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Daigre C, Palma-Álvarez RF, Sorribes-Puertas M, Ortega-Hernández G, Perea-Ortueta M, Ros-Cucurull E, Segura L, Colom J, Braquehais MD, Ramos-Quiroga JA, Grau-López L. Abstinence duration and psychopathology among addiction outpatients during 18 months of COVID-19. Front Psychiatry 2024; 15:1339730. [PMID: 38389986 PMCID: PMC10881849 DOI: 10.3389/fpsyt.2024.1339730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
Background The COVID-19 pandemic has impacted the mental health of patients with substance use disorder (SUD). However, few longitudinal studies have been done which examine associations between the pandemic, SUD patients' mental health and their drug use. Objectives This study aimed to examine duration of abstinence according to psychiatric status among SUD outpatients followed-up for 18 months from the pandemic related lockdown. Methods A follow-up study of 316 SUD outpatients was undertaken. Sociodemographic features, and clinical and consumption related variables were recorded. Pre, during and post lockdown information was evaluated. Abstinence/substance use was monitored at the patient's scheduled follow-up appointments, and psychiatric disorders and psychological variables were revaluated at 18 months. Results Survival analyses were used to compare the duration of abstinence (in months) from the beginning of the lockdown. It was observed that 70% of patients consumed the main substance for which they were being treated at some point during the follow-up. Men, younger patients, those with more symptoms of anxiety and personality disorders, and patients who experienced increased craving during follow-up, showed shorter duration of abstinence. While patients who had previously maintained at least one year of abstinence, achieved better results. Conclusions During the first year and a half of the pandemic, SUD outpatients presented alterations in mental health, such us anxiety, depression and maladaptive personality traits and a high rate of relapse. For this reason, despite the health and social crisis and their restrictive measures, a comprehensive treatment should be ensured.
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Affiliation(s)
- Constanza Daigre
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Center on Mental Health (CIBERSAM), Barcelona, Spain
| | - Raul Felipe Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Center on Mental Health (CIBERSAM), Barcelona, Spain
| | - Marta Sorribes-Puertas
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - German Ortega-Hernández
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Marta Perea-Ortueta
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Elena Ros-Cucurull
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Lidia Segura
- Subdirecció general de Drogodependències, Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Joan Colom
- Subdirecció general de Drogodependències, Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Maria Dolores Braquehais
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Galatea Care Programme for Sick Health Professionals, Galatea Clinic, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Center on Mental Health (CIBERSAM), Barcelona, Spain
| | - Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Center on Mental Health (CIBERSAM), Barcelona, Spain
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2
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Corrales M, García-González S, Richarte V, Fadeuilhe C, Daigre C, García-Gea E, Ramos-Quiroga JA. Long-term efficacy of a new 6-session cognitive behavioral therapy for adults with attention-deficit/hyperactivity disorder: A randomized, controlled clinical trial. Psychiatry Res 2024; 331:115642. [PMID: 38103281 DOI: 10.1016/j.psychres.2023.115642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 11/23/2023] [Accepted: 11/26/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that affects about 2.8 % of the adult population. Cognitive behavioral therapy (CBT) has been demonstrated to be the most effective psychological intervention for ADHD. The aim of this study was to explore the efficacy of a new 6-session CBT program in comparison with a 12-session CBT program for adults with ADHD at short- and long-term. METHODS 81 adults with ADHD (58 % males; mean age = 41.27±9.26 years old) were randomly assigned to each treatment condition (6- or 12-session CBT). Validated instruments were used to assess ADHD symptoms, comorbidities (anxiety and depression), and functional impairments at post treatment, and at 3- and 6-month follow-up. RESULTS A significant improvement in ADHD severity, comorbidities (anxiety and depression) and functional impairments were found in both CBT programs after treatment. Furthermore, this improvement was also reported at 3- and 6-month follow-up. CONCLUSION The current study highlights that a 6-session CBT program is as effective as a 12-session CBT program for ADHD improvement at post treatment and follow-up. The newly developed 6-session CBT program can be used to treat a larger number of patients, reducing the financial cost.
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Affiliation(s)
- M Corrales
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - S García-González
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - V Richarte
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Fadeuilhe
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Daigre
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - E García-Gea
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - J A Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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3
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Palma-Álvarez RF, Daigre C, Ballabriga- Córdoba T, Monterde-Ochoa E, Sierra-Fortuny M, Cantillo M, Pelaez M, Castrillo E, Camañes L, Roncero C, Ramos-Quiroga JA, Grau-López L. CLINICAL VIEW ON SUBSTANCE-INDUCED PSYCHOTIC SYMPTOMS IN A MEDICALLY SUPERVISED INJECTING ROOM: A DECADE OF EXPERIENCE. Actas Esp Psiquiatr 2023; 51:188-191. [PMID: 37817739 PMCID: PMC10803840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 07/01/2023] [Indexed: 10/12/2023]
Abstract
Medically supervised injecting rooms (MSIRs) are extremely important facilities for people who inject drugs (PWID) as MSIRs provide a safe place for the consumption of street-sourced drugs, impacting overdose rates and viral transmitted infections.
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Affiliation(s)
- Raul F. Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Constanza Daigre
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | | | | | | | - Miguel Cantillo
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Manuel Pelaez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Eduardo Castrillo
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Laura Camañes
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Carlos Roncero
- Psychiatry Service, University of Salamanca Health Care Complex, Insitute of Biomedicine, Salamanca, Spain
- Psychiatry Unit, School of Medicine, University of Salamanca, Salamanca, Spain
| | - Josep A. Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
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4
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Palma-Álvarez RF, Daigre C, Ros-Cucurull E, Perea-Ortueta M, Ortega-Hernández G, Ríos-Landeo A, Roncero C, Ramos-Quiroga JA, Grau-López L. Clinical features and factors related to lifetime suicidal ideation and suicide attempts in patients who have had substance-induced psychosis across their lifetime. Psychiatry Res 2023; 323:115147. [PMID: 36913874 DOI: 10.1016/j.psychres.2023.115147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/15/2023]
Abstract
Suicidal behaviors are common among patients with substance use disorders (SUD). However, the prevalence and clinical factors related to suicide behaviors among patients who have had substance-induced psychosis (SIP) is unknown. This study aims to explore the prevalence, clinical features, and factors related to lifetime suicidal ideation (SI) and suicide attempts (SA) in patients who have had SIP across their lifetime. A cross-sectional study was conducted in an outpatient center for addiction treatment between 01/01/2010 and 12/31/2021. 601 patients were evaluated with validated scales and questionnaires (79.03% males; M age 38.11±10.11 years). The prevalence of SI and SA was 55.4% and 33.6%, respectively. SI was independently related to any type of lifetime abuse, depressive spectrum disorders, benzodiazepine use disorder, borderline personality disorder, and the level of depressive symptoms. SA was independently associated with lifetime physical abuse, benzodiazepine use disorder, the number of psychotic symptoms, borderline personality disorder, and the level of depressive symptoms. The main factors related to SI and SA in those patients should be evaluated in daily clinical practice and considered in any approach to clinical practice as well as in health policies targeting suicide prevention.
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Affiliation(s)
- Raul Felipe Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.
| | - Constanza Daigre
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Elena Ros-Cucurull
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Marta Perea-Ortueta
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Germán Ortega-Hernández
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Ana Ríos-Landeo
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Carlos Roncero
- Psychiatry Service, University of Salamanca Health Care Complex, Insitute of Biomedicine, Salamanca, Spain; Psychiatry Unit, School of Medicine, University of Salamanca, Salamanca, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
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5
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Brynte C, Aeschlimann M, Barta C, Begeman AHA, Bäcker A, Crunelle CL, Daigre C, De Fuentes-Merillas L, Demetrovics Z, Dom G, López LG, Icick R, Johnson B, Joostens P, Kapitány-Fövény M, Karsinti E, Kiefer F, Konstenius M, Levin FR, Luderer M, Markus W, Matthys F, Moggi F, Palma-Alvarez RF, Paraskevopoulou M, Ramos-Quiroga JA, Schellekens A, Soravia LM, Therribout N, Thomas A, van de Glind G, van Kernebeek MW, Vollstädt-Klein S, Vorspan F, van den Brink W, Franck J. The clinical course of comorbid substance use disorder and attention deficit/hyperactivity disorder: protocol and clinical characteristics of the INCAS study. BMC Psychiatry 2022; 22:625. [PMID: 36151539 PMCID: PMC9502646 DOI: 10.1186/s12888-022-04259-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Substance use disorders (SUD) often co-occur with attention deficit hyperactivity disorder (ADHD). Although the short-term effects of some specific interventions have been investigated in randomized clinical trials, little is known about the long-term clinical course of treatment-seeking SUD patients with comorbid ADHD. AIMS This paper presents the protocol and baseline clinical characteristics of the International Naturalistic Cohort Study of ADHD and SUD (INCAS) designed and conducted by the International Collaboration on ADHD and Substance Abuse (ICASA) foundation. The overall aim of INCAS is to investigate the treatment modalities provided to treatment-seeking SUD patients with comorbid ADHD, and to describe the clinical course and identify predictors for treatment outcomes. This ongoing study employs a multicentre observational prospective cohort design. Treatment-seeking adult SUD patients with comorbid ADHD are recruited, at 12 study sites in nine different countries. During the follow-up period of nine months, data is collected through patient files, interviews, and self-rating scales, targeting a broad range of cognitive and clinical symptom domains, at baseline, four weeks, three months and nine months. RESULTS A clinically representative sample of 578 patients (137 females, 441 males) was enrolled during the recruitment period (June 2017-May 2021). At baseline, the sample had a mean age (SD) of 36.7 years (11.0); 47.5% were inpatients and 52.5% outpatients; The most prevalent SUDs were with alcohol 54.2%, stimulants 43.6%, cannabis 33.1%, and opioids 14.5%. Patients reported previous treatments for SUD in 71.1% and for ADHD in 56.9%. Other comorbid mental disorders were present in 61.4% of the sample: major depression 31.5%, post-traumatic stress disorder 12.1%, borderline personality disorder 10.2%. CONCLUSIONS The first baseline results of this international cohort study speak to its feasibility. Data show that many SUD patients with comorbid ADHD had never received treatment for their ADHD prior to enrolment in the study. Future reports on this study will identify the course and potential predictors for successful pharmaceutical and psychological treatment outcomes. TRIAL REGISTRATION ISRCTN15998989 20/12/2019.
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Affiliation(s)
- Christoffer Brynte
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Sweden.
