Michael Soyka

..Future studies on the role of different subtypes of alcoholics according to their genetic or psychological profile to explain or even predict the effects of opioid antagonists in the treatment of alcohol dependence are needed...

..Alcoholism is a widespread disorder with substantial mortality and negative treatment outcomes. To date, few medications have been found to reduce relapse rates or drinking in alcohol-dependent patients...

..Most psychiatrists engaged in substitution treatment work in specialized outpatient wards (51.3%), and few were operative in their own or private practice (7.2%). Implications of these critical findings are discussed...

..Some recent studies have suggested a lower risk of fatal intoxications in drug-dependent patients under buprenorphine compared to methadone treatment...

..OCDS scores were higher in patients with a less favorable outcome. In line with previous findings, our results showed that the intensity of craving as measured by the OCDS may predict outcome in outpatient alcoholics...

..Few medications have been tested for outpatient alcohol detoxification. Previously we had shown a combination of carbamazepine and tiapride to be effective in an open study. This database is an extension of our previous work...

..When the second patient was retested after clinical recovery, FDG PET findings were normalized, suggesting the probable thalamic dysfunction to be a functional rather than a structural abnormality...

..These findings support and extend the three previous studies implicating a GABA-A receptor subunit as contributing to the genetic risk for alcohol dependence. Possible implications of these findings are discussed...

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..Selective attention improved in both patient groups during treatment. We propose that the improvement of attention may facilitate rehabilitation of drug-dependent patients...

..This may indicate that comorbid psychiatric symptoms need to be considered when assessing brain responses in alcohol-dependent patients...

..More longitudinal research and studies controlling for the effects of dosage and duration of opioid addiction are necessary to examine whether cognitive ability may improve under long-term MMT...

..The aim of the study was to examine the practicability and implementation efficacy of an alcohol outpatient detoxification model and the concomitant 'motivational' psychotherapeutic approach...

..We assessed whether patients under buprenorphine, a partial mu-opioid agonist, perform better in cognitive tests measuring psychomotor performance as described in previous nonrandomized studies...

..048, P = 0.049, d.f. = 2), which did not remain significant after correction for multiple testing. There was no association between SLC6A9 glycine transporter polymorphisms and alcohol dependence, and also none in haplotype analysis...

..This first part of the guidelines covers the treatment of alcohol dependence; Part 2 will be devoted to the treatment of drug dependence...

..The intensity of withdrawal symptoms showed the strongest correlation with drop-out. Future studies are warranted to further address patient profiles and outcome under different substitution regimens...

..To develop evidence-based practice guidelines for the pharmacological treatment of opioid abuse and dependence...

..The aim of the present study was to analyze these variants in a large sample of the Munich Gene Bank of Alcoholism...

..INTROduction: Cognitive impairment has been reported in drug-dependent patients under opioid maintenance treatment...

..Results from this study suggest that a combination of the anticonvulsant carbamazepine and tiapride is an effective and safe treatment for outpatient alcohol detoxification in patients with moderate severity of withdrawal syndrome...

..Benefits in the treatment of alcohol dependence might be optimized by matching the efficacy profiles of specific antidipsotropics with the motivational status of alcohol-dependent patients...

..This prospective study investigated predictors for relapse 3 years after completion of an intensive outpatient treatment programme for alcoholism...

..In line with previous research, the results from this study give further evidence that a combination of the anticonvulsant carbamazepine and tiapride is an effective and safe treatment for alcohol withdrawal treatment...

..Several studies have reported criminal and violent behaviour in people with schizophrenia but few have investigated the association between affective disorders and violent behaviour...

..007. The results were discussed in the context of the Classical, Operant Conditioning Theory, the Cognitive Craving Theory of Tiffany, Gilbert's STAR Model, and the Self-Medication Hypothesis...

..The results emphasize the importance of monitoring trait anxiety in studies regarding cognitive functions in subjects with alcohol use disorder...

..Among patients with risperidone, seven patients (35%) passed all test parameters without major failures. Clinical implications of these findings are discussed...

..Our results do not provide evidence for an involvement of NEUROD2 polymorphisms in the pathophysiology of alcohol dependence. Further association studies are needed to confirm our findings...

..2 to 39.8%. Withdrawal symptoms, craving and compliance improved significantly after transfer to (R)-methadone. We conclude that transfer from racemic to (R)-methadone is a safe and practical procedure...

..Taking into account the high comorbidity of opioid dependent patients and the severity of dependence, the mortality rate of approximately 1% confirms that maintenance treatment could be regarded as a fairly safe treatment...

