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Background and aims Existing evidence suggests that text message interventions can help people to reduce their alcohol consumption. However, studies with alcohol-dependent patients are lacking. In this study a 1-year automatic mobile phone-based short messaging service (SMS) intervention on alcohol consumption in patients after alcohol detoxification in hospital was compared with treatment as usual. Design Multi-center, randomized, controlled, two parallel-group, observer-blinded trial. Setting and participants Primary and secondary care: four hospitals and community (1 million residents, 7600 km2 area in Germany). A total of 462 patients with alcohol dependence (ICD-10) were included during inpatient detoxification treatment. Patients were randomly assigned (1 : 1) to an SMS intervention and treatment as usual (SMS + TAU; n = 230; mean age: 45.4 years; 22.6% women) or TAU alone (n = 232 mean age: 44.5 years; 22.8% women). Planned, automated messages were sent to patients over 1 year to record assistance needs. A 'yes' or missing response triggered a telephone call from a hospital therapist. Outcome was assessed by an independent survey center. Measurements The primary end-point was a three-category alcohol consumption measure covering months 10-12 after discharge: abstinence, non-heavy drinking, heavy drinking [men > 60 g/day; women > 40 g/day equal to World Health Organization (WHO) criteria: high risk and very high risk, mean consumption]. Secondary end-points were number of abstinent days over 12 months and frequency of abstinence. Results The arms differed primarily in the heavy drinking category (intervention group 22.2%, TAU-only group 32.3%) in months 9-12. This is reflected by an odds ratio (OR) = 1.68, 95% confidence interval (CI) = 1.11-2.54, P = 0.015 for heavy drinking versus non-heavy drinking/abstinence. No difference between treatments was found with respect to any drinking versus abstinence (OR = 1.13). These results were confirmed by models adjusting for randomization strata. Conclusions In Germany, a 12-month mobile phone short messaging service-based intervention enhanced the reduction in heavy drinking for 1 year in routine care among adults with alcohol dependence discharged from inpatient alcohol detoxification.

Introduction Colorectal cancer (CRC) is the third most common cancer in the U.S. Early detection of CRC can substantially increase survival rates. Test compliance may be improved by offering a blood-based test option. Methods Endoscopy II trial specimens were tested for AFP, CA19-9, CEA, hs-CRP, CyFra 21-1, Ferritin, Galectin-3, and TIMP-1 levels. These biomarkers, as well as patient demographic information (e.g., age, gender), were included in algorithm development. Six statistical methods were utilized to develop algorithms that would discriminate cancer vs. noncancers. Statistical methods included logistic regression, adaptive index modeling, partial least-squares discriminant analysis, feature vector (weighted and unweighted), and random forest. The performance of these algorithms was compared against benchmark criteria established for stool-based tests. Results Using several statistical methods, the presence of CRC and high-risk adenomas was detected with an AUCs of at least 0.65–0.76, with a few of models approaching the stool-based tests benchmark performance. Further, common markers were utilized across the different statistical techniques, with model complexities ranging from 3 to 9 markers. Conclusions Predictive models identified subjects with CRC and high-risk adenomas with the similar levels of statistical accuracy. Clinical performance differences were minimal across the statistical techniques, although the intuitive interpretations, model complexity, clinical adoption and implementation varied.

Background: A pre-post pilot study was conducted to test the feasibility, acceptability, and potential effectiveness of a fully automatized computer-based intervention targeting hazardous drinking and depressiveness in proactively recruited health care patients (HCPs). To address the importance of the sample selection when testing interventions, HCPs were compared to media recruited volunteers (MVs). Method: In a multicenter screening program 2,773 HCPs were screened for hazardous drinking and depressive symptoms. MVs were recruited via media solicitation. Over a period of 6 months, study participants received 6 individualized counseling letters and weekly short messages. Pre-post data were analyzed for 30 participants (15 HCPs, 15 MVs). Intervention acceptability was assessed in post-intervention interviews conducted with 32 study participants. Results: MVs showed higher problem severity and motivation to change than HCPs. Over the course of the intervention both subsamples reduced regular binge drinking (HCPs: p = 0.016; MVs: p = 0.031) and depressiveness (HCPs: p = 0.020; MVs: p < 0.001). MVs further reduced average daily alcohol consumption (p = 0.034). The intervention received positive ratings from both subsamples, the alcohol module was rated more favorably by MVs than by HCPs (p = 0.012). Subsamples further differed in terms of intervention usage (p = 0.013). Conclusion: The intervention was technically and logistically feasible, well accepted, and may have the potential to reduce hazardous drinking and depressive symptoms in different populations. Subsamples differed in terms of problem severity, motivation to change, intervention usage, pre-post changes, and attitudes toward the intervention, showing that intervention development should involve the intended target populations to avoid biased conclusions on intervention effectiveness and acceptability.

Individuals with pathological gambling have an increased risk for suicidal events. Additionally, the prevalence of comorbid psychiatric disorders is high among pathological gamblers. This study analyzes whether the type of gambling is associated with suicidal events in pathological gamblers independently from comorbidity. Participants were recruited in 4 different ways: via random telephone sample from the general population, via individual invitation for study participation in gambling locations, through various media and the distribution of a leaflet in various settings, and via inpatient treatment facilities for pathological gambling. The final sample included 442 participants with a lifetime diagnosis of pathological gambling. A standardized clinical interview was conducted. High financial losses were associated with suicidal events (odds ratio [OR] = 1.94, 95% 95% confidence interval [CI], [1.11, 3.37]), as were mood disorders (OR = 7.70, 95% CI, [4.44, 13.37]) and female gender (OR = 2.52, 95% CI, [1.20, 5.28]). Gambling on electronic gambling machines in gambling halls or bars was associated with increased odds of suicidal events (OR = 2.94, 95% CI, [1.38, 6.24]). Other types of gambling, such as casino games or betting on sports, or the number of DSM-IV criteria for pathological gambling were not associated independently with suicidal events. Our findings suggest that gambling on electronic gambling machines in gambling halls or bars is associated with suicidal events in pathological gamblers independently of comorbidity. This result shows that the type of gambling needs to be considered as a relevant factor in gambling research. (PsycINFO Database Record Language: en

Zusammenfassung. Ziel der vorliegenden Arbeit war es, mithilfe einer systematischen Literaturrecherche die derzeit zugänglichen evidenzbasierten computergestützten Interventionen zur Reduktion depressiver Symptome zu identifizieren. Insgesamt ließen sich 37 Interventionen ausfindig machen, welche überwiegend (51,4 %) ausschließlich auf Methoden der kognitiven Verhaltenstherapie basieren. Für den englischen Sprachraum gibt es ein breites Angebot an internetbasierten, computer- und/oder smartphonegestützten Interventionen. Das deutschsprachige Angebot ist jedoch noch gering. Sprachliche und kulturelle Anpassungen der fremdsprachigen Interventionssysteme für den deutschsprachigen Raum würden eine erhebliche Erweiterung des verfügbaren Angebotes ermöglichen. Zur Ausschöpfung des Potenzials computergestützter Interventionen scheint die Frage essenziell, wie zukünftig Angebote für geeignete Patientengruppen qualitätsgesichert bereitgestellt werden können.

