Abstracts of the International Conference Addiction, Psychiatry and Mental Health, Rome, Italy, 11–12 November 2019. Hotel Mercure Roma West, Rome, Italy

: The International Conference and Addiction, Psychiatry and Mental Health (Addiction 2019) organized by the Coalesce Research Group was held on 11–12 November 2019 at Hotel Mercure Roma West, Rome, Italy. The conference highlighted the theme, “Novel approaches and Developments in Addiction Research and Psychiatry”. Benevolent responses and active participations were received from the scientists, doctors, researchers, students, and leaders from the ﬁelds of addiction research, who made this event inspiringly successful. studied a subsample of approximately 36 individuals from the cohort with data on palmitoyl-protein thioesterase-1 enzymatic activity from ﬁrst-episode psychosis (FEP) and performed a bivariate correlation analysis with psychiatric assessment scores. After adjusting for sex, age, body mass index (BMI) and total serum protein, our data demonstrated that PPT1 enzymatic activity is signiﬁcantly associated with schizophrenia and its Positive and Negative Syndrome Scale (PANSS) scores. This longitudinal study compared the PPT1 enzymatic activity in FEP schizophrenia patients and healthy volunteers, and the former exhibited a signiﬁcant 1.5-fold increase in PPT1 enzymatic levels (1.79 mM / hr / mL, and 1.18 mM / hr / mL; p < 0.05; 95% CI, 2.3–2.9, and 1.4–1.8). The higher PPT1 enzymatic levels in FEP schizophrenia patients were positively associated with larger PANSS scaling scores (r = 0.32, p = 0.0079 for positive scaling; r = 0.41, p = 0.0006 for negative scaling; r = 0.45, p = 0.0001 for general scaling; and r = 0.34, p = 0.0048 for PNASS-S scaling). Higher enzymatic PPT1 in FEP schizophrenia patients is signiﬁcantly associated with increased PANSS scaling values, indicating more serious rates of developing psychosis. Enzymatic activity of PPT1 ma provide an important new view for schizophrenia disorders. of to enhance their wellbeing. The current research to explore the levels of wellbeing in young people living in care in and the strategies used to enhance these young people’s ability to thrive. Social care workers perceptions and behaviors in relation to young people’s wellbeing were explored in semi structured interviews. The emerged from the data related to the stress and anxiety that young people faced in their lives and the potential beneﬁt of physical activity interventions to overcome this. The impact of signiﬁcant relationships in young people’s lives in terms of their wellbeing was also recognized as central to both the experience of stress, and to developing positive outcomes. The results discussed in relation to for developing young people’s wellbeing and for future research. Individual human subjects can be studied using multiple positron-labeled radiotracers to test more than one facet of brain function. PET and SPECT have been used to help us understand many aspects of the pharmacokinetics and pharmacodynamics of abuse drugs, and have made valuable contributions in terms of drug mechanisms, drug interactions (e.g., cocaine and Alcohol) and drug toxicity. They have also been used to study the acute e ﬀ ects of drugs on active drug addict populations delays diagnosed by the linguistic Parental reports via medical clinics interview applied as a measure of screen media use in children. Screen viewing variables and child-maternal characteristics interviewed in both groups. All children followed up for 6months after the departure of the screen media. This study included 237 children with delayed speech development, divided into two groups: toddlers 47 (19.8%), and 190 (80.2%) preschoolers, range between 15-60 months. One hundred eighty-four (77.6%) were male children with a male to female ratio 3.47:1. Approximately 94% of children had speech delays while 12 children were of no speech. The ﬁrst time of exposure to screen in both toddlers and preschooler children ( < 24 months of age), was 82.9% and 64.7% respectively. A signiﬁcant association between screen viewing and speech delays was detected in both groups, notably those started screen exposure at < 24 months of age and spent ≥ 4 h / day on screens. In both age groups, a marked association identiﬁed between high exposure to a screen ( ≥ 4 h / day) and child-maternal interaction during exposure as well as the maternal level of education. Speech improvement identiﬁed in 36.7% of children following 6months of the departure of the screen devices. This study demonstrated the positive relations between initial onset and high frequency of screen viewing and speech delays in young children, especially in toddlers. To support healthy child development in digital life, immediate attention from parents, instructors, researchers and health specialists on the proper use of screen time according to child age, Providing a broad interpretation of youth problems related to alcohol and drug addictions, as well as from the internet, constitutes an inevitably complex scientiﬁc work that involves signiﬁcant relationships with both sociological and psychological concepts and variables. Among these, the ascribed social status, gender, social context, type of school attended, and self-esteem have a recognized importance. The aim of this study is to analyze the correlation between addictions and interpersonal relationships, lifestyles, social deviance, such as bullying and cyber-bullying, and stereotypes about diversity. The speech will be particularly focused on the scientiﬁc recent results of the GAP project of the Italian National Research Council. This project consists of making periodical sample surveys conducted in electronic and telematic mode with the help of structured and semi-structured survey questionnaires and innovative research tools reﬁned and validated over multiple applications that can be ﬁlled out both in the presence of the interviewer and remotely. The results of the GAP project are statistically representative of the Italian student population aged 13 / 19 years (overall, the GAP project