Dermatological aspects of synthetic cannabinoid addiction.

CONTEXT: Synthetic cannabinoids (SCs) have recently become one of the most abused substances among young population and have caused severe health consequences in our country and worldwide. OBJECTIVE: The aim of this study was to investigate sociodemographic and dermatological findings in SC addicts. MATERIALS AND METHODS: A total of 136 SC users who applied to our hospital's Substance Dependence Center outpatient clinic and diagnosed with drug addiction according to DSM-4 criteria between September 2014 and September 2015 were enrolled to our study. Patients were evaluated by dermatologist and psychiatrist with sociodemographic and clinical data sheets. Data were obtained by direct conversation with patients, clinical examination findings, and laboratory tests, if necessary. RESULTS: Of 136 patients, 12 (8.8%) were female and 124 (91.2%) were male, aged between 17 and 53 with mean age of 25.8 ± 9.2. Most common use way of SC was smoking and patients majorly used opiates before SC. The majority of the patients enrolled to our study were low-educated and almost 50% did not have a regular job. The most frequent dermatologic complaints were periorbital darkening, hallowed-cheeks and premature aging, hair loss and gray hair, and acnes, whereas most frequent dermatologic examination findings were artifact lesions such as blade scars and tobacco scars-stains, tattoos, and acnes. DISCUSSION AND CONCLUSIONS: Given the increased prevalence of SC use in our country and around the world, dermatologists should continue to familiarize themselves with the common mucocutaneous markers of this substance use. Awareness of signs of SCs use will facilitate earlier diagnose, intervention, and directed treatment.

Abnormal white matter integrity in synthetic cannabinoid users.

Synthetic cannabinoids have become increasingly popular in the last few years especially among adolescents and young adults. However, no previous studies have assessed the effects of synthetic cannabinoids on the structure of the human brain. Understanding the harms of synthetic cannabinoid use on brain structure is therefore crucial given its increasing use. Diffusion tensor imaging (DTI) was performed in 22 patients who used synthetic cannabinoids more than five times a week for at least 1 year and 18 healthy controls. Fractional anisotropy (FA) was significantly reduced in the cannabinoid group compared to controls in a cluster of white matter voxels spanning the left temporal lobe, subcortical structures and brainstem. This cluster was predominantly traversed by the inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, fornix, cingulum-hippocampus and corticospinal tracts. Long-term use of synthetic cannabinoids is associated with white matter abnormalities in adolescents and young adults. Disturbed brain connectivity in synthetic cannabinoid users may underlie cognitive impairment and vulnerability to psychosis.

[A case of diaper fetishism]. / Bir Olgu Nedeniyle Bebek Bezi Fetisizmi.

Some people cannot obtain satisfaction from ordinary sexual relationships; instead they prefer alternative methods. They are referred to in psychiatric terminology as paraphiliacs. Fetishism is a type of paraphilia in which a person is sexually attracted to objects and some body parts. Most fetishists do not intend to cause harm to other people, but may have problems when others become involved in the problem. Underlying personality disorders extending through childhood are thought to be the source of the etiology. Perverted people do not wish to change their behavior pattern. They never seek treatment from a therapist. Psychological issues obviously play a crucial role in determining the choice of paraphilia and the underlying meaning of the sexual acts. Psychodynamic models (object relations theory, self psychology, drive theory) can shed light on the meaning of a perversion. In this case report, a 22- year-old man with diaper fetishism is presented. When family dynamics are considered, the mother has been described as psychologically distant from her son. The fetish object was recognized during childhood at around the age of four. During puberty, the fetish object became sexually attractive. Our patient exhibited his first perverted behavior when he was six years old. Later, he could control this behavior. At the age of twelve, the perverted behavior became sexually arousing. This paper emphasizes the diaper fetishism case through the patient's past psychiatric and medical history. Diaper fetishism is discussed in the light of forensic, cognitive and psychodynamic theories.