Drug substance abuse has been related with chronic insomnia and other sleep disorders that are thought to interfere in detoxification treatment and relapse induction. These disorders can persist after drug detoxification.

To describe sleep disorders refered by drug dependents patients in an inpatient detoxification unit.

We prospectively studied drug dependents patients admitted to our Detoxification Unit from January 2005 to March 2009. The first night, patients were asked to complete an 11-item questionnaire measure designed to assess the relationship between sleep disorders and drug use. Responses ranged from 1 to 7. The questionnaire measured the following:

1. a) insomnia before hospitalization;

2. b) patients’ beliefs about the relationship between insomnia and drug use;

3. c) insomnia in previous detoxifications;

4. d) patients’ worry about insomnia;

5. e) treatment of sleep disorder with benzodiazepines.

The study sample included 150 patients (75.3% men). 39% of the patients suffered from alcohol abuse, 34.67% from cocaine abuse, 22.67% from opiod abuse, 21% from cannabis abuse, 18% from benzodiazepine abuse, and 12.67% of patients were polydrug users.Lifetime prevalence of sleep disorders was 68.1%. 64% had suffered insomnia the months previous to detoxification. 80.1% of patients’ refered sleep disorders in relationship with substance abuse. 69.4% were worried about insomnia during detoxification. 75.4% of patients took benzodiazepines without prescription.

Sleep disorders in patients with drug abuse are frequent. A high prevalence of patients having worries about insomnia during the detoxification treatment and believing in a relationship between their sleep disorders and the drug abuse was found.

We aimed to study the relationship between impulsivity and the addiction severity in 3 groups of outpatients attending our clinic, through the Barrat Impulsivity Scale (BIS-11) and the standarized, semistructured interview EuropAsi.

174 outpatients were analized (82.6% men, 113 cocaine-dependent as main drug (mean age 32.71 y.o. (31.45–33.96)), 43 cocaine and heroin-dependent (mean age 36.68 y.o. (33.52–39.85)) and 18 heroin dependent (mean age 37.94 (32.71–41.50)). 26.3% were cannabis-dependent and 10.9% abused of Cannabis. Statistical analysis used was the Kruskal-Wallis Test.

Differences in motor impulsivity were found between the 2 groups with cocaine dependency and the only heroin-dependent (mean = 20.59, ST ± 7.7 and mean = 17.11, ST ± 7.3, respectively; W: .019). EuropASI, showed intergroup differences in the medical, use of alcohol and legal areas. In the medical area the most affected were the heroin dependent group (mean score = .40), followed by cocaine and heroin group (mean score = .27) and the cocaine-dependent (Mean = .10). In the use of alcohol area the most affected were the cocaine group (Mean = .16) followed by the cocaine and heroin-dependent (mean = .11) and heroin dependent (Mean = .06). In the legal area the most affected were the the cocaine and heroin-dependent (Mean =.22) followed by heroin-dependent (Mean = .09) and cocaine-dependent (Mean = .07).

Patients suffering from stimulant dependency alone or together with heroin dependency show different impulsivity levels. The addiction severity varies depending on the substance of abuse. Treatment programs should be designed attending patients’ needs.

Many risk factors for cocaine-induced psychosis (CIP)in cocaine-dependent patient (CDP) have been described although there not exactly known. Differences in the personality traits or disorders in CDP with or without CIP has been described. However, there are few studies studding the relationship between CIP and personality with a dimensional approach in order to clarify if there are any personal dimension related with CIP or/and personality disorders (PD) in CDP.

This study the relationship between CIP and personality trails evaluates with ZKPQ, and attempted to identify any personality dimension as a risk factors for CIP.

We performed a cross-sectional, observational study in 260 (75.5% man, 36.5 y.o) CDP according DSM-IV-TR seeking treatment between May 2009 and April 2013. The SCID-I, SCID–II, ZKPQ and a structured interview about CIP were performed.

