World addiction medicine reports: formation of the International Society of Addiction Medicine Global Expert Network (ISAM-GEN) and its global surveys.

Addiction medicine is a dynamic field that encompasses clinical practice and research in the context of societal, economic, and cultural factors at the local, national, regional, and global levels. This field has evolved profoundly during the past decades in terms of scopes and activities with the contribution of addiction medicine scientists and professionals globally. The dynamic nature of drug addiction at the global level has resulted in a crucial need for developing an international collaborative network of addiction societies, treatment programs and experts to monitor emerging national, regional, and global concerns. This protocol paper presents methodological details of running longitudinal surveys at national, regional, and global levels through the Global Expert Network of the International Society of Addiction Medicine (ISAM-GEN). The initial formation of the network with a recruitment phase and a round of snowball sampling provided 354 experts from 78 countries across the globe. In addition, 43 national/regional addiction societies/associations are also included in the database. The surveys will be developed by global experts in addiction medicine on treatment services, service coverage, co-occurring disorders, treatment standards and barriers, emerging addictions and/or dynamic changes in treatment needs worldwide. Survey participants in categories of (1) addiction societies/associations, (2) addiction treatment programs, (3) addiction experts/clinicians and (4) related stakeholders will respond to these global longitudinal surveys. The results will be analyzed and cross-examined with available data and peer-reviewed for publication.

Comparing attention, impulsivity, and executive functions between patients with opiate use disorder: Buprenorphine maintenance treatment versus active users, in comparison with healthy controls.

Background: Opioid use disorders (OUDs) affect over 16 million people worldwide, with a particularly high prevalence rate in Asia. OUDs are associated with significant health consequences, including neurocognitive impairment, which affects individuals' ability to make decisions, respond to stressful situations, and regulate behavior. Understanding the specific ways in which OUDs affect cognitive functioning is important in treatment considerations. Methods: This study compared the attention, impulsivity, and executive functions of Turkish men with active OUD (n = 40) with those of men in remission from OUD who were on buprenorphine/naloxone maintenance (BMT; n = 41) and with those of a comparison group of healthy controls (HC; n = 43). The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess neurocognitive functioning. Results: Analyses found significant impairment in measures of continuous attention, cognitive impulsivity, motor impulsivity, and executive functions in the two patient groups compared to the control group, but the two patient groups did not differ from each other. Conclusion: The data from this study indicate that individuals with OUD exhibit neurocognitive damage, and those in remission from OUD who receive maintenance treatment do not show improvement in this domain. Neurocognitive damages should be considered in long-term treatment planning of patients with OUD.

HCV Genotype Distribution Among People Who Inject Drug in Turkey: Findings from Multicenter and Cross-Sectional Study.

Background: Hepatitis C virus (HCV) infection is very common in people who inject drugs (PWID). Studies about the prevalence and genotype distribution of the HCV among PWID are very crucial for developing strategies to manage HCV infection. This study's objective is to map the distribution of HCV genotypes among PWID from various regions of Turkey. Method: This prospective, multicenter, cross-sectional study involved 197 PWID who tested positive for anti-HCV antibodies from 4 different addiction treatment facilities in Turkey. Interviews were done with people who had anti-HCV antibodies, and blood samples were taken to check the HCV RNA viremia load and genotyping. Results: This study was conducted on 197 individuals with a mean age of 30.3 ± 8.6 years. 9.1% (136/197 patients) had a detectable HCV-RNA viral load. Genotype 3 was the most commonly observed genotype by 44.1%, followed by genotype 1a by 41.9%, genotype 2 by 5.1%, genotype 4 by 4.4%, and genotype 1b by 4.4%. Whereas genotype 3 was dominant with 44.4% at the central Anatolia region of Turkey, the frequencies of genotypes 1a and 3, which were predominantly detected in the south and northwest regions of Turkey, were very close to each other. Conclusion: Although genotype 3 is the predominant genotype in the PWID population in Turkey, the prevalence of HCV genotype varied across the country. To eliminate HCV infection in the PWID, treatment and screening strategies that differ by genotype are essentially required. Especially identification of genotypes will be useful in developing individualized treatments and determining national prevention strategies.

