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Social anxiety disorder is a mental condition with anxiety and avoidance in social settings and is frequently accompanied by self-medication with alcohol. Epidemiological studies demonstrate that the risk that patients with social anxiety disorder will develop alcohol dependence is more than two-fold. We will discuss epidemiological research findings about this comorbidity, as well as reasons for the comorbidity and the various treatments available for these conditions. Very few studies have analyzed the efficacy of treatments for the combination of these disorders and it is not yet clear whether to treat the social anxiety disorder first, to treat the alcohol use disorder first or to treat both conditions simultaneously. Nevertheless, we propose to treat the symptoms of social anxiety disorder and alcohol use disorder in combination with the hope of achieving maximal improvement in these patients. Disclosure: I received financial assistance from Lundbeck Israel.

Hyperhidrosis is a reason for treatment by many specialists in medicine, such as dermatologists, family medicine doctors, surgeons and also psychiatrists. Hyperhidrosis causes considerable distress and disability. Despite the fact that the condition has been known for thousands of years, it is yet unclear whether excessive sweating derives from emotional" activation of the central nervous system, whether the emotional symptoms evolve due to local dysfunction of the sweat glands, or a combination of the two problems. In this article, we will present two conditions: hyperhidrosis and Social Anxiety Disorder, a mental condition with anxiety and avoidanrce in social settings that is frequently accompanied by sweating. We will discuss the similarities and differences between these disorders and the various treatments available for these conditions. Research shows that social anxiety does not explain hyperhidrosis, but that excessive sweating reduces the threshold for social anxiety. Among people with hyperhidrosis, the functional disability and the emotional problems are mediated by the social anxiety. We propose treating the symptoms of hyperhidrosis and social anxiety disorder in combination in order to achieve maximal improvement in these patients.

Physical activity is an important aspect of good health for everyone, and is even more important for psychiatric patients who usually live an unhealthy lifestyle, and take medications that tend to reinforce the metabolic syndrome. This article presents research dealing with the efficacy of physical activity in treating different psychiatric problems from the medical-physiological aspect, as well as from the psychological aspect. It is advised that physicians and mental health professionals should ask and encourage patients to participate in regular physical activity.

Gambling behaviour is well-known for many centuries and is growing in popularity and frequency. Its etiology is multi-factorial and in this paper we review new developments in the field of pathological gambling, both regarding etiology and treatment progress. The aim of this review is to increase the physicians' awareness towards this entity.

The Internet provides inexpensive, interesting and comfortable recreation, but sometimes users get hooked. Thus, the computer-internet addiction concept has been proposed as an explanation for uncontrollable and damaging use. Symptoms of addiction could be compared to other addictive behaviors such as pathological gambling, kleptomania, trichotillomania, sex addiction and pyromania. Although criteria to diagnose this addiction have been proposed, methods of assessing excessive computer-internet use are limited. Early diagnosis could help the patient that suffers from this addiction before developing additional psychiatric diagnoses. A review of the proposed etiologies in the literature is summarized, together with recommendations for physicians and mental health officials.

Caffeine is considered to be the most commonly used psychoactive drug in the world and about 80% of adult individuals use caffeine-containing foods and beverages. Coffee is a powerful stimulant and its popularity results from this quality. Due to its ubiquitous use and presumably magical effects, caffeine has been suggested as an important factor in the development of, and also the protection from, cancer, neurological disorders and gallbladder stones. While its stimulant properties are valued phenomena in an achievement-oriented society, caffeine also has deleterious effects and can cause a wide range of side effects, either due to abuse or due to abrupt discontinuation of its use. This review summarizes the data available concerning the syndrome of intoxication (caffeinism) and considers the clinical importance of the phenomenon.

The current psychiatric literature emphasizes the important risk factors of suicide and parasuicide, which include the following: age, family status, psychopathology, substance abuse, biological markers and so forth. Recently, more emphasis has been placed on the yearly distribution of suicide and parasuicide. This distribution includes parameters such as national and religious holidays, birthdays, anniversary days, the lunar cycle and weather. It has been suggested by many researchers that this distribution is an important precipitant to a cumulative and complicated psycho-pathological process, terminating in suicidal behavior. Analysis of theories and research findings regarding these topics are provided, together with suggestions for research and prevention.

The frequent use of selective, serotonin reuptake inhibitors has increased the risk of the serotonin syndrome. This condition is related to stimulation of 5HT1A receptors and is characterized by agitation, confusion, tremor, fever and shivering. A 29-year-old woman and a 69-year-old man with the syndrome are reported. The importance of early diagnosis and treatment is emphasized, and aspects of the syndrome in patients with obsessive-compulsive disorder are presented.

Anorexia nervosa is a psychiatric disorder characterized by excessive dieting, severe weight loss, disturbed body image and inexplicable fear of gaining weight. It afflicts mainly upper class women of developed countries. We present a 16-year-old recent immigrant from Russia, where she had developed anorexia nervosa, obsessive-compulsive disorder and depression. The management of this patient is presented in the light of the sociocultural theory of the pathogenesis of anorexia nervosa and the clinical link between eating disorders and depression and obsessive-compulsive disorders.

Coexistence of diabetes mellitus and anorexia nervosa has been noted in the past 2 decades. The nature and treatment of diabetes offer numerous opportunities for the anorectic patient to lose weight. Improper adjustment of the insulin dose, failure to inject insulin, clandestine vomiting and failure to provide urine samples allow the anorectic diabetic to achieve morbid weight loss. The treatment of patients with both conditions is difficult; behavioral management combined with psychotherapy was found to be most effective. An illustrative case is presented.