Anecdotal evidence suggests that the general public including patients with mental health problems are largely unaware of the potential risks of codeine abuse and dependence. Despite this, little research has been done in establishing the public’s level of awareness on this issue.

To assess the extent of use of codeine-containing preparations, as well as the level of knowledge regarding the dependency potential of codeine, in patients admitted to an acute psychiatric hospital.

150 patients admitted consecutively to an acute psychiatric hospital over a 2 month period were asked to fill out an anonymous 18-item semi-structured questionnaire. The results were compiled and analysed using descriptive statistics with SPSS version 17.

116 questionnaires were returned giving a response rate of 77% (54% female, mean age 46.7 years, SD = 15 years). 90% of respondents reported that they had ever used codeine-containing medications, 80% have bought them over the counter, 65% always used them without prescription, and 7% reported daily use of such medicines. 14% reported using them for the euphoriant effect, 5% to curb cravings, and the remaining mainly for migraines or aches and pains. 11% of all patients had used a codeine-containing medication as recently as 24 hours prior to their admission and 66% of patients indicated that they were aware of the dependence potential of codeine.

Awareness among psychiatric patients regarding the dependence potential of codeine is high. Additionally, a considerable proportion of patients indicated use of codeine for euphoriant effects or to curb cravings

Life’s skill because of great theory and researching background is very important in avoiding of getting further into drug. “Teaching life skill’s s” collection by Dr.Botvin is the same and tries by contrasting sense of person to increase great self-independency and self-confidence.

It is an important key on taking drug. Because there is no influence avoiding program on universities, we verified this program on this research.

All university student of Payam noor, Babol branch on the years of 88-89 are of research collection. Research sample of about 100 girl and boys student were chosen and divided on two 50 persons groups. (Control and testing) testing group students passed life skills course but the other did not passed. The two groups were compared by health and good behavior of Dr.Botvin’s Questionnaires and on the base of dependent and independent group of T-teaching statistic.

The mean score of university student have had differences to the scores on pre-testing phase. Because after- testing we had increasing information about materials, changing attitude to material and increasing skills.

Teaching life skills increased testing group’s skills level. In this case, this program is an avoiding factor and decrease drug taking on future. Teaching life skills collection is an avoiding factor on drug taking.We propos to teach this as an optional course on all universities. To do research on all other factor on life skills and noticing to time of teaching (long term, short term) is very interesting.

Patients with schizophrenia and bipolar disorder appear to have more difficulties with smoking cessation than the general population. Moreover, gender and unsuccessful smoking cessation are associated with depression and negative emotional experience. Less attention has been given to the association of cigarette smoking in women and the use of other substances.

To determine the influence of gender and substance abuse on smoking cessation in a long-term follow up after a first psychotic episode.

Patients were evaluated at years 1, 3, and 5 obtaining information about functional outcome, positive and negative symptoms and substance use. At 8th year, functional outcome and use of substance were recorded. Patients were classified in two groups: those who stopped smoking during follow-up, and those who did not stop.

At baseline, rates of tobacco smoking were high with no differences between genders. Difficulty with smoking cessation was associated with female (p = 0.017) and typical antipsychotics (p = 0.032). Those who used alcohol continuously were less likely to stop smoking (p = 0.050) controlling for typical antipsychotics. The interaction with gender was not significant. Continuous cannabis use was not associated with smoking cessation, but women who use cannabis continuously were less able to stop smoking than men (adjusted p = 0.036).

Women are less prone to quit smoking than men during long-term follow-up after the development of psychosis. Different treatments should be considered for men and women in relation to tobacco dependence in patients with psychotic disorder. Treatment for women smokers should probably be more supportive and intensive.

This study aims to obtain health and risk behaviors of drug abusers (addicts), when in confinement situation in therapeutic communities;

Using quantitative methods, the study focused on a group of 75 addicts, all male, with ages 19 to 51 years (average: 34.07), mostly unmarried (77.30%), living in Lisbon (40.00%) and with a past marked mainly by consumption of cocaine (80.00%) and heroin (69.30%). As an instrument to measure the behaviors we used the “Health and Risk Behaviour Scale” (Albuquerque, 2004).

