Library of Congress Cataloging-in-Publication Data

Contents

Preface

Part I. Epidemiology and Pathophysiology of Alcohol and Drug Abuse and Dependence

Epidemiology of Alcohol, Tobacco and Substance Use

Abstract

Introduction

Alcohol

Tobacco

Illicit Drug Use

Conclusion

References

Serotonin Dysfunction in Alcoholism

Abstract

Introduction

Studies in Non Human Primates and Humans on the Psychopathological Correlates of Central Serotonin Dysfunction

Serotonin Dysfunction and the Development of Alcohol Dependence

Serotonin Dysfunction in Manifest Alcoholism

Conclusion

References

Depressed-like Behavior and Alcohol

Drinking Are Co-morbid but Independent in the Fawn-Hooded Rats

Abstract

1. Introduction

2. Co-morbidity of Depression and Alcoholism in Humans

3. Animal Model of Depression

4. Animal Model of Alcohol Seeking Behavior

5. Fawn-Hooded Rats as a Genetic Animal Model of Co-morbidity

6. Alcohol Drinking and Depressed-like Behavior Are Independent in FH/Wjd Rats

7. Conclusion

8. References

Psychophysiological Aspects of Alcohol Epileptic Syndrome

Abstract

Introduction

Conclusion

Practical Guidelines

References

Part II. Comorbidity of Alcohol and Drug Abuse and Dependence with Other Psychiatric Disorders

Comorbidity of Anxiety Disorders with Alcohol and Drug Abuse and Dependence: A Comprehensive Review

Abstract

Introduction

Hypotheses Describing the Presence of Disorders Accompanying Alcohol Addiction

Substance-related Artifact Hypothesis

Self-medication Hypothesis

Genetic Predisposition Hypothesis

GABAergic System Hypothesis

Panic Disorder

Epidemiology

Etiology

Treatment

Social Phobia

Epidemiology

Social Anxiety Disorder and Substance Abuse Disorders

Etiology

Treatment

Obsessive Compulsive Disorder

Epidemiology

Etiology

Treatment

Posttraumatic Stress Disorder (PTSD)

Epidemiology

PTSD Prevalence for Different Substances

Etiology

Models for the Development of a Comorbid State

Pathophysiology

The HPA Axis in Cases in which PTSD and Addiction Coexist

The Noradrenergic System in PTSD and Addiction

Interaction between Noradrenergic Systems and the HPA Axis

Treatment

Generalized Anxiety Disorder (GAD)

Epidemiology

Etiology

Treatment

References

Co-occurrence of Substance Use Disorders with Anxiety Disorders: Epidemiology, Psychobiology, Clinical Features, and Treatment

Abstract

Introduction

Relationship between Anxiety and Alcohol and Substance Use Disorders

Comorbidity of Alcohol and Substance Use Disorders with Anxiety Disorders and Attachment Theory

