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1St International Conference on Behavioral Addictions March 11–12, 2013 Budapest, Hungary

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1St International Conference on Behavioral Addictions March 11–12, 2013 Budapest, Hungary Journal of Behavioral Addictions 2(Suppl. 1), pp. 1–50 (2013) DOI: 10.1556/JBA.2.2013.Suppl.1 1st International Conference on Behavioral Addictions March 11–12, 2013 Budapest, Hungary PLENARY PRESENTATIONS PL-01 Subthreshold conditions: Prevention or medicalization? JUDIT BALAZS Institute of Psychology, Eötvös Loránd University, Budapest, Hungary Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary E-mail: [email protected] Recently there has been a growing interest in subthreshold lescents from 11 countries show that adolescent subthres- form of disorders in children and adolescents. In these cases hold depression is associated with an increased burden of individuals do not qualify for any diagnoses of mental disor- disease and suicide risk (Balazs et al., 2012). Subthreshold ders, when rigorous standardized classification criteria [Di- forms of behavior addictions have been gaining attention in agnostic and Statistical Manual of Mental Disorders 4th Edi- recent years, however, definitions and diagnostic criteria of tion (DSM-IV) (American Psychiatric Association, 1994) different types of behavior addictions are controversial. Fo- and International Classification of Mental and Behavioral cusing on Internet addiction we compared the characteristics Disorders 10th Edition (ICD-10) (World Health Organiza- of maladaptive and pathological Internet use among adoles- tion, 1992)] are applied, however, they have clinically rele- cents (Durkee et al., 2012). Based on international and our vant psychiatric symptoms, which cause substantial func- own data, subthreshold conditions may represent good tar- tional impairment. Most research on adolescent sub- gets for preventive interventions. While we appreciate the threshold conditions, similarly to adults was carried out on concerns about medicalization of normal variability of reac- subthreshold depressive episode. It was found to be a highly tions, we would like to emphasize, that recognition and ap- prevalent condition, which has an increased risk for devel- propriate care of adolescent subthreshold conditions may oping future depressive episodes. Our data on 12,395 ado- improve and even save lives of young people. PL-02 Neurogentics, medical monitoring and nutrigenomic solutions to diagnose and treat Reward Deficiency Syndrome (RDS): From bench to bedside KENNETH BLUM1,3–7*, DAVID HAN2,5 and JOHN GIORDANO3,7 1Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, USA 2Department of Management Science & Statistics, University of Texas at San Antonio, San Antonio, Texas, USA 3Department of Holistic Medicine, G&G Holistic Addiction Treatment, North Miami Beach, Florida, USA 4Global Integrated Services Unit, University of Vermont Center for Clinical & Translational Science, College of Medicine, Burlington, Vermont, USA 5Dominion Diagnostics, LLC, North Kingstown, Rhode Island, USA 6Department of Addiction Research & Therapy, Malibu Beach Recovery Center, Malibu Beach, California, USA 7Department of Nutrigenomics, LifeGen, Inc., Austin, Texas, USA *E-mail: [email protected] In 1990 Blum et al. reported in JAMA the first confirmed as- tions. Utilizing Bayesian mathematical models they pro- sociation in the field of “Psychiatric Genetics” of the dopa- posed that carrying the DRD2A1 allele at birth the predic- mine D2 receptor Taq A1 allele and sever alcoholics. While tive value for many addictions (e.g. drugs, alcohol, nicotine, the media wrongly touted the concept of an “Alcogene” the glucose, ADHD, Tourette’s, autism, obesity, pathological study authors recognized the importance of a “Reward gambling, Internet gaming, self-mutilation, sex, among oth- Gene.” Following replication and even controversy the find- ers) was as high as 74%. In accord with the new definition of ing has been established in the scientific literature as a major addiction published by the American Society of Addiction genetic polymorphism involved in multi-addictions not only Medicine (ASAM), it is well known that individuals, who drugs and alcohol. Moreover, in 1996, Blum et al. reported present to a treatment center involved in both chemical de- in the Journal of the Royal Society of Medicine on the then pendency and other documented related “Reward Defi- new concept “Reward Deficiency Syndrome (RDS)” to de- ciency Syndrome (RDS)” behaviors, have impaired brain re- scribe a common genetic rubric to explain behavioral addic- ward circuitry. They have hypodopaminergic function due ISSN 2062-5871 © 2013 Akadémiai Kiadó, Budapest Unauthenticated | Downloaded 09/26/21 12:21 AM UTC 1st International Conference