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INTRODUCTION: Currently, there is no scientific consensus on the concept of alcohol addiction recovery beyond substance use control. This conceptual issue challenges the implementation of therapeutic strategies and mental health policies that are unrestricted to symptomatic remission. Aiming to contribute to its definition, this study aimed to examine the recovery experience of individuals with alcohol addiction using dialectical phenomenological psychopathology (DPP) as a theoretical and methodological framework. METHODS: A dialectical phenomenological analysis was conducted through an examination of online interviews with eight Brazilian, São Paulo state citizens who were self-declared to be undergoing alcohol addiction recovery (or who declared that they had completely recovered). RESULTS: Participants' reports generated eight categories that were subdivided into two groups. The first group indicated experiential elements of recovery, such as changes in self-relation, changes in interpersonal relations, and changes in time relations, giving new meanings to suffering and alcohol use, and recovery as a continuous process. The second group referred to how the participants interpreted recovery according to their worldviews: as a spiritual experience, moral reformation, and mentality change. CONCLUSION: These categories can be understood through the lens of DPP as a process of change in the subjects' being in the world, characterized by the continued management of their existential imbalances in the dimensions of spatiality, temporality, selfhood, and intersubjectivity. The results are preliminary when it comes to conceptualizing recovery but may help future studies to develop recovery-oriented therapeutic strategies.

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This paper argues that a dialectical synthesis of phenomenology's traditional twin roles in psychiatry (one science-centered, the other individual-centered) is needed to support the recovery-oriented practice that is at the heart of contemporary person-centered mental health care. The paper is in two main sections. Section I illustrates the different ways in which phenomenology's two roles have played out over three significant periods of the history of phenomenology in 20th century psychiatry: with the introduction of phenomenology in Karl Jaspers' General Psychopathology in 1913; with the development a few years later of structural phenomenological psychopathology; and in the period of post-War humanism. Section II is concerned with the role of phenomenology in contemporary mental health. There has been a turn to phenomenology in the current period, we argue, in response to what amounts to an uncoupling of academic psychiatry from front-line clinical care. Corresponding with the two roles of phenomenology, this uncoupling has both scientific aspects and clinical aspects. The latter, we suggest, is most fully expressed in a new model of "recovery," defined, not by the values of professionals as experts-by-training, but by the values of patients and carers as experts-by-experience, specifically, by what is important to the quality of life of the individual concerned in the situation in question. We illustrate the importance of recovery, so defined, and the challenges raised by it for both the evidence-base and the values-base of clinical decision-making, with brief clinical vignettes. It is to these challenges we argue, that phenomenology through a synthesis of its twin roles is uniquely equipped to respond. Noting, however, the many barriers to such a synthesis, we argue that in the current state of development of the field, it is by way of a dialectical synthesis of phenomenology's roles that we should proceed. From such a dialectic, a genuine synthesis of roles may ultimately emerge. We conclude with a note on the wider significance of these developments, arguing that contrary to 20th century stereotypes, they show psychiatry to be leading the way for healthcare as a whole, in developing the resources for 21st century person-centered clinical care.

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The clinical presentation of obsessive-compulsive patients is characterized by unwanted, intrusive, nonsensical, self-related, and recurrent ideas, thoughts, images, or impulses associated with active compulsive compensations. Under the operational diagnostic criteria adopted by the biological- and cognitive-oriented neopositivist medical paradigm, it is known as "obsessive-compulsive disorder." However, this paradigm has been criticized for its controversial assumptions, limited methodologies, theoretic biases, and inconsistency in producing practical outcomes. To bypass some of these issues, we propose a complementary approach that draws on and further develops existing psychopathological studies of the obsessive-compulsive anthropological condition based on dialectical phenomenological psychopathology. As such, we refer to the global clinical configuration as the "obsessive-compulsive existential type." Our theoretical inspiration comes from the classical phenomenological work on obsessions undertaken by Straus and Gebsattel, which identified the negative transformation of the obsessive-compulsive life-world or the endogenous emergence of the anti-eidos (diluting existential force). We then propose to broaden the concept of anti-eidos, especially in its dialectical correlation with eidos (unifying existential force), representing the existential dialectic between transformation and permanence. Next, we detail the dynamics of anthropological disproportions in obsessive-compulsive existential type, essentially the supremacy of the anti-eidos over the eidos. This primary imbalance modifies the obsessive-compulsive existential structure, consisting of polymorphic temporality; weakened intentionality; maladjusted calibration of distance with the world and others; an integral, isolated, besieged self with dwindling self-agency, and tense and over-protecting embodiment. We also analyze compensatory hyperreflexivity and compulsive rituals as expressions of structural counterbalancing designed to contain the primary structural disproportions and derangements. The heterogeneous obsessive-compulsive clinical manifestations are the complex result of the primary structural alteration and subsequent phenomenological compensations. They tend to be variable in temporal span and rarely assume a fixed form, hindering diagnosis. We correlate structural frameworks with multiple clinical examples. Finally, we raise some insights on how our study may contribute to scientific research and therapeutic proposals.

