The long-term outcome of patients with addictive disorders is closely linked to the bio-psycho-social variables, the interactions between factors and, to psychiatric comorbidities.

Our case report is about a 28 years old male with an 8-years history of heroin dependence, and occasionally cocaine, ecstasy abuse.

4 years ago, he started a long-term Methadone maintenance treatment, and during this time he had several relapses and hospitalizations, most of them generated by recurrent major depressive episodes.

At his last admission in the detox clinic, transferred from the Emergency Hospital with a chronic amphetamine intoxication, minor ECG and EEG abnormalities, he had paranoid thoughts, delusional-hallucination behavior, ambivalence toward his mother, ideas of culpability, dysphoria, occasional suicidal thoughts, insomnia and fatigue, also opiates and amphetamines urine positive tests. At that moment he was under treatment with Methadone (75 mg/day ongoing) and Venlafaxine (stopped). He received an atypical antipsychotic as co-therapy (Quetiapine titrated up to 400 mg/day). After 3 weeks of hospitalization the symptomatology improved, with delusional thoughts and behavior remission.

In ambulatory, the patient was maintained on: Methadone 75 mg/day, Quetiapine 300 mg/day and received CBT, with a high compliance to pharmaco- and psychotherapy.

The patient outcome based on screening tests, CGI, MADRS and Quality of Life Scales proved the usefulness, efficiency and high tolerability of an atypical antipsychotic in the acute phase (psychotic-affective episode secondary to amphetamine intake) and also in long-term therapy for the prevention of drug and potentially addictive substances subsequent to depressive episodes along with Methadone.

The aim of this paper was to compare the quantity and frequency of alcohol use and its associated negative consequences between two groups of college students who were risk alcohol users, randomly allocated in a clinical trial to intervention or control group.

Students who had undergone the Brief Alcohol Screening and Intervention for College Students – BASICS - (N=145 at baseline; 142 at 12 months, and 103 at 24 months, loss of 29.7 %) were compared with a Control group ((N=121 at baseline; 121 at 12 months and 113 at 24 months, loss of 9.3%), who did not undergo treatment. Risky alcohol use was defined as AUDIT ≥8 and/or RAPI ≥5 problems in the last year. Variables included drinking frequency, quantity and peak consumption, dependence assessment, and family and friends abuse assessment.

There was some improvement in treated students at 24-month follow-up shown by less drinks consumed used per occasion and lower AUDIT and RAPI scores.

This is the first brief intervention work on heavy episodic drinking with college students in Brazil and the results are encouraging However, it is difficult to conduct individual prevention strategies in a country where culture favors alcohol abuse due to poor public policy on alcohol and lack of law enforcement.

One of these peculiarities is considerable and reliable predominance of total square of the vessels in control group above that in the trial one (p<0,001). Analysis of the square of the vessels in both groups according to time parameters (weeks development) has allowed to establish that square occupied by vessels in the control group, is more at week 10 and 12 these differences are not reliable and at week 11 value of the square in control group significantly exceeds the trial one, being reliably (p<0,001).

According to terms of the development of the embryos it was allowed to establish that for 7-12 weeks significant differences are observed in indices of the mean vessels square between trial and control groups at week 11 – in control the square is more in average by 13,91 mcm2 (р<0,05).

Alcoholization of the maternal organism in the period of the pregnancy renders significant impact on the dynamic of the development of blood vessels of the embryonic human brain, what is expressed, primarily, in delay of the development of embryonic capillaries of the growing brain.

Brain damage is a common of long-term, heavy alcohol consumption.At the recent study, the relationships between duration and lifetime quantity of drinking and the development of cognitive problems is unclear.Some of them have proposed that cognitive performance worsens in direct proportion to the severity and duration of alcoholism.

In this study we want to show that alcohol consumption for long period of time infected the brain and cause the cognitive impairments.

we exposed the 201 male patients under the ages 35-65 who treated at the Department of Alcoholism, Institute of Addicitons, Belgrade in period June 2006 - June 2007.We used the data collected from patients history of illness, psychiatry interviews, structural imaging techniques -computed tomography(CT)of brain and medical protocol including the criteria of alcohol dependency and late residual according the ICD-X.

