Phosphatidylethanol (PEth) is a direct ethanol metabolite, and has recently attracted attention as biomarker of ethanol intake. The aims of the current study are: (1) to characterize the normalization time of PEth in larger samples than previously conducted; (2) to elucidate potential gender differences; and (3) to report the correlation of PEth with other biomarkers and self-reported alcohol consumption. Fifty-seven alcohol-dependent patients (ICD 10 F 10.25; 9 females, 48 males) entering medical detoxification at three study sites were enrolled. The study sample was comprised of 48 males and 9 females, with mean age 43.5. Mean gamma glutamyl transpeptidase (GGT) was 209.61 U/l, average mean corpuscular volume (MCV) was 97.35 fl, mean carbohydrate deficient transferrin (%CDT) was 8.68, and mean total ethanol intake in the last 7 days was 1653 g. PEth was measured in heparinized whole blood with a high-pressure liquid chromatography method, while GGT, MCV and %CDT were measured using routine methods. PEth levels at day 1 of detoxification ranged between 0.63 and 26.95 micromol/l (6.22 mean, 4.70 median, SD 4.97). There were no false negatives at day 1. Sensitivities for the other biomarkers were 40.4% for MCV, 73.1% for GGT and 69.2% for %CDT, respectively. No gender differences were found for PEth levels at any time point. Our data suggest that PEth is (1) a suitable intermediate term marker of ethanol intake in both sexes; and (2) sensitivity is extraordinary high in alcohol dependent patients. The results add further evidence to the data that suggest that PEth has potential as a candidate for a sensitive and specific biomarker, which reflects longer-lasting intake of higher amounts of alcohol and seemingly has the above mentioned certain advantages over traditional biomarkers.

SMO has proved safe and effective in the treatment of alcohol withdrawal syndrome and in the prevention of relapses. Craving for and abuse of SMO have been reported, in particular in some subtypes of alcoholic patients, e.g., those affected by co-addiction and/or psychiatric comorbidity. Future multicenter, multinational, randomized clinical trials should be useful to optimize the treatments in relation with patients' characteristics, for example, pharmacogenetic, neurobiological, and psychological.

Up to two thirds of adolescents consume alcohol and about a quarter engage in abusive behavior at some point. Many users begin alcohol use at young ages, and binge drinking is a dominant pattern for a proportion of youth. Because neurogenesis is inhibited by ethanol, consequences of adolescent alcohol abuse include changes in brain development and impairment of neurocognitive performance. A variety of mental and psychosocial problems are also often witnessed in alcohol abusing youth. Apart from the influence exerted by genetic and psychosocial factors, the chance of developing problematic alcohol consumption is increased by consumption in a binge drinking manner and by first contact with alcohol at a young age. Discrimination of alcohol consumption within the frames of normal adolescent behavior from problematic use is still a challenging issue. Different prevention programs provide treatment either directly to the adolescent, in the context of the school, or within the frame of the adolescent's family. Although some of these efforts have been shown to be effective in reducing alcohol misuse in youth, hardly any intervention reveals satisfactory outcomes in a long-term prospect. Successful prevention strategies would need to comprise treatment of current neuropsychological impairment as well as of comorbid mental health problems and concurrent other substance misuse.

There is limited research exploring attachment style and defenses in adolescents. The purpose of the current research is to explore the relationship between adolescent attachment style and development of defense mechanisms, as well as attachment style and problem behaviors. A total of 1487 students from two California high-schools completed three self-report questionnaires to establish defense mechanisms, psychiatric symptoms, and attachment style. Attachment styles characterized by a positive selfimage predict greater levels of mature defense mechanisms, and lower levels of immature defense mechanisms, both in the interpersonal and intrapsychic domains. Relationships between insecure attachment styles and psychopathology were mediated by greater levels of immature defense mechanisms. These results provide initial compelling evidence that: a) attachment style is an important determinant of the type of defense mechanisms utilized by the individual to maintain psychological stability; and b) defense mechanisms serve to transmit the detrimental effects of insecure attachment style on psychological health.

Background Alcohol Dependence (AD) is often accompanied by co-morbid depression. Recent clinical evidence supports the benefit of subtype specific pharmacotherapy in treating the population of AD subjects with co-morbid major depressive disorder (MDD). However, in many AD subjects, depression is a reactive response to chronic alcohol use and withdrawal, and abates with a period of abstinence. Genetic markers may distinguish alcohol dependent subjects with MDD not tied chronologically and etiologically to their alcohol consumption. In this work we investigated the association of adenylyl cyclase genes (ADCY1–9), which are implicated in both AD and mood disorders, with alcoholism and co-morbid depression. Methods Subjects from Vienna, Austria (n = 323) were genotyped and SNPs (1,152) encompassing the genetic locations of the nine ADCY genes were examined. The Vienna cohort contained alcohol dependent subjects differentiated using the Lesch Alcoholism Typology. In this typology subjects are segregated into four types. Type III alcoholism is distinguished by co-occurrence of symptoms of depression and by affecting predominantly females. Results We identified four haplotypes associated with the phenotype of Type III alcoholism in females. One haplotype was in a genomic area in proximity to ADCY2, but actually within a lincRNA gene, two haplotypes were within ADCY5, and one haplotype was within the coding region of ADCY8. Three of the four haplotypes contributed independently to Type III alcoholism and together generated a positive predictive value of 72% and a negative predictive value of 78% for distinguishing women with a Lesch Type III diagnosis versus women designated as Type I or II alcoholics. Conclusions Polymorphisms in ADCY8 and ADCY5 and within a lincRNA are associated with an AD phenotype in females, which is distinguished by co-morbid signs of depression. Each of these genetic locations can rationally contribute to the polygenic etiology of the alcoholism/depression phenotype and the use of these genetic markers may aid in choosing appropriate and beneficial treatment strategies.