It was found that addicts in hospital:

• a) practice little exercise/physical activity,

• b) care little for the food component,

• c) the majority continues to use semi-legal drugs, and

• d) express little concern about the effects associated with consumption of alcohol and tobacco.

Conversely, we found that they care a lot about their sexual behavior, adopting preventive behaviors against sexually transmitted diseases.

The evidence presented here should be taken into account by several health professionals (doctors, nurses, psychologists,) in an assistance model reorientation and multidimensional accompanying underlying the internment addict and their families.

Comorbidity between Substance Use Disorder (SUD) and other psychiatric disorders, known as Dual Diagnosis, is an issue of growing interest in Mental Health. The high association between Personality Disorders (PD) and substance use is reported in scientific literature. However, not many studies have been published regarding the prevalence of this disorder in a psychiatric unit. AIMSTo determine the prevalence of substance abuse among patients with a Personality Disorder in a psychiatric unit.

A retrospective descriptive study was carried out among all patients admitted to our psychiatric unit during one year. The data collected from the discharge clinical records of patients were: demographic variables, personal psychiatric history and substance use, urine tests and clinical diagnoses at discharge.

We obtained a sample of 334 patients. There was comorbidity between Mental Disorder and SUD in 10.17% of subjects; including 4% diagnosed with Personality Disorder (80% belong to Cluster B). 53.3% of patients with PD substance abuse was reported. Excluding nicotine dependence and benzodiazepines, the most common substances used were cannabis (50%), alcohol (37.5%) and cocaine (25%).

This study shows that Personality Disorder is the Mental Disorder most commonly associated with SUD, among inpatients in our psychiatric unit. In order to detect cases of Dual Diagnosis, we suggest optimize recording in clinical history substance use and systematic urine tests in all patients admitted, which would benefit from specific treatment for their condition.

Recent studies have revealed that neurocognitive and personality domains are important contributors of prolonged abstinence in alcohol dependence.

To reveal further factors related to the ability of maintaining prolonged abstinence in alcohol dependence. Therefore executive and personality functioning were compared of patients with short (STA) and long-term abstinence (LTA).

STA patients (N = 44) were involved from an inpatient center, LTA patients (N = 46; min. 3 years of abstinence) were involved from AA Groups. Decision-making, inhibition and planning as components of executive functioning, coping strategy, temperament and character factors as indicators of personality functioning were evaluated. MANCOVA and Mann-Whitney U statistical analyses were applied to compare the two groups.

No significant differences were found between the STA and LTA patients along decision-making (F = 0.008, p = 0.992), planning (Mann-Whitney U = 794.5, p = 0.065) and inhibition (Mann-Whitney U = 921.5, p = 0.442). Lower levels of novelty seeking and harm avoidance and higher levels of self-directedness and cooperativeness were found in the LTA group (F = 3.32, p = 0.001) along with lower level of emotion oriented coping (F = 3.32, p = 0.001).

Decision-making, inhibition and planning components of executive functioning are independent from the length of abstinence in alcohol dependence. The similar decision-making pattern of the two groups reflect the core feature of addictive behavior; preference toward immediate higher reward and lower punishment despite the long term negative consequences. It is hypothesized that the higher levels of adaptive personality factors in the LTA group decrease the risk of relapse, and contribute to the ability of maintaining prolonged abstinence.

Little is known about the excess mortality associated with use of some illicit substances. In particular, this concerns the risks associated with injection drug use and psychiatric disorders.

This study estimated mortality following substance abuse treatment among primary users of cannabis, cocaine, amphetamine, MDMA, and opioids. The risks associated with injection drug use and psychiatric comorbidity were assessed.

A register of individuals in treatment for illicit substance disorders was linked with registers on psychiatric treatment and mortality. The study population consisted of 20581 individuals who received treatment in Denmark between 1996 and 2006. There were 1441 deaths recorded over 111445 person-years of follow-up.

