Psychiatric home hospitalisation is a service aiming to support people with mental illnesses in their acute stage at their own home. This care model has been recently implemented in our territory with the main objective of avoiding hospital admissions.

Our goal is to describe a cohort of patients followed up over 2-years in the context of a pilot mental health program within a community-based model (Mutua Terrassa University Hospital).

We conducted a prospective longitudinal study including 125 patients attended from 01/11/2020 to 09/11/2022 in our reference area of 250,000 inhabitants. The team was formed by 1 psychiatrist and 1 mental health nurse. DSM-5 diagnoses, socio-demographic variables, mean stay and care trajectories were collected.

One-hundred twenty-five patients were attended (women: 70). Mean age at consultation: 38.3 years-old. Mean stay: 24 days. The most frequent diagnoses: non-affective psychotic disorders (58%), affective disorders (30%), followed by anxiety and personality disorders. Referrals from Community Mental Health Outpatient Services (CMHS) (72%), Acute Inpatient Unit (25%), and Psychiatric Emergency Service (3%). Referrals after discharge: CMHS (83%), Adult Acute Inpatient Unit (13%), others (4%). Individualized mental health plans were carried out in all cases, in coordination with community mental health services. Follow-up adherence after discharge was about 95%. Patients with first-episode of psychosis showed the highest degree of satisfaction (N=46).

Patients with emerging psychosis were the profile of users who showed the highest benefit of our service. Women showed higher adherence, and loss to follow-up was lower than we expected.

None Declared

Alpha-pyrrolidinohexanophenone (α-PHP) is a synthetic cathinone with uneven distribution throughout the world. Its use is not uniformly regulated and its distribution is legal in some European countries. Easily accessible and available through different websites. Synthetic cathinones inhibit monoamine transporters which include dopamine, norepinephrine, and serotonin, resulting in increased neurotransmitter synaptic concentration. Ways of administration show wide range regarding latency period. Onset and appearance of symptoms as well as their duration and intensity may fluctuate. A decreasing order of latency (oral, inhaled, sublingual and intravenous) has been reported. α-PHP can result in the appearance of psychiatric symptoms, include among others, intoxication with sensory perception disturbances and α-PHP -induced psychotic episodes.

The aim of our study was to assess the epidemiology, clinical and legal features regarding Alpha-pyrrolidinohexanophenone (α-PHP).

Review the current bibliography to upgrade the existing knowledge. -Present assorted cases with diverse clinical features. All cases include variability through psychopathological interview, symptoms assessment and treatment response according to rating scales (PANSS, YMRS). -Evaluate different treatment administration ways during acute phase and after hospital discharge.

Differences were observed after hospitalization in the response using diverse rating scales. We used antipsychotics to treat intoxication with sensory perception disturbances and α-PHP -induced psychotic episodes. α-PHP had a negative impact on the quality of life of the patients.

α-PHP is a synthetic cathinone with potential risk to mental health and life of users. It is mandatory to implement common legislation all through the European Union to prevent its use and possible implications on population’s mental health.

No significant relationships.

Patients with substance use disorders (SUD) have higher alexithymia levels and present frequently suicidal ideation (SI) and suicide (SA) [1,2]. Beside, alexithymia has been related to suicidal behaviors in several psychiatric disorders[3]. Although, there are some studies on alexithymia and suicidality in SUD patients, to our knowledge there are no studies on this issue in Spanish population.

To compare the alexithymia levels in SUD patients with and without SI and SA in an outpatient addiction treatment center in Spain.

This is a cross-sectional study performed on 110 patients (74.3%males; mean age 43.6±14.5years old) for whom we had information from the Toronto Alexithymia Scale(TAS-20) and the presence or not of lifetime SI and SA.

Lifetime SI and SA were present in 55.5% and 35.5% of the sample respectively. The mean score of TAS-20, difficulties identifying feelings (DIF), difficulties describing feelings (DDT), and externally-oriented thinking(EOT) were 57.2±13.3, 20.0±7.0, 14.7±4.5, and 22.5±4.5 respectively.