Background The biomarkers alpha-fetoprotein (AFP) and protein induced by vitamin K absence/antagonist-II (PIVKA-II) may be useful for detecting early-stage hepatocellular carcinoma (HCC). We evaluated the performance of AFP and PIVKA-II levels, alone and in combination with clinical factors, for the early detection of HCC. Methods In a case–control study, serum AFP and PIVKA-II were measured using the ARCHITECT immunoassay analyzer system in a cohort of 119 patients with HCC, 215 patients with non-malignant liver disease, and 34 healthy subjects. Five predictive models for detecting HCC were developed based on age, gender, AFP, and/or PIVKA-II levels; the best model was validated in an independent cohort of 416 patients with HCC and 412 control subjects with cirrhosis. Results In both cohorts, AFP and PIVKA-II concentrations were higher in patients with HCC compared to healthy controls and patients with non-malignant liver disease. The model that combined AFP and PIVKA-II, age, and gender had the highest AUC of 0.95 (0.95, 95% CI 0.93–0.98), with a sensitivity of 93% and a specificity of 84% in the development cohort, and an AUC of 0.87 (95% CI 0.85–0.90), sensitivity of 74%, and specificity of 85% in the validation cohort. When limiting the validation cohort to only early-stage HCC, the AUC was 0.85 (95% CI 0.81–0.88), sensitivity was 70%, and specificity was 86%. Conclusions Compared to each biomarker alone, the combination of AFP and PIVKA-II with age and gender improved the accuracy of detecting HCC and differentiating HCC from non-malignant liver disease. Electronic supplementary material The online version of this article (10.1186/s12014-018-9222-0) contains supplementary material, which is available to authorized users.

The German federal states initiated the “Pathological Gambling and Epidemiology” (PAGE) program to evaluate the public health relevance of pathological gambling. The aim of PAGE was to estimate the prevalence of pathological gambling and cover the heterogenic presentation in the population with respect to comorbid substance use and mental disorders, risk and protective factors, course aspects, treatment utilization, triggering and maintenance factors of remission, and biological markers. This paper describes the methodological details of the study and reports basic prevalence data. Two sampling frames (landline and mobile telephone numbers) were used to generate a random sample from the general population consisting of 15,023 individuals (ages 14 to 64) completing a telephone interview. Additionally, high-risk populations have been approached in gambling locations, via media announcements, outpatient addiction services, debt counselors, probation assistants, self-help groups and specialized inpatient treatment facilities. The assessment included two steps: (1) a diagnostic interview comprising the gambling section of the Composite International Diagnostic Interview (CIDI) for case finding; (2) an in-depth clinical interview with participants reporting gambling problems. The in-depth clinical interview was completed by 594 participants, who were recruited from the general or high-risk populations. The program provides a rich epidemiological database which is available as a scientific use file. Copyright © 2015 John Wiley & Sons, Ltd.

Aims: To test the feasibility, acceptability and initial effectiveness of a text message-based aftercare treatment programme among alcohol outpatients. Methods: Clients treated for alcohol use disorders from three Swiss outpatient alcohol treatment centres were invited by their counsellors to participate in a study testing an interactive aftercare programme employing the use of text messages and personal phone calls. Fifty study participants were randomly assigned to either the 6-month aftercare programme ( n = 25) or treatment as usual ( n = 25). The intervention consisted of (a) monitoring of self-selected drinking goals at regular intervals, (b) motivational text messages to stick to self-selected drinking goals and (c) proactive telephone calls from counsellors when participants neglected to stick to their drinking goals or expressed a need for support. Follow-up interviews were conducted 6 months after randomization. Results: Throughout the programme, participants received a total of 421 text message prompts. Out of these, participants provided valid replies to 371 (88.1%) within 48 h. Out of the 25 participants in the intervention group, 11 (44.0%) sent at least one call-for-help reply. Based on complete case data, at risk alcohol use at follow-up was 41.7% in the control group and 28.6% in the intervention group (OR = 0.56, 95% CI = 0.16–1.95, P = 0.36). Conclusions: The interactive low-intensive aftercare programme was well accepted by the participants. Testing its efficacy within an adequately powered randomized controlled trial might be reasonable.

BACKGROUND: In public health settings, short message service (SMS) appears to be a promising low-cost modality for reducing alcohol consumption. Here, we test a simple interactive SMS-based helpline with detoxified alcohol-dependent patients to extend findings to curative settings. METHODS: This controlled, prospective, 2-group before-after block-assignment, open pilot study tested the feasibility and efficacy of an 8-week outpatient interactive mobile phone SMS intervention (n = 42) against treatment as usual (TAU; n = 38) after inpatient detoxification. Patients were asked whether they needed any help via an automatically generated text message twice a week. A therapist called the individual back when notified. Alcohol consumption was assessed using the telephone version of Form-90 4 and 8 weeks after discharge from inpatient detoxification. The primary end point was defined as attaining low-risk consumption (males ≤30 g or 3.75 units per drinking day (DDD); females ≤20 g or 2.5 units per DDD) 8 weeks after discharge. Missing data were replaced by multiple imputation. RESULTS: Among all messages sent, 20.5% were followed by a phone call. Feasibility and acceptability were good, as indicated by successful implementation of the SMS procedure and the rapid inclusion of patients. Adherence was satisfactory with 57.14% of the participants replying to at least 50% of the prompts. Patients reported a typical preadmission DDD of 281.25 ± 244.61 g. In the SMS group, 55.7% of 42 patients, and 40% of 38 patients in the TAU group, achieved low-risk consumption (risk diff: 0.16; 95% CI -0.06 to 0.37; p = 0.122). CONCLUSIONS: In detoxified alcohol-dependent patients, relapse prevention based on SMS was well received and implemented efficiently and rapidly. An adequately powered multicenter study is currently being conducted to test the nonsignificant but encouraging findings of this exploratory study with more rigorous trial methods (ISRCTN78350716).

