Adolescents and young adults are an understudied and often a misrepresented population in oncology research and practice.

The current study was designed to assess the impact of cancer on a sample of Portuguese young adults with cancer, regarding emotional distress, quality of life (QOL) and personal growth.

The specific aims of the present work are 1) to assess current emotional distress, QOL and personal growth of young adults with cancer, which are compared to those of a group of healthy controls, and 2) to assess current emotional distress, QOL and personal growth of young adults with cancer according to treatment status (patients or off treatment survivors).

A sample of 36 Portuguese young adults with cancer and 435 healthy controls was evaluated through four instruments: Socio-demographic and clinical questionnaire, Hospital Anxiety and Depression Scale (HADS), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30), and Personal Growth Subscale (PG) from the Psychological Well Being Scale.

Cancer patients scored lower than controls in the role, cognitive and social domains of QOL and in personal growth. Cancer patients scored lower than cancer survivors in the role domain of QOL and personal growth.

The cancer patients revealed QOL and personal growth difficulties, mainly those undergoing treatment. These issues need to be considered in the psychosocial intervention within adolescents and young adults’ oncology care.

To report a case of isoniazid-induced delirium.

A 56-year-old man affected by alcoholism and hepatic cirrhosis was admitted to hospital for a suspected pneumonia with pleural effusion and thickenings. A Mantoux skin test was positive. A core biopsy of the pleural nodules revealed a tubercular granulomatous pleuritis. An isoniazid, ethambutol and rifampicin therapy was then started. Subsequently the patient developed a state of delirium. A diagnostic work-up was carried out considering different hypothesis: hepatic encephalopathy was ruled out because of lack of response to appropriate treatment; negative encephalic CT scan, liquor examination and EEG excluded a tubercular involvement of the central nervous system or other neurologic etiologies. Haloperidol and delorazepam were administered under the suspicion of Wernicke-Korsakoff syndrome, without any benefit. Finally a toxic etiology was considered. Among isoniazid side effects psychosis is described, though rare. Isoniazid therapy was then stopped and substituted by moxifloxacin, with progressive improvement of the state of consciousness.

Cases of isoniazid-related psychiatric disorders reported include psychosis, obsessive-compulsive disorder and mood alterations. Two mechanisms are generally considered as responsible: pyridoxin deficiency and isoniazid toxicity, a molecule chemically near to iproniazid, a powerful monoamineoxidase inhibitors. This is the first report of a case of isoniazidinduced pure delirium, with all clinical features according to DSM-IV criteria. We also confirmed successful resolutions of symptoms only by discontinuation of therapy.

In the work-up of a state of delirium, when investigating the toxic hypothesis, clinicians should consider neuropsychiatric side effects of isoniazid.

Recovery is currently the guiding principle for mental health policies in English-speaking countries with growing influence internationally.

Recovery is defined not only by symptom reduction but mainly by opportunities for inclusion and success in social roles. Recovery means leading a meaningful life after and despite mental health problems and disabilities. Being a mother is an integral part of what constitutes a meaningful life for many women.

Peer support is an essential ingredient of recovery-oriented services and the evidence on its feasibility and positive impact is growing.

Peer support for mothers during pregnancy and the perinatal period has a long tradition in most societies. Examples of groupbased as well as individual peer support programs with direct contact or telephone based interventions have been described and evaluated mainly for breastfeeding and for the prevention of postpartum depression.

Recently, peer support programs especially designed for mothers with mental health problems have been developed. First experiences are encouraging. More research is needed and will include recovery-dimensions as outcome variables as well as qualitative and user-led designs. Areas of special interest in the development of recovery-oriented interventions are the need for ongoing support while children grow up, the prevention of unnecessary custody loss, issues of disclosure and assistance for children as supporting relatives.

Recovery-orientation and peer support offer new insights and new ways of support for mothers with mental health problems and disabilities.

Electroconvulsive therapy (ECT) is a medical treatment that is most effective for mood disorders.It has also been shown to be an effective form of treatment for schizophrenia. However, many unanswered questions remain regarding its role in the management of people with schizophrenia.

Evaluate the main indications of ECT in schizophrenia patients.

To investigate the efficacy of ECT in the treatment of schizophrenic patients, evaluating its effects in the short-term and the long-term, comparing ECT with pharmacotherapy, and assessing the effects of treatment and the main indications for use in patients with schizophrenia.

