Brain-derived neurotrophic factor (BDNF) plays important roles in neurotransmitter release and synaptic plasticity and has been hypothesized to be involved in the development and maintenance of addictive disorders. Also, alterations in secretion of stress hormones within the <a name="_Hlk388856744">hypothalamic–pituitary–adrenal </a>(HPA) axis have repeatedly been found in substance-related addictive disorders. It has been suggested that glucocorticoids might modulate behavioural responses to substances of abuse. Therefore, we investigated alterations of BDNF expression and HPA axis activity in non-substance-related addictive disorders, i.e. pathological gambling (PG) and Internet use disorder (IUD).

We measured serum BDNF levels, plasma levels of copeptin, a vasopressin (AVP) surrogate marker, adrenocorticotropic hormone (ACTH) and cortisol in male patients with PG (n=14), IUD (n=11) and carefully matched healthy controls for PG (n=13) and IUD (n=10).

BDNF serum levels were significantly increased in patients with PG in comparison to healthy control subjects (p = 0.016). Furthermore, cortisol plasma levels correlated negatively with the PG-YBOCS total severity score (r² = -.626, p = .039) in patients with PG. There was no significant difference in BDNF serum levels of patients with IUD in comparison to control subjects. Plasma levels of copeptin, ACTH and cortisol in patients with PG and IUD did not differ among groups.

These preliminary results might suggest that the pathophysiology of PG shares some characteristics with substance-related addictive disorders on a neuroendocrinological level, whereas those similarities could not be observed in IUD.

Meta is a multi-faceted concept. This concept includes knowledge, beliefs, processes and strategies that, knowledge evaluation, supervision or control of the.

The object of this research is to compare met cognition beliefs and controlling thought in Obsessive Compulsive Disorder and depression disorders to normal groups.

The statistical society of this research includes 50 persons afflicted by thought-action obsession, 50 persons afflicted to obsession disorder, 50 persons in normal groups in any group (25men, 25women). Also; normal person has been selected randomly through peering to disease groups in variables like gender, age, economical status and education level among Zare hospital employee.

The findings show the dimension of obsession thought in depressed persons and normal persons is different. Also, there is positive meaningful relation among the score of thought control approaches and obsession signs. Among sub scales of thought control, angry approaches forecast obsession signs.

Therefore, research findings are follower of obsessive compulsive Disorder met cognition pattern and shows thought blending beliefs and thought control approaches could be influential on the beginning and continuing obsessive compulsive disorder and depression.

Online clinical trial is an emergent design that could be of particular interest in problem gamblers, due to poor access to health care system. Online gamblers could benefit from non face-to-face therapy. Our study is the first exclusively online randomized controlled trial among problem gamblers with a naturalistic recruitment in their gambling environment.

This randomized clinical trialassessed the efficacy of 3 internet-based brief interventions on problem poker gamblers compared to a control group at 6 and 12 weeks.

All poker gamblers who have started a poker session on Winamax site, on Day-1 during the inclusion period were screened; subjects could be included only once. Subjects could be included if they obtained minimum scores of the Canadian Problem Gambling Index – Problem Gambling Severity (CPGI-PGSI) ≥5. 1109 Subjects were randomized in 4 groups: (1) Control= waiting list, n=264; (2) email with personal normative information, n= 288; (3) self-help program to be downloaded, based on Cognitive Behavioral Therapy (CBT) and Motivational Interviewing(MI), n= 259; (4) same program of CBT and MI dispensed weekly by email contacts with a psychologist, n= 298. Subjects were followed and gambling behavior was assessed at the end of the program at 6 weeks and after a maintenance phase at 12 weeks. The main judgment criterion was change in CPGI-PGSI at 6 weeks.

High dropout rate occurred on the CPGI-PGSI and was higher in groups 3 and 4. Mean CPGI-PGSI scores decrease in all the 4 groups. No significant difference could be shown between the 3 intervention groups vs control group in any of the measured outcomes (no missing data due to automatic collection by the operator except for CPGI).

In non-treatment –seekers problematic poker gamblers, inclusion process in a clinical trial could be equivalent to 'prompt commitment there and then”, which is a recognized brief, and therefore have a therapeutic effect. This could explain that no difference could be shown between the groups. High dropout rate could be explained by the non-treatment-seeking status, but also by poor acceptability of therapeutic interventions requiring high personnel investment in this population.

