Alcoholism

[antonlavey]

[h2]5. Why do drug addiction and mental illness often coexist?[/h2]The source document for this Digest states:

There is an increased comorbidity, or co-occurrence, of substance dependence in individuals who have mental illness as compared to individuals without any mental disorder. This indicates either a shared neurobiological basis for both, or an interaction of effects at some level. Research on the origins of both mental illnesses and substance dependence will help to shed light on treatment and prevention strategies for both. There are several hypotheses as to why mental illness and substance dependence may co-occur:

1. There may be a similar neurobiological basis to both;
2. Substance use may help to alleviate some of the symptoms of the mental illness or the side effects of medication;
3. Substance use may precipitate mental illnesses or lead to biological changes that have common elements with mental illnesses.

There is some evidence for all of these hypotheses. It is interesting that the effects of many psychoactive substances can produce psychiatric-like syndromes. For example, amphetamines and cocaine can induce psychotic-like symptoms. Hallucinogenic substances can produce hallucinations, which are an aspect of some psychoses. Furthermore, psychoactive substances regularly alter mood states, producing eithereuphoric and happy feelings, or inducing depressive symptoms, especially during substance withdrawal. Psychoactive substances can alter cognitive functioning, which is also a core feature of many mental illnesses. These factors all suggest common neurobiological substrates to both mental illnesses and substance dependence.

Some studies in the US have reported that more than 50% of the people with any mental disorder also suffer from substance dependence compared to 6% of the general population; and the odds of exhibiting substance dependence are 4.5 times higher for people with any mental disorder than for people without mental disorder (52). Clearly, there is a substantial overlap in these disorders.

The lifetime prevalence of alcohol dependence is 22% for individuals with any mental disorder compared to 14% for the general population, and the odds of having alcohol dependence if a person also has any mental disorder is 2.3 times higher than if there is no mental disorder (52). Studies in the United States over the last 20 years indicated that lifetime rates of major depressive disorder were 38-44% in people with alcohol dependence compared with only 7% in non-dependent individuals (35, 53-61). Further, approximately 80% of people with alcohol dependence have depressive symptoms (52, 62-64). An individual with alcohol dependence is 3.3 times more likely to also have schizophrenia, while a person with schizophrenia is 3.8 times more likely to exhibit alcohol dependence than the general population (52).

Higher percentages of people with mental illness, particularly people with schizophrenia, smoke tobacco compared to the general population. Depending on the particular mental illness, it has been reported that 26-88% of psychiatric patients smoke, compared to 20-30% of the general population (65-67). There are several close links between a major depressive disorder and tobacco smoking. In the US, up to 60% of heavy smokers have a history of mental illness (67, 6, and the incidence of major depressive disorder among smokers is twice that of non-smokers (65). Moreover, smokers who had a history of clinical depression were half as likely to succeed in quitting smoking than smokers without such history (14% versus 28%) (65). Epidemiological data indicate that the lifetime rates of major depressive disorder were 32% in cocaine users, and only 8 - 13% among non-cocaine users (52, 54, 56, 58, 69).

There is also a high degree of comorbidity of schizophrenia with psychostimu- lant use. Psychostimulant use is 2-5 times higher among patients with schizophrenia compared to people without schizophrenia, and more prevalent than in other psychiatric populations (70). Thus, it seems clear that substance dependence shares a considerable link with mental illness. Although most of the research on comorbidity has been carried out in only a few countries and the cultural validity of the data is unknown, neuroscience research into the treatment and prevention of one disorder will be beneficial to the other.

 

[stuntman mike]

a simpler way to illustrate the pathology of alcoholism is the peculiar inability to utilize past experiences to deter repeating behavior that will likely result in grave consequences. it's as if some vital connection is missing from the brain that far exceeds some kind of moral failing or weak personal commitment. i speak from personal experience.
and once again i retierate: the amount you drink has nothing to do with being an alcoholic. 

 

[stuntman mike]

a simpler way to illustrate the pathology of alcoholism is the peculiar inability to utilize past experiences to deter repeating behavior that will likely result in grave consequences. it's as if some vital connection is missing from the brain that far exceeds some kind of moral failing or weak personal commitment. i speak from personal experience.
and once again i retierate: the amount you drink has nothing to do with being an alcoholic. 