A systematic review of the literature was conducted for ECT and schizophrenia. Forty-nine articles from peerreviewed journals were identified.

The most common indication for using ECT for schizophrenia patients was to augment pharmacotherapy, while the most common accompanying symptoms were, in order, catatonia, aggression and suicide. Catatonic patients responded significantly better to ECT than patients with any other subtype of schizophrenia. The combination of ECT with pharmacotherapy can be useful for drug-resistant patients. The use of an ECT-risperidone combination or ECT-clozapine combination in patients non-responsive to prior pharmacotherapy was found to be most effective.

ECT, combined with pharmacotherapy, may be a viable option for a selected group of people with schizophrenia. In particular, the use of ECT is recommended for drug-resistant patients, for schizophrenic patients with catatonia, aggression or suicidal behavior, and when rapid global improvement and reduction of acute symptomatology is desired.

The Eating Disorder Examination Questionnaire (EDEQ; Fairburn & Beglin, 1994) is a widely used measure composed of 28 items derived from the EDE Interview. The questionnaire has been considered an adequate measure of eating related psychopathology, including with overweight samples. EDEQ also assesses frequencies of eating disordered behaviors in terms of the number of episodes in the past four weeks (6 items not contributing to scores).

To investigate reliability and factorial structure of the EDEQ in a large sample of Portuguese overweight women.

The EDEQ was administered to an outpatient sample of 276 women (Mean age = 43.85 ± 11.89; Mean BMI = 32.82 Kg/m2 ± 5.43) attending a weight loss treatment consultation in a public medical center.

The EDEQ Cronbach a was .88. All items contributed to the internal consistency. A three factors structure (variance explained = 50.37%) was selected: Factor (F) 1 “Weight and shape concern/dissatisfaction” (a = .91); F2 “Eating concern” (a = .71) and F3 “Restraint” (a = .63). The mean total score was 2.36 (± 1.07). The regular occurrence of overeating episodes, selfinduced vomiting, laxative misuse and excessive exercise was reported by 10%, 1.5%, 4.1%, and 8.9% of participants, respectively.

The EDEQ Portuguese version showed adequate psychometric properties in a sample of overweight women. Its factorial structure, mean scores and specific eating disorder behaviors frequencies are in accordance with other studies with obese participants. The EDEQ Portuguese version could be very useful to clinical and epidemiological purposes in a broad range of eating disturbances.

Alexithymia correlates with fundamental psychological traits of eating disorders in a complex causal model and high relapse rates which may be due to a lack of affect regulation. The literature does not reach definitive conclusions about the usefulness of this construct in the clinical field.

The purpose of this preliminary study was to evaluate the presence of alexithymia and its correlation with epidemiological variables, psychological characteristics, symptom severity, and general psychopathological dimensions.

A sample of 125 patients with eating disorders was recruited from outpatient care for eating disorders at the San Paolo Hospital in Milan. Patients were administered the following scales: the TAS20, SCL-90 and EDI-2.

The results indicate that 38% of the sample were alexithymic, an underestimation when compared to literature; different types of ED did not differ in alexithymia scores. The TAS20 did not correlate with the epidemiological variables. Diagnoses of Axis II disorders predicted the presence of alexithymia, suggesting that it may contribute to affective dysregulation found in personality disorders. The TAS20 further correlated with EDI-2, in particular with the subscales relating to the body and the relational aspects, and with the level of general psychopathology on the SCL-90, indicating that alexithymia may be a dimension that extends across nosographies in disorders of affective dysregulation.

In Psychiatry there is a controversial discussion about the use of coercion in general. Against this background the question, by which factors physical restraint rates can be influenced is of foremost importance.

In early 2008 we determined that those patients from the Geropsychiatry unit were most affected by physical restraints.

With the aim, to decrease physical restraint rates, a new concept of care was implemented in the Geropsychiatry unit. It included changes to staffing structure and staffing levels.

We performed a pre-post study (pre: 1st half of 2008, post I: 1st half of 2009, post II: 1st half of 2010, post III: 1st half of 2011). The evaluation focused on the criteria “staff number”, “physical restraint rates” and “fall rates”. The information value of the results is limited due to the used study design.