Negative Kommentare uber Korpergewicht und Aussehen („teasing“, „lastern“) in der Jugend hangen mit korperlicher Unzufriedenheit und mit erhohtem Korpergewicht im Erwachsenenalter zusammen. Es wurden 134 Krankenpflegeschuler (Alter 16 bis 24 Jahre) im Hinblick auf Zusammenhange zwischen erinnerten Lastererfahrungen in Kindheit und Jugend [Teasing-Fragebogen nach Thompson), aktuellen Korperbildaspekten [Korperbildfragebogen, Fragebogen zu korperlichen Aspekten von Ausdruck, Scham und Abgrenzung (FK-ASA)] und Korpergewicht untersucht. Probanden mit einem Body-Mass-Index (BMI)> 25 kg/m2 berichteten uber mehr Lastererfahrungen als Normalgewichtige, jene mit einem BMI

Background/aims: The application of intranasal oxytocin enhances facial emotion recognition in normal subjects and in subjects with autism spectrum disorders (ASD). In addition, various features of social cognition have been associated with variants of the oxytocin receptor gene (OXTR). Therefore, we tested for associations between mind-reading, a measure for social recognition and OXTR polymorphisms. Methods: 76 healthy adolescents and young adults were tested for associations between OXTR rs53576, rs2254298, rs2228485 and mind-reading using the “Reading the Mind in the Eyes Test” (RMET). Results: After Bonferroni correction for multiple comparisons, rs2228485 was associated with the number of incorrect answers when subjects evaluated male faces (P =0.000639). There were also associations between OXTR rs53576, rs2254298 and rs2228485 and other RMET dimensions according to P

Wir haben an einer Stichprobe von 74 mannlichen Freizeit-Bodybuildern Zusammenhange zwischen regelmasigem Steroidgebrauch (Einnahme n=31; keine Einnahme n=43) und Selbstwert (Multidimensionale Selbstwertskala MSWS), Korperbild (Fragebogen zum Korperbild FK-ASA) sowie Teasing (Physical Appearance Related Teasing Scale PARTS) untersucht. In einer logistischen Regression pradizierten Alter (p=0,001), niedrige Werte fur die Korperbildskala Korperausdruck (p=0,036) und hohe Werte fur Selbstwert (p=0,024) die Einnahme von Steroiden; Trainingshaufigkeit und erinnertes Teasing (Lastern) zeigten keine Effekte. Entgegen fruheren Befunden war nicht niedriger sondern hoher Selbstwert mit Steroideinnahme assoziiert.

Background Public stigma and self-stigma are two facets of mental illness stigma. Self-stigma denotes the internalization of negative public perceptions by persons with mental illness and has been shown to decrease general self-efficacy. To date, self-stigma has not been examined in people suffering from alcohol dependence, a particularly severely stigmatized mental disorder. Methods By adopting the Self-Stigma in Mental Illness Scale (SSMI), we developed the Self-Stigma in Alcohol Dependence Scale (SSAD). The scale is based on a focus-group derived list of 16 negative stereotypes about alcohol dependent persons. It consists of four 16-item subscales measuring four hypothetical stages of self-stigma, stereotype awareness (aware), stereotype agreement (agree), self-concurrence (apply), and self-esteem decrement (harm). We employed the SSAD in a cross-sectional study of 153 patients hospitalized for alcohol detoxification to examine its reliability and validity. Results The four stages of self-stigma could be reliably measured with the SSAD (Cronbach's alpha, 0.86–0.93). Each step in the process of self-stigmatization was most closely associated with its preceding step. Other significantly related independent variables in multiple regression analyses included desire for social distance (associated with agree), duration of drinking problems (associated with apply) and depressive symptoms (associated with apply and harm). Both apply and harm were significantly related to reduced drinking-refusal self-efficacy in analyses controlling for depressive symptoms and variables related to duration and severity of the drinking problem. Discussion The SSAD showed good validity and reliability measuring the stages of self-stigma in this group. Self-stigma appears to be associated with lower drinking-refusal self-efficacy.

Dysregulations of the hypothalamic-pituitary-adrenal (HPA) axis have been implicated in the pathogenesis of depressive disorders and the corticotropin-releasing hormone (CRH) was found to modulate emotional memory consolidation. Recently, two studies have reported an interaction between childhood abuse and the TAT-haplotype of the CRH-Receptor Gene (CRHR1) connecting childhood adversities and genetic susceptibility to adult depression. We tested the hypothesis of an interaction of childhood maltreatment with single nucleotide polymorphisms (SNPs) and haplotypes of the CRHR1 gene not previously investigated. Caucasian subjects (n = 1,638) from the German general population (Study of Health in Pomerania, SHIP) were analyzed. As in the previous studies, childhood abuse and neglect were assessed with the Childhood Trauma Questionnaire (CTQ) and depression with the Beck Depression Inventory (BDI-2). The CRHR1-SNPs were genotyped on the Affymetrix Genome-Wide Human SNP Array 6.0 platform. We identified an interaction between the TAT-haplotype and childhood physical neglect. The interaction with physical neglect showed significant (P < 0.05) results in 23 of the 28 SNPs, with rs17689882 (P = 0.0013) reaching "gene-wide" significance. Although we did not replicate the specific interaction of abuse and the TAT-haplotype of the CRHR1 gene we confirmed the relevance of an interplay between variants within the CRHR1 gene and childhood adversities in the modulation of depression in adults. The largest effect was found for rs17689882, a SNP previously not analyzed. Relevant sample differences between this and prior studies like lower BDI-2 scores, less childhood maltreatment and higher psychosocial functioning may account for the differences in gene-environment interaction findings. © 2010 Wiley-Liss, Inc.

OBJECTIVE Although among the most prevalent psychiatric conditions, alcoholism seems to be neglected within the current debate on mental illness stigma. We establish the state of current research on public attitudes towards alcohol dependent people. METHODS In an extensive search of the literature, we identified 49 population studies on this topic between 1948 and 2008. 27 studies contained relevant information from Western countries and were included in this review. RESULTS Although most people regard alcoholism as an illness, there is a strong tendency to blame those affected for their condition. Psycho-social causal attributions prevail over biologic explanations. Most people regard alcohol dependent persons as unpredictable and dangerous. The desire for social distance is stronger towards alcohol dependent persons than towards those with other psychiatric diagnoses such as depression or schizophrenia; only those addicted to illegal drugs suffer stronger rejection. Preferences of the public for resource allocation within the health care system put alcohol dependent patients at a potential disadvantage. CONCLUSIONS Alcoholism is a severely stigmatized condition. In order to change the stigma of alcoholism, studies exploring theoretical models and mechanisms of stigmatization seem necessary.