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INTRODUCTION: Alcohol misuse emerges from a complex range of psychopathological experiences and personal and cultural values. For this reason, understanding the reasons why a person seeks treatment is crucial to effective care. This study aimed to identify the values which guide the decision-making process of persons seeking voluntary hospitalization for treatment for alcohol misuse, as well as the values of significant others. METHODS: A phenomenological investigation was conducted through interviews with 25 individuals (and family members) who had voluntarily admitted themselves to a hospital in São Paulo, Brazil, with the objective of maintaining abstinence from alcohol dependence. RESULTS: The main factors that determined the treatment-seeking decision were damage to social relationships and fear of illness and deterioration of the physical condition; the factors related to treatment expectations were restoring personality and awareness of morbidity; and the single factor considered most important to the success of the treatment was willpower. CONCLUSIONS: The results of this study contribute to developing strategies for bringing care closer to the patient's perspective of the disease and encourage their active participation in the formulation of care.

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In this paper, I analyze General Psychopathology, the seminal psychopathological work of the philosopher and psychiatrist Karl Jaspers, from a dialectical perspective, showing how it can contribute to contemporary psychiatry. Dialectical interpretations of this work are still scarce and generally address the part of the work in which Jaspers makes direct reference to dialectics. Instead, I expose the implicit dialectic by which the overall form of the work is organized. I take the "psychology of meaning" as an example for this dialectical account. I suggest two consequences of this dialectical account of the "psychology of meaning" for psychopathology, which I call intrisec ambiguity and epistemic particularism. Finally, I conclude by pointing out how both notions help shed some epistemological and pragmatic light on the discipline of psychiatry, in a sustained state of crisis.

Neste trabalho, analiso a Psicopatologia Geral, o trabalho psicopatológico seminal do filósofo e psiquiatra Karl Jaspers, por uma perspectiva dialética, mostrando como esta pode contribuir para a psiquiatria contemporânea. As interpretações dialéticas deste trabalho ainda são escassas e geralmente abordam a parte do trabalho na qual Jaspers faz referência direta à dialética. Em vez disso, exponho a dialética implícita pela qual a forma geral do trabalho é organizada. Tomo a "psicologia compreensiva" como um exemplo para este relato dialético. Sugiro duas conseqüências dessa apreensão dialética da "psicologia compreensiva" para a psicopatologia, que denomino ambiguidade intrínseca e particularismo epistêmico. Finalmente, concluo apontando de que modo ambas as noções ajudam a lançar alguma luz epistemológica e pragmática sobre a disciplina da psiquiatria, em contínuo estado de crise.

Dans cet article, j'analyse la Psychopathologie générale, l'ouvrage psychopathologique fondamental du philosophe et psychiatre Karl Jaspers, d'un point de vue dialectique, en montrant comment il peut contribuer à la psychiatrie contemporaine. Les interprétations dialectiques de cet ouvrage sont encore rares et portent généralement sur la partie de l'ouvrage dans laquelle Jaspers fait directement référence à la dialectique. En revanche, j'expose la dialectique implicite par laquelle la forme générale de l'ouvrage est organisée. Je prends la "psychologie compréhensive" comme exemple pour ce compte-rendu dialectique. Je suggère deux conséquences de cette appréhension dialectique de la "psychologie compréhensive" pour la psychopathologie, que je qualifie d'ambiguïté intrinsèque et de particularisme épistémique. Enfin, je conclus en montrant comment ces deux notions permettent d'éclairer d'un point de vue épistémologique et pragmatique la discipline psychiatrique, qui est en état de crise continue.

