Since 2003, Russia has experienced steep decline in alcohol psychoses incidence rate (APIR) and a parallel downward trend in the population drinking, driven mainly by a decrease in vodka (spirits) consumption. A coincidence in these trends allows us to hypothesize that the reduction in the APIR during recent decade might be attributed to the shift in the structure of consumption from vodka towards beer as a result of alcohol policy reforms.

In this study we will test the hypothesis of beverage-specific effect on APIR by analyzing Russian's time series data.

Time-series analytical modeling techniques (ARIMA) were used to examine the relation between the sale of different alcoholic beverages (vodka, wine, beer) and APIR between 1980 and 2010.

The analysis suggests that of the three beverages vodka alone was associated with APIR. The estimated effect of vodka sale on the alcohol psychoses rate is clearly statistically significant: a 1 liter increase in vodka sale would result in a 27.4% increase in the APIR.

The findings from this study provide support for the hypothesis that the shift in the structure of consumption from vodka towards beer as a result of alcohol control measures has had a positive impact on bringing down the APIR in Russia during recent decade. This research evidence also suggest that Russian government's attempt to curb the high level of alcohol-related problems have been successful and provide additional evidence that pricing policy may be an effective strategy to reduce an alcohol-related burden.

The problem of the consumption of alcohol surrogates in the former Soviet republics has attracted the attention of researchers after the epidemic of poisonings by surrogate alcohols, which swept across Russia and Belarus in 2006. Isolated studies suggest that the main consumers of noncommercial alcohol are heavy drinkers and alcohol dependent individuals.

This study was design to explore the prevalence, drinking pattern, types, reasons and correlates of the consumption of alcohol surrogates among alcohol dependent patients.

The study was conducted in the Belarusian city Grodno in 2013 with 326 alcohol dependent patients (223 men and 103 women) admitted to narcological clinic using structured interviews.

The results suggest that 52.9% of men and 30.3% of women regularly consume samogon (moonshine), while 11.8% of men and 10.8% of women use surrogates, the most popular among which are medications with a high percentage of ethanol and industrial spirits. The belief that, according to quality criteria, samogon exceeds licensed vodka is the main motive for its consumption.

This is the first in-depth study of the alcohol surrogates drinking pattern, types, reasons and correlates among alcohol dependent patients in Belarus. The results from present study confirm that the use of alcohol surrogates is common among alcohol dependent patients even though its use may have been underreported. These findings emphasize the urgency of implementing comprehensive alcohol policy, which need to address overall consumption, harmful drinking pattern and taking into account the consumption of alcohol from illicit sources.

Anxiety disorders (AD) are associated with an increase of physical comorbidity but the effects of these diseases on hospital-based mortality are unclear. Objectives and aims. To investigate whether the burden of physical comorbidity and its relevance for hospital-based mortality differs between individuals with and without AD during a 12.5-year observation period in general hospital admissions. Methods. All comorbidities with a prevalence ≥ 1% were compared between 11,481 AD individuals and those of 114,810 randomly selected and group-matched hospital controls of the same age and gender. Comorbidities that were risk factors for later hospital-based mortality were identified using multivariate forward logistic regression analysis.

AD individuals compared to controls had a substantial excess comorbidity, but a reduced total number of in-hospital deaths. Altogether, twenty-two diseases were increased in comparison with controls, which included cardiovascular diseases and their risk factors. The most relevant comorbidities in AD individuals were hypertension, asthma, cataract, and ischemic heart disease. Risk factors for hospital-based mortality were lung cancer, alcoholic liver disease, respiratory failure, heart failure, pneumonia, bronchitis, non-specific dementia, breast cancer, COPD, gallbladder calculus, atrial fibrillation, and angina. The impact of atrial fibrillation, angina, and gallbladder calculus on hospital-based mortality was higher in AD individuals than in controls. In contrast, other mortality risk factors had an equal or lower impact on hospital-based mortality in group comparisons. Conclusions. AD individuals have a reduced risk for hospital-based mortality in general hospitals. Atrial fibrillation, angina and gallbladder calculus are major risk factors for general hospital-based mortality in AD individuals.

To investigate variations in cortical thickness (CT) in GAD patients versus healthy controls (HCs).