There were no significant changes regarding the socio-demographic and performance data. The number of registered nurses (pre: 100%; post III: 122%) and assistant staff (pre: 100%; post III: 142) in real time increased by a total of 52 working hours per day on average. There were a significant decrease of the ratio of physically restrained patients (pre: 0.19; post III: 0.08; p < 0.0005), the total duration of restraint (pre: 3162 h; post III: 781 h; p < 0.0001), a reduction regarding further restraint criteria and insignificant changes in fall rates.

The results emphasize that changes to staffing levels can influence physical restraint rates. More and highquality research is needed.

In Brazil there is a great demand for evaluation of the capacity to exercise civil rights of mentally ill patients, aiming their judicial interdiction as a protective measure. In Rio de Janeiro, the Public Attorney Office counts with a seven psychiatrists team, that among other functions, will evaluate the civil capacity of individuals, giving the district attorneys a technical psychiatric background to decide whether, or not, to demand a judicial interdiction.

Analyze five case reports in which district attorneys have demanded a civil capacity evaluation.

This is a serial cases study of five patients, where each individual was assessed. The final psychiatric diagnosis was obtained with a psychiatric evaluation of the patients, the examination of their records or relatives interview.

The five patients, each with a different diagnosis, were assessed individually. The civil incapacity is not an absolute state, but a relative situation, and the reasons and circumstances are important elements in forensic evaluation.

Interdiction is not always the best, or even the most convenient solution to social, economic and legal problems occasioned by the absence or loss of insight or self-determination caused by disability or mental illness. It is vital to characterize the absence or loss of sense of judgment, self-determination or volition, and it is necessary to determine that such damage would be significant to the specific conditions of the familiar and socio-economic profile of each citizen.

The high prevalence of psychiatric comorbidity in drug dependent individuals is well known. However, there is limited literature available regarding the comorbidity of psychiatric disorders in drug addicts on methadone maintenance treatment (MMT).

To determine the comorbidity of mental disorders in patients on MMT.

The Symptom Checklist 90-Revised (SCL-90R) [1] was completed by 85 drug addicts (65 male and 20 female) on MMT. We recorded demographic data, duration of addiction, and duration of MMT.

The mean age of the sample was 42.0 ± 8.8 years old, the mean duration of substance use was 24.3 ± 8.2 years and the mean duration of MMT was 6.8 ± 4.1. The majority of participants (78.8%) were unemployed and 58.3% of them had no children. Participants scored higher on the depression, paranoid ideation, anxiety, hostility, somatization, interpersonal sensitivity and psychoticism SCL-90R sub-scales, with average scores >1 [2]. On the contrary, lower scores were recorded in the obsessive-compulsive and phobic anxiety sub-scales. The percentage of participants that reported abnormal scores for each sub-scale was as follows: 89.3% for depression, 83.3% for paranoid ideation, 74.7% for anxiety, 66.7% for hostility, 64.7% for somatization, 51.2% for psychoticism and 35.7% for phobic anxiety. No abnormal scores were recorded regarding obsessive-compulsive symptoms. Only 8.4% of participants did not score abnormally on any sub-scale.

Drug-addicted patients on MMT show a high comorbidity of psychiatric disorders. In particular, the likely presence of depressive and paranoid symptoms should be taken into serious account when deciding on a therapeutic strategy.

The quality of a woman's relationship with her partner is associated with an increased risk of developing anxiety and depression in the postpartum.

To assess the prevalence of post-partum depression (PPD) and correlation between anxiety and depression in postpartum and the marital relationship in a sample of couples recruited at the Gynaecology Ward, “Maggiore della Carità” Hospital, Novara.

Evaluation of marital relationship functioning with regards to PDD onset.

This longitudinal study involved 44 couples recruited from February 2012 to March 2012. Single women, women suffering from severe chronic illnesses, drug addiction or alcoholism and with a previous diagnosis of psychiatric disorders were excluded. Mothers-to-be were assessed for depression and anxiety, during pregnancy and after delivery with the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Depression Inventory-II (BDI-II). Both parents were assessed with the Relationship Satisfaction Scale (RSS); Relationship Assessment Scale (RAS); Marital Adjustment Test (MAT).

The prevalence of PDD was 18% according to the EPDS and 10.5% according to the BDI-II. No gender differences emerged as far as the partner relationship is concerned. The Chi-square analysis revealed a statistically significant inverse correlation between the development of PDD assessed with EPDS after delivery and RSS score (p = 0.039) and RAS (p = 0.05). A statistically significant inverse correlation emerged between BDI-II and RAS (p = 0.005), and BDD and MAT (p = 0.006).