Alcohol dependence (AD) is 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 on general hospital-based mortality differs between individuals with and without alcohol-dependence (AD) during a 12.5 year observation period in general hospital admissions. Methods. All comorbidities with a prevalence ≥ 1% were compared between 23,371 individuals with AD and those of 233,710 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. Results. Hospital-based mortality rates were 20.4 % in individuals with AD and 8.4% in controls. Individuals with AD compared to controls had a substantial excess comorbidity of physical diseases. In the AD sample 32 physical diseases contributed to the prediction of hospital-based mortality in univariate analyses and 23 physical diseases were risk factors for hospital-based mortality in multivariate analyses. All mortality risk factors had either an equal or a lower impact on hospital-based mortality in individuals with AD compared to controls. Conclusions. Physical multimorbidity is the major reason for the excess general hospital-based mortality in individuals with AD compared to controls.

Addiction is one of the most rapidly expanding psychopathological phenomena. Thishas brought abut also an increasing differentiation between kinds ofaddictions. The question of this studyis whether there are indeed different kinds of addiction. A previous study showedthat a cognitive orientation questionnaire of addiction (see Methods) identifiedbasic similarities and specific differences between addiction to alcohol and todrugs.

Thisstudy was designed to explore the differences between two types of addictionthat have been defined: substance addictions, e.g., to alcoholism, tobacco or drugs, and process addictions, e.g., shopping, internet usager, games), or gambling.

Theaim was to apply the Cognitive Orientation Questionnaire of Addiction that hasbeen applied in a previous study to the issue of exploring the differencesbetween substance and process addictions. It was hypothesized that they woulddiffer not in the basic structure of the underlying motivation but in certainspecific themes constituting the motivation.

Threegroups of subjects (22-45 yrs) participated: 25 with substance addictions, 25with process addictions and 25 controls. They were administered the CognitiveOrientation Questionnaire of Addiction that is based on assessing motivation interms of four types of beliefs referring to specific themes.

Aregression analysis showed that the our types of beliefs differentiated significantlybetween the addicted subjects andcontrols. Specific themes differentiated between the two groups of addicted subjects.

There seems to a general psychological tendency for addiction, with particularfeatures characteristic of specific types of addiction.

there is a worldwide rapid growth of computer addiction (CA) causing many social problems due to the high level of aggressive behavior in addicts.

to study the aggressive behavior in people with CA.

to develop effective treatment and prevention programs of aggressive behavior in computer addicts.

The inclusion criterion was the pathological inclination to computer use, on the basis of F63.8 (ICD-10). 49 patients were included (24 only with CA – group A and 25 with CA and another psychiatric disorder – group B). The age range was 12-35 years (mean age = 20,2 ± 3,1 yrs). The male to female ratio was 9:1. The clinical, psychological, laboratory and mathematical methods were used.

Aggression in 93.8% addicts occurred to people limiting their access to computer. The types of aggressions found were: verbal (93,8%), physical (48,9%), direct (93,8%), indirect (20,4%), external (79,6%), auto-aggression (20,4%). In psychological Liri test, the mean score of aggression was 6,0 ± 2,3, i.e. moderate level. The aggression in group A was more severe than that in group B. The laboratory method showed that all patients had decreased level of dopamine (625,29±5,42 micromol/L) in urine, deficit of noradrenaline (83,11±1,01 nmol/day) in urine; and big amount of free serotonin (0,16± 0,002 micromol/L) in blood. Both psychopharmacotherapy and psychotherapy were used for their treatment.

computer addicts have a high level of aggressive behavior. Simultaneous use of psychotherapy and psychopharmacotherapy gives noticeable results. The preventive programs in this field are developed.

the rapid growth of Computer Addiction (CA) induces to study it in detail.

to study the structural, phenomenological, clinical and dynamical features of CA and discriminate its primary clinical forms.

clinical, mathematical, statistical. 49 patients were examined (45 males, 4 females). The mean age was 20.1 ± 6.7 years. The inclusion criterion was the pathological inclination to computer use, on the basis of F63.8 (ICD-10). Patients were divided into 2 groups: A – CA as isolated disorder (40.81%), B – CA with another psychiatric disorder (59.18%).

all patients reported having a strong desire of using computer, constant mental return to positive emotions related with virtual activities. All of them had psychic comfort while using computer and psychic discomfort in its absence. All the individuals had difficulty in controlling time limit while using computer and feelings of tachychronia. Suppression of vital functions was observed in all cases. Poor memory and concentration problems were detected in 89.79% cases. 91.83% patients had physical discomfort in absence of computer usage. Many behavior problems related to restriction of computer usage were detected: progressive social isolation – 100%, conflicts with relatives – 100%, robbing – 22.44%, suicidal behavior – 4.08%. Two stages of CA development were identified: initial and stage of expanded clinical picture. Two clinical forms were recognized: primary and secondary.

CA has staging, progressive course. Clinical phenomenological structure of CA includes syndromes of changed reactivity, psychophysical dependence and changed personality.

Phenomenological definition of computer game addiction (CGA) is poorly understood and structured at present days.

To conduct research and classificate the phenomenological definition CGA.

To determine the particular qualities of the phenomenological definition of the CGA.