| | - Myriam Aeschlimann
- grid.5734.50000 0001 0726 5157University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Csaba Barta
- grid.11804.3c0000 0001 0942 9821Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Budapest, Hungary
| | | | - Amanda Bäcker
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Sweden
| | - Cleo Lina Crunelle
- grid.411326.30000 0004 0626 3362Department of Psychiatry, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel, 1090 Jette, Belgium
| | - Constanza Daigre
- grid.411083.f0000 0001 0675 8654Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d’Hebron, Barcelona, Spain ,grid.430994.30000 0004 1763 0287Psychiatry Group, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain ,grid.469673.90000 0004 5901 7501Biomedical Network Research Centre On Mental Health (CIBERSAM), Madrid, Spain ,grid.7080.f0000 0001 2296 0625Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Laura De Fuentes-Merillas
- grid.491352.8Novadic-Kentron Addiction Care; Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, the Netherlands
| | - Zsolt Demetrovics
- grid.5591.80000 0001 2294 6276Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary ,grid.513141.30000 0004 4670 111XCentre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - Geert Dom
- grid.5284.b0000 0001 0790 3681University of Antwerp, Antwerp, Belgium ,PC Multiversum, Boechout, Belgium
| | - Lara Grau López
- grid.411083.f0000 0001 0675 8654Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d’Hebron, Barcelona, Spain ,grid.430994.30000 0004 1763 0287Psychiatry Group, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain ,grid.469673.90000 0004 5901 7501Biomedical Network Research Centre On Mental Health (CIBERSAM), Madrid, Spain ,grid.7080.f0000 0001 2296 0625Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Romain Icick
- grid.508487.60000 0004 7885 7602Université de Paris Cité, Paris, France
| | | | | | - Máté Kapitány-Fövény
- grid.11804.3c0000 0001 0942 9821Faculty of Health Sciences, Semmelweis University, Budapest, Hungary ,National Institute of Mental Health, Neurology and Neurosurgery – Nyírő Gyula Hospital, Budapest, Hungary
| | - Emily Karsinti
- grid.414095.d0000 0004 1797 9913Université Paris-Nanterre, CliPsyD Laboratory FR and APHP, Fernand Widal Hospital, Universitary Department of Psychiatry and Addictology, Paris, France
| | - Falk Kiefer
- grid.7700.00000 0001 2190 4373Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany ,grid.7700.00000 0001 2190 4373Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Maija Konstenius
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Sweden
| | - Frances R. Levin
- grid.21729.3f0000000419368729Vagelos College of Physicians and Surgeons, New York City, USA ,grid.413734.60000 0000 8499 1112New York State Psychiatric Institute, New York City, USA
| | - Mathias Luderer
- grid.411088.40000 0004 0578 8220Department of Psychiatry, Psychosomatic Medicine and Psychoterapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Wiebren Markus
- grid.491352.8Iriszorg Addiction Care, Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, the Netherlands
| | - Frieda Matthys
- grid.411326.30000 0004 0626 3362Department of Psychiatry, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel, 1090 Jette, Belgium
| | - Franz Moggi
- grid.5734.50000 0001 0726 5157University Hospital of Psychiatry, Translational Research Center, University of Bern, Bern, Switzerland
| | - Raul Felipe Palma-Alvarez
- grid.411083.f0000 0001 0675 8654Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d’Hebron, Barcelona, Spain ,grid.430994.30000 0004 1763 0287Psychiatry Group, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain ,grid.469673.90000 0004 5901 7501Biomedical Network Research Centre On Mental Health (CIBERSAM), Madrid, Spain ,grid.7080.f0000 0001 2296 0625Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Maria Paraskevopoulou
- Department of Psychiatry, RadboudumcDonders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands
| | - J. Antoni Ramos-Quiroga
- grid.411083.f0000 0001 0675 8654Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d’Hebron, Barcelona, Spain ,grid.430994.30000 0004 1763 0287Psychiatry Group, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain ,grid.469673.90000 0004 5901 7501Biomedical Network Research Centre On Mental Health (CIBERSAM), Madrid, Spain ,grid.7080.f0000 0001 2296 0625Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Arnt Schellekens
- Department of Psychiatry, RadboudumcDonders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands ,grid.491352.8Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, the Netherlands
| | - Leila M. Soravia
- grid.5734.50000 0001 0726 5157University Hospital of Psychiatry, Translational Research Center, University of Bern, Bern, Switzerland ,Südhang Clinic, Kirchlindach, Switzerland
| | - Norman Therribout
- grid.414095.d0000 0004 1797 9913Université Paris-Nanterre, CliPsyD Laboratory FR and APHP, Fernand Widal Hospital, Universitary Department of Psychiatry and Addictology, Paris, France
| | - Anil Thomas
- Mt. Sinai, Icahn School of Medicine, New York City, USA ,grid.137628.90000 0004 1936 8753NYU Grossman School of Medicine, New York City, USA
| | - Geurt van de Glind
- grid.438049.20000 0001 0824 9343University of Applied Sciences-Utrecht, Utrecht, the Netherlands
| | - Michiel Willem van Kernebeek
- grid.411326.30000 0004 0626 3362Department of Psychiatry, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel, 1090 Jette, Belgium
| | - Sabine Vollstädt-Klein
- grid.7700.00000 0001 2190 4373Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany ,grid.7700.00000 0001 2190 4373Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Florence Vorspan
- grid.508487.60000 0004 7885 7602Université de Paris Cité, Paris, France
| | - Wim van den Brink
- grid.509540.d0000 0004 6880 3010Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Johan Franck
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Sweden
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6
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Palma-Álvarez RF, Daigre C, Ros-Cucurull E, Perea-Ortueta M, Serrano-Pérez P, Hernández GO, Ramos-Quiroga JA, Grau-López L, Roncero C. Confirmatory factor analysis of 20-item toronto alexithymia scale in spanish patients with substance use disorder. Actas Esp Psiquiatr 2022; 50:208-215. [PMID: 36273380 PMCID: PMC10803880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 09/01/2022] [Indexed: 06/16/2023]
Abstract
Alexithymia is highly prevalent in patients with substance use disorders (SUDs) and has been implied in SUD pathogenesis and treatment outcomes. However, the psychometric properties of the most-used instrument for evaluating alexithymia (the 20-item Toronto Alexithymia Scale, TAS-20) have been scarcely studied in relation to SUD patients.
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Affiliation(s)
- Raul F. Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autonoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM). Barcelona, Spain
| | - Constanza Daigre
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autonoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM). Barcelona, Spain
| | - Elena Ros-Cucurull
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autonoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM). Barcelona, Spain
| | - Marta Perea-Ortueta
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Pedro Serrano-Pérez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autonoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Germán Ortega Hernández
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Josep A. Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autonoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM). Barcelona, Spain
| | - Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autonoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM). Barcelona, Spain
| | - Carlos Roncero
- Psychiatry Service, University of Salamanca Health Care Complex, Institute of Biomedicine, University of Salamanca, Salamanca, Spain
- Psychiatry Unit, School of Medicine, University of Salamanca, Salamanca, Spain
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7
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Beneria A, Santesteban-Echarri O, Daigre C, Tremain H, Ramos-Quiroga JA, McGorry PD, Alvarez-Jimenez M. Online interventions for cannabis use among adolescents and young adults: Systematic review and meta-analysis. Early Interv Psychiatry 2022; 16:821-844. [PMID: 34464502 DOI: 10.1111/eip.13226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 07/22/2021] [Accepted: 08/18/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Young people present high rates of cannabis use, abuse, and dependence. The United Nations estimates that roughly 3.8% of the global population aged 15-64 years used cannabis at least once in 2017. Cannabis use in young people may impair cognitive skills, interfere with learning, impact relationships, and lead to long term behavioural and psychological consequences. Online cannabis interventions (OCI) are increasingly popular, but their dissemination is not often supported by empirical evidence. AIM To systematically compile and analyse the effectiveness of OCI for the reduction of cannabis use among adolescents and young adults (AYA). METHODS Pooled effect sizes of cannabis use between treatment and control groups were estimated. For each comparison, Hedge's g was calculated using a random effects model. RESULTS The search strategy yielded 4531 articles. Of those, a total of 411 articles were retrieved for detailed evaluation resulting in 17 eligible studies (n = 3525). Analyses revealed that online interventions did not significantly reduce cannabis consumption (Hedge's g = -0.061, 95% CI [-0.363] to [-0.242], p = .695) and high heterogeneity was noted (Q = 191.290). More recent studies using structured interventions, daily feedback, AYA centred designs, and peer support, specifically targeting CU seemed to have positive effects to address CU in this population. CONCLUSIONS The lack of positive outcomes suggests that more specific and targeted interventions may be necessary to promote cannabis-related behavioural change among young people. These targeted interventions may include structured CU modules, daily feedback, peer support for increased adherence, user-centred design procedures, and input from key stakeholders such as families and service providers.
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Affiliation(s)
- Anna Beneria
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Catalonia, Spain
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Olga Santesteban-Echarri
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- The Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada
| | - Constanza Daigre
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain
| | - Hailey Tremain
- Orygen, Parkville, Australia. Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Catalonia, Spain
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Patrick D McGorry
- Orygen, Parkville, Australia. Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mario Alvarez-Jimenez
- Orygen, Parkville, Australia. Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
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8
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Daigre C, Grau-López L, Palma-Alvarez RF, Perea-Ortueta M, Sorribes-Puertas M, Serrano-Pérez P, Quesada M, Segura L, Coronado M, Ramos-Quiroga JA, Colom J. A Multicenter Study on the Impact of Gender, Age, and Dual Diagnosis on Substance Consumption and Mental Health Status in Outpatients Treated for Substance Use Disorders During COVID-19 Lockdown. J Dual Diagn 2022; 18:71-80. [PMID: 35324373 DOI: 10.1080/15504263.2022.2051110] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objective COVID-19 and lockdown measures impacted mental health globally and had a particular impact on patients with substance use disorders (SUD). However, the impact of gender, age, and dual diagnosis on consumption patterns and mental health during COVID-19 lockdown among patients with SUD has not been analyzed in depth. Therefore, this study aimed to examine substance use and mental health status during COVID-19 lockdown considering gender, age, and previous dual diagnosis in patients with SUD treated in different outpatient addiction clinics in Catalonia. Methods: Thirteen clinics participated and 588 patients were enrolled in the study, of whom 70.7% were men and 29.3% were women. The mean age was 48 ± 11.3 years, and 63.2% had dual diagnoses. Results: Men reported significantly more frequent alcohol and cocaine consumption during lockdown, while women experienced more anxiety and depressive symptoms. Younger patients more frequently reported consuming cocaine and cannabis, breaking the lockdown rule, worsened family relationships, and reduced incomes. Older patients more frequently reported maintaining abstinence. Previous dual diagnosis was more often associated with benzodiazepine use disorder, less active working during lockdown, and more anxiety and depressive symptoms than not having previous dual diagnosis. Conclusions: Both new psychiatric symptoms and general worsening of existing symptoms were frequent during the lockdown. Differences based on the gender, age, and dual diagnosis of outpatients treated for substance use disorders should be considered in the planning of protection measures such as home confinement.
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Affiliation(s)
- Constanza Daigre
- Addiction and Dual Diagnosis Section, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Psychiatry, Mental Health and Addiction Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lara Grau-López
- Addiction and Dual Diagnosis Section, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Psychiatry, Mental Health and Addiction Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Raúl F Palma-Alvarez
- Addiction and Dual Diagnosis Section, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Psychiatry, Mental Health and Addiction Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Perea-Ortueta
- Addiction and Dual Diagnosis Section, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Psychiatry, Mental Health and Addiction Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Sorribes-Puertas
- Addiction and Dual Diagnosis Section, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Psychiatry, Mental Health and Addiction Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Pedro Serrano-Pérez
- Addiction and Dual Diagnosis Section, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Psychiatry, Mental Health and Addiction Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Quesada
- Addiction and Dual Diagnosis Section, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Psychiatry, Mental Health and Addiction Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lidia Segura
- Subdirecció General de Drogodependències, Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Marta Coronado
- Subdirecció General de Drogodependències, Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Addiction and Dual Diagnosis Section, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Psychiatry, Mental Health and Addiction Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Colom
- Subdirecció General de Drogodependències, Agència de Salut Pública de Catalunya, Barcelona, Spain
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- Subdirecció General de Drogodependències, Agència de Salut Pública de Catalunya, Barcelona, Spain.,Collaborative Addiction Research Group of the Agència de Salut Pública de Catalunya, Barcelona, Spain
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9
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Fadeuilhe C, Daigre C, Grau-López L, Richarte V, Palma-Álvarez RF, Corrales M, Sáez B, Baz M, Ramos-Quiroga JA. The impact of insomnia disorder on adult attention-deficit/hyperactivity disorder severity: A six-month follow-up study. Psychiatry Res 2022; 308:114349. [PMID: 34998087 DOI: 10.1016/j.psychres.2021.114349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVES The longitudinal relationship between insomnia disorder and adult attention-deficit/hyperactivity disorder (ADHD) has been scarcely investigated. This study aimed to evaluate the relationship between the remission of insomnia disorder and adult ADHD clinical severity, psychiatric and medical comorbidities, and the health-related quality of life (HRQoL) in a 6-month follow-up. METHODS Ninety-two adult patients with ADHD and insomnia disorder (52.2% males; mean age 39.5 ± 11.0 years) were comprehensively assessed at baseline, 3 months, and 6 months of a follow-up period. The evaluation included semi-structured interviews (for ADHD and comorbidity assessment), the Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Epworth Sleepiness Scale. The diagnosis of ADHD and insomnia disorder was performed according to DSM-5 criteria. At baseline and follow-up, psychoeducation/sleep hygiene and, if necessary, pharmacological were prescribed for insomnia. RESULTS Eighty-seven patients completed the 6-month follow-up. Insomnia disorder remission was reported in 72.4% of cases and was related to a greater improvement in ADHD symptoms and severity throughout the follow-up period. Additionally, an improvement in psychiatric comorbidities and better HRQoL were associated with insomnia disorder remission. CONCLUSION The current study highlights that the treatment of insomnia disorder in ADHD adult patients may have an important role in the outcome of ADHD therapeutic approaches by reducing their severity.
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Affiliation(s)
- C Fadeuilhe
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - C Daigre
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - V Richarte
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - R F Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Corrales
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - B Sáez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - M Baz
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - J A Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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10
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Grau-López L, Daigre C, Palma-Alvarez RF, Sorribes-Puertas M, Serrano-Pérez P, Quesada-Franco M, Segura L, Coronado M, Ramos-Quiroga JA, Colom J. COVID-19 Lockdown and Consumption Patterns among Substance Use Disorder Outpatients: A Multicentre Study. Eur Addict Res 2022; 28:243-254. [PMID: 35038702 PMCID: PMC8805052 DOI: 10.1159/000521425] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 12/03/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION COVID-19 has had a great impact on mental health in the general population. However, few studies have focused on patients with substance use disorders (SUDs). This research aimed to compare the clinical status and substance use patterns of SUD outpatients, before and during confinement due to the COVID-19 pandemic. METHODS This multicentre study recruited 588 patients (29.2% women; M age = 47.4 ± 11.7 years) in thirteen centres for addiction treatment in Catalonia, Spain. All subjects were evaluated with validated instruments and ad hoc questionnaires. The sample was divided into 3 groups according to how the substance consumption pattern changed during lockdown (maintained pattern, worsened pattern, and improved pattern). RESULTS More than 62% of the patients maintained or worsened their consumption pattern during confinement, and about 38% improved throughout this time. Diverse factors were associated with the changes in pattern like age, addiction severity, psychological distress during lockdown, social and familial issues, and therapeutic variables. CONCLUSION The home lockdown during the COVID-19 pandemic was associated with major implications for substance consumption and psychiatric distress among SUD outpatients. Considering this, the need to plan appropriate interventions in cases of similar health crises is highlighted.