Rewarding and Anxiolytic Effects of Alcohol

Obsessive Compulsive Disorder and Substance Use Disorders

Social Anxiety Disorder and Substance Use Disorders

Panic Disorder-Generalized Anxiety Disorder and Substance Use Disorder

Posttraumatic Stress Disorder and Substance Use Disorders

Treatment of Anxiety Disorders with Concurrent Substance Use Disorders

Conclusion

References

Alcohol Dependence and PTSD Comorbidity

Abstract

Introduction

Research on PTSD and Alcohol Use Disorders Comorbidity

Consequences of PTSD and Alcohol Use Disorders Comorbidity

Models of Association between PTSD and Alcohol Use Disorders

Early Childhood Trauma and Risk for Alcohol Misuse

Suicidal Behaviors and Comorbidity of PTSD and Alcohol Use Disorders

Conclusion

References

Comorbidity of Bipolar Disorder with Alcohol and/or Drug Abuse

Abstract

Introduction

Epidemiology

Relations between SUDs and Bipolar Disorder

Impact of SUDs on Bipolar Disorder

Treatment

Conclusion

Acknowledgments

References

Part III. Treatment of Alcohol and Drug Abuse and Dependence

Pharmacological Treatment of Alcohol, Tobacco and Substance Use

Abstract

Introduction

1. Alcohol

1.1. Management of Alcohol Intoxication

1.2. Management of Alcohol Withdrawal Syndrome and Delirium Tremens

New Non-benzodiazepine Medications in the Treatment of AWS

1.3. Management of Relapse Prevention

2. Tobacco

2.1. Management of Intoxication

2.2. Management of Withdrawal and Relaps Prevention

3. Cannabis

3.1. Management of Intoxication

3.2. Management of Withdrawal and Relapse Prevention

4. Psychostimulants

4.1. Management of Intoxication

4.2. Management of Withdrawal and Relaps Prevention

5. Opioids

5.1. Management of Intoxication

5.2. Management of Withdrawal and Detoxification Treatments

5.3. Maintenance Treatment in Opioid Dependence

Opioid Agonists Medications

Opioid Antagonist Medications

6. Sedative-Hypnotics

6.1. Management of Intoxication

6.2. Management of Withdrawal

7. Ecstasy

8. Hallucinogens

Conclusion

References

Pharmacotherapy for Alcohol Dependence

Abstract

Introduction

Main Targets of Ethanol

Recently Used Medications

Future Medications

GABA-ergic System

Glutamatergic System

Dopaminergic System

Serotonergic System

Other Neurotransmitter Systems

Conclusion

References

Management of Acute Psychiatric Conditions in a Dual Diagnosis Unit

Abstract

Introduction

Goals of Treatment

Prevalence

Primary v/s Secondary Distinction

Substance Abuse and Cognitive Disorders

Clinical Features and Treatment

Substance Abuse and Psychotic Disorders

Clinical Features and Treatment

Management of Schizophrenia

Substance Abuse and Mood Disorders

Clinical Features and Treatment

Pharmacotherapy of Mood Disorders

Non-pharmacological Interventions

Substance Abuse and Anxiety Disorders

Etiology

Treatment

Substance Abuse and Personality Disorders

Presentation and Management

Treatment Considerations

1. General Medical Conditions and Physical Examination

Other (or Unknown) Substance-Related Disorders

2. Lab Investigations and Rationale

3. Medication Issues

4. Smoking Privileges

5. Suicide, Agitation and Aggressive Behaviors

6. Court Commitments and Legal Issues

7. Non-pharmacological Treatments

9. Post-Discharge Treatment Options

Conclusion

References

Part IV. Substance Use Disorders

and Self-Injurious Behaviour

Self-Injurious Behavior in Individuals with Alcohol and Drug Abuse and Dependence

Abstract

Definition, Types and Classification of Self-Injurious Behavior

Comorbidity and Prevalence

Functions of Self-Injurious Behavior

Dissociation

Self-Injurious Behavior and Substance Use Disorders

Trauma History

Axis I Disorders, Personality Disorders and Self-Injurious Behavior

Suicide Attempt History and Self-injurious Behavior

Treatment

Conclusion

References

Part V. Substance Use Disorders and Suicide: Epidemiology, Pathophysiology, Clinical Aspects

Epidemiological Evidence for the Link between Suicide and Substance Use, Abuse and Dependence

Abstract

Introduction

Evidence for a Link between Substance Abuse and Suicidal Behaviors

Substance Use, Abuse and Dependence as Distal Factors for Suicidal Behaviors

Relationship with other Mental Health Disorders

Trauma and Life Stress

Substance Use, Abuse and Dependence as Proximal Risk Factors for Suicidal Behaviors