There has been debate whether polymorphisms within the serotonin transporter-linked polymorphic region (5-HTTLPR) moderate susceptibility to posttraumatic stress disorder (PTSD). The authors investigated 5-HTTLPR genotypes and their interaction with the number of traumatic events in the prediction of PTSD in a general population sample.Analyses were based on data from 3,045 subjects who participated in the Study of Health in Pomerania. All participants were assessed with the PTSD module of the Structured Clinical Interview for DSM-IV. The short (S)/long (L) polymorphism of 5-HTTLPR (rs4795541) and the A-G polymorphism (rs25531) were genotyped.Among the participants, 1,663 had been exposed to at least one traumatic event, and 67 (4.0%) developed PTSD. Among those who had experienced less than three traumatic events, the lifetime prevalence of PTSD was 2.6%, 3.5%, and 4.3% for those with zero, one, and two L(A) alleles, respectively, but the lifetime prevalence was 0%, 7.3%, and 19.6%, respectively, among those with three or more traumatic experiences. This finding suggests that there is an additive excess risk for frequent trauma in the L(A)/L(A) genotype, which was confirmed by the relative excess risk due to interaction (RERI). In allelic analysis, RERI was 3.3. Thus, the odds ratio for PTSD in L(A) allele carriers exposed to three or more traumas was 3.3 times higher as a result of the interaction between PTSD and the L(A) allele.An additive gene-environment interaction with the high expression L(A) allele of 5-HTTLPR and frequent trauma in PTSD was found. The attributable proportion indicated that more than 60% of all L(A) allele carriers who were exposed to three or more traumas developed PTSD as a result of an interaction between genotype and exposure.

A new questionnaire to assess body dissatisfaction and shame, body boundary and body expression is presented. Scales BOUNDARY AND BODY PSYCHOTICISM, BODY EXPRESSION and BODY DISSATISFACTION AND SHAME were developed deductively. The first version was given to a sample of 134 nurse students and 512 psychotherapeutic inpatients. An item and factor analysis was conducted in the total sample. A 3-factor solution was found in a confirmatory factorial analysis (39% variance explained). The final version of the questionnaire consists of 46 items. The scales showed a satisfactory or good reliability and validity. To test criterion validity SCL-90-R and the body image questionnaire (FKB-20) were used. All SCL-90-R subscales were highly correlated with body dissatisfaction and shame (KUS) (r>0.5). BODY BOUNDARY AND PSYCHOTICISM scale (AKP) was correlated with SCL-90-R scales psychoticism (r=0.56), interpersonal sensitivity (r=.55) and anxiety (r=0.51). BODY DISSATISFACTION AND SHAME scale (KUS) was also correlated (r=0.77) with scale REJECTION OF THE BODY of FKB-20. First results of the Questionnaire of physical aspects of boundary, shame and expression (FK-ASA) suggest that the scales describe the postulated aspects of body image.

Background: Both reduced postsynaptic dopamine D2 receptor function and the character variable self-directedness (SDD) are related to the level of alcohol consumption. We examined for interactions between DRD2 exon 8(rs6276), a polymorphism which has been associated with various alcohol-related phenotypes, SDD and alcohol consumption. Methods:A total of 144 male and 186 female probands with alcohol dependence or abuse diagnoses and without were included in the study. All subjects were assessed with the alcohol section of the Semi-Structured Assessment for the Genetics of Alcoholism and the Temperament and Character Inventory. Results: Male probands with A/A genotype reported significantly higher alcohol consumption in a typical week (ANOVA; p = 0.024); those with A/A genotype and low SDD showed particularly high consumption levels (interaction DRD2 × SDD: p = 0.019). Alcohol dependence/abuse (DSM-IV) but not nicotine dependence was also relevant for higher alcohol consumption (trend: p = 0.052). In the female group, only alcohol disorders predicted alcohol consumption. Conclusions:Our findings support a role for a gene-personality interaction of DRD2 exon 8 × SDD in alcohol consumption in males.

Schizophrenia has a considerable genetic background. Epidemiological studies suggest an inverse clinical association between schizophrenia and migraine. However, it is unclear to what extent this inverse comorbidity can be explained by genetic mechanisms or by schizophrenia-related behavioral factors. For both disorders hypotheses of glutamate N-methyl-D-aspartate (NMDA) receptor dysfunction have been developed in the past. We hypothesized that both conditions share common genetic factors with inverse effects, primary in the glutamatergic system and genes involved in NMDA activation. Data from the population based Study of Health in Pomerania (N=3973) were used. Based on the results from the recent genome-wide association study for schizophrenia, we calculated polygenic scores (PRS) for subsets of SNPs with different p-value cutoffs and for biological sub-entities. These scores were tested for an association of distinct biological pathways with migraine. The PRS for schizophrenia was inversely associated with migraine in our sample. This association was exclusively based on the genome-wide hits and on single nucleotide polymorphisms near or within genes encoding proteins involved in glutamatergic neurotransmission. This association could be attributed to a single intronic variant rs4523957 in SRR encoding serine-racemase. Additional expression quantitative trait loci analyses of functional variants in SRR and gene-by-gene interaction analyses further supported the validity of this finding. SRR represents the rate limiting enzyme for the synthesis of D-serine, an important co-agonist of the NMDA receptor. According to our results, a decreased versus increased activation of NMDA receptors may play a role in the etiology of schizophrenia, as well as in migraine.

Twin studies suggest a genetic influence upon perceived parenting. The D2 dopaminergic receptor is involved in the modulation of social behaviors, and might influence parenting and its perception. A polymorphism (E8) in exon 8 of the D2 receptor gene (DRD2) has been previously associated with alcoholism-related phenotypes. Similarly, the Pro385Ser variant of GABRA6, the polymorphic gene for GABA(A) receptor α6 subunit, has been associated with alcohol- and depression-related traits; and rat pups maintained a more immature GABAR phenotype after brief separation distress. The relationships among DRD2 (E8) and GABRA6 (Pro385Ser) polymorphisms, and perceived parenting were studied here. The association of DRD2 (E8) and GABRA6 (Pro385Ser) genotypes and perceived parental rearing behavior (short-EMBU; questionnaire concerning own memories concerning upbringing) were determined in 207 unrelated adults using multivariate analysis of variance. Temperaments (Temperament and Character Inventory; TCI) were included as covariates. Probands with DRD2 (E8) A/A genotype showed higher scores for father rejection (P = 0.011), parents overprotection (P = 0.021), and father overprotection (P = 0.016) in the total group. An interaction between DRD2 and GABRA6 genotypes on father rejection (P = 0.010) and parents rejection (P = 0.030) was also observed. Further analyses showed that these associations were restricted to the female subgroup only; however, secondary gender-specific analyses were not corrected for multiple testing. Our findings support a role for DRD2 (E8) and GABRA6 (Pro385Ser) in perceived parenting. © 2006 Wiley-Liss, Inc.