has so far involved over 6000 students). The scientiﬁc evidence indicates the deterioration and mutation of traditional social relations towards a virtual vision of commonality and collectivism. This occurs in the presence of widely tolerant opinions towards the use and abuse of alcohol, new and traditional drugs, and virtual relationships, which are experienced with an attitude of hedonistic and individualistic nihilism. The scientiﬁc evidence shows the need to support informal social control, school education and culture, as well as the need for orientation actions for young people, increasingly targeted and responsive to social complexity. the and the in demand for health services as well as the lack of interventions aimed at this the “Dual Pathology Group” was implemented in a unit of treatment of alcohol use disorder in Portugal. To characterize the population attending the group “Dual Pathology Group”. A sociodemographic questionnaire was used to characterize the population attending the group and to adjust the existing intervention, a questionnaire to characterize knowledge about the consequences of alcohol consumption, hospital anxiety and depression scale (HADS), and inventory of psychopathological symptoms (BSI) 10. The results show the existence of comorbidities in what refers especially to depression and anxiety. The group interventions especially to depression and anxiety are an important strategy for maintaining abstinence from alcohol consumption. Parkinson’s disease (PD) is the second most commonly neurodegenerative disease after Alzheimer’s disease which occurs to nearly 1% of the population > 50 years old. Inﬂammatory and bone biomarkers have both become valuable tools for PD diagnosis and prognosis. However, no studies have examined these markers in Saudi patients diagnosed with PD. To assess the biomarkers and proinﬂammatory cytokines from blood with PD in serum. In our study, we included 26 patients with PD and 24 controls. Blood samples were withdrawn from subjects with PD and their matched controls. Biomarkers multiplex assay from Milliplex was used to assess the levels of IL-1B, IL-6, TNF- α , osteoprotegerin (OPG), osteopontin (OPN), and PTH (parathyroid hormone). Data was analyzed using the Statistical Package, GraphPad Prism. We found that IL-1ß cytokine is signiﬁcantly higher in patients with PD ( p value = 0.0014). However, there are no statistically signiﬁcant variances found among the two studied groups with regard to the IL-6 and TNF- α cytokines levels. We also found that levels of PTH are decreased in the PD subjects than the age-matched controls ( p value = 0.003). Also, the bone matrix glycoproteins, including osteoprotegerin (OPG) and osteopontin (OPN), are signiﬁcantly up regulated ( p value = 0.04 for OPG and p value = 0.003 for OPN), as compared to the controls. Our ﬁndings are consistent with the possibility that inﬂammatory and bone markers can be used as biomarkers in PD prognosis. However, to clarify the natural role and consequence of these markers in PD pathology, further larger cohort studies are needed. abusers and of Biomarkers assay to the of (SAP), and (CRP) in and p and p value Alzheimer’s disease (AD) is considered to be the most common neurodegenerative disorder. While the amphetamine causes dangerous physical and psychotic problems to the human body, amphetamine has more prevalence of distribution in our community. Some speciﬁc inﬂammatory biomarkers are linked to AD. The identiﬁcation of neurodegenerative biomarkers will help in understanding pathogenesis, identifying disease prior to the onset of the symptoms and exploring a new therapeutic method. On the same line, perivenous studies found that those biomarkers were found in amphetamine abusers. This study aims to investigate the association between AD and amphetamine addiction. This is a case-control study. Seventeen amphetamine-drug abusers with age less than 40 were recruited from Al Amal Psychiatric hospital. Matched age and sex healthy subjects were recruited, as well. After obtained ethical approval and informed consent, serum was thrown to measure alpha 1 antitrypsin, Pigment epithelium-derived factor (PEDF) and macrophage inﬂammatory protein-4 (MIP-4) using Luminex technique. Alpha 1 antitrypsin, PEDF, and MIP-4 levels showed a signiﬁcant increase in amphetamine-drug abusers compared to healthy control ( p = 0.03, p = 0.001, and p = 0.012; respectively). This study highlighted the importance of the interaction and association between the changes of those inﬂammatory biomarkers and the development of AD in the amphetamine- abusers. various immune cells are produced to counter its e ﬀ ect, including angiogenic molecules, cytokines, and chemokines. These molecules can serve as potential biomarkers in monitoring the progress or diagnosis of ischemic stroke. This project aimed at investigating the angiogenic molecules that might be used as biomarkers in plasma of ischemic stroke patients. The plasma from selected ischemic stroke candidates from KAUH was isolated from peripheral blood and analyzed using Luminex Milliplex technology; Statistical analysis was performed using Prism 7 software. The obtained results show that the di ﬀ erence between ﬁve biomarkers varied between patients and control, where we found that there were signiﬁcantly high serum levels of angiopoietin, endoglin, endothelin-1, and VEGF-A angiogenic biomarkers compared to the controls, whereas the G-CSG was less signiﬁcant. The correlations coe ﬃ cient of measured angiogenic biomarkers among controls showed there were no signiﬁcant correlations. In patients, signiﬁcant results were obtained showed there was a strong relationship between angiopoietin, endoglin, endothelin-1, and VEGF-A angiogenic biomarkers. The current diagnostic investigations can be used as parameters for the determination of stroke and its possible causes. Correct diagnosis and cause-determination is the best possible solution for the prevention and treatment of ischemic stroke. Luminex technology is an e ﬃ cient tool for the assessment of di ﬀ erent angiogenic.


