% women).

Use of legal drugs was 45.2% (50% in men and 43.3% women). In this case, the greatest differences were obtained in the use of bupropion (26.7% women versus 0% men), new generation anticonvulsants such as gabapentin and pregabalin (31.7% women and 12.5% men) and the use of intranasal route of administration (31.7% women versus 0% for men). At the other extreme we find more abuse benzodiazepines abuse in men (45.8 versus 20% in women) and sedative antipsychotics (37.5% vs. 8.3%)

Although there is a serious problem with the misuse of legal psychotropic drugs by inmates in prisons, there is still greater consumption of illegal substances.

Men's consumption pattern is more “traditional” (predominance of illegal substances and “classical” legal substances orally).

Women's consumption pattern is more experimental at both the use of new psychoactive drugs and the use of alternative routes of administration.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Neurobiological research describes one of mechanisms overlap in the Cortico-Striatal-Limbic Circuit (CSLC), which can be disrupted due to chronic stress and alcohol abuse that primarily modulated by the hypothalamic-pituitary-adrenal (HPA) axis, from which cortisol is an end-product.

To investigate the effects of chronic stimulant abuse on the CSLC. This was examined by relating cortisol levels with grey matter volume in brain structures associated with addiction and stress.

We hypothesized that stimulant-dependent individuals show increased cortisol levels and abnormalities in the CSLC. We further hypothesized relationships between altered grey matter volume and increased cortisol levels in the patients.

Twenty-two alcohol-dependent individuals, men only and 21 healthy volunteers (matched for age and gender) underwent an assessment session. Cortisol, DHEA and DHEA-S was assessed in blood plasma. Mood, impulsivity and compulsivity were measured by clinical instruments.

Alcohol-dependent individuals showed higher levels of cortisol in blood plasma, and decreased levels of progesterone and its metabolites DHEA and DHEA-S, which were associated with distinct expression in impulsivity and compulsivity in alcoholic patients. Indices of these steroids were changed compared with healthy persons. Plasma cortisol was positively correlated with the duration of alcohol use. The relationships observed between cortisol, progesterone and its metabolites: DHEA and DHEA-S may be explained by abnormal functioning of HPA axis.

Optimizing of disrupted homeostasis during chronic ethanol consumption being provided with specific mechanism by manipulation of endogenous neurosteroids activity may prove a beneficial pharmacotherapeutic strategy in the intervention of alcohol abuse.

The authors have not supplied their declaration of competing interest.

The problem of the treatment of alcohol addiction is very difficult due to the reoccurrence of relapses. One of the major concepts of the formation of alcohol addiction is the concept of epileptic origin of compulsive craving for alcohol.

We investigated therapeutic efficacy of long-term dosing of original anticonvulsant (m-ch-BHU) on symptoms of alcohol withdrawal syndrome (AWS) in patients with a compulsive craving for alcohol.

Sixty-eight male alcoholic patients aged from 24 to 53 years with different levels of alcohol abuse were examined. Type of course of alcoholism in examined patients was of middle-progressing character. Clinical evaluation of state of patients was carried out with traditional clinical description. Quantitative characterization was conducted according to Hamilton Anxiety Scale and Hamilton Depression Scale. m-ch-BHU was administered to alcoholic patients at dose from 300 mg a day during 21 days against the background of conventional medication as well as in post-withdrawal period under various degrees of severity of affective disorders.

Among affective disorders dysphoric symptoms have a marked tropism for m-ch-BHU. Of the other clinical manifestations in the structure of AWS cerebral diencephalic paroxysms, cardiovascular and myofascial symptoms have the most pronounced sensitivity to the drug. In patients with complicated forms of alcoholism application of m-ch-BHU is effective also in phase of remission in spontaneously arising symptom complex of neurovegetative manifestations of primary pathological craving for ethanol called “dry abstinence”.

Our data allows recommending the use of m-ch-BHU under outpatient conditions as an anti-recurrent and preventive agent.

The authors have not supplied their declaration of competing interest.

Severe traumatic brain injury (TBI) causes neuropsychiatric disturbances. Emotional and personality disturbances seem to cause much more seriously handicap than residual cognitive or physical disabilities. The prognosis may be poor associated with marked social impairment, so a multidisciplinary approach team is required in order to improve patient's quality of life and reintegration in family and society.

To summarize the latest literature about this field and to present a case report.

To explore and learn more about chronic psychiatric changes in severe post-traumatic brain injury and share with the scientific community how challenging the approach of this entity can be.

A brief review of the latest literature was performed, using PubMed and the keywords “traumatic brain injury” and “psychiatric changes”. A case report is presented.