We have developed to quantify map, which one describes a set of feelings that occur before game starts, during gaming and after game. We had been interviewed 300 students at the age between 18 and 23 years old. Obtained Data has been classified by the cluster analysis method using the software Statistica 6.0.

1. 1. According to the results of the cluster analysis method, feelings of boredom, joy during gaming and tiredness after gaming were the least specific for CGA.

2. 2. Virtual reality immersion syndrome, obsessive want to play and irritation in the case of forced game interruption was moderately specific for CGA.

3. 3. Asthenic-depressive distresses with phenomena of time derealization, vegetative regulation disturbance, growing tiredness and drowsiness in case of conscious suppression of obsessive want to play became the most unique for CGA.

Thus, the most and least specific symptoms CGA had been identified by the cluster analysis method, that will be able to improve the diagnosis of the disorder.

Trifluoperazine, a typical antipsychotic, has been frequently used in psychotic disorders for many years. Sudden discontinuation of trifluoperazine is known to cause relapse of psychotic symptoms in patients suffering from major psychosis.

Mr P, a 34 years old male, professor of physics, was admitted on August 12, 2014, his fourth admission in the last one year, with chief complaints of extreme restlessness, tremors of the hands and blurring of vision for two days prior admission. The patient had been taking 12-16 tablets of a combination of trifluoperazine 5mg and trihexyphenidyl 2mg for about one week prior to his hospitalization.

The patient described experiencing a feeling of numbness once he took the aforementioned tablets which 'insulated' him from problems at home. He reported experiencing severe restlessness and anxiety if he did not take the tablets.

The patient was diagnosed as suffering from Obsessive Compulsive Disorder one year back when he had presented with chief complaints of recurrent disturbing thoughts as to whether he had kept his car keys in a particular pocket and whether he had locked his car or not. To relieve the extreme anxiety provoked by these thoughts, he would be compelled to carry out checking compulsions. He was started at that time on

Paroxetine and a combination of trifluoperazine and trihexyphenidyl. The recurrent thoughts and compulsive acts were relieved in about a month. He stopped taking paroxetine of his own but continued taking the combination of trifluoperazine and trihexyphenidyl following which he was hospitalized with us.

There have been sporadic reports of addiction to antipsychotic drugs, including trihexyphenydyl, risperidone and quetiapine. Most of them are associated with a typical withdrawal syndrome on sudden stoppage of antipsychotic drug in question which is the prime reason behind the patient taking to the antipsychotic drug again. Most of the patients were known cases of schizophrenia or another long term psychotic illness. The case presented here is unique in the sense that the patient does not suffer from any psychotic illness.

Obviously, the problem of addiction is complex. This case points to the need for a fresh research into the mechanisms leading to dependence to a particular drug.

patients with dual pathology have worse clinical evolution and worse therapeutic response. The repeated administration of substances sensitizes the dopaminergic systemwith downregulation of the reward circuit. When the drug use stops, the exposureto stimuli produces a dopamine increase and craving appears.

to prove usefulness of paliperidone in dual pathology for craving andfor drug abuse.

18 patients diagnosed with dual pathology. They were treated with paliperidone and all of them were interviewed about craving andsubstance use.

4 groups: Cannabis (5%). Cannabis and cocaine (16.66%). Cannabis andother two or more substances (16.66%). Cocaine and alcohol (16.66%). All ofthem were diagnosed of dual pathology: induced psychotic disorder (33.33%),personality disorder (27.77%), conduct disorder (16.66%), paranoid schizophrenia (11.11%), bipolar disorder (5.55%), and dysmorphic disorder(5.55%). 38.89% achieved abstinence. 50% reduced significantly substance use.77.78% verbalized a decrease in craving.

cannabis disables the gabaergic interneurons, which stop inhibiting the dopaminergic neurons and a large amount of dopamine is released from the accumbens nucleus . Cocaine increases dopamine and 5-HT levels on thebrain. Paliperidone presents an affinity for D2 and 5TH2a receptors, so this might explain the results, because it blocks the enhancer effect, which contributes to the craving decrease and to the drug withdrawal.

paliperidone seems to be a good choice in dual pathologydue to the improvement on craving and drug abuse

4.4% of the global burden of diseases are due to alcohol consumption. Ethanol addiction is caused by multiple factors like personal and environmental vulnerability.

To analyze the provenience, the educational level, the most frequent personality trades and the genetic load for psychiatric disorders in a sample of subjects with ethanol addiction.

To demonstrate that a specific profile for a person with high risk for ethanol addiction exists.

A sample of 46 subjects, admitted between November 2013 and January 2014 in Timisoara's Psychiatric Clinic with Ethanol Addiction was analyzed. We evaluated the following: provenience, personality trades, genetic load for psychiatric disorders and occupational status. Personality trades were evaluated using the Personality Assessment Schedule – ICD-10 version.