..Tricyclics have been found to be more effective than serotonin reuptake inhibitors in improving depressive symptoms in these patients...

..Violence and criminality in patients with schizophrenia has been described in several studies but prediction of later criminal behavior is difficult...

..In summary, results of this study indicate a favorable outcome of socially stable alcohol-dependent patients and patients with a lower degree of depression, anxiety and craving in an intensive outpatient rehabilitation program...

..As previously demonstrated in another sample of schizophrenic patients, the AMDP syndromes mania (and hostility) is associated with a higher risk of later criminal behavior...

..A significant association between suicide attempts and the 5-HTT promoter polymorphisms (5-HTTLPR) S-allele has been reported in a sample of French alcohol-dependent subjects, and this paper evaluates this phenomenon in a German sample...

..Dual diagnosis" schizophrenics had a significantly higher rate of suicide attempts and were less likely to be married. Possible clinical implications of these findings are discussed...

..Implications for the self-medication hypothesis for substance use in schizophrenia and future research in this area are discussed...

..Conflicting results were reported on the role of the mu-opioid receptor (OPRM1) polymorphism A118G (Asn40Asp, rs1799971) in the development of alcoholism...

..The impact of other personality disorders does not play a substantial role in subtyping alcoholics...

..We conclude that delusional jealousy is a comparatively rare phenomenon that is most frequent in schizophrenia and related psychoses. Quite a number of affected patients are aggressive, which may indicate a risk of future violence...

..Although the efficacy of flupenthixol as an anti-craving drug in dual diagnosis patients has to be explored in further studies, the drug may be considered a promising medication for these patients...

..1995) and relapse during and after completion of an intensive outpatient treatment programme...

..The aim of this study is to test the potential influence of a bi-allelic cannabinoid receptor gene (CNR1) polymorphism (G1359A) on severe alcohol withdrawal syndromes...

..We analysed the MAOAuVNTR functional polymorphism in the promoter region of the X-chromosomal monoamine oxidase A (MAOA) gene. Genotypes with three-repeat alleles were reported to be associated with antisocial as well as impulsive traits...

..Previously, we reported a high prevalence of aggression in a large sample of schizophrenic patients treated between 1990-1995 in the psychiatric hospital of the University of Munich...

..The present study examined whether craving as measured by the obsessive-compulsive drinking scale (OCDS) predict long-term outcome in alcohol-dependent inpatients...

..05) were associated with concomitant daily consumption of BZDs in opioid dependent subjects. These finding underline the need to further explore the causes, interactions and consequences of concomitant BZD and opiate use...

..Taking the substantial numbers of animal studies suggesting a possible role of CB1 antagonists for the treatment of alcohol dependence into account, it seems worthwhile to further test cannabinoid blockers in the treatment of alcoholism...

..To study the value of demographic and alcohol-related variables for predicting 24-month treatment outcome in an outpatient setting...

..CCT and ECG were normal. To our knowledge, this is the first description of a seizure related to hyponatremia in an adult carbamazepine-treated patient...

..Furthermore we wanted to know whether functional polymorphisms (5-HTTLPR and 5HT2C Ser23Cys), have any influence on this responsivity...

..To determine abstinence rates and to obtain safety data during the use of integrated therapy with acamprosate and the main established psychotherapeutic intervention programmes in the treatment of alcohol dependence...

..Despite numerous established psychosocial approaches, relapse to heavy drinking is common in alcohol-dependent patients after detoxification and relapse prevention remains a significant medical challenge...

..The present results indicate that patients with comorbid personality disorder can be successfully integrated into a high-structured outpatient therapy...

..Higher serotonin levels among carriers of the S allele might exhibit increased liability of serotonin-mediated, psychopathology-like anxiety and depression and may impair social skills reflected by harm avoidance...

..This case report is about a 52 year old male suffering of alcoholism in addition. Aspects of this special comorbidity are discussed. Neuroleptic treatment with Risperidone led to a partial remission of the delusional syndrome...

..We examined the analogy of both treatment elements used in inpatient rehabilitation of alcohol dependents and the published knowledge concerning the effectiveness of therapy elements...

..The authors are optimistic over the possibilities offered by this Internet research methodology...

..Our data do not support the hypothesis of A-6526G, G-5806T or A-779C polymorphisms to be associated with suicide attempts in alcohol-dependent individuals...

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..A difficult question remains the allocation of patients to different treatments. Current concepts of treatment for alcoholics are described and results of different treatment studies are given...

