Suicide is a major and preventable public health problem. Risk factors may vary with age, gender, or ethnic group, being substance abuse one of the most frequent.

To investigate the relation of substance related disorder and suicide attempt.

Review of the suicidal attempts of patients with personal history of substance related disorder attended during the year 2010.

We identified 85 cases.

Alcohol (64″3%) and cocaine (47″7%) were the two most identified substances. Cannabis (17″2%) and heroin (23″06%) were less consumed. Benzodiacepines abuse was very frequent among the patients attended (38″2%).

Previous attempts were found in 43″8% of the patients.

Drug overdose was the most commonly method used (98″4%), especially with benzodiacepines and antidepressants, but non psychiatric drugs were also frequent. Substance overdosage or intoxication was the second most frequent method used (23%), and poisoning the third (9%). Most of times these methods were presented with concomitant drug overdose.

Defenestration threats were very rare (2″34%), and always associated with hospitalization request by the patient.

We did find significant differences when studying triggers (family, partnership, economical or others) compared with non substance abusers suicidal attempts.

• - Chronic substance misuse and acute substance abuse is associated with a higher risk of suicide, what may be explained by the disinhibiting effects of psychoactive substances.

• - As benzodiazepine misuse is associated with suicide, special care must be taken when prescribing to at risk patients such as substance abusers

Polysubstance dependent alcoholics (PSA) show a high risk of relapse. Decision-making deficits might be predictive of relapse so that high-risk relapse PSA are easily identified and novel more effective treatment interventions can be found.

To evaluate the effect of decision-making as measured by neurocognitive measures like the Iowa Gambling Task (IGT) and the Delay Discounting Task (DDT) on short-term relapse in PSA. The possible confounding effects of personality disorders (PD) are also examined.

Forty-one PSA following an inpatient addiction treatment were questioned about their substance use. After two weeks of stable abstinence they performed self-report questionnaires (Barratt Impulsiveness Scale - Sensitivity to Punishment and Sensitivity to Reward Questionnaires) and neurocognitive measures of decision-making (DDT - IGT). Thirty-seven PSA were retrieved three months after treatment completion and questioned about their current substance use. Thirty-one healthy controls (HC) were also asked to perform the self-report questionnaires and neurocognitive measures.

All PSA showed decision-making deficits in comparison to the HC. Abstinence was associated with better IGT performances, an older age at onset, and a greater likelihood of a cluster C PD.

IGT performances but not DDT performances are associated with short-term relapse in PSA. It is assumed that the processes involved in the DDT are more important to the initiation of the addiction while the processes involved in the IGT are more important to the maintenance of and the relapse in the addiction.

Pathological gamblers (PG) are often compared to substance dependent patients. Analogous to research into relapse into chemical addictions, a longitudinal outcome design was created to evaluate the impact of impulsivity measures on one-year relapse of pathological gamblers.

Twenty-two PG without comorbid substance use disorders and 31 healthy controls (HC) were compared on measures of impulsivity (Baratt Impulsiveness Scale, Delay Discounting Task, Iowa Gambling Task, Sensitivity to Punishment and Sensitivity to Reward Questionnaires, Stroop Color Word Task). The associations between these impulsivity measures and one-year relapse of pathological gambling were examined.

PG_Abstainers (N = 9) had a later age of onset and gambled for a shorter period than PG_Non-abstainers (N = 13). The PG groups did not differ in impulsivity measures. Healthy controls and PG differed on the Barratt Impulsiveness Scale and the Stroop Color Word Task, but not on the other impulsivity measures.

The present data show that PG are not always impulsive and that gambling histories, rather than impulsivity measures, predict one-year relapse.

Alcohol misuse could be a treatable risk factor for suicidal behaviour, which is seldom approached in the emergency room.

This study aimed to evaluate the impact of alcohol misuse in an interventional follow up program of patients immediately after a suicidal attempt.

Transversal study based on a post hoc analyse of a controlled randomized study done. Epidemiological data and the impact of alcohol misuse were evaluated in relation to suicidal relapse, in compliance for the treatment and in the evolution of Beck’s scores of depression. The study took place in the Rouen University Hospital and lasted for 2 years.