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Affiliation(s)
- Lara Grau-López
- Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Constanza Daigre
- Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Raúl Felipe Palma-Alvarez
- Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Marta Sorribes-Puertas
- Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Pedro Serrano-Pérez
- Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Marta Quesada-Franco
- Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Lidia Segura
- Subdirecció general de Drogodependències, Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Marta Coronado
- Subdirecció general de Drogodependències, Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Joan Colom
- Subdirecció general de Drogodependències, Agència de Salut Pública de Catalunya, Barcelona, Spain
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11
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Quesada-Franco M, Pintor-Pérez L, Daigre C, Baca-García E, Ramos-Quiroga JA, Braquehais MD. Medically Serious Suicide Attempts in Personality Disorders. J Clin Med 2021; 10:4186. [PMID: 34575302 PMCID: PMC8469317 DOI: 10.3390/jcm10184186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/02/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022] Open
Abstract
Medically serious suicide attempts (MSSA) represent a subgroup of clinically heterogeneous suicidal behaviors very close to suicides. Personality disorders (PD) are highly prevalent among them, together with affective and substance use disorders. However, few studies have specifically analyzed the role of PD in MSSA. These suicide attempts (SA) are usually followed by longer hospitalization periods and may result in severe physical and psychological consequences. The aim of this study is to compare the profile of MSSA patients with and without PD. MSSA were defined according to Beautrais 'criteria, but had to remain hospitalized ≥48 h. Overall, 168 patients from two public hospitals in Barcelona were evaluated during a three-year period. Mean hospital stay was 23.68 (standard deviation (SD) = 41.14) days. Patients with PD (n = 69) were more likely to be younger, female, make the first and the most serious SA at a younger age, reported recent stressful life-events and more frequently had previous suicide attempts compared to those without PD. However, no differences were found with regards to comorbid diagnoses, current clinical status, features of the attempt, or their impulsivity and hopelessness scores. Therefore, focusing on the subjective, qualitative experiences related to MSSA among PD patients may increase understanding of the reasons contributing to these attempts in order to improve prevention strategies in the future.
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Affiliation(s)
- Marta Quesada-Franco
- Department of Psychiatry, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (C.D.); (J.A.R.-Q.)
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Luis Pintor-Pérez
- Department of Psychiatry, Hospital Clinic, Instituto de Investigaciones Biomédicas Augusto Pi I Sunyer (IDIBAPS), Universitat de Barcelona, 08036 Barcelona, Spain;
| | - Constanza Daigre
- Department of Psychiatry, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (C.D.); (J.A.R.-Q.)
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), 08035 Barcelona, Spain;
| | - Enrique Baca-García
- Department of Psychiatry, Madrid Autonomous University, 28017 Madrid, Spain;
- CIBERSAM (Centro de Investigacion en Salud Mental), Carlos III Institute of Health, 28040 Madrid, Spain
- Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, 30900 Nîmes, France
- Psychology Department, Universidad Católica de Maule, Talca 3605, Chile
- Department of Psychiatry, University Hospital Jimenez Diaz Foundation, 28020 Madrid, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (C.D.); (J.A.R.-Q.)
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), 08035 Barcelona, Spain;
- Psychiatry, Mental Health and Addictions Research Group, Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
| | - María Dolores Braquehais
- Biomedical Network Research Centre on Mental Health (CIBERSAM), 08035 Barcelona, Spain;
- Psychiatry, Mental Health and Addictions Research Group, Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Integral Care Program for Sick Health Professionals, Galatea Clinic, 08017 Barcelona, Spain
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Forner-Puntonet M, Castell-Panisello E, Quintero J, Ariceta G, Gran F, Iglesias-Serrano I, Gisbert-Gustemps L, Daigre C, Ibañez-Jimenez P, Delgado M, Español-Martín G, Parramon G, Pont T, Ramos-Quiroga JA. Impact of COVID-19 on Families of Pediatric Solid Organ Transplant Recipients. J Pediatr Psychol 2021; 46:927-938. [PMID: 34313783 PMCID: PMC8344614 DOI: 10.1093/jpepsy/jsab058] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/02/2021] [Accepted: 05/04/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic and lockdown measures have had a clear psychological impact on families, and specifically those with children with chronic illnesses have reported greater overloads and exhaustion. The objective of this study was to evaluate the exposure, impact and experience of the pandemic on families of pediatric solid organ transplant (SOT) recipients compared to families of healthy children and adolescents. METHODS We recruited 96 families, 48 with a pediatric SOT recipient and 48 healthy controls, matched by child age and gender. A primary caregiver from each family responded to an online sociodemographic questionnaire and the COVID-19 Exposure and Family Impact Survey (CEFIS), which explores the exposure, impact and experience of the pandemic and lockdown on families. RESULTS Exposure to the pandemic was greater in families of healthy children and adolescents. The impact was mostly negative in both groups: caregivers reported increased anxiety (76%) and mood disturbances (71.9%) and hindered quality of sleep (64.6%) and health habits (58.3%). On the positive side, family relationships improved. Qualitatively, the SOT group positively perceived isolation and established hygienic measures as protective and destigmatizing, although they reported fear of virus transmission to their child. CONCLUSIONS The psychological impact of the pandemic has been similar in both groups, although families of transplant recipients have protected themselves more, probably because they are used to prevention measures and they see contagion as a graver risk. Additionally, SOT recipients' families presented some idiosyncratic elements, especially a decrease in their perception of stigma associated with the medical condition.
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Affiliation(s)
- Mireia Forner-Puntonet
- Department of Psychiatry, Hospital Universitari Vall d’Hebron
- Group of Psychiatry, Mental Health and Addictions, Vall d’Hebron Research Institute (VHIR)
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona
| | | | - Jesús Quintero
- Pediatric Hepatology and Liver Transplant Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona
| | - Gema Ariceta
- Pediatric Nephrology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona
| | - Ferran Gran
- Pediatric Cardiology Department, Hospital Universitari Vall d’Hebron
| | | | - Laura Gisbert-Gustemps
- Department of Psychiatry, Hospital Universitari Vall d’Hebron
- Group of Psychiatry, Mental Health and Addictions, Vall d’Hebron Research Institute (VHIR)
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona
- Biomedical Network Research Centre on Mental Health (CIBERSAM)
| | - Constanza Daigre
- Department of Psychiatry, Hospital Universitari Vall d’Hebron
- Group of Psychiatry, Mental Health and Addictions, Vall d’Hebron Research Institute (VHIR)
- Biomedical Network Research Centre on Mental Health (CIBERSAM)
| | - Pol Ibañez-Jimenez
- Group of Psychiatry, Mental Health and Addictions, Vall d’Hebron Research Institute (VHIR)
| | | | - Gemma Español-Martín
- Department of Psychiatry, Hospital Universitari Vall d’Hebron
- Group of Psychiatry, Mental Health and Addictions, Vall d’Hebron Research Institute (VHIR)
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona
- Biomedical Network Research Centre on Mental Health (CIBERSAM)
| | - Gemma Parramon
- Department of Psychiatry, Hospital Universitari Vall d’Hebron
- Group of Psychiatry, Mental Health and Addictions, Vall d’Hebron Research Institute (VHIR)
| | - Teresa Pont
- Department of Donor and Transplant Coordination, Hospital Universitari Vall d'Hebron
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d’Hebron
- Group of Psychiatry, Mental Health and Addictions, Vall d’Hebron Research Institute (VHIR)
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona
- Biomedical Network Research Centre on Mental Health (CIBERSAM)
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Álvarez RP, Daigre C, Ros-Cucurull E, Serrano-Pérez P, Ortega-Hernandez G, Fadeuilhe C, Sorribes M, Pereira A, Ramos-Quiroga J, Roncero C, Grau-López L. Insomnia at the onset of addiction treatment may be related to earlier relapses: A one-year follow-up study. Eur Psychiatry 2021. [PMCID: PMC9475577 DOI: 10.1192/j.eurpsy.2021.1497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction 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. Objectives To analyze how insomnia impacts on the time of the first substance relapse in SUD outpatients after the onset of addiction treatment. Methods 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. Results 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%).![]() Conclusions 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
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14
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Daigre C, Rodríguez L, Roncero C, Palma-Álvarez RF, Perea-Ortueta M, Sorribes-Puertas M, Martínez-Luna N, Ros-Cucurull E, Ramos-Quiroga JA, Grau-López L. Treatment retention and abstinence of patients with substance use disorders according to addiction severity and psychiatry comorbidity: A six-month follow-up study in an outpatient unit. Addict Behav 2021; 117:106832. [PMID: 33529849 DOI: 10.1016/j.addbeh.2021.106832] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/10/2020] [Accepted: 01/09/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The impact of psychiatric comorbidity and addiction features throughout the course of addiction has been widely studied. This is a naturalistic study conducted in an outpatient unit, where treatment follow-up studies are scarce compared to studies including inpatients or those under experimental conditions. Therefore, this follow-up study aims to analyze the treatment adherence and abstinence of outpatients with SUD (Substance Use Disorders) according to addiction severity and psychiatric comorbidity. METHODS The current six-month follow-up study examined 404 SUD outpatients. Psychiatric comorbidity, addiction severity, substance consumption and treatment adherence were systematically evaluated using semistructured interviews. Survival analyses were conducted to compare the time of treatment adherence and abstinence in a bivariate and multivariate level. RESULTS A progressive dropout was observed, reaching 32.2% of dropouts at the six-month follow-up. More than 50% achieved abstinence during the first month and similar percentages were found until the six-month follow-up. At the multivariate level, treatment adherence, cannabis use disorder and polyconsumption were independently associated with earlier dropout. ADHD was the only mental disorder significantly related with dropout. Regarding substance consumption, the time of abstinence was independently associated with months of treatment adherence and the achievement of abstinence before starting treatment. In general, dual diagnosis was associated with less time of abstinence, but only depressive disorder across the lifespan was related to less time of abstinence in the multivariate model. CONCLUSION These findings highlight the importance of an accurate diagnosis at the beginning of treatment, especially in an outpatient setting, addressing the treatment needs and promoting strategies that improve treatment adherence and reduce the risk of relapses.
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Affiliation(s)
- Constanza Daigre
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Spain.
| | - Laia Rodríguez
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Carlos Roncero
- Psychiatry Service, Salamanca University Health Care Complex, Institute of Biomedicine, University of Salamanca, Salamanca, Spain; Psychiatry Unit. School of Medicine. University of Salamanca, Spain
| | - Raul Felipe Palma-Álvarez
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Spain
| | - Marta Perea-Ortueta
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Marta Sorribes-Puertas
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Nieves Martínez-Luna
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Elena Ros-Cucurull
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Spain
| | - Lara Grau-López
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Spain
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15
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Martínez-Luna N, Daigre C, Palma-Álvarez F, Perea-Ortueta M, Grau-López L, Roncero C, Castell-Panisello E, Ramos-Quiroga JA. Psychiatric Comorbidity and Addiction Severity Differences in Patients With ADHD Seeking Treatment for Cannabis or Cocaine Use Disorders. J Atten Disord 2021; 25:978-988. [PMID: 31550967 DOI: 10.1177/1087054719875787] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objective: The objective of this study was to compare psychiatric comorbidity and consumption-related variables in ADHD patients seeking treatment for cocaine, cannabis, or both. Method: Assessment was conducted using European Addiction Severity Index (EuropASI), Conners' Adult ADHD Diagnostic Interview (CAADID), Structured Clinical Interview for DSM Disorders (SCID), Adult Self-Report Scale (ASRS), Wender Utah Rating Scale (WURS), Barratt Impulsiveness Scale-11 (BIS-11), and FIDI, with statistical analyses of analysis of variance (ANOVA), Student's t test, chi-square test, and multinomial regression model. Results: In total, 1,538 patients with substance use disorder (SUD) were evaluated for ADHD; 239 (15.5%) had ADHD, with cannabis 41, cannabis/cocaine 36, and cocaine 74. Men represented 80%, with mean age of 32.9 ± 10 years. Significant variables were-in bivariate analysis-more years of cannabis use in cannabis group and younger age for cocaine use disorder in cannabis/cocaine group, and-in multivariate analysis-lifetime anxiety disorder and younger age at onset of any SUD in cannabis group and working affected scale in cannabis and polysubstance use in cannabis/cocaine group. Conclusion: Groups with cannabis use had higher severity. ADHD features were similar in all groups. The assessment of ADHD and comorbid disorders is important.