En este artículo analizo la Psicopatología General, la obra psicopatológica seminal del filósofo y psiquiatra Karl Jaspers, desde una perspectiva dialéctica, mostrando cómo puede contribuir a la psiquiatría contemporánea. Las interpretaciones dialécticas de esta obra son todavía escasas y suelen abordar la parte de la obra en la que Jaspers hace referencia directa a la dialéctica. En cambio, yo expongo la dialéctica implícita mediante la cual se organiza la forma general de la obra. Tomo la "psicología comprensiva" como ejemplo de este relato dialéctico. Sugiero dos consecuencias de esta aprehensión dialéctica de la "psicología comprensiva" para la psicopatología, que denomino ambigüedad intrínseca y particularismo epistémico. Finalmente, concluyo señalando cómo ambas nociones contribuyen a arrojar alguna luz epistemológica y pragmática sobre la disciplina de la psiquiatría, que se encuentra en contínuo estado de crisis.

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Recently, there have been calls to develop a more contextual approach to phenomenological psychopathology-an approach that attends to the socio-cultural as well as personal and biographical factors that shape experiences of mental illness. In this Perspective article, we argue that to develop this contextual approach, phenomenological psychopathology should adopt a new paradigm case. For decades, schizophrenia has served as the paradigmatic example of a condition that can be better understood through phenomenological investigation. And recent calls for a contextual approach continue to use schizophrenia as their primary example. We argue, in contrast, that substance misuse provides a better paradigm case around which to develop a contextually sensitive phenomenological psychopathology. After providing a brief vignette and analysis of a case of substance misuse, we explain why this kind of condition requires considerable sensitivity and attention to context, better motivating the incorporation and development of new contextually sensitive approaches.

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In this paper, we present how a dialectical perspective on phenomenological psychopathology, called Dialectical Phenomenology (DPh), can contribute to current needs of psychiatric diagnosis. We propose a three-stage diagnostic methodology: first- and second-person stages, and synthetic hermeneutics stage. The first two stages are divided into a pre-dialectical and a dialectical phase. The diagnostic process progresses in a trajectory of increasing complexity, in which knowledge obtained at one level is dialectically absorbed and intertwined into the next levels. Throughout the article, we offer some examples of each step. In overall, the method starts off from the patient's own narrative, proceeds to two stages of phenomenological reduction designed to guarantee the scientific validity of the object, and concludes with a hermeneutical narrative synthesis that is dialectically composed of the patient's and psychopathologist's shared narratives. At the end of this process, the initial first-person narrative is transformed into a specific scientific object, a full dialectical phenomenological psychiatric diagnosis. This form of diagnosis constitutes a comprehensive alternative for an integral assessment of the complexities of human psychological alteration, bringing together both the interpretation of the suffering person and the scientific categories of psychiatry.

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Phenomenological psychopathology has been defined as a human science that is concerned with the object on which clinical psychology and psychiatry act. How psychopathological experiences are understood is an important factor determining decision-making in clinical care. An accurate understanding of psychopathology is fundamental to the effectiveness of mental health treatments. This is even more important in a field such as substance use disorders in which social and cultural values influence both diagnosis and decision-making. In this article, we offer a contribution to clinical decision-making in substance use disorders by suggesting the association of Phenomenological Psychopathology and Values-Based Practice, constituting a Values-based Phenomenology We present a fictitious clinical case (to preserve confidentiality), illustrating a three-step practical application of Values-based Phenomenology. We conclude that although still a nascent discipline, Values-based Phenomenology offers a promising approach to reducing the gap between services and patients' needs in clinical decision-making, and thus to improving clinical care in substance use disorders.

A psicopatologia fenomenológica é uma ciência humana que define o objeto sobre o qual atuam a psicologia clínica e a psiquiatria. O modo como são compreendidas as experiências psicopatológicas é um fator importante nas tomadas de decisão clínica. Uma compreensão acurada de psicopatologia é fundamental para a efetividade dos tratamentos em saúde mental. Isso é mais importante ainda em um campo como o dos transtornos por uso de substâncias, no qual há um importante imbricamento entre valores sociais e culturais. Neste artigo, se oferece uma contribuição para as tomadas de decisão clínica nos transtornos por uso de substâncias por meio da associação entre a psicopatologia fenomenológica e a Prática Baseada em Valores, constituindo uma fenomenologia baseada em valores. Apresenta-se um caso clínico fictício (visando à preservação de confidencialidade) ilustrativo dos três passos da aplicação prática da fenomenologia baseada em valores. Conclui-se que a fenomenologia baseada em valores constitui uma abordagem promissora para o aprimoramento das tomadas de decisão clínica nos transtornos por uso de substâncias.