A total of 228 patients, 50 (22.2%) men and 173 (78.8%) women were included. The group with alcohol misuse was composed of 31 (13.9%) patients, and the group without alcohol misuse was composed of 192 (86.9%) patients. The group with alcohol misuse had a lower employment level (n = 16, 51.6%) versus (n = 54, 28.1%) p = 0.009 and was older (mean age 41+/−12 years) than the group without alcohol misuse (mean age 31+/−13 years), p = 0.05. The group with alcohol misuse was composed of 15 (48.4%) of men, compared to 35 (18.2%) of men in the group without alcohol misuse, p = 0.0005. No statistical differences were found for evolution of the depression’s score obtained with the Beck’s scale, nor for the compliance, nor for the suicidal relapse.

Our conclusions are limited by age and sex difference among alcoholic and non alcoholic groups.

In a cross-sectional descriptive study, patients meeting DSM-IV criteria for schizophrenia(n = 30) and mood disorder (n = 30) randomly selected in two psychiatric hospital in Shiraz, Iran, and a control group (30) randomly selected in normal population without history of psychiatric disorders; completed questionnaire for substance use.

Results showed %40 of patients with schizophrenia, %36.6 of subjects with mood disorders and % 36.6 of control group had substance use disorder.

These data suggest that schizophrenia and mood disorders can lead to substance use disorders. Also, in our study high rate of substance use in control group is an alarm. Since substance is caused by and can cause psychiatric disorders and substance use can effect various aspects of social life.

Patients with Acute alcohol intoxication (F 10.0) are referred most often to psychiatry or internal departments.

To examine some epidemiological characteristics of patients with acute alcohol intoxication treated at the admission departments of Psychiatry and Internal Medicine in Tuzla during 2009 year.

We selected from the admission protocols 91(1.8%) of 5 055 patients examined in Psychiatry, and 76(0.5%) of 14 460 patients examined in Internal Medicine admission, who were diagnosed with F 10.0 according to ICD-10. Observed variables were sex, age, treatment they received at the admission departments and the instructions given for further treatment.

We found that Majority of them were males. Patients referred to the Psychiatry were somewhat older (43.2 years), than patients in the Internal Medicine (38.4 years). The most common referral to the Psychiatry was in March 14(13.4%), and November 11(12.1%), while in the Internal Medicine there were 9(14.28%) in November and 8(12.69%) in December. At Psychiatry, 29(31.86%) patients were hospitalized and 62(68.13%) continued with outpatient treatments. At Internal Medicine 40(52.6%) of 76 patients were detoxified, 30(39.47%) patients were referred to the Department for Psychiatry, while in-home treatment was offered to 40 patients (52.63%).

The prevalence of acute alcohol intoxication compared to other diagnoses is higher in the Psychiatry admission than in the Internal Medicine, males were more frequent patients, and patients referred to Psychiatry were somewhat older. The most frequent alcohol intoxication in Psychiatry was recorded in October and November, while in Internal Medicine it was in November and December.

Early onset of substances use disorders (SUD) has been related to some personality characteristics and a higher prevalence of social, psychiatric and organic problems.

To describe personality differences in early onset of alcohol use (EO, age≤ 15) subjects and late onset of alcohol use (LO, age≥16), both affected of acute non-substance use psychiatric disorders (Non-SUD) and alcohol related substance use disorders (alcohol SUD).

Data on sociodemographic and clinical factors were gathered among subjects meeting DSM-IV criteria of alcohol SUD. Psychometric characteristics were explored with TCI-R.

The whole sample (N = 188; age 36,8 ± 9,2; 71,4% male) showed mainly hallucinations/delusions (37,7%) at admittance and personality disorders (50,3%) as a most prevalent non-SUD. Most common comorbid SUD were alcohol (59,5%).

EO subjects (N = 103) had more prevalence of legal problems (51,4% vs. 15,9%), sedatives misuse (73,8% vs. 54,1%), polydrug abuse (2 ± 1,1 vs. 1,6 ± 1,0) and higher score in ASI psychopathology (5,8 ± 1,3 vs. 4,8 ± 1,8). Most frequent dual diagnosis in EO subjects were psychosis+cannabis SUD (8,7%).