Loretta Breuning
Inner Mammal Institute, USA; loretta@innermammalinstitute.org The good feeling of dopamine is released when an animal steps toward meeting its needs. A young monkey learns to find food because dopamine rewards each step that works. Our human ancestors foraged constantly to survive, and dopamine made them feel good on the quest. We have inherited a brain that rewards us with dopamine when we step toward rewards. The brain defines rewards with neural pathways built from past dopamine flows. Unsustainable dopamine strategies often result. To stop a harmful reward strategy, a person needs a new reward strategy to replace it with. We can't just abstain from dopamine because it's the brain's signal that survival needs are being met. Anyone can learn the natural way to stimulate the joy and excitement of dopamine: by stepping constantly toward meeting needs.

Austin Mardon
The Antarctic Institute of Canada, Canada; aamardon@yahoo.ca In a rousing story, two psychological wellness advocates Austin Mardon and his wife Catherine Mardon have been battling with schizophrenia and post-traumatic stress disorder for a significant part of their lives. Schizophrenia is a serious mental illness that affects large amounts of population both in Canada and abroad. Schizophrenia is treated variably around the world, with different medications being used. The aim of this study was to examine how compliance with treatment for schizophrenia Integrated calm assertive response (ICAR) is an innovative protocol for various methods of calming the body and installing missing neuro programs into your mind (like software) to create new neuro pathways of positive resources (on your hard drive) to the mind's automatic responses (subconscious). ICAR is based on the science of neuroplasticity and the art of psychology, created for adolescents with adverse childhood experiences (ACES) using trauma informed care ethics and values. Studies show that your experiences are constantly changing your brain; ICAR creates the new experience for the client to create a new self by rewriting the story of their early childhood experiences and installing missing resources. ICAR is unique to the individual with their inputting their culturally competent strengths to build up their inner peace and self-confidence, thus they no longer respond to negative energetic situations. Filling the gaps of what they did not receive during the first seven years of development creates a sense of wholeness in their core self. Changing their life story in the present creates new streams of thoughts feelings and actions by having a new sense of calm, relaxed, well-being and confidence in reacting to environmental triggers.

Shiyong Peng
Xinxiang Medical University, China; 171010@xxmu.edu.cn Genome-wide association studies have confirmed that schizophrenia is an inheritable multiple-gene mental disorder. Longitudinal studies about depression, first-episode psychosis, and acute psychotic relapse have mostly searched for brain imaging biomarkers and inflammatory markers from the blood. However, to the best of our knowledge, the association between enzymatic activities with diagnosis or prediction of treatment response in people with schizophrenia has barely been validated. Under the Longitudinal Study of National Mental Health Work Plan (2015-2020), we have studied a subsample of approximately 36 individuals from the cohort with data on palmitoyl-protein thioesterase-1 enzymatic activity from first-episode psychosis (FEP) and performed a bivariate correlation analysis with psychiatric assessment scores. After adjusting for sex, age, body mass index (BMI) and total serum protein, our data demonstrated that PPT1 enzymatic activity is significantly associated with schizophrenia and its Positive and Negative Syndrome Scale (PANSS) scores. This longitudinal study compared the PPT1 enzymatic activity in FEP schizophrenia patients and healthy volunteers, and the former exhibited a significant 1.5-fold increase in PPT1 enzymatic levels (1.79 mM/hr/mL, and 1.18 mM/hr/mL; p < 0.05; 95% CI, 2.3-2.9, and 1.4-1.8). The higher PPT1 enzymatic levels in FEP schizophrenia patients were positively associated with larger PANSS scaling scores (r = 0.32, p = 0.0079 for positive scaling; r = 0.41, p = 0.0006 for negative scaling; r = 0.45, p = 0.0001 for general scaling; and r = 0.34, p = 0.0048 for PNASS-S scaling). Higher enzymatic PPT1 in FEP schizophrenia patients is significantly associated with increased PANSS scaling values, indicating more serious rates of developing psychosis. Enzymatic activity of PPT1 ma provide an important new view for schizophrenia disorders.

New Dimensions of Stress and Its Numerical Modeling
Ktiri Fouad ISPITS, Rabat, Morocco; f_ktiri@yahoo.com In the present study, we introduce a new stress approach, which completes the transactional theory of Folkman and Lazarus (1984). It is a numerical model in which we take into account another variable named PSS (previous state of stress) that we estimate necessary to explain why psychological state of stress occurs or not. In our model, stress is presented in the form of a mathematical function (equation) of three variables (PSS, SV, R). By evaluating each of these components, this equation enables us to evaluate the generated stress intensity of a person. By improving this formula, the present model enables us to take into account another type of stimulus (positive stimulus) and to evaluate it. Many instances of daily stress that take into account these new dimensions have been cited. The stress formula efficiency has been tested by applying it on these examples and to some concepts like violence and stress accumulation. RQSI (required quantity of stress index) is an index that we have introduced in our numerical model. The calculated RQSI enables us to evaluate the average amount of stress (positive or negative) that a person receives from each stimulus he has been exposed to during a period of time. A new definition of stress phenomena, on the basis of our new numerical data model, is proposed.

Monique Brion and Alain Maurel
Paris Descartes University, France; monique.brion@parisdescartes.fr (M.B.) Today, tobacco smoking is a well-established risk factor for the development and progression of number of chronic diseases and among these, periodontitis. Although this has been an accepted fact for years, many hypotheses remain, concerning smoke exposure. The aim of this study was to compare the gingival blood flow (GBF) of young smokers and non-smokers with healthy periodontium. Sixty volunteers 30 smokers and 30 non-smokers were included in the study. The test group (smokers) was composed of 15 females and 15 males mean age 37 ± 12 years. The control group (nonsmokers) included 15 females and 15 males mean age 24 ± 6 years. Smokers had an average of 19.3 ± 3.6 packet years of smoking and were all checked for CO exhaled, urinary cotinine level, and Fagerström index. Blood flow was evaluated with a laser Doppler flow meter (Periflux 4 ® , Perimed, Järfälla, Sweden) on the gingival papillae mesial to the right maxillary canine. Measurements were performed in the morning between 10 AM and 12 AM. All subjects were instructed not to smoke within 2 h prior to the test. All volunteers were in excellent health, and the non-smokers had never smoked. The mean GBF for the test group was 62.14 ± 64 PU (perfusion unit), versus 182.4 ± 16.7 PU for the control group. This difference is statistically significant (p < 0.001). In the control group, the mean GBF was lower in females than in males (149.6 ± 7.8/188.6 ± 24.4). This could be because the majority of the females were on the birth pill. However, this was not observed in the test group. The present study showed that GBF was significantly lower in young otherwise healthy smokers than in matchable non-smokers. Older adults who drink problematically (OADP) are the largest, and growing, group of substance users among those 55 and older. This group often chooses moderation as a goal instead of abstinence. Nothing is known about older adult problem drinkers' craving in response to drinking contexts-an important area to understand for treatment in the context of moderation as a goal. To explore the association between alcohol cue/context and both presence and intensity of craving among heavy drinkers 55 and older. Data were from a randomized controlled trial testing stepped care brief interventions for alcohol use disorder. Participants were: 97 aged 22-54 years and 66 aged 55+ years. For this study, we focused on the individual level responses describing drinking contexts using ecological momentary assessment across 12 weeks. Data were analyzed using a multilevel-model approach. When controlling for AUD severity, overall, OADP were significantly less likely to experience any craving than younger counterparts. All contexts predicted craving among OADP, as they did among younger counterparts. Interaction terms revealed that one particular alcohol cue was less likely to elicit any craving among OADP compared to younger counterparts: a location where alcohol is served. For those experienced craving, overall, being older increased the intensity of craving by half a unit; however older adults were less reactive to being in a location where alcohol was served. Understanding how context drives craving in unique ways among OADP allows for tailored and concrete points for intervention, particularly mobile interventions.