Cross-national presence and sociodemographic correlates of the suicide crisis syndrome.

BACKGROUND: The Suicide Crisis Syndrome (SCS) has been proposed as an acute, pre-suicidal mental state that precedes imminent suicidal behavior; however, its cross-national applicability and sociodemographic correlates have not yet been determined. The present study assessed the presence and severity of the SCS in ten countries and examined several potential sociodemographic correlates (i.e., age, gender, marital status, race/ethnicity) of the SCS. METHODS: 5528 community-based adults across 10 participating countries provided information on their SCS symptoms and sociodemographic characteristics in an anonymous online survey obtained via convenience sampling during the first year of the COVID-19 pandemic. RESULTS: The SCS occurred cross-nationally, with rates ranging from 3.6% (Israel) to 16.2% (Poland). Those in the United States, South Korea, Poland, and Turkey had the highest severity of symptoms. Participants who were older, identified as cisgender men, and married tended to have lower rates of the SCS than their respective counterparts. There were minimal differences in the SCS by race/ethnicity. LIMITATIONS: These data were both cross-sectional and collected via convenience sampling, limiting generalizability of findings and information about the SCS's predictive utility. CONCLUSIONS: These findings support the cross-national presence of the SCS during the COVID-19 pandemic. Sociodemographic correlates aligned with those of suicidal behavior more generally, providing additional evidence for the concurrent/predictive validity of the SCS.

The effect of perceived social support on quality of life in Turkish men with alcohol, opiate and cannabis use disorder.

OBJECTIVE: The purpose of this study was to investigate the effect of perceived social support on the quality of life of male patients with alcohol, opiate and synthetic cannabinoid use disorders by considering sociodemographic factors and mood, and to compare these three groups in terms of social support and quality of life. METHOD: One hundred and thirtyone (131) patients who were hospitalized at Addiction Clinic of Istanbul Erenkoy Psychiatric and Neurological Diseases Training and Research Hospital in Turkey and diagnosed as alcohol, opiate and synthetic cannabinoid use disorder were included in the study. Sociodemographic Data Form, Turkish version of the World Health Organization Quality of Life Questionnaire Scale (WHOQOL-BREF-TR), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Multidimensional Scale of Perceived Social Support (MSPSS), API (Addiction Profile Index) were applied to the participants. RESULTS: A total of 131 male patients were 32 synthetic cannabinoids, 51 opiates and 48 alcohol use disorders diagnosed. The mean age of alcohol users was higher than the other groups. Separation/divorce rate was higher in alcohol users and single rate in opiate users. Alcohol use was higher in living alone and opiate users lived with first degree relatives. The crime history was higher in the cannabis group. Prison experience, probation and self-injury were higher among opiate users. Family history of substance use was higher in opiate users. Crime was found to be less in alcohol users. In the comparison of alcohol and substance (opiate, cannabis) groups, the rate of self-injury (93.8%) was found to be significantly higher in the substance user' group. There was no statistically significant difference between the groups in terms of depression and anxiety scores. When the alcohol and substance (opiate, cannabis) comparisons were made between the groups, the mean depression (21.02 ± 11.6) and anxiety (20.09 ± 17.49) of the alcohol group was significantly higher. The "effect on life" (31.8 ± 6.13) and "motivation" subscales (10.38 ± 2.39) of API was found to be significantly higher in patients with substance use. In the opioid group, physical, environmental and psychological subscales of the WHOQOL-BREF-TR did not show significant correlation with MSPSS, and the family, friend' subscales and total perceived social support were significantly correlated with the social subscale of WHOQOL-BREF-TR. In the alcohol group, the environmental and social subscales of WHOQOL-BREF-TR showed a significant correlation with perceived social support from the family and private person and total perceived support. CONCLUSION: Addiction is a recurrent and chronic disease and inevitably reduces quality of life. Social support has an important role on the quality of life. Improving the quality of life seems to be one of the main goals during the addiction treatment. For this purpose, it is very important to provide psychosocial support with pharmacological treatment by evaluating the medical, mental and social needs of the dependent patient as a whole.

