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.

The goal of this study is to assess the differences in peak and medium velocity, peak and medium acceleration of eyeball movements after the administration of methadone.

Twenty-eight opioid addicts were examined. Patients admitted oculomotor impaired were excluded.

In this study, we made use of the Saccadometer Advanced (Advanced Clinical Instrumentation, Cambridge, UK), allowing the measurement of eye position with the time resolution of 1 msec (1000 Hz). The eye movement measurement is automated and synchronised with stimuli presentation. Before and after the administration of methadone two saccadic tests were carried out: Prosaccades Test (PT) and Antisaccades Test (AT).

The average of peak and medium velocity and the average of peak and medium acceleration of eyeball movements in the test AT were lower than in the PT test. After administration of a single dose of methadone the peak and medium velocity, peak and medium acceleration decreased in both tests (PT and AT). After administration of methadone prolonged the duration of saccades, and prolonged the duration of rising and falling slope of saccades.

It was found that methadone (μ-opioid receptor agonist) is associated with change of velocity and acceleration of eyeball movements.

The authors have not supplied their declaration of competing interest.

It is necessary to search for and to carry out effective treatments for chemical dependency – including behavioral addictions. One of the methods used in various disorders is a biofeedback HRV (BF-HRV). The aim of the study is to examine the impact of BF-HRV on people addicted behaviorally to gambling and chemically dependent patients on opioids.

Twenty-four opioid addicts were examined. We used emWave (HeartMath) with a heart rhythm monitor to learn stress reduction and emotional management skills. For a detailed analysis of the HRV data was used Kubios 2.0 software (Biosignal Analysis and Medical Imaging Group).

The average value of the three components of HRV, i.e. low (LF), medium (MF) and high (HF) frequencies of spectral energy FFT recorded during six consecutive sessions of BF-HRV were the following: 1st session LF 63%; MF: 17%; HF: 19%. Changing parameters in the next sessions: 2nd session LF −9.27%, MF: +0.50%, HF: +6.19%; 3rd session LF −11.11%, MF: +1.00%, HF: −10.07%; 4th session LF −14.27%, MF: −4.17%, HF: +18.77%; 5th session LF −15.02%, MF: −2.04%, HF: +17.07%; 5th session LF −15.02%, MF: −2.04%, HF: +17.07%; 6th session LF −20.86%, MF: −4.04%, HF: +24.90.

After the BF-HRV training decrease low and medium frequencies (LF-MF) and increase high frequency (HF). Recent studies suggest that LF-HRV is an index of cardiac sympathetic control and the LF/HF ratio is an index of sympathovagal balance.

The authors have not supplied their declaration of competing interest.

Tobacco dependence (TD) often coexists with alcohol dependence. Previous research documented that both biological and environmental factors influence simultaneous development of the two disorders. However, it has not been determined whether the same psychological and psychopathological factors affect TD in alcohol-dependent males and females.

The objective of the study was to assess risk factors for high severity of TD in alcohol-dependent individuals considering gender differences.

The study entailed two groups: male (n = 284) and female (n = 102) subjects entering alcohol addiction treatment programs in Warsaw, Poland. Standardized instruments were used to assess: severity of TD – Fagerstrom Test for Nicotine Dependence, personality traits – NEO-Five Factor Inventory to assess, consequences of drinking – Short Inventory of Problems, impulsivity – Barratt Impulsivity Scale, and Sleep Disorder Questionnaire-7 as a measure of insomnia.

In the studied sample, current smokers comprised 79.1% (n = 225) of male and 79.4% (n = 81) of female participants. Multivariate regression model showed that high negative consequences of drinking (P = 0.001) and low NEO Openness score (P = 0.009) were associated with high risk of TD in female alcoholics (corr. R2 = 0.223; P < 0.0005). Bivariate analyses showed that TD was associated with impulsivity, openness, agreeableness and neuroticism in male alcohol-dependent subjects. Insomnia was the only significant predictor for high severity of TD in the males (corr. R2 = 0.068; P = 0.002).

Different factors contribute to severity of tobacco dependence in male and female alcohol-dependent individuals entering addiction treatment.

The authors have not supplied their declaration of competing interest.

The objective of current study was conducted to determine whether low vitamin D level and BMD are associated with depressive symptoms as burden in Arab women during the menopausal and post-menopausal period.

A cross-sectional descriptive study.

A multi-stage sampling design was used and a representative sample of 1436 women aged 45–65 years were included.

