采用HPLC-MS-AIS法测定钩藤中四种生物碱含量

目的 采用高效液相-质谱联用-自体内标法（HPLC-MS-AIS）测定钩藤中四种主要的吲哚类生物碱（钩藤碱、异钩藤碱、去氢钩藤碱、异去氢钩藤碱）含量。方法 采用C₁₈色谱柱（3.0 mm×50 mm，3.3 μm）；0.1%甲酸水溶液∶乙腈=82∶18为流动相；流速0.5 mL/min；柱温30℃。质谱条件：电喷雾离子源；正离子多反应监测模式；毛细管电压为4 000 v；选择质子数/电荷数（m/z）：385.25/160.10（钩藤碱）、385.30/160.10（异钩藤碱）、383.25/160.15（去氢钩藤碱）、383.25/160.15（异去氢钩藤碱）作为检测离子对；进样量2 μL。结果 钩藤碱、异钩藤碱、去氢钩藤碱、异去氢钩藤碱线性范围分别为2.30~600.00 ng/mL（r=0.999 3）、2.30~600.00 ng/mL（r=0.999 2）、2.47~650.00 ng/mL（r=0.999 4）、2.47~650.00 ng/mL（r=0.999 2），精密度和稳定性的相对标准偏差（RSD）均<5.00%，准确度为92.40%~104.10%，加样回收率为95.90%~104.60%。结论 采用HPLC-MS-AIS法测定钩藤中四种生物碱含量简便准确，可作为钩藤药材质量控制的新方法。     

护士职业紧张、心理资本和失眠的关系：心理资本的中介作用

目的 探讨护士职业紧张、心理资本和失眠的关系,并检验心理资本在护士职业紧张与失眠之间的中介作用。方法 于2021年3月-5月,采用分层随机抽样法选取某三甲医院的810名护士为研究对象。采用付出-回报失衡问卷（ERI）、心理资本量表（PCQ）和阿森斯失眠量表（AIS）分别评定护士的职业紧张、心理资本和失眠情况,采用PROCESS中介效应检验分析心理资本在护士职业紧张与失眠之间的中介作用。结果 回收有效问卷658份（81.23%）,护士付出-回报比与AIS评分呈正相关（r=0.379,P?0.01）,与PCQ评分呈负相关（r=-0.275,P?0.01）;PCQ评分与AIS评分呈负相关（r=-0.402,P?0.01）。护士职业紧张可以负向预测心理资本（β=-11.024,t=-7.324,P<0.01）以及正向预测失眠（β=4.117,t=10.478,P<0.01）;心理资本可负向预测失眠（β=-0.087,t=-9.083,P<0.01）。当心理资本作为中介变量加入时,职业紧张对失眠的预测作用有统计学意义（β=3.158,t=8.185,P<0.01）。结论 心理资本在护士职业紧张和失眠之间起部分中介作用。     

新冠肺炎疫情压力与社会适应：忍耐和社会支持的中介作用

目的 考察新冠肺炎（COVID-19）疫情压力对大学生社会适应的影响，以及忍耐和社会支持在其中的中介作用，并比较忍耐与社会支持中介效应的差异。方法 通过整群随机取样选取3 219名大学生，采用COVID-19疫情压力问卷、社会适应能力诊断量表（SAI）、忍耐问卷（PQ）和社会支持评定量表（SSRS）进行评定，应用SPSS的Process插件进行中介效应检验。结果 大学生COVID-19疫情压力问卷评分与PQ和SSRS评分均呈正相关（r=0.297、0.229，P均<0.01），与SAI评分呈负相关（r=-0.430，P<0.01），PQ和SSRS评分与SAI评分均呈正相关（r=0.374、0.283，P均<0.01），PQ与SSRS评分呈正相关（r=0.271，P<0.01）。忍耐在COVID-19疫情压力与社会适应之间具有部分中介作用（β=0.049，95% CI：0.039~0.062），社会支持在COVID-19疫情压力与社会适应之间具有部分中介作用（β=0.016，95% CI：0.009~0.025）。结论 COVID-19疫情压力对大学生社会适应具有负性影响，忍耐和社会支持对此负性作用起缓冲作用，且忍耐的中介效应更明显。     