GAD patients and matched HCs underwent a 3T magnetic resonance imaging (MRI) session.

Structural MRI was acquired from 24 DSM-IV GAD patients (age=41±13.9) and 23 HCs (age=39±13.4). CT was estimated using Freesurfer5.3 (Fischl and Dale, 2000). Results were manually corrected if necessary. We considered 21 regions of interest (ROIs) per hemisphere (4 cingulate, 6 frontal, 3 parietal, 5 temporal, 1 occipital, entorhinal, insula), for each of which a mean CT value was calculated. A t-test was performed for each region, correcting results for multiple comparisons.

The groups were statistically homogeneous in terms of age, gender, handedness, and IQ (p>0.05). Though ROI volumes were preserved in GAD (p>0,05; Bonferroni corrected), a significantly reduced CT was found in right caudal middle (t(46)=3.621, p=0.015) and right superior frontal (t(46)=3.215, p=0.049) regions.

The found decreased CT in GAD patients compared to HCs in superior frontal and caudal middle areas (right side) sustains prior neuroimaging findings showing abnormalities in prefrontal cortex. Reduced right frontal CT may be involved in cognitive dysfunction and symptomatology of the disorder.

To explore socio-economic inequalities in fatal overdose cases related to non-prescribed opioids’ and cocaine use.

Overdose cases recorded in Luxembourg between 1994 and 2011 were individually matched with four controls, in a nested case-control study design, according to sex, year of birth, drug administration route and duration of drug use. 272 cases vs. 1,056 controls were analyzed. The study sample was stratified according to a Social Inequality Accumulation Score (SIAS), based on educational attainment, employment, income, financial situation and professional status of father or legal guardian of subjects. Least squares linear regression analysis on overdose mortality rates and ridit scores were applied to determine the Relative Index of Inequality (RII).

A negative linear relationship between the overdose mortality rate and the relative socioeconomic position was observed. We found a difference in mortality of 29.22 overdose deaths per 100 drug users between the lowest socioeconomic class compared to the most advantaged class. In terms of Relative Inequality Index, the overdose mortality rate of opioid and cocaine users with lowest socioeconomic profiles was 9.58 times as high as that of their peers from the highest socioeconomic class (95% CI; 6.49 – 13.26).

Our results suggest the existence of a social gradient in opioid and cocaine related overdose fatalities. Medical services, emergency and psychiatric wards should take due account of the socio-economic situation of substance abusing patients and refer those at increased risk to socially supportive offers, thus contributing to reduce drug-related mortality.

Tobacco smoking rate is high (21%) among Romanian adolescents.

To assess youngsters attitudes and beliefs towards tobacco dependence, their compliance to smoking cessation interventions and success rate of a standard smoking cessation program.

231 subjects participated in the Adolescent Smoking Cessation (ASC) pilot program. Subjects were evaluated based on the ASC questionnaire, a validated set of questions about personal data, nicotine addiction profile, willingness to involve in ASC whether current smoker or not. Smoking status was validated by carbon monoxide determination in exhaled air. Participants were delivered 6 interactive ASC sessions about smoking hazards and methods to quit smoking. A final evaluation was done to assess program's impact and to reward quitters and reducers by prizes.

Study group was made of 52.4% every day smokers, 10.4% at least once/week but not every day smokers, 6% less than once/week smokers, 23.4% never smokers and 7.8% ex-smokers. Abstinence rate was 12.3% in every day smokers and 16.6 % in at least once a week but not every day smokers. The program registered a high attendance rate/sessions as 85.2 % of subjects were present in all sessions. Also, significant changes occured in participants beliefs about addiction to tobacco, as evaluated by standard personal smoking and cessation beliefs questionnaire.

ASC was appreciated as an efficient program with 12.3% of daily smokers to quit smoking and its positive impact on personal nicotine addiction beliefs in 90 % of participants.

Smokers with psychiatric comorbidities are prevalent in our current practice. Varenicline (Champix) is a first line pharmacotherapy indicated to treat nicotine addiction.

To assess efficacy and safety of varenicline in current practice of a smoking cessation center treating smokers with high prevalence of psychiatric disorders.