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Affiliation(s)
- Nieves Martínez-Luna
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Constanza Daigre
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
| | - Felipe Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Marta Perea-Ortueta
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
| | - Carlos Roncero
- Psychiatry Service, University of Salamanca Health Care Complex, Salamanca, Spain.,Institute of Biomedicine of Salamanca , University of Salamanca, Spain
| | - Eudald Castell-Panisello
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
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16
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Álvarez RP, Daigre C, Ros-Cucurull E, Serrano-Pérez P, Ortega-Hernandez G, Perea-Ortueta M, Vendrell-Serres J, Gallego L, Ramos-Quiroga J, Grau-López L, Roncero C. Patients with substance use disorder who have higher alexithymia levels present more suicidality history: Preliminary results in an outpatient addiction treatment center in Spain. Eur Psychiatry 2021. [PMCID: PMC9480106 DOI: 10.1192/j.eurpsy.2021.1552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionPatients 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.ObjectivesTo compare the alexithymia levels in SUD patients with and without SI and SA in an outpatient addiction treatment center in Spain.MethodsThis 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.ResultsLifetime 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.ConclusionsSI 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.
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Palma-Álvarez RF, Soriano-Dia A, Ros-Cucurull E, Daigre C, Serrano-Pérez P, Ortega-Hernández G, Perea-Ortueta M, Gurrea Salas D, Ramos-Quiroga JA, Grau-López L. Catatonia Related to Cannabis and Synthetic Cannabinoids: A Review. J Dual Diagn 2021; 17:159-171. [PMID: 33902405 DOI: 10.1080/15504263.2021.1904163] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
Cannabis and synthetic cannabinoids (SC) are related to several neuropsychiatric symptoms and disorders, especially psychotic symptoms and disorders. Interestingly, catatonia-like symptoms associated with cannabis and SC have been generally neglected in research and scarcely described despite the clinical repercussions. Hence, this review aims to analyze current clinical publications on catatonia induced by cannabis or SC in a systematized way. Methods: A search using PRISMA guidelines was performed on three databases based on a specific inclusion and exclusion criteria. Results: 11 publications describing 14 patients (10 males; mean age 22.50 ± 6.67 years old) with catatonia apparently precipitated by the use of cannabis (n = 6) or SC (n = 8) were found. Clinical features and treatment are described and discussed. Conclusion: From a clinical perspective, cannabis and SC use may be related to catatonia-like symptoms and catatonia syndrome in the same way these substances (cannabis and SC) are related to induced-psychotic episodes. However, further research will be required to understand the exact nature of that relationship. Additionally, investigations focused on the clinical significance (i.e., prognosis, evolution, and outcomes) of catatonia-like symptoms induced by cannabis and SC use in patients are also needed.
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Affiliation(s)
- Raul Felipe Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Albert Soriano-Dia
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Elena Ros-Cucurull
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Constanza Daigre
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Pedro Serrano-Pérez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Germán Ortega-Hernández
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Marta Perea-Ortueta
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | | | - Josep-Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
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18
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Pineda-Cirera L, Cabana-Domínguez J, Grau-López L, Daigre C, Sánchez-Mora C, Palma-Álvarez RF, Ramos-Quiroga JA, Ribasés M, Cormand B, Fernàndez-Castillo N. Exploring allele specific methylation in drug dependence susceptibility. J Psychiatr Res 2021; 136:474-482. [PMID: 32917399 DOI: 10.1016/j.jpsychires.2020.07.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 07/24/2020] [Accepted: 07/30/2020] [Indexed: 01/17/2023]
Abstract
Drug dependence is a neuropsychiatric condition that involves genetic, epigenetic and environmental factors. Allele-specific methylation (ASM) is a common and stable epigenetic mechanism that involves genetic variants correlating with differential levels of methylation at CpG sites. We selected 182 single-nucleotide polymorphisms (SNPs) described to influence cis ASM in human brain regions to evaluate their possible contribution to drug dependence susceptibility. We performed a case-control association study in a discovery sample of 578 drug-dependent patients (including 428 cocaine-dependent subjects) and 656 controls from Spain, and then, we followed-up the significant associations in an independent sample of 1119 cases (including 589 cocaine-dependent subjects) and 1092 controls. In the discovery sample, we identified five nominal associations, one of them replicated in the follow-up sample (rs6020251). The pooled analysis revealed an association between drug dependence and rs6020251 but also rs11585570, both overcoming the Bonferroni correction for multiple testing. We performed the same analysis considering only cocaine-dependent patients and obtained similar results. The rs6020251 variant correlates with differential methylation levels of cg17974185 and lies in the first intron of the CTNNBL1 gene, in a genomic region with multiple histone marks related to enhancer and promoter regions in brain. Rs11585570 is an eQTL in brain and blood for the SCP2 and ECHDC2 genes and correlates with differential methylation of cg27535305 and cg13461509, located in the promoter regions of both genes. To conclude, using an approach that combines genetic and epigenetic data, we highlighted the CTNNBL1, SCP2 and ECHDC2 genes as potential contributors to drug dependence susceptibility.
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Affiliation(s)
- Laura Pineda-Cirera
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Catalonia, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain; Institut de Recerca Sant Joan de Déu (IR-SJD), Esplugues de Llobregat, Catalonia, Spain
| | - Judit Cabana-Domínguez
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Catalonia, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain; Institut de Recerca Sant Joan de Déu (IR-SJD), Esplugues de Llobregat, Catalonia, Spain
| | - Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Constanza Daigre
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Cristina Sánchez-Mora
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Catalonia, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Raul Felipe Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Marta Ribasés
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Catalonia, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Bru Cormand
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Catalonia, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain; Institut de Recerca Sant Joan de Déu (IR-SJD), Esplugues de Llobregat, Catalonia, Spain.
| | - Noèlia Fernàndez-Castillo
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Catalonia, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain; Institut de Recerca Sant Joan de Déu (IR-SJD), Esplugues de Llobregat, Catalonia, Spain.
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19
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Palma-Álvarez RF, Ros-Cucurull E, Daigre C, Perea-Ortueta M, Serrano-Pérez P, Martínez-Luna N, Salas-Martínez A, Robles-Martínez M, Ramos-Quiroga JA, Roncero C, Grau-López L. Alexithymia in Patients With Substance Use Disorders and Its Relationship With Psychiatric Comorbidities and Health-Related Quality of Life. Front Psychiatry 2021; 12:659063. [PMID: 33897505 PMCID: PMC8062860 DOI: 10.3389/fpsyt.2021.659063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/15/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Alexithymia frequently correlates with several psychiatric disorders, including substance use disorder (SUD). However, most studies reporting the associations between alexithymia and psychiatric disorders have been performed in populations without SUD. This research, therefore, evaluates alexithymia in Spanish patients with SUD and the relationship among alexithymia, psychiatric comorbidities, psychological symptoms/traits, SUD variables, and health-related quality of life (HRQoL). Methodology: A cross-sectional study was conducted with 126 Spanish outpatients with SUD (75.4% males; mean age 43.72 ± 14.61 years), correlating their alexithymia levels (using the Toronto Alexithymia Scale 20 [TAS-20]) to their psychiatric comorbidities, psychological symptoms/traits, SUD variables, and HRQoL. Results: Alexithymia was significantly higher in patients who had cannabis use disorder. Higher alexithymia scores were also related to higher levels of depression, anxiety, impulsivity, and lower HRQoL. After multivariate analysis, trait anxiety, impulsivity, and the physical component summary of the HRQoL were found to be independently related to alexithymia. Conclusions: SUD patients with higher alexithymia levels have more frequently psychiatric comorbidities, present specific psychological features, and have worse HRQoL. Hence, it is important to evaluate these factors and offer more accurate psychotherapeutic approaches for this patient population.
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Affiliation(s)
- Raul F Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Elena Ros-Cucurull
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Constanza Daigre
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Marta Perea-Ortueta
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Pedro Serrano-Pérez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | | | - Anna Salas-Martínez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - María Robles-Martínez
- Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain.,Hospital del Mar Institute for Biomedical Research (IMIM), Barcelona, Spain
| | - Josep A Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Carlos Roncero
- Psychiatry Service, University of Salamanca Health Care Complex, Insitute of Biomedicine, Salamanca, Spain.,Psychiatry Unit, School of Medicine, University of Salamanca, Salamanca, Spain
| | - Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
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20
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Beneria A, Castell-Panisello E, Sorribes-Puertas M, Forner-Puntonet M, Serrat L, García-González S, Garriga M, Simon C, Raya C, Montes MJ, Rios G, Bosch R, Citoler B, Closa H, Corrales M, Daigre C, Delgado M, Dip ME, Estelrich N, Jacas C, Lara B, Lugo-Marin J, Nieto-Fernández Z, Regales C, Ibáñez P, Blanco E, Ramos-Quiroga JA. End of Life Intervention Program During COVID-19 in Vall d'Hebron University Hospital. Front Psychiatry 2021; 12:608973. [PMID: 34040548 PMCID: PMC8143029 DOI: 10.3389/fpsyt.2021.608973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 04/06/2021] [Indexed: 01/02/2023] Open
Abstract
Introduction: The coronavirus disease 19 (COVID-19) and its consequences have placed our societies and healthcare systems under pressure. Also, a major impact on the individual and societal experience of death, dying, and bereavement has been observed. Factors such as social distancing, unexpected death or not being able to say goodbye, which might predict Prolonged Grief Disorder (PGD), are taking place. Moreover, hospitals have become a habitual place for End of Life (EOL) situations but not in the usual conditions because, for example, mitigation measures prevent families from being together with hospitalized relatives. Therefore, we implemented an EOL program with a multidisciplinary team involving health social workers (HSW) and clinical psychologists (CP) in coordination with the medical teams and nursing staff. Objectives: We aim to describe an EOL intervention program implemented during COVID-19 in the Vall d'Hebron University Hospital (HUVH). We present its structure, circuit, and functions. Descriptive analyses of the sample and the interventions that required psychological and social attention are reported. Material and methods: The total sample consists of 359 relatives of 219 EOL patients. Inclusion criteria were families cared for during the COVID-19 pandemic with family patients admitted to the HUVH in an EOL situation regardless of whether or not the patient was diagnosed with COVID-19. Results: Our program is based on family EOL care perceptions and the COVID-19 context features that hinder EOL situations. The program attended 219 families, of which 55.3% were COVID-19 patients and 44.7% had other pathologies. The EOL intervention program was activated in most of the EOL situations, specifically, in 85% of cases, and 78% of relatives were able to come and say goodbye to their loved ones. An emotional impact on the EOL team was reported. It is necessary to dignify the EOL situation in the COVID-19 pandemic, and appropriate psychosocial attention is needed to try to minimize future complications in grief processes and mitigate PGD.
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Affiliation(s)
- Anna Beneria
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Eudald Castell-Panisello
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Marta Sorribes-Puertas
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Mireia Forner-Puntonet
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laia Serrat
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Sara García-González
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Maria Garriga
- Department of Social Work, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Carmen Simon
- Department of Social Work, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Consuelo Raya
- Department of Social Work, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Maria José Montes
- Department of Social Work, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Giuliana Rios
- Department of Social Work, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Rosa Bosch
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Bárbara Citoler
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Helena Closa
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Montserrat Corrales
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Constanza Daigre
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Mercedes Delgado
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Maria Emilia Dip
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Neus Estelrich
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Carlos Jacas
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Benjamin Lara
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Jorge Lugo-Marin
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Zaira Nieto-Fernández
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Christina Regales
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Pol Ibáñez
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Eunice Blanco
- Department of Social Work, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
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21
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Grau-López L, Marcos-Fosch C, Daigre C, Palma-Alvarez RF, Rando-Segura A, Llaneras J, Perea-Ortueta M, Rodriguez-Frias F, Martínez-Luna N, Riveiro-Barciela M, Ramos-Quiroga JA, Colom J, Esteban R, Buti M. Barriers to linkage to care in hepatitis C patients with substance use disorders and dual diagnoses, despite centralized management. Therap Adv Gastroenterol 2021; 14:17562848211016563. [PMID: 34471422 PMCID: PMC8404622 DOI: 10.1177/17562848211016563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 04/13/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) management is a challenge in patients with substance use disorder (SUD). This study aimed to describe an HCV screening and linkage to care program in SUD patients, and analyze the characteristics of this population in relation to HCV infection, particularly the impact of psychiatric comorbidities (dual diagnosis). METHODS This study was a prospective clinical cohort study using a collaborative, multidisciplinary model to offer HCV care (screening, diagnosis, and therapy) to individuals with SUD attending a dedicated hospital clinic. The characteristics of the participants, prevalence of HCV infection, percentage who started therapy, and adherence to treatment were compared according to the patients' consumption characteristics and presence of dual diagnosis. HCV screening, diagnosis, treatment initiation, and sustained virologic response were analyzed. RESULTS 528 individuals attended the center (November 2018-June 2019) and 401 (76%) accepted screening. In total, 112 (28%) were anti-HCV-positive and 42 (10%) had detectable HCV RNA, but only 20 of the latter started HCV therapy. Among the 253 (63%) patients with a dual diagnosis, there were no differences in HCV infection prevalence versus patients with SUD alone (p = 0.28). Dual diagnosis did not lead to a higher risk of HCV infection or interfere with linkage to care or treatment. CONCLUSION This study found a high prevalence of dual diagnosis and HCV infection in SUD patients, but dual diagnosis was not associated with an increased risk of acquiring HCV or more complex access to care. Despite use of a multidisciplinary management approach, considerable barriers to HCV care remain in this population that would need more specific focus.
