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Sociodemographic and psychopatology features of outpatients dual diagnosis
- C. Barral, L. Grau-López, L. Miquel, D. Bachiller, F. Gideoni, C. Rodríguez-Domínguez, L. Rodríguez-Martos, E. Ros, L. Laviña, C. Roncero
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- Journal:
- European Psychiatry / Volume 26 / Issue S2 / March 2011
- Published online by Cambridge University Press:
- 16 April 2020, p. 10
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Introduction
Dual diagnosis patients are characterized by low rates of adherence and treatment compliance. During last years new resources have dedicated to these patients where substance use and mental disorder are treated simultaneously.
ObjectivesThe aim of this study is to describe sociodemographic and psychopatology features of dual diagnosis outpatient.
MethodsAll subjects in the study were outpatients at dual diagnosis program at Vall d’Hebron University Hospital, Barcelona, Spain during 2007 to 2008. These patients were following up until December 2009. Sociodemographic data, psychiatric diagnosis and substance abuse were assessed by using EuropASI, SCID-I y SCID-II and by reviewing their medical histories.
ResultsA total of 90 patients were recruited for this study during 2007–2008 and were followed one year. 62,5% of them remain until the end of the treatment. 67,9% were men, medium age was 37 years old (± 1.4). Most of them live with their own families (57,1%) and their marital status was single (48,2%). In this sample the most prevalent psychiatric diagnosis was Major Depressive Disorder (36,4%) followed by Psychotic Disorder (36,2%). The most abused substance was cocaine (33,9%) followed by cannabis (26,8%), alcohol (16,1%), heroin (17,9%). More of 60% were polydrug.
ConclusionsThe patients who maintained inculcation with the outpatient program of dual diagnosis were men with medium level of academic level and good family and social environment.
EPA-1366 – Gender Differences in Cocaine-dependent Patients
- C. Roncero, C. Daigre, L. Grau-López, E. Ros-Cucurrull, J. Pérez-Pazos, N. Martínez-Luna, D. Bachiller, J.M. Vazquez, E. Castrillo, E. Palma, J. Alvaros, M. Casas
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- Journal:
- European Psychiatry / Volume 29 / Issue S1 / 2014
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
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Introduction
Cocaine dependence disorder has been widely described. However, differences due to gender remain unknown.
AimTo compare clinical gender differences in a large sample of cocaine-dependent patients.
MethodsWe performed a cross-sectional, observational study in 902 patients (35.47 yo, 21.3% women) with a cocaine dependence according DSM-IV criteria, seeking treatment during 2005 to 2013. Sociodemographic and clinical variables were collected The SCID-I, SCID–II, BIS and a structured interview about cocaine-induced psychosis were performed. Simple descriptive statistics were carried out for demographic and clinical data. Bivariate analysis was made to compare the main variables by sex using SPSSvs18.0.
ResultsNo differences in age of dependence onset, other clinical variables or cocaine-induced psychosis were detected. However, less cocaine used in the last month (2.12 vs 3.37g) (p < 0.009), more impulsivity (67.2 vs 63.03) (p < 0.040), and more sedative dependence (21.2% % vs 8.3%)(p< 0.00) were detected in women than in men. Affective disorders lifetime were the most prevalent (57,4%) in women. More comorbidity with anxiety disorders (p< 0.025) eating disorders (p< 0.000) and personality disorders (p< 0.039) were detected in women than in men.
ConclusionsSedative dependence and anxiety disorders should be investigated in cocaine-dependent women in order to treat these conditions. Surprisingly high impulsivity level was detected and could moderate cocaine consumption. However, no difference have been found previously in studies about gender differences in cocaine-dependent patients, so this finding should be confirm in new studies.
2359 – Voluntary Discharge Related Factors In Drug Dependent Patients In Detoxification Process In An Inpatient Unit
- L. Grau-López, C. Roncero, L. Rodriguez-Cintas, C. Daigre, D. Bachiller, C. Barral, A. Egido, A. Abad, M. Bellido, M. Casas
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- European Psychiatry / Volume 28 / Issue S1 / 2013
- Published online by Cambridge University Press:
- 15 April 2020, 28-E1487
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Introduction
It's known that adherence to treatment is a key factor in the treatment of addictions. The presence of comorbid substance dependence disorder and other psychiatric disorder is very high. Comorbid psychiatric disorders interfere with adherence to drug treatment and detoxification.
AimsTo analyze the percentage of patients who had a voluntary discharge to Hospital Detoxification Unit and to describe sociodemographic, clinical and diagnostic test characteristics.