128 smokers with concurrent stable psychiatric, respiratory or cardiovascular disorders (study group) and 124 healthy smokers (control group) were treated with varenicline and counseling, for 12 weeks to stop smoking. Abstinence rate was assessed in both groups at 12 weeks. Varenicline safety, cessation profile and compliance to treatment were monitored in psychiatric disorders smokers compared to other co-morbidities and to controls.

54.6 % smokers with comorbidities (12/22 cardiovascular, 14/30 respiratory, 44/76 psychiatric) and 33.8 % healthy smokers successfully quit smoking. Withdrawal symptoms and adverse effects picture did not differ significantly between groups. The figure shows compliance to treatment and number of adverse events in healthy and psychiatric, respiratory and cardiovascular disease smokers.

Smokers with psychiatric co-morbidities achieved a higher abstinence rate, compared to respiratory and cardiovascular disease smokers and to control group. Varenicline proved comparable safety in both study and control groups.<a name="_GoBack"></a>

We recently identified association between GRIN2B rs2058878 variant and abstinence length in acamprosate-treated alcoholics (Karpyak et al. 2014). Here we present results of additional analyses exploring associations in the same sample (225 alcoholics treated with acamprosate for three months) at the gene and gene-set levels, for 12 genes involved in glycine signaling, 4 genes involved in glutamate reuptake, synthesis and degradation and 7 genes encoding NMDA receptor subunits.

After adjustment for relevant covariates, gene-level tests were performed using principal components (PC) analysis. Gene-set analyses were performed using the PC-Gamma approach with varying soft truncation threshold (STT) for the Gamma method for combining gene-level p-values.

Shorter abstinence was associated with increased intensity of alcohol craving and lower number of days between last drink and initiation of acamprosate treatment. After adjustment for covariates, we observed nominally significant association of abstinence length with variation in the AMT (p=0.024), GRIN3A (p=0.016) and SHMT2 (p=0.039) genes, and marginally significant evidence for association with the GRIN2B (p=0.067) and GLRB (p=0.060) genes. At the gene-set level, association of abstinence length with variation in the glycine pathway was nominally significant (p=0.042 with STT=0.37). Marginal evidence of association with abstinence length was also observed for variation in the NMDA-receptor subunits (p<0.1 for STT<0.15).

Our findings suggest association of abstinence length in acamprosate-treated alcoholics with variation in the glycine signaling pathway and genes encoding NMDA receptor subunits. Investigation of the mechanisms underlying these associations and their usefulness for individualized treatment selection should follow.

Alcoholics show attentional bias when viewing alcohol-related pictures, a low magnitude of the startle response when viewing alcohol-related cues, and a poor inhibitory control. However, it has not been studied which clinical and drinking variables modulate these paradigms.

To explore which clinical and drinking variables modulate attentional bias, affective modulation of the startle reflex and behavioural inhibition in alcoholics.

127 alcoholics were tested with 3 psychophysiological tasks: the dot probe task (attentional bias), the startle response when viewing alcohol cues (affective modulation of the startle reflex) and the Stop Signal Task-Modified (behavioural inhibition). Clinical variables were evaluated using the Barrat Scale (BS), the Hamilton Anxiety Scale (HAS) and the Hamilton depression Scale (HDS). Drinking variables were assessed with the Timeline follow back (TLF).

Attentional bias correlated with the number of drinking days, mean intake of alcohol and score of the HDS. Affective modulation of the startle reflex correlated with mean intake of alcohol, scores of the HDS and the BS. Behavioural inhibition correlated with scores of the HDS, the HAS and the BS.

Psychophysiological tasks correlated with drinking variables (mean intake of alcohol and the number of drinking days) and clinical variables (impulsivity, anxiety and depression). Clinicians should take these variables into account when treating alcoholics because they can be controlled with appropriate pharmacological treatment and it is well known that attentional bias, affective modulation of the startle reflex and behavioural inhibition are implicated in maintaining alcohol consumption and increasing the risk of relapse.

Ketamine is an anesthetic agent, also used for other medical purposes (pain, depression). Due to its pharmacological properties, ketamine is diverted and abused. This recreational use has become widespread in France.

we explore different kinds of ketamine diversion in order to analyze its abuse liability.

based on data collected from addictovigilance tools and from different surveys, we present the characteristics of patients and their various ketamine misuses.