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Affiliation(s)
- Lara Grau-López
- Addiction and Dual Diagnosis Section, Department of Psychiatry, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Cristina Marcos-Fosch
- Liver Unit, Internal Medicine Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Hospital Universitari Vall d’Hebron, Department of Medicine of the UAB (Universitat Autònoma de Barcelona), Barcelona, Spain
| | - Constanza Daigre
- Addiction and Dual Diagnosis Section, Department of Psychiatry, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Raúl Felipe Palma-Alvarez
- Addiction and Dual Diagnosis Section, Department of Psychiatry, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Ariadna Rando-Segura
- Liver Disease-Viral Hepatitis Laboratory, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain
| | - Jordi Llaneras
- Liver Unit, Internal Medicine Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Marta Perea-Ortueta
- Addiction and Dual Diagnosis Section, Department of Psychiatry, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | | | - Nieves Martínez-Luna
- Addiction and Dual Diagnosis Section, Department of Psychiatry, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Mar Riveiro-Barciela
- Liver Unit, Internal Medicine Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Josep Antoni Ramos-Quiroga
- Addiction and Dual Diagnosis Section, Department of Psychiatry, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Joan Colom
- Director of the Programme for Prevention, Control and Treatment of HIV, STIs and Viral Hepatitis. Agency of Public Health of Catalonia. Generalitat de Catalunya
| | - Rafael Esteban
- Liver Unit, Internal Medicine Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
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22
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Fadeuilhe C, Daigre C, Richarte V, Grau-López L, Palma-Álvarez RF, Corrales M, Ramos-Quiroga JA. Insomnia Disorder in Adult Attention-Deficit/Hyperactivity Disorder Patients: Clinical, Comorbidity, and Treatment Correlates. Front Psychiatry 2021; 12:663889. [PMID: 34122179 PMCID: PMC8187558 DOI: 10.3389/fpsyt.2021.663889] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/16/2021] [Indexed: 01/08/2023] Open
Abstract
Introduction: Several investigations have been performed on insomnia symptoms in adult attention-deficit/hyperactivity disorder (ADHD). However, the relationship between insomnia disorder and adult ADHD has been neglected in research. The main objective of the current study is to analyze the differences between adult ADHD patients with and without insomnia disorder, in terms of ADHD clinical severity, medical and psychiatric comorbidity, psychopharmacological treatment, and quality of life. Material and Methods: Two hundred and fifty-two adult patients with ADHD (mean age 37.60 ± 13.22 years; ADHD presentations-combined: 56.7%, inattentive: 39.7%, hyperactive/impulsive: 3.6%) were evaluated with an exhaustive clinical and psychological evaluation protocol including semistructured interviews (for comorbidities and ADHD assessment) and symptom rating scales for ADHD. The diagnosis of ADHD and insomnia disorder was made according to DSM-5 criteria. Furthermore, the Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Epworth Sleepiness Scale were administered. Results: Insomnia disorder was found in 44.4% of adult ADHD patients and was more common in combined presentation (64.3%) and in patients with more ADHD severity. Comorbidities (both medical and psychiatric), especially mood disorders (42%), anxiety disorder (26.8%), personality disorder (39.3%), and any substance use disorder (11.6%), were associated with a higher insomnia disorder prevalence. ADHD stimulant treatment was related to lower insomnia disorder compared to patients without medication, as well as ADHD stable treatment. Additionally, worse health-related quality of life was associated with insomnia disorder. Conclusion: Insomnia disorder is highly prevalent in adult ADHD and is related to higher ADHD severity and more psychiatric and medical comorbidities. Some stimulants and stable pharmacological ADHD treatment are associated with better outcomes of insomnia disorder.
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Affiliation(s)
- Christian Fadeuilhe
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Constanza Daigre
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Vanesa Richarte
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Raul F Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Montse Corrales
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josep A Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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23
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Grau-López L, Grau-López L, Daigre C, Palma-Álvarez RF, Martínez-Luna N, Ros-Cucurull E, Ramos-Quiroga JA, Roncero C. Insomnia Symptoms in Patients With Substance Use Disorders During Detoxification and Associated Clinical Features. Front Psychiatry 2020; 11:540022. [PMID: 33312131 PMCID: PMC7704430 DOI: 10.3389/fpsyt.2020.540022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 10/15/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Insomnia is highly prevalent in patients with substance use disorders (SUD), and it has been related to a worse course of addiction. Insomnia during detoxification in a hospital has not been adequately studied. This study aims to compare sociodemographic, clinical, and psychopathological characteristics of SUD patients undergoing a detoxification program, by comorbidity and insomnia symptoms. Methodology: We recruited 481 patients who received pharmacological and psychotherapeutic treatment for detoxification. They were evaluated through semi-structured interviews, standardized questionnaires, and a specific sleep log. A bivariate and multivariate analysis of the data was performed. Results: Insomnia was reported by 66.5% patients, with sleep-maintenance insomnia the most frequent issue, followed by early morning awakening and sleep-onset insomnia. Patients with alcohol use disorder and cannabis use disorder had higher prevalence of sleep-onset insomnia. Patients with cocaine and heroin use disorder had higher prevalence of sleep-maintenance insomnia. Independent factors that allowed the identification of insomnia symptoms included being female (OR: 3.43), polysubstance use (OR: 2.85), comorbid anxiety disorder (OR: 2.02), and prior admission for detoxification (OR: 1.22). Conclusions: Insomnia symptoms are very prevalent in patients admitted for detoxification. The diagnosis and therapeutic strategies for the insomnia symptoms should be improved, especially in women and in patients with greater addiction severity and with anxiety disorders.
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Affiliation(s)
- Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Laia Grau-López
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Constanza Daigre
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Raúl Felipe Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Nieves Martínez-Luna
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Elena Ros-Cucurull
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Jose Antonio Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Carlos Roncero
- Psychiatric Service, University of Salamanca Health Care Complex, Institute of Biomedicine of Salamanca, University of Salamanca, Salamanca, Spain.,Psychiatric Unit, School of Medicine University of Salamanca, Salamanca, Spain
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Roncero C, Ortega L, Pérez-Pazos J, Lligoña A, Abad AC, Gual A, Sorribes M, Grau-López L, Casas M, Daigre C. Psychiatric Comorbidity in Treatment-Seeking Alcohol Dependence Patients With and Without ADHD. J Atten Disord 2019; 23:1497-1504. [PMID: 26269096 DOI: 10.1177/1087054715598841] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To estimate the prevalence of ADHD in adult patients treated for alcohol dependence and to analyze the characteristics of consumption and psychiatric comorbidity, in function of a possible ADHD in adulthood. Method: We administered the Adult ADHD Self-Report Scale (ASRS) to 726 alcohol-dependent patients. Clinical diagnosis, following Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) criteria was made in the first four weeks of treatment. A subsample of 297 patients was evaluated using Conners' Adult ADHD Diagnostic Interview for DSM-IV (CAADID-II) to test the psychometric properties of ASRS. Results: After analyzing the properties of the ASRS (sensitivity: 83.3%; specificity: 66.1%), the prevalence of ADHD, in the whole sample, was estimated to be 16.2%. Being younger, lifetime history of cocaine dependence and the presence of an affective, anxiety or personality disorder were associated with a possible ADHD. Conclusion: The estimated prevalence of ADHD in patients being treated for alcohol dependence is high, and the presence of a possible ADHD in adulthood is associated with an increase in psychiatric comorbidity.
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Affiliation(s)
- Carlos Roncero
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Barcelona Public Health Agency (ASPB), Barcelona, Spain.,3 Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,4 Universitat Autònoma de Barcelona, Spain
| | - Lluisa Ortega
- 5 Institut Clinic de Neurociències, Barcelona, Spain.,6 Unitat de Conductes Adictives, Barcelona, Spain
| | - Jesús Pérez-Pazos
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Barcelona Public Health Agency (ASPB), Barcelona, Spain
| | - Anna Lligoña
- 5 Institut Clinic de Neurociències, Barcelona, Spain.,6 Unitat de Conductes Adictives, Barcelona, Spain
| | - Alfonso C Abad
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Barcelona Public Health Agency (ASPB), Barcelona, Spain
| | - Antoni Gual
- 5 Institut Clinic de Neurociències, Barcelona, Spain.,6 Unitat de Conductes Adictives, Barcelona, Spain
| | - Marta Sorribes
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Barcelona Public Health Agency (ASPB), Barcelona, Spain
| | - Lara Grau-López
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Barcelona Public Health Agency (ASPB), Barcelona, Spain.,4 Universitat Autònoma de Barcelona, Spain
| | - Miquel Casas
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,3 Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,4 Universitat Autònoma de Barcelona, Spain
| | - Constanza Daigre
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Barcelona Public Health Agency (ASPB), Barcelona, Spain.,4 Universitat Autònoma de Barcelona, Spain
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Roncero C, Palma-Álvarez RF, Díaz-Morán S, Grau-López L, Rodríguez-Cintas L, Ros-Cucurull E, Álvarez AI, Casas M, Daigre C. Cocaine relapse and health-related quality of life: a 23 weeks study. Actas Esp Psiquiatr 2019; 47:37-44. [PMID: 31017271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 03/01/2019] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Cocaine dependence is a disorder where relapses are frequently presented and many factors are involved. Furthermore, cocaine dependence is associated with poor health-related quality of life (HRQoL) outcomes. This study aims to explore perceived HRQoL as an indicator of drug relapse in cocaine-dependent patients (CDP). SUBJECTS AND METHODS A longitudinal study was carried out in CDP during 23 weeks. A consecutive sampling method was applied, 39 participants composed the initial sample (mean age 35.6 years), only 15 participants completed outpatient follow-up period. CDP were assessed with psychiatric and HRQoL instruments (SCID-I, SCID-II, BDI, STAI scale and SF-36) in different points of the study. The patients were followed up, and cocaine relapses were assessed. The sample was divided according with the relapse (early vs. late relapse). Data were compared and analyzed in order to evaluate whether HRQoL measure could be related to cocaine relapse. RESULTS There are differences in perceived HRQoL measures between CDP with/without early relapse, especially in Mental health and Social functioning dimensions (p<0.05). Furthermore, Late/relapse-patients have higher improvement of HRQoL than patients with early relapse. CONCLUSIONS Perceived HRQoL might predict early relapse and could be a possible predictor tool of potential future relapses. More research in this field is needed.