Material and methodsWe descriptively studied drug dependents patients admitted to our Detoxification Unit from June 2008 to August 2012. Data was gathered at admission on demographic (age), clinical (main abused drug, psychiatric comorbidities, polydrug users, binge consumption previous intake) and alcoholtest and/or urinalysis. Results from patients with and without voluntary discharge were compared.
ResultsThe study sample included 469 patients (77.7% men, average age 38.3 ± 9). 10.7% of the patients had voluntary discharge. We found significant differences between voluntary discharge and the non-voluntary discharge group on younger people (37,6 vs 40,42,p < 0,05), on heroine as main drug of abuse (40% vs 13,4%, p < 0,0001) and psychiatric comorbidities (60,8% vs 39,2%,p = 0,02), being psychotic disorders (26% vs 13,6%,p < 0,02) and borderline personality disorder (56% vs 29,4%,p < 0,0001) the most significant. Also patients who had binge consumption previous intake (84% vs 56.6%,p < 0.0001) and patients with positive urinalysis(84% vs 58.2%,p < 0.0001) had more voluntary discharge. Patients with comorbid depressive disorders had non-voluntary discharge(6% vs 18.4%,p < 0.02).
ConclusionsFew patients had a voluntary discharge. Younger people, opiate dependence, having psychotic and borderline personality co morbidity, binge consumption previous intake and positive urinalysis might be considered as risk factors for voluntary discharge.
2346 – Cocaine-induced Psychosis And Impulsivity In Cocaine-dependent Patients
- C. Roncero, L. Grau-López, C. Daigre, L. Rodriguez-Cintas, L. Miquel, N. Martínez-Luna, C. Barral, D. Bachiller, A. Egido, J. Alvarós, C. Miguel
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- Journal:
- European Psychiatry / Volume 28 / Issue S1 / 2013
- Published online by Cambridge University Press:
- 15 April 2020, 28-E1475
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Introduction
Cocaine induced psychosis (CIP) is common but not developed in all cases. Many risk factors have been linked with CIP. A lifetime diagnosis of ADHD has been associated with the categorical presence of CIP.
ObjectivesThe objective of this study is to determinate the relationship between impulsivity and impulsivity-realetd disorders (BPD, BN and ADHD) and CIP.
AimsWe study the presence of psychotic symptoms using a clinical interview for psychotic symptoms in a large sample of cocaine-dependent patients. Patients suffering from schizophrenia or bipolar disorders were excluded. Finally we included 287 patients in the study.
MethodsA structured interview about psychotic symptoms were systematically conducted. The Structured Clinical Interview for DSM IV Axis I and Axis II disorders were used in order to identify the comorbidity. CAADID-II (Conners’ Adult ADHD Diagnostic Interview for DSM-IV) were used in order to identify ADHD comorbidity. Barrat impulsivity scale were used for evaluate impulsivity.
ResultsBIS total were 63.78. We identify a significant association between CIP and BIS cognitive subscale p < 0.003 and BIS total p < 0.021. We also identify a significant association between CIP and adult ADHD in cocaine-dependent patients p < .0.002. We fail to identify association between CIP and BPD and BN.
ConclusionsCIP is related with BIS cognitive subscale and BIS total scores, and with ADHD comorbidity in cocaine-dependent patients. As well these findings could be useful for a clinical approach to the risks of psychotic states in cocaine-dependent patients.
Anxiety and Depression in Drug-dependents Patients with Cluster C Personality Disorders
- C. Roncero, A. De Miguel, A. Fumero, L. Grau-López, R. Martin, L. Rodriguez-Cintas, J.M. Bethencourt, D. Bachiller, N. Tarifa, A. Beneria, M. Casas, C. Martínez, C. Daigre
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- European Psychiatry / Volume 30 / Issue S1 / March 2015
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
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Introduction
Substance-dependent patients(SDP) have more personality disorders(PD) than general population; and they present more frequent and severe levels of depression and anxiety.
ObjectivesTo study cluster C personality disorders in SDP.
MethodsWe included a clinical sample of 822(621 males) SDP according to the DSM-IV-TR criteria seeking treatment in the Outpatient Drug Clinic Vall d’Hebron in Barcelona, Spain.
The assessment process consisted of three interview sessions conducted by trained psychiatrists and psychologists using SCID I and II, BDI, STAI-R/S. Exclusion criteria were:intoxication at baseline examination, severe somatic disease at baseline examination and low language proficiency.