The Potential Risks of Cyber Suicide Challenges in a Schizophrenic Patient
Alexandra Popescu 1 , Simona Trifu 2 and Antonia Trifu 2 1 "Prof. Dr. Alexandru Obregia" Psychiatry Hospital, Romania; Alexandra110493@yahoo.com 2 University of Medicine and Pharmacy "Carol Davila", Romania The "Blue Whale Challenge" is a social media phenomenon thought to have originated in Russia in the year 2015. It is purported to be a "game" in which the "player" receives up to 50 tasks by an online administrator. The initial tasks are more inclined to self-harm and general antisocial behaviour, the final task being suicide. The name is believed to be derived from "beached whales" suggesting suicide. Although the target public of this disturbing game consists mainly of teenagers it has proven to be eminently more harmful among mental health patients of all ages especially the ones with psychotic disorders. When psychosis overlaps an already dangerous online "game" the potential risks are magnified. Our case study intends to highlight the increased risks, both towards self and others, in a 35-year-old patient, a former police agent, diagnosed with paranoid schizophrenia approximately 10 years ago, now resistant to treatment. Methods included emergency psychiatric hospitalization, medical surveillance, daily psychiatric monitoring, psychological evaluation, psychodynamic interview, and case study. The patient is not only fully engaged in the so-called "suicide game" but, because of his delirious ideation and bizarre psychotic behaviour, his mind is now inventing additional tasks through the means of imperative commands. His current task is to go to three different psychiatrists and prove his sanity in front of them to "release him" from his diagnosis as he motivates that the objective of the Blue Whale Challenge is more than committing suicide at the end, it is the liberation of the soul. When speaking about former tasks, he confessed to many previous acts of violence. Additionally, he believes that everyone is receiving orders from the Blue Whale, including the medical staff, making it difficult to establish a trustfilled doctor-patient relationship. In 2019, it is estimated that there will be around 2.77 billion social media users around the globe, up from 2.46 billion in 2017 according to statistica.com. Among them, there are inevitably mentally ill users making cyber-crime a greater risk.

Jihene Mrabet
American University in the Emirates, UAE; jihene.mrabet@aue.ae What narcissistic foundations can we hope to build when a child is born out of maternal desire, apart from a sufficiently good object investment? What future hope for the evolution of his subjectivity prey to a fantasy experience of submission, domination and affective ambivalence? What place to seek for in a family dynamic raising a big brother to the omnipotent status? What recourse to adopt in order to survive the destructiveness of internal objects, threatening and barring the road to the hallucinatory realization of desire? These are the questions we asked ourselves when we encountered the Addiction; when we encountered Ms A in our office and when she started exposing her struggle for existence. A struggle with Addiction, a struggle against Addiction. Addiction she considered once as her best, friend, helping her denying her psychic distress. Addiction that proved destructive, plunging her into more suffering. The addiction that allowed her to survive her pains imprisoned her in a vicious cycle of ephemeral enjoyment and exposed her to a certain death, breaking any investment with her primary love objects.

Lavinia Mclean and Rebecca Penco
International Islamic University Malaysia, Malaysia; lavinia.mclean@tudublin.ie (L.M.) It is now accepted that children in care are a particularly vulnerable group, and at a greater risk of poor health outcomes. This is recognized as stemming from these young people's experiences of poverty, trauma, abuse and from a lack of access to resources. Children living in residential care are therefore argued to represent a particular group of young people who face significant obstacles, whilst having access to a range of resources designed to enhance their wellbeing. The current research was designed to explore the levels of wellbeing in young people living in care in Ireland, and the strategies used to enhance these young people's ability to thrive. Social care workers perceptions and behaviors in relation to young people's wellbeing were explored in semi structured interviews. The main themes that emerged from the data related to the stress and anxiety that young people faced in their lives and the potential benefit of physical activity interventions to overcome this. The impact of significant relationships in young people's lives in terms of their wellbeing was also recognized as central to both the experience of stress, and to developing positive outcomes. The results are discussed in relation to recommendations for developing young people's wellbeing and for future research.

Usefulness of Neuroimaging Studies in the Diagnosis of Addictions
Juan Manuel Isusi Alcazar 1,2 1 Hospital Angeles Metropolitano, Mexico; manuelisusialcazar38@gmail.com 2 Military Hospital for Women and Newborn, Mexico Individual human subjects can be studied using multiple positron-labeled radiotracers to test more than one facet of brain function. PET and SPECT have been used to help us understand many aspects of the pharmacokinetics and pharmacodynamics of abuse drugs, and have made valuable contributions in terms of drug mechanisms, drug interactions (e.g., cocaine and Alcohol) and drug toxicity. They have also been used to study the acute effects of drugs on active drug addict populations and normal controls, and to assess the neurochemical consequences of drug-abuse candidate therapies. A particularly productive strategy has been the use of PET in conjunction with neuropsychological tests of subjects, to allow the correlation of data from images with unique human aspects of the effects of drugs, such as euphoria and desire.