EO group was characterized by higher impulsiveness (102,9 ± 16,4 vs 97,0 ± 14,5), disorderliness (127,6 ± 19,2 vs. 117,4 ± 21,7), harm avoidance (30,7 ± 4,9 vs. 28 ± 7,6), eagerness of effort (34,7 ± 7,5 vs. 31,6 ± 8,0), ambitious (19,2 ± 4,6 vs. 17,9 ± 3,1), perfectionist (29,8 ± 5,9 vs. 27,8 ± 6,2), responsibility (30,5 ± 6,9 vs. 27,9 ± 7,7), resourcefulness (25,9 ± 6,3 vs. 23,2 ± 6,8), enlightened second nature (17,7 ± 3,9 vs. 13,9 ± 4,6), social acceptance (32,0 ± 5,8 vs. 29,4 ± 7,1) and lower anticipatory worry (71,7 ± 18,5 vs. 79,8 ± 17,9), dependence (54,5 ± 12,4 vs. 59,2 ± 14,9).

EO was characterized by higher scores in impulsiveness, disorderliness, and self-directedness and showed more severity on social, psychopathologic and substance problems.

Mephenesin is a central muscle relaxant, acting through a depression of the activity of some neurones in the caudate nucleus. It was proposed as a potential treatment of alcohol withdrawal syndrome in the 50s. This over the counter medicine is now mainly prescribed to treat spasticity or as an adjunctive treatment of painful muscle spasm. We know little about this substance except that side effects are venous thrombosis, haemolysis or cutaneous intolerance. Yet, no case of abuse or dependence has been reported.

To report a series of 5 clinical cases in patients who developed abuse or dependence to mephenesin.

We performed a systematic search in data bases of both Paris addictovigilance and poison centres from 1999 to 2010. Clinical details were obtained from clinicians when possible. A literature search was also performed to describe mephenesin mechanisms of actions that could be implied.

Three (3) women et 2 men aged 35 to 52 years (m : 43.6) were identified as abusing mephenesin, among which 4 patients had a full DSM IV criteria of dependence. All had a previous history of abuse or substance dependence (alcohol, heroin, codeine, ketamine…).The average mephenesin daily intake was 13 g (9 to 24 g) when the maximum recommended dosage is 3 gr/d. In one case, a withdrawal syndrome was observed (tremor, aggressiveness).

Mephenesin may be abused by patients with previous risk factors, especially a personal history of alcohol dependence.

This case shows the importance of knowledge of psychiatrists concerning the psychoactive substances of ethnobotanical plants, because of their legality and easy procuration possibility. We consider that the role of psychiatrists in mediatizing the side effects of these plants is very important.

Binge Drinking is a constant problem behaviour in adolescents across Europe. However, epidemiological data on alcohol consumption of adolescents with different migration backgrounds are rare.

Create insight on alcohol consumption patterns in adolescents with different migration backgrounds living in Germany.

In the years 2007/2008, a representative written survey of N = 44,610 students in the 9th grade of different school types in Germany was carried out (net sample). The return rate of questionnaires was 88% regarding all students whose teachers respectively school directors had agreed to participate in the study. 27.4% of the adolescents surveyed have a migration background whereby the Turkish culture is the largest group followed by adolescents who emigrated from former Soviet Union states.

More than half (57.4%) of the German 9th-graders engaged in binge drinking at least once during the 4 weeks prior to the survey. Students with migration background of the former Soviet Union showed mainly similar drinking behaviour like German adolescents (56.2%). Adolescents with Turkish roots engaged in binge drinking less frequently than adolescents of German descent (23.6%). However, in those adolescents who consumed alcohol in the last 4 weeks, binge drinking is very prominent across cultural backgrounds.

Common expectations concerning drinking behaviour of adolescents of certain cultural backgrounds (‘migrants with Russian background drink more’/‘migrants from Islamic imprinted countries drink less’) are only partly affirmed. Possibly, the degree of acculturation to the permissive German alcohol culture plays a role here.

Neurotoxic effects of alcohol consumption are well-known. There is plenty of literature on frontal lobe impairment on the behavioral and structural brain imaging level. However, only few functional imaging studies investigated altered neural patterns and even less abstinence-related neural recovery. Here, we investigated if frontal lobe activity tends to normalize in patients that remain successfully abstinent.

In a cross-sectional design three patient groups (acute withdrawal, detoxified, abstinent) and healthy controls (each n = 20) performed a phonological and semantical verbal fluency task (VFT) while brain activity was measured with near-infrared spectroscopy (NIRS).

First, for the phonological condition patients in the acute withdrawal phase and also detoxified patients showed less fluency-related frontal lobe activation compared to controls despite equal performance. Second, significant linear trend effects from withdrawal patients over detoxified and abstinent patients up to healthy controls indicated more normal activation patterns in the abstinent group that did not differ from the controls. In the detoxified group brain activation increased with time since detoxification.