SI and SA may be related to alexithymia levels. Hence, alexithymia should be further analyzed in SUD patients in longitudinal studies in order to analyze the bilateral association with suicidal spectrum behaviors. REFERENCES Rodríguez-Cintas L, et al. Factors associated with lifetime suicidal ideation and suicide attempts in outpatients with substance use disorders. Psychiatry Res. 2018;262:440-5. Morie KP, et al. Alexithymia and Addiction: A Review and Preliminary Data Suggesting Neurobiological Links to Reward/Loss Processing. Curr Addict Rep. 2016;3(2):239-48. Hemming L, et al. A systematic review and meta-analysis of the association between alexithymia and suicide ideation and behaviour. J Affect Disord. 2019;254:34-48.

Insomnia has been related to a more severe substance use disorder presentation (1). There are few longitudinal studies in outpatients center for SUD treatment that evaluate how insomnia impacts on relapses.

To analyze how insomnia impacts on the time of the first substance relapse in SUD outpatients after the onset of addiction treatment.

This is a one-year follow-up study performed on 116 patients (73.3% males; mean age 43.4±14.3) for whom we had information from baseline insomnia and the time for the first relapse. A Kaplan-Meier survival analysis was performed. This is part of a greater research on Alexithymia in SUD in a longitudinal study.

The initial sample consisted of 116 patients, information on relapses was available for 113 patients. The main substances used at baseline were alcohol (62.1%), cocaine (56.0%), cannabis (42.2%), and opiates (30.2%).

It is important to evaluate insomnia at the onset of addiction treatment because insomnia may be related to earlier relapses. Furthermore, it should be analyzed further on how insomnia treatment impact on substance relapses. REFERENCES 1. Miller MB, Donahue ML, Carey KB, Scott-Sheldon LAJ. Insomnia treatment in the context of alcohol use disorder: A systematic review and meta-analysis. Drug Alcohol Depend. 2017;181:200-207. doi:10.1016/j.drugalcdep.2017.09.029

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.

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.

The aim of this study is to describe sociodemographic and psychopatology features of dual diagnosis outpatient.

All 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.

A 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.

The 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.

Cocaine dependence disorder has been widely described. However, differences due to gender remain unknown.

To compare clinical gender differences in a large sample of cocaine-dependent patients.

We 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.

No 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.

Sedative 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.

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.

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.

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.

Cocaine consumption can induce transient psychotic symptoms. Cocaine induced psychosis (CIP) is common but not developed in all cases. However, prevalence and clinical features are not well known. In psychiatry settings different studies have reported prevalence ranging between 29%–86.5%.There are few samples including more than 150 patients for studding this topic.

The objective of this study is to determinate the CIP prevalence and the most prevalent psychotic symptoms.

We study presence of psychotic symptoms using a clinical interview for psychotic symptoms in a large sample of 287 cocaine-dependent patients.

We study the presence of psychotic symptoms using a clinical interview for psychotic symptoms in a large sample of cocainedependent patients. Patients suffering from schizophrenia or bipolar disorders were excluded. Finally we included 287 patients in the study. (80.8% men and 35.77 yo).

A structured interview were systematically conducted. The Structured Clinical Interview for DSM IV Axis I and Axis II disorders were used in order to identify the comorbidity.

Psychotic symptoms were detected in 59.9% of the sample. The most frequent symptoms reported lifetime was suspiciousness 38.6% and paranoid beliefs 27.2% Auditory hallucinations were reported by 23.6%, visual hallucinations by 13.3%, and kinesthetic hallucinations by 7.8%. Motor alterations were not evaluated.

Our dates confirm previous study. CIP prevalence is high. Motor alterations were not evaluated, so symptoms could be underestimated. Identifying this kind of symptoms can be useful in order to minimize risks of psychotic states for the patients or others.

The aim of this study is to describe the features of cocaine-dependent patients who have had cocaine-induced tactile/somatic hallucinations (CITSH), and to analyze the association with addiction-related variables and psychiatric comorbidity, comparing patients with CITSH, patients with cocaine psychotic symptoms (CIP) and no CITSH, and patients without any psychotic symptom.