Barban N, Jansen R, de Vlaming R, Vaez A, Mandemakers JJ, Tropf FC, Shen X, Wilson JF, Chasman DI, Nolte IM, Tragante V, van der Laan SW, Perry JR, Kong A; BIOS Consortium, Ahluwalia TS, Albrecht E, Yerges-Armstrong L, Atzmon G, Auro K, Ayers K, Bakshi A, Ben-Avraham D, Berger K, Bergman A, Bertram L, Bielak LF, Bjornsdottir G, Bonder MJ, Broer L, Bui M, Barbieri C, Cavadino A, Chavarro JE, Turman C, Concas MP, Cordell HJ, Davies G, Eibich P, Eriksson N, Esko T, Eriksson J, Falahi F, Felix JF, Fontana MA, Franke L, Gandin I, Gaskins AJ, Gieger C, Gunderson EP, Guo X, Hayward C, He C, Hofer E, Huang H, Joshi PK, Kanoni S, Karlsson R, Kiechl S, Kifley A, Kluttig A, Kraft P, Lagou V, Lecoeur C, Lahti J, Li-Gao R, Lind PA, Liu T, Makalic E, Mamasoula C, Matteson L, Mbarek H, McArdle PF, McMahon G, Meddens SF, Mihailov E, Miller M, Missmer SA, Monnereau C, van der Most PJ, Myhre R, Nalls MA, Nutile T, Kalafati IP, Porcu E, Prokopenko I, Rajan KB, Rich-Edwards J, Rietveld CA, Robino A, Rose LM, Rueedi R, Ryan KA, Saba Y, Schmidt D, Smith JA, Stolk L, Streeten E, Tönjes A, Thorleifsson G, Ulivi S, Wedenoja J, Wellmann J, Willeit P, Yao J, Yengo L, Zhao JH, Zhao W, Zhernakova DV, Amin N, Andrews H, Balkau B, Barzilai N, Bergmann S, Biino G, Bisgaard H, Bønnelykke K, Boomsma DI, Buring JE, Campbell H, Cappellani S, Ciullo M, Cox SR, Cucca F, Toniolo D, Davey-Smith G, Deary IJ, Dedoussis G, Deloukas P, van Duijn CM, de Geus EJ, Eriksson JG, Evans DA, Faul JD, Sala CF, Froguel P, Gasparini P, Girotto G, Grabe HJ, Greiser KH, Groenen PJ, de Haan HG, Haerting J, Harris TB, Heath AC, Heikkilä K, Hofman A, Homuth G, Holliday EG, Hopper J, Hyppönen E, Jacobsson B, Jaddoe VW, Johannesson M, Jugessur A, Kähönen M, Kajantie E, Kardia SL, Keavney B, Kolcic I, Koponen P, Kovacs P, Kronenberg F, Kutalik Z, La Bianca M, Lachance G, Iacono WG, Lai S, Lehtimäki T, Liewald DC; LifeLines Cohort Study, Lindgren CM, Liu Y, Luben R, Lucht M, Luoto R, Magnus P, Magnusson PK, Martin NG, McGue M, McQuillan R, Medland SE, Meisinger C, Mellström D, Metspalu A, Traglia M, Milani L, Mitchell P, Montgomery GW, Mook-Kanamori D, de Mutsert R, Nohr EA, Ohlsson C, Olsen J, Ong KK, Paternoster L, Pattie A, Penninx BW, Perola M, Peyser PA, Pirastu M, Polasek O, Power C, Kaprio J, Raffel LJ, Räikkönen K, Raitakari O, Ridker PM, Ring SM, Roll K, Rudan I, Ruggiero D, Rujescu D, Salomaa V, Schlessinger D, Schmidt H, Schmidt R, Schupf N, Smit J, Sorice R, Spector TD, Starr JM, Stöckl D, Strauch K, Stumvoll M, Swertz MA, Thorsteinsdottir U, Thurik AR, Timpson NJ, Tung JY, Uitterlinden AG, Vaccargiu S, Viikari J, Vitart V, Völzke H, Vollenweider P, Vuckovic D, Waage J, Wagner GG, Wang JJ, Wareham NJ, Weir DR, Willemsen G, Willeit J, Wright AF, Zondervan KT, Stefansson K, Krueger RF, Lee JJ, Benjamin DJ, Cesarini D, Koellinger PD, den Hoed M, Snieder H, Mills MC.

A survey on present applications of stochastic optimization in the power industry is presented. In particular, the motivation for changing over from deterministic to stochastic optimization models, the theory of stochastic optimization and the implementation of risk aversion is described. Furthermore, several characteristic applications in the power industry, such as short-term unit commitment, middle-term portfolio optimization, long-term investment planning and emissions-trading, are discussed.

Medizinische Behandlung uber lange Distanzen ist seit Jahrzehnten Gegenstand faszinierender Berichte: aus entlegenen Gebieten Australiens, aus der Raumfahrt, von Schiffen oder Arktisstationen wurden immer wieder spektakulare Aktionen berichtet. Es ist inzwischen moglich, EKGs, hochauflosende radiologische oder histologische Bilder zu ubermitteln und danach Therapieentscheidungen zu treffen. Das spart Ressourcen und macht Kompetenz weit verfugbar.

The primary purpose of the study was to test a hypothetical model for aggressive and delinquent conduct problems in adolescence. A total of 168 adolescents from 121 families were studied using several questionnaires and a semi-structured interview. The following factors were considered: obstetric complications temperament (novelty-seeking), self-esteem, family influences (perceived parenting, alcohol abuse/dependence of parents, antisocial personality disorder of the father) and peer-group characteristics (peer rejection and membership in a deviant peer group). The evaluation methods applied included correlation analyses and testing of two hypothetical models using structural equation modeling. The correlation analyses revealed significant relationships between adolescent aggressive and delinquent behavioral problems and parental antisocial behavior; perceived parental rejection and low emotional warmth; adolescent novelty-seeking, self-esteem, peer rejection and peer deviance. The two empirical models, separately for aggressive and delinquent behavior problems, revealed direct relationships between paternal antisocial behavior, parental rejection, adolescent novelty seeking, peer deviance, peer rejection, and offspring aggression and delinquency. There were, however, two differences with respect to the relationships between peer rejection, peer deviance, aggression and delinquency. First, peer rejection was more strongly associated with aggressive behavior and only moderately linked to delinquency. Second, deviance in the peer-group was found to be closely related with delinquency but only moderately with aggression. Our findings suggest that several pathways for aggressive and delinquent conduct problems are comparable while others were not. Regarding the findings of the empirical models, we conclude that only intervention measures that include parents, peers and individual adolescents may help decrease the incidence of aggressive and delinquent conduct problems.

