Alcohol detoxification and social anxiety symptoms: a preliminary study of the impact of mirtazapine administration

Background: Social anxiety disorder is fairly prevalent among alcohol abusing/dependent subjects. The objective of the present study was to investigate: (a) the incidence of social anxiety symptoms in inpatient alcoholics, (b) the effect of alcohol detoxification on these symptoms, and (c) whether a combined psychotherapeutic/mirtazapine treatment during the post-detoxification phase of alcoholism has a greater impact on the aforementioned symptoms than a non-pharmacological approach. Method: Social anxiety symptoms were assessed through the Liebowitz Social Anxiety Scale (LSAS) following a 4-5-week detoxification period in two groups: group A (n = 21) that followed a detoxification protocol of cognitive-behavioral orientation and group B (n = 33) that was assigned to mirtazapine in addition to the standard protocol. Concomitant psychopathology was monitored through the HARS and HDRS, and level of functioning through the GAS. Results: A marked reduction of social anxiety symptoms was evidenced in both groups. However, patients on mirtazapine improved significantly more compared to controls. Limitations: A single measure of social anxiety, i.e., the LSAS was used. Also, a longer follow-up period is needed to ascertain remission of social anxiety symptoms. Conclusions: The present study found a rather high incidence of social anxiety symptoms in inpatient alcoholics which subsided following alcohol detoxification; moreover, it provides preliminary evidence that a combined psychotherapeutic/mirtazapine treatment (30-60 mg/daily) has a greater impact on the aforementioned symptoms than non-pharmacological treatment alone. (C) 2003 Elsevier B.V. All rights reserved

Ejaculation control techniques in ancient China [Techniques de contrôle de l'éjaculation dans l'ancienne Chine]

The erotic literature of ancient China constitutes an inexhaustible source of information on ejaculation control techniques, which remain valid today and are the source of the techniques advocated by contemporary sex therapists. © 2010 Springer

Impact of alcohol detoxification on anxiety and depressive symptoms

Anxiety and depression are frequently encountered ‘collateral’ symptoms in alcohol abusing subjects. The present study investigated the effect of detoxification on these symptoms over 4-5 weeks of abstinence from alcohol. Psychopathology and global functioning were assessed at baseline and at weekly intervals over this period from 28 alcoholics treated oil an inpatient basis. At intake, they displayed high levels of anxiety and depression; also, global functioning was seriously impaired. Following detoxification, scores on all measures of psychopathology were notably reduced. These findings allude to the depression-inducing properties of alcohol, which should be considered in the differential diagnosis of mood symptoms in alcohol abusing individuals. (C) 2002 Elsevier Science Ltd. All rights reserved

Mirtazapine improves alcohol detoxification

The objective of the present study was to determine whether a combined psychotherapeutic-psychopharmacological (with mirtazapine) treatment of collateral anxiety and depressive symptomatology during the post-withdrawal phase of alcoholism facilitates the process of alcohol detoxification, which is a decisive stage in the treatment of alcohol-dependent individuals. For that purpose, the rate of remission of anxiety and depressive symptoms over a 4-week detoxification period was evaluated between two groups: the first group followed a standard detoxification protocol (n = 33) and the second group was assigned to mirtazapine in addition to standard treatment (n = 35). A marked reduction of anxiety and depressive symptoms was demonstrated in both groups. However, patients on mirtazapine improved more and at a faster rate compared to controls. Thus, mirtazapine, used adjunctively to short-term psychotherapy, may help the detoxification process by minimizing physical and subjective discomfort. Consequently, it may improve patient compliance in alcohol detoxification programs and facilitate the initial phase treatment of alcohol abuse dependence

Rejection attitudes, poor parental bonding, and stressful life events in heroin addicts' families

Background: The influence of family factors on the development and/or on maintenance of heroin addiction still remains unclear. Objectives: The aim of this study was to investigate family factors, which might be associated with heroin addiction in a sample of male individuals. Methods: A group of 40 heroin addicts' families was compared with a group of 17 families with a member presenting schizophrenia and a group of 27 families with mentally healthy members in regard to (1) parents' rejection attitudes toward their adult child, (2) quality of parental bond, as perceived by the adult child, and (3) stressful life events in the nuclear family. Results: The main findings showed that the degree of rejection by the fathers in the heroin addicts' families as well as in the subjects with schizophrenia was significantly higher compared to the fathers' degree of rejection in the control group. Moreover, the degree of rejection by mothers in the heroin addicts' families was significantly higher compared to the mothers' degree of rejection in the control group. Heroin addicts reported that they had perceived less care from their fathers than healthy controls. The total number of stressful life events in the nuclear family was higher in the patients with schizophrenia in comparison to the healthy controls. Also, in the heroin addicts' group, a significantly higher number of fathers presented a current or past psychiatric disorder. Conclusions: The findings of this study showed the importance of negative family factors in the course of heroin addiction. © 2014 Informa Healthcare USA, Inc

Mood disorder with mixed features due to vitamin B-12 and folate deficiency

Vitamin B-12 and folate deficiency is often associated with affective disorders mainly of the depressive type. We report a case of a 42-year-old woman with a mood disorder with mixed depressed/manic features that was due to vitamin B-12 and folate deficiency. The psychopathology developed over a five-year period without hematologic or other overt clinical characteristics of pernicious anemia. Replacement treatment with vitamin B-12 and folate was rapidly followed by full clinical remission, electroencephalographic normalization and neuropsychological improvement. At a one-year follow-up this condition was stable. Consequently, patients who respond poorly to psychopharmacologic treatment and/or present with atypical mood symptoms would warrant determination of vitamin B-12 and folate serum levels. (C) 2002 Elsevier Science Inc. All rights reserved

Percutaneous endoscopic gastrostomy: Adequacy and quality of information given to decision-makers

Background/Aim: Nowadays percutaneous endoscopic gastrostomy (PEG) is widely available, but patient-selection criteria and quality of informed consent are debated. The aims of this retrospective study were to evaluate the quality of information given to the decision-makers (relatives) and determine the overall acceptance of the procedure by the patients’ family. Methods: The relatives of patients with PEG were interviewed by telephone, using a structured questionnaire. They (n = 55; 36% spouses, 34% children, 30% other) gave information about themselves and the patient (34 males, 21 females, median age 69, range 16-92 years) who underwent PEG tube placement for eating disorders or dysphagia. Results: At the time of evaluation 30/55 (54.6%) patients had died. The cumulative median survival was significantly longer in patients younger than 75 years by 58 days (p = 0.009). Relatives believed that PEG could improve the patients’ quality of life (56%) or/and the underlying disease. Although 93% of the decision-makers considered that their opinion had been taken into account when the procedure was done, 25% said that they had not adequately been informed about alternative methods and the complications of the procedure (38%). 54% said that the procedure had improved the quality of life of the family. Most of the decision-makers believed that their decision was correct (87%) and they would recommend PEG (84%) to other patients suffering from dysphagia. Conclusion: Though several decision-makers were not satisfied with the quality of information given before informed consent, the overall acceptance of the PEG placement for nutritional support is high. Copyright (C) 2003 S. Karger AG, Basel