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Affiliation(s)
- Carlos Roncero
- Psychiatry Service, University of Salamanca Health Care Complex Salamanca, (Spain). Instituto de Biomedicina de Salamanca (IBSAL), Universidad de Salamanca, (España)
| | - Raúl F Palma-Álvarez
- Departamento de Psiquiatría y Medicina Legal. Instituto de Neurociencias. Universidad Autónoma de Barcelona (España) Sección de Adicciones y Patología Dual, Hospital Universitario Vall Hebron-Agencia de Salud Pública de Barcelona (ASPB). Barcelona (España) Servicio de Psiquiatría, Hospital Universitario Vall Hebron. Universidad Autónoma de Barcelona. CIBERSAM (Spain)
| | - Sira Díaz-Morán
- Departamento de Psiquiatría y Medicina Legal. Instituto de Neurociencias. Universidad Autónoma de Barcelona (España)
| | - Lara Grau-López
- Departamento de Psiquiatría y Medicina Legal. Instituto de Neurociencias. Universidad Autónoma de Barcelona (España) Sección de Adicciones y Patología Dual, Hospital Universitario Vall Hebron-Agencia de Salud Pública de Barcelona (ASPB). Barcelona (España) Servicio de Psiquiatría, Hospital Universitario Vall Hebron. Universidad Autónoma de Barcelona. CIBERSAM (Spain)
| | - Laia Rodríguez-Cintas
- Departamento de Psiquiatría y Medicina Legal. Instituto de Neurociencias. Universidad Autónoma de Barcelona (España) Sección de Adicciones y Patología Dual, Hospital Universitario Vall Hebron-Agencia de Salud Pública de Barcelona (ASPB). Barcelona (España) Servicio de Psiquiatría, Hospital Universitario Vall Hebron. Universidad Autónoma de Barcelona. CIBERSAM (Spain)
| | - Elena Ros-Cucurull
- Departamento de Psiquiatría y Medicina Legal. Instituto de Neurociencias. Universidad Autónoma de Barcelona (España) Sección de Adicciones y Patología Dual, Hospital Universitario Vall Hebron-Agencia de Salud Pública de Barcelona (ASPB). Barcelona (España) Servicio de Psiquiatría, Hospital Universitario Vall Hebron. Universidad Autónoma de Barcelona. CIBERSAM (Spain)
| | - Ana I Álvarez
- Psychiatry Service, University of Salamanca Health Care Complex Salamanca, (Spain). Instituto de Biomedicina de Salamanca (IBSAL), Universidad de Salamanca, (España)
| | - Miguel Casas
- Departamento de Psiquiatría y Medicina Legal. Instituto de Neurociencias. Universidad Autónoma de Barcelona (España)
| | - Constanza Daigre
- Sección de Adicciones y Patología Dual, Hospital Universitario Vall Hebron-Agencia de Salud Pública de Barcelona (ASPB). Barcelona (España) Servicio de Psiquiatría, Hospital Universitario Vall Hebron. Universidad Autónoma de Barcelona. CIBERSAM (Spain)
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Ros-Cucurull E, Palma-Álvarez RF, Daigre C, Jacas C, Perea M, Sorribes-Puertas M, Quesada M, Martínez-Arias R, Ros-Montalbán S, Casas M, Ramos-Quiroga JA, Roncero C, Grau-López L. Sex differences in an old adult sample with substance use disorder: A 6 months follow-up study. Psychiatry Res 2018; 270:1157-1165. [PMID: 30551310 DOI: 10.1016/j.psychres.2018.10.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/15/2018] [Accepted: 10/15/2018] [Indexed: 01/17/2023]
Abstract
Substance use disorder (SUD) is a worldwide concern that has its own particularities regarding age and sex. This study aims to assess the differences between old SUD women and men regarding socio-demographics, clinical factors and outcomes. A 6-months follow-up longitudinal study was conducted in an outpatient center, on a convenience sample of 115 SUD old adults (≥65 years old, average age of 71.57). Descriptive, bivariate, and multivariate analyses were performed. Data showed statistical significant differences between men and women related to sociodemographic variables (marital status, coexistence, criminal records and stress factors), medical and psychiatric conditions (women suffer higher rates of depression and anxiety, with worse health-related quality of life), family records (women had more presence of family psychiatric records) and SUD related parameters (men tend to use more alcohol, had an early onset, consume higher doses, report more craving and more tobacco life use while women had higher rates of prescription drugs use). At 6-month follow-up, the whole sample showed excellent rates of adherence and abstinence, without sex differences. The study points out sex differences on several sociodemographic and clinical variables, indicating their specific needs. This research could facilitate better approaches by considering a sex perspective in SUD old adults.
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Affiliation(s)
- Elena Ros-Cucurull
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain; Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain; Autonomous University of Barcelona, Barcelona, Spain.
| | - Raúl Felipe Palma-Álvarez
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain; Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain; Autonomous University of Barcelona, Barcelona, Spain
| | - Constanza Daigre
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain; Autonomous University of Barcelona, Barcelona, Spain
| | - Carlos Jacas
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain; Autonomous University of Barcelona, Barcelona, Spain
| | - Marta Perea
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain; Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain
| | - Marta Sorribes-Puertas
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain; Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain
| | - Marta Quesada
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain; Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain; Autonomous University of Barcelona, Barcelona, Spain
| | | | | | - Miguel Casas
- Autonomous University of Barcelona, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain; Autonomous University of Barcelona, Barcelona, Spain
| | - Carlos Roncero
- Psychiatry Service, University of Salamanca Health Care Complex, Institute of Biomedicine of Salamanca (IBSAL) Salamanca, Spain
| | - Lara Grau-López
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain; Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain; Autonomous University of Barcelona, Barcelona, Spain
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Ros-Cucurull E, Palma-Álvarez RF, García-Raboso E, Cardona-Rubira C, Jacas C, Grau-López L, Robles-Martínez M, Daigre C, Ros-Montalbán S, Casas M, Ramos-Quiroga JA, Roncero C. Benzodiazepine Use Disorder and Cognitive Impairment in Older Patients: A Six-Month-Follow-Up Study in an Outpatient Unit in Barcelona. J Stud Alcohol Drugs 2018; 79:844-852. [PMID: 30573014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
OBJECTIVE Adverse health effects including cognitive impairment have been described in older adults with benzodiazepine misuse, although the literature about this issue is scarce. The present study aimed to assess cognitive decline in older adults with benzodiazepine use disorder and changes in cognitive state at the 6-month follow-up, as well as whether patients achieved abstinence. METHOD A 6-month follow-up longitudinal study was conducted in an outpatient drug center in Barcelona in a sample of older adults (≥65 years old) who had benzodiazepine use disorder. The sample was compared with an equivalent control group. A neuropsychological protocol was performed at baseline and after 6-month follow-up covering the most important cognitive domains. RESULTS The final sample comprised 33 patients with an average age of 73.5 years. At baseline, patients presented impairment in several domains compared with the control group: visual immediate recall (p < .001), visual delayed recall (p < .001), copy (p < .001), working memory (p < .003), immediate verbal learning (p < .002), total words learned (p < .009), set switching (p < .001), verbal fluency (p < .007), speed processing (p < .002), solving problems (p < .006), nonverbal fluency (p < .004), and sustained attention in all three areas omissions (p < .001), variability (p < .001), and perseverance (p < .005). At 6-month follow-up, patients achieving abstinence showed improvement compared with patients in active consumption in visual delayed recall (p < .006), total words learned (p < .010), and verbal fluency (p < .013). CONCLUSIONS Benzodiazepine misuse in older adults may produce negative effects on cognitive skills. Recovery of some of these cognitive deficits may be possible with benzodiazepine abstinence.
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Affiliation(s)
- Elena Ros-Cucurull
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- International Institute for Neuroscience, Barcelona, Spain
| | - Raúl Felipe Palma-Álvarez
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- International Institute for Neuroscience, Barcelona, Spain
| | - Elena García-Raboso
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain
| | | | - Carlos Jacas
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
| | - Lara Grau-López
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
| | - María Robles-Martínez
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain
| | - Constanza Daigre
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
| | | | - Miguel Casas
- Autonomous University of Barcelona, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
| | - Carlos Roncero
- Psychiatry Service, University of Salamanca Health Care Complex, Institute of Biomedicine, Salamanca, Spain
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Ros-Cucurull E, Palma-Álvarez RF, García-Raboso E, Cardona-Rubira C, Jacas C, Grau-López L, Robles-Martínez M, Daigre C, Ros-Montalbán S, Casas M, Ramos-Quiroga JA, Roncero C. Benzodiazepine Use Disorder and Cognitive Impairment in Older Patients: A Six-Month-Follow-Up Study in an Outpatient Unit in Barcelona. J Stud Alcohol Drugs 2018. [DOI: 10.15288/jsad.2018.79.844] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Elena Ros-Cucurull
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- International Institute for Neuroscience, Barcelona, Spain
| | - Raúl Felipe Palma-Álvarez
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- International Institute for Neuroscience, Barcelona, Spain
| | - Elena García-Raboso
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain
| | | | - Carlos Jacas
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
| | - Lara Grau-López
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
| | - María Robles-Martínez
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain
| | - Constanza Daigre
- Addiction and Dual Diagnosis Unit, Vall Hebron University Hospital, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
| | | | - Miguel Casas
- Autonomous University of Barcelona, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Psychiatry Service, CIBERSAM, Vall Hebron University Hospital, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
| | - Carlos Roncero
- Psychiatry Service, University of Salamanca Health Care Complex, Institute of Biomedicine, Salamanca, Spain
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Grau-López L, Grau-López L, Daigre C, Palma-Álvarez RF, Rodriguez-Cintas L, Ros-Cucurull E, Roncero C. Pharmacological Treatment of Insomnia Symptoms in Individuals with Substance Use Disorders in Spain: A Quasi-Experimental Study. Subst Use Misuse 2018; 53:1267-1274. [PMID: 29185897 DOI: 10.1080/10826084.2017.1402056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Pharmacological treatment of insomnia in patients with addictions has been hardly investigated and there are few researches about it in an inpatient detoxification. The aim of this study was to describe the outcomes of the pharmacological treatment of insomnia in SUD patients admitted to a detoxification unit in Spain, with a focus on the primary substance of abuse and co-occurring mental disorders. METHODS A quasi-experimental study was conducted in 481 addicted in patients, who were admitted for substances detoxification in Vall d´Hebron University Hospital, Barcelona, Spain, from 2010 to 2015. The patients underwent systematic evaluation of axes I and II psychiatric disorders (SCID-I, SCID-II, and CAADID). Insomnia was evaluated using a night time sleep log. Substance-dependent patients, who had insomnia during hospital detoxification, received a psychotropic medication with hypnotic effect, keeping the regular clinical practice without randomization. RESULTS At discharge, insomnia was considered to have been alleviated in 63.8% (n = 204) of patients while 36.2% (n = 116) of patients remained with insomnia disturbances. Comparing hypnotic treatments it was observed that mirtazapine and clotiapine were the treatment that corrected the insomnia more frequently. DISCUSSION Since insomnia is not corrected in all patients, it should be further investigated in medications with hypnotic purpose. Based on the results of this work, randomized clinical trials might be proposed.
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Affiliation(s)
- L Grau-López
- a Addiction and Dual Diagnosis Unit , Department of Psychiatry , Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM , Barcelona , Spain.,b Department of Psychiatry and Legal Medicine , Universidad Autónoma de Barcelona , Barcelona , Spain
| | - L Grau-López
- c Department of Neurosciences , Germans Tries i Pujol Hospital , Badalona, Barcelona , Spain
| | - C Daigre
- a Addiction and Dual Diagnosis Unit , Department of Psychiatry , Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM , Barcelona , Spain.,b Department of Psychiatry and Legal Medicine , Universidad Autónoma de Barcelona , Barcelona , Spain
| | - R F Palma-Álvarez
- a Addiction and Dual Diagnosis Unit , Department of Psychiatry , Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM , Barcelona , Spain
| | - L Rodriguez-Cintas
- a Addiction and Dual Diagnosis Unit , Department of Psychiatry , Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM , Barcelona , Spain.,b Department of Psychiatry and Legal Medicine , Universidad Autónoma de Barcelona , Barcelona , Spain
| | - E Ros-Cucurull
- a Addiction and Dual Diagnosis Unit , Department of Psychiatry , Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM , Barcelona , Spain.,b Department of Psychiatry and Legal Medicine , Universidad Autónoma de Barcelona , Barcelona , Spain
| | - C Roncero
- a Addiction and Dual Diagnosis Unit , Department of Psychiatry , Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM , Barcelona , Spain.,b Department of Psychiatry and Legal Medicine , Universidad Autónoma de Barcelona , Barcelona , Spain
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Rodríguez-Cintas L, Daigre C, Braquehais MD, Palma-Alvarez RF, Grau-López L, Ros-Cucurull E, Rodríguez-Martos L, Abad AC, Roncero C. Factors associated with lifetime suicidal ideation and suicide attempts in outpatients with substance use disorders. Psychiatry Res 2018; 262:440-445. [PMID: 28951146 DOI: 10.1016/j.psychres.2017.09.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 07/24/2017] [Accepted: 09/09/2017] [Indexed: 12/11/2022]
Abstract
Risks factors for suicide are multiple and highly prevalent in addicted patients (previous suicide attempts, substance abuse, impulsivity, history of sexual abuse and other factors). The aim of this study is to identify and to compare the clinical and socio-demographic profile of SUD outpatients with lifetime suicidal behavior (previous suicidal ideation and/or suicide attempts) and to analyze the factors related to it. A retrospective cohort study of 696 addicted patients, according to DSM-IV-TR criteria (APA, 2000) were collected from the Addiction Unit of Vall d'Hebron University Hospital. Lifetime suicidal ideation in addicted patients is associated with presence of: borderline personality disorder (BPD), depressive disorders, sexual abuse, polydrug abuse, attention-deficit hyperactivity disorder, and motor impulsivity. The factors associated with suicide attempts were: borderline personality disorder, lifetime abuse (whether emotional, physical or sexual), co-occurrent psychotic disorders, polydrug abuse, anxiety disorders and depressive symptoms. We conclude that previous suicidal ideation and lifetime suicide attempts should be considered in the clinical care of addicted patients. Factors related to both suicidal behaviors share similarities and differences according to our findings and need to be deeply explored in the future.