Total 201 male patients with diagnosis of alcohol dependent and long-term and heavy alcohol consumption:

25(12,43%) have clearly reduced cortex and loss of brain volume(visibly on computed tomography);82(40,79 %) have deficits in problem-solving, short-term and working memory and visuospatial abilities;36 (17,91%) have personality and behavior impairments;25(12,43 %) have deficits in learning and planning abilities;15 (7,46 %) have alcoholic dementia;18 (8,95 %) –other persisting cognitive impairment(poor attention, global inadequacy).

The most prevalent alcohol-associated brain impairments affect visuospatial abilities and higher cognitive functioning. Heavy alcohol consumption may affect cognitive functioning and structural brain abnormalities but clear association has not been established yet.

The need for information about the effects of computers on their users also increases.

All the students, aged between 15 to 18 years old, come from 7 high schools of Iasi, Romania. The studied group of samples comprised 350 teenagers who answered to a questionnaire comprising 36 questions related to computer activities. The authors examined the online construction of identity and sexuality at 350 teenagers, who had been involved in an online relationship and (a) the identification of a possible Internet addiction, (b) perceived realism of the Internet, and (c) construction of network identities.

The survey reveal that amount of time spent online for the Internet are positively related to more favorable perceptions of online relationships. We find approximately 3.5% of cases with possible pathological Internet use.

Having an identity and having a network identity are different subjects.

The survey included a representative sample of 245 school students of ages 11 to 14. All of the students came from 7 high schools of Iasi, Romania. The students answered to a questionnaire comprising 34 questions related to internet activities. These were aimed at highlighting: 1.The frequency of internet use by the students; 2. The interference of excessive use with academic performance, socialization, personality; 3. The identification of a possible pathological internet use.

Results show that the school students prefer to spend a considerable amount of time with their computers, over 5 hours/day. The purpose of this article is to describe how internet use affect socialization, academic performance, personality and to discuss how identity are constructed in cyberspace.

Some researchers have argued that the Internet provides a community to belong to as other more traditional types of communities are breaking down through urbanization and other social changes. It has been suggested that people with low selfesteem turn to the Internet to reduce the chances of rejection, to find support, and to discuss their emotions. Other scholars have suggested that the appeal of the Internet lies in the possibility it offers to construct a new identity for oneself.

To analyze the dynamics of alcoholic psychosis treatment in Kaunas medical university clinic‘s, department of Psychiatry in 2002 – 2006. The importance of this problem indicates statistics data, which shows increasing numbers of alcoholic psychosis (in 1990 – 12, in 2005 – 89,8 cases per 100 000 people) and usage of alcohol (form 7 to 13,2 liters pure alcohol per year) in Lithuania.

A retrospective analysis of 4432 case-histories was performed. Research included patients who were treated in KMUC department of Psychiatry during the years of 2002-2006 and diagnosed with F10.4, F10.5, F10.6 and F10.7 (according to IDC – 10).

KMUC departament of Psychiatry contains 70 beds. 4432 patients were treated in KMUC departament of Psychiatry in 2002 – 2006: 781 in 2002; 843 in 2003; 956 in 2004; 934 in 2005; 918 in 2006

There were 321 patients with alcoholic psychosis: 45 in 2002 (5, 76 % of all patients); 44 in 2003 (5,21 % of all patients); 69 in 2004 (7,21 % of all patients); 78 in 2005 (8,35 % of all patients); 85 in 2006 (9,25 % of all patients).

287 patients were diagnosed with F10.4 (Withdrawal state with delirium) 42 in 2002; 37 in 2003; 61 in 2004; 69 in 2005; 78 in 2006.

The increasing numbers of patients with alcoholic psychosis were observed. The most often diagnosis in alcolic psychosis group was F10.4. Our results indicate the great importance of this problem, and a necessity of further researches.

To investigate the influence of National Programme for Control of Drugs and Prevention of Drug Addiction 2004–2008 on frequency of visits to Kaunas District Dependence Diseases Center (KDDDC).

A retrospective analysis of 27721 visits to Kaunas District Dependence Diseases Center in 2002 – 2006 was performed. Cases with F11 (Mental and behavioural disorders due to use of opioids) diagnoses were selected.

There were 27721 visits to Kaunas District Dependence Diseases Center registered in 2002 – 2006: 4250 in 2002; 6887 in 2003; 6924 in 2004; 5111 in 2005; 4539 in 2006.

There were 18369 (66, 26 %) visits due to F11 diagnoses during period of five years: 2896 in 2002 (68, 14 %); 5164 in 2003 (74, 98 %); 4980 in 2004 (71, 90 %), 2895 in 2005 (56, 64 %); 2434 in 2006 (53, 62 %).