儿童青少年精神障碍患者睡眠不足及相关因素

目的 探讨儿童青少年精神障碍患者睡眠不足的现况及相关影响因素。方法 选取2021年2月-6月就诊于阜阳市第三人民医院且符合《国际疾病分类（第10版）》（ICD-10）精神分裂症、抑郁障碍、童年情绪障碍诊断标准的131例儿童青少年患者为研究对象，采用自制调查问卷收集患者的一般人口学资料、睡眠情况、生活情况、家庭和学校情况等信息，比较睡眠充足组和睡眠不足组人口学资料的差异，采用Spearman法分析患者睡眠不足的相关因素。结果 ①在131例儿童青少年精神障碍患者中，93例（71.0%）存在睡眠不足，睡眠不足组与睡眠充足组在疾病类别（χ²=8.798，P=0.012）、近6个月内被打（χ²=3.427，P=0.035）或被骂（χ²=4.145，P=0.031）以及一年内遭受网络欺凌（χ²=4.187，P=0.041）方面，差异均有统计学意义。②在睡眠不足的患者中，77例（82.8%）存在入睡困难，69例（74.2%）存在夜间多醒。③儿童青少年精神障碍患者睡眠不足与近6个月内有被骂经历（r=0.210，P=0.037）或被打经历（r=0.145，P=0.023）以及一年内遭受网络欺凌（r=0.179，P=0.041）呈正相关。结论 儿童青少年精神障碍患者睡眠不足的发生风险较高，且与抑郁障碍、有被打和被骂经历、经受过网络欺凌相关。     

医学生焦虑、抑郁情绪对网络游戏障碍的影响：性别的调节作用

目的 探究焦虑、抑郁情绪对医学生网络游戏障碍的影响以及性别在其中的调节效应，为预防和干预医学生网络游戏障碍提供参考。方法 于2021年11月，选取四川省某医学院校11 771名医学生作为研究对象，通过问卷星网络平台，采用焦虑自评量表（SAS）、抑郁自评量表（SDS）和简式网络游戏障碍量表（IGDS9-SF）进行评定，采用多元分层回归分析性别在焦虑、抑郁情绪和网络游戏障碍关系中的调节作用。结果 ①男生SDS评分低于女生（t=-8.302，P<0.01），IGDS9-SF评分高于女生（t=33.384，P<0.01）。②医学生SAS评分与SDS评分呈正相关（r=0.735，P<0.01），SAS和SDS评分与IGDS9-SF评分均呈正相关（r=0.288、0.238，P均<0.01）。③焦虑、抑郁情绪可以正向预测网络游戏障碍（β=0.245、0.058，t=18.864、4.444，P均<0.01）。④性别在焦虑情绪与网络游戏障碍之间具有调节作用（β=-0.194，t=-4.518，P<0.01）。结论 焦虑、抑郁情绪对医学生网络游戏障碍有正向预测作用。焦虑情绪对医学生网络游戏障碍的影响受到性别的调节，相比于女生，焦虑情绪对男生网络游戏障碍的影响更大。     

血清NGB、BNP水平与颅脑损伤患者伤情严重程度及预后的相关性研究

目的 探究血清神经珠蛋白（NGB）、脑钠肽（BNP）水平与颅脑损伤（TBI）患者伤情严重程度及预后的相关性。方法 以127例TBI患者为研究对象,99例健康志愿者作为对照。利用ELISA法检测血清中的NGB和BNP水平,格拉斯哥预后评分(GOS)判断预后。分析TBI患者治疗前血清中NGB和BNP的含量与TBI程度的关系。结果 末次随访TBI患者预后良好组血清中NGB和BNP的含量低于预后不良组（P<0.05）。TBI患者血清中NGB和BNP的含量与TBI程度成正相关（r=0.705,0.781;P<0.05）,与格拉斯哥昏迷评分（GOS）评分呈负相关（r=-0.886,-0.812;P<0.05）。血清中NGB含量与TBI程度有相关性(OR=1.059,95％CI:1.004~1.325,P=0.030)。ROC曲线结果显示,血清中BNP含量与TBI程度有相关性(OR=1.217,95％CI:1.015～1.377,P=0.020)。结论 血清NGB、BNP水平与TBI患者伤情严重程度及预后康复效果呈正相关。     