Our results support the assumption of an increase in frontal brain activity from alcohol dependency over abstinence up to normal functioning. Longitudinal studies are needed to further elucidate recovery processes in alcohol dependency.

Individuals with co-occurring disorders have higher levels of psychological distress and poorer psychosocial functioning, as compared with individuals with substance dependence only. Studies identified substance abuse as a risk factor, which increases the likelihood that an individual with mental disorders may become violent.

To examine the gender differences in drug-related problems and predictors of recidivism among a sample of 1,444 offenders with co-morbid drug abuse and mental disorders participating in California's Proposition 36.

Characteristics and problem severity in multiple key life areas were assessed at intake using Addiction Severity Index, and drug treatment participation, mental health diagnoses and arrests were based on official records.

Women demonstrated greater problem severity than men in family relationships, health, psychological health, and sexual and physical abuse history. Men on the other hand had greater criminal history, high rates of attention disorder, and psychotic disorder. Logistic regression analyses showing that for the combined sample, male, young age, cocaine use (relative to methamphetamine), drug abuse severity, methadone treatment, arrest history and fewer prior treatment history were associated with higher recidivism at 12-month follow-up; lower education, cocaine use, and arrest history were related to women's recidivism, while young age, outpatient treatment, and arrest history were predictors of men's recidivism.

Although the specific type of mental disorder did not seem to be predictive of recidivism, the high rates of mental health disorder and arrest of this population is problematic. Intervention strategies taking into consideration gender-specific problems and needs can improve outcomes for both.

The objective was to study risky behaviors for HIV infection by drug dependents and assess their needs for prevention.

This study was conducted on 188 drug addicts using a pre tested and pre designed qustionnaire sheet.

The majority of studied addicts were ageing 20–40 years (81.4%), males (88.8%), of urban residence(69.7%) and of single marital status (69.7%). Illiteracy represented 10.6% and 22.3% were unemployed. Practicing drug injection was found among 44.7% out of them 42.9% shared needles. Knowledge about HIV/AIDS was found among the majority of studied addicts but deeper knowledge about modes of transmission was defective. Only 11.2% were ever screened for HIV compared with 43.6% for viral hepatitis. Risk perception for HIV infection was found among 28.6% of injecting drug users and 22% of addicts with unsafe sexual relations. Nearly two thirds had extramarital sex with multiple partners while 66.9% reported never use condoms. Hepatitis B and C and sexually transmitted infections were significanlty higher among dependents with unsafe sexual behaviros and drug injection.

Risky behaviors for HIV infection are common among studied addicts. Their risk perception and knowledge about HIV/AIDS was, however, found defective. There is urgent need for outreach programs to increase their awarness about harm reduction meaures.

Aim of this study was to investigate the relationship of social anxiety (SA) severity with drinking motives in male alcohol dependent inpatients.

Participants were 155 consecutively admitted male alcohol dependents. Patients were investigated with the Drinking Motives Questionnaire—Revised (DMQ-R), the Social Phobia Scale (SPS), and the Social Interaction Anxiety Scale (SIAS).

Mean scores of DMQ-R subscales were positively correlated with social anxiety scales in different degrees. Conformity motives predicted both SPS (together with social motives) and SIAS.

SPS which evaluates social phobia-circumscribed type was predicted by conformity and social motives, whereas SIAS which evaluates social phobia-generalised type was predicted by only conformity motives. This suggests that different types of motivation may be related with different types of social phobia.

The aim of this study was to investigate the relationship between alexithymia and drinking motivations among male patients with alcohol dependency.

Participants were 136 male patients consecutively admitted to an alcohol dependency treatment unit. The Toronto Alexithymia Scale (TAS-20) and the Drinking Motives Questionnaire—Revised (DMQ-R) were administered to all participants.

In alexithymic group (N = 44, 32.4%) duration of education was lower, whereas current age, age onset of regular alcohol use, marital and employment status did not differ between groups. Scores of drinking motives and severity of general psychopathology were higher in alexithymic group. Alexithymia total and factors of alexithymia (other than thirth factor) were positively correlated with drinking motives. TAS- difficulty in identifing feelings was significant covariant for enhancement, coping and confirmity motives, whereas TAS- difficulty in describing feelings was significant covariant for only confirmity motives in MANCOVA analysis.