on Behavioral Addictions to genetic or environmental negative pressures upon the re- shown to activate mesolimbic caudate accumbens (fMRI ward neuro-circuitry. Over the last two decades our labora- study) dopamine to reduce cravings and also shown to in- tory developed a number of important tools to assist in atten- duce regulation of widespread theta activity (qEEG study) in uating all RDS behaviors during the recovery process. To the PFC-Cingulate Gyrus brain region to reduce relapse and this end we have systematically evaluated the role of “Re- increase focus in both heroin and psychostimulant addicts; ward Deficiency Solution System™” which includes: 1) Ge- using mRNA analysis to determine treatment outcome by netic Addiction Risk Score (GARS) panel to diagnose RDS; reward gene expressions pre and post. Finally our laboratory 2) Comprehensive Analysis of Reported Drugs (CARD)™ with others are developing lentiviral incorporation of vari- to determine compliance to prescription medications as well ous cDNA’s having dopaminergic function to rodent models as abstinence from licit and illicit psychoactive drugs; 3) a (e.g. Lewis, etc.) as novel gene therapy approaches already nutrigenomic based natural dopamine D2 receptor agonist established by Volkow’s group for cocaine and alcohol. PL-03 Investigating compulsivity using endophenotype-probes: A trans-diagnostic perspective NAOMI A. FINEBERG National Treatment Service for OCD (England), Hertfordshire Partnership NHS Foundation Trust, Queen Elizabeth II Hospital, Welwyn Garden City, AL7 4HQ, United Kingdom University of Hertfordshire Postgraduate Medical School, College Lane, Hatfield, Herts, United Kingdom E-mail: [email protected] Compulsions are repetitive, stereotyped behaviours, per- have identified under-activation in these neural systems formed according to rigid rules and designed to reduce or during reversal of responses. This lateral OFC hypoactivity avoid unpleasant consequences. Obsessive–compulsive dis- contrasts with enhanced ventromedial OFC activity that has order (OCD) is the archetypal compulsive disorder and rep- been reported in both PET and fMRI studies following resents an ideal illness-model for translational research into symptom-provocation in OCD, possibly reflecting func- psychobiological factors underpinning compulsive activity tional subdivisions within the OFC. Resting state FMRI im- and its remediation. A focus on compulsivity is also relevant aging additionally identifies functional disconnection of the for other disorders exhibiting compulsive behaviour such as orbitofrontal cortex in patients with OCD and similar behavioural or substance addiction; a current theory of ad- changes in stimulant dependent individuals that correlate diction proposes a shift from impulsive to compulsive be- with the severity of compulsive activity across both patient haviour, ultimately dominated by stimulus-response habits. groups and that may represent a biomarker for compulsivity Identification of intermediate markers of brain dysfunction across diagnostic categories. These data are compatible with (endophenotypes), such as neuropsychological and neuro- theories implicating the failure of top-down cortical inhibi- imaging parameters, may constitute a useful link between tion releasing striatally-mediated compulsive activity. Thus, genotype and phenotype in disorders characterised by compulsive symptoms could emerge from an imbalance of compulsivity. Patients with OCD and their unaffected activity within the frontal cortex or the striatum, or both. The first-degree relatives exhibit deficits in inhibitory control connectivity of these regions is a likely crucial factor. Dif- and aspects of mental flexibility, which have in turn been ferent circuits may mediate action-outcome and habit learn- linked with grey matter and white matter changes in neural ing, with OCD being biased towards the latter. Ongoing regions such as the right frontal lobes and basal ganglia. Ad- work shows enhanced avoidance-habits in OCD, which may ditionally, functional MRI probes of orbitofrontal integrity turn out to be core to compulsion. PL-04 Holistic interventions promote enhanced recovery from behavioral addictions in an in-patient facility: Where “science meets recovery” JOHN GIORDANO1* and KENNETH BLUM1–3 1Department of Holistic Medicine, G&G Holistic Addiction Treatment, North Miami Beach, Florida, USA 2Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, USA 3Global Integrated Services Unit, University of Vermont Center for Clinical & Translational Science, College of Medicine, Burlington, Vermont, USA *E-mail: [email protected] In accord with the new definition of addiction published by hypodopaminergic function due to genetic or environmental the American Society of Addiction Medicine (ASAM),
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