 

[antonlavey]

[h2]The Neurobiology of Substance and Behavioral Addictions[/h2]

Jon E. Grant, JD, MD, MPH, Judson A. Brewer, MD, PhD, and Marc N. Potenza, MD, PhD



CNS Spectr. 2006;11(12)924-930
[table][tr][td]
Needs Assessment
Over the last decade, the volume of research on behavioral addictions has grown significantly, particularly in the neurobiology of these disorders, their relationship to substance addictions, and effective treatment interventions. This article provides the most up-to-date knowledge regarding the pathophysiology and treatment of these behaviors.

Learning Objectives
At the end of this activity, the participant should be able to:
• Understand the clinical characteristics of behavioral addictions.
• Understand the shared neuropathophysiology of behavioral and substance addictions.
• Discuss the available treatments for behavioral addictions.


Target Audience: Neurologists and psychiatrists

CME Accreditation Statement

This activity has been planned and implemented in accordance with the Essentials and Standards of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Mount Sinai School of Medicine and MBL Communications, Inc. The Mount Sinai School of Medicine is accredited by the ACCME to provide continuing medical education for physicians. 


Credit Designation
The Mount Sinai School of Medicine designates this educational activity for a maximum of 3 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity


Faculty Disclosure Policy Statement

It is the policy of the Mount Sinai School of Medicine to ensure objectivity, balance, independence, transparency, and scientific rigor in all CME-sponsored educational activities. All faculty participating in the planning or implementation of a sponsored activity are expected to disclose to the audience any relevant financial relationships and to assist in resolving any conflict of interest that may arise from the relationship. Presenters must also make a meaningful disclosure to the audience of their discussions of unlabeled or unapproved drugs or devices. This information will be available as part of the course material.


This activity has been peer-reviewed and approved by Eric Hollander, MD, chair at the Mount Sinai School of Medicine. Review date: November 13, 2006. Dr. Hollander does not have an affiliation with or financial interest in any organization that might pose a conflict of interest.

To Receive Credit for This Activity

Read the three CME-designated articles, reflect on the information presented, and then complete the CME quiz. To obtain credits, you should score 70% or better. The estimated time to complete all three articles and the quiz is 3 hours. Release date: December 2006. Termination date: December 2008.
[/td][/tr][/table]


Return


http://mbldownloads.com/1206CNS_Grant_CME.pdf

http://mbldownloads.com/1105CNS_Olden_CMEx.pdfCNS Spectr. 2006;11(12)924-930
Dr. Grant is associate professor in the Department of Psychiatry at the University of Minnesota Medical School in Minneapolis. Dr. Brewer is a resident in the Department of Psychiatry at the Yale University School of Medicine in New Haven, Connecticut. Dr. Potenza is associate professor in the Department of Psychiatry at the Yale University School of Medicine.

Disclosures: Dr. Grant receives grant/research support from Forest, GlaxoSmithKline, the National Institute of Mental Health (NIMH), and Somaxon; and is a consultant to Somaxon. Dr. Brewer receives grant/research support from the NIMH. Dr. Potenza receives grant/research support from the Connecticut Department of Mental Health and Addictive Services, Mohegan Sun, the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, OrthoMcNeil, the United States Department of Veteran Affairs (VA), and Women’s Health Research at Yale University School of Medicine; is a consultant to Boehringer Ingelheim and Somaxon; is on the advisory board of Boehringer Ingelheim; and holds stock options in Somaxon.

Funding/Support: This work was supported by NIMH grant K23 MH069754-01A1 awarded to Dr. Grant, NIMH training grant T32 MH19961 awarded to Dr. Brewer, and National Institute of Drug Abuse grant R01 DA013039, by a VA Veterans Integrated Service Network 1 Mental Illness Research Education and Clinical Center and Research Enhancement Award Program grant, and by a Women’s Health Research at Yale University School of Medicine grant awarded to Dr. Potenza.

Submitted for publication: August 11, 2006; Accepted for publication: October 30, 2006.

Please direct all correspondence to: Jon E. Grant, JD, MD, MPH, University of Minnesota Medical School, 2450 Riverside Avenue, Minneapolis, MN 55454; Tel: 612-273-9736, Fax: 612-273-9779; E-mail: grant045@umn.edu.