Background: Behavioral problems in adolescence have been shown to be associated with the presence of a positive family history of alcoholism (FH+), obstetric complications (OCs), and negative parenting practices. Method: This study tested the relation of these factors to aggression/delinquency and attention problems in an untreated population sample of 154 adolescents in Pomerania. Furthermore, we evaluated the predictive strength of a FH+, OCs and negative parenting styles in a prospective subsample of 127 adolescents using a hierarchical regression analysis. Results: Group comparisons between offspring with higher vs. lower values on aggression/delinquency revealed that only rejection by the parents was significantly more often reported by teenagers with higher measures on these behavioral problems. Offspring with higher values on attention problems had more OCs reported by the mother and also had more feelings of parental rejection compared to controls. The results of the hierarchical regression analysis showed that parental rejection was the only significant predictor for both aggression/delinquency, and attention problems measured 1 year after the initial assessment. Conclusion: We conclude that parental rejection is a major risk factor for both aggression/delinquency and attention problems. Reflecting the fact that these behavioral problems have been reported to be strongly associated with later substance misuse, the improvement of parenting practices should be considered in prevention and intervention programs.

Background: Several studies from different epidemiological backgrounds have shown that unipolar depression is more prevalent in females than in males. This study examines gender differences in depression in a sample of 4075 probands recruited representatively from the general population in the northern German epidemiological catchment area of Lubeck. Methods: Probands were interviewed with M-CIDI by lay interviewers. Results: Being married only seems to increase the female depression risk when having children, while higher education reduced female excess; both male and female risk for depression raised sharply in separated, divorced and widowed probands. Not being employed was associated with an increased risk in male depression whereas in females risk was nearly unchanged. The gender ratio increased with the minimum number of depressive symptoms. Female excess was not reduced by a higher degree of subjective impairment or melancholic features. Females also predominated in longer episode durations. Female excess in the total group emerged beginning from adolescence with a tendency for a male excess in the prepubescent ages. No birth cohort effect was observed. Limitations: The cross-sectional design of this study precluded causal analysis of reported associations and some retrospective assessments are error-prone because of recall bias. Conclusions: We support previous findings of variations in gender differences in depression, however observed social parameter influences underline the need for a more detailed analysis of subgroups and underlying psychological mechanisms.

Considering that epidemiological research on dissociative disorders has suggested a 9 to 1 predominance of female cases, this study investigated the relationship between gender and dissociation using a dimensional approach. A total of 2,153 participants from different diagnostic groups completed the Dissociative Experience Scale. In order to control for the confounding effect of current psychopathology a subgroup 790 subjects additionally completed the SCL-90. We did not find any differences in the general or pathological dissociation scores. Hypothetical gender differences in dissociative psychopathology were not a function of diagnostic categories. There were no significant sex differences in the distribution of high dissociators. Our findings suggest that men and women do not generally differ in dissociative psychopathology. The implications for future investigations on the epidemiology, etiology, and psychobiology of dissociative symptoms are discussed.

Kinder alkoholkranker Eltern (CoAs) weisen ein erhohtes Risiko fur Storungen durch psychotrope Substanzen und andere psychische Probleme auf. Suchtmittelexposition allein ist jedoch keine ausreichende Erklarung fur dieses Phanomen. Aus diesem Grunde untersuchten wir in unserer Familienstudie spezifische Risiken fur ein problematisches Trinkverhalten im Jugendalter unter Berucksichtigung des elterlichen Trinkverhaltens. Die Ergebnisse der Studie zeigen ein geringeres Ausmas an elterlicher Warme und Unterstutzung bei COAs im Vergleich zu nonCOAs, wahrend sich beide Gruppen sonst nicht signifikant unterschieden, wenn die Analysen fur Madchen und Jungen nicht getrennt berechnet wurden. Unter Berucksichtigung des Geschlechts wiesen mannliche COAs, im Vergleich zu mannlichen Kontrollen hingegen mehr Aufmerksamkeitsprobleme, Angste/Depressionen und Alkoholprobleme auf. Des Weiteren konnten die Faktoren Substanzgebrauch in der Peergroup und Alter als signifikant bedeutsam fur ein problematisches Trinkverhalten im Jugendalter gefunden werden.

We tested the use of some subscales of the psychiatric symptom checklist SCL-90-R in predicting relapse within a 1-year follow-up period after a combined detoxification- and abstinence-focused day patient psychotherapy program in 20 men and 13 women with alcohol dependence. Scores of the SCL-90-R subscales interpersonal sensitivity (p = 0.008), anxiety (p = 0.022), phobic anxiety (p = 0.019) and Global Severity Index (GSI; p = 0.040) on admission were higher in the subgroup with relapse within the first year after therapy. A decrease in depression (p = 0.004), anxiety (p = 0.006) and GSI (p = 0.006) scores during therapy was associated with a longer abstinence duration (shorter vs. longer than 24 weeks). Therefore we propose to further investigate the capacity of the SCL-90-R to identify subgroups at higher risk for relapse after detoxification and abstinence therapy in patients with alcohol dependence.

The risk for suicidal ideation and suicide attempts among pathological gamblers is high compared to the general population. Little is known about the interplay of Axis I and Axis II disorders, severity of gambling disorder, and suicidal ideation and suicide attempts. The study aims to address this linkage. The sampling design of the study "Pathological Gambling and Epidemiology" (PAGE) included four recruitment channels: general population, gambling locations, project telephone hotline, and in-patient treatment for pathological gambling. A total of 442 study participants with lifetime pathological gambling received a clinical interview. The multivariate analysis showed mood disorders (Relative Risk Ratio, RRR=5.14, 95%-Confidence Interval, CI=2.91-9.07), substance use disorders (RRR=1.73, CI=1.02-2.94), and early onset of gambling disorder (RRR=0.96, CI=0.93-0.99) to be associated with suicidal ideation. Suicidal attempts were associated with female sex (RRR=3.58, CI=1.56-8.19), mood disorders (RRR=11.92, CI=4.70-30.26), and Cluster B personality disorders (RRR=2.40, CI=1.13-5.10). Among study participants with suicide attempts, more had a Cluster B personality disorder than among participants with ideation solely (RRR=3.08, CI=1.48-6.40). Among this large mixed sample of pathological gamblers, high proportions of individuals with suicidal events, multi-morbidity on Axis I, and a strong linkage to Cluster B personality disorders were found.