TRIM38非CpG岛DNA甲基化与胶质瘤异柠檬酸脱氢酶突变的关系研究

目的 探讨TRIM38基因非CpG岛DNA甲基化与胶质瘤异柠檬酸脱氢酶（IDH）基因突变之间的关系。方法 利用中国胶质瘤基因组图谱计划（CGGA）数据库的多组学数据和临床资料，比较在IDH野生型或突变型的胶质瘤中，TRIM38非CpG岛DNA甲基化的改变模式以及与基因表达和临床预后的关系。结果 共纳入CGGA胶质瘤325例及非肿瘤对照脑组织（NTB组）11例，分析发现IDH野生型胶质瘤TRIM38非CpG岛DNA甲基化和基因表达，相对NTB组分别发生低甲基化（P =0.000）和高表达（P=0.007），且两者之间呈负相关（P=0.017）。生存分析显示，TRIM38非CpG岛DNA甲基化水平与IDH野生型肿瘤的预后有关（P=0.061）。结论 IDH突变可能通过限制TRIM38基因非CpG岛DNA低甲基化介导的肿瘤促癌基因表达上调，为IDH突变相关的胶质瘤提供“保护作用”。     

抑郁障碍患者精神运动性迟滞与血浆G-CSF、M-CSF水平的相关性

背景 抑郁障碍的发病机制与神经炎症密切相关,且异质性高,细化亚型有助于明确抑郁障碍的生物标志物。精神运动性迟滞严重影响抑郁障碍转归,但其机制尚不清楚。既往研究提示,粒细胞集落刺激因子（G-CSF）和巨噬细胞集落刺激因子（M-CSF）可能参与伴精神运动性迟滞的抑郁障碍发生过程,但目前研究不足。目的 分析抑郁障碍患者G-CSF和M-CSF水平与精神运动性迟滞的相关性,探索伴精神运动性迟滞抑郁障碍的潜在生物学特征。方法 纳入2018年4月―2019年4月在上海市精神卫生中心门诊就诊、符合《精神障碍诊断与统计手册（第5版）》（DSM-5）诊断标准的50例抑郁障碍患者为研究对象。采用汉密尔顿抑郁量表17项版（HAMD-17）评定抑郁障碍严重程度。根据HAMD-17迟滞因子评分对患者分组：该因子评分≥8分者为迟滞组（n=22）,<8分者为无迟滞组（n=28）。同期招募与患者组年龄和性别相匹配的健康对照组共22例。使用Luminex液相悬浮芯片技术检测所有受试者血浆G-CSF和M-CSF水平。采用Spearman相关分析考查抑郁障碍患者HAMD-17迟滞因子评分与血浆G-CSF和M-CSF水平的关系。结果 抑郁障碍患者血浆G-CSF水平低于健康对照组［57.34（39.24,83.15）pg/mL vs.71.47（61.20,79.99）pg/mL,Z=-2.098,P<0.05］。迟滞组、无迟滞组、健康对照组血浆G-CSF水平差异有统计学意义［63.92（54.60,89.43）pg/mL vs. 47.80（33.41,74.66）pg/mL vs. 71.47（61.20,79.99）pg/mL,H=8.247,P=0.016］,三组血浆M-CSF水平差异有统计学意义［20.05（16.05,22.23）pg/mL vs. 13.05（11.43,17.50）pg/mL vs. 18.95（14.59,22.88）pg/mL,H=7.620,P=0.022］。事后两两比较显示,无迟滞组血浆G-CSF水平低于健康对照组（调整后P<0.05）,迟滞组血浆M-CSF水平高于无迟滞组（调整后P<0.05）。抑郁障碍患者HAMD-17迟滞因子评分与血浆M-CSF水平呈正相关（r=0.348,P<0.05）。结论 抑郁障碍患者精神运动性迟滞可能与血浆M-CSF水平升高有关。     

老年失智失能量表的质量评价

目的 对老年失智失能量表进行可行性和信效度分析。方法 采取方便抽样方法纳入成都市十三大区县共17个调查点的痴呆患者290例，使用基本资料调查表、简易精神状态评价量表（MMSE）、神经精神问卷（NPI）、躯体生活自理量表（PSMS）和老年失智失能量表进行评定。采用Cronbach’s α系数、Spearman-Brown系数、Guttman分半信度及重测信度等指标考察量表的信度，以MMSE、NPI、PSMS为效标，分别对老年失智失能量表的认知功能、精神行为症状和日常生活能力三个维度进行效标关联效度分析。结果 共276例（95.17%）患者完成有效问卷填写。老年失智失能量表总评分及各维度评分的组内相关系数为0.828~0.976，Spearman-Brown系数为0.790~0.917，Guttman分半信度为0.812~0.857，Cronbach’s α系数为0.737~0.886。老年失智失能量表认知功能维度评分与效标MMSE评分呈正相关（r=0.948，P<0.01），精神行为症状维度评分与效标NPI评分呈正相关（r=0.893，P<0.01），日常生活能力维度评分与效标PSMS评分呈正相关（r=0.997，P<0.01）。量表各维度评分与总评分均呈正相关（r=0.634~0.841，P均<0.05）。结论 老年失智失能量表具有良好的可行性，信效度较好，是评定老年失智失能状况的一种较为可靠的工具。     