The prevalence of PDD was consistent with the literature. Satisfaction with the marital relationship and the functioning of parental relationship correlates with PDD onset. Clinical implications are discussed.

Knowledge about the mechanisms underlying the relationship between perfectionism and eating behaviors in overweight/obese women is very scarce.

To investigate the relationship between perfectionism, eating behaviors and affect in overweight women.

The Portuguese validated versions of the Eating Disorders Examination Questionnaire/EDEQ, the Multidimensional Perfectionism Questionnaire and the Profile of Mood States were administered to an outpatient sample of 276 women (Mean age = 43.85 ± 11.89; Mean BMI = 32.82 ± 5.43) attending a weight loss treatment in a public hospital.

Correlations between Social Prescribed Perfectionism/SPP and EDEQ total (T) and its dimensional scores (Weigh and Shape Concern and Dissatisfaction/WSCD, Eating Concern/EC, Restraint) were all moderate (r > .30) and significant (p > .001). Self-Oriented Perfectionism/SOP was also significantly correlated with EDEQ-T, WSCI and Restraint (r = .20). Positive affect/PA was negatively correlated and Negative affect/NA was positively correlated with all EDEQ dimensions (r > .25; p > .001). SPP, but not SOP, was significantly correlated with PA (r = −.27) and NA (r = .34). Participants with high (>M+SD) vs. low (< MSD) SOP and SPP had significantly higher means in EDEQ-T, WSCI, EC and Restraint (all p < .001). Linear regression showed that SPP, PA and NA were predictors of EDEQ-T and WSCI; SPP and NA were predictors of EC; NA was the unique predictor of Restraint (all p < .001). Controlling for NA/PA, SPP still being a significant predictor of all EDEQ, WSCD and EC, accounting for significant increments of variance (4.4%, 2.9% and 4.3%, respectively; p < .001).

As in studies with other type of samples, SPP is related to disordered eating in overweight women.

Antidepressant drugs have been found underused in the older population relative to younger adults, particularly in the USA before Medicare part D. No study assessed the antidepressant use according to age in France.

To compare the patterns of antidepressant use among young and older adults: treatment duration, switches, association of antidepressants, coprescription of psychotropic drugs and adherence to treatment.

A historical cohort study included 27,306 young adults and 7,747 older adults, who were beneficiaries of the French national health care insurance and initiated a new antidepressant treatment over the study period. They were followed for atleast six months.

Most patients received only one type of antidepressant (91.81% of young adults and 91.73% of older). The coprescription of psychotropic drugs was frequent in both groups (62.91% in young adults and 62.36% in older). The associations of antidepressant drugs were rare (1.42% in young adults and 1.50% in older). Elderly patients had a significantly longer duration of treatment than young adults (m = 135.4 days, SD = 198.6 vs m = 104.3 days, SD = 159.6; HR = 0.9; 95%CI=[0.88–0.93]; p < 0,0001). Furthermore, they had a higher probability of good adherence than young adults when treatment was initiated by a general practitioner (23.28% vs 16.02%; OR = 1.3 [1.22–1.41]), a hospital practitioner (OR = 1.76 [1.35–2.30]) or a specialist other than psychiatrist (OR = 1.85 [1.26–2.70]).

The use of antidepressant drugs was similar in both age groups, except for the treatment duration and adherence that were better in the older patients. This result may be attributed to the French healthcare system.

The aim of the study is to evaluate risk factors for attempted suicide in psychiatric patients.

We compared three groups: psychiatric patients who attempted suicide, patients with the same diagnosis and no history of attempted suicide and healthy controls, through the administration of the following tests: TCI, SCL-90, WHOQOL, SASS, SF 36 and IIP.

The subjects were matched for sociodemographic characteristics (sex, age, level of education, field of employment and role, marital status) with a 1:1:1 ratio.

We obtained statistically significant differences between patients who attempted suicide and patient who didn’t in subscales: harm avoidance (TCI, p = 0.021) and environment area (WHOQOL, p = 0.021).

We also underline we were able to discriminate healthy subjects from patients, but we didn’t obtain statistically significant differences between controls and patients who attempted suicide in the subscales egocentricity (IIP, p = 0.051), aggressiveness (IIP, p = 0.057) and self-transcendence (TCI, p = 0.255).