Monique Brion and Alain Maurel
Paris Descartes University, France; monique.brion@parisdescartes.fr In antiquity, the Greek and the Romans smoked essentially a pipe, however, they did not smoke tobacco leaves but pear tree, eucalyptus, or other leaves since the tobacco plant did not grow at that time in Europe. Pipes belonging to 1000 yrs. BC were also found in South and Central America where tobacco smoking was a habit particularly during religious ceremonies. Inca or Aztec warriors would smoke before combating to stimulate bravery and fight against hunger and fatigue. 1492 Christopher Columbus discovered America and among the many plants and seeds brought back to Spain and Portugal by great explorers, there was tobacco. Rapidly, tobacco use became both a medicinal and recreative habit in Europe. Jean Nicot de Villemain who was ambassador of France to Portugal sent some tobacco leaves to the court of France to help take care of the migraines of Queen Catherine de Médicis. Although great prevention campaigns have favoured a reduction in the prevalence of smoking in recent years, tobacco smoking remains one of the major preventable causes of ill-health and premature deaths worldwide. Smoking today means more than 6 million premature deaths in the world per year. Tobacco smoke contains many carcinogens and toxic substances as well as nicotine, a strong psychoactive addictive drug. Such substances include flavourings such as sugar, menthol, and even more hidden substances such as ammonia that help soften the taste and sooth irritation of the oral tissues. It is essential to orient prevention towards the younger populations, the health risk for youths being greater than that of adults. However, teenagers are not concerned by diseases that could possibly occur at age 50, 60, or over. Talking to teenagers about their attractiveness, their smile, their breath, the black stains on teeth, and halitosis caused by tobacco smoking could be a better approach. Although the benefits of smoking have been recognized since antiquity, none today can deny that it is definitely harmful for health. However, some specific features of nicotine in it could probably be helpful in number circumstances.

Philip Henschke
Mercy Hospital for Women, Australia; PHenschke@mercy.com.au The endocannabinoid system plays a complex role in the development of the fetal, infant and adolescent brain. From very early on in fetal development, endogenous cannabinoids and CB1 receptors are identifiable in white matter and regions of cellular proliferation. They are thought to play key roles in crucial events such as neuronal proliferation, migration, and synaptogenesis. The use of exogenous cannabinoids has the potential to result in supra-physiological stimulation and impact normal central nervous system development. Currently, there are limited data about the safety and potential consequences of using cannabis for medicinal purposes during pregnancy. Further, there is very limited data about the safety of prescribing cannabidiol during pregnancy. Cannabidiol has low affinity for CB1 and CB2 receptors which may mitigate against potential impacts on the developing brain. However, evidence suggests that cannabidiol modulates the expression of key placental transporters which may permit altered transport of medications, naturally occurring carcinogens, hormonal precursors and apoptotic molecules, which in turn may impact on pregnancy outcomes. This presentation will focus on what is currently known about the potential impacts of use of medicinal cannabis products in pregnancy.

Sherif Darwish Abdalla
Recovery Alex for Psychiatry and Addiction Treatment, Egypt; shd203@yahoo.com Every addiction professional who work with patients has struggled at some time with his patients' motivation and sometimes stood helpless trying to move them one step further in the trans-theoretical model of motivation (motivational cycle of Prochaska and Di-clemente). The five stages of the motivation from pre-contemplation, contemplation, planning, action, and maintenance, with the sometimes inevitable and frustrating relapses, has always helped in further understanding PF patients and choosing the right techniques to handle them. Unfortunately, a lot of unexpected events can happen that make the patient relapse unpredictably. In this workshop we will try to shed some light on some behaviors that the patient can undergo that may give us a clue on where exactly in the motivation cycle he is. Secondly, we will try to make some links and connect ideas about his real understanding on the behavior of change and how to prioritize our actions with the patient. In this workshop, we will try first to explain further these insights and how they can change our practice and understanding to motivational interviews. Then, we will ask the participants to make role plays to practice these new techniques.

Screen Viewing: Is It the Cause or the Consequence of Delayed Speech Development in Children?
Elham Khattab Aljammas and Zaina Wale Aziz Ninevah University, Iraq; elham.aljammas@gmail.com Our children rely on technology for the majority of their lives, particularly during the last 2decades, which limits challenges to creativity, vision, and development of optimal sensory and motor functioning. This new lifestyle results in a delay of the developmental milestones especially their speech. Therefore, in this study, we tried to identify the association between screen viewing and delayed speech in both toddlers and preschool children. The aim of this study is to identify the impact of screen exposure on delayed speech development in both toddlers and preschooler children, and to interpret if there is an association between screen viewing variables and child-maternal characteristics in both groups. A case-series study was carried on 237 children with speech delays as a chief complain, divided into two groups: toddlers and preschooler children, range between 15-60 months, who did programme visits to the private psychiatric medical clinics from January 2017 to January 2019 in Mosul city. Speech delays diagnosed by the linguistic specialist. Parental reports via psychiatric medical clinics interview applied as a measure of screen media use in children. Screen viewing variables and child-maternal characteristics interviewed in both groups. All children followed up for 6months after the departure of the screen media. This study included 237 children with delayed speech development, divided into two groups: toddlers 47 (19.8%), and 190 (80.2%) preschoolers, range between 15-60 months. One hundred eighty-four (77.6%) were male children with a male to female ratio 3.47:1. Approximately 94% of children had speech delays while 12 children were of no speech. The first time of exposure to screen in both toddlers and preschooler children (<24 months of age), was 82.9% and 64.7% respectively. A significant association between screen viewing and speech delays was detected in both groups, notably those started screen exposure at <24 months of age and spent ≥4 h/day on screens. In both age groups, a marked association identified between high exposure to a screen (≥4 h/day) and child-maternal interaction during exposure as well as the maternal level of education. Speech improvement identified in 36.7% of children following 6months of the departure of the screen devices. This study demonstrated the positive relations between initial onset and high frequency of screen viewing and speech delays in young children, especially in toddlers. To support healthy child development in digital life, immediate attention from parents, instructors, researchers and health specialists on the proper use of screen time according to child age, is recommended.

