Severity of negative mood and anxiety symptoms occurring during acute abstinence from tobacco: A systematic review and meta-analysis.

This review was conducted with the following goals: To quantify the severity of mood and anxiety symptoms emerging during acute abstinence from tobacco (1). To explore sex differences related to the experience of specific symptoms (2). To investigate the early time course of symptoms (3). A meta-analysis was performed from 28 studies assessing mood and anxiety symptoms during the earliest phases of tobacco abstinence (up to 24 hrs post-quit) conducted from 1999 to 2019. Results revealed a significant (p < 0.0001) increase in 'anxiety', 'anger/irritability', 'depressed mood /sadness', and composite negative affect ('NA') in the 24 hours following smoking cessation. The largest effect size was detected for 'anxiety' (0.63). A qualitative analysis was performed to investigate sex differences and the time course of the specific symptoms. Results indicated that female smokers may experience worse mood symptoms compared to male smokers and that these symptoms may emerge within 3 hrs post-quit. Smoking cessation programs should implement sex-tailored interventions in order to improve their effectiveness, while future research should focus on alternative methods of nicotine administration.

Profiles of cognitive dysfunction in chronic amphetamine and heroin abusers.

Groups of subjects whose primary drug of abuse was amphetamine or heroin were compared, together with age- and IQ-matched control subjects. The study consisted of a neuropsychological test battery which included both conventional tests and also computerised tests of recognition memory, spatial working memory, planning, sequence generation, visual discrimination learning, and attentional set-shifting. Many of these tests have previously been shown to be sensitive to cortical damage (including selective lesions of the temporal or frontal lobes) and to cognitive deficits in dementia, basal ganglia disease, and neuropsychiatric disorder. Qualitative differences, as well as some commonalities, were found in the profile of cognitive impairment between the two groups. The chronic amphetamine abusers were significantly impaired in performance on the extra-dimensional shift task (a core component of the Wisconsin Card Sort Test) whereas in contrast, the heroin abusers were impaired in learning the normally easier intra-dimensional shift component. Both groups were impaired in some of tests of spatial working memory. However, the amphetamine group, unlike the heroin group, were not deficient in an index of strategic performance on this test. The heroin group failed to show significant improvement between two blocks of a sequence generation task after training and additionally exhibited more perseverative behavior on this task. The two groups were profoundly, but equivalently impaired on a test of pattern recognition memory sensitive to temporal lobe dysfunction. These results indicate that chronic drug use may lead to distinct patterns of cognitive impairment that may be associated with dysfunction of different components of cortico-striatal circuitry.

The prescribing practices of olanzapine in a psychiatric hospital in Britain.

The aim of this study was to review the prescribing practices at St Andrew's Hospital of the atypical antipsychotic drug olanzapine. Forty-one patients were treated with olanzapine by nine preservers during a 9-month study period. Two distinct categories of patients received the drug. Category A (n=30) patients were long-stay tertiary referrals, predominantly male and with a diagnosis of schizophrenia. For this group olanzapine was prescribed in high doses and half had additional anfipsjchotic medication; 17 patients (57%) improved but 30% were withdrawn from treatment. Category B (n=11) patients were acute admissions, younger, had a variety of diagnoses and were prescribed olanzapine at lower doses. All Category B patients improved after starting olanzapine and there were no dropouts. The presenters consistently reported positive experiences about the use of olanzapine.

Alcohol and alcohol problems research. 17. Malta.

This article is an enquiry into the current status of alcohol in Maltese culture. The responses of society to alcoholism depend on the way members of the community perceive the problems incurred by the use and abuse of a dependence producing substance like alcohol. These perceptions and subsequent responses are very much influenced by prevailing attitudes and beliefs. Malta is a melting point of cultures. This factor, together with a high density population and Malta's geopolitical strategic position, combine to make Malta a tolerant society. There is a laissez-faire response to alcoholism, at least partly due to the present inability to identify the need to take appropriate measures. The police force, medical profession and politicians still do not feel the responsibility or the need to provide effective laws and regulations, specialized treatment services or educative programmes on alcohol-related issues. A systematic enquiry is needed urgently to determine the severity and degree of the problems posed by alcohol abuse among the Maltese. Such an enquiry should be followed by a well planned national policy which includes local approaches and interventions. Finally, these interventions must be evaluated frequently and developed to achieve better results in the future.