The Role of Acute Intoxication

Impulsivity, Aggression and other Personality Factors

Demographic Risk Factors

Underreporting

Psychological Autopsy

Implications for Prevention

Conclusion

References

Epidemiology of Suicidal Behavior in Individuals with Alcohol and/or Drug Abuse

Abstract

Introduction

Connection between Alcohol Consumption and Suicide

Suicide among Alcoholic Individuals

Alcoholism among Suicide Attempters and Completers

Time-series, Aggregate Level Studies

Hungarian Situation

Suicidal Behavior among Youth

Conclusion

References

Substance Use Disorders and Risk of Completed Suicide

Abstract

Introduction

Substance Use Disorders in General

Alcohol Use Disorders

Risk Factors for Suicide in Alcoholism

Suicide and Substance Use Disorders other than Alcohol

Co-morbidity in Substance Use Disorders

Conclusion

References

Psychosocial Risk Factors for Suicide Attempts among Drug Users

Abstract

Introduction

Prevalence of Suicide among Substance Users

Prevalence of Suicide Attempts among Substance Users

Risk Factors for Suicide Attempts

Sociodemographic Factors

Family Dysfunction

Comorbid Psychopathology

Depression

Personality Disorders

Anxiety Disorders

Polydrug Dependence

Distinguishing Suicide Attempts and Self Mutilation

Clinical Implications

Conclusion

References

Links between Personality, Alcohol Use, and Suicide in Emerging Adulthood

Abstract

Introduction

Neuroticism

Neuroticism and Drinking to Cope (Self-medication)

Neuroticism and Suicide Attempts

Obsessive Compulsive Personality Disorder

OCD May Protect against Suicide

Antisocial Personality Disorder and Psychopathology

Antisocial Personality Disorder and Conduct Disorder

APD, Environment, Substance Use, and Deviant Behaviors

APD, Anxiety, and Death

Conclusion

References

Acute Alcohol Use and Suicide Attempts

Abstract

Introduction

Evaluating the Evidence

Prevalence of Acute Alcohol Use Surrounding Suicide-Related Behavior

Gender

Age

Chronic Alcohol Use

Summary

Strength of the Association

Case-control Research

Summary

Case-crossover

Summary

Purpose of Consumption

Non Suicide-Related Alcohol Motives

Prevalence

Mechanisms

Suicide-Related Alcohol Motives

Prevalence

Mechanisms

Summary

Methodological Limitations

Operalization of Suicide Attempt

Measurement of Acute Alcohol Use

Ascertainment of Suicide Attempters

Summary

Conclusion

References

Prevention of Suicidal Behavior in Individuals with Alcohol and/or Drug Abuse

Abstract

Introduction

Primary Prevention

Secondary Prevention

Assessment of the Risk Factors for Suicidal Behavior in Individuals with Alcohol and/or Drug Abuse

Depression, Severity of Substance Abuse, and Associated Mental Disorders

History of Suicide Attempt(s)

Suicidal Ideation, Plan and Intent

Impulsivity and Aggression

Physical Illnesses, Negative Life Events, Demographic and Situational Variables

Management of the Suicidal Risk in Individuals with Alcohol and/or Drug Abuse

First Actions in Primary Care

Psychosocial Interventions

Pharmacological Treatment

Tertiary Prevention

Conclusion

References

Suicidal Behavior among Users of Alcohol and Illicit Drugs

Abstract

1. Introduction

2. Prevalence of Fatal and Non-Fatal Suicidal Behavior among Substance Users

2.1. Alcohol and other Substance Users

2.2. Adolescents

3. Substance Use, Abuse and Dependence Associated with Suicide

3.1. Alcohol and other Substance Users

3.2. Adolescents

4. Substance Use, Comorbid Psychiatric Disorders and Suicidal Behavior

5. Conclusion

References

Bad Together: Alcohol Dependence, Impulsivity and Suicide

Abstract

Introduction: Alcohol Dependence and Suicidal Behavior: Epidemiological and Clinical Relations

Definition of Alcohol Use Disorders

Defnition of Impulsive Behavior

How Are Impulsive Behaviors and Alcohol Dependence Related?

Is there an Interrelationship between Alcohol Use Disorders, Impulsivity and Suicidality?