We have studied notifications received between 2000-2014 and 4 recent surveys. Results are reflected in the below table:

Notifications reported 6 cases DSM-IV of dependence. In 2 cases, ketamine was used to manage withdrawal of medically prescribed opioids for pain. In 2 cases, ketamine was identified as an adulterant in ecstasy. We report also 5 victims of criminal use of ketamine for sexual assault.

Results provides insight into the myriad uses of ketamine. Abuse increase and avaibility of ketamine extends in general population.

Health professional must be informed about the widespread use of ketamine and its consequences. Our results point out the necessity to reinforce its monitoring in France.

Polydrug use is mostly common among adolescents and young adults, often with the intention of enhancing or counteracting the effects of another drug. It significantly increases the risks, due to drug synergy and increased side effects.

We investigated the prevalence of polydrug users in a population of Italian young adults using a specifically designed questionnaire.

We aimed to assess the prevalence of polydrug abusers in a large sample of general population, and also to identify possible associations between alcohol misuse (e.g., binge drinking behaviours) and polydrug use.

We administered the questionnaire to a sample of 3000 subjects, aged 18 to 26, investigating socio-economic characteristics, alcohol abuse (with a specific focus on binge drinking) and use of psychoactive substances (cannabis, cocaine and Novel Psychoactive Substances-NPS). Collected data underwent statistical analyses.

80.5% of the sample habitually consumed alcoholic beverages. Among alcohol consumers, 34.2% used cannabis, 5.4% cocaine, 3.7% NPS, and 79,2% had binge drinking behaviours. Among those who did not consume alcohol, 4% used cannabis, 0.4% used cocaine, and 0% used NPS. Polydrug use was more common among binge drinkers. 35.6% of cocaine abusers also used NPS, in comparison to 1.4% of non-abusers.

According to scientific literature, alcohol and cocaine are the substances most commonly involved in risky polydrug use. Binge drinking and NPS appear to ben involved in polydrug use too. The combined effects of the different drugs need to be considered in identifying an appropriate and timely intervention strategy

In the last years, the number of new psychoactive substances (NPS) has been increasing exponentially. Since 2008, more than 300 NPS have been identified across the Europe. Despite the health risks of this emerging trend, there is limited information about the clinical manifestations of poisonings linked to the use of these substances.

A systematic literature search was performed in August 2014 using the following electronic databases: ‘Pubmed' and ‘Web of Science'. Were included original case studies describing a possible association between NPS use and physical health conditions.

A total of 158 articles meeting the inclusion criteria for synthetic cannabinoids (CBs) (n=49), synthetic cathinones (SC) (n=64), 2C and D series derivatives (n=16), tryptamine derivatives (n=15) and piperazine derivatives (n=14) were included in this study. The majority of patients were adolescents or young adult men (median age 23 years). This analysis showed that the use of these substances may cause side effects on several organ systems similar to those of well-known traditional street drugs, including: psychiatric, neurological, cardiovascular, hepatic, thermoregulatory and even renal problems, which can even lead to significant morbidity and sometimes to death. In addition, atypical and more worsen complications were also observed.

Among the reported side effects of NPS, psychiatric disorders were the most described. Thus, this review summarizes the clinical manifestations of intoxications with NPS in order to inform health professionals about the most important risks of these products.

To study qualitatively different subgroups of Social Anxiety Disorder (SAD) based on harm-avoidance (HA) and novelty-seeking (NS) dimensions.

One-hundred and forty-two university students with SAD (SCID-DSM-IV) were included in the study. The temperament dimensions HA and NS from the Cloninger's Temperament and Character Inventory were subjected to cluster analysis to identify meaningful subgroups. The identified subgroups were compared for sociodemographics, SAD severity, substance use, history of suicide and self-harm attempts, early life events, and two serotonin-transporter-gene-polymorphisms (5-HTTLPR and STin2.VNTR).