Bone mineral densitometry measurements [BMD] (g/m2) was assessed at the BMD unit using. Data on body mass index (BMI), clinical biochemistry variables including serum 25-hydroxyvitamin D were collected. The Beck Depression Inventory (BDI) was administered for depression purposes.

Of the 1436 women living in urban and rural areas, 1106 women agreed to participate (77.0%). There were statistically significance differences between menopausal stages with regards to ethnicity, education level, systolic and diastolic blood pressure, parity, sheesha smoking and depressive symptoms. Overall, 30.4% of women were affected with osteopenia/osteoporosis in menopause and postmenopausal (24.4% vs. 35.7%; P = 0.0442). Osteopenia in menopause and postmenopausal (18.7% vs. 29.3%; P = 0.030) and osteoporosis (9.9% vs. 15.9%; P = 0.049) were significantly higher in post-menopausal women than in pre-menopausal women (P = 0.046). Similarly, vitamin D deficiency was more prevalent among postmenopausal women than menopausal women. The study revealed that vitamin D level, hemoglobin level, serum iron fasting plasma glucose, calcium, triglycerides, HDL cholesterol, LDL cholesterol, alkaline phosphate and magnesium were considerably lower in postmenopausal compared to menopause women (P < 0.001).

The study confirmed strong association between vitamin D level and BMD in Arab women during the menopausal and post-menopausal period.

The author has not supplied his declaration of competing interest.

The author has not supplied his declaration of competing interest.

Anxiety disorders are the most common mental disorders, and their prevalence is substantially higher in women than in men. Research has confirmed the existence of gender differences in several types of anxiety disorders.

The current investigation sought to determine whether any observable gender differences existed in anxiety for a nonclinical sample.

the sample consisted of 300 males and 300 female students from a secondary school in Kuwait. The genders were matched in age (males = 16.52 ± 0.90 & females = 16.37 ± 0.96, t = 1.93, P > .05). The inclusion criteria for all participants: sample of the population of Al-Jahra city, aged between 15 and 18 years old, school grades 10, 11, 12, and the social status of the parents (married). The Arabic version of Beck Anxiety Inventory (BAI) was administered to participants. BAI reliabilities ranged from .88 to .87 with a mean .87 (alpha) denoting good internal consistency. The convergent correlations in eight samples between BAI and Kuwait University Anxiety Scale KUAS (mean r = .52) for validity coefficients.

The results revealed that females (18.67 ± 11.11) had significantly higher mean anxiety than their male (14.52 ± 10.37) counterparts (f = 22.27, P < .000).

Therefore, we can conclude that female preponderance of anxiety has been a consistent finding within literature.

The author has not supplied his declaration of competing interest.

Thirty-five definite vestibuler migraine patients (according to Neuhauser criteria), 35 MO patients and 32 healthy controls were included. All patients were evaluated for their lifetime psychiatric disorders with Structured Clinical Interview for DSM–IV/Clinical version (SCID-I/CV). All three groups evaluated by:

– Hamilton Anxiety Rating Scale (HARS);

– State-Trait Anxiety Inventory (STAI), (STAI-X1) and the other trait anxiety STAI-X2);

– Beck depression inventory (BDI);

– Lifetime Panic Agoraphobic Spectrum Scale (PAS-SR);

– Penn State Worry Questionnaire (PENN);

– Separation Anxiety Symptoms Inventory (SASI);

– Adult Separation Anxiety Questionnaire (ASA).

Psychiatric diagnosis history (SCID-I); comparison of VM and MO did not indicate a significant difference (P < 0.05). VM and MO patients were significantly different than HC in terms of anxiety symptoms in “HAM-A, PENN, ASA, PAS-SR and PAS-SR subscales (P < 0.05)”. VM was significantly different than MO patients in BDE and PAS-SR (overall; separation anxiety, agoraphobia, reassurance seeking) (P < 0.05). The longer the history of migraine the higher was the anxiety points in both in VM and MO patients (P < 0.05). Headache and vertigo severity in VM patients were significantly correlated with the elevated anxiety and depression points (P < 0.05).

VM and MO patients significantly different in anxiety and mood disorder when compared with healthy controls. Our findings showed that VM patients were more vulnerable to psychiatric disorders. For that reason, multidisciplinary approach for the treatment of VM may facilitate the treatment process.

The authors have not supplied their declaration of competing interest.