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Objective: The psychometric properties of the Drug Abuse Screening Test (DAST-10), developed to screen individuals for drug problems, are evaluated in Turkish patients with drug use disorder. Method: Participants included 100 adolescents with drug use disorder in a substance abuse treatment program for adolescents, 123 heroin dependent adults in a residential substance abuse treatment program, and 35 alcohol dependents from the same clinic who did not report a drug abuse problem. Results: The DAST-10 was found to be a psychometrically sound drug abuse screening measure with high convergent validity (r=0.76) when correlation with the Drug Use Disorders Identification Test (DUDIT) was measured and to have a Cronbach’s alpha of 0.92. In addition, a single component accounted for 59.35% of total variance, and the DAST-10 had sensitivity and specificity scores of 0.98 and 0.91, respectively, when using the optimal cut-off score of 4. Additionally, the DAST-10 showed good discriminant validity as it significantly differentiated patients with drug use disorder from alcohol dependents. Conclusions: These findings support the DAST as a reliable and valid drug abuse screening instrument that measures a unidimensional construct. Further research is warranted with additional clinical populations and with high risk populations such as those in criminal justice settings.

Personality dimensions and defense styles that are related with relapse during 12 month follow-up in male alcohol dependents Objective: The aim of this study was to evaluate the defense styles and the personality dimensions that are related with relapse to alcohol use 12 months after inpatient treatment in male alcohol dependents. Methods: Participants were 70 consecutively admitted male alcohol dependents. Among these patients 44 were available to examine after 1 year. Patients were investigated with the Temperament and Character Inventory (TCI) and Defense Styles Q (DSQ) at baseline. Results: Among 44 alcohol dependent inpatients 61.4% (n=27) were considered as relapsed to alcohol use. Current age was lower in relapsed group. Age at regular alcohol use, duration of education, regular income did not differ between groups. Rate of history of self-mutilation and/or suicide attempt at baseline were higher in relapsed group. Rate of changing social environment during 12 months after inpatient treatment was lower in the relapsed group, whereas using drugs and spending time with substance using friends were higher in this group. Mean scores of “acting-out”, “devaluation” and “displacement” were higher in the relapsed group. Also same immature defense styles predicted relapse together with self-directedness (SD). When current age was included in the analysis, being younger and high acting-out predicted relapse in alcohol dependents after inpatient treatment. Conclusions: Clinicians must be careful for younger alcohol dependents with lower SD and for those who

BACKGROUND: To determine the factors involved in violent behavior in patients with bipolar disorder (BD) and to investigate the relationship between violence and substance use disorder (SUD). METHODS: A sample of 100 male inpatients diagnosed with BD type I who were experiencing a current mood episode participated in the study. Violent behavior was defined as physical aggression against others. All patients were evaluated using the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HDRS), Positive and Negative Syndrome Scale-positive subscale (PANSS-p), Barratt Impulsivity Scale-11 (BIS-11), Buss-Perry Aggression Questionnaire (BPAQ) and Overt Aggression Scale (OAS). Lifetime SUD and current use of substances were evaluated. Logistic regression analysis was conducted to predict violent behavior. RESULTS: Current substance use (CSU) rather than lifetime SUD was found to be related to violent behavior in patients with BD, and CSU was associated with a threefold increase in the risk of violence. The rate of lifetime SUD in our sample was 59%, and the rate of CSU was 39%. The most commonly abused substances were cannabis and alcohol, followed by synthetic cannabinoids, in both groups of patients with lifetime SUD and CSU. Individuals abusing any substance were more likely to have a criminal record and history of incarceration than other patients. One of the most significant risk factors for violence was a previous history of violent behavior. LIMITATIONS: The sample was limited to male patients. Data on some participants' recent substance use from standard urine analysis was not obtained. The data on the use of synthetic cannabinoids was obtained from patients and their families owing to the lack of equipment for detecting synthetic cannabinoids using laboratory analysis. CONCLUSIONS: CSU appears to be a significant predictive factor in violent behavior in male patients. Further investigation of co-occurrence of violence with CSU and improvement in treatment strategies might reduce or prevent violence in patients with BD. Language: en

Rabia Bilici,1 Esra Yazici,2 Ali Evren Tufan,3 Elif Mutlu,4 Filiz Ä°zci,1 Görkem Karakas Ugurlu5 1Erenkoy Mental Health and Neurology Training and Research Hospital, Department of Psychiatry, Istanbul; 2Sakarya University, Medical Faculty, Department of Psychiatry, Sakarya, 3Abant Izzet Baysal University, Medical Faculty, Department of Child and Adolescent Psychiatry, Bolu, 4Bakirköy Mental Health and Neurology Training and Research Hospital, Department of Psychiatry, Istanbul, 5Yildirim Beyazit University, Medical Faculty, Department of Psychiatry, Ankara, Turkey Background: Motivation for treatment on the part of patients with addictive disorders is known to affect their prognosis, and lack thereof is reported to be among the most common reasons for failed treatment adherence and relapse after treatment. This study evaluated the relationship between volunteering, personality, demographic factors, and motivation for treatment. Methods: The study was conducted at a substance dependence center in the eastern part of Turkey. Forty-five patients (mean age 37.9±11.2 years) with a substance use disorder were included. They were assessed using the Structured Clinical Interview for DSM (Diagnostic and Statistical Manual of Mental Disorders) Axis II disorders. Depression and anxiety were evaluated using the Beck depression and anxiety inventories, and motivation for treatment was measured using the Turkish version of the Texas Christian University Motivation for Treatment scale. Results: All patients had been using substances daily and 41 (88.9%) had been using multiple drugs. The most commonly used substance was heroin (n=18, 40%). Voluntary admission was a predictor of motivation for treatment (P

Defense styles that are related with history of self-mutilation and suicide attempt in alcohol dependent inpatients Objective: The aim of this study was to investigate the relationship of defense styles with history of selfmutilation (SM) and suicide attempt (SA) in alcohol dependent inpatients. Method: Participants were consecutively admitted 118 male alcohol dependent inpatients. Patients were investigated with the Self-Mutilative Behavior Questionnaire (SMBQ) and the Defense Style Questionnaire (DSQ). Results: Acting-out was higher in alcohol dependent patients with a history of SM (n=53, 44.92%) and predicted SM in this group, together with being younger. On the other hand, sublimation, anticipation and suppression (and total mature defense style score) were lower in alcohol dependent patients with suicide attempt history (n=31, 28.44%), but only low anticipation predicted suicide attempt history in this group together with being younger. Conclusion: These results show that to reduce self-mutilative behaviors and SAs among young alcohol dependent inpatients, therapies should focus on increasing the use of mature defense styles and decreasing the use of immature defense styles.