Most of the subjects were males (86.95%), unemployed (39.13%), have finished high school (47.82%) and had one of the parents with chronic consumption of ethanol. The sample was equally distributed between urban and rural. The most frequent personality trades were: the need to be liked and accepted, sensitivity to critique and rejection; intrapsychic tension and anxiety; the sense of inferiority, submission, excessive docility and a lack of assuming responsibility.

The profile of a person predisposed for alcohol addiction is: an unemployed male, without a higher education, with a chronic ethanol consumer father, and with certain personality trades like the need to be liked and accepted, sensitivity to critique and rejection; intrapsychic tension and anxiety; the sense of inferiority, submission, excessive docility and a lack of assuming responsibility.

Nicotine dependence is a worldwide health problem. The results of the implementation of a treatment program using Varenicline as a specific medicine for nicotine dependence during admission in a clinic for chemical dependency treatment are demonstrated, and also that this treatment is possible and safe for patients with comorbid psychiatric disorders and drug abuse disorders.

Between August 2012 and August 2013, 122 patients were evaluated in a clinic for psychiatric and drug abuse tratment in Rio de Janeiro, Brazil. The treatment consisted of a smoking cessation therapy concurrently with the psychiatric treatment. These patients had used pharmacological therapy associated with intensive cognitive behavioral therapy, occupational therapy and moderate physical activity. Smoking was limited to three cigarretes daily since the first day of hospitalization. The medicine used for treatment was Varenicline.

despite the drastic reduction to three cigarretes daily, 100% of the patients adhered to treatment e are discharged from the clinic as tobacco abstainers. Only 67,21% answered the questionnaire after 12 month of follow-up, and 52,43% were still in abstinence.

A high number of patients accepted the treatment. Behavioral group therapy and physical activities can be important allies for Varenicline. The use of Varenicline was safe in patients with psychiatric disordes, with no cases of suicide.

Written historical evidence reveals that Cannabis sativa has been used medically, recreationally and spiritually for more than five centuries in many cultures. To this day it is considered the most-used plant-based psychoactive substance with millions of different usages across the world.

To review what the empirical and clinical studies, conducted over the past two decades, indicate about effects of the consumption of prepared cannabis on physical and mental health as well as the impact on social functioning.

Generally, research supports cannabis' clear acute effect on neurocognition, while non-acute effects for prolonged use of marijuana are unclear and still insufficiently explored. Due to CBD (cannabidiol's) safety and tolerability, the absence of psychoactive or cognitive effects, the existence of clinical trials with positive results and its broad pharmacological spectrum, CBD (cannabidiol) is a cannabinoid whose initial results will likely lead to implementation into clinical practice. The fact that the results of previous studies establish the claim of CBD (cannabidiol) as an antipsychotic and anxiolytic, makes the above developments even more likely. However, long-term, double-blind, placebo studies with samples of patients with different psychotic and anxiety disorders are still necessary. Likewise, due to CBD's biphasic effects, determining an adequate therapeutic dose remains a challenge to conclude, the cannabinoid system represents a promising target for new therapeutic interventions in psychiatry.

However, further controlled studies are essential to determine the precise mechanisms of action of cannabinoids on various neuropsychiatric disorders as well as the safety of their use are needed.

Many time people get addicted to a drug like opiods when prescribed for some medical purpose. Neurobiological models of addiction has proposed cellular adaptation as mechanism of drug addiction. Excessive release of dopamine in NA due to drug intake produces euphoric sensation leading to pathological learning. Repeated use of drug increase glutametergic drive from prefrontal to NA cause compulsive seeking of drug in drug addicts. Is it possible to prevent medically induced addiction.

Pub med search was made by using key words, addiction model, dopamine, glutamate, anticraving medicine, oxidative stress.

Different antiglutametergic medication like ketamine, mementine, accomprosate modulate glutamatic excitation to prevent addiction. Natural medicine like N acetyle cystine and oxytocin have protective role . Typical antipsychotic can block surge of dopamine in NA.

When addictive drug has to be used inevitably for medical purpose it should be combined with other drugs to prevent development of addiction. First euphoria related to dopamine release in NA can be blocked by use of low dose typical antipsychotic or dopamine partial antagonist . NMDA is molecular target of various addictive drugs. Memtentine, ketamine or accomprosate can minimize effects of glutametergic plasticity. N accetyle cystine can restore glutamatergic pathway by its system of cystine- glutamate antiporter. It is source of glutathione largest anti oxidant system of body. Intranasal oxytocin can prevent addiction through its action on stress, learning, memory and intimacy. Intranasal oxytocin can be delivered directly to the brain.

Different strategies can be used to prevent medically induced addiction.