---

[h1]Abstract[/h1]Behavioral addictions, such as pathological gambling, kleptomania, pyromania, compulsive buying, and compulsive sexual behavior, represent significant public health concerns and are associated with high rates of psychiatric comorbidity and mortality. Although research into the biology of these behaviors is still in the early stages, recent advances in the understanding of motivation, reward, and addiction have provided insight into the possible pathophysiology of these disorders. Biochemical, functional neuroimaging, genetic studies, and treatment research have suggested a strong neurobiological link between behavioral addictions and substance use disorders. Given the substantial co-occurrence of these groups of disorders, improved understanding of their relationship has important implications not only for further understanding the neurobiology of both categories of disorders but also for improving prevention and treatment strategies.

[h1]Introduction[/h1]Several disorders, particularly those formally categorized in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edtion-Text Revision as impulse-control disorders not elsewhere classified, have been described as “behavioral

 

[antonlavey]

[h2]The Neurobiology of Substance and Behavioral Addictions[/h2]

Jon E. Grant, JD, MD, MPH, Judson A. Brewer, MD, PhD, and Marc N. Potenza, MD, PhD



CNS Spectr. 2006;11(12)924-930
[table][tr][td]
Needs Assessment
Over the last decade, the volume of research on behavioral addictions has grown significantly, particularly in the neurobiology of these disorders, their relationship to substance addictions, and effective treatment interventions. This article provides the most up-to-date knowledge regarding the pathophysiology and treatment of these behaviors.

Learning Objectives
At the end of this activity, the participant should be able to:
• Understand the clinical characteristics of behavioral addictions.
• Understand the shared neuropathophysiology of behavioral and substance addictions.
• Discuss the available treatments for behavioral addictions.


Target Audience: Neurologists and psychiatrists

CME Accreditation Statement

This activity has been planned and implemented in accordance with the Essentials and Standards of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Mount Sinai School of Medicine and MBL Communications, Inc. The Mount Sinai School of Medicine is accredited by the ACCME to provide continuing medical education for physicians. 


Credit Designation
The Mount Sinai School of Medicine designates this educational activity for a maximum of 3 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity


Faculty Disclosure Policy Statement

It is the policy of the Mount Sinai School of Medicine to ensure objectivity, balance, independence, transparency, and scientific rigor in all CME-sponsored educational activities. All faculty participating in the planning or implementation of a sponsored activity are expected to disclose to the audience any relevant financial relationships and to assist in resolving any conflict of interest that may arise from the relationship. Presenters must also make a meaningful disclosure to the audience of their discussions of unlabeled or unapproved drugs or devices. This information will be available as part of the course material.


This activity has been peer-reviewed and approved by Eric Hollander, MD, chair at the Mount Sinai School of Medicine. Review date: November 13, 2006. Dr. Hollander does not have an affiliation with or financial interest in any organization that might pose a conflict of interest.

To Receive Credit for This Activity

Read the three CME-designated articles, reflect on the information presented, and then complete the CME quiz. To obtain credits, you should score 70% or better. The estimated time to complete all three articles and the quiz is 3 hours. Release date: December 2006. Termination date: December 2008.
[/td][/tr][/table]


Return


http://mbldownloads.com/1206CNS_Grant_CME.pdf

http://mbldownloads.com/1105CNS_Olden_CMEx.pdfCNS Spectr. 2006;11(12)924-930
Dr. Grant is associate professor in the Department of Psychiatry at the University of Minnesota Medical School in Minneapolis. Dr. Brewer is a resident in the Department of Psychiatry at the Yale University School of Medicine in New Haven, Connecticut. Dr. Potenza is associate professor in the Department of Psychiatry at the Yale University School of Medicine.

Disclosures: Dr. Grant receives grant/research support from Forest, GlaxoSmithKline, the National Institute of Mental Health (NIMH), and Somaxon; and is a consultant to Somaxon. Dr. Brewer receives grant/research support from the NIMH. Dr. Potenza receives grant/research support from the Connecticut Department of Mental Health and Addictive Services, Mohegan Sun, the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, OrthoMcNeil, the United States Department of Veteran Affairs (VA), and Women’s Health Research at Yale University School of Medicine; is a consultant to Boehringer Ingelheim and Somaxon; is on the advisory board of Boehringer Ingelheim; and holds stock options in Somaxon.