Standardized Mortality Ratios (SMRs) for primary users of specific substances were: Cannabis: 4.9, cocaine: 6.4, amphetamine: 6.0, heroin: 9.1, and other opioids 7.7. For MDMA the crude mortality rate was 1.75/1000 person-years, and the SMR was not significantly elevated. Sharing of syringes was associated with increased mortality in both primary users of opioids (hazard ratio (HR): 1.58 [95% CI 1.22–1.99], p < .001) and cocaine/amphetamine (HR: 9.52 (95% CI 3.94–23.02, p < .001). Overall, psychiatric comorbidity was associated with modestly increased mortality (HR: 1.15 [95% CI 1.03–1.29], p = .012) and in particular for primary users of cocaine/amphetamine (HR: 2.74 [95% CI 1.56–4.80], p < .001).

High SMRs were found among individuals who had received treatment for cannabis, cocaine, amphetamine, and opioid use disorders. Injection drug use was clearly associated with excess mortality, while the impact of psychiatric comorbidity was generally modest.

Religion and to be religious plays an important role in social life,values and mental health. Upon Alport & Ross(1967) religion can be divided in two forms: Intrinsic and Extrinsic religious orientation. Internal religious orientated lives with their religion but who is external religious orientated abuse the religion in order to external uses. The intrinsic religious oriented people tend to religion for developing in personality, life, attitude and cognition and like to reach the optimal goal that is cognition of God and this is a factor that makes hopeful and not disappointing from bad event and not reaching to goals. (Homayouni, 2010). So the study investigated differences between Intrinsic-Extrinsic religious orientation in addicted and nonaddicted people.

Participants were 91 addicted and 91 nonaddicted people that were randomly selected and Alport's Religious Orientation Scale(AROS) was administered on them. Independent T test was used to analyze the data.

Findings showed significant differences in religious orientation between two groups specially in Extrinsic religious orientation. Addicted people got more scores in Extrinsic religious orientation than nonaddicted people.

Findings indicated that people with Extrinsic religious orientation have more tendency to addiction. They apply the religious to reach their goals and external ends, such as ways to make friends or increase community social standing and prestige. when they do not reach their goals, they disappointed and get mental illness that may lead to addiction.

Allport, G.W. & Ross, M.J. (1967). Personal religious orientation and prejudice. Journal of Personality and Social Psychology, 5, 432–443

Homayouni, A(2010). Psychological aspects of religious orientation and humans abnormal behavior. 18th European Congress of Psychiatry, 27 February-2 March Munich, Germany

Dual diagnosis patients are characterized by low rates of adherence and treatment compliance. During last years new resources have dedicated to these patients where substance use and mental disorder are treated simultaneously.

The aim of this study is to describe sociodemographic and psychopatology features of dual diagnosis outpatient.

All subjects in the study were outpatients at dual diagnosis program at Vall d’Hebron University Hospital, Barcelona, Spain during 2007 to 2008. These patients were following up until December 2009. Sociodemographic data, psychiatric diagnosis and substance abuse were assessed by using EuropASI, SCID-I y SCID-II and by reviewing their medical histories.

A total of 90 patients were recruited for this study during 2007–2008 and were followed one year. 62,5% of them remain until the end of the treatment. 67,9% were men, medium age was 37 years old (± 1.4). Most of them live with their own families (57,1%) and their marital status was single (48,2%). In this sample the most prevalent psychiatric diagnosis was Major Depressive Disorder (36,4%) followed by Psychotic Disorder (36,2%). The most abused substance was cocaine (33,9%) followed by cannabis (26,8%), alcohol (16,1%), heroin (17,9%). More of 60% were polydrug.

The patients who maintained inculcation with the outpatient program of dual diagnosis were men with medium level of academic level and good family and social environment.

The motivation of the patient may affect response to treatment and prognosis.

The objective of this study was to compare the various types of application of patients in terms of their motivation and sociodemographic variables.