Although SSRI, benzodiazepines, mood stabilizers and antipsychotics are commonly used, new options are reported such as methylphenidate and cholinesterase inhibitors. The presented patient, a 27-year-old male, began with neuropsychiatric disturbances after a work-related fall from 9 meters high: convulsions and alcohol compulsive drinking. Three years have passed and his changes are still difficult to approach. Besides other medication, such as benzodiazepines and mood stabilizers, flufenazine injections and naltrexone seemed to be determinant in his behaviour and mood stabilization. He is also on a long-term alcoholism programme.

Although the understanding of TBI-associated neuropsychiatric disorders has improved in the last decade, further research is needed, such as randomized-controlled studies to study new pharmacological and non-pharmacological approach.

The authors have not supplied their declaration of competing interest.

Within Switzerland, video game players seeking specialised treatment are usually referred to gambling addiction services. The Centre for Excessive Gambling (CJE) is a specialised gambling addiction unit in Lausanne University Hospital. Between 2003 and 2015 the service offered also support to 64 adults seeking treatment for videogaming-related disorders.

According to international literature, Internet disorder treatment programmes have been developed. However, little is known about clinical profile of users seeking treatment. Studies into Internet or gaming disorders typically employ Internet survey methods or use student samples. The current presentation will outline demographic and clinical features of video gamers receiving treatment at the CJE.

Data were collected from the medical records of 57 video gamers seeking treatment at the CJE between 2003 and 2015.

The sample includes 93% men, mostly single (91%), with an average age of 25 years ± 7. On average the sample spent 9 hours ± 5 per day playing video games. A disorder had emerged an average of 3 years ago ± 3. The crisis preceding the first consultation was familial (50%), emotional (29%) or professional (16%). Sixty-five percent of the sample had a mood disorder and 20% reported suicidal ideations.

Treatments should address comorbidities and family problems associated with video game disorders. Offering consultations for parents could be useful, even in absence of the young player.

The authors have not supplied their declaration of competing interest.

Psychoactive substance use (PSU) in patients with schizophrenia can affect the course of the disease and causes many side effects. There is no clear evidence whether cannabis use can trigger the first episode of schizophrenia. The main causes of cannabis use in patients with schizophrenia are also still not defined.

Determine causes of PSU in cannabis users with schizophrenia.

The aim of this study was to find out the causes of PSU in patients with schizophrenia.

Thirty-five cannabis users with schizophrenia (28 males, 7 females) were asked to complete 15-item questionnaire about the reasons of psychoactive substance intake. Eighteen of them used also stimulants. Additional information if PSU or schizophrenia occurred first was also taken.

The results indicated that regardless of stimulants use PSU occurred before schizophrenia in 83% of patients. Main reasons of substance intake were: need for relaxation (86%) which was more often in marihuana group (100%) than in marihuana and stimulants group (73.7%) and this difference was statistically significant (P = 0.049), curiosity (80%), self-regulation of well-being (74%), shyness, need for altered states of consciousness, expectation that psychoactive substances could help them in problem solving, relationships and sleep disorders (49–54%).

PSU usually occur before the first episode of schizophrenia. Anxiety, curiosity and looking for unprofessional help are the most common reasons. The results may indicate an increased need of psychoeducation and social support in many areas of life. Future research should be considered.

The authors have not supplied their declaration of competing interest.

There are extensive investigations explaining smoking abstinence effect, yet little is known about the cognitive and metacognitive mechanisms that underlie the severity of smoking abstinence effects. Several studies reported that that problem-solving appraisal is associated with psychological maladaptive behaviors, such as depression, anxiety.

Examining the role of problem-solving appraisal as mediator, moderator and/or predictor of the severity of withdrawal symptoms and probably relapse.

Studying the role of problem-solving appraisal in the severity of smoking abstinence withdrawal symptoms.

The present study utilized a two-group pretest and posttest design to examine the mediating, moderating and predicting role of problem-appraisal of smoking-abstinence effects. A total of 92 adult men smokers were administered the problem-solving inventory (PSI-Ar) as well as several self-report measures of most reported smoking abstinence effects (pre-test), and then were asked to stop smoking for 48 h and administered again the same measures except the PSI-Ar (post-test).

The results revealed that problem-solving appraisal acts as a possible mediator and predictor but not moderator of the severity of smoking-abstinence effects. The individuals with who appraised themselves as ineffective problem solvers have shown more sever abstinence effects i.e. somatization, depression, general anxiety, panic, mood states, smoking urges, insomnia and habitual sleep duration.

Problem-solving appraisal plays a key role in severity of smoking-abstinence effects by means of mediating the relationship between abstinence effects before and after smoking abstinence. The findings are discussed in the context of future research and possible intervention recommendations.

The author has not supplied his declaration of competing interest.

The harmful use of alcohol causes a large disease, social and economic burden in societies. Metacognition is a complex concept referring to the cognitive control and regulation of many types of cognitive processes.

Metacognitions are considered to be an important factor in the development and continuance of psychological disorders.