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Cannabis is the most commonly used illegal drug, and is associated with well-documented adverse health outcomes, both acute and chronic. Cannabis use prevalence in Brazil is lower than in high-use regions in the Americas (e.g., North America), but concentrated among young people. Frameworks for cannabis control are increasingly shifting towards public health-oriented principles, with some countries undertaking respective policy reforms. These frameworks require a continuum of population-level interventions (e.g., prevention and treatment) including targeted prevention of adverse health outcomes among users. In this context, and based on examples from other health fields, an international expert group developed the evidence-based Lower-Risk Cannabis Use Guidelines (LRCUG), originally for Canada, including a set of 10 recommendations based on systematic data reviews and expert consensus methods. The LRCUG form a scientific population-health prevention tool to reduce adverse public health impacts for broad application among cannabis users. In Canada, the LRCUG have been formally endorsed and are supported by leading national health organizations and government authorities within the continuum of cannabis interventions. As the LRCUG are being internationalized, this paper introduces the LRCUG's concept and content - including their original recommendations translated into Portuguese - to the Brazilian context as an evidence-based population-level intervention tool for uptake, dissemination, and discussion. Sociocultural adaptation may be required for meaningful implementation.

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Cannabis is the most commonly used illegal drug, and is associated with well-documented adverse health outcomes, both acute and chronic. Cannabis use prevalence in Brazil is lower than in high-use regions in the Americas (e.g., North America), but concentrated among young people. Frameworks for cannabis control are increasingly shifting towards public health-oriented principles, with some countries undertaking respective policy reforms. These frameworks require a continuum of population-level interventions (e.g., prevention and treatment) including targeted prevention of adverse health outcomes among users. In this context, and based on examples from other health fields, an international expert group developed the evidence-based Lower-Risk Cannabis Use Guidelines (LRCUG), originally for Canada, including a set of 10 recommendations based on systematic data reviews and expert consensus methods. The LRCUG form a scientific population-health prevention tool to reduce adverse public health impacts for broad application among cannabis users. In Canada, the LRCUG have been formally endorsed and are supported by leading national health organizations and government authorities within the continuum of cannabis interventions. As the LRCUG are being internationalized, this paper introduces the LRCUG's concept and content - including their original recommendations translated into Portuguese - to the Brazilian context as an evidence-based population-level intervention tool for uptake, dissemination, and discussion. Sociocultural adaptation may be required for meaningful implementation.

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Este artigo apresenta uma proposta fenomenológica estrutural de psicologia do desenvolvimento dos primeiros 12 meses de vida. A literatura clássica fenomenológica fomenta, neste artigo, um aprofundamento da compreensão antropológica piagetiana do desenvolvimento. As descrições minuciosas de Jean Piaget do desenvolvimento de seus três filhos foram utilizadas como paradigma para a apresentação de uma proposta de como a temporalidade se apresenta nos 12 primeiros meses de vida. Ao constatarmos uma temporalidade em expansão, porém imatura, aprofundamos a compreensão do papel vital do contato interpessoal no primeiro ano de vida como fator constituinte de uma estrutura psíquica saudável.

This article presents a structural phenomenological proposal of developmental psychology of the first 12 months of life. In this article, the classical phenomenological literature fosters a deepening of Piagetian anthropological understanding of development. Jean Piaget's detailed descriptions of the development of his three children acted as a paradigm for the presentation of a proposal of how temporality presents itself in the first 12 months of life. When we see an expanding but immature temporality, we deepen our understanding of the vital role of interpersonal contact in the first year of life as an essential factor of a healthy psychic structure.

Este trabajo presenta una propuesta fenomenológica estructural de psicología del desarrollo de los primeros 12 meses de vida. La literatura clásica fenomenológica fomenta, en este trabajo, una profundización de la comprensión antropológica piagetiana del desarrollo. Las descripciones minuciosas de Jean Piaget del desarrollo de sus tres hijos fueron utilizadas como paradigma para la presentación de una propuesta de como la temporalidad se presenta en los 12 primeros años de vida. Al constatar una temporalidad en expansión, aunque inmatura, profundizamos la comprensión del papel vital del contacto interpersonal en el primer año de vida como factor constituyente de una estructura psíquica saludable.