To demonstrate that patients who apply for treatment themselves have greater motivation and less depression and anxiety.

Patients who applied or were referred for treatment of addiction to the Elazig Hospital for Mental Disorders were included in this study. Patients diagnosed according to DSM-IV criteria, giving written informed consent and who did not have severe comorbid psychopathology were enrolled. Beck Depression and Anxiety Scales, and Motivation for Treatment Scale (MfT) were used in evaluation. p was set at 0.05.

Forty five male patients with a mean age of 37.9 (S.D. 11.2) were enrolled in the study. The mean scores for Beck Depression and Anxiety Scales and the Motivation for Treatment Scale were 27.7 (S.D. 12.8), 25.2 (S.D. 15.2) and 67.4 (S.D. 11.4); respectively. When the socio-demographic and clinical variables of the patients who applied voluntarily and those who were referred for treatment involuntarily were compared by Mann-Whitney U test, only the total score on the Motivation for Treatment Scale as well as those of its subscales for seeking help and being ready for treatment differed betwen groups (p: 0.01, 0.05 and 0.01; respectively).

Types of application for treatment may affect levels of motivation in patients for treatment. Techniques for motivational interview may especially be important for patients applying involuntarily.

Identification of clinical differences of formation and prognosis of severity of associated forms of alcoholism in relevant variants of co-morbid brain impairment.

With clinical-psychopathological method we examined inpatient samples with stage 2 alcoholism with co-morbid traumatic (group I, n = 105); hypertensive (group II, n = 45) and vertebrogenic (spinal cord artery syndrome) (group III, n = 37) brain impairment. Control - 30 patients with alcoholism without co-morbid pathology.

In group I alcoholism is forming at early age in persons with pre-morbidly problematic social adaptation - in 62,2% conditioned by presence of excitable traits of the character. Dominance of dysphoria in intoxication and in alcohol withdrawal syndrome (AWS) predetermines formation of psychopath-like degradation with total and persistent social disadaptation. Beyond AWS, reactive lability, lingering asthenic-sub-depressive states with inclusion of dysphoric, hysteric-excitable components remain during low quality of remission. In group II later formation of alcoholism in 26,7% of cases was preceded by psychodisadaptive disturbances conditioned by pre-morbidly anxious constitution of personality. In structure of AWS anxious-phobic modality of depressive disorders against the background of cardiovascular manifestations of toxicogenic effects of ethanol determines development of torpid asthenic-depressive states (with cardiophobic and hypochondriac components). For patients from group III we have identified intermediary tempo of increasing of progression of alcoholism with obligate diencephalic psychovegetative, psychosensory and severe psychoorganic cognitive disorders against the background of asthenic, more seldom dysphoric variants of change of the personality.

Prognosis of associated forms of alcoholism is various in distinguished variants (traumatic, hypertensive, vertebrogenic) comorbid brain impairment.

The effect of pharmacotherapy of substance-related disorders is moderate at best.

Therapeutic drug monitoring (TDM) could be an instrument to improve the outcomes. TDM is for most of these drugs not established yet.

The authors built a literature based rating scale to evaluate the necessity of TDM for these pharmacological agents.

A literature research was performed for TDM related properties of acamprosate, bupropion, buprenorphine, clomethiazole, disulfiram, methadone, naltrexone, and varenicline. A rating scale was established for evaluation. It included 28 items related to five categories (efficacy, toxicity, pharmacokinetics, patient characteristics and cost effectiveness). For comparison, three reference substances with established TDM were similarly assessed: clozapine, lithium and nortriptyline.

The three reference substances, lithium, clozapine and nortriptyline, achieved scores of 15, 18, and 14 points, respectively. Rating of methadone (19 points), bupropion (14 points), buprenorphine (14 points), disulfiram (13) and naltrexone (12 points in the indication opioid-dependency and 10 points in the indication alcohol dependency) achieved more than 30% of the reachable points, whereas acamprosate (9 points), clomethiazole (9 points), and varenicline (5 points) had fewer points especially in the main characteristics in favor of TDM.