Results39.2% of the sample presented at least one PD and 9.55% presented a cluster C PD. Of them the found prevalence were Avoidant(44.9%), Dependt(11.5%), Obssessive-compulsive(37.2%), comorbidity (6.4%). The addiction prevalences that Cluster C PD patients show were: dependent of alcohol 9.4%, benzodiazepines 18.5%, opioids 6.1%, cocaine 9.7 and cannabis 12.3%.
70.5% of the PD cluster C group were men, however differences according to the cluster C PD were found, being higher the proportion of men in Obsessive-compulsive PD (85.7%) and fewer in Dependent PD patients (33.7%)(χ2 =12.19, p = .007).
Cluster C PD patients presented more depressive symptoms and showed higher scores in anxiety-trait than patient with Cluster A or B PD, being this difference statistically significant.
ConclusionThere is a high rate of cluster C personality disorders among addicted patients. Higher levels of anxiety depression are detected in these patients. Clinicians should be check systematically this symptoms and traits in addicted patients.
P-83 - A new Model for the Apomorphine Test as a Biological Marcket in Cocaine Dependent-patients
- C. Roncero, C. Daigre, L. Grau-López, D. Bachiller, A. Egido, X. Castells, S. Gómez-Baeza, L. Miquel, N. Martinez-Luna, O. Esteve, M. Casas
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- Journal:
- European Psychiatry / Volume 27 / Issue S1 / 2012
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
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Introduction
Until now, no reliable biological markers of risk and relapse in cocaine-dependent patients have been identified. The yawn-inducing Apomorphine test has been proposed as a marker for predicting relapse during cocaine withdrawal.
ObjectivesStudying the Apomorphine complete Test as a predictor of relapse in intranasal cocaine dependet-patients during abstinence.
Aims39 (35 men) cocaine addicts were recruited and included in an addiction program involving 2 weeks in-patient setting and a 23 follow-up weeks. Dependence was diagnosed according to DSM-IV-TR criteria and other axis I comorbid main diagnosis were excluded.
MethodsWe performed the Apomorphine complete Test (including an Apomorphine Test plus a Placebo Test) at the beginning (day 1) and end (day 11 or 12) of a detoxification program. Patient received 0′005 mg/kg of apomorphine and 0′005 mg/kg of placebo subcutaneously each test.
ResultsThe patients who relapse prematurely (before 4 weeks), yawn more 11′42 (0–31) in the Apomorphine complete Test realized the first day of the detoxification compared with patients that relapse no prematurely (after 4 weeks of follow-up), 6′83 (0–20), Z -2′14 p < 0′03. A model can establish, with a point of court of 7 yawns in the first Apomorphine complete Test that has a sensibility of 61 ′ 9% and a specificity of 70 ′ 6%.
ConclusionsThere an increased number of yawns in relapse-patients The Apomorphine complete Test could be proposed as a biological marker of early relapse.
Contributors
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- By Aakash Agarwala, Linda S. Aglio, Rae M. Allain, Paul D. Allen, Houman Amirfarzan, Yasodananda Kumar Areti, Amit Asopa, Edwin G. Avery, Patricia R. Bachiller, Angela M. Bader, Rana Badr, Sibinka Bajic, David J. Baker, Sheila R. Barnett, Rena Beckerly, Lorenzo Berra, Walter Bethune, Sascha S. Beutler, Tarun Bhalla, Edward A. Bittner, Jonathan D. Bloom, Alina V. Bodas, Lina M. Bolanos-Diaz, Ruma R. Bose, Jan Boublik, John P. Broadnax, Jason C. Brookman, Meredith R. Brooks, Roland Brusseau, Ethan O. Bryson, Linda A. Bulich, Kenji Butterfield, William R. Camann, Denise M. Chan, Theresa S. Chang, Jonathan E. Charnin, Mark Chrostowski, Fred Cobey, Adam B. Collins, Mercedes A. Concepcion, Christopher W. Connor, Bronwyn Cooper, Jeffrey B. Cooper, Martha