There were 205 child visits in period of five years: 50 in 2002; 46 in 2003; 71 in 2004; 6 in 2005; 32 in 2006.

During the implementation of National Programme for Control of Drugs and Prevention of Drug Addiction 2004–2008 the attendance of Kaunas District Dependence Diseases Center because of F11 diagnoses decreased. The increased number of child visits in 2006 was due to improved education of parents.

The ultimate challenge in Psychiatry today is the treatment of patients suffering simultaneously from both psychotic disorders and substance abuse. Cannabis is the most widely used illicit substance in the Western world. Scientists believe that cannabis is related to psychosis as it interrupts the operation of neurotransmitters like dopamine and this disrupts the organism's normal function.

This research focuses on 14 cases of young patients treated in a private psychiatric clinic, who developed psychotic symptoms after cannabis abuse without having any prior psychiatric problems. For the conduct of this study we took under consideration:

The age when the abuse started

The abuse frequency

The abuse time period

Family history of psychiatric disorders or substance abuse

The onset of psychotic symptoms

A combination of psychotherapy and pharmacologic therapy was used in the treatment of those patients. Their average hospitalisation time was 1.67 months.

Cannabis abuse seems to have caused patients psychotic symptoms while they did not have any active psychiatric disorder prior to the abuse. The abuse interruption along with suitable drug treatment contributed to the control of the psychotic symptoms. A 3 year follow-up revealed that 8 out of 14 patients re-abused cannabis, 4 had psychotic symptoms without cannabis abuse, while only 2 recovered fully from both.

The patient history study generates the question whether cannabis abuse is the cause of psychosis or merely a consequence. Cannabis abuse can be a causal factor however it is not a necessary and adequate prerequisite for psychosis.

To explore information extent, experience level and possible negative consequences of psychoactive substance use in medical students.

636 medical students were included in the cross-sectional study. All respondents filled in a questionnaire concerning their knowledge, use and negative consequences of use of psychoactive substances.

The most frequent regularly used psychoactive substance was caffeine (49,8 % of all respondents), followed by alcohol (12,7 %) and tobacco (12,6 %). 36,6 % respondents have had at least one experience with any illicit psychoactive substance and the most common illicit drug repeatedly or regularly used was marijuana (11,7 % of respondents). We found a significant link between tobacco and cannabinoid's use as well as between the use of cannabinoids and other illicit drugs. Further analysis showed that students who use specific psychoactive substances have significant risk of developing problems in academic life.

Medical students are interested in psychoactive substances. They are well informed about different types of drugs. We found a high prevalence of psychoactive substance use amongst them, which has significant risk of developing problems in academic life.

Cocaine dependence is an increasing problem in France. Most cocaine addicts do not perceive themselves as dependent, although they may experiment craving for cocaine.

We decided to adapt in French a craving questionnaire (Anton 1998) that was first developed to assess craving in alcoholic patients. This questionnaire conceptualizes craving for cocaine as made of two dimensions (obsessions and compulsions) and is based on the Y-BOCS.

Fifty patients in two outpatient addiction clinics were recruited.

Preliminary results regarding craving scores, as well as the scores on the two dimensions (obsessions and compulsions) are described. Reliability, sensitivity to change, and construct validity of this questionnaire are discussed. The effect of sex, type of cocaine used (crack or cocaine) and place of treatment on craving scores were tested with one-way ANOVA.

The French version of this craving questionnaire can be used in cocaine dependent patients. It could be a sensitive tool to measure efficacy of pharmacological and/or psychological treatments in cocaine addiction.

Insomnia is a symptom and its proper treatment depends on finding the cause of sleeplessness and treating the underlying etiology. Transient insomnia is most commonly caused by psychiatric disorders such as substance abuse.

The aim of this study was to investigate the hypnotic effectiveness of different classes of sedative-hypnotic medications in treating opiate-withdrawal insomnia.

A total of 40 patients with opiate withdrawal were given a four groups of drugs 1.bezodizepines with a short (brotizolam and midazolam) or 2.intermediate (nitrazepam) elimination half-life,3.non-benzo hypnotics (zolpidem) and 4.antidepresants (mianserin or trazodone) in a randomized prospective trial.The efficacy for sleep inducing and prologed sleeping were clinical monitiroing. Sleep was assessed by means of the Sleep Evaluation Questionnaire and three insomnia items of the Hamilton Depression Rating Scale.

Results the scores of two sleep measures showed that all aspects of sleep, except the time it takes to fall a sleep, were not significantly different.The result demosntrated highest range of sleep inducing effects in the frist days of administration for nitrazepam 49,5 % and slight for zolpidem 15,3%, midazolam 12,2%, brotizolam 7,5% and low for mianserin 10%, trazodine 5,5%.In contrast, zolpidem and trazodine show effeciveness not only as a sleep inducer but also after prolged unsuccessful attempt to sleep.

In Conclusion, apart from the initial efficacy and development of tolerance, dependence and rebound insomnia the benzodiazepines are no longer the "first line" medication for tretment of opiate-withdrawal insomnia. Non -benzo hypnotics and antidepresants can be used rationaly to consolidate sleep with a less side effects.

Substance dependency is a deviation that in many years exposed the humankind mainly youth, to the risk situation. In the recent years, young people are the main victims of this phenomenon. Regarding to character of our society that youth are majority of population and because this group is targeted in preventive programs of substances, so this research was done to describe the experiences of youth with substance dependency about causes of substance use.

This is a qualitative- phenomenological study. Participants in this study were 12 youth with substance dependency with range of 18 to 30 years old that was selected with purposive sampling method. Data were collected with in-depth interview and analysis was done via Colaizzi method.

Three themes or main concepts were derived from this study that each of these themes has any subthems. These are including Personal factors, Family factors and Social factors.

The findings of this study indicated that people underlined of different factors such as personal, family and social factors refer to the consumption of opioid and finally depend to this substance. Regarding to findings of present study, the researchers of this study believed that the first level of prevention can useful about this. Thus in this level of prevention, three approaches of individual centered, family centered and community centered suggested.

In the mid 19th century 'Euclidian Geometry'found itself replaced by a group of previously unimaginable spheres: the "Riemann' Geometries". Only this radical shift of paradigm from the obviousness of concrete practice into the abstract worlds of relational and symbolic order allowed Einstein's and Maxwell's theories to emerge and modern mathematics to be developed.

Psychopathology is in urgent need of a comparable turn - beyond the narrow field of clinical observation towards a theory of 'mental formation' - only from which a concept of mental illness can be deducted.

The presentation reconstructs an interdisciplinary network towards a "New Psychopathology", including Kurt Goldstein, Arthur Kronfeld and Kurt Lewin, relocating psychopathological observation away from the brain to the relational order between the individual and its environment. Their joint theoretial approach was based on Ernst Cassirer's "Philosophy of Symbolic Forms", applying the ideas of change in mathematival perspectives to mental complexity and cultural development - and: its pathological disorders.

"Symbolic Forms" emerge as magic, myth, language, religion, law, politics, science, the arts and others. They are transcultural universal phenomena which can be seen as "invariants" in a "Matrix of Mental Formation".This cultural construct breaks down in mental crisis.

Psychiatric illness is always connected to a breakdown of "Symbolic Formation". Its typical symptoms are not a lack of organic function - but derive from an inability to manage its complex 'meanings'in the constant change of parallel frames of reference. A structural concept(MATRIX) is presented as an underlying relational order to psychopathological classification.

Hindsight bias means knowing the outcome may profoundly influence the perception of past events and prevent a realistic appraisal of what actually occurred.

To evaluate the role of hindsight bias on psychiatrists' diagnosis.

A psychiatric vignette was made, and validated by expert psychiatrists in national board of psychiatry. They defined the most probable (Bipolar Mood Disorder) and the least probable diagnosis (Schizoaffective disorder). We designed three types of questionnaire, Type A: the basic vignette with an additional explain that in pervious admission the diagnosis was Schizoaffective disorder, Type B: the basic vignette with a suggestion of Bipolar mood disorder, and Type C: the basic vignette without any suggestion. These three forms were sent out to psychiatrists by randomization and concealment allocation in three groups to evaluate their diagnosis.

Of the 240 psychiatrists included,173 persons responded (response rate 72%).There were 52 persons in group A with Schizoaffective disorder suggestion, 63 in group B with Bipolar mood disorder suggestion and 58 in the control group. There was a significant increase of schizoaffective disorder diagnosis (Pv <0.001) but there was not a significant difference for Bipolar Mood Disorder or any other diagnoses. There was no difference in mean age, sex and duration of clinical practice between groups.

According to this study decision-making in psychiatry may be vulnerable to biases like hindsight bias. Insight via education appears the major means to avoid distorting decision-making processes.