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Affiliation(s)
- Laia Rodríguez-Cintas
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Constanza Daigre
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María Dolores Braquehais
- Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Raúl Felipe Palma-Alvarez
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain
| | - Lara Grau-López
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Ros-Cucurull
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lola Rodríguez-Martos
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain
| | - Alfonso Carlos Abad
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain
| | - Carlos Roncero
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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31
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Roncero C, de Miguel A, Fumero A, Abad AC, Martín R, Bethencourt JM, Grau-López L, Rodríguez-Cintas L, Daigre C. Anxiety and Depression in Drug-Dependent Patients with Cluster C Personality Disorders. Front Psychiatry 2018; 9:19. [PMID: 29472875 PMCID: PMC5810269 DOI: 10.3389/fpsyt.2018.00019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 01/18/2018] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Comorbidity between personality disorders (PD) and substance-use disorders (SUD) is one of the most common findings in the psychiatric field. The patients with Cluster C disorders present maladjustment traits often characterized by high levels of anxiety. The main aim of this study was to find evidences about higher anxiety and depression prevalence on Cluster C than others Clusters, analyzing similarities and differences within, with other Cluster A and B PD patients and patients without PD. METHOD A total of 822 substance dependent patients (ages18-78; Mean = 38.35, SD = 10.14) completed the structured clinical interview for DSM-IV Axis I and Axis II disorders, Beck Depression Inventory, and State-Trait Anxiety Inventory. RESULTS Results supported poly-consumption in Cluster C patients, being greater alcohol consumption as well as abuse of both stimulants and depressants. Anxiety and depression did not show just one pattern for all patients with SUD-Cluster C PD. There was a relation between anxiety and depression for all the groups except for the Dependent-PD. CONCLUSION Interventions should focus on aspects like depression and anxiety more than on the substance consumed.
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Affiliation(s)
- Carlos Roncero
- Psychiatric Service, University of Salamanca Health Care Complex, Institute of Biomedicine of Salamanca, University of Salamanca, Salamanca, Spain.,Addiction and Dual Diagnosis Unit, Hospital Universitari Vall d'Hebron-ASPB, Barcelona, Spain.,Psychiatry Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Adelia de Miguel
- Sciences of Health School, Universidad of La Laguna, Tenerife, Spain
| | - Ascensión Fumero
- Sciences of Health School, Universidad of La Laguna, Tenerife, Spain
| | - Alfonso C Abad
- Addiction and Dual Diagnosis Unit, Hospital Universitari Vall d'Hebron-ASPB, Barcelona, Spain.,Psychiatry Services, Hospital Universitario Vall d'Hebron, CIBERSAM, Barcelona, Spain
| | - Rita Martín
- Sciences of Health School, Universidad of La Laguna, Tenerife, Spain
| | | | - Lara Grau-López
- Addiction and Dual Diagnosis Unit, Hospital Universitari Vall d'Hebron-ASPB, Barcelona, Spain.,Psychiatry Department, Universitat Autònoma de Barcelona, Barcelona, Spain.,Psychiatry Services, Hospital Universitario Vall d'Hebron, CIBERSAM, Barcelona, Spain
| | - Laia Rodríguez-Cintas
- Addiction and Dual Diagnosis Unit, Hospital Universitari Vall d'Hebron-ASPB, Barcelona, Spain.,Psychiatry Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Constanza Daigre
- Addiction and Dual Diagnosis Unit, Hospital Universitari Vall d'Hebron-ASPB, Barcelona, Spain.,Psychiatry Department, Universitat Autònoma de Barcelona, Barcelona, Spain.,Psychiatry Services, Hospital Universitario Vall d'Hebron, CIBERSAM, Barcelona, Spain
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Roncero C, Palma-Álvarez RF, Barrau V, Urbano N, Martínez-Luna N, Ortiz-Medina MB, Daigre C. Early cannabis use and its relation to the development of psychiatric disorders: a review. sm 2017. [DOI: 10.17711/sm.0185-3325.2017.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Cannabis is the most widely used illegal drug in the world. Both an early cannabis use onset and the amount used contribute to the risk of suffering mental disorders in adulthood. Objective. Review longitudinal studies conducted on adolescents associating early cannabis use with the subsequent occurrence of mental disorders. Method. A search was conducted in PubMed until December 2016, focusing on longitudinal researches and prioritizing studies that clearly distinguished between an early and late onset of cannabis use. To achieve the objective, the word “cannabis” was used in combination with the main psychiatric diseases. A manual search of articles that appeared in the references was also conducted. Results. Fifteen studies met the inclusion criteria, but only five studies discriminated clearly between early and late onset of cannabis use. An association was found between early onset of cannabis use and mental disorders, particularly psychosis. The information regarding affective and anxiety disorders is more controversial. Discussion and conclusion. Early onset of cannabis use is associated with mental disorders, especially psychosis. Prevention plans for cannabis use in adolescents should be developed in order to decrease the risk of mental disorders.
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Daigre C, Grau-López L, Rodríguez-Cintas L, Ros-Cucurull E, Sorribes-Puertas M, Esculies O, Bones-Rocha K, Roncero C. The role of dual diagnosis in health-related quality of life among treatment-seeking patients in Spain. Qual Life Res 2017; 26:3201-3209. [PMID: 28786018 DOI: 10.1007/s11136-017-1668-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 01/22/2023]
Abstract
PURPOSE The comorbidity of any substance use disorder and another mental disorder is defined as dual diagnosis. Dual diagnosis is very common and clinical and therapeutic consequences have been described. This cross-sectional study aimed to analyse health-related quality of life (HRQoL) according to clinical characteristics and psychiatric comorbidities in patients with substance dependence. METHODS A total of 1276 substance-dependent patients seeking treatment were recruited. HRQoL was evaluated by the Short-Form 36 (SF-36) questionnaire. The SCID-I, SCID-II and Conners' adult ADHD diagnostic interview were used to evaluate dual diagnosis. A visual analogue scale was used to measure craving. Bivariate and multivariate analyses were performed, and correction for multiple tests was conducted. RESULTS Substance-dependent patients had impaired quality of life, especially in the mental component. SF-36 physical and mental component scores were 47.7 ± 10.9 and 36.1 ± 14.1, respectively. Furthermore, 65% of the patients had dual diagnosis, 51% had an Axis I DSM-IV-TR mental disorder and 35% had some personality disorder. Impaired physical quality of life was independently associated with medical condition, age, being female, depressive disorder and anxiety disorder. Depression disorder, any personality disorder, active consumption last month, Attention deficit hyperactivity disorder, anxiety disorder, suicide attempt were independently associated with worse mental quality of life. CONCLUSION These findings emphasize the significance of dual diagnosis in the impairment of HRQoL in substance-dependent patients, particularly with regard to mental component. In addicted patients with low scores on SF-36, psychiatric comorbidity should be evaluated and treated in an integrated approach.
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Affiliation(s)
- Constanza Daigre
- Addiction and Dual Diagnosis Unit, Psychiatry Deparment, Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Agencia de Salud Pública de Barcelona, CIBERSAM, Barcelona, Spain.
| | - Lara Grau-López
- Addiction and Dual Diagnosis Unit, Psychiatry Deparment, Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Agencia de Salud Pública de Barcelona, CIBERSAM, Barcelona, Spain
| | - Laia Rodríguez-Cintas
- Addiction and Dual Diagnosis Unit, Psychiatry Deparment, Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Agencia de Salud Pública de Barcelona, CIBERSAM, Barcelona, Spain
| | - Elena Ros-Cucurull
- Addiction and Dual Diagnosis Unit, Psychiatry Deparment, Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Agencia de Salud Pública de Barcelona, CIBERSAM, Barcelona, Spain
| | - Marta Sorribes-Puertas
- Addiction and Dual Diagnosis Unit, Psychiatry Deparment, Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Agencia de Salud Pública de Barcelona, CIBERSAM, Barcelona, Spain
| | | | - Katia Bones-Rocha
- Faculty of Psychology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Carlos Roncero
- Addiction and Dual Diagnosis Unit, Psychiatry Deparment, Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Agencia de Salud Pública de Barcelona, CIBERSAM, Barcelona, Spain
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Ros-Cucurull E, Cardona-Rubira C, García-Raboso E, Palma-Álvarez R, Grau-López L, Daigre C, Rodríguez-Cintas L, Sorribes-Puertas M, Martínez-Arias R, Cuautle A, Ortiz-Medina M, Fadeuilhe C, Jacas C, Casas M, Roncero C. Cognitive impairment associated with drug use in old age people. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionSubstance use disorder is a growing phenomenon among old adults. It is usually significantly undervalued, misidentified, under diagnosed and poorly treated. It has been related to cognitive impairment but there are few studies focused on the elderly.AimTo evaluate the relationship between drug use and cognitive impairment in old adults.MethodsWe conducted a prospective study (basal and 6 month follow up) in 67 patients over 65 years old seeking for treatment for drug misuse (alcohol and prescription drugs, mainly benzodiacepines) in addiction and dual diagnosis unit in Barcelona. A specific protocol was performed to evaluate attention, executive function, working memory, learning capacity, fonetic and visual fluency, decision-making, visual construction and cognitive flexibility (FCT, CPT-II, N-BACK, COWAT FAS, TAP, SDMT, IGT, CVLT, TOL, RFFT, STROOP). Patients were compared with a control group (healthy non drug users) with same characteristics (gender, age range and education status). The protocol consisted in two separated sessions of 90 minutes each one performed by a neuropsychologist.ResultsResults obtained suggested that patients under drug misuse had worse scores in fluency, visual construction, memory and attention compared with controls. After 6 month treatment and achieving abstinence patients improve in cognitive skills as verbal learning, short-term memory and free recall of verbal information. Cognitive impairment profile changes depending on the substance abused (alcohol or benzodiacepines).ConclusionsDrug use can produce deleterious effects in old adults. However, those who achieve abstinence may improve some cognitive functioning as verbal learning, short-term memory and free recall of verbal information.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Martínez-Luna N, Rodriguez-Cintas L, Daigre C, Grau-Lopez L, Palma-Alvarez R, Esojo A, Roncero C. Comparative study of psychiatric comorbidity differences in patients with ADHD and cocaine substance use disorders and patients ADHD and cannabis use disorders. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Substance Use Disorders (SUD) and Attention Deficit Hyperactive Disorder (ADHD) are frequent conditions in out drug treatment centers. There are evidences about the high prevalence of ADHD in SUD patients (20%) compared with just ADHD in general population (1–7.3%). Both disorders and psychiatric comorbidity are important in the diagnosis proceeding. The objective of this study is search the difference in psychiatric comorbidity conditions between patients with ADHD and Cocaine SUD and ADHD and Cannabis SUD. ADHD was present in 158 patients of a total sample in which 46,8% used cocaine, 17.1% cannabis and 36.1% used both. Mood disorders were 26.8% in cocaine users, 21.7% in cannabis and 18.9% in both. Anxiety disorders were 20.3% in cocaine users, 37.5 in cannabis and 13% in both users. Primary psychotic disorders were 2.9% in cocaine users, none in cannabis and 11,1% in both drug users. Personality disorders by cluster were, Cluster A: 11.3% in cocaine group, 36% in cannabis group and 24.5 in cannabis and cocaine group. Cluster B: 33.8% in cocaine group, 44% in cannabis group and 51.9% in cannabis and cocaine group. Cluster C: 9.9% in cocaine group, 28% in cannabis group and 19.2% in cannabis and cocaine group. There could be common pathways of neuronal damage related to psychiatric comorbidity depending of used drug, the differences in comorbidity found in this study could explain a little part of it. It is important to manage SUD-ADHD and other psychiatric comorbidity in order to improve the outcomes of these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Comín M, Redondo S, Daigre C, Grau-López L, Casas M, Roncero C. Clinical differences between cocaine-dependent patients with and without antisocial personality disorder. Psychiatry Res 2016; 246:587-592. [PMID: 27839828 DOI: 10.1016/j.psychres.2016.10.083] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 07/26/2016] [Accepted: 10/21/2016] [Indexed: 12/27/2022]
Abstract
The aim of this study is to compare the features of two groups of cocaine dependent patients in treatment, one of them with co-morbid diagnosis of antisocial personality disorder and the other not. Cross-sectional design, with 143 cocaine-dependent patients attending a drug unit, distributed in two groups: patients with and without Antisocial Personality Disorder. As results, we found that the 15.38% of the sample were diagnosed with an Antisocial Personality Disorder. In relation to socio-demographic variables, Antisocial Personality Disorder patients have less probability of being working or studying (9.1% vs. 47.9%). After multivariate analysis it was found that significantly Antisocial Personality Disorder patients have more opiates dependence (OR: 0.219; 95% IC 0.072-0.660), sedative dependence (OR: 0.203; 95% IC 0.062-0.644) and in more cases show Borderline Personality Disorder (OR: 0.239; 95% IC 0.077-0.746). This study highlights significant differences between cocaine addicts with or without an Antisocial Personality Disorder. All these differences are good indicators of the complexity of the patients with this personality disorder. Better knowledge of their profile will help us to improve the design of specific treatment programs.