These results suggest this rating scale is sensitive to detect the appropriateness of TDM for drug treatment. Literature based rating and clinical experience give evidence that TDM has the potential to optimize the pharmacotherapy of substance related-disorders with different rank orders of the single substances.

To evaluate, in a sample of pathological gamblers, the effects of personality traits and psychiatric comorbidity on the severity of this condition.

40 patients were evaluated with the following instruments: EuropASI, modified for pathological gambling; MINI; TCI, and BIS-11. Univariate linear regression analyses were conducted to evaluate the relationships between different scales.

Age of onset was influenced by Novelty Seeking and NS-1 subscale, with higher scores related to earlier onset, Harm Avoidance 2 subscale, with higher scores related to a later onset; the presence of a lifetime panic disorder was related with a later onset; A positive correlation was found between age of onset of pathological gambling and both cigarette and cannabis smoking. Higher NS1 scores were related to a higher amount of money spent during the last month, while higher scores on the HA2 and Cooperativeness 5 subscales were related to a lesser number of days in which the patient had gambled during the last month. Moreover, higher scores in Gambling severity scores are related with the presence of a comorbid alcohol or substance abuse or dependence, dysthymia, post traumatic stress disorder, bipolar II mood disorder, and with higher BIS-11 Motor Impulsiveness, Non-planned Impulsiveness and total scores.

Personality traits and psychiatric comorbidity influence the age of onset of gambling, the severity of gambling and the functional and economic impact of the disease on the patient’s life. An evaluation of these aspects is needed to determine treatment options with a greater understanding of the phenomenon.

Individuals who grow up in alcoholic families seem to have a family environment and climate different from those who grow up in non alcoholic families.

Data on expressed emotion and parental attitudes in alcoholic family are lacking.

Study the level of expressed emotion and the parental attitudes in children of alcoholics (COAs) compared with children of non alcoholics (non COAs).

The Level of Expressed Emotion Scale (LEES) and the Parental Attitudes Scale (PAD) were used to measure respectively the expressed emotion and the family climate. The LEES was filled by the COAs or by the non COAs; the PAD was filled by their significant parent. COAs and non COAs were matched for age and gender.

COAs perceived a statistically lower level of intrusiveness from their parents and a significantly higher emotional response and attitudes toward illness from their parents than non COAs. According to the PAD, there was no difference in the family climate between the two groups. When correlations between LEES and PAD were evaluated, among COAs high level of expressed tolerance (LEES tolerance/expectation subscale) was significantly correlated with a low dominance in the children (PAD Dominance/Submissiveness); among controls, high level of expressed emotion (LEES total score) was significantly correlated with lower pleasure in the children (PAD Pleasure/Displeasure subscale).

COAs and non COAs seem to perceive the emotion expressed in their family environment differently and correlate it with their parental attitudes according to a different pattern.

evaluation of medical consequences of intoxication with spice plants (Bonsai, “magic charge”, “mariciuca”, Salvia divinorum, Mitragina speciosa and others). The precise composition of substance used was not clear but the known drugs were excluded. Material and method: all patients with diagnosis of intoxication of spice plants, admitted for at least 24 hours in Department of Drug Dependence, in a 3 months period, in 2010 were evaluated, not only concerning psychiatric psychopathology but also for other medical symptoms or diseases.

We excluded the patients who have used other known drugs, and had positive results in blood and urine analysis. 17 patients used spice plants associate with alcohol less then 0.5%0, coffee or tobacco, 7 patients used only spice plants. The cardiovascular symptoms were present in 53%, gastrointestinal symptoms in 73%, neurological symptoms in 53%, renal symptoms 5%. We verified the personal history of diseases and also co-morbid acute diseases. Psychiatric symptoms were characteristic to substance induced psychotic disorders.

This study wanted to define and underline the specificity of clinical presentation of intoxication with spice plants, being useful to be known in emergency settings. These medical implications of use of this legal spice plants should also involve community, administrative or political actions for prevention of these medical consequences.