The purpose of this study is to examine the probable relations between alcohol abuse and Metacognitions with the Metacognitions Questionaire – 30 (MCQ-30).

Twenty-three men and 16 women, aged between 22 and 64 years, inpatients in Eginition Hospital, due to alcohol dependence, completed the Greek-Version of the MCQ-30.

The mean total scores of alcoholics were higher than the ones of the healthy subjects. Namely, the group of the alcohol abused patients presented a higher score in comparison with the normal group in three of the five metacognitive dimensions. Additionally, alcoholic men outscored alcoholic women in two of the five factors. Specifically, alcoholic men appeared to be less confident about their memory and attention than alcoholic women. Furthermore, alcoholic men, compared to alcoholic women claimed in a significant greater level that worrying helped them to function.

The above findings suggest that metacognitions could play a role in the orientation and maintenance of alcoholic abuse behavior. Moreover, these results may pose the question of whether these metacognitive beliefs could be seen as an indicator of differentiating alcoholic men from women. Overall, further research could provide additional information concerning the relation between Metacognitions and alcoholic dependence.

The authors have not supplied their declaration of competing interest.

Internet as a vast global network, consisting of commercial, educational, informational and communicational facilities, has a huge impact on human behavior. Designed simultaneously by the needs of users and technical capacity, has become an addictive medium thanks to low cost of usage and broad availability. Social networking sites (SNSs) have a special place in the cyberspace. Due to the wide range of services, additionally differing on latitude, age and other variables, SNSs’ impact on a life of an average user is difficult to assess.

The study assess the changes between 2013 and 2015 in usage patterns and impact of the social networking sites on users with focus on possibility of dependence development and emphasis on gender differences.

Anonymous questionnaire, available on-line, was prepared solely for the purpose of the study. Questions were related to the types and frequency of specific activities undertaken by the private profiles of users and based on pilot study conducted in January 2013.

The first stage (March–April 2013) consisted of 1248 respondents, the second stage (August–September 2015) gathered 1112 respondents. Research showed changes in age of users, type of information looked for and tools used to browse SNSs.

Private profiles are no longer used only for communication or personal expression; it is a new way of getting to know what is happening and sharing voices of communities. As a tool of making money, which is more and more visible, SNSs interfere with previous patterns of portals’ usage.

The authors have not supplied their declaration of competing interest.

Alcohol dependence is one of the psychiatric disorders for which hereditary influence is strongest. In fact, the importance of genetic factors in transmission of vulnerability to alcohol dependence was first described in literature many years ago by psychiatrists who dedicate to its study. That vulnerability may be explained by an epigenetic model in which biological hereditary factors associate with environmental factors to cause alcohol dependence.

Study the influence of genetic factors on alcohol dependence.

During 4 consecutive months a sample of alcoholic patients was collected from the Alcohol Treatment Unit of CHPL (inpatients and outpatients). Biographic data, patient's psychiatric diagnosis and family history of alcohol dependence or of dependence of other drugs were recorded.

Initial sample included 122 patients. After exclusion of patients who were also hospitalized in that period, the final sample included 102 patients (26% female), with a mean age of 48 years old. Main patients’ diagnosis was alcohol dependence but most of them (52%) presented psychiatric comorbidity. Most patients (55%) had family history of alcohol dependence or dependence of other substances, 26% did not have and 19% did not know. For 61% of patients, the father and/or mother were the affected relative. Most patients (61%) who had a family history of alcohol dependence or dependence of other substances had 2 or more affected relatives.

Most patients with alcohol dependence have family history of alcohol dependence or dependence of other substances, usually in more than 1 relative, which must be taken in account during treatment.

The authors have not supplied their declaration of competing interest.

Women face unique and greater health risks from smoking than men and have a different nicotine dependence pattern.

To design a personalized approach for women addressing Romanian tobacco dependence treatment centers to quit smoking.

A group of 68 smoking women received a 3 months tobacco dependence treatment intervention, consisting of 3 DVD educational sessions, 20 minutes each and a face to face cognitive – behavioral counseling intervention, emphasizing particularities of tobacco dependence in women (pregnancy risks, passive smoking, female hormones configuration, nicotinic receptors interactions, efficacy of nicotine dependence therapy according to gender, etc.).

Females under study were heavy smokers (17.16 ± 8.03 SD packs cigarettes/years) with high nicotine dependence scores (6.52 ± 6.03 SD).

Abstinence rate evaluated in end of treatment (3EOT) phase by an office visit (self-declared abstinence and exhaled carbon monoxide validation) was 38% and increased at 44.1% at 6 months follow-up when evaluated by a telephone contact visit (6TCV).

Personalized tobacco dependence treatment approach, focusing on specific women tobacco use concerns increased abstinence rates, comparatively to previous data in women not benefiting educational DVD and face to face sessions [1].