a b s t r a c t Background: Alcohol dependence is a severely stigmatized disorder. Perceived stigma may deter help- seeking and is associated with higher co-morbidity and self-stigma in persons with alcohol dependence. We assess changes in the perception of alcohol-related stigma over 21 years in the general population. Methods: Two representative population surveys using identical methodology were conducted in Germany in 1990 and 2011 (n = 1022 and n = 967), eliciting the perceived discrimination and devalu- ation of someone with a history of alcohol problems as measured with an adoption of Link's Perceived Discrimination and Devaluation Scale (aPDDS), and perceived negative stereotypes of an "alcoholic." Results: Both on item level and using factor scores, attitudes changed significantly between 1990 and 2011. Perceived discrimination and devaluation of someone with a history of alcohol dependence decreased considerably by 0.44 standard deviations (SD). Perceived negative stereotypes related to unpredictabil- ity of an "alcoholic" increased slightly by 0.15 SD, while perceived stereotypes related to strangeness decreased (−0.23 SD). Conclusions: Our findings suggest that particularly the image of someone who has received treatment for alcohol dependence has improved in Germany. This parallels increasing acceptance of professional treatment for alcohol dependence among the general population over the last twenty years, and contrasts with overall unchanged negative attitudes toward persons who actually suffer from alcohol problems. © 2014 Elsevier Ireland Ltd. All rights reserved.

In der Studie wurden 57 Frauen einen Tag vor, einen Tag und drei Monate nach einem stationaren Schwangerschaftsabbruch (SA) bezuglich verschiedener psychosozialer Einflussfaktoren auf spateres psychisches Befinden und Beschwerden untersucht. Weiterhin wurden als relevant beschriebene Faktoren (z. B. Qualitat der Beziehung, Kohasion) mittels Gruppenvergleich (Kontrollgruppe, n = 40 Frauen wegen Schwangerschaftskomplikationen) auf ihre Bedeutsamkeit fur einen SA uberpruft. Die Ergebnisse unserer Studie zeigen, dass die meisten Frauen im Vorfeld eines SA eine Vielzahl von psychischen und korperlichen Problemen berichten. Es konnte aber ebenso gefunden werden, dass sich das Befinden und korperliche Beschwerden des Grosteils der untersuchten Frauen einen Tag nach dem SA, als auch drei Monate spater, signifikant verbesserten. Wahrend unmittelbar nach dem SA Gefuhle wie Erleichterung und Entspannung uberwogen, waren es nach drei Monaten Frohlichkeit und Aktivitat. Es zeigte sich weiterhin, dass Frauen mit starker ausgepragter angstlich-depressiver Grundstimmung einen Tag vor dem SA, aber auch spater (nach drei Monaten), viele Beschwerden und ein schlechteres Befinden berichteten. Es scheint, dass es diesen Frauen weniger gut gelingt, vom SA im Sinne der Problemlosung (Stressmodell) zu profitieren. Letztendlich konnte die hohe Bedeutsamkeit der Qualitat der Beziehung und Kohasion fur die Entscheidung zum SA gezeigt werden, wahrend eine Schwangerschaftsberatung kaum Einfluss hatte. In this study, 57 women were examined in terms of the influence of different psychosocial factors on their subsequent mental well-being and physical complaints one day before, one day after, and 3 months after undergoing an in-patient abortion. Furthermore a control group of 40 in-patients (women with pregnancy related problems) were included in the study. The results show that prior to the abortion, most women reported a multitude of psychological and physical problems. However, it was also shown that for the majority of the women interviewed, mental well-being and physical complaints improved significantly one day and 3 months after the abortion. While feelings such as relief predominated immediately postoperatively, after 3 months, participants reported feeling cheerful and interested in activities. Further, it was demonstrated that women whose general mood was more pronouncedly anxious-depressive one day prior to operation later (after 3 months) reported many complaints and worse well-being. It appears that these women were not able to experience the abortion as a problem solutions. Finally, the great importance of the quality of their relationship and cohesion was demonstrated in the decision to abort, while pregnancy counselling was found to have no effect.

Einleitung: Nur ein Teil aller alkoholabhangigen Patienten wird leitliniengerecht behandelt. In der Behandlung stellen chronische Verlaufe und haufige Rezidive oft hohe Anforderungen an die Beteiligten des Versorgungssystems. Eine Ausweitung vorhandener Angebote ist allein aus okonomischen Grunden kein Ausweg. Kostengunstige flexible ambulante telemedizinische Therapiesysteme konnten eine Alternative darstellen. Methode: Wir fuhren seit Mai 2012 eine DFG-geforderte multizentrische, kontrollierte, randomisierte Studie zur Wirksamkeit eines interaktiven SMS-basierten Kommunikationssystems zur Trinkmengenverminderung nach Alkoholentgiftung durch (www.controlled-trials.com/ISRCTN78350716). In 4 Studienzentren in Mecklenburg-Vorpommern (Rostock, Greifswald, Schwerin, Stralsund) sollen bis November 2013 insgesamt 462 Probanden eingeschlossen werden. Die Probenden erhalten uber 12 Monate automatische SMS mit einer Frage zum aktuellen Hilfebedarf. Bei Alkoholruckfallen oder signalisierten Notlagen erfolgt eine kurze bedarfs- und losungsorientierte telefonische Intervention. Alkoholkonsum und Psychopathologie werden in Katamnesen nach 3, 6, 9 und 12 Monaten erfasst. Diskussion/Ergebnisse: Eine vorgeschaltete Pilotstudie lieferte Hinweise fur Machbarkeit, Effizienz und Effektivitat. Bei Patienten mit Konsummengen im Dosisbereich vergleichbarer Therapiestudien zeigte sich, dass die SMS-Intervention innerhalb von 8 Wochen zu einer Erhohung des Anteils von Probanden mit “low-risk”-Konsum (WHO) fuhrte (Risk Difference: 0,27, 95% CI: -0,02 – 0,51; χ2= 4.893, p = 0,087; NNT = 3,7). Schlussfolgerung: In unserem Beitrag diskutieren wir Fragen des Studiendesigns und bisherige Erfahrungen in Hinblick auf eine mogliche Umsetzung des Projekts in die Regelversorgung. Hier beleuchten wir insbesondere okonomische Aspekte und die Auswirkungen verschiedener Anreize auf die beteiligten Mitspieler bei der Behandlung der Alkoholabhangigkeit.