Neurobiology of Impulsivity and Suicidal Behavior in Alcohol Dependence

The Role of Neurotransmitters

Genetics

Pharmacotherapy

Psychotherapy

References

Suicidal Behavior in Alcohol Use Disorders: Neurobiological Aspects

Abstract

Introduction

Alcohol and Suicide

Serotonin

Dopamine

Brain Damage

The Role of Cognitive Impairment

Alcohol and Cognitive Dysfunction

Suicide and Cognitive Impairment

Possible Role of Selenium Deficiency

Selenium and Alcohol

Selenium, Mood, and Behavior

Conclusion

References

Socio-political Dilemmas: Alcohol/substance Abuse and Suicide

Abstract

Introduction

Suicide

Alcohol and Suicide

The Culture of Drinking Alcohol

Alcohol and Suicide Revisited

Conclusion

References

Part VI. Substance Use Disorders and Suicide in Adolescents and the Elderly

Substance Abuse and Suicide Risk among Adolescents

Abstract

Introduction

Suicide and Substance Use among Adolescents: Epidemiologic Aspects

Substance Use, Substance Abuse and Substance Use Disorders among Adolescent Suicide Attempters

Suicide, Substance Abuse and other Psychiatric Disorders: Comorbidity Matters

The Relationship between Suicide and Substance Abuse: Explanations

The Risk of Suicide in the Different Kinds of Drug Abuse

Heroin

Cocaine

Cannabis

Suicidal Behavior and Alcohol Abuse

Epidemiology

Risk Factors

Prevention

Conclusion: A Note on Intervention

References

Alcoholism and Suicidal Behavior in the Elderly

Abstract

Introduction

Alcohol Use Disorders and Suicide in the Elderly

Alcohol Use Disorders and Attempted Suicide

Acute Alcohol Intoxication and Suicidal Behavior

A Model of Suicidal Behavior in Alcoholism

Implications from a Public Health Perspective

Implications for Care Providers

Conclusion

References

Part VII. Suicidal Behavior in Individuals with Comorbid Substance Use Disorders

and Other Psychiatric Disorders

Comorbid Bipolar and Substance Use Disorders: Impact on Suicidal Behavior

Abstract

Introduction

Epidemiology of Bipolar Disorders

Epidemiology of Substance Abuse

Epidemiology of Comorbid Bipolar and Substance Use Disorders

Theories about the Relationship between BPD and Substance Abuse

The Role of Temperament

The Temporal Sequence between BPD and Substance Abuse

Bipolar Disorder and Suicide

Impact of Substance Abuse on Suicidal Behavior

Impact of Substance Abuse on Suicidal Behavior Related to BP

Sex Differences in BPD, Substance Abuse and Suicidal Behavior

The Special Group of Bipolar Patients with PTSD, Childhood Sex Abuse and Severe Comorbid Alcohol Use Disorder

Treatment Aspects: Bipolar Disorders Comorbid with Substance Abuse

Further Treatment Recommendations

Strategies for Reducing Alcohol Ingestion

Suggestions for Future Research

Conclusion

Comorbidity of Bipolar Disorder with Alcohol and Drug Abuse, Leading to Suicidal Behavior

Abstract

Background

Methods

Results

Conclusion

Introduction

1. Bipolar Disorder and Suicidal Behavior

1.1. Neurobiology of Suicidal Behavior in Bipolar Disorder Individuals

1.2. Bipolar Disorder and Alcohol/Drug Comorbidity

2. Impact of Comorbid Bipolar Disorder and Alcohol/Drug Use Disorders on Suicidal Behavior

2.1. Risk Factors of Suicidal Behavior Considering SUD and BD Comorbidity

2.2. Neurobiology of Suicidal Behavior in Comorbidity between Bipolar Disorder and Alcohol/Drug Individuals

3. Conclusion

References

Comorbid Features of Suicidal Behavior, Depression and Alcohol Abuse

Abstract

Introduction and Epidemiology

Causation or Correlation?

Biological Factors

Other Psychiatric Disorders

Childhood Abuse

Self Medication Model

Developmental and Situational Contributors

Aggression

Substance Use

Stress

Stigmatization and Low Self-esteem

Suggestions for Prevention

Screening

Individual Treatment

Community and Environmental Factors

Future Research Suggestions

References

Index

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