These results underline the importance of caring, with preventing purpose, about personal history data such as socioeconomic status, living environment perceived safety, different tendency to inhibit own behaviors (correlated to previous suicide attempts), closure to external relations and aggressiveness.

The main objective of the study is to explore associations between alcohol consumption and marijuana use in young adults and to discuss the opportunities for brief intervention.

Face to face structured interviews were carried out with 2,221 young adult Czechs (mean age 29.9, sd. 5.8 years). 51.4% were males. Alcohol consumption was calculated using beverage specific quantity frequency method. Alcohol-related problems were assessed using the Czech version of the AUDIT. Frequency of marijuana use in the last twelve months was asked as well.

The overall alcohol consumption was 9.2 litres of pure alcohol per person and year. The last year prevalence of marijuana use was 21.8%. Marijuana use positively correlated with the frequency of beer drinking (r=.27), frequency of heavy episodic drinking [HED] (r = .32) and with the summary score in AUDIT (r = .39). Harmful or problem drinkers (AUDIT score >16) reported marijuana use more frequently than moderate drinkers (60% compared to 18.8%; OR = 6.54; 95% CI = 4.7; 9.1). OR for marihuana use in heavy episodic drinkers was 4.3 (95% CI = 3.3; 5.6).

The results suggest that frequent HED and harmful drinking are closely associated with marijuana use in younger adults. Since marijuana use (including heavy use) is rather common in the Czech Republic, it would be recommendable to also extend screening and brief intervention to reduce the use of cannabis. The existing guidelines for brief intervention should be modified in order to cover marijuana consumption as well.

An analysis of the literature on eating disorders (ED) indicates that Eds are often comorbid with the diagnosis of Personality Disorder (PD). This seems to be a psychopathological feature, characteristic of this patient population. However, the double classification seems to be often insufficient when describing a very complex psychopathological picture. These observations have informed our intention to investigate these two distinct nosographic groups by means of a single construct.

The aim of this study is to identify and describe (through tests that evaluate defense mechanisms) the defensive styles that characterize the two groups of patients, in order to outline a defensive profile that can assimilate or differentiate the psychopathological groups.

The study was carried at the Department of Psichiatry of the San Gerardo Hospital in Monza. The Defence Style Questionnaire-40 (Farma Cortinovis, 2000) was administered and analysed. The sample consisted of 40 participants with eating disorders, recruited among the outpatients for eating disorders, and 40 patients with personality disorders recruited from two Psychiatric Outpatient Services.

The data analysis showed a statistical significance in the use of Immature defense mechanisms and Neurotic defence mechanisms in both clinical samples.The patients with PD used a significantly higher number of psychotic defense mechanisms than patients with ED. These results may suggest that in ED patients, the symptoms can be themselves considered as defense mechanisms, or a defensive style that characterizes and makes specific the psychopathological picture.

Clinical guidelines recommend slow clozapine dose titration, a procedure introduced in the 1980's to decrease the risk of drug-induced seizures and hypotension. The procedure is considered safe, but may delay adequate control of symptoms.

To evaluate the effectiveness and safety of rapid clozapine dose titration in schizophrenia patients at high risk of harming themselves or others.

The rapid clozapine dose titration was used for a consecutive cohort of schizophrenia patients (N = 111, mean age 42.1%, 52% males) admitted to a single psychiatric hospital. Clozapine was started with a dose of 12.5–25 mg and additional doses of 25–50 mg where given as needed every 6 hours. The clozapine treatment was intiated on admission for 73 patients who had been treated with clozapine in the past (Group 1). Thirty-eight patients received clozapine after failing to respond to other antipsychotics (Group 2).

Admission PANSS scores were similar in the 2 groups (104.3 ± 2.9 vs. 103.8 ± 5.1, p = 0.48). Symptom control was obtained after 4.1 ± 3.1 days with a maximum dose of 352.7 ± 176.1 mg clozapine/day in group 1 and after 7.1 ± 4.8 days (p < 0.001) with a maximum dose of 408.6 ± 187.5 mg clozapine/day (p = 0.12) in Group 2. The PANSS scores at discharge indicated similar reduction in symptom severity (60.5 ± 5.4 vs. 59.8 ± 7.4, p = 0.539). None of the patients treated had seizures, syncope, neutropenia or other significant adverse events.

Rapid clozapine dose titration appears safe and effective when used in schizophrenia patients with or without prior exposure to the drug.

