Social Anxiety Disorder and Alcohol Use Disorders

High rates of comorbidity were found between alcohol use disorders and social anxiety disorder in epidemiologic studies. Although many studies show strong relationship between social anxiety disorder and alcohol use disorder diagnosis, inconsistency about the causal relationship still remains. High rates of comorbidity is a subject of concern since patients with both alcohol use disorder and social anxiety disorder show more severe symptoms and more functional impairment than those patients who have only one of these disorders. Thus social anxiety symptoms among those with alcohol use disorder and alcohol use disorder symptoms among those with social anxiety disorder must be evaluated carefuly. In this article studies that tried to explain the high comorbidity between social anxiety and alcohol related problems have been reviewed. Better understanding of this complex relationship would help physicians to easily recognize these individuals with dual diagnosis which would increase the efficiency of existent treatments

Remission and Relapse in Alcohol and Substance Addiction

Alcohol and substance addiction is a chronic disease and continues throughout individual's life once after addiction develops. Therefore its natural course is characterized by remissions and relapses. In addiction, relapse periods can be followed by remission periods and individuals encounter with negative effects of alcohol and substances in these relapse periods. Many factors have been defined to determine the risk of relapse up to the date. These factors can be situational or personal and they also have physiological bases. Interaction of these factors with each other is critical in terms of relapse. Relapse is a quite well studied area in the literature, in order to prevent the individuals from restarting alcohol and substance use again. Defining the challenges of addicted patients in remission periods and recurrent periods of relapse in detail will guide clinicians to determine treatment strategies in addiction and to prevent subsequent relapse periods. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(3.000): 243-256

Determining Risk Factors of Bleeding in Patients on Warfarin Treatment

Background. Warfarin is a commonly used oral anticoagulant agent. The most common adverse effects of warfarin are bleeding complications. Methods. We performed a 1-year retrospective chart review of emergency department patients using warfarin. A total of 65 patients with bleeding disorder (study group) and 63 patients without bleeding (control group) were included, making up a total of 128 subjects. Demographic data, frequency of international normalized ratio (INR) checks, and routine blood results were extracted. Logistic regression analysis was used to determine which factors were most closely associated with bleeding complications. Results. Median age was 62.0±14.4 and 61.9±14.5 for study group and control group, respectively. Educational status and frequency of INR checks were similar in both groups (P=0.101 and P=0.483, resp.). INR levels were higher in the study group (5.45±3.98 versus 2.63±1.71, P<0.001). Creatinine levels were also higher in the study group (1.14±0.57 mg/dL versus 0.94±0.38 mg/dL, P=0.042). Acetylsalicylic acid use was more frequent in the study group and was associated with a 9-fold increase in bleeding complications (P<0.001). Conclusions. High INR levels, high creatinine levels, and acetylsalicylic acid use were associated with bleeding complications in ED patients using warfarin

Tobacco use among 10th grade students in Istanbul and related variables

Aim of this study was to determine prevalence of cigarette smoking and hookah use among 10th grade students in Istanbul, Turkey, and to compare sociodemographic, psychological and behavioral variables according to frequency of tobacco use. Cross-sectional online self-report survey conducted in 45 schools from the 15 districts in Istanbul/ Turkey. The questionnaire included sections about demographic data, family characteristics, school life, psychological symptoms and use of substances including tobacco, hookah, alcohol, marijuana, volatiles, heroin, cocaine, non-prescribed legal tranquillizers (benzodiazepines, alprazolam etc.) and illegal tranquillizers (flunitrazepam). The analyses were conducted based on the 4957 subjects. Trial at least once in life is observed as 45.4% for hookah use and as 24.4% for cigarette use. Risk of hookah and cigarette use was significantly higher in male students than in female students. Frequency of tobacco use is related with various sociodemographic, psychological and behavioral variables. Our data also shows that using tobacco and alcohol increases the risk of all the other substances use and these effects are interrelated. The data suggest that there is a link between tobacco use and substance use, psychological, behavioral and social factors. There is also a strong association between tobacco use and suicidal behavior as well as self-mutilative, impulsive, hyperactive, delinquent, aggressive and behavioral problems. The illumination of these relationships may be relevant in prevention and management of tobacco use as well as important problems, such as substance use, impulsivity, hyperactivity, delinquent, aggressive self-mutilative and suicidal behavior among 10th grade students in Istanbul. (C) 2013 Elsevier B.V. All rights reserved