医学生偏头痛患者睡眠时间不足的发生率及影响因素分析

目的 调查医学生偏头痛患者睡眠时间不足的发生率及影响因素，为改善睡眠质量提供参考。方法 采用整群抽样方法，于2018年7月-2019年7月选取川北医学院在校医学生中符合《国际头痛疾病分类（第3版）》（ICHD-3）偏头痛诊断标准的546名患者为研究对象，并根据每夜睡眠时间是否>6 h分为睡眠时间充足组（n=367）与睡眠时间不足组（n=179）。收集医学生一般人口学资料及临床资料，采用匹兹堡睡眠质量指数量表（PSQI）评定睡眠情况，采用汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表24项版（HAMD-24）评定焦虑抑郁情况，采用视觉模拟评分法（VAS）和头痛影响测试量表（HIT-6）评定头痛严重程度及其对日常生活的影响。采用Logistic回归分析探索偏头痛患者睡眠时间不足的影响因素。结果 在546名医学生偏头痛患者中，有179人（32.78%）存在睡眠时间不足。睡眠时间不足组和睡眠时间充足组的年龄（t=2.107）、头痛频率（Z=-2.972）、焦虑状态（χ2=14.053）、抑郁状态（χ2=10.773）、PSQI评分（t=-13.247）及睡眠质量（χ2=94.754）差异均有统计学意义（P?0.05或0.01）。相关分析显示，偏头痛患者睡眠时间与年龄呈负相关（r=-0.100，P<0.01），与头痛频率、焦虑状态、抑郁状态呈正相关（r=0.135、0.169、0.139，P均<0.01）。多因素Logistic回归分析显示，年龄（OR=0.860，95% CI：0.743~0.996，P=0.045）、头痛频率（OR=1.051，95% CI：1.006~1.098，P=0.026）、抑郁状态（OR=1.712，95% CI：1.024~2.861，P=0.040）是医学生偏头痛患者睡眠时间不足的影响因素。结论 医学生偏头痛患者睡眠时间不足的发生率较高，头痛频率高和抑郁状态是其危险因素，年龄是保护因素。     

Diagnostic Difficulties and Treatment Implications

Summary: Differentiation between types of epileptic seizures has been aided in recent years by the introduction of intensive neurodiagnostic techniques and the development of increasingly detailed classification systems. Paradoxically, these developments have not simplified the task of matching the appropriate antiepileptic drug to a particular seizure type. It is reasonable to assume that anticonvulsant drugs will have different effects on different types of seizures, but faulty, circular reasoning can enter the picture if one also assumes that responses of seizures to different drugs signify different seizure types. There are several examples of differential diagnoses that can fall prey to this problem, including the diagnosis between partial seizures with secondary generalization and generalized tonic-clonic seizures, and the diagnosis between complex partial seizures and absence seizures with automatisms, among others. Considerations of etiology in future classification systems can further complicate the problem: should one then choose an anticonvulsant drug on the basis of individual seizure type or on the basis of the type of epilepsy? Ramifications of this issue extend even to the drug approval process. Official sanction is not given for use of a drug for a seizure type not included in the original efficacy studies, even if later scientific evidence shows that seizure type to be related to a type that is included. New trials must be undertaken. These problems arise from how we choose to classify seizures.     

Cognitive Dysfunction Associated with Antiepileptic Drug Therapy

Summary: Epilepsy is frequently associated with cognitive dysfunction. However, the reasons for this correlation are unclear. Possible influential factors include patient age; duration, frequency, etiology, and type of seizures; hereditary factors; psychosocial issues; and antiepileptic drug (AED) therapy. Whereas many of these factors are beyond the physician's control, AED therapy is one element that can be addressed in treatment decisions by recognizing the potential cognitive effects of particular AEDs. For example, phenobarbital impairs memory and concentration; phenytoin affects attention, problem solving ability, and performance of visuomotor tasks. In contrast, carbamazepine may affect concentration, while valproate would appear to have minimal effects on cognition. Moreover, cognitive effects of AEDs are amplified with coadministration of multiple anticonvulsants (polytherapy). A review of studies on the cognitive effects of monotherapy with AEDs, as opposed to those of polytherapy, provides evidence that drug-related cognitive dysfunction can be reversed if patients are switched to a simpler therapeutic regimen. Future research should be directed toward developing reliable measures for assessing and monitoring cognition, and understanding the particular cognitive side effects of each AED. Physicians also need to revise their opinions about which side effects are "tolerable" for epileptic patients.     