CIP was reported for 66.4% of the patients. Patients with CIP had an earlier onset of cocaine dependence (p<0.05). Any PD was identified in 46.9% of the sample. Patients with CIP were diagnosed with ASPD more frequently (28.9% vs. 15.6%, X2=9.9, p<0.05). ZKPQ mean were: Sociability (6.3± 3.6), Neuroticism-Anxiety (10.8± 4.8), Impulsive Sensation Seeking (10.8±4.5), Aggression Hostility (9.06±3.2) and Activity (8.3±3.4). Patients with CIP presented higher scores in Neuroticism-Anxiety (11,4±4,7 vs. 9,6±5, t=2.7, p<0.05) and Aggression-Hostility (9,4±3,1 vs. 9,4±3,1, t=2.3, p<0.05) than patients without CIP.

The detection of high scores of neuroticism-anxiety and aggression-hostility trails should lead to evaluate the presence of CIP in CDP in order to alert them of the risk of develop CIP.

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.

To analyze the percentage of patients who had a voluntary discharge to Hospital Detoxification Unit and to describe sociodemographic, clinical and diagnostic test characteristics.

We 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.

The 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).

Few 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.

The objective of our study is to describe the prevalence of insomnia during active consumption and hospitalisation for detoxification, and its influence on relapses at 3 and 6 months in drug-dependent patients.

We conducted a prospective study of drug-dependence inpatients admitted to the hospital detoxification unit between June 2008 and November 2012, and performed psychiatric follow-up on an outpatient basis over the six months following discharge. Insomnia prior to admission was measured by clinical interview from the patient concerning sleep habits, and during hospital stay using a sleep log filled out by nurse team. Demographic, clinical and diagnostic variables were recorded and a structured clinical interview (SCID) was conducted to assess psychiatric diagnoses. Relapse was deemed to be renewed use of the substance that brought about admission, which was assessed by alcohol testing and/or urinalysis.

We included 434 patients. Insomnia during consumption was reported by 64.3% of patients and 66.1% reported insomnia during hospital stay. Of the patients with preadmission insomnia, 68.3% relapsed at 3 months from discharge, as did 71% of patients with insomnia during hospital stay. Patients who relapsed at 3 months of follow-up showed significantly greater sleep initiation dysfunction prior to and during hospitalisation. Of the patients with preadmission insomnia, 69.2% had relapsed at 6 months from discharge. Patients who relapsed at 6 months of follow-up showed significantly greater sleep initiation dysfunction and global insomnia prior to and during hospitalisation.

Sleep disorders should be study as a prognostic factor in drugdependent patients.

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.

The objective of this study is to determinate the relationship between impulsivity and impulsivity-realetd disorders (BPD, BN and ADHD) and CIP.

We 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.

A 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.

BIS 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.

CIP 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.

Little is known about medical students’ interest in their training on drug addiction, their personal experience of consumption and whether these aspects influence the detection of addiction in patients.

To study the interest of medical students enrolled on the psychiatry course in the area of addictions, and evaluate the influence of such interest, a history of personal consumption and gender on the detection of addiction in patients.

Voluntary participation was offered to all students from academic years 2008–2009 to 2012–2013. Of the 505 potential students, 336 questionnaires were collected, of which 71.13% were female.

Of the respondents, 88.5% considered that drug dependence issues are important to their professional future and 63% that the approach to drug-related diseases is important. A total of 34% of the students had already assessed addicted patients in their previous clinical training. The students report consuming alcohol(69%), cigarettes(19.5%) and illegal drugs(15.8%). The female students consumed fewer illegal drugs than the men(p0.022) and more frequently considered that the list of topics to be covered was appropriate(p0.021). The male students consumed more illegal drugs more frequently(p 0.005), knew more consumers(p 0.023), and those who drink alcohol consumed more illegal drugs than women(p < 0.005). However, the men seemed to have assessed fewer addicted patients in their previous clinical experience(p0.094).

Consumption among medical students may have a normalizing role on consumption and prevent the detection of addicts. It is important to educate and raise awareness on drugs, as this may influence detection. The focus should be particularly on the male group.

Drug use among medical students is partially unknown. However, consumption among medical students may have a similar role if compared with the rest of population.

To study drugs use among medical students comparing gender and evolution on drugs use.

Students enrolled in the fifth year of the medical studies at the Universidad Autónoma de Barcelona, from the course 2008-2009 to 2014-2015, were offered the chance to participate voluntarily in the study.

