[What can be expected today of pharmacotherapy in the Alcohol Use Disorders?].

During the last past years, numerous drug have been proposed to treat Alcohol Use Disorders. Besides classical drugs as acomprosate or naltrexone, new compounds are developed in this new indication. They are used in substitution therapies (baclofen), either when the aim of the treatment is total abstinence from alcohol or as an aid for craving reduction facilitating a "controlled drinking", or also for the maintaining of abstinence (nalmefene).

Memory deficits in late-onset schizophrenia.

Late-onset schizophrenia (LOS) is a controversial diagnosis, mainly characterized by more positive symptoms and less deterioration. LOS could be considered as either an extreme of typical schizophrenia (but for old age patients, and short duration of the disorder), or an independent group of patients with a specific diagnosis, with no clear evidence in favor or against any of these hypotheses. The aim of the present study is to characterize the memory cognitive profile of LOS patients without related organic factors (N=25), compared to early-onset schizophrenic patients (EOS, N=44), matched for the duration of the disorder, and healthy controls (HC, N=23), matched for the age of patients.

Frequency of gambling problems among parents of pathological, versus nonpathological, casino gamblers using slot machines.

Familial and twin studies suggest the implication of a genetic factor in pathological gambling, but mainly assess probands through treatment settings or advertisements. The question raised here is: are parents of casino pathological gamblers using slot machines more affected with pathological gambling than nonpathological gamblers, all interviewed on site at the same casino? Three hundred and fifty-five casino gamblers on slot machines, which included 96 pathological gamblers, 116 problem gamblers, and 143 nonproblem gamblers, were recruited in situ at the largest casino in the Paris suburbs. We evaluated pathological gambling and two addictive disorders (alcohol dependence and tobacco consumption) in the gamblers and their 690 parents (through the proband).

The executive control of attention differentiates patients with schizophrenia, their first-degree relatives and healthy controls.

Attentional and executive impairments have been reported in patients with schizophrenia and in their healthy first-degree relatives. However, its nature remains unclear and discrepancies between studies have been observed. These might be due to differences in the clinical severity of the illness or in sociodemographic factors.

Presence of co-morbid substance use disorder in bipolar patients worsens their social functioning to the level observed in patients with schizophrenia.

Bipolar disorder has been considered to have a better prognosis than schizophrenia at the very beginning of its definition. However, psychosocial functioning may vary not only because of the characteristics of the disorder, but also of co-morbid conditions, especially regarding substance use disorder (SUD). The purpose of this study was to compare the social adjustment level of patients with bipolar disorder with that observed in patients with schizophrenia, taking into account substance use disorder (SUD).

A genetic schizophrenia-susceptibility region located between the ANKK1 and DRD2 genes.

Background: The gene coding for the D2 dopamine receptor (DRD2) is considered to be one of the most pertinent candidate genes in schizophrenia. However, genetic studies have yielded conflicting results whereas the promising TaqIA variant/rs1800497 has been mapped in a novel gene, ANKK1.

Methods: We investigated eleven single nucleotide polymorphisms (SNPs) spanning the DRD2 and ANKK1 genes, using both a case-control association study comparing 144 independent patients to 142 matched healthy subjects, and a transmission disequilibrium test in 108 trios.

The role of brief motivational intervention on self-efficacy and abstinence in a cohort of patients with alcohol dependence.

Objectives: Brief interventions are effective in reducing heavy drinking in the general population but few studies examined whether it is also effective in alcohol dependent patients, and whether brief intervention increases self-efficacy.

Method: One hundred and seven patients with alcohol-dependence were randomized in a controlled trial examining the efficacy of a brief motivational intervention on both self-efficacy level and days of abstinence.

Results: We found that brief motivational interventions had no effect on days of abstinence, nor on self-efficacy, but that high self-efficacy was consistently correlated with a longer period of abstinence, at all assessment-points.

The 3' part of the dopamine transporter gene DAT1/SLC6A3 is associated with withdrawal seizures in patients with alcohol dependence.

Background: Some studies have reported that the A9 allele of the variable nucleotide tandem repeat (VNTR) of the gene which encodes the dopamine transporter (DAT1/SLC6A3) is associated with alcoholism withdrawal symptoms such as alcohol withdrawal seizures (WSs), whereas others did not. We investigated whether polymorphisms within the DAT1 gene are associated with WS taking into account some of the confounding factors such as the severity of alcohol dependence.

Methods: To further assess the role of this gene in WS, we genotyped the VNTR and 7 single nucleotide polymorphisms (SNPs) encompassing the DAT1 gene in a sample of 250 alcohol-dependent subjects (175 men and 75 women), of whom 24% exhibited WSs, taking into account the severity of alcohol dependence.

The CNR1 gene as a pharmacogenetic factor for antipsychotics rather than a susceptibility gene for schizophrenia.

Neurobiological research suggests a significant role of the endocannabinoid system in schizophrenia vulnerability and also in the quality of response to antipsychotics. Genetics offer an opportunity to disentangle its involvement in the disease vulnerability vs an influence on antipsychotics' effects. The possible role of a tag SNP (the 1359G/A polymorphism) of the gene encoding the cannabinoid receptor type 1 (CNR1) in schizophrenia and/or therapeutic response to atypical antipsychotics was assessed in a cohort of 133 French schizophrenic patients compared to 141 normal control subjects.

Lifetime positive symptoms in patients with schizophrenia and cannabis abuse are partially explained by co-morbid addiction.