Addictions, Deviance and Social Conditioning among Young People in Italy
Antonio Tintori Sapienza University of Rome, Italy; antonio.tintori@irpps.cnr.it Providing a broad interpretation of youth problems related to alcohol and drug addictions, as well as from the internet, constitutes an inevitably complex scientific work that involves significant relationships with both sociological and psychological concepts and variables. Among these, the ascribed social status, gender, social context, type of school attended, and self-esteem have a recognized importance. The aim of this study is to analyze the correlation between addictions and interpersonal relationships, lifestyles, social deviance, such as bullying and cyber-bullying, and stereotypes about diversity. The speech will be particularly focused on the scientific recent results of the GAP project of the Italian National Research Council. This project consists of making periodical sample surveys conducted in electronic and telematic mode with the help of structured and semi-structured survey questionnaires and innovative research tools refined and validated over multiple applications that can be filled out both in the presence of the interviewer and remotely. The results of the GAP project are statistically representative of the Italian student population aged 13/19 years (overall, the GAP project has so far involved over 6000 students). The scientific evidence indicates the deterioration and mutation of traditional social relations towards a virtual vision of commonality and collectivism. This occurs in the presence of widely tolerant opinions towards the use and abuse of alcohol, new and traditional drugs, and virtual relationships, which are experienced with an attitude of hedonistic and individualistic nihilism. The scientific evidence shows the need to support informal social control, school education and culture, as well as the need for orientation actions for young people, increasingly targeted and responsive to social complexity.

Donna L. Roberts
Embry-Riddle Aeronautical University, USA; donna.roberts@erau.edu Addiction is a serious and ever-increasing problem, with escalating costs both at the macro (society) level and the micro (personal) level. Statistics on the opioid crisis are shocking. Opioid abuse was declared a nationwide public health emergency in October 2017 after the number of deaths in the U.S. from opioid abuse rose to over 40,000 per year. But statistics only tell us the big picture-the macro view. The true agony of this crisis can only be fully understood at the human level-the micro level-where lives are destroyed, and families devastated. The aim of this study is to provide a perspective on the opioid crisis from both a macro view based on the statistics and a micro view that emphasizes the human element. Statistics were drawn from the National Institute on Drug Abuse (NIDA), the U.S. Department of Health and Human Services (HHS), the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) in order to depict the magnitude of this drug crisis and its consequences for society. Case studies were analyzed to help understand the impact of opioid abuse on individuals and families. More than two million Americans have become dependent on or abused prescription pain pills and street drugs. About 11.4 million Americans misused prescription pain medicine in 2016 and 2017, according to the HHS, along with 886,000 people using heroin. During 2017, there were 49,068 overdose deaths that involved an opioid, according to the CDC. The number of overdose deaths related to heroin increased 533% between 2002 and 2016. More than 130 people died every day from opioid-related drug overdoses in 2016 and 2017, according to the HHS. This epidemic is fueled not only by an increased use of prescription opioids, but also an increase in the use of heroin and illegally-produced fentanyl. The year 2019 marks 20 years since Purdue Pharma launched its flagship signature drug, Oxycontin, and unleashed this epidemic that has touched everyone from celebrities to common citizens, in metropolitan, suburban and rural areas alike. The abuse of opioids has spread across every demographic in the U.S.

Hadi Eltonsi
Cairo University, Egypt; mhmeltonsi@yahoo.com Clients receiving psychotherapy require several sessions even if with drugs and use of will power over time. The purpose of the treatment is achieving immediate, nonmedicinal, effortless, painless healing without complications. For personality development, relief of neurotic disease, psychosomatic symptoms and diseases, treating emotional obesity and smoking. After joint analysis with client and a definition of psychological and physical goals of treatment, the healer as a trained behavioral, cognitive, and logo psychotherapist arrives with client to a new corrected understanding of the case and roots of conflicts in childhood, taking around two hours. Then, in less than an hour, performs non-verbal interpersonal hypnosis with transfer of energy and telepathy to client till deep sleep, when he implants the required personality, ideas, emotions, motives, and attitudes into the subconscious embodying the required state. The subconscious and conscious mind will have the same agreed upon analysis and targets for immediate results in that session of three hours. The healer got a patent in Egypt 2016 for his discovery of the immediate healing for personality development and for mentioned purposes. Up till now treating more than 700 cases aging between 12 and 80 years with relief of more than 80% of cases either totally or mostly. Results include immediate non-medicinal, revolutionary, life-transforming healing for a wide spectrum of cases achieving higher grades of maturity, insight, harmony, and efficiency, saving client time, effort, interests, and complications.

Darren Aitchison
National Louis University, USA In this study, the research team built upon their prior work on training teachers on the use of school based restorative justice technologies using behavioral skills training and performance feedback. This study is directly related to those prior works as part of a design-based research project, or DBR. This article contains the fourth and fifth iterations for this project. In the first phase, the discipline that restores model is used in comorbidity with the good behavior game in three public school classrooms. The second phase is also DTR and the GBG, but it follows one class across different instructors, and a hero procedure is introduced as well. In both phases experimental control is demonstrated. A brief academic analysis is also presented. Evidence of functional relations is not as strong, but it does indicate that the use of the GBG in combination with restorative justice does not take away from classroom instruction, as some have suggested.