Two subgroups of SAD were identified by cluster-analysis: a larger (61% of the sample) inhibited subgroup of subjects with ‘high-HA/low-NS’, and a smaller (39%) atypical impulsive subgroup with high-moderate HA and NS. The two groups did not differ in social anxiety severity, but did differ in history of lifetime impulsive-related-problems. History of suicide attempts and self-harm were as twice as frequent in the impulsive subgroup. Significant differences were observed in the pattern of substance misuse. Whereas subjects in the inhibited subgroup showed a greater use of alcohol (p=0.002), subjects in the impulsive subgroup showed a greater use of substances with a high-sensation-seeking-profile (p<0.001). The STin2.VNTR genotype frequency showed an inverse distribution between subgroups (p=0.005).

Our study provides further evidence for the presence of qualitatively different SAD subgroups and the propensity of a subset of people with SAD to exhibit impulsive, high-risk behaviors.

Diabetes causes life expectancy reduction in to one third of optimal degree.several chronic complications are known for diabetes but psychiatric complications are rarely researched wherea diabetic patients have two times grater risk for mood disorders establishment than general population. So we aim to evaluate the anxiety disorders in diabetic type two patient's reffering to Gorgan's 5th Azar hospital clinic of diabetes in 1391 and then estimate their counter relations with their quality of life

A cross sectional study consists of 330 prooved DMT2 patients were referring to Gorgan's 5th azrar hospital clinic of diabetes in 1391. Datas were collected by demographic, Beck Anxiety Inventory & WHOQOL-BREF questionnaires . Tables, Diagrams, Central & dispersion indices were used to describe the Datas. Chi square used for estimating the comparison of QOL between 2 groups . Pearson correlation coefficient also used to demonstrate the relation between QOL and BAI .results and the applied hardware for this purpose was SPSS.(p value = 0/005)

In this study 35/45% were male and 64/54% were female, There was no significant correlation between anxiety with independent factors. There was just a significan correlation between ' other diseases” and quality of life. Positive significant correlation between anxiety and quality of life were observed.

Anxiety disorders in patients with diabetes can reduce the overall quality of life, Not only as a factor adversely affecting the mental realm It applies to all areas of quality of life effects, so identification and treatment of these disorders can improve patients quality of life is.

Fibromyalgia is a chronic pain disorder that includes somatic and emotional symptoms. The evidence supports a relationship between fibromyalgia and varios forms of psychopathology, especially affective disorders.

The aim of this study is to determinate whether the patients with Fibromyalgia could be diagnosed with several psychiatric disorders.

We were also interested in the perception of their health status and functioning.

We included 15 outpatients (13 women and 2 men), mean age 49,6 diagnosed with Fibromyalgia (tender points). They completed the Somatoform Dissociation Questionnaire (SDQ-20), the Hamilton Depression Rating Scale, and the Short Form Health Survey (SF-36).

The Psychiatrist scheduled an interview to determinate if they met criterias for Histrionic Personality Disorder Diagnostic Criteria (ICD-10) or Somatization Disorder Diagnostic Criteria (ICD-10).

All patients had scores below 50 on the SF-36 Health Survey.

Two-thirds of patients met diagnostic criteria for Somatization Disorder Diagnostic, and the rest of patients would have met diagnostic criteria if age criteria A considered would have been 35 years old. Four patients met diagnostic criteria for Histrionic Personality Disorder and 80% of the patients had scores greater than 20 on the Hamilton Depression Rating Scale.

Fibromyalgia patients could have more than one psychiatric diagnosis. Most of the patients could met the criteria for somatization disorder. All patients had a low level of funcioning and health perception.

Pathological gambling is a behavioral addictive disorder that usually results in a severe financial and psychosocial disaster. A longer duration of the disorder is associated with more severe problems. Thus, early therapeutic interventions may reduce the burden of pathological gambling.

To explore factors associated with time to seeking help.

Data of all subjects who attended for their first time the largest treatment institution for pathological gamblers in Vienna, the 'Spielsuchthilfe” from the years 2002 to 2013, and who had never had treatment for pathological gambling before, were analyzed.

In total 2313 subjects (1941 men and 372 woman) with pathological gambling or problem gambling could be included in the analysis. The mean time from beginning of the problem to first treatment was 6.4 years (SD 6.8). In an analysis of variance of the years from 2002 to 2013 there was no significant difference in the time to first treatment. Women attended treatment significantly earlier than men (mean 4.9 vs. 6.7 years) and subjects with later onset of the disorder (> 26 years) (mean 5.0 vs. 8.0 years).