Funding/Support: This work was supported by NIMH grant K23 MH069754-01A1 awarded to Dr. Grant, NIMH training grant T32 MH19961 awarded to Dr. Brewer, and National Institute of Drug Abuse grant R01 DA013039, by a VA Veterans Integrated Service Network 1 Mental Illness Research Education and Clinical Center and Research Enhancement Award Program grant, and by a Women’s Health Research at Yale University School of Medicine grant awarded to Dr. Potenza.

Submitted for publication: August 11, 2006; Accepted for publication: October 30, 2006.

Please direct all correspondence to: Jon E. Grant, JD, MD, MPH, University of Minnesota Medical School, 2450 Riverside Avenue, Minneapolis, MN 55454; Tel: 612-273-9736, Fax: 612-273-9779; E-mail: grant045@umn.edu.

---

[h1]Abstract[/h1]Behavioral addictions, such as pathological gambling, kleptomania, pyromania, compulsive buying, and compulsive sexual behavior, represent significant public health concerns and are associated with high rates of psychiatric comorbidity and mortality. Although research into the biology of these behaviors is still in the early stages, recent advances in the understanding of motivation, reward, and addiction have provided insight into the possible pathophysiology of these disorders. Biochemical, functional neuroimaging, genetic studies, and treatment research have suggested a strong neurobiological link between behavioral addictions and substance use disorders. Given the substantial co-occurrence of these groups of disorders, improved understanding of their relationship has important implications not only for further understanding the neurobiology of both categories of disorders but also for improving prevention and treatment strategies.

[h1]Introduction[/h1]Several disorders, particularly those formally categorized in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edtion-Text Revision as impulse-control disorders not elsewhere classified, have been described as “behavioral

 

[stuntman mike]

and the linkages between addiction/alcoholism and co-ocurring mental illnesses has been known for many years now. effective treatment for substance-related disorders in the very least, should include comprehensive psychiatric assessments - more accurately done once the person has been off drugs and alcohol for 6 months. plain drug rehab has been replaced by behavioral health treatment. 

 

[stuntman mike]

and the linkages between addiction/alcoholism and co-ocurring mental illnesses has been known for many years now. effective treatment for substance-related disorders in the very least, should include comprehensive psychiatric assessments - more accurately done once the person has been off drugs and alcohol for 6 months. plain drug rehab has been replaced by behavioral health treatment. 

 

[antonlavey]

Originally Posted by Stuntman Mike

a simpler way to illustrate the pathology of alcoholism is the peculiar inability to utilize past experiences to deter repeating behavior that will likely result in grave consequences. it's as if some vital connection is missing from the brain that far exceeds some kind of moral failing or weak personal commitment. i speak from personal experience.
and once again i retierate: the amount you drink has nothing to do with being an alcoholic. 

The "they can't doing something that is obviously detrimental to their health" explanation usually doesn't get the job done in these arguments because people will play the "will power" card. It's more fun to throw out overwhelming amounts of information and show dude that this is pretty much common, well-established knowledge in the scientific community.
  

 

[antonlavey]

Originally Posted by Stuntman Mike

a simpler way to illustrate the pathology of alcoholism is the peculiar inability to utilize past experiences to deter repeating behavior that will likely result in grave consequences. it's as if some vital connection is missing from the brain that far exceeds some kind of moral failing or weak personal commitment. i speak from personal experience.
and once again i retierate: the amount you drink has nothing to do with being an alcoholic. 

The "they can't doing something that is obviously detrimental to their health" explanation usually doesn't get the job done in these arguments because people will play the "will power" card. It's more fun to throw out overwhelming amounts of information and show dude that this is pretty much common, well-established knowledge in the scientific community.
  

 

[mneezy1]

Originally Posted by Stuntman Mike

a simpler way to illustrate the pathology of alcoholism is the peculiar inability to utilize past experiences to deter repeating behavior that will likely result in grave consequences. it's as if some vital connection is missing from the brain that far exceeds some kind of moral failing or weak personal commitment. i speak from personal experience.
and once again i retierate: the amount you drink has nothing to do with being an alcoholic. 

That's pretty deep. Alcoholism (and addiction in general) is certainly a disease IMO.

 

[mneezy1]

Originally Posted by Stuntman Mike

a simpler way to illustrate the pathology of alcoholism is the peculiar inability to utilize past experiences to deter repeating behavior that will likely result in grave consequences. it's as if some vital connection is missing from the brain that far exceeds some kind of moral failing or weak personal commitment. i speak from personal experience.
and once again i retierate: the amount you drink has nothing to do with being an alcoholic. 