Cet article présente une proposition phénoménologique structurelle de la psychologie du développement des 12 premiers mois de la vie. La littérature phénoménologique classique promeut, dans cet article, un approfondissement de la compréhension anthropologique piagétienne du développement. Les descriptions détaillées de Jean Piaget sur le développement de ses trois enfants ont servi de paradigme à une proposition sur comment la temporalité se présente au cours des 12 premiers mois de la vie. Lorsque nous voyons une temporalité en expansion mais immature, nous approfondissons notre compréhension du rôle vital du contact interpersonnel au cours de la première année de la vie en tant que facteur constitutif d'une structure psychique saine.

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Phenomenological psychopathology is a body of scientific knowledge on which the clinical practice of psychiatry is based since the first decades of the twentieth century, a method to assess the patient's abnormal experiences from their own perspective, and more importantly, a science responsible for delimiting the object of psychiatry. Recently, the frontiers of phenomenological psychopathology have expanded to the productive development of therapeutic strategies that target the whole of existence in their actions. In this article, we present an overview of the current state of this discipline, summing up some of its key concepts, and highlighting its importance to clinical psychiatry today. Phenomenological psychopathology understands mental disorders as modifications of the main dimensions of the life-world: lived time, lived space, lived body, intersubjectivity, and selfhood. Psychopathological symptoms are the expression of a dialectical modification of the proportions of certain domains of the life-world or of the lived experience. The far-reaching relevance of the concepts of proportion and dialectics for the clinical agenda is explored. The article presents two contemporary models for clinical practice based on phenomenological psychopathology: Dialectical-proportional oriented approach and Person-centered dialectic approach (P.H.D. method). The main characteristics of these approaches are considered, as well as the new perspectives they bring to the challenges of psychiatric care in the twentieth-first century.

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Os nomes de Foucault e Binswanger figuram lado a lado com tão pouca frequência que, à primeira vista, a aproximação entre os autores pode apresentar-se como uma questão despropositada. No presente trabalho, com base na análise de algumas de suas obras e nas contribuições de seus comentadores, procuramos apresentar algumas indicações para uma breve incursão em certos aspectos da história desse acercamento, cujos desdobramentos não se reduzem a uma casual afinidade intelectual entre o filósofo francês e o psiquiatria suíço. Defendemos a existência de uma convergência entre ambos, centrada em aspectos como a recusa de modelos explicativos organicistas e psicodinâmicos; e a utilização metodológica da noção de a priori. Concluímos pela existência de uma importante aproximação entre as obras dos dois autores.

The names Foucault and Binswanger are so seldom seen together that the question of any convergence between the authors may at first sound preposterous. In the present study, based on the analysis of some of their works and on contributions from their commentators, we sought to present some indications for a brief incursion into certain aspects of the story behind this connection, whose implications cannot be dismissed as a mere casual intellectual affinity between the French philosopher and Swiss psychiatrist. We argue that there exists a convergence between the two, centered on aspects such as the rejection of organicist and psychodynamic explanatory models; and the methodological use of the notion of a priori. We conclude that there is an important convergence between the works of the two authors.

Los nombres de Foucault y Binswanger aparecen uno junto al otro tan infrecuentemente que, inicialmente, la aproximación entre los autores puede presentarse como una cuestión sin sentido. En este trabajo, basado en el análisis de algunas de sus obras y en las contribuciones de sus comentadores, hemos buscado presentar algunas indicaciones para una breve incursión en determinados aspectos de la historia de esta aproximación, cuyos desenvolvimientos no se reducen a una casual afinidad intelectual entre el filósofo francés y el psiquiatra suizo. Defendemos la existencia de una convergencia entre los dos, centrada en aspectos como el rechazo a los modelos explicativos organicistas y psicodinámicos; y el empleo metodológico de la noción de a priori. Concluimos en favor de la existencia de una importante aproximación entre las obras de los dos autores.

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Two fundamentally different approaches among phenomenological psychopathologists can be discerned. One is what we call fixed essentialism, where the pathognomonic element of, say, schizophrenia is conceived of as a single, enduring and intrinsically morbid way of grasping all entities in the world, including self and body. The other, which we call dialectical essentialism, accounts for the same manifestations of, say, schizophrenia, but through a process which is not life-enduring, and, most critically vis-à-vis the former formulation, is not in itself a single morbid defect: a morbid pattern of world, self and body is achieved by an imbalance between two or more otherwise healthy constituents of the 'normal' human being, whose imbalance and attempts to resolve this - the dialectic - induce the 'morbidity'.