Carbamazepine Efficacy in Adults With Partial and Generalized Tonic-Clonic Seizures

Summary: Carbamazepine and phenytoin are drugs of choice in initial monotherapy for adult partial and secondarily generalized tonic-clonic seizures. These designations reflect the results of the Veterans Administration Epilepsy Cooperative Study Group of 1985. An earlier comparative study of carbamazepine and phenytoin by Ramsay and associates found both drugs equally effective in controlling new-onset seizures. Among the advantages of carbamazepine is that it causes relatively few cognitive and dysmorphic side effects. Its disadvantages are its unavailability in parenteral formulation and its metabolic autoinduction. The latter must be compensated for by planned dosage increases to maintain therapeutic plasma steady-state levels during the first 2 or 3 months of treatment. Carbamazepine is judged a drug of choice in the treatment of these secondarily generalized tonic-clonic seizures, and the drug of choice in children, adolescents, and women susceptible to the dysmorphic side effects associated with other anticonvulsant agents.     

Etiologic and Preventive Aspects of Epilepsy in the Child–Bridging the Gap Between Laboratory and Clinic

Summary: Four broad categories of basic phenomena are pertinent to developing ways to prevent epilepsy. These include mechanisms of epileptogenesis, ictal initiation and temporary entrainment by the seizure discharge of normally functioning brain, seizure propagation, and control mechanisms that function both to restrain the cascade of epileptic events culminating in a seizure and to arrest the epileptic event and restore the interictal state. In newborns and children, hypoxia-ischemia is a major factor leading to epileptogenesis, and several schemes are proposed to classify, quantify, and prevent hypoxic-ischemic encephalopathy. Control mechanisms must be better understood in order to develop prophylactic recommendations for epilepsy, and an experimental model of "kindling antagonism" may increase our understanding of these. Programs of prevention of seizures in children will evolve only if basic researchers and clinicians work productively together to develop an adequate understanding of factors important in epileptogenesis and antiepileptogenic control mechanisms.     

Predisposing and Causative Factors in Childhood Epilepsy

Summary: We review information from large studies of defined populations, examining the role of known factors and especially of prenatal and perinatal factors in contributing to nonfebrile seizure disorders of early childhood. We depend especially, but not exclusively, on the recently completed analyses from the Collaborative Perinatal Project of the National Institute of Neurological and Communicative Disorders and Stroke, the NCPP. About 4% of children in the NCPP who had at least one non-febrile nonsymptomatic seizure by the age of 7 years had a previous seizure during acute neurologic illness, such as meningitis or during the acute illness after trauma. Many such seizures should potentially be preventable. Of children with seizures, 10% had had a neonatal seizure and 13% had had a febrile seizure. Among the hundreds of prenatal and perinatal factors explored as predictors of childhood seizure disorders, the principal predictors identified were congenital malformations of the fetus, cerebral and noncerebral; family history of certain neurologic disorders; and neonatal seizures. In agreement with the British National Child Development Study, labor and delivery factors in the NCPP appeared to contribute very little to childhood seizure disorders. Maldevelopment, rather than damage at birth to an initially intact nervous system, appeared to be the more common mechanism. Most seizure disorders of early childhood remained unexplained by the large set of prenatal and perinatal characteristics examined.     

Anticonvulsant Drugs and Cognitive Function: A Review of the Literature

Summary: Alterations of cognitive function are separate from disturbances of behavior seen in association with epilepsy. The nature of the cognitive disability may to a certain extent depend on the seizure type. Partial seizures, mainly derived from a temporal lobe focus, impair memory tasks, while generalized seizures seem to have more effect on attentional abilities. A number of studies, reviewed in this paper, suggest that anticonvulsant drugs further impair cognitive function. Maximal impairments are seen in patients receiving polytherapy: rationalization of polytherapy improves cognitive abilities. Studies in children and adults have allowed differentiation of the effects of various commonly used antiepileptic agents. Maximal cognitive deficits are seen with. phenytoin, while phenobarbital and sodium valproate induce moderate disturbances, and carbamazepine seems relatively free from such toxicity. Further research is needed on the interrelationship between types of seizure disorders, types of anticonvulsant medications, and cognitive function.     