That's pretty deep. Alcoholism (and addiction in general) is certainly a disease IMO.

 

[badmoonrison]

Originally Posted by Stuntman Mike

a simpler way to illustrate the pathology of alcoholism is the peculiar inability to utilize past experiences to deter repeating behavior that will likely result in grave consequences. it's as if some vital connection is missing from the brain that far exceeds some kind of moral failing or weak personal commitment. i speak from personal experience.
and once again i retierate: the amount you drink has nothing to do with being an alcoholic. 

So basically they can't learn from their mistakes? That's what I drew from that.

 

[badmoonrison]

Originally Posted by Stuntman Mike

a simpler way to illustrate the pathology of alcoholism is the peculiar inability to utilize past experiences to deter repeating behavior that will likely result in grave consequences. it's as if some vital connection is missing from the brain that far exceeds some kind of moral failing or weak personal commitment. i speak from personal experience.
and once again i retierate: the amount you drink has nothing to do with being an alcoholic. 

So basically they can't learn from their mistakes? That's what I drew from that.

 

[antonlavey]

Originally Posted by badmoonRison

Originally Posted by Stuntman Mike

a simpler way to illustrate the pathology of alcoholism is the peculiar inability to utilize past experiences to deter repeating behavior that will likely result in grave consequences. it's as if some vital connection is missing from the brain that far exceeds some kind of moral failing or weak personal commitment. i speak from personal experience.
and once again i retierate: the amount you drink has nothing to do with being an alcoholic. 

So basically they can't learn from their mistakes? That's what I drew from that.

He's trying to say the positive reinforcement of doing the addictive behaviour (euphoria, escape) supercedes the negative consequences.

 

[antonlavey]

Originally Posted by badmoonRison

Originally Posted by Stuntman Mike

a simpler way to illustrate the pathology of alcoholism is the peculiar inability to utilize past experiences to deter repeating behavior that will likely result in grave consequences. it's as if some vital connection is missing from the brain that far exceeds some kind of moral failing or weak personal commitment. i speak from personal experience.
and once again i retierate: the amount you drink has nothing to do with being an alcoholic. 

So basically they can't learn from their mistakes? That's what I drew from that.

He's trying to say the positive reinforcement of doing the addictive behaviour (euphoria, escape) supercedes the negative consequences.

 

[eight2one]

I certainly went thru an alcoholic phase, NO GOOD came from it...

I stay have a relapse every now and then

 

[eight2one]

I certainly went thru an alcoholic phase, NO GOOD came from it...

I stay have a relapse every now and then

 

[Master Zik]

No real pity for alcoholics.

As for the argument I've seen scans of a brain after the effects of alcoholism and when it comes to it being a mental addiction (it is a mental illness) I find it hard to believe 100% if the person really does drink like an alcoholic that they're mentally addicted due to the amount of holes, yes literal holes in your brain drinking alcohol causes.

 

[Master Zik]

No real pity for alcoholics.

As for the argument I've seen scans of a brain after the effects of alcoholism and when it comes to it being a mental addiction (it is a mental illness) I find it hard to believe 100% if the person really does drink like an alcoholic that they're mentally addicted due to the amount of holes, yes literal holes in your brain drinking alcohol causes.

 

[stuntman mike]

Originally Posted by badmoonRison

Originally Posted by Stuntman Mike

a simpler way to illustrate the pathology of alcoholism is the peculiar inability to utilize past experiences to deter repeating behavior that will likely result in grave consequences. it's as if some vital connection is missing from the brain that far exceeds some kind of moral failing or weak personal commitment. i speak from personal experience.
and once again i retierate: the amount you drink has nothing to do with being an alcoholic. 

So basically they can't learn from their mistakes? That's what I drew from that.

that's because you didn't comprehend what i wrote in its' entirety. read the sentence after the one you underlined. there is a great illustrative story in the book alcoholics anonymous (written in 1939) called the jaywalker:
"Our behavior is as absurd and incomprehensible with respect to the first drink as that of an individual with a passion, say, for jay-walking. He gets a thrill out of skipping in front of fast-moving vehicles. He enjoys himself for a few years in spite of friendly warnings. Up to this point you would label him as a foolishchap having +%%+* ideas of fun. Luck then deserts him and he is slightly injured several times in succession. You would expect him, if he were normal, to cut it out. Presently he is hit again and this time has a fractured skull. Within a week after leaving the hospital a fast-moving trolley car breaks his arm. He tells you he has decided to stop jay-walking for good, but in a few weeks he breaks both legs.

On through the years this conduct continues, accompanied by his continual promises to be careful or to keep off the streets altogether. Finally, he can no longer work, his wife gets a divorce and he is held up to ridicule. He tries every known means to get the jay-walking idea out of his head. He shuts himself up in an asylum, hoping to mend his ways. But the day he comes out he races in front of a fire engine, which breaks his back. Such a man would be crazy, wouldn't he?"

 

[stuntman mike]

Originally Posted by badmoonRison

Originally Posted by Stuntman Mike

a simpler way to illustrate the pathology of alcoholism is the peculiar inability to utilize past experiences to deter repeating behavior that will likely result in grave consequences. it's as if some vital connection is missing from the brain that far exceeds some kind of moral failing or weak personal commitment. i speak from personal experience.
and once again i retierate: the amount you drink has nothing to do with being an alcoholic. 

So basically they can't learn from their mistakes? That's what I drew from that.

that's because you didn't comprehend what i wrote in its' entirety. read the sentence after the one you underlined. there is a great illustrative story in the book alcoholics anonymous (written in 1939) called the jaywalker:
"Our behavior is as absurd and incomprehensible with respect to the first drink as that of an individual with a passion, say, for jay-walking. He gets a thrill out of skipping in front of fast-moving vehicles. He enjoys himself for a few years in spite of friendly warnings. Up to this point you would label him as a foolishchap having +%%+* ideas of fun. Luck then deserts him and he is slightly injured several times in succession. You would expect him, if he were normal, to cut it out. Presently he is hit again and this time has a fractured skull. Within a week after leaving the hospital a fast-moving trolley car breaks his arm. He tells you he has decided to stop jay-walking for good, but in a few weeks he breaks both legs.

On through the years this conduct continues, accompanied by his continual promises to be careful or to keep off the streets altogether. Finally, he can no longer work, his wife gets a divorce and he is held up to ridicule. He tries every known means to get the jay-walking idea out of his head. He shuts himself up in an asylum, hoping to mend his ways. But the day he comes out he races in front of a fire engine, which breaks his back. Such a man would be crazy, wouldn't he?"

 

[shaunhillftw49]

Originally Posted by AntonLaVey

[h2]The Neurobiology of Substance and Behavioral Addictions[/h2]

Jon E. Grant, JD, MD, MPH, Judson A. Brewer, MD, PhD, and Marc N. Potenza, MD, PhD



CNS Spectr. 2006;11(12)924-930
[table][tr][td]
Needs Assessment
Over the last decade, the volume of research on behavioral addictions has grown significantly, particularly in the neurobiology of these disorders, their relationship to substance addictions, and effective treatment interventions. This article provides the most up-to-date knowledge regarding the pathophysiology and treatment of these behaviors.

Learning Objectives
At the end of this activity, the participant should be able to:
• Understand the clinical characteristics of behavioral addictions.
• Understand the shared neuropathophysiology of behavioral and substance addictions.
• Discuss the available treatments for behavioral addictions.


Target Audience: Neurologists and psychiatrists

CME Accreditation Statement

This activity has been planned and implemented in accordance with the Essentials and Standards of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Mount Sinai School of Medicine and MBL Communications, Inc. The Mount Sinai School of Medicine is accredited by the ACCME to provide continuing medical education for physicians. 


Credit Designation
The Mount Sinai School of Medicine designates this educational activity for a maximum of 3 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity


Faculty Disclosure Policy Statement

It is the policy of the Mount Sinai School of Medicine to ensure objectivity, balance, independence, transparency, and scientific rigor in all CME-sponsored educational activities. All faculty participating in the planning or implementation of a sponsored activity are expected to disclose to the audience any relevant financial relationships and to assist in resolving any conflict of interest that may arise from the relationship. Presenters must also make a meaningful disclosure to the audience of their discussions of unlabeled or unapproved drugs or devices. This information will be available as part of the course material.


This activity has been peer-reviewed and approved by Eric Hollander, MD, chair at the Mount Sinai School of Medicine. Review date: November 13, 2006. Dr. Hollander does not have an affiliation with or financial interest in any organization that might pose a conflict of interest.

To Receive Credit for This Activity

Read the three CME-designated articles, reflect on the information presented, and then complete the CME quiz. To obtain credits, you should score 70% or better. The estimated time to complete all three articles and the quiz is 3 hours. Release date: December 2006. Termination date: December 2008.
[/td][/tr][/table]


Return


http://mbldownloads.com/1206CNS_Grant_CME.pdf

http://mbldownloads.com/1105CNS_Olden_CMEx.pdfCNS Spectr. 2006;11(12)924-930
Dr. Grant is associate professor in the Department of Psychiatry at the University of Minnesota Medical School in Minneapolis. Dr. Brewer is a resident in the Department of Psychiatry at the Yale University School of Medicine in New Haven, Connecticut. Dr. Potenza is associate professor in the Department of Psychiatry at the Yale University School of Medicine.

Disclosures: Dr. Grant receives grant/research support from Forest, GlaxoSmithKline, the National Institute of Mental Health (NIMH), and Somaxon; and is a consultant to Somaxon. Dr. Brewer receives grant/research support from the NIMH. Dr. Potenza receives grant/research support from the Connecticut Department of Mental Health and Addictive Services, Mohegan Sun, the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, OrthoMcNeil, the United States Department of Veteran Affairs (VA), and Women’s Health Research at Yale University School of Medicine; is a consultant to Boehringer Ingelheim and Somaxon; is on the advisory board of Boehringer Ingelheim; and holds stock options in Somaxon.

Funding/Support: This work was supported by NIMH grant K23 MH069754-01A1 awarded to Dr. Grant, NIMH training grant T32 MH19961 awarded to Dr. Brewer, and National Institute of Drug Abuse grant R01 DA013039, by a VA Veterans Integrated Service Network 1 Mental Illness Research Education and Clinical Center and Research Enhancement Award Program grant, and by a Women’s Health Research at Yale University School of Medicine grant awarded to Dr. Potenza.

Submitted for publication: August 11, 2006; Accepted for publication: October 30, 2006.

Please direct all correspondence to: Jon E. Grant, JD, MD, MPH, University of Minnesota Medical School, 2450 Riverside Avenue, Minneapolis, MN 55454; Tel: 612-273-9736, Fax: 612-273-9779; E-mail: grant045@umn.edu.

---

[h1]Abstract[/h1]Behavioral addictions, such as pathological gambling, kleptomania, pyromania, compulsive buying, and compulsive sexual behavior, represent significant public health concerns and are associated with high rates of psychiatric comorbidity and mortality. Although research into the biology of these behaviors is still in the early stages, recent advances in the understanding of motivation, reward, and addiction have provided insight into the possible pathophysiology of these disorders. Biochemical, functional neuroimaging, genetic studies, and treatment research have suggested a strong neurobiological link between behavioral addictions and substance use disorders. Given the substantial co-occurrence of these groups of disorders, improved understanding of their relationship has important implications not only for further understanding the neurobiology of both categories of disorders but also for improving prevention and treatment strategies.

[h1]Introduction[/h1]Several disorders, particularly those formally categorized in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edtion-Text Revision as impulse-control disorders not elsewhere classified, have been described as “behavioral

 

[shaunhillftw49]

Originally Posted by AntonLaVey

[h2]The Neurobiology of Substance and Behavioral Addictions[/h2]

Jon E. Grant, JD, MD, MPH, Judson A. Brewer, MD, PhD, and Marc N. Potenza, MD, PhD



CNS Spectr. 2006;11(12)924-930
[table][tr][td]
Needs Assessment
Over the last decade, the volume of research on behavioral addictions has grown significantly, particularly in the neurobiology of these disorders, their relationship to substance addictions, and effective treatment interventions. This article provides the most up-to-date knowledge regarding the pathophysiology and treatment of these behaviors.

Learning Objectives
At the end of this activity, the participant should be able to:
• Understand the clinical characteristics of behavioral addictions.
• Understand the shared neuropathophysiology of behavioral and substance addictions.
• Discuss the available treatments for behavioral addictions.


Target Audience: Neurologists and psychiatrists

CME Accreditation Statement

This activity has been planned and implemented in accordance with the Essentials and Standards of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Mount Sinai School of Medicine and MBL Communications, Inc. The Mount Sinai School of Medicine is accredited by the ACCME to provide continuing medical education for physicians. 


Credit Designation
The Mount Sinai School of Medicine designates this educational activity for a maximum of 3 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity


Faculty Disclosure Policy Statement

It is the policy of the Mount Sinai School of Medicine to ensure objectivity, balance, independence, transparency, and scientific rigor in all CME-sponsored educational activities. All faculty participating in the planning or implementation of a sponsored activity are expected to disclose to the audience any relevant financial relationships and to assist in resolving any conflict of interest that may arise from the relationship. Presenters must also make a meaningful disclosure to the audience of their discussions of unlabeled or unapproved drugs or devices. This information will be available as part of the course material.


This activity has been peer-reviewed and approved by Eric Hollander, MD, chair at the Mount Sinai School of Medicine. Review date: November 13, 2006. Dr. Hollander does not have an affiliation with or financial interest in any organization that might pose a conflict of interest.

To Receive Credit for This Activity

Read the three CME-designated articles, reflect on the information presented, and then complete the CME quiz. To obtain credits, you should score 70% or better. The estimated time to complete all three articles and the quiz is 3 hours. Release date: December 2006. Termination date: December 2008.
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http://mbldownloads.com/1206CNS_Grant_CME.pdf

http://mbldownloads.com/1105CNS_Olden_CMEx.pdfCNS Spectr. 2006;11(12)924-930
Dr. Grant is associate professor in the Department of Psychiatry at the University of Minnesota Medical School in Minneapolis. Dr. Brewer is a resident in the Department of Psychiatry at the Yale University School of Medicine in New Haven, Connecticut. Dr. Potenza is associate professor in the Department of Psychiatry at the Yale University School of Medicine.

Disclosures: Dr. Grant receives grant/research support from Forest, GlaxoSmithKline, the National Institute of Mental Health (NIMH), and Somaxon; and is a consultant to Somaxon. Dr. Brewer receives grant/research support from the NIMH. Dr. Potenza receives grant/research support from the Connecticut Department of Mental Health and Addictive Services, Mohegan Sun, the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, OrthoMcNeil, the United States Department of Veteran Affairs (VA), and Women’s Health Research at Yale University School of Medicine; is a consultant to Boehringer Ingelheim and Somaxon; is on the advisory board of Boehringer Ingelheim; and holds stock options in Somaxon.

Funding/Support: This work was supported by NIMH grant K23 MH069754-01A1 awarded to Dr. Grant, NIMH training grant T32 MH19961 awarded to Dr. Brewer, and National Institute of Drug Abuse grant R01 DA013039, by a VA Veterans Integrated Service Network 1 Mental Illness Research Education and Clinical Center and Research Enhancement Award Program grant, and by a Women’s Health Research at Yale University School of Medicine grant awarded to Dr. Potenza.

Submitted for publication: August 11, 2006; Accepted for publication: October 30, 2006.

Please direct all correspondence to: Jon E. Grant, JD, MD, MPH, University of Minnesota Medical School, 2450 Riverside Avenue, Minneapolis, MN 55454; Tel: 612-273-9736, Fax: 612-273-9779; E-mail: grant045@umn.edu.

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[h1]Abstract[/h1]Behavioral addictions, such as pathological gambling, kleptomania, pyromania, compulsive buying, and compulsive sexual behavior, represent significant public health concerns and are associated with high rates of psychiatric comorbidity and mortality. Although research into the biology of these behaviors is still in the early stages, recent advances in the understanding of motivation, reward, and addiction have provided insight into the possible pathophysiology of these disorders. Biochemical, functional neuroimaging, genetic studies, and treatment research have suggested a strong neurobiological link between behavioral addictions and substance use disorders. Given the substantial co-occurrence of these groups of disorders, improved understanding of their relationship has important implications not only for further understanding the neurobiology of both categories of disorders but also for improving prevention and treatment strategies.

[h1]Introduction[/h1]Several disorders, particularly those formally categorized in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edtion-Text Revision as impulse-control disorders not elsewhere classified, have been described as “behavioral

 

[antonlavey]

^^^You really gonna front like you read all that. Dude asked for evidence, and I bombarded him with it.

Joe Grant with the MD, JD, MPH

 

[antonlavey]

^^^You really gonna front like you read all that. Dude asked for evidence, and I bombarded him with it.

Joe Grant with the MD, JD, MPH