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Due to growing skepticism about the current psychiatric model, psychopathology has once again aroused interest in the psychiatric field. This article intends to examine the current perspectives of the phenomenological approach of psychopathology in the context of psychiatry. To this end, we will situate phenomenology along the historical course of psychopathology, presenting the particularities of its understanding of the psychiatric object, and finally, we will defend, in general terms, the affinity of the phenomenological approach with the aspirations and practical needs of the field of psychiatry.

Dado o crescente ceticismo em relação ao modelo psiquiátrico dominante atual, a psicopatologia voltou a despertar interesse como ciência. O presente artigo pretende examinar as perspectivas atuais da psicopatologia fenomenológica no cenário da psiquiatria. Para tal, situaremos sua posição no curso histórico da disciplina psicopatologia, apresentaremos as particularidades de seu entendimento de objeto psiquiátrico e, por fim, defenderemos, em linhas gerais, a afinidade da abordagem fenomenológica com as aspirações e as necessidades de natureza prática do campo da psiquiatria.

En raison du scepticisme croissant à l´égard du modèle psychiatrique dominant actuel, l´interêt pour la psychopathologie comme science est en train de ressurgir. L’article qui suit examine les perspectives contemporaines de la psychopathologie phénoménologique dans le domaine de la psychiatrie. Pour ce faire, les auteurs situent la psychopathologie phénoménologique dans l´histoire de la discipline de la psychopathologie, présentent les particularités de sa façon de comprendre l´objet psychiatrique et pour conclure, soutiennent la pertinence de l´approche phénoménologique en ce qui concerne les aspirations et les exigences pratiques du domaine de la psychiatrie.

Teniendo en cuenta el creciente escepticismo relacionado al modelo psiquiátrico dominante en la actualidad, la psicopatología volvió a despertar interés como ciencia. El presente artículo examina las perspectivas contemporáneas de la psicopatología fenomenológica en el campo psiquiátrico. Para la realización de esta tarea, los autores la ubicarán en el curso histórico de la disciplina psicopatológica, presentarán las particularidades de la comprensión de su objeto psiquiátrico y, finalmente, defenderán la pertinencia del aporte fenomenológico a las aspiraciones y necesidades prácticas de la psiquiatría.

Angesichts des wachsenden Skeptizismus in Bezug auf das aktuelle dominante psychiatrische Modell, steigt das Interesse an die Psychopathologie als Wissenschaft erneut an. Der vorliegende Artikel untersucht die aktuellen Perspektiven der phänomenologischen Psychopathologie im Bezug zur zeitgenössischen Psychiatrie. Zu diesem Zweck analysieren wir ihre Situation im historischen Verlauf der Psychopathologie als Disziplin, erläutern wie sie das psychiatrische Objekt definiert und beschreiben abschliessend in generellen Zügen, wie weit die phänomenologische Vorgehensweise den praktischen Bestrebungen und Bedürfnissen der Psychiatrie entgegenkommt.

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OBJECTIVE: The search for genetic vulnerability factors in cocaine dependence has focused on the role that neuroplasticity plays in addiction. However, like many other drugs, the ability of an individual to metabolize cocaine can also influence susceptibility to dependence. Butyrylcholinesterase (BChE) metabolizes cocaine, and genetic variants of the BChE gene (BCHE) alter its catalytic activity. Therefore, we hypothesize that cocaine users with polymorphisms in BCHE can show diverse addictive behaviors due to differences in effective plasma concentrations of cocaine. Those polymorphisms might also influence users to prefer one of the two main preparations (crack or powder cocaine), despite having equal access to both. The present work investigates polymorphisms in BCHE and if those genetic variants constitute risk factors for cocaine dependence and for crack cocaine use. METHODS: A total of 1,436 individuals (698 cocaine-dependent patients and 738 controls) were genotyped for three single nucleotide polymorphisms (SNPs) in BCHE: rs1803274, rs4263329, and rs4680662. RESULTS: For rs4263329, a nominal difference was found between cases and controls. For rs1803274 (the functional SNP), a statistically significant difference was found between patients who used crack cocaine exclusively and those who used only powder cocaine (P = 0.027; OR = 4.36; 95% CI = 1.18-16.04). Allele frequencies and genotypes related to other markers did not differ between cases and controls or between the two cocaine subgroups. CONCLUSIONS: Our findings suggest that the AA genotype of rs1803274 is a risk factor for crack cocaine use, which is more addictive than powder cocaine use. Further studies are needed in order to confirm this preliminary result and clarify the role of BCHE and its variants in cocaine dependence.

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