Effects of NMD A- and AMPA-Receptor Antagonists on Different Forms of Epileptiform Activity in Rat Temporal Cortex Slices

Summary: Lowering extracellular magnesium induces different patterns of epileptiform activity in rat hippocampus and entorhinal cortex. Short recurrent epileptiform discharges in the hippocampus are stable over time, whereas seizurelike events (SLEs) in the entorhinal cortex, the subiculum, and the neighboring neocortex develop into late recurrent discharges which are not blocked by clinically employed antiepileptic drugs. We tested the sensitivity of the different epileptiform discharge patterns to. /V-methyl-D-aspartate (NMDA)- and non-NMDA-receptor antagonists. As NMDA-receptor antagonist we used dextrorphan, ket-amine, and 2-aminophosphonovalerate (2APV); as α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA)-receptor antagonist we employed the quinoxaline derivative glutamate 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX). The findings show that the different patterns of epileptiform activity, including the late recurrent discharges, are sensitive to all NMDA-receptor antagonists. However, when dextrorphan was employed to suppress seizure-like events, later recurrent discharges did not develop during the remaining time course of the experiment. CNQX reversibly suppressed recurrent discharges in the hippocampus and SLEs in the entorhinal cortex. However, late recurrent discharges become insensitive to CNQX, even at a high concentration of 60 μM m. This finding suggests a prominent role for NMDA receptors in the generation of late recurrent discharges.     

The influence of comorbid depression on seizure severity

PURPOSE: To determine the relation between depressive symptoms and seizure severity among people with epilepsy. METHODS: A postal questionnaire was used to survey a nationwide community sample about seizures and depression. The Seizure Severity Questionnaire (SSQ) assessed the severity and bothersomeness of seizure components. The Centers for Epidemiological Studies-Depression scale categorized levels of depression. RESULTS: Respondents categorized as having current severe (SEV, n = 166), mild-moderate (MOD, n = 74), or no depression (NO, n = 443) differed significantly in SSQ scores (all p < 0.0001). People with SEV or MOD reported significantly worse problems than did those with NO depression for overall seizure recovery (mean, 5.3, 4.9, 4.5, respectively); overall severity (5.0, 4.5, 4.2); and overall seizure bother (5.3, 4.8, 4.4) (all p < 0.005). Cognitive, emotional, and physical aspects of seizure recovery also were rated worse among people with SEV than with NO depression (all p < 0.05). Symptoms of depression were significantly correlated with higher levels of all components of generalized tonic-clonic seizure severity (r = 0.33-0.48; all p < 0.0001), and partial seizures (r = 0.31-0.38; all p < 0.01). CONCLUSIONS: Clinically depressed people with epilepsy reported higher levels of perceived severity and bother from seizures, as well as greater problems with overall seizure recovery than did nondepressed people experiencing similar types of seizures. The pervasive influence of depressive symptoms on reports of seizure activity suggests that people with epilepsy should be screened for depression. These data highlight the importance of detecting and treating depression among people with epilepsy.     

Une phénoménologie de la dépendance à l'alcool. Une expérience primordiale de la « nostrité »

The phenomenological approach to alcoholism interestingly focuses on specific dynamics of interpersonal relationships displaying the founding of the Self from a primary “us” and its original basis in the human feast. Priorities for treatment intervention recommend to involve social setting and relationships of the patients, reaching their active participation to a motivational and long term group treatment, underlying the specific therapeutic effect of world exchanges. Biopsychosocial determination of alcoholism could be primarily based on components of interpersonal relationships. Regarding social background, drinking is one of the most famous supports for the achievement of the feast, a founding marker of present time. Taking an existential point of view, the feast appears as the heart of mankind because it presents a primary “us”, a plural state which indicates the beginning and founding of the Self from the others. During the feast, we regularly have to reach our Self from the “us” while avoiding two main dangers, drunkenness, an increase in the dizziness of upright verticality, and addiction, an opposite vertical surrender to alcohol and falling into in the alcoholic relapse, both situations imply a spatial domination and the disappearance of others. Treatment programs of alcohol addicts need to integrate the necessity of reaching the existential basic trust from the support of a group to the appropriation of the community which can be defined as an original “usness”.