Measures for prevention of homelessness should include: foundation of national registry of homeless persons, development of systemic multisectorial cooperation and special psychosocial intervention strategies. In homeless population, health care measures should be focused on prevention and treatment of mental health disorders and chronic somatic diseases.

Introduction: Tourette syndrome (TS) is a neurodevelopmental disorder with a high prevalence of psychiatric comorbidity. The most common comorbid disorder in patients with TS is attention-deficit/hyperactivity disorder (ADHD). To date, there have been few reports concerning the association of TS with addiction. Methods: We report on 4 patients with TS, ADHD, and heroin addiction. Results: All 4 patients were male and initially presented with TS when they were between 5 and 12 years of age, although 2 of the patients were not diagnosed with TS until they were adults. The patients currently range in age from 21 to 52 years, all having experienced the onset of heroin addiction in adolescence. A reduction in tics during periods of heroin abuse was noted in all patients. Discussion: The lifetime prevalence of psychiatric comorbidity in patients with TS is 85.7%, with 57.7% of patients having ≥2 psychiatric conditions in addition to TS. All of the 4 patients in our case series demonstrated a pattern of severe tics, ADHD, impulsive behavior, and heroin addiction. Our observation that these 4 patients with TS showed reduced tics during periods of heroin dependence could be related to the previously described effects of opiates on dopaminergic transmission. Conclusions: The observed reduction of tics during heroin dependence warrants further clinical research.

Introduction:Socio-cultural context of transition society intensifies overall risks of use and misuse of tobacco, alcohol and illicit drugs.Aim:To determine the prevalence of tobacco, alcohol and marijuana use among adolescents and young adults in Serbia.Method:The study included 3180 participants aged between 16 and 35 years from different, both urban and rural, parts of Serbia. Collection of data was conducted in May 2003. Participants completed self-administered anonymous questionnaires (modified YOUTH RISK BEHAVIOUR SURVEY) that consisted of sociodemographic characteristics and experiences related to alcohol, tobacco and marijuana use.Results:Majority of participants (64%) reported experience with smoking cigarettes at least once, while 51% smoke regularly. Prevalence of smoking was by 10% higher among males. Overall, 75% of the participants reported lifetime alcohol use, and 19% reported drinking alcohol at the age of fifteen or younger. Of the total number 36% experienced alcohol-induced blackouts at least once a month. Males were prone to blackouts significantly more often then females (3:1). The overall prevalence of marijuana use among participants was 32%. During one month before survey 10% of participants had smoked marijuana. Our study showed that the risk of marijuana use in regular cigarette smokers is two-fold higher then in non-smokers. Alcoholism of both parents and family dysfunctionality were related to significantly higher risk of marijuana use.Conclusion:Early tobacco use, history of family disorganization and parental alcoholism were identified as factors related to increased risk of alcohol and marijuana abuse among adolescents and young adults in Serbia.

Background:Narcotics addiction has commonly been regarded as a single-substance phenomenon.Aims and Methods:Follow-up interviews on a sample of 32 heroin addicts who had been in nonmethadone treatment for narcotics addiction at our Institute (spring 2007) were used to examine alcohol use and substitution of alcohol for heroin. Groups were classified as: no use of alcohol, irregular consumption and daily consumption, with aim to identify background and baseline factors related to substitution. We analyzed data relevant to the aims of our research in two stages of addiction career (before the treatment and 6 months after the beginning of treatment)Results:One fourth of the sample (8 patients) used alcohol as a substitution pattern. The substitution was found to be related to higher levels of alcohol problems before addiction. The results showed a strong relationship between substitution and parental alcohol problems and family quarrels which had existed before the treatment, as well as 6 months after they entered the treatment Aggressive behavior of the subjects who used alcohol in the substitution pattern caused problems with law in the both stages of addiction career. All 8 patients fulfilled criteria for depression (HAM/D below 21).Conclusions:The results confirmed the validity of substitution as a powerful construct in identifying behavioral differences before and after addition.The phenomenon of substance substitution during the treatment should be considered not as evidence of the treatment failure but as an additional aspect of the addiction that must be addressed within the therapeutic framework.

IntroductionGlobal socio-cultural and family context of Serbian society intensifies risks of marijuana use (MU).ObjectivesPrevalence of MU in young population in Serbia and identification of family factors related to increased risk of MU.AimFive indicators were examined: prevalence of MU, age of first MU, MU during one month before survey, motives for MU, family factors of risk for MU.MethodThe study included 2987 participants aged between 16 and 35 years from different parts of Serbia. Collection of data was conducted in April 2007. Participants completed self-administered anonymous questionnaires (modified YOUTH RISK BEHAVIOUR SURVEY) that consisted of sociodemographic characteristics and experiences related to MU.ResultsThe prevalence of lifetime MU among participants was 32%. First use was reported by 14% to occur at the age of sixteen or younger. During one month before survey 10% of participants had smoked marijuana. Risk of MU in regular cigarette smokers is two-fold higher than in non-smokers. Key motives for MU are curiosity (59%), achieving “good mood” (12%), persuasion by persons of the same age (11%), the emotional crisis (8,5%). Alcoholism of both parents and family dysfunctionality - especially physical and verbal conflicts between parents - were related to significantly higher risk of marijuana use.ConclusionEarly use of marijuana, history of family disorganization, parental alcoholism and conflicts were identified as factors significantly related to increased risk of marijuana use among young population in Serbia.