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The level of high-risk alcohol consumption WHO is estimated at more than 40 mg for women and 60 mg for men.

Nalmefene is a new treatment that breaks the cycle of continued use of alcohol.

A sample of 18 patients of a Mental Health Centre in the province of Leon alcohol dependent and high consumption They received nalmefene 18 mg daily continuous treatment for 6–9 months is selected. We appreciate the adherence of patients and the efficacy, tolerability and impact on physical health.

We appreciate reduction in the amount of alcohol ingested observed by both the patient and their relatives without any cases of neglect and few side effects.

We got two patients leave the alcohol completely and an average decline in consumption over 9 Basic Units of Drink.* (90 g).

We observed improvement in the quality of life in patients with multiple pathologies and difficult social situation.

The authors have not supplied their declaration of competing interest.

To describe the case and management of a patient with marchiafava bignami disease (MBD) with frontal cortical lesions, no specific symptoms at first referral to the emergency room, and late onset of atypical psychiatric symptoms.

We report the case of a 44-year-old patient with a history of chronic alcohol abuse, eventually diagnosed with MBD.

Magnetic resonance showed lesions in the splenium and in the body of corpus callosum and bilateral lesions of the frontal cortex. The patient showed late-onset atypical psychiatric symptoms, which were drug resistant.

The case we describe seems to support the existing few ones describing cortical involvement in MBD, which suggest that this is associated with a poorer prognosis. Psychiatric symptoms may be challenging to treat because of drug resistance. The involvement of psychiatrists together with neurologists and radiologists, with a consultation–liaison approach has proved important for the achievement of diagnosis and of the most appropriate management and treatment for this patient.

The authors have not supplied their declaration of competing interest.

Alexithymia represents a personality construct, characterized by an inability in identifying and verbally describing own and others’ emotions. According to the recent research on emotional dysregulation and the alexithymic construct, it has been described a positive correlation between alcoholism and alexithymia. The present study aims to evaluate the presence of alexithymia in a sample of alcohol dependant patients and, therefore, analyze how the presence of these alexithymic traits may influence/interact with a range of cognitive processes such as the anger rumination, metacognitive capabilities and dissociative experiences.

A sample of 40 alcohol dependant inpatients affected with alcohol dependence and alcohol-related issues were recruited, evaluated and compared with a sample of 40 healthy controls. A clinical evaluation and a complete clinical and psychological assessment were carried out in order to investigate alcohol-related clinical patterns, alexithymia construct, anxiety and depression symptomatology and cognitive pattern.

Subjects with alcohol addiction show higher total scores in all tests except the scale that evaluates anxiety, compared to healthy controls. Finally, a factorial ANOVA analysis demonstrated that alcoholism seems to be determined by the lack of emotional recognition from which derives a dissociative state, which consequently generates a depressive rumination.

According to the recent literature, the present study identifies a significant proportion of alexithymic patients within the sample of subjects affected by alcohol-related disorders. Other clinical variables (i.e. depression, pathological anxiety-related worry, anger rumination, dissociation and metacognitive capabilities) mirror a specific cognitive pattern in the sample of alcoholics rather than the healthy group.

The authors have not supplied their declaration of competing interest.

Detoxification treatment of adults at younger ages suffering from polysubstance dependence on our department pursues an integrative therapeutic concept. In addition to addiction-specific, topic-centred group and talk therapy orientation also behavioural therapy elements are included: a penalty points system provides negative sign stimuli for undesirable behaviour.

Since 2010, both rate of psychotic disorders and number of N-methylamphetamine consumers (P < 0.001) have been growing impressively while the proportion of repeated admissions amounted to > 55%. Dissatisfying trends were identified by longitudinal measurement, e.g. regarding ALOS, kind of discharge, bed occupancy.

Targeted changes in treatment were established in the 2nd half of 2014. In particular, the penalty point system was adapted towards less restrictive rules, combined with slightly reduced therapeutic intensity in order to come better on the disorder-related needs of the patients. Staffing level and structure remained stable.

Key figures including quality criteria and performance data such as LOS, kind of admission and discharge, service intensity, and bed occupancy were evaluated by a pre-post study (pre: 1st half of 2014, N = 76/post: 1st half of 2015, N = 77) using descriptive and test statistics.

Socio-demographic patient data remained stable. Regarding selected key figures there were significant changes (LOS > 21 days: P < 0.05; bed occupancy: P < 0.001; therapeutic contacts < 25 min: P < 0.001) and positive trends, e.g. decreased ratio of non-regular discharges.

Our data suggest that punishment-oriented interventions impede addressing specific needs of inpatients with multiple substance use whereas more need-oriented interventions may lead to improvements. Further evaluation including patient satisfaction is indispensable.

The authors have not supplied their declaration of competing interest.