A cross-sectional study was conducted in 767 cocaine-dependent patients in an outpatient treatment center for addictions. The following data were obtained: sociodemographic characteristics, CIP information, addiction-related variables and psychiatric comorbidity. A bivariate and multivariate analysis was performed.

Of the whole sample, 6.6% reported CITSH at some point of their lives, 48.4% had suffered some CIP other than CITSH, and 45% had not experienced any psychotic symptom. According to multivariate analysis, risk of overdose increases by 12.1 (OR) times the probability of having had CITSH compared patients with CIP-no-CITSH. Other variables associated to patients with CITSH were: age of drug use onset, presence of episodes of overdose, prevalence of psychotic disorder induced by cocaine. In general, in all variables studied, patients with CITSH presented worse clinical features (addiction variables and psychiatric comorbidity) than patients with CIP without CITSH and non-CIP group.

CITSH are usually associated with other psychotic symptoms induced by cocaine. The patients who experienced CITSH are more severe cases compared both with patients with CIP without CITSH and patients without CIP. Increased risk of overdose is an important issue in this type of patients.

Life functioning difficulties are a relevant but undervalued consequence of major depression. Mood symptoms and cognitive deficits have a significant, and somehow independent, impact on them. Therefore, cognitive difficulties should be considered a potential target to improve patients’ functioning.

To examine the degree in which objective and subjective cognition explain functional outcome.

To assess objective cognitive function (CF) with a neuropsychological battery and to measure subjective CF using measures of cognitive perception.

Ninety-nine patients with depression were assessed by age, sex and level of schooling. Depressive symptoms severity was measured by Hamilton Depression Rating Scale (HDRS-17). Objective CF consisted in the following cognitive domains: memory, attention, executive functioning and processing speed. Subjective CF was assessed with Perceived Deficit Questionnaire-Depression (PDQ-D). Functioning Assessment Short Test (FAST) was used to evaluate life functioning, excluding the cognitive domain. All the listed measures were included in a multiple regression analysis with FAST scores as dependent variable.

The regression model was significant (F1,98 = 67.484, P < 0.001) with an R of 0.825. The variables showing statistical power included (from higher to lower β-coefficient) HDRS-17 (β = 0.545, t = 8.453, P < 0.001), PDQ-D (β = 0.383, t = 6.047, P < 0.001) and DSST (β = −0.123, t = −1.998, P = 0.049).

The severity of depressive symptoms is the variable that best explains life functioning. Surprisingly, the second factor hindering it is the patients’ perception of their cognition. Current findings highlight the importance of correcting cognitive bias in order to improve functionality. However, results have to be taken cautiously as mood symptoms could partly explain the bias.

The authors have not supplied their declaration of competing interest.

Pain medication misuse is commonly found in patients under headache treatment and may produce co-morbid anxiety and depressive symptomatology. Management of this issue requires a comprehensive and integrative treatment including psychotherapy. Group interventions have been scarcely studied in addictive disorders, those interventions aims to decrease drug misuse and improve related psychiatric symptoms.

To study the efficacy of group interventions base on cognitive-behavior approach in patients with pain medication misuse.

Patients with pain medication misuse were included and were evaluated with BDI, STAI, SF36 and HIT scales (basal and at the end of treatment sessions). Patients were recruited from headache outpatient unit. Twelve sessions of one hour were performed with a cognitive-behavior approach (weekly).

We present preliminary results about the efficacy of group interventions in patients with pain medication misuse. Descriptive results pre- and post- treatment were analyzed in depressive symptoms (M = 20.14, SD = 12.25; M = 14.67, SD = 19.50) and in areas of quality of life: physical functioning (M = 48.75, SD = 31.13; M = 60.50, SD = 41.68), bodily pain (M = 12, SD = 9.25; M = 42.75, SD = 34.09), general health perceptions (M = 25.75, SD = 16.96; M = 44.25, SD = 22.33), vitality (M = 33.75, SD = 13.82; M = 48, SD = 34.82).

Pain medication misuse is commonly found in chronic headache patients, consequently worst outcomes for both pathologies. Group interventions may be useful in management of pain, anxiety and other comorbidities. Furthermore, it may favor drug use decrease and even abstinence.

The authors have not supplied their declaration of competing interest.

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.