Recent prospective findings have shown that cannabis use by young people could be a risk factor for psychotic symptoms in adulthood, but the long-term impact of cannabis abuse on the clinical features of declared schizophrenia remains to be explored. We assessed the independent influence of cannabis abuse on the clinical symptoms of schizophrenia, after controlling for frequently co-occurring addictive disorders. Patients with schizophrenia, and with (N=66), or without (N=139) cannabis abuse, were compared for lifetime positive and negative symptoms, taking into account presence of any other addictive disorders.

Study of compulsive buying in patients presenting obsessive-compulsive disorder.

Objective: The authors assessed the prevalence of compulsive buying (CB) among patients presenting an obsessive-compulsive disorder (OCD). They compared the buying style of patients with and without CB.

Method: One thousand five hundred consecutive patients were assessed by a general practitioner in Paris (France).

Negative symptoms of schizophrenia could explain discrepant data on the association between the 5-HT2A receptor gene and response to antipsychotics.

Pharmacogenetic studies assessing the role of 5-HT(2A) receptor gene in antipsychotic efficacy yielded conflicting data. Phenotypical heterogeneity of schizophrenia might explain such discrepancies. For example, negative symptoms are known to reflect severity of illness and to restrain therapeutic response.

Family-based association study of the 5-HT transporter gene and schizophrenia.

The gene coding for the 5-HT transporter (5-HTT) is considered as a candidate gene for schizophrenia, because this transporter plays a key role in serotonin neurotransmission. Previous genetic studies focusing on this gene yielded conflicting results, presumably because of stratification biases linked to the case-control association study approach, and the potential genetic and phenotypic heterogeneity of schizophrenia. We investigated the 5-HTTLPR and 17-bp VNTR (variable number of tandem repeats) polymorphisms of this gene in 103 trios using the transmission disequilibrium test.

The A9 allele of the dopamine transporter gene increases the risk of visual hallucinations during alcohol withdrawal in alcohol-dependent women.

Previous studies have found an association between the A9 allele (nine-copy repeat) of the dopamine transporter (DAT) gene and two complications of alcohol withdrawal, namely delirium tremens (DT) and alcohol withdrawal seizures (AWS). Most of these studies only included male alcohol-dependent patients. Even those that included a small proportion of women did not look at the effect of gender.

Clinical and etiopathogenic specificities of the French concept of psychose hallucinatoire chronique compared to schizophrenia.

The French concept of psychose hallucinatoire chronique (PHC) is characterized by late-onset psychosis, occurring predominantly in females. Symptoms are rich and frequent hallucinations but almost no dissociative features or negative symptoms. This diagnosis is classified among schizophrenia disorders (paranoid type) according to DSM-IV.

The 3' region of the DRD2 gene is involved in genetic susceptibility to schizophrenia.

The gene coding for the D2 dopamine receptor (DRD2) is considered as one of the most relevant candidate genes in schizophrenia. Previous genetic studies focusing on this gene yielded conflicting results, for example because of differences in methodology (linkage versus association studies) and variability in the loci analyzed (the DRD2 gene having many polymorphic sites). We used a progressive strategy with two different approaches (case-control and transmission disequilibrium test) and investigated six genetic polymorphisms spanning the DRD2 gene in 103 patients with DSM-IV criteria of schizophrenia, their 206 parents and 83 matched healthy control subjects.

Association between dopamine receptor D1 gene DdeI polymorphism and sensation seeking in alcohol-dependent men.

Background: Among genetic and biopsychological factors involved in alcohol-dependence vulnerability, dopamine receptor subtypes genes and temperament's dimensions, such as sensation seeking, have been particularly incriminated. Moreover, it is suggested that higher levels of sensation seeking could be associated with a modification of sensitivity to dopamine in postsynaptic receptors.

Methods: We investigated whether the DRD1 DdeI polymorphism could be associated with the sensation-seeking level among a sample of 72 alcohol-dependent male and female patients.

Alcohol dependence among elderly French inpatients.

Objective/methods: The authors compared groups of heavier and lighter drinkers in a geriatric hospital inpatient unit in France, using questionnaire measures of alcohol dependence, sociodemographic characteristics, and cognitive status.

Results: Alcohol consumption is more frequent in men than in women; 9% of the geriatric patients (3% of women and 18% of men) show symptoms of alcohol dependence. Alcohol dependence is also associated with benzodiazepine treatment and nicotine dependence.

Study of Internet use by customers of a large French store for computers.

The objective of this work was to study the relation to the Internet of subjects who own a computer and who use it for professional or personal reasons. We interviewed 150 customers of the biggest French store that specializes in computers. Each day, the mean of duration for connecting time was 6.

The A9 allele of the dopamine transporter gene is associated with delirium tremens and alcohol-withdrawal seizure.

Background: The dopamine transporter (DAT) plays a key role in homeostatic regulation of dopaminergic neurotransmission and could thus be involved in the variability of two severe alcohol-withdrawal symptoms, alcohol-withdrawal seizure (AWS) and delirium tremens (DT). Interestingly, an association was found between the DAT gene (9-copy repeat) and the risk for these symptoms in two previous case-control studies.

Methods: We reanalyzed the role of the DAT gene in the lifetime risk for AWS and DT in 120 alcohol-dependent patients, taking into account potentially confounding factors.

Screening for domestic violence among patients admitted to a French emergency service.

Objective: The authors assessed the prevalence of domestic violence among patients examined in the emergency service of a general hospital. They compared the socio-demographic status and psychiatric comorbidity of victims of domestic violence and other patients.

Method: An assessment was made on 126 consecutive patients received by the emergency service of Bichat-Claude Bernard hospital (Paris, France).