..To study the validity of the EuropASI in the patient allocation context and to measure the alcohol severity changes with treatment...

..Although this result is suggestive for a significant role of this polymorphism in the pathogenesis of delirium tremens in alcohol-dependent individuals, further investigation and confirmation are warranted...

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..Adult antisocial personality occurred more often in males than females. Possible implications of these findings are discussed...

..The literature concerning the pathophysiology and the diagnostic and therapeutic aspects of cobalamin deficiency is reviewed...

..The aim of this study is to evaluate the BIS-5 in two German psychiatric inpatient samples and healthy controls proving the originally proposed four-factor structure as well as convergent and discriminate validity...

..The concept behind the project and the clinical results achieved with the first 47 detoxified patients are presented and discussed...

..A better understanding of the glutamatergic mechanisms in alcohol dependence may therefore also be of relevance for the development of new anti-craving-drugs and therapy-research...

..Future studies should focus on dosing issues, the differentiation between short- and long-term effects and the identification of subgroups of patients with particular psychopathology...

..K(D) might be influenced by duration of alcohol dependence, but not sufficiently to yield differences between alcohol-dependent and control subjects...

..Alcohol dependents were investigated because these personality disorders and impulsive behavior are very frequent in alcohol dependence anf of clinical relevance...

..Anti-dipsotropics or so-called anti-craving-agents like acamprosate and naltrexone are primarily given to increase the rate of abstinence but could successfully be used in a harm reduction strategy (less drinking, shorter relapses)...

..After a brief description of a case report relevant aspects of psychiatric evaluation of persons responsible for war crimes are outlined and possible implications for forensic research are discussed...

..After successful treatment (abstinence)--prevention of relapse, where necessary using so-called anti-craving drugs such as acamprostate...

..Current IBZM SPECT data do not support a dopamine receptor dysfunction in alcohol hallucinosis but TRODAT SPECT showed reduced dopamine transporter binding. Possible implications of these findings are discussed...

..The negative results in this study question the role of these polymorphisms in the pathogenesis of alcohol withdrawal-induced seizures and delirium tremens...

..Psychopathological symptoms significantly associated with aggression were e.p. delusional ideas and disorganized thinking. Possible risk factors for aggression in schizophrenia and clinical implications are discussed...

..Our findings question the hypothesis of reduced platelet MAO activity to be a possible vulnerability marker for alcoholism...

..A short review of new experimental therapies in the treatment of cocaine-dependence is shown...

..This finding suggests that in patients with ASPD, alcohol dependence might be a secondary syndrome as suggested by previous research...

..Finally, some of the ethical, legal and social implications of the links between gene therapy and the Intemet are considered...

..Useful and established possibilities are discussed. Finally, the risks of this kind of communication are shown and listed...

..Results indicate the predictive value of AA attendance for relapse prevention after controlling for confounding variables. The value of self-help-groups in the network of alcoholism treatment is discussed...

..Although the number of patients dependent on legal drugs is estimated to be as high as 1.9 million, very few are in clinical treatment. Research deficits in this area are evident...

..These findings support the hypothesis that the GRIN1 locus may modify the susceptibility to seizures during alcohol withdrawal. This novel finding warrants replication...

..Furthermore, the potential influence of concurrent personality disorders and depressive conditions were assessed...

..05), and especially for the sustained influx at the end of the observation period (P = 0.001). The detailed mechanisms of this disturbed calcium homeostasis need further investigation...

..The possible implications of these findings are discussed...

..The systematic review gives access to the most important fields of mental health on the Internet. Finally, some of the risks of this kind of communication for therapy and society are visible...

..Moreover, the formulation of such guidelines would help with forensic issues in case of serious adverse events occurring during this combination therapy...

..In conclusion, auditory P300 had a low discriminative power with regards to subgroups of inpatient alcoholics defined by family history and antisocial personality traits. Reasons for the negative findings in this study are discussed...

..These findings are in line with a number of more recent studies questioning the association between novelty-seeking and DRD4 dopamine receptor gene polymorphism. Possible implications of these findings are discussed...

..Here, vitamin B12 and folic acid state were assessed. Results on iron metabolism in patients with alcohol dependence in comparison with social drinkers are presented...

..Neuroimaging studies may well help further elucidate the interrelationship between neurocognitive functioning, personality traits, and antisocial and violent behavior...

..These results are in line with prior research on this topic...

..Irritability is often linked with problem drinking. The aim of this study is to examine the possible influence of irritability on craving induced by a cue-exposure paradigm...