The students agreed to participate anonymously in a survey filled in during the beginning days of the psychiatry classes. They were asked about their drug consumption, including legal drugs (alcohol and tobacco) and illegal drugs. During the seven study years, 469 questionnaires were collected (74.1% of women) and mean age was 22.77 (20-35) yearsold.

The students reported consuming alcohol (66.7%; 65.5% women, 70.4% men), tobacco (18.6%; 18.1% women, 20% men) and illegal drugs (15.1%; 12.4% women, 22.8% men). The female students consumed fewer illegal drugs than the men (p 0.008) as showed above. Comparing 2008/2009 and 2014/2015 courses, the consumption was: alcohol 75.5% and 65.7%, tobacco 24.5% and 13.2% and illegal drugs 22.4% and 14.7%.

Drug consumption is an important problem among medicalstudents who will becomeprescribing doctors in a few months after the survey. There is a decreased tendency to use illegal drugs. Due to the gender differences on illegal drug use a special focus must be placed on the male group.

The aim of this study was to test the efficacy of caffeine with or without biperiden in the treatment of cocaine dependent patients.

A randomized, double blind, placebo-controlled clinical trial has been carried out in an inpatient regime during up to 13 days. Eligible patients were randomized to caffeine plus biperiden or caffeine plus biperiden placebo or caffeine placebo plus biperiden placebo.

Eighty five treatment-seeking patients were enrolled in this study. Patients were stabilized with a mean caffeine dose up to 15 mg/Kg. Results show that all three treatments are well tolerated and a clear reduction in cocaine withdrawal and craving was observed. Nevertheless, no statistically significant differences were found between groups in any outcome.

This study shows that inpatient cocaine detoxification with high caffeine doses, with or without biperiden, is well tolerated and allows further research on the usefulness of caffeine in the treatment of cocaine withdrawal and craving. Nevertheless, the selection of an inpatient hospital regime hampered the demonstration of the superiority of caffeine treatment versus placebo.

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.

Studying the Apomorphine complete Test as a predictor of relapse in intranasal cocaine dependet-patients during abstinence.

39 (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.

We 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.

The 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%.

There an increased number of yawns in relapse-patients The Apomorphine complete Test could be proposed as a biological marker of early relapse.

Legal and illegal drugs can cause psychotic symptoms, in cocaine-dependent patients the prevalence of these symptoms may reach 86% (Vorspan, 2012). It is estimated that 13–32% of cocaine-dependent patients have kinaesthetic hallucinations (Siegel, 1978; Mahoney, 2008; Roncero, 2012).

To compare the prevalence of substance-induced psychotic symptoms and compare the use of welfare/social resources and social adjustment among cocaine-dependent patients (CD) and other substances dependences (OtherD).

Two hundred and six patients seeking treatment at the Addictions and Dual Diagnosis Unit of the Vall d’Hebron. Patients were assessed by ad hoc questionnaire designed to collect demographic data and psychotic symptoms associated with consumption, a record of the care/social resources used by the patient and the scale of social adaptation (SASS). A descriptive and bivariate analysis of the data was performed.

CD were 47.1% vs. 52.9% OtherD (66.1% alcohol, 17.4% cannabis, 8.3% opioid, 8.3% benzodiazepines/other drugs). Of cocaine dependent-patients, 65.6% present psychotic symptoms vs. 32.1% for the OtherD. Different exhibiting psychotic symptoms are: self-referential (69.7% vs. 30.7%), delusions of persecution (43.4% vs. 12.2%), hallucinations (49.4% vs. 14.3%), auditory hallucinations (43.5% vs. 11.4%), visual hallucinations (30.4% vs. 5.7%) and kinaesthetic hallucinations (7.2% vs. 2.9%).

Cocaine-dependent patients significantly use more health care resources in reference addiction unit (76.3% vs. 62.4%, P:.035) and infectious diseases (22.7% vs. 5.5%, P:.000) and justice-related (50.5% vs. 26 resources 0.6%; P:1.001) and less resources and mental health (25.8% vs. 43.1%; P:.013).

Regarding social adaptation, no differences were found in the SASS. Kinaesthetic hallucinations do not appear to be related to a greater use of resources and in social adaptation.

References not available.

The authors have not supplied their declaration of competing interest.