Suchi Deshpande
Happiness Strategist and Laughter Coach, Singapore; suchi11sg@gmail.com There is a lack of awareness about what happy hormones are, how to use positive words to feel energetic and what can be done to get happy hormones. People tend to feel unhappy for multiple reasons and neuropathic pain adds on Stress levels of not only the patient but the caregivers as well. Being in pain leads to feeling depressed and anxious in some cases. A review of books and research shows that getting a dosage of happy hormones will not only ease slight pain of the patient but feeling happy will also have a positive impact on the recovery of the patient. Adopting Laughter therapy and getting hormones which makes one feel good will help many to recover from neuropathic pain/long term sadness caused by having grief, anger or resentment, depression & anxiety. One needs to work on his/her energies using Laughter Therapy which is a positive approach for not having Depression & Anxiety caused by Neuropathic pain. The therapy can be used as a Holistic way to recovery. Laughter therapy, which includes ways to get the dosage of happy hormones promotes overcoming depression & anxiety caused by neuropathic pain, is a fun way to manage pain. Repeated sessions to be conducted to remind patients that life while having pain or during the recovery should go beyond just seeking medical and counselling help and also include rebuilding spiritual, physical, emotional, relational and mental health. The model has been put together from for testing in many settings including hospitals, elderly homes and senior citizen centres. This is not a research book or paper. It is just an effort to demystify the help available for depression & anxiety caused by pain. It is an attempt to motivate and encourage people to seek help and take a simple approach to remember and work on all aspects of their recovery. Clinical epidemiology supported by neurosciences shows the existence of a strong interconnection between psychiatric disorders and substance use. This comorbidity is recognized by the World Health Organization as Dual Pathology. It is estimated that a percentage varying between 40% and 70% of users with psychiatric disorders also exhibit substance use. The existence of this comorbidity leads to a greater number of relapses and the more chronic course of psychiatric pathology with more frequent exacerbations and worse response to treatment The need for a multidisciplinary approach to these individuals in different treatment contexts has therefore arisen in order to optimize results in the treatment, rehabilitation and enhancement of social capacities. Due to all the aforementioned and taking into account the increase in demand for health services as well as the lack of interventions aimed at this population, the "Dual Pathology Group" was implemented in a unit of treatment of alcohol use disorder in Lisbon, Portugal. To characterize the population attending the group "Dual Pathology Group". A sociodemographic questionnaire was used to characterize the population attending the group and to adjust the existing intervention, a questionnaire to characterize knowledge about the consequences of alcohol consumption, hospital anxiety and depression scale (HADS), and inventory of psychopathological symptoms (BSI) 10. The results show the existence of comorbidities in what refers especially to depression and anxiety. The group interventions especially to depression and anxiety are an important strategy for maintaining abstinence from alcohol consumption.

Prevalence and Forms of Violence among Families with Alcohol Dependence Members in Albania
Shpetim Dokasni 1 , Dorina Osmanaj 1 , Edlira Plaka 2 and Ervin Toci 3 1 University Medical Center of Tirana "Mother Teresa", Albania; doksanishpetim@yahoo.it (S.D.) 2 Primary Medical Service, Albania 3 University of Medicine, Albania Alcohol abuse and alcoholism (alcoholic dependence) are major risk factors who contribute to domestic violence, and specifically to sexual violence worldwide. In Albania, there are not enough data for sexual violence due to alcoholism, probably from oriental influence to cultural tradition. The aim of this study was to determine the presence of domestic and sexual violence among families of alcohol abusers in Albania. A study including 168 alcoholic patients was carried out during September 2016 in Tirana, Albania. Patients showed up at the premises of Alcohology Clinic, University Hospital Center "Mother Teresa". Alcoholic dependence was determined by the addiction specialist based on ICD10 criteria. Social workers monitored subjects, behavioral problems. Phone calls were made to monitor the selected cases and confidential appointments with wives of alcoholic patients were carried out to assess episodes of violence. Among the study participants, domestic violence was detected in 71.4% of cases and sexual violence was reported in 53% of cases. Domestic violence generally included verbal offense, various forms of insulting, rude or improper talking, threats of physical abuse, etc. Meanwhile, sexual violence generally included betrayal doubts and suspicions directly and openly targeting the wife, unfaithful relationships or extramarital sexual relationships, attempted raping or forced sexual activity. Domestic and sexual violence is a common phenomenon among families living with alcohol dependence member(s) in Albania. Further interventions are needed to address these aspects in family settings.

Rebecca Penco and Lavinia McLean
Technological University Dublin, Ireland; rebecca.penco@tudublin.ie Stress is an aspect of our lives we have almost come to accept as our norm. High performance athletes have been identified as a specific group who face increased levels of stress, due to intensive training load, competition and environmental pressures. The current research was conducted with a group of high-performance athletes in Ireland (n = 124), to explore the experience of stress and any relationship with coping strategies and social support. The findings indicated a negative correlation between tasks focused coping strategies and perceived stress. While female athletes reported a higher level of stress overall, there was no significant gender difference found in coping strategies or levels of perceived social support. The findings are discussed in relation to recommendations for managing stress and future, research in the area. Parkinson's disease (PD) is the second most commonly neurodegenerative disease after Alzheimer's disease which occurs to nearly 1% of the population >50 years old. Inflammatory and bone biomarkers have both become valuable tools for PD diagnosis and prognosis. However, no studies have examined these markers in Saudi patients diagnosed with PD. To assess the biomarkers and proinflammatory cytokines from blood with PD in serum. In our study, we included 26 patients with PD and 24 controls. Blood samples were withdrawn from subjects with PD and their matched controls. Biomarkers multiplex assay from Milliplex was used to assess the levels of IL-1B, IL-6, TNF-α, osteoprotegerin (OPG), osteopontin (OPN), and PTH (parathyroid hormone). Data was analyzed using the Statistical Package, GraphPad Prism. We found that IL-1ß cytokine is significantly higher in patients with PD (p value = 0.0014). However, there are no statistically significant variances found among the two studied groups with regard to the IL-6 and TNF-α cytokines levels. We also found that levels of PTH are decreased in the PD subjects than the age-matched controls (p value = 0.003). Also, the bone matrix glycoproteins, including osteoprotegerin (OPG) and osteopontin (OPN), are significantly up regulated (p value = 0.04 for OPG and p value = 0.003 for OPN), as compared to the controls. Our findings are consistent with the possibility that inflammatory and bone markers can be used as biomarkers in PD prognosis. However, to clarify the natural role and consequence of these markers in PD pathology, further larger cohort studies are needed.