Although there was an increasing amount of information on the media on gambling in the last years this did not promote help seeking behavior to the same extent. The results suggest that subjects with a later onset of the disorder and probably more stable personality attend treatment in an earlier stage of the disorder . Thus, prevention programs should focus more on the needs of younger subjects.

On the basis of experimental observations the attachment style influences the exploration behaviour and the use of social support.

Education attitudes and temperament factors also have an effect on the exploration activities and the attachment styles.

In our research we wanted to analyse the temperament factors behind the avoidant attachment style, parental attitudes, and phobic anxiety forms.

We conducted the analysis with 380 university students (244 women, 136 men) aged 19-26. We applied SPSRQ (to determine the operation of behavioural activation system (BAS), we used FSS for measuring agoraphobic fears, ECR-R questionnaire and Szondi test for measuring attachment. With Szondi test the classification to attachment style is more insecure, but if it is completed with exploration, it is more informative in attachment behaviour. Besides, we measured the memories about parental attitudes (EMBU-r).

On the basis of the lineal regression, in the case of women the features of enhanced BAS activity had a positive effect on the development of attachment avoidance. Beside exploration, the adult spatial competence and the predictive force of personal feeling of safeness could be proven in the case of women. In the case of men, novelty seeking (BAS activity) significantly determined the development of attachment avoidance, beside the effect of warm mother attitude.

The results strengthened the temperament effect of novelty seeking in the case of both sexes. The exploration motivated by avoidance and novelty seeking can be disadvantageous to safe growing-up, however exploration experiences can support the later adapting behaviour.

The present study was aimed to confirm that a family history of alcoholism and early alcohol initiation are the factors associated with the development of alcohol dependence.

The study was based on authors' anonymous questionnaire. In the index group there were 125 people, aged 22–68, members of AA groups. In the control group there were 231 people, aged 17–65, with no history of alcoholism. The results were considered as significant with a p value < 0.05. Statistical analysis was performed with Statistica 6.0 software.

Alcohol initiation before the age of 15 and before the age of 12 were more common in the index group (49% vs. 42% and 13% vs. 8%; p <0,05, respectively). Impact of social environment was greater for the index group – 11% (3% of the control group;p <0.05) drank alcohol for the first time at school while in the control group, alcohol was more often introduced at home (24% vs 22%). Respondents of the index group were less often raised by both parents (78 % vs 87 %; p<0,05) and more often one or both parents abused alcohol (43 % vs 19 % and 15 % vs 1 % respectively; p<0,05). Alcohol dependent respondents were more frequently punished for their failures, abused physically/verbally and could not depend on their parents.

Based on the results of present study, we confirmed that the factors that have an impact on development of alcohol dependence are early drinking onset and family structure.

Results of many investigations prove the significant influence of ethnocultural factors on clinical-dynamic characteristics of basic mental disorders associated with alcohol use.

To identify clinical and medico-biological parameters of heterogeneity of alcohol dependence in representatives of the native population of Siberia.

Clinical-dynamic parameters of heterogeneity of alcohol dependence in 155 patients of Tuvinian and Russian nationalities with lucid and psychotic forms of disease were studied.

Formation of withdrawal syndrome in Tuvinians occurs at a reliably later age as compared with Russians (37,7 and 29,6 years, respectively; p=0.00004). However, in Tuvinians these symptoms are formed progressively – in average for 2-2,5 years of systematic alcohol use that is two-fold quicker than in Russians. In Tuvinians, matched in age clinical-dynamic parameters of formation of alcoholism with Russians, manifestation of alcoholic psychosis occurs at the same age (37,4 ± 7,8 years). In this case Tuvinians with psychotic form of alcoholism approximate to Russians with lucid alcoholism, i.e. those Tuvinians have an unfavorable prediction of development of the illness whose dynamic of formation of alcohol dependence is similar to such one in Russians with lucid course of alcoholism.

Tuvinians reliably later than Russians begin use alcohol systematically but type of course of alcoholism in them acquires highly progressive character. Comparability of age clinical indices of formation of alcoholism in Russians and Tuvinians is predictively unfavorable feature for Tuvinians with likely development of psychotic forms of alcoholism.