Antidepressant withdrawal mania is a rare paradoxical event. It was initially reported in unipolar patients but it can also occur in bipolar patients, despite adequate mood-stabilizing treatment. It has been described with all antidepressant classes and may be self-limited or require medical hospitalization. Tapered withdrawal doesn’t seem to prevent the condition, though most reported cases developed after abrupt antidepressant discontinuation. Chronic antidepressant therapy enhances dopaminergic neurotransmission in the mesolimbic system. Noradrenergic hyperactivity and cholinergic overdrive secondary to antidepressant cessation are the most accepted theoretical mechanisms proposed.

Case report, discussion and literature review.

We report a case of fluoxetine withdrawal mania and discuss its implications on clinical practice.

Case report and non systematic literature review.

We present a case of a divorced 59-year-old woman who developed a manic episode shortly after antidepressant discontinuation. She was under antidepressant therapy since 2001, due to an unipolar chronic depressive disorder. She was put on fluoxetine 20 mg q.d. since 2005. On May 2012, she discontinued the antidepressant therapy upon misunderstanding medical advice. Few weeks later, she was involuntarily admitted to our inpatient unit presenting a manic episode with psychotic features. She started valproic acid 1000 mg q.d. and risperidone 4 mg q.d. and a complete remission was quickly obtained.

This case illustrates the potential for mania related to antidepressant discontinuation. Differential diagnosis includes spontaneous mania, antidepressant withdrawal syndrome and antidepressant induced mania. Finally, the authors discuss the adequacy of categorizing this entity in bipolar spectrum disorders.

The Children's Depression Inventory (CDI) is a 27-item, symptom-oriented scale for youths aged 7-17. In Portugal some psychometric parameters has never been analyzed before.

To analyse the reliability and construct and concurrent validity of the CDI in a Portuguese adolescents sample.

969 adolescents (59.34% girls), aged 15.80 ± 1.51, answered the Portuguese versions of the CDI and of the Rosemberg Self Esteem Scale (SE). To study the temporal stability, 204 (58.74% girls) respondents answered the questionnaires again after approximately 5 weeks.

CDI mean scores were difference between genders [Girls=10.84 ± 6.025 vs. Boys: 8.90 ± 6.477, p < .001]. The Cronbach's alpha (α) was .85 for the total sample, .83 for the Girls, and .87 for the Boys. Pearson correlations between the test and the re-test was r = .81 for the total sample, r = .78 for the Girls sub-sample and r = .83 for the Boys sub-sample. Based on factorial and parallel analysis, a 4-factors structure was selected for the total sample (variance explained, VE = 38.93%), the Girls (VE = 36.92%) and the Boys (VE = 41.98%). The items content were similar in the total sample and by gender, but the order of the factors was different. The four factors were: “Depression and Negative Self Esteem”, “Ineffectiveness and Somatic Symptoms”, “Anhedonia”, “Interpersonal Problems”. The SE and CDI total scores were negative and statistically (p < .001) correlated in the total sample (r = -.67), in Girls (r = -.69) and in Boys (r = -.63).

The Portuguese CDI has good reliability and validity, showing to be an adequate instrument for measuring depressive symptoms in Portuguese adolescents.

Sexual identity is often neglected in the analyzes of a potential patient and this represents a very bias and a potential blurring factor especially when we research about attempted suicide or substance abuse.

We analyzed EBM Literature published in the last five year, and text otherwise and previously published but esteemed as important for our purpose.

Lesbian population (L) have a greater and huger use of illicit drug.

It's necessary to add that a great part of L population uses drug by injection, thus including all the considerations about related infections (2).

Epidemiologically,we can attest that 10% of bisex (B) and 8,8% of L population have an ev drug intake.

It results of the greatest interest the fact that we can measure an increase in rapist's victims in the population analyzed compared to GP (64%vs44%), and in ⅓ of the cases violence occurred during childhood.

Adding that homosexual population is at major risk of suicide and attempted suicide, we are obliged to wonder if there's a common pathway or a sum of risk factors leading to these conducts.

The evidence of a possible correlation between sexual abuse and via PTSD the conservation of victim role, as well as the development of dissociation or personality disorder might explain a deeper use of illicit drug or alcohol in this population. International researchers in the field of SUD strongly demand to analyze sexual orientation as a risk factor for SUD since the given evidence quoted above.