Parkinson's Disease-Related Biomarkers That May Appear in Amphetamine Abusers
Abdulaziz Al-Kaabi, Aziza Al-Rafiah and Rania Magdami King Abdulaziz University, Saudi Arabia; aalrafiah@kau.edu.sa Parkinson's disease (PD) is one of the most common neurodegenerative disorders. It is characterized by degeneration of dopaminergic substantia nigra pars compacta (DASNc) neurons. Amphetamines addiction may cause a serious of psychotic and physical damages to our bodies. Some of the inflammatory biomarkers related to PD may appear in the blood of amphetamines abusers. In this study, we aimed to quantify the inflammatory biomarkers in amphetamine abuser serum samples to find the link between the presence of these biomarkers in those abusers and the incidence of PD. In our study, seventeen amphetamine drug abusers with age less than 40 were recruited from Al Amal Psychiatric hospital. Matched age and sex of healthy subjects were also recruited. Blood samples were withdrawn from both groups. Biomarkers multiplex assay from Milliplex was used to assess the levels of serum amyloid-P (SAP), complement C4 and c-reactive protein (CRP) in serum samples. Data was analyzed using the Statistical Package, GraphPad Prism. We found that SAP and CRP levels are significantly higher in amphetamine abusers compared to controls (p value = 0.001 and p value = 0.029) respectively. However, there are no discernible differences found between the two studied groups with regard to complement C4 level. Our findings indicate that the increased level of these inflammatory biomarkers (SAP and CRP) in the amphetamine abusers may give a potential possibility of their serum level to be a screening marker for PD incidence or progression in amphetamine abusers.

Amphetamine-Related Biomarkers That Accelerate Neurodegenerative Disorders
Mohammed Mousa Yahya Abu-Illah, Aziza Al-Rafiah and Rania Magdami King Abdulaziz University, Saudi Arabia; aalrafiah@kau.edu.sa Alzheimer's disease (AD) is considered to be the most common neurodegenerative disorder. While the amphetamine causes dangerous physical and psychotic problems to the human body, amphetamine has more prevalence of distribution in our community. Some specific inflammatory biomarkers are linked to AD. The identification of neurodegenerative biomarkers will help in understanding pathogenesis, identifying disease prior to the onset of the symptoms and exploring a new therapeutic method. On the same line, perivenous studies found that those biomarkers were found in amphetamine abusers. This study aims to investigate the association between AD and amphetamine addiction. This is a case-control study. Seventeen amphetamine-drug abusers with age less than 40 were recruited from Al Amal Psychiatric hospital. Matched age and sex healthy subjects were recruited, as well. After obtained ethical approval and informed consent, serum was thrown to measure alpha 1 antitrypsin, Pigment epithelium-derived factor (PEDF) and macrophage inflammatory protein-4 (MIP-4) using Luminex technique. Alpha 1 antitrypsin, PEDF, and MIP-4 levels showed a significant increase in amphetamine-drug abusers compared to healthy control (p = 0.03, p = 0.001, and p = 0.012; respectively). This study highlighted the importance of the interaction and association between the changes of those inflammatory biomarkers and the development of AD in the amphetamine-abusers.

Angiogenesis Biomarkers in Ischemic Stroke Patients
Yasser Almohaya, Talal Gadah, Azizah Alrafia and Ibtisam Alofi King Abdulaziz University, Saudi Arabia; aalrafiah@kau.edu.sa Stroke has become a global health issue and ischemic stroke is the most common type of stroke, affecting a significant number of populations worldwide. According to WHO, around 16.9 million individuals get stroke either annually or biannually, most of which (80%) are due to ischemia. In third world countries, the death toll stands at 70%, hence attributing to a high death rate. The approximation of death from stroke will rise at an average of 12 million by 2030. During the progress of ischemic stroke, various immune cells are produced to counter its effect, including angiogenic molecules, cytokines, and chemokines. These molecules can serve as potential biomarkers in monitoring the progress or diagnosis of ischemic stroke. This project aimed at investigating the angiogenic molecules that might be used as biomarkers in plasma of ischemic stroke patients. The plasma from selected ischemic stroke candidates from KAUH was isolated from peripheral blood and analyzed using Luminex Milliplex technology; Statistical analysis was performed using Prism 7 software. The obtained results show that the difference between five biomarkers varied between patients and control, where we found that there were significantly high serum levels of angiopoietin, endoglin, endothelin-1, and VEGF-A angiogenic biomarkers compared to the controls, whereas the G-CSG was less significant. The correlations coefficient of measured angiogenic biomarkers among controls showed there were no significant correlations. In patients, significant results were obtained showed there was a strong relationship between angiopoietin, endoglin, endothelin-1, and VEGF-A angiogenic biomarkers. The current diagnostic investigations can be used as parameters for the determination of stroke and its possible causes. Correct diagnosis and cause-determination is the best possible solution for the prevention and treatment of ischemic stroke. Luminex technology is an efficient tool for the assessment of different angiogenic.