The Effect of Attention Deficit and Hyperactivity Disorder on Treatment Compliance in Individuals Undergoing Probation Addiction Program Treatment.

Objective: The social and legal problems caused by substance use necessitate compulsory treatment. Individuals with substance use disorder who also have attention deficit and hyperactivity disorder (ADHD) are more frequently prone to crime and more severe substance use. The aim of this study was to investigate the effect of ADHD on the treatment compliance. Methods: One hundred one patients who applied to the Probation Erenköy Mental Health and Neurological Diseases Training and Research Hospital, and who were determined to participate in the probation addiction program (PAP), were included. The participants were evaluated with a sociodemographic form, the Addiction Profile Index (API), The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), the Wender Utah Rating Scale, and the Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS), before commencing the PAP. The diagnosis of ADHD was confirmed by interview. After the PAP was completed, participants were re-evaluated Results: It was determined that 67.3% of the participants had ADHD and 41.2% of the patients with ADHD were noncompliant in completing the program. There was no statistically significant relationship between ADHD and treatment compliance. The SOCRATES total values at the beginning of treatment were significantly higher in patients with ADHD. The API total scores were significantly higher in the ADHD group before and after the program. Severe craving and severity of addiction were important factors that increased treatment noncompliance. Conclusion: ADHD is higher in the probation population and the severity of addiction is also higher, both before and after the program. Treatment motivation in patients with ADHD decreases toward the end of the program.

Self-reported changes in alcohol and tobacco use during COVID-19: findings from the eastern part of WHO European Region.

BACKGROUND: The COVID-19 pandemic might impact substance use behaviours around the globe. In this study, we investigate changes in alcohol and tobacco use in the second half of 2020 in countries of the eastern part of the WHO European Region. METHODS: Self-reported changes in alcohol and tobacco use among 11 295 adults from 18 countries in the eastern part of the WHO European Region were collected between August 2020 and January 2021. The non-probabilistic sample was weighted for age, gender and education. For each country, proportions of respondents reporting a decrease, no change or increase in substance use over the past 3 months were examined, and multinomial regression models were used to test associations with age, gender and past-year alcohol use. RESULTS: In most countries, about half of the respondents indicating past-year alcohol or tobacco use reported no change in their substance use. Of those alcohol users who reported changes in their alcohol use, a larger proportion reported a decrease than an increase in most countries. The opposite was true for tobacco use. Women, young adults and past-year harmful alcohol users were identified as being more likely to change their substance use behaviour. CONCLUSION: We found diverging overall trends for alcohol and tobacco use in the second half of 2020. The patterns of change vary according to age, gender and past-year substance use. Individuals at risk to increase their substance use during the COVID-19 pandemic require most policy considerations.

The pathway to care of patients with SUD who presented at addiction treatment centers (AMATEM) in Turkey.

AIM: Recent studies have shown that alcohol and drug use in Turkey is rising year on year. In order to prevent and treat substance use disorder (SUD), many Alcohol and Drug Research, Treatment and Training Centres (AMATEM) have been established in Turkey. The purpose of this study was to investigate the pathway to care of patients who presented at AMATEM. METHOD: A total 235 patients with SUD between16-69 age groups who presented at AMATEMs in 2017 were included in this study. A sociodemographic form and a structured self-report questionnaire consisting of 36 items assessing the pathways of care were given to all the patients. Data were analysed with descriptive statistics using SPSS software. RESULTS: The majority of the patients included in the study were single (55%) and male (96%). Patients mostly had a secondary school level of education (51%) and social security (65%). The majority of the patients stated that they used more than one substance (44%), opiates (20%) or alcohol (18%). CONCLUSION: This is the first study evaluating the pathway of care in patients with SUD in Turkey. It was observed that a significant majority of patients with SUD presented to AMATEMs and patients who applied to different health institutions stated that they were mostly informed about SUD and AMATEM. There were also patients with negative attitudes towards AMATEMs and non-medical treatment seeking behavior other than AMATEM. Families, relatives and friends of patients with SUD have an important place in reaching the treatment.