These suggest that drinking motives may be a mediator in the relationship between alexithymia alcohol dependence.

Drug addiction is one of the most common social disorders in Iran. It is estimated that about 2 million Iranian are addicted and the number is rising.

This study is done to investigate the educational history and its related issues of addicted participants.

Participants are a convenience sample of 71 drug addicted males who came to one of the 17 addiction treatment centers in Yasouj- Iran. Data were collected via a self administered questionnaire.

Patients were all male, age from 19 to 50 years old. Only 1.4% (one patient) was illiterate, and 10.1% had university degrees. 59.9% did not started (1.4%) or finished (58.5%) their national compulsory educational program. Addiction was reported as the main reason for withdrawing from school (19.6%). More than 73% of the participants had educational difficulties (e.g. failed subject) and 74% used to be aggressive during their study period. More than 46% were under 18 years old (33.3% under 16) when they used drugs for the first time. School was the place of the first use of drug for 6.1% of the participants.

Educational issues seem to be a common problem for the drug addicted participants. This is due to either addiction itself or educational problems can be considered as indicators for later attempt for using drugs or more precisely addiction. It would be reasonable to do further work to find out more specific educational difficulties which can predict later risk for addiction.

To estimate the percentage and risk factors of Internet addiction (IA) at Greek Internet cafés.

We used a questionnaire including questions on demographics, Internet use duration, Internet applications and sites visited, degree of Internet use influence on daily schedule and social relations, psychosocial characteristics of users and Young's IA Test (48 items overall). Our randomly selected sample included Internet café users in Athens and other big Greek cities. The sample size was 686 people (74%/26% M/F) and 12%, 70% and 18% were between 7–14, 15–25 and 26–45 years old respectively.

Cronbach's alpha ranged from 0.79 to 0.90 for all 6 sections of our questionnaire. The prevalence of IA among Internet café visitors was 20.8% (16.0% men, 4.8% women). IA was significantly associated to Internet use duration per day, Internet Café visits number per week, number of hours playing at Internet cafés per visit, duration playing violent games (e.g. Counter-Strike, Quake, Assassin), duration visiting Facebook and MySpace, and degree of Internet use influence on daily schedule, social relations and psychological attitudes (p < 0.01). Binary logistic regression showed that significant predictive factors of IA were the length of time playing violent games [ORCounter-Strike = 23.6 (95% CI 1.2 − 40.1); ORAssassin = 10.9 (95% CI 1.5 − 43.2)], visiting Facebook [OR = 41.9 (95% CI 19.7 − 87.5)], and deterioration of social relations (p = 0.009).

IA is frequent in Internet cafés, possibly due to an online gaming addiction affecting multiple aspects of a person's life.

To present the epidemiology and psychological predictors of Internet Addiction (IA) among Greek University students.

This random sample consisted of 3545 students, drawn from 24 higher education institutions (1618/1927 M/F, mean age 20.12 ± 2.4 years). The survey was conducted in the 4 Greek cities: Athens, Preveza, Thessaloniki and Amfissa.

The prevalence rates of IA according to Young's Test in the four cities were: Athens (17.5%), Preveza (15.9%), Thessaloniki (19.3%), Amfissa (16.3%). There was a statistically significant association between location and IA (χ2 = 28.251, df = 3, p < 0.001), gender and IA for males and females (p < 0.001). We performed a t-test with the dependent variable S = sum of scores in the psychological features of loneliness, feeling abandoned, disappointed, aimless in life, and with low self-esteem; the grouping variable was IA. Results showed that the variable S was much lower for the non-addicted than for addicted students (t = 19.329, p < 0.005, df = 3085). Binary logistic regression was performed to assess the impact of psychological characteristics on the likelihood that respondents would be Internet Addicted. The model was statistically significant χ2(10, N = 3085) = 316.3, p < 0.001. The model classified correctly 85.1% of the cases. The strongest predictors of IA were the following: Loneliness (OR = 2.15, 95% CI = 1.67-2.71), feeling abandoned (OR = 1.63, 95% CI = 1.2-2.1), low self-esteem (OR = 1.72, 95% CI = 1.4-2.1) and fear of losing their job (OR = 1.36, 95% CI = 1.01-1.7).

Loneliness, helplessness, low self-esteem and fear of unemployment are the strongest predictors of IA among Greek university students.