To examine the impact of migrants on the average firm productivity, wages and welfare we construct a general equilibrium model with monopolistic competition a la Melitz (2003) considering heterogeneous firms with different productivity levels and imperfect substitutability between migrants and natives. This gives rise to wage differences between natives and migrants. As a consequence firms with a higher share of migrants realize wage cost advantages. The heterogeneous distribution of migrants in our model might foster regional disparities. In the long run equilibrium it depends on the migrant share, which kind of firms survive in the market. Above a certain migrant share only those firms stay in the market which are highly productive or are able to compensate a lower productivity level by wage cost advantages. By modeling this process, we show that a higher migrant share may explain a higher average productivity in a region. Though the relative wages of natives to migrants increase in the migrant share, in contrast the welfare effects for natives are ambiguous: it might be the case that in a region with a higher migrant share the welfare of a native can be lower compared to a worker in a region of the same size with lower migrant share.

Partial sleep deprivation (PSD) results in a pronounced decrease of depressive symptoms in the majority of patients with major depressive disorder. Generally this acute antidepressant effect is not stable, relapse usually occurs after one night of recovery sleep. We therefore studied whether light therapy, beginning in the morning after PSD, is able to prevent the relapse after sleep deprivation, using a controlled, balanced, parallel design. All patients received an antidepressant medication, which was kept constant before and during the study period. Fourteen of 20 patients (70%) showed a reduction of at least 40% in the Hamilton Depression Rating Scale (HDRS) in the morning after PSD and were classified as PSD responders. Responders as well as nonresponders were randomly assigned to receive either bright light (BL/3000 lux) or dim light (DL/100 lux) therapy during the following 6 days after PSD. In the responder group BL therapy prevented significantly (p = 0.005) the relapse after the next night of sleep and prolonged significantly (p = 0.011) the antidepressant effects of PSD up to 7 days. In contrast, patients in the DL condition relapsed after the recovery night and showed no further improvement of the depressive syndrome after 1 week of DL therapy. PSD nonresponders did not benefit from light treatment. These findings indicate that BL therapy might be efficacious to prevent relapse after PSD.

This paper analyzes the performance of migrants on the German labor market and its dependence on the tasks performed on their jobs. Recent work suggests quantifying the imperfect substitutability relationship between migrants and natives as a measure for the hurdles migrants have to face. Our theoretical work adopts that migrant shares are very heterogeneous across firms which is hard to reconcile with an aggregate production function. We argue that the ability to integrate migrants may form a competitive advantage for firms. We show in a Melitz-type framework that the output reaction to wage changes varies across firms. Hence, substitution elasticities of an aggregate production function can be quite different from those individual firms are faced with. Finally we estimate elasticities of substitution for different aggregate CES-nested production functions for Germany between 1993 and 2008 using administrative data and taking into account the task approach. We find significant variation in the substitutability between migrants and natives across qualification levels and tasks. We show that especially interactive tasks seem to impose hurdles for migrants on the German labor market.

Economic debate about the consequences of immigration in Germany has largely focused on the wage effects for natives at an aggregate level. Especially the role of imperfect substitutability of migrants and natives gained importance. A new topic is to focus on the firm level by estimating production functions in an equilibrium framework to gain information about substitution elasticity. Additionally recent literature emphasizes the impact of the task dimension beside the qualification of workers: migrants are heavily concentrated in agglomerations and work in different jobs than natives do. This gives an explanation on the micro level for imperfect substitutability. The task approach is thus a key to understand imperfect substitution on the firm level. Our contribution in this article is manifold: we examine the effects of the relative (dis-)advantages in performing certain tasks and draw implications on the labor market outcomes. Using this we construct a simple model with a monopolistic competition framework a la Dixit-Stiglitz considering heterogeneous firms with different productivity levels and two types of jobs for migrants and natives. Firms differ in the ability to employ migrants which gives rise to wage differences between natives and migrants. This wage differences lead to wage cost advantages for firms. In the long run equilibrium only those firms with survive in the market which have a sufficiently high productivity level or can compensate their lower productivity level by wage cost advantages. We show that the increase of productivity might be explained by a higher migrant share. Regional disparities in our model stem from the unequal distribution of migrants. Thus part of the agglomeration advantages can be explained by the empirical stable observation that migrants tend to move to cities. The conclusions of the model are in line with three empirical facts in Germany. Firstly, the average productivity of firms is higher in cities where also the migrant share is higher. Secondly, the wage difference between migrants and natives in a region is increasing in the share of migrants in that region. Thirdly, less productive firms are more likely to employ a higher share of migrants, as wage advantages and productivity acts as a substitute. keywords: immigration, firm heterogeneity, skills, tasks, regional labor markets JEL: R23, J15, J24, J61

Aims: Stigma is likely to aggravate the severe medical and social consequences of alcohol dependence. We aim to explore the characteristics of the alcohol dependence stigma by comparing it with the stigma of other conditions. Methods: On the basis of a systematic literature search, we identified 17 representative population studies published before July 2010 that examine aspects of the stigma of alcoholism and simultaneously of other mental, medical or social conditions. Seven surveys were located in Europe, five in North America, three in New Zealand and one each in Brazil and Ethiopia, respectively. Results: Compared with people suffering from other, substance-unrelated mental disorders, alcohol-dependent persons are less frequently regarded as mentally ill, are held much more responsible for their condition, provoke more social rejection and more negative emotions, and they are at particular risk for structural discrimination. Only with regard to being a danger, they are perceived to be at a similarly negative level to that of people suffering from schizophrenia. Conclusion: Alcoholism is a particularly severely stigmatized mental disorder. Cultural differences are likely, but under-researched. We discuss possible reasons for the differences between the stigma of alcoholism and of other mental diseases and the consequences for targeted anti-stigma initiatives.

Although among the most prevalent psychiatric conditions, alcoholism seems to be neglected within the current debate on mental illness stigma. We establish the state of current research on public attitudes towards alcohol dependent people.In an extensive search of the literature, we identified 49 population studies on this topic between 1948 and 2008. 27 studies contained relevant information from Western countries and were included in this review.Although most people regard alcoholism as an illness, there is a strong tendency to blame those affected for their condition. Psycho-social causal attributions prevail over biologic explanations. Most people regard alcohol dependent persons as unpredictable and dangerous. The desire for social distance is stronger towards alcohol dependent persons than towards those with other psychiatric diagnoses such as depression or schizophrenia; only those addicted to illegal drugs suffer stronger rejection. Preferences of the public for resource allocation within the health care system put alcohol dependent patients at a potential disadvantage.Alcoholism is a severely stigmatized condition. In order to change the stigma of alcoholism, studies exploring theoretical models and mechanisms of stigmatization seem necessary.