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Affiliation(s)
- Marina Comín
- Addiction and Dual Diagnosis Unit, Psychiatry Department, Vall Hebron Hospital-ASPB, Universitat Autònoma de Barcelona, CIBERSAM, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Spain.
| | - Santiago Redondo
- Department of Personality, Assessment and Psychological Treatment, Universitat de Barcelona, Spain
| | - Constanza Daigre
- Addiction and Dual Diagnosis Unit, Psychiatry Department, Vall Hebron Hospital-ASPB, Universitat Autònoma de Barcelona, CIBERSAM, Spain
| | - Lara Grau-López
- Addiction and Dual Diagnosis Unit, Psychiatry Department, Vall Hebron Hospital-ASPB, Universitat Autònoma de Barcelona, CIBERSAM, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Miguel Casas
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Carlos Roncero
- Addiction and Dual Diagnosis Unit, Psychiatry Department, Vall Hebron Hospital-ASPB, Universitat Autònoma de Barcelona, CIBERSAM, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
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Barral C, Daigre C, Bachiller D, Calvo N, Ros-Cucurull E, Gancedo B, Grau-López L, Ferrer M, Casas M, Roncero C. Severity factors associated with borderline personality disorder among misusers in an outpatient sample in Spain. J Addict Dis 2016; 36:93-96. [DOI: 10.1080/10550887.2016.1274594] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Carmen Barral
- SAPD Vall d'Hebron, Department of Psychiatry, Vall d'Hebron University Hospital-ASPB, Barcelona, Spain
- Department of Psychiatry, Vall d'Hebron University Hospital, Barcelona, Spain
- Department of Psychiatry, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Constanza Daigre
- SAPD Vall d'Hebron, Department of Psychiatry, Vall d'Hebron University Hospital-ASPB, Barcelona, Spain
- Department of Psychiatry, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Diana Bachiller
- SAPD Vall d'Hebron, Department of Psychiatry, Vall d'Hebron University Hospital-ASPB, Barcelona, Spain
- Department of Psychiatry, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Natalia Calvo
- Department of Psychiatry, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Elena Ros-Cucurull
- SAPD Vall d'Hebron, Department of Psychiatry, Vall d'Hebron University Hospital-ASPB, Barcelona, Spain
- Department of Psychiatry, Vall d'Hebron University Hospital, Barcelona, Spain
- Department of Psychiatry, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Beatriz Gancedo
- Department of Psychiatry, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Lara Grau-López
- SAPD Vall d'Hebron, Department of Psychiatry, Vall d'Hebron University Hospital-ASPB, Barcelona, Spain
- Department of Psychiatry, Vall d'Hebron University Hospital, Barcelona, Spain
- Department of Psychiatry, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Marc Ferrer
- SAPD Vall d'Hebron, Department of Psychiatry, Vall d'Hebron University Hospital-ASPB, Barcelona, Spain
- Department of Psychiatry, Vall d'Hebron University Hospital, Barcelona, Spain
- Department of Psychiatry, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Miguel Casas
- SAPD Vall d'Hebron, Department of Psychiatry, Vall d'Hebron University Hospital-ASPB, Barcelona, Spain
- Department of Psychiatry, Vall d'Hebron University Hospital, Barcelona, Spain
- Department of Psychiatry, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Carlos Roncero
- SAPD Vall d'Hebron, Department of Psychiatry, Vall d'Hebron University Hospital-ASPB, Barcelona, Spain
- Department of Psychiatry, Vall d'Hebron University Hospital, Barcelona, Spain
- Department of Psychiatry, Universidad Autónoma de Barcelona, Barcelona, Spain
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Roncero C, Grau-López L, Palma-Álvarez RF, Rodriguez-Cintas L, Ros-Cucurull E, Esojo A, Daigre C. Higher severity of cocaine addiction is associated with tactile and somatic hallucinations. Eur Psychiatry 2016; 42:63-69. [PMID: 28212507 DOI: 10.1016/j.eurpsy.2016.11.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 11/09/2016] [Accepted: 11/09/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND 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. METHOD 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. RESULTS 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. CONCLUSION 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.
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Affiliation(s)
- C Roncero
- Addiction and Dual Diagnosis Unit, Psychiatry Department, University Hospital Vall Hebron - ASPB, CIBERSAM, Passieg Vall d'Hebron, 119-129, 08035 Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autónoma Barcelona, 08193 Bellaterra, Barcelona, Spain.
| | - L Grau-López
- Addiction and Dual Diagnosis Unit, Psychiatry Department, University Hospital Vall Hebron - ASPB, CIBERSAM, Passieg Vall d'Hebron, 119-129, 08035 Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autónoma Barcelona, 08193 Bellaterra, Barcelona, Spain
| | - R F Palma-Álvarez
- Addiction and Dual Diagnosis Unit, Psychiatry Department, University Hospital Vall Hebron - ASPB, CIBERSAM, Passieg Vall d'Hebron, 119-129, 08035 Barcelona, Spain
| | - L Rodriguez-Cintas
- Addiction and Dual Diagnosis Unit, Psychiatry Department, University Hospital Vall Hebron - ASPB, CIBERSAM, Passieg Vall d'Hebron, 119-129, 08035 Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autónoma Barcelona, 08193 Bellaterra, Barcelona, Spain
| | - E Ros-Cucurull
- Addiction and Dual Diagnosis Unit, Psychiatry Department, University Hospital Vall Hebron - ASPB, CIBERSAM, Passieg Vall d'Hebron, 119-129, 08035 Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autónoma Barcelona, 08193 Bellaterra, Barcelona, Spain
| | - A Esojo
- Addiction and Dual Diagnosis Unit, Psychiatry Department, University Hospital Vall Hebron - ASPB, CIBERSAM, Passieg Vall d'Hebron, 119-129, 08035 Barcelona, Spain
| | - C Daigre
- Addiction and Dual Diagnosis Unit, Psychiatry Department, University Hospital Vall Hebron - ASPB, CIBERSAM, Passieg Vall d'Hebron, 119-129, 08035 Barcelona, Spain
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Alvarez FJ, Rodriguez-Cintas L, Roncero C, Daigre C, Río MCD, Abad CA, Vela N, Herrero-Fernandez A, Grau-López L, Ros-Cucurrull E, Casas M. 547 Accidents among substance use dependent patient seeking treatment: cocaine versus other substances. Inj Prev 2016. [DOI: 10.1136/injuryprev-2016-042156.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rodríguez-Cintas L, Daigre C, Grau-López L, Barral C, Pérez-Pazos J, Voltes N, Braquehais MD, Casas M, Roncero C. Impulsivity and addiction severity in cocaine and opioid dependent patients. Addict Behav 2016; 58:104-9. [PMID: 26922157 DOI: 10.1016/j.addbeh.2016.02.029] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 11/30/2015] [Accepted: 02/14/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Impulsivity as a personality trait is a risk factor for the development and maintenance of cocaine and opioid dependence. The objective of this study is to analyze the relationship between impulsivity and addiction severity in cocaine and opioid dependent patients. METHODS A cross-sectional, observational study of 526 patients with lifetime cocaine dependence (CD, n=351), opiate dependence (OD, n=51) and comorbid cocaine and opiate dependence (COD, n=124) to throughout life, according to DSM-IV-TR, was conducted. The sample was recruited at the Addiction and Dual Diagnosis Unit of Vall d'Hebron University Hospital from January 2006 to April 2013. Patients were evaluated with the EuropASI, the SCID I and II interviews, and the Barratt Impulsivity Scale (BIS-11). Descriptive statistics of the main variables (including mean, standard deviation) was performed. Chi square test was used to compare categorical variables and Kruskal-Wallis test to compare continuous variables. Spearman correlation was used to analyze the relationship between EuropASI scores and BIS-11 scores. RESULTS The mean age of the patients was 36.37years±8.08 (19-66). CD and COD were more impulsive and had higher addiction severity than OD. OD patients had worse medical status than CD and COD patients while COD patients had more severe drug use and legal problems than the other groups. However, impulsivity and addiction severity were only positively correlated in CD patients. CONCLUSIONS Impulsivity should be appropriately screened and addressed in cocaine dependents as it may be related to addiction severity.
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Affiliation(s)
- Laia Rodríguez-Cintas
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Constanza Daigre
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lara Grau-López
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carmen Barral
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jesús Pérez-Pazos
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain
| | - Núria Voltes
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain
| | - María Dolores Braquehais
- Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miquel Casas
- Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carlos Roncero
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain; Department of Psychiatry, Vall d'Hebron University Hospital, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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Grau-López L, Daigre C, Granell A, Grau-López L, Fadeuilhe C, Calcedo-Barba A, Roncero C. Risk factors for temporary work disability. Actas Esp Psiquiatr 2016; 44:119-124. [PMID: 27388103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 07/01/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The relationship among labor difficulties and psychiatric disorders is important and bidirectional. However, current information about the influence of psychiatric disorders in temporary work disability in Spain is inconclusive. For this reason, we aimed to describe the prevalence of the conclusions of psychiatric expert’s reports including maintain o revoke the temporary disability (TD). We also aimed to compare sociodemographic, clinical and therapeutic variables according with the decision of maintain or revoke this condition. METHODOLOGY A descriptive study was conducted in psychiatric patients that were examined by psychiatric experts during one year. At the examination time, the patients had a sick leave mean of 5 months. The psychiatric experts assessed their ability to work according to the interference of the psychiatric symptoms. RESULTS A total of 380 patients were included (66.8% women, 42±10.9 years), 87.9% had a result of revoke the temporary work disability. No sociodemographic or therapeutic factors were associated with the continuity of sick leave. The most common diagnosis of patients who obtained a revoked temporary work disability was adjustment disorder (66.2% vs 13%, p=0.001) and patients who maintained the temporary work disability was major depressive disorder (45.7% vs 3.9%, p=0.001). CONCLUSIONS After a psychiatric expert’s examination the most of the results suggest to revoke the temporary work disability. Major depressive disorder is the most commonly diagnostic associated to continue sick leave.
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Affiliation(s)
- Lara Grau-López
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d’Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM. Spain
| | - Constanza Daigre
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d’Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM. Spain
| | - Alfred Granell
- SAICE, S.L. Specializing in the valuation of Psychiatry and Clinical Neuropsychology company. Barcelona, Spain
| | - Laia Grau-López
- Department of Neurosciences, Germans Trias i Pujol University Hospital, Badalona, Barcelona, Spain
| | - Christian Fadeuilhe
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d’Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM. Spain
| | - Alfredo Calcedo-Barba
- Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Carlos Roncero
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d’Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM. Spain
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Grau-López L, Daigre C, Grau-López L, Rodriguez-Cintas L, Egido Á, Casas M, Roncero C. Administrative prevalence of insomnia and associated clinical features in patients with addiction during active substance use. Actas Esp Psiquiatr 2016; 44:64-71. [PMID: 27099212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 03/01/2016] [Indexed: 06/05/2023]
Abstract
INTRODUCTION A bidirectional relation between substance use and insomnia has been described, although there are few studies examining insomnia in the population of people with addiction. The aim of this study was to describe the prevalence of insomnia during active substance use in patients with addiction and its associated clinical features. PATIENTS AND METHODS Descriptive study in patients diagnosed with substance dependence disorder admitted to a Hospital Detoxification Unit. The existence of insomnia prior to admission was assessed using the Oviedo Sleep Questionnaire (OSQ). Demographic variables, consumptionrelated clinical variables, and diagnostic variables were collected and the SCID-I and -II (Structured Clinical Interview for DSM-IV) and CAADID (Conners’ Adult ADHD Diagnostic Interview for DSM-IV) were administered to evaluate the psychiatric diagnoses. Bivariate and multivariate analyses were made of the data. RESULTS 481 patients (72.6% men, age 40.6±10.1 years) were enrolled. 64.3% of the patients reported insomnia during active substance use. The most common type of insomnia was fragmented nocturnal sleep (49.9%). The factors significantly associated with insomnia were polysubstance drug use, medical comorbidities (most notably, infectious diseases), anxiety disorder, personality disorder (particularly cluster C), a greater number of previous admissions for detoxication, and early age at onset of substance use. CONCLUSIONS Insomnia is highly prevalent in patients with addiction during active use of the substance. Fragmented nocturnal sleep was the most common type of insomnia. Patients with addiction and comorbid anxiety disorder, medical comorbidity, and early onset of dependence were more likely to experience insomnia.
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Affiliation(s)
- Lara Grau-López
- Sección de Adicciones y Patología Dual, Vall d’Hebron. Hospital Universitario Vall Hebron. Universitat Autònoma de Barcelona. Agencia de Salud Pública de Barcelona Departamento de Psiquiatría, Hospital Universitario Vall d’Hebron. Universitat Autònoma de Barcelona. CIBERSAM
| | - Constanza Daigre
- Sección de Adicciones y Patología Dual, Vall d’Hebron. Hospital Universitario Vall Hebron. Universitat Autònoma de Barcelona. Agencia de Salud Pública de Barcelona Departamento de Psiquiatría, Hospital Universitario Vall d’Hebron. Universