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The growing evidence of Neuroscience leads to a better understanding of cerebral processes in cases of acute or chronic intake of psychotropic substances (ps). Predominantly, structures of the "reward system" contributed to the development of addiction. Chronic consumption of ps provides changing in brain equilibrium and leads to adaptations in the brain architecture. In this article, the complex responses of neurons and neuronal networks are presented in cases of chronic intake of ps. The alterations affect the cognitive, emotional and behavioral processings and influence learning and stress regulation. In summary, all cerebral adaptations are integrated in a complex model of biological, psychological and social factors and therefore, addiction arises as a consequence of combination of individual protecting and risk factors.Die Ergebnisse aus den Neurowissenschaften tragen dazu bei die Hirnprozesse bei akutem und chronischem Konsum psychotroper Substanzen besser zu verstehen. Bei der Entwicklung zur Sucht sind insbesondere Hirnstrukturen des sogenannten Belohnungssystems beteiligt. Der chronische Konsum psychotroper Substanzen führt dort zu Veränderungen von chemischen Gleichgewichten und Anpassungen der Hirnarchitektur. In diesem Artikel werden die komplexen Antworten auf den chronischen Konsum psychotroper Substanzen auf den Ebenen der Nervenzellen und den vernetzten Nervenzellverbänden dargestellt. Diese Veränderungen zeigen Auswirkungen auf Denken, Fühlen und Verhalten und beeinflussen Lernprozesse und Stressverarbeitung. Zusammenfassend sind alle cerebralen Anpassungen eingebettet in ein vielschichtiges Modell von biologischen, psychologischen und sozialen Faktoren, sodass Sucht nur durch das Zusammenwirken von zahlreichen individuellen Schutz- und Risikofaktoren erklärt werden kann.

The objective of this review is to summarise the recent state of research on intake criteria for forensic psychiatry in Germany. Therefore, a systematic literature review was conducted on the legal basis of paragraph 64 of the German Penal Code for forensic psychiatry. Although the patients were very heterogeneous, relatively robust indicators were identified that may yield an unsuccessful therapy outcome. A younger age, previous delinquency, absence of an educational and vocational qualification, and personality disorders are the most robust indicators adversely affecting therapy in German forensic psychiatric institutions.

Insecure attachment (IA) and attention-deficit/hyperactivity disorder (ADHD) are discussed as risk factors for increased alcohol intake and the development of alcoholism.Among a sample of 517 consecutively admitted German inpatients with alcohol dependence we investigated the contribution of IA to alcoholism phenotypes, taking into consideration comorbid ADHD.IA was significantly associated with increased alcohol consumption, increased frequency of withdrawal symptoms, increased frequency of physical or psychological problems that are likely to have been worsened by alcohol, and reduced social activities because of alcohol use. ADHD has no significant effect on these parameters.IA developed as a result of social interactions during childhood long before alcohol dependence. The results point to an important effect of IA on the severity and acceleration of alcohol dependence. Therefore, it might be helpful to improve efforts in primary prevention and psychotherapy of alcohol dependence by considering the specific needs of subjects with an IA.

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