Turkish adaptation of Wilson-Sims psychiatric fall risk assessment scale.

PURPOSE: This study aimed to adapt the Wilson-Sims Fall Scale to Turkish and assess the levels of sensitivity and selectivity. DESIGN AND METHODS: The scale consisting of two sections and 15 items including age, gender, mental and physical status, elimination, impairments, gait/balance, falls' history, medications, and detox protocol was administered to 750 patients in psychiatric clinic. FINDINGS: The kappa coefficient of the study (K: 0.44, p < .000) showed a moderate agreement. The sensitivity and selectivity rates of the scale were 78.5% and 77.6%, respectively. Positive and negative predictive values were 6.25% and 99.4%. PRACTICE IMPLICATIONS: The scale has acceptable sensitivity and selectivity values. It is best practice to use both Wilson-Sims and Itaki Scale simultaneously for identification of patients at risk of falling.

Psychiatric emergency visit trends and characteristics in a mental health epicenter in Istanbul during COVID-19 lockdown.

BACKGROUND: We aimed to explore the impact of the preventive measures and partial lockdown to the psychiatric emergency department (PED) visits during COVID-19 pandemic in a mental health epicenter in Istanbul. METHODS: A total of 5839 patients admitted to PED during the lockdown period (LP) between March 30 and May 31, 2020, were enrolled in this retrospective cohort study. Data of these patients were compared to those of patients in the same period in 2019 between April 1 and June 2, 2019 (non-LP). We also investigated the monthly number of PED visits and hospitalizations between March 1 and December 31, 2020, and compared it to the same period in 2019. RESULTS: The volume of PED visits and hospitalizations in LP decreased by 12% and 41.6%, respectively. The rates of patients presenting anxiety and depressive disorders and bipolar disorders were found to significantly increase in LP than non-LP (p < 0.001; p < 0.001; p < 0.01, respectively). Depressive disorders, prior history of mental illness, and aggressive behavior were found to predict frequent PED visits while decrease in age and male gender found to predict hospitalizations. Regarding suicide attempt, younger patients and those with new-onset mental disorders were found to be at high risk in LP. Patients diagnosed with COVID-19 in PED visits were mostly with psychotic and bipolar disorders. CONCLUSION: Policy-makers should focus on studies on mental health services to reorganize and enhance such services, which are crucial to prevent and manage adverse mental health consequences of the pandemic and congestion in PEDs.

Attachment Styles of Parents with Alcohol Use Disorder and the Relation of Their Parenting Perception to Their Parenting Attitudes.

Objective: Many neurobiological, genetic, environmental, and spiritual factors are involved in addiction etiology. This study aims to examine parental perceptions, attachment styles, and parental attitudes. Methods: This is a cross-sectional study. Patients diagnosed with alcohol use disorder (AUD) were enrolled in the Addiction Clinic of the Erenköy Mental Hospital. The structured clinical interview for DSM-5 (SCID-5) was applied, and the sociodemographic data form, Adult Attachment Style, Family Life and Child Rearing Attitude Scale, and Parent Attachment Scale were administered to the participants. Results: It was determined that 21.5% of participants had depressive episode and anxiety disorder diagnoses; 15.4% of participants had children with a history of psychiatric treatment; 16.9% had children with a history of alcohol/substance use. The avoidant attachment score average of individuals with APD was found to be higher. The positive perception of parents participating in terms of care and protection toward their own parents was significant in all subdimensions with secure attachment. When the child-rearing attitudes of parents with secure attachment were examined, the dimensions of democratic attitude and recognition of equality were statistically significantly higher. Conclusion: Parenting and attachment are associated with many steps of addiction. In the fight against addiction, it is very important to treat addiction as a family problem. The education and interventions to be made can be protective in terms of psychopathology and addiction issues, which may provide early intervention for these problems. In addition, constructive interventions related to family relationships are important in increasing the social support of people who are being treated for AUD.

Investigation of the discrimination and characterization of blood serum structure in patients with opioid use disorder using IR spectroscopy and PCA-LDA analysis.

Harmful illicit drug use, such as opioid use disorder (OUD), causes multiple diseases that result in physiological, pathological, and structural changes in serum biochemical parameters based on the period of use. Fourier-transform infrared (FTIR) spectrometry is a noninvasive optical technique that can provide accurate evidence about the biochemical compounds of analytical samples. This technique is based on the detection of functional groups and the spectral analysis of the region of the selected bands, which provides a reliable and accurate tool for evaluating changes in the biochemical parameters of OUD patients. In the present study, the Attenuated Total Reflection (ATR)-FTIR technique and clinical laboratory biochemical results were used to investigate the phospholipid-protein balance in the blood serum of participants with OUD by comparing their data to that of healthy controls. To compare the biochemical laboratory results with serum vibrational spectroscopy, we used infrared (IR) spectroscopy to distinguish the serum of the OUD patients, who had an average duration of use of 7.31 ± 3.8 years (ranging from 6 to 15 years). We aimed to compare the clinical reports with findings from IR spectroscopy coupled with chemometrics analysis, principal component analysis (PCA), and linear discriminant analysis (LDA). The serum samples of the OUD male patients (n = 20) and healthy male individuals (n = 14) were evaluated using FTIR spectroscopy (range of 4000 cm-1 - 400 cm-1). We focused on the areas where the results showed significant band differences and significant chemometric differences at the fingerprint region (1800 cm-1- 900 cm-1), Amide I (1700 cm-1-1600 cm-1), C-H stretching band (3000 cm-1-2800 cm-1), triglyceride (Tg) levels and cholesterol esters (1800 cm-1-1700 cm-1), and total protein region (1700 cm-1 -1350 cm-1). The intensity of these band areas was significantly different (p < 0.01) between OUD patients and healthy controls. Moreover, different bands on the serum spectrum of the OUD patients were explored. The results successfully specified the distinctions between OUD and the healthy controls (HCs). We compared the results with biochemical markers, such as albumin (Alb), Tg, and total cholesterol (Tc) levels of the patients, as well as the data of the healthy subjects obtained from the hospital. Additionally, we found that the Tg, Tc, and Alb levels decreased as the duration of heroin use increased based on the biochemical markers of the OUD patients. The laboratory biochemical reports and the vibrational spectroscopic analysis were correlated. The confidence of specificity, sensitivity, and accuracy was 100%, 92.85%, and 97.06% in the second derivative, respectively. Thus, we demonstrated that IR spectroscopy, multivariate data analysis, and clinical reports are consistent and correlated. Furthermore, FTIR is a simple and readily available diagnostic test that can successfully differentiate the serum samples of OUD patients from those of healthy subjects.

Biochemical assay and spectroscopic analysis of oxidative/antioxidative parameters in the blood and serum of substance use disorders patients. A methodological comparison study.

Substance abuse such as opioids, cannabis, and alcohol causes activation on the immune system and the release of reactive oxygen species (ROS) into the blood and serum. These substances cause an effect on oxidant and antioxidant status in patients with substance abuse. Mainly, wide-open to the ROS are lipids and proteins included blood, which suffers peroxidation. In this study, for the first-time differentiation of the effects of cannabis, alcohol and other synthetic substances on blood and serum samples, were performed. For this purpose, the level of the malondialdehyde (MDA) and glutathione (GSH) in serum and red blood cells, was measured using biochemical assay methods and Fourier Transform InfraRed spectroscopy (FTIR). The results showed, that peroxidation which is dignified as the production of MDA was increased for substance use disorder (SUD) patients (18.01 ±â€¯2.97) compared to the control group (10.75 ±â€¯2.28) (p < 0.001) and for antioxidant capacity, GSH level were significantly increased for SUD patients (p < 0.001). For the discrimination of protein and lipid region obtained from FTIR spectroscopy, we extracted features by principal component analyze (PCA) of protein (1800 cm-1 to 900 cm-1) and lipid (3200 cm-1 to 2800 cm-1) regions for blood and serum samples collected from patients with different types of SUD and healthy control (HC) participants. For the consideration of lipid oxidation, lipid saturation, lipid desaturation and protein aggregation the peak heights at 1740 cm-1 to 2960 cm-1, 2920 cm-1 to 2960 cm-1, 3012 cm-1 to 2960 cm-1, and 1630 cm-1 to 1650 cm-1 regions were studied for SUD and HC. Moreover, more visible changes were noticed for proteins region, than for lipids. The most notice structural changes were observed in amide II in serum spectra. Then we classified protein and lipid region's PCA results of blood and serum by Linear discriminant analysis (LDA) and Support vector machine (SVM). Confidence of the specificity, sensitivity and accuracy of blood and serum were obtained as 100%, 100% and 100% individually. This is the first comparative study on the spectrochemical tool and biochemical assay on SUD. Our results presented 100% discrimination of disorder region compared to healthy subjects.

The comparison of violence, and the relationship with childhood trauma in Turkish men with alcohol, opiate, and synthetic cannabinoid use disorder.

OBJECTIVE: The objectives of this study are, first, to explore the prevalence of lifetime violent and criminal behaviors among alcohol, opioid, and synthetic cannabinoid (SC) users in the treatment program; second, to examine and compare sociodemographic characteristics, childhood traumatic experiences, and impulsivity of these groups. PATIENTS AND METHOD: This cross-sectional cohort study includes 110 male patients who received inpatient treatment in AMATEM (Alcohol and Substance Addiction Treatment Center) Clinic of Erenköy Training and Research Hospital for Psychiatry and Neurology between October 2014 and May 2015, diagnosed with alcohol, opioid, SC use disorder. The patients who were included in the study were given Data Collection Form, APIsoft (Addiction Profile Index), Childhood Trauma Questionnaire (CTQ-28), and Barratt Impulsiveness Scale (BIS-11). Statistical analysis was performed with SPSS 15.0 statistic software package. RESULTS: We found that resorting to verbal and physical violence was more frequent in SC group in comparison with alcohol and opiate groups (for verbal violence 88.5%, 60%, 70%; P = 0.02; for physical violence (82%, 40%, 60%; P = 0.001). Criminal involvement was also higher for SC users than alcohol and opioid users (94%, 85%, 68.5%; P = 0.01). The average CTQ-28 scores for SC group (P = 0.017) were high whereas there was no difference in the average BIS-11 scores (P = 0.073) between groups. There was no difference between the groups in terms of severity of addiction (P = 0.2). Our study ascertained that the patients exhibited mild and moderate addiction. CONCLUSION: Although creating a treatment for addiction, we think that a holistic treatment that will take into consideration the used substance and the individual's childhood traumatic events along with his/her impulsive and aggressive behaviors could make a significant contribution to the prevention of the patient's possible violent and criminal behaviors in the future.

Sociodemographic characteristics of Turkish patients who violated a supervised probation program.

We aimed to investigate sociodemographic characteristics of individuals under a supervised probation program used in Turkey and to compare characteristics of noncompliant versus no-need-to-treat individuals in order to determine the effect of sociodemographic characteristics on success of the supervised probation program. In total, 4,006 individuals who submitted to the supervised probation program of our hospital were evaluated retrospectively from patient data and follow-up records. The mean age of patients was 28.4 ± 8.0 years. We compared the sociodemographic characteristics of "no-need-to-treat" patients (n = 2,205) and "noncompliant" patients (n = 391). We found differences between sociodemographic characteristics of no need to treat and noncompliant groups. We conclude that age, education, presence of self-mutilation, starting age of smoking or substance use, and family history are important factors affecting treatment compliance and success. Therefore, more detailed programs for noncompliant patients should be developed to increase treatment performance.

The Effect of Synthetic Cannabinoids on P-Wave Dispersion: An Observational Study.

OBJECTIVE: The aim of this study was to investigate the effect of synthetic cannabinoids (SC) on P-wave dispersion (PD) in patients who consume SC. MATERIALS AND METHODS: The study population included 72 patients who consumed SC and 36 age- and sex-matched healthy controls. The severity of addiction was detected using the addiction profile index (BAPI). The PD was measured by 12-lead ECG obtained upon admission to hospital. Statistical analyses were performed using the SPSS v20.0 statistical software package. RESULTS: The mean age of the patients and controls was 26.9 ± 7.0 and 26.3 ± 6.5 years, respectively. Mean duration of SC consumption was 1.7 ± 0.7 years. Mean BAPI score of patients who consumed SC was 12.8 ± 3.4. Patients who consumed SC had a significantly higher PD value than controls (37.7 ± 11.5 vs. 30.6 ± 6.4 ms, p < 0.001). The BAPI score was significantly correlated with PD value (r = 0.675, p < 0.001). In the linear regression model that included PD value, age and heart rate, PD value was significantly and independently correlated with BAPI score (r2 of the model = 0.339; p < 0.001). CONCLUSIONS: In this study, patients who consumed SC had significantly higher PD values than controls, and the BAPI score correlated with the PD value. Hence SC consumption could lead to an increased risk of cardiovascular disease through prolonged PD. We recommend the use of the simple and inexpensive ECG to assess cardiovascular risk in patients who consume SC.

Levels of the Staff's Exposure to Violence at Locked Psychiatric Clinics: A Comparison by Occupational Groups.

This study explored the rates of exposure to violence among physicians, nurses, and other health care staff members working at the locked psychiatric clinics, to examine the quantity and types of violence exposed, and to compare occupational groups by the level of exposure to violence. In parallel with the existing literature, the present study supports the proposition that physicians and nurses working at psychiatric units represent a risky group in terms of exposure to violence. The survey found that 87.6% of staff members viewed security measures insufficient. It is considered by the authors that preventive actions should be taken to reduce the risk of exposure to violence against the staff members working at the locked psychiatric clinics.

Urinary Incontinence during Sleep Associated with Extended Release Form of Bupropion HCI.

Bupropion hydrochloride (HCI) is an antidepressant that acts as a norepinephrine and dopamine reuptake inhibitor and has three different dosage forms including immediate release (IR), sustained release (SR), and extended release (ER). Despite its relatively safe side effect profile bupropion may cause several side effects. Here, we aimed to report a case with major depression using extended release form of bupropion hydrochloride who was presented with urinary incontinence during sleep, an uncommon side effect of bupropion.

Effect of Different Psychoactive Substances on Serum Biochemical Parameters.

BACKGROUND: Psychoactive substances affect mainly central nervous system and brain function causing changes in behavior. OBJECTIVES: The purpose of this study was to determine the effects of different psychoactive substances on serum biochemical parameters. PATIENTS AND METHODS: The study included 324 drug dependents, and 69 controls. The patient group was determined according to DSM-IV (The diagnostic and statistical manual of mental disorders, fourth edition) criteria. All patients and control subjects were tested for routine biochemical parameters and urine toxicology parameters for psychoactive substance use. Cases and controls with accompanying diseases like diabetes, cancer, metabolic disorders etc. are excluded from the study. Moreover, an association between urine toxicology results and changes in biochemical parameters was evaluated for statistical significance. RESULTS: There was a statistically significant difference in the Gamma-Glutamyl Transferase (GGT), uric acid, creatinine, urea, albumin, Aspartate Aminotransferase (AST) medians between the dependent and control groups (P < 0.05). We found a statistically significant difference in sodium and albumin levels between the opium-dependent and control groups (P < 0.05). In the benzodiazepin dependent group, we found a significant difference in GGT, urea, glucose, sodium, T protein, and AST levels (P < 0.05). Moreover, a statistically significant difference was observed in triglyceride and GGT levels between the ethyl glucuronide and control groups (P < 0.05). CONCLUSIONS: In psychoactive substance dependents, serum routine biochemistry parameters can be used to predict the need for intensive monitoring and treatment programs.