الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Substance dependence is an important social problem in many countries.200 millions people make use of one type of illict substances or another substance, opioid estimated as 16 million of them. Egyptian surveys found a gradual increase in the use of tramadol among Egyptians reaching about 65% in subject seeking substance abuse treatment programs.Genetic and environmental factors contribute to predisposition of drug addiction. It has been estimated that genetic factors account for (40-60%) of vulnerability to drug addiction while environmental factors provide the remainder. Heritable influences depend on environmental risk factors, and vice versa. This situation known as gene- environment interaction.It was found that mu opioid receptor gene has been associated with opiate addiction. A118 G variant was one of first discovered single nucleotide polymorphism in mu opioid receptor gene (OPRM1)that has been evaluated in a number of genetic studies showing contribution to opiate and drug addiction.The present study was carried out between Neuropsychiatry and Medical Biochemistry departments faculty of Medicine Menoufia University. It involved 60 subjects, 40 patients with tramadol addiction and 20 apparently healthy persons. They were males with age ranging from ( 20 - 50 ) years. The patients were attendants of outpatients clinic and inpatient of Shebin El-kom hospital of mental health during the period from January to April 2014. They were classified into the following groups:group 1: Include20 patients with tramadol addiction group 2: Include20 patients with tramadol induced psychotic disorders group 3 : Include 20 age and sex matched healthy subjects.Both cases and controls will be subjected to: Informed consent. All patients will be subjected to full medical history and examination.Semi structured interview sheet for addiction. The structured clinical interview for DSM-IV Axis I disorders SCIDI) . Temperament and character entory- revised (TCI- R). Laboratory investigations were measured for both patients and controls including:- Detection of tramadol in urine . - Detection of OPRM1 A118G polymorphism by PCR.The main findings we found in our study As regard socio-demographic data assessment there was no significant difference between (Tramadol dependence, Tramadol induced psychotic disorders and Normal groups) as regard Age,marital status, Education, Employment and Socioeconomic status.In Comparison between Tramadol dependence and Tramadol induced psychotic disorders groups regarding Clinical characteristics:- that there was no significant difference between Tramadol dependence and Tramadol induced psychotic disorders groups) as regard (Age of onset of abuse / years, Average daily dose in past year/ day, Duration of Tramadol abuse/year, Relapse,Overdose and Hospitalization In Comparison between studied groups regarding PCR:-there was significant difference as regard AA genotype Its percentage was higher in normal group(70%) than Tramadol dependence group(30%) and tramadol induced psychotic disorders group (25%).There was also significant difference as regard AG genotype Its percentage was higher in tramadol dependence (30%) and tramadol induced psychotic disorder(30%)more than the Normal group(20%)and as regard GG genotype Its percentage was higher in tramadol induced psychotic disorders group(40%) more than tramadol dependence(35%) and Normal group(10%). In Comparison between different genotypes among tramadol dependence groups regarding personality scale:- There was in comparison between different genotypes (AA genotype ,AG genotype and GG genotype) among tramadol dependence groups as regard(Novelty seeking, Harm avoidance,Reward dependence, persistence, Self directedness, Cooperativeness and Self transcendence) no statistically significant difference (pvalue>0.05) by using Kruskal Wallis test. from our study we concluded that The social and environmental factors have been acknowledged of contributing to the risk of addiction, A118G allele in< exon 1 of the OPRM1 gene associated with opiate addiction. this implies that genetics and environmental factors plays an important role in the development of addiction and DNA research in human can contribute to help delineate the substances and systems in the brain which are related to dependence and to determine whether or not certain individuals are susceptible to drug addiction from our study we recommended that Further studies are required to understand precisely how genetic polymorphism affects on development of vulnerability to addiction.