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Benzodiazepines are commonly prescribed since the 1960, when they replaced barbiturics. Although there is no doubt about their efficacy in treating anxiety, insomnia or other psychiatric disorders, we should also take into account the fact that these drugs are easily misused.
In this work we analyze the intake of benzodiazepines among patients hospitalized due to medical problems.
Retrospective review of clinical histories of patients attended by the Drug Unit of the Psychiatry Service in the last twelve months. Bibliographical review of the theme. Data analyzed using the SPSS software 15.0 version.
45 patients were subjected to our survey, 41 of them male. 66% were HIV Positive patients, and the most frequent cause of hospitalization was pneumonia (51’1%). Most of the patients attended were drug abusers (see the graphic below). When the benzodiazepines abusers were asked how they obtained them, 40’6% recognized the got them without prescription, 25% said they got them legally, and 34’4 answered that they got them legally but also without prescription. 62’5% of the patients usually took alprazolam.
Benzodiazepine abuse, in particular alprazolam, is quiet common among the patients we see.
In half of the cases the use of benzodiazepines could have worsen the prognosis of the patients.
One of the most important prognostic factors in patients diagnosed with schizophrenia is the number of hospitalizations they need during their life. In this work we describe risk factors which determinate psychotic relapse.
Retrospective review of the clinical histories of patients diagnosed with schizophrenia who needed hospitalization during the year 2008 using Hospital Ramon Cajal's history software. Data were analyzed using the SPSS software 15.0 version.
- Socio-demographic: We collected a total of 57 patients, 60% were men and 77,2% were single who lived with their families. 52,8% only had Primary education and 14% had been to University. 38,6% were pensioner and 12,3% workers.
- Risk factors: 54,4% had abandoned their medication, 7% had had recent modifications in their medication, and 35,1% received long acting antipsychotic. 42,1% were identified as substance users.
- 40,4% had been diagnosed with schizophrenia more than three years ago; 57,9% had had less than 3 previous hospitalizations, and 54,4% need hospitalization the previous year.
Male under 30 years old have more risk of needing more hospitalizations. The main risk factor for suffering new psychotic episodes is the medication nonadherence, modifying medication only causes new episodes in few patients. Patients receiving long-acting antipsychotic agents suffer less psychotic relapse. Substance abuse among schizophrenia patients is a major complicating factor since almost half of the hospitalizations are related to it.
Voluntary drug overdoses are an important part of psychiatric demand in the emergency service. Nevertheless, a protocolized attention for these cases does not exist. Therefore, its management only depends on doctors’ personal criteria. Many of these cases have been previously diagnosed as Personality Disorder.
Studying the differences in management of drug overdosing depending on previous diagnosis of personality disorder. Also, we look for associated factors that can influence the final decision.
We conducted a retrospective analysis of 112 drug overdoses attended from July to December 2009. Data were analyzed using SPSS software.
34 attended patients (30,4%) have previous diagnosis of personality disorder. In these, the most frequent diagnosis was parasuicide attempt in the Emergency Service. In contrast, the rest of the patients were diagnosed as suicidal attempt.
We found statistically significant differences (p < 0,05) in the destination after Emergency evaluation (ambulatory or hospitalization) depending on a previous personality disorder diagnosis.
The media of previous overdoses in personality disorder group was significantly higher (3,29 Vs 0,64; P < 0,01).
We found that humor and anxiety disease comorbility, associated toxicomany, alcohol or cocaine use during the overdose, were more frequent in the group with personality disorder.
Although drug overdoses in patients with personality disorder have less letal intention, these patients were hospitalized more frequently than the others. This finding could be explained because of the presence of other associated factors that contribute to the global risk of overdosing. Previous overdoses seem to have significant influence in final decision.
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