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.

The authors have not supplied their declaration of competing interest.

The current situation in Ukraine is characterized by multitude social-stress factors, resulting in an increase in alcohol consumption and alcohol addiction, which arises as a mechanism to compensate the adverse mental stress and different variant of chronic stress disorder.

Substantiate the neurobiological basis of mutual influence of stress burden and alcohol addiction.

To study the biochemical mechanisms that underlie the vicious circle of stress and alcohol addiction.

Studies the features of hypothalamic-pituitary-adrenal (HPA) axis under stress and alcohol available in Medline, Institute for Scientific Information Databases (Science citation index expanded and Social sciences citation index), EMBASE, and Cochrane Library were identified and reviewed.

Alcohol, just like stress, affects the HPA axis, changing the reaction of its parts and, by reducing the production of cortisol, which produces in response to stress and prolongs subjective experiences of nervous tension caused by stress. Stress, through the output of cortisol, reduces the effect of alcohol leads to a desire to further alcohol abuse. The system includes elements of the extended amygdala, which have as reinforcement and stress reactivity. Central nucleus amygdala plays a leading role in the reinforcing effects of pharmacological agents with narcogene potential and performs persuasive role in the activation of hypothalamic reinforcement mechanisms. This allows us to consider neurohormonal system, including the amygdala, hypothalamus, pituitary and adrenal glands as structural and functional basis of formation depending on various narcogene, primarily alcohol.

Dysregulation of the HPA axis is a neurobiological basis of mutual influence of stress burden and alcohol addiction.

The authors have not supplied their declaration of competing interest.

The potential adverse consequences, personal distress, shame and guilt presented by patients who suffer from codependency require a more in-depth understanding of the phenomenology of this disorder.

To determine targets of psychotherapy work with the codependency wives of men with alcohol dependence (AD).

To determine the features of clinical manifestations of codependency as a model of health disorders associated with stress.

Integrated clinical-psychopathological and psychodiagnostic research, using anxiety and depression scales M. Hamilton, scale of psychosocial stress L. Reeder and methods for determining stress and social adaptation of Holmes and Rahe.

One hundred and sixty wives of men with AD, depending on the type of AD (TF Babor's classification), were divided into two groups: group A, 80 patients with AD type A and 80 their wives, and group B, 80 men with AD by type B TF Babor, and 80 wives. Comparison group consisted of 50 married women whose husbands are not suffering from AD.

All the wives of men with AD distortions emotional state of the prevalence of pathological manifestations of depression and anxiety clinically delineated levels and high levels of psychosocial stress and low stress, unlike women men without alcohol problems. It was found that the more severe psychopathological manifestations occurring in the wives of men with a family history, burdened alcohol and drug abuse (group B).

Available data suggest that a single mechanism of family experiences a stressful situation, we were put in the basis for developing a comprehensive treatment measures and psychotherapeutic support codependent wives patients with AD.

The authors have not supplied their declaration of competing interest.

Use of the Internet lately has significantly been increased worldwide. The time users spend browsing the Internet is constantly increased resulting to serious consequences incurred in personal, professional and social life.

The purpose was to explore whether the economic crisis is affecting the use and addiction to Internet, whether the economic crisis is a risk factor in the appearance of addiction to the Internet and if the occupation and the existence of extra-curricular activities act as barriers to the development of addiction to the Internet on students.

A questionnaire was prepared based on the diagnostic tool IAT (Internet Addiction Test). The survey was conducted in June of 2014 on 632 students.

It was found that 6.2% of the sample population has moderately addictive behavior and 0.5% has a serious addiction. Addiction levels to the Internet are affected by someone working while studying and his monthly income, by daily time spent by the student in activities besides school, by the time spent daily on the Internet and by the operations mostly used. Also found that the risk of developing Internet addiction is higher among students who said they had difficulty paying their bills and Internet subscription and to those who due to economic crisis would stop all their activities in order to obtain money.

The economic crisis is a factor that affects on Internet addiction and occupation and activities may act as a deterrent to the emergence of the phenomenon.

The authors have not supplied their declaration of competing interest.

In 2013, the American Psychiatric Association included Internet Gaming Disorder in the appendix of the 5th edition of the DSM-5, suggesting more research is necessary for the condition to be officially accepted as mental disorder. Criticisms have emerged as to the viability, validity and reliability of the proposed condition, and researchers have pointed out that the subsuming of Internet addiction under the umbrella term of Internet Gaming Disorder (as is the case in the DSM-5) is highly problematic.

The objective of this talk is to provide a comprehensive and inclusive analysis of clinical research of Internet-use related addictions from a holistic perspective, given the ambiguity of previous research in the field.

A systematic literature review was conducted using the database Web of Science, and a total of 44 empirical and clinically relevant studies were identified.

Results indicated that the published clinical research studies can be categorized into four areas, including (i) treatment seeker characteristics, (ii) psychopharmacotherapy, (iii), psychological therapy, and (iv) combined treatment, each of which will be discussed.

At the present day, both diagnosis and research of Internet-use disorders appears rather broad. Furthermore, there appears a need for developing a gold standard of clinical assessment. This will support the establishment of efficacious and effective treatments which need to be tailored to the individual help seekers’ needs.

The authors have not supplied their declaration of competing interest.

Physical comorbidities are common in patients with concurrent mental illness and substance use disorder. Interventional studies addressing health promotion for this group of patients are scarce.

To examine the physical health condition of a non-selected group of patients with substance use disorder comorbid to other psychiatric disorders. Further, to analyze for possible changes in their health condition during a two-year intervention study in relation to physical measures and substance use. Finally, to analyze for possible associations between changes in physical measures and in substance use.

The patients were enrolled in the project continuously from October 2013 through May 2015. Physical health measures were obtained at the enrolment date and continuously as part of daily clinical practice. Interventions consisted of individual consultations with a research nurse, group sessions and an opportunity to do physical exercise together with the research nurse. Interventions included health promotion activities, i.e. guidance on healthy food intake, smoking cessation and a physically active life.

In total, 64 patients (mean age 32.7 years, SD 10.7) were included in the study. Patients were mostly diagnosed with psychotic disorders (11%), affective disorders (44%) or developmental disorders (34%). Baseline measures showed that 89% of the patients smoked cigarettes daily, 61% had used cannabis and 20% had used amphetamines within the past month. Further, few patients did moderate or vigorous physical exercise. Further results are in progress.

These interventions seem relevant and manageable in an outpatient setting.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.