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The majority of available US-published reports present populations with community spread in urban areas. The objective of this report is to describe a rural healthcare system's utilisation of therapeutic options available to treat Coronavirus Disease 2019 (COVID-19) and subsequent patient outcomes. A total of 150 patients were treated for COVID-19 at three hospitals in the Dakotas from 21 March 2020 to 30 April 2020. The most common pharmacological treatment regimens administered were zinc, hydroxychloroquine plus azithromycin and convalescent plasma. Adjunctive treatments included therapeutic anticoagulation, tocilizumab and corticosteroids. As of 1 June 2020, 127 patients have survived to hospital discharge, 12 patients remain hospitalised and 11 patients have expired. The efficacy of hydroxychloroquine and azithromycin use has yet to be determined but was not without risks of corrected QT interval prolongation and arrhythmias in our cohort. We did not appreciate any adverse effects that appeared related to tocilizumab or convalescent plasma administration in those patient subsets. These findings may provide insight into disease severity and treatment options in the rural setting with limited resources to participate in clinical trials and encourage larger comparative studies evaluating treatment efficacy.
The response to librational forcing of a cube in rapid rotation about a diagonal axis is explored. In this orientation, the faces of the cube are all oblique to the rotation axis. The system supports inertial waves, which predominantly comprise beams emitted from the edges and vertices of the cube. Which ones emit and the resulting complicated pattern of three-dimensional reflections and subsequent focusing depend on the libration frequency. Direct numerical simulations of the Navier–Stokes flows with no-slip boundary conditions at low Ekman number (
) and small libration amplitude (
) exhibit complicated spatio-temporal structure that is remarkably well described by considerations of the inviscid reflections of wavebeams over the whole range of libration frequencies from zero to twice the mean rotation rate of the cube.
The following commentary on Jang and Choi’s chapter Issues and New Directions in Personality Disorder (PD) Genetics (This Volume) echoes their call to harness advances in PD assessment rather than rely on politically derived "top down" nosologies. We first discuss how recent work in the joint hierarchical structure of PD traits and psychopathology, as well as, personality dynamics (i.e., how personality manifests in different situations) likely offer fruitful avenues for exploring the more nuanced role of genetics in the development and maintenance of PD. Second, we highlight the need to better understand the role of environment in PD genetics and discuss emerging models (e.g., common pathway model). Third, we stress the need for more research and larger samples in order to arrive at stronger conclusions. Fourth, we consider how advances in gene-environment research can help to determine targets for PD prevention and treatment.
Previous literature supports antipsychotics’ (AP) efficacy in acute first-episode psychosis (FEP) in terms of symptomatology and functioning but also a cognitive detrimental effect. However, regarding functional recovery in stabilised patients, these effects are not clear. Therefore, the main aim of this study is to investigate dopaminergic/anticholinergic burden of (AP) on psychosocial functioning in FEP. We also examined whether cognitive impairment may mediate these effects on functioning.
A total of 157 FEP participants were assessed at study entry, and at 2 months and 2 years after remission of the acute episode. The primary outcomes were social functioning as measured by the functioning assessment short test (FAST). Cognitive domains were assessed as potential mediators. Dopaminergic and anticholinergic AP burden on 2-year psychosocial functioning [measured with chlorpromazine (CPZ) and drug burden index] were independent variables. Secondary outcomes were clinical and socio-demographic variables.
Mediation analysis found a statistical but not meaningful contribution of dopaminergic receptor blockade burden to worse functioning mediated by cognition (for every 600 CPZ equivalent points, 2-year FAST score increased 1.38 points). Regarding verbal memory and attention, there was an indirect effect of CPZ burden on FAST (b = 0.0045, 95% CI 0.0011–0.0091) and (b = 0.0026, 95% CI 0.0001–0.0006) respectively. However, only verbal memory post hoc analyses showed a significant indirect effect (b = 0.009, 95% CI 0.033–0.0151) adding premorbid IQ as covariate. We did not find significant results for anticholinergic burden.
CPZ dose effect over functioning is mediated by verbal memory but this association appears barely relevant.
Until now, no reliable biological markers of risk and relapse in substance-dependent patients have been identified. The yawn-inducing test with apomorphine has been proposed as a marker of the functional status of the dopaminergic system and therefore a predictor of suffering an addiction or predisposition to relapse.
Studying the safety and efficacy of apomorphine test as a predictor of relapse in intranasal cocaine dependent, diagnosed according to DSM-IV-TR.
We performed the test of apomorphine at the beginning (day 1) and end (day 11/12) of a detoxification program in 33 patients (29 men). The majority of patients relapsed after 22 weeks of follow up (87% relapse). The average yawns in the sample were 10.9 ± 9.3 in the initial test (Apo 1) and 10.2 ± 10.2 in the final test (Apo 2). The 42% of patients relapsed early (before 4 weeks) and 45% late (afther 4 weeks). 58% of the sample (N = 19), which did not fall belatedly filled an average of 8.0 yawns in Apo1 and 8.1 on Apo2 and 42% who did so early (N = 14), 14,8 in Apo1 and 14.6 in Apo2. Therefore there are an increased number of yawns in patients with early relapse. No important side effects were reported.
Patients with early relapse have a higher number of yawns that those falling late or abstainers The apomorphine test is a safe test and it is a readily applicable tool in clinical practice and may be a biological marker of risk.
To analyse the consequences of broadening DSM-IV criteria for generalized anxiety disorder (GAD) on the utilization of health care resources and corresponding costs.
Multicentre, prospective and observational study conducted in outpatient psychiatric clinics selected at random and weighted by geographical density of population. Patients with GAD according to DSM-IV criteria and subjects with anxiety symptoms fulfilling broader criteria were compared. Broadening criteria was considered 1-month of excessive or non-excessive worry and only 2 associated symptoms listed on DSM-IV for GAD. Socio-demographic data, medical history and health care resources and corresponding costs were recorded during a 6-month period.
A total of 3,549 patients were systematically recruited; 12.8% excluded because not fulfilling inclusion criteria, 1,815 patients in DSM-IV criteria group (DG) and 1,264 in broad criteria group (BG). Both groups were similar on their sociodemographic characteristics at baseline. Type of treatments prescribed at psychiatric clinics during the study were similar in frequency; anti-depressives (77.0% in DG vs. 75.3% in BG, ns), benzodiazepines (71.5% vs. 67.2% respectively, ns), and anti-convulsants (72.1% vs. 67.0% respectively, ns). Health care resources utilization were statistically reduced to a similar extent in both groups as a consequences of treatments yielding to a cost-of-illness in the 6-month period of 1,196 (1,158) and 1,112 (874), respectively; p=0.304.
In a large sample of subjects, broadening of GAD criteria could lead to earlier diagnosis that would not be associated necessarily to an increase in health care resources utilization or costs to the National Health System.
The European Foundation for Quality Management (EFQM) Excellence Model is a non-prescriptive framework based on nine criteria. The aim of this work is to describe the implementation of the EFQM model as a quality framework for the improvement of an inpatient medium-stay psychiatric unit.
In 2005 a multidisciplinary performance improvement work group was convened to begin a project with these aims:
- The definition of the unit's mission.
- The identification of the unit's main processes.
- The identification of performance and quality results.
- The establishment of an audit period of clinical outcomes.
- The creation of a protocol for admissions.
Between 2005 and 2008 the group designed the following:
- A map showing the medium-stay unit process as well as the main processes.
- The key performance indicators.
- An ECT protocol.
- The Quality Indicators.
- A patient satisfaction survey.
Every year we decide the objectives of each indicator and revise them every month. Efficiency in the use of resources improved, due to an increase in annual admissions (from 190 in 2005 to 213 in 2009) as well as a decrease in length of hospital stays (from 62 days in 2005 to 48 days in 2009).
The management through processes according to the EFQM model is an instrument for the improvement of the quality of assistance. This type of management allows for the definition of the unit's mission, the measure and analysis of results and for the establishment of areas of improvement.
The purpose of this study is to investigate if the MDA plasma concentrations are correlated to negative psychopathology in paranoid schizophrenic inpatients.
The sample was comprised by 38 patients who were admitted in the psychiatric ward of the University Hospital of the Canaries. Thirty eight patients were male and 9 were female with medium average age of 37.41±11.23. Exclusion criteria were psychoactive substance use, presence of acute or chronic organic pathology, treatment with immunosuppressive medication, pregnancy and mental retardation or severe cognitive impairment. There were performed two blood extractions following the circadian rhythm, at 12:00 and at 24:00 hours. One hour before night blood collection, each patient was placed in a reclined position in bed, with the eyes closed, in complete darkness and with eyes covered with a mask. Blood was centrifuged at 3.000 rpm for 10 minutes. Specific biological and psychopathological determinations were performed at admission and at discharge. Psychopathology was assessed with PANSS and by the same psychiatrist. Statistical analyses were carried out with the Social Statistical Package for the Social Sciences (SPSS). MDA was determined spectrophotometrically.
MDA level at night was 1.94±1.54 while MDA level at midday was 2.23±1.36.Mean PANSS negative score was 15.73±6.31.Serum MDA level correlated positively with PANSS negative scores, both at midday and night (midday r=0.39, p< 0.01, midnight r=0.41, p< 0.01).
The total negative subscale score correlated positively with day and night time levels of MDA, therefore we can conclude that MDA may be used as a marker of negative psychopathology.
According to 2008 data, there are 80.000 patients undergoing replacement opiate programs (RMP) in Spain. However, the clinical therapeutic management and the psychiatric and medical comorbidities have not been well described.
To describe the current therapeutic management and psychiatric comorbilities of opiate-dependent patients undergoing a RMP in Spain.
We carried out an observational, cross-sectional, multicenter study from September 2008 to February 2009. Patients > 18 years, with written informed consent, with a opiate-dependence according to DSM-IV-TR criteria and currently scheduled in a RMP in Spain were included.
624 patients (38.89±7.95 y.o.,84% men) were included in the study from 74 centers.
Psychiatric comorbidities were clinically detected in 68% of all valuable patients, most frequently anxiety (53%), mood (48%) and sleep disorders (41%). Patients receiving buprenorphine-naloxone suffered less sleep disorders (19% vs. 43%; p=0.0327) The proportion of patients with at least one psychiatric comorbidity was directly related to methadone dose (p=0.0066).
The most frequent replacement therapy was methadone (94%), usually in ≤ 40 mg/day (38%) and 40-80 mg/day doses (40%); mean follow up period being 45.88±51.86 months. Significant differences were found between methadone doses and retention. Patients with HIV and HCV infection received higher doses of methadone (HIV+ patients (p=0.0024) and HCV+/ HIV+ patients (p=0.0250) due to ARV treatment; and showed less PMM retention.
Patients present high rates of dual diagnosis, and infectious and non-infectious comorbidities, expecting higher doses of methadone than found (54.04±47.26 mg/day) in the study to assure a proper retention in the maintenance programs.
To evaluate the effect of pregabalin as a tapering therapy over the subjective sleep quality of patients who underwent a benzodiazepine withdrawal program.
This was a secondary analysis of a 12-week, prospective, and observational study carried out in patients aged 18 years or over, who met DSM-IV-TR criteria for benzodiazepine dependence without other major psychiatry disorder. Evaluations included the Benzodiazepine Withdrawal Symptom Questionnaire, the Hamilton Anxiety Rating Scale, the Clinical Global Impression scale, and the MOS-Sleep Scale. Changes from baseline to the endpoint in the different scales’ scores as well as correlations of these changes with those of the MOS-Sleep scores were calculated.
282 patients met the criteria for analysis. Mean pregabalin dose was 315 (166) mg/day at end-of-trial. We observed a significant and clinically relevant improvement in sleep outcomes at the study endpoint as measured with the MOS-Sleep Summary Index, that was reduced from 55.8 (18.9) pts at baseline to 25.1 (18.0) pts at week 12 (55% reduction), as well as with the six dimensions of the MOS-Sleep Scale. Moderate correlations were observed between Summary Index and sleep domains with improvements in the anxiety symptoms and in the disease severity as well. Also, sleep ameliorations were observed in the 52% successfully benzodiazepines withdrawals but, although to a lesser extent, in the remaining failures as well.
Pregabalin treatment improves subjective sleep quality in patients who underwent a benzodiazepine withdrawal program and this effect appears partly independent of the improvement of anxiety or withdrawal symptoms.
We present the case of a schizophrenic patient with severe insomnia that had a partial response to high doses of benzodiazepines and sedating antipsychotics. Treatment with agomelatine allowed to suspend benzodiazepine treatment and restore quality of sleep.
Mr. Y is a 36 year old male patient diagnosed with simple schizophrenia that has complained of insomnia since the age of sixteen. During the last three years the treatment that the patient was following was stable and consisted of 100 mg of diazepam, 300 mg of levomepromazine and 120 mg of clotiapine every night. During the last year 60 mg of duloxetine were added to treat a moderate depression. His mood improved with the prescribed treatment, but eleven months later it worsened. In an attempt to simultaneously treat the mood and the sleep disorder, during a period of 4 days, a dosis of 12.5 mg of aglomelatin at dinner was introduced while the morning dose of duloxetine was reduced to 30mg. On the fifth day, agomelatine was increased to 25 mg at dinner while duloxetine was suspended. The antipsychotic treatment was kept stable while the patient was instructed to reduce 10 mg of diazepam every week until next appointment one month later. In the next appointment the patient had completely suspended diazepam one week before the appointment. The patient referred improved sleep quality and no rebound insomnia.
Agomelatine may be a valid treatment of insomnia in schizophrenia.
Benzodiazepines are widely used drugs. However, their chronic use has revealed that they can lead to dependence. The objective of this study is to review the different pharmacological strategies used in the management of benzodiazepine dependence and new trends in pharmacological interventions.
We searched in MEDLINE and in the Cochrane Database System Review, selecting studies from 1980 until the present, in which a pharmacological intervention was made for benzodiazepine detoxification in mono-dependence cases.
There is a consensus about gradual rather than abrupt tapering benzodiazepines in benzodiazepine discontinuation. Other extended traditional strategy has been switching from short half-life to long half-life benzodiazepines before gradual taper. A great variety of agents have been used as adjuvant medication in Benzodiazepine Withdrawal Syndrome (BWS) with varying degrees of success. In the last years research has focus in the use of anticonvulsant drugs. Both carbamzepine and valproate, have demonstrated to be beneficial in benzodiazepine discontinuation. Also, preliminary data suggest that new anticonvulsant agents (gabapentin, pregabalin, oxcarbazepine and topiramate) could be helpful.
Although multiple drugs have been investigated for pharmacological management of BWS, only few have demonstrated significant efficacy. Anticonvulsant drugs are one of them. Both, carbamazepine and valproate, have shown benefits in reducing withdrawal severity. The available data currently support the use of new anticonvulsant (gabapentin, pregabalin, oxacarbazepine and topiramate), in the treatment of different drug-dependences such as alcohol, cocaine and opiate dependence. Moreover, there is a growing trend in the literature toward the use of these agents in benzodiazepine mono-dependence.
Suicide is a major public health problem, one of the leading causes of death and one of the first causes of years of life lost. It is a voluntary act that can be carried out by men and women, children and adults, rich and poor, people of every race and religion.
The aim of this text is to outline the most popular suicides and briefly discuss the representation of suicide in art. Painters such as Vincent Van Gogh, Edvard Munch, Jackson Pollock, musicians as Kurt Cobain, Jim Morrison, Janis Joplin, Jimi Hendrix, the actresses Lupe Vélez, Carole Landis, Pier Angeli, Capucine, Marylin Monroe, Lucy Gordon and the actors Heath Ledger and Freddie Prinze decided the end of their lives in different ways and at different stages.
In the literary field, we find the world renowned suicides of Socrates, Seneca and Caton. Other famous and more recent suicidal writers are Ernest Hemingway, Dylan Thomas, Virginia Woolf, Yukio Mishima, Alfonsina Stormi and Cesare Pavese among others.
Suicide has been represented in several plays and operas, not only people of flesh and blood kill themselves but also fictional characters. the love-death of Liu in Turandot and Tosca in the opera of the same name Are noteworthy, both were composed by Giacomo Puccini. In Hamlet, tragedy written by William Shakespeare, is Ophelia who dies drowning at the sea.
Immigrant population has been growing up in Spain in the last decades. The immigration process constitutes a vulnerability factor for the development of psychological issues. Moreover, ethnicity determines a great variability in the symptomatic expression of psychiatric diseases. The objective of this study was to investigate the demographical characteristics and clinical profiles of immigrant patients that visit the emergency services of general hospitals.
An epidemiological study was conducted to evaluate profiles and demographical characteristics of immigrant population attended at the emergency services of the “Hospital 12 de Octubre” Madrid, during 2007. The data were acquired through a protocol developed for this study and applied to all foreign patients attended.
2976 patients were attended during 2007. Immigrant patients were 10% of the sample. There mean age was 29.46 years. 42.1% were men and 57.9% were women. The nationalities of the sample were as follow: 47.8% were Latin American, 23.7% Eastern Europeans, 16.1% were Maghribian and 4.7% were Africans. 48.2% were attended because of suicide attempt (the 59% of Latin Americans and the 54.5% of Eastern Europeans) and 14.3% had psychosis (the 42.9% of Africans and the 36.2% of Maghribians). 30% were diagnosed of a current Substance Use Disorder (the 16.9% of Eastern Europeans).
We found several clinical and demographical differences within the ethnic groups studied. Latin Americans and Eastern Europeans consult for suicide attempt, whereas Maghribians and Africans are attended for psychosis. Psychiatrists should consider cultural and ethnic factors when interviewing foreign population.
Oxidative stress suposses an imbalance between oxidants and antioxidants molecules. Negative and positive family environment have been related with worse and better outcomes respectively in schizophrenic patients.
Our objetive is to determine antioxidant defense in healthy controls and unaffected relatives of early onset psychosis patients and to asses its relationship with familiar environment.
We included 82 healthy controls (HC) and 14 healthy controls with second degree family history of psychosis (HCWFHP), aged between 9 to 17.
Total antioxidant status and lipid peroxidation test were determined in plasma and antioxidant enzime activities and glutathione levels were determined in erytrocytes.
We used the Global Assesment Functioning scale (GAF) and the Family Environment Scale (FES). The FES is made up of ten subscales: cohesion, expressiveness, conflict, independence, achievement, intellectual-cultural, social, moral, organization and control.
The analyses showed a significant decrease in total antioxidant level in HCWFHP compared with the HC (U Mann Withney = 281.00, p=0.009, effect size= -0.78).
HC and HCWFHP did not differ in the GAF scale, nevertheless the scores of HCWFHP were significantly higher in cohesion and intellectual-cultural dimensions of the FES (p=0.007, p=0.025).
Adjusting by this two FES dimensions, antioxidant status remained significantly different between groups: OR= 10.86, p=0.009.
Although we cannot induce causative relations, we can state that family environment is not playing a role in inducing oxidative stress in these subjects. It could be hypothesized that families with affected relatives protect themselves with positive envionmental factors such as cohesion and intellectual-cultural activities.
Startle reflex (SR) is a defensive response to sudden, intense stimuli. Prepulse inhibition (PPI) refers to the ability of innocuous sensory events to reduce SR. PPI has been described as an operational measure of sensorimotor gating that is reduced in several neuropsychiatric disorders, such as schizophrenia, but there is no extensive experience in addictions and alcoholism. The objective of this study was to examine the existence of impairments on SR and PPI in abstinent alcoholic males.
Subjects were 40 abstinent alcoholic males, aged 18 to 65 years (mean age 44.73), who had met DSM-IV criteria for Alcohol Dependence, being abstinent for more than a month at the moment they were tested. Participants underwent testing for PPI. Subjects were then compared with 35 equal controls.
Magnitudes of the SR were lower in abstinent alcoholic males when compared with controls. This differences were significant (p< 0,05) in trials with prepulse presented 30, 60 or 120 msec before the onset of startle stimulus. There was a significant less percentage of PPI when prepulse was presented 30 msec before the startle stimulus (p< 0,05).
Abstinent alcoholic males exhibit a decrease in the startle response magnitude and in the PPI of the SR. These data suggest that sensory information processing mechanisms could be damaged in abstinent alcoholic patients. The fact that these findings are common to other psychiatric disorders, could indicate the existence of a common vulnerability marker, and could explain the important comorbidity between alcoholism and other mental illness.
Stress and trauma have been reported as leading contributing factors in schizophrenia. And certainly child abuse (neglect, emotional, physical and sexual abuse among others) has a lasting negative impact, which is well established in literature.
To consider the presence of infant trauma and its relationship with psychopathology in paranoid schizophrenics.Methods. 37 patients (mean age 29±6.3; years from onset 9.20±4.7), meeting DSM IV paranoid schizophrenia criteria, undergoing treatment in a university hospital are studied. The PANSS is administered in order to rate psychopathology.
27 patients had infant trauma (55.8%). Main traumas are: sexual abuse (12.8%), child abuse (7.7%), both sexual and child abuse (5.18%), parental separation (7.7%), extra-rigid parents (2.6%), alcoholic parents (18.2%), child abuse and mother's death in childhood (2.6%). Infant trauma and psychopathology showed a significant relationship concerning Hostility (No 1.75±1.209, Yes 2.26±1.759), Unnatural Movements and Posture (No 1.55±0.945, Yes 1.16±0.545), Depression (No 1.25±0.550, Yes 1.74±1.284) and Preoccupation (No 2.75±1.410, Yes 3.26±1.996).
Infant trauma is common in paranoid schizophrenia and our findings give some evidence to a relationship with psychopathology, especially with dimensions as Hostility, Unnatural Movements and Posture, Depression and Preoccupation. Despite sample size, a high proportion (55.8%) of the patients presented infant trauma and future research is needed in order to open new avenues in this field, particularly studies concerning infant trauma and symptomatology specificity will be greatly appreciated as well as the plausible link to personality traits and personality disorders.
Cocaine consumption can induce transient psychotic symptoms, expressed as paranoia or hallucinations. Cocaine induced psychosis (CIP) is common but not developed in all cases.
To describe the Risk Factors for developing cocaine-induced psychosis in cocaine dependent patients, according DSM-IV-TR criteria.
This is the first European study about the relationship of CIP with consumption pattern variables and personality disorders, we evaluated 220 cocaine dependents over 18 years, 80'5% males, mean age 33.9 years (SD = 7.6). Patients were recluted from an outpatient clinic department and subsequently systematically evaluated using SCID I and SCID II interviews for comorbidity disorders, and a clinical-based systematic psychotic symptoms form.
A high proportion of cocaine dependent patients reported psychotic symptoms (51.8%) under influence of cocaine. The most frequent reported psychotic symptoms were paranoid beliefs and suspiciousness (42.4%). After a logistic regression analysis we found that a model consisted of high cocaine consumption (mean of 12.01 grams per week), cannabis dependence history and to use intranasal or smoked rout of administration had a sensitivity of 63.2% and a specificity of 70.2%.
We conclude that is relevant to evaluate CIP in patients consuming high amounts of cocaine, with cannabis dependence history and who do not use intranasal rout. It could be useful for preventing consequences or risks of psychotic states for themselves or others.
We assessed parents’ perceptions of and satisfaction with daily lisdexamfetamine dimesylate (LDX; Vyvanse®, US tradename, Shire US Inc.) treatment for their children with attention-deficit/hyperactivity disorder (ADHD) previously treated with osmotic-release oral system methylphenidate (OROS-MPH).
Parents of children with ADHD were surveyed via telephone or Internet about their child's experience before and approximately 6 weeks after initiating LDX treatment. Participants received a $25 coupon toward their child's next LDX prescription after survey completion. Post hoc analyses using the Wilcoxon signed rank test were performed.
School time was the most frequently reported most bothersome time of day at baseline (41%), followed by homework time (23%). At follow-up, most parents reported improvement during their child's most bothersome time of day. Significantly less interference from ADHD symptoms with school activities, family interactions, homework, and social interactions was reported (all P< .01). LDX tolerability and convenience were rated, on average, 7.1 and 8.0, respectively (1=not at all well tolerated/convenient, 9=very well tolerated/convenient). Satisfaction with LDX was significantly higher than satisfaction with OROS-MPH treatment (6.9 and 5.0, respectively, P< .01 [1=not at all satisfied, 9=very satisfied]). Eighty-four percent of parents reported that they intend for their child to continue taking LDX.
Parents of children with ADHD who were previously treated with OROS-MPH and currently taking LDX reported less interference of ADHD symptoms with daily activities after LDX treatment and high satisfaction with LDX. LDX was also well tolerated and convenient to use.
There are few studies about the characteristics of Substance Use Disorder patients that relapse, defined by restart of the substance use that motivated the intake, after discharge from a Detoxification Unit.
To analyze the percentage of patients who had a relapse in the following 3 months after discharge and to describe their sociodemographic, clinical and therapeutical characteristics.
We prospectively studied drug dependents patients admitted to our Detoxification Unit from June 2008 to August 2009. Data was gathered at admission on demographic (gender, age), clinical (main abused drug, psychiatric comorbidities, polydrug users) and therapeutical variables (hospitalisation duration, prescribed treatment). Patients were followed up for 3 months and assessed for relapse at 1 and 3 months by clinical interview, alcohol screening test and/or urinalysis. Results from patients with and without relapses were compared.
The study sample included 103 patients (77,7% men, average age 38,31±9). At month 3, 57,3% of the patients had relapsed. We found significant differences between the relapse and the non-relapse group on the percentage of polydrug users (68,6% vs 31,4%, p=0,05), on heroine as main drug of abuse (76% vs 24%, p=0,05) and psychiatric comorbidities (60,8% vs 39,2%, p=0,04), being psychotic disorders the most frequent. No significant differences were found between the 2 groups concerning therapeutical variables.
More than half of the patients that ended the detoxification process relapsed in the first 3 months. Polydrug use, opiate dependence and having a psychiatric comorbidity might be considered as risk factors for relapse.