Cordoba-Amorocho, Stephen B. Corn, Darin J. Correll, Gregory J. Crosby, Lisa J. Crossley, Deborah J. Culley, Tomas Cvrk, Michael N. D'Ambra, Michael Decker, Daniel F. Dedrick, Mark Dershwitz, Francis X. Dillon, Pradeep Dinakar, Alimorad G. Djalali, D. John Doyle, Lambertus Drop, Ian F. Dunn, Theodore E. Dushane, Sunil Eappen, Thomas Edrich, Jesse M. Ehrenfeld, Jason M. Erlich, Lucinda L. Everett, Elliott S. Farber, Khaldoun Faris, Eddy M. Feliz, Massimo Ferrigno, Richard S. Field, Michael G. Fitzsimons, Hugh L. Flanagan Jr., Vladimir Formanek, Amanda A. Fox, John A. Fox, Gyorgy Frendl, Tanja S. Frey, Samuel M. Galvagno Jr., Edward R. Garcia, Jonathan D. Gates, Cosmin Gauran, Brian J. Gelfand, Simon Gelman, Alexander C. Gerhart, Peter Gerner, Omid Ghalambor, Christopher J. Gilligan, Christian D. Gonzalez, Noah E. Gordon, William B. Gormley, Thomas J. Graetz, Wendy L. Gross, Amit Gupta, James P. Hardy, Seetharaman Hariharan, Miriam Harnett, Philip M. Hartigan, Joaquim M. Havens, Bishr Haydar, Stephen O. Heard, James L. Helstrom, David L. Hepner, McCallum R. Hoyt, Robert N. Jamison, Karinne Jervis, Stephanie B. Jones, Swaminathan Karthik, Richard M. Kaufman, Shubjeet Kaur, Lee A. Kearse Jr., John C. Keel, Scott D. Kelley, Albert H. Kim, Amy L. Kim, Grace Y. Kim, Robert J. Klickovich, Robert M. Knapp, Bhavani S. Kodali, Rahul Koka, Alina Lazar, Laura H. Leduc, Stanley Leeson, Lisa R. Leffert, Scott A. LeGrand, Patricio Leyton, J. Lance Lichtor, John Lin, Alvaro A. Macias, Karan Madan, Sohail K. Mahboobi, Devi Mahendran, Christine Mai, Sayeed Malek, S. Rao Mallampati, Thomas J. Mancuso, Ramon Martin, Matthew C. Martinez, J. A. Jeevendra Martyn, Kai Matthes, Tommaso Mauri, Mary Ellen McCann, Shannon S. McKenna, Dennis J. McNicholl, Abdel-Kader Mehio, Thor C. Milland, Tonya L. K. Miller, John D. Mitchell, K. Annette Mizuguchi, Naila Moghul, David R. Moss, Ross J. Musumeci, Naveen Nathan, Ju-Mei Ng, Liem C. Nguyen, Ervant Nishanian, Martina Nowak, Ala Nozari, Michael Nurok, Arti Ori, Rafael A. Ortega, Amy J. Ortman, David Oxman, Arvind Palanisamy, Carlo Pancaro, Lisbeth Lopez Pappas, Benjamin Parish, Samuel Park, Deborah S. Pederson, Beverly K. Philip, James H. Philip, Silvia Pivi, Stephen D. Pratt, Douglas E. Raines, Stephen L. Ratcliff, James P. Rathmell, J. Taylor Reed, Elizabeth M. Rickerson, Selwyn O. Rogers Jr., Thomas M. Romanelli, William H. Rosenblatt, Carl E. Rosow, Edgar L. Ross, J. Victor Ryckman, Mônica M. Sá Rêgo, Nicholas Sadovnikoff, Warren S. Sandberg, Annette Y. Schure, B. Scott Segal, Navil F. Sethna, Swapneel K. Shah, Shaheen F. Shaikh, Fred E. Shapiro, Torin D. Shear, Prem S. Shekar, Stanton K. Shernan, Naomi Shimizu, Douglas C. Shook, Kamal K. Sikka, Pankaj K. Sikka, David A. Silver, Jeffrey H. Silverstein, Emily A. Singer, Ken Solt, Spiro G. Spanakis, Wolfgang Steudel, Matthias Stopfkuchen-Evans, Michael P. Storey, Gary R. Strichartz, Balachundhar Subramaniam, Wariya Sukhupragarn, John Summers, Shine Sun, Eswar Sundar, Sugantha Sundar, Neelakantan Sunder, Faraz Syed, Usha B. Tedrow, Nelson L. Thaemert, George P. Topulos, Lawrence C. Tsen, Richard D. Urman, Charles A. Vacanti, Francis X. Vacanti, Joshua C. Vacanti, Assia Valovska, Ivan T. Valovski, Mary Ann Vann, Susan Vassallo, Anasuya Vasudevan, Kamen V. Vlassakov, Gian Paolo Volpato, Essi M. Vulli, J. Matthias Walz, Jingping Wang, James F. Watkins, Maxwell Weinmann, Sharon L. Wetherall, Mallory Williams, Sarah H. Wiser, Zhiling Xiong, Warren M. Zapol, Jie Zhou
- Edited by Charles Vacanti, Scott Segal, Pankaj Sikka, Richard Urman
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- Essential Clinical Anesthesia
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- 05 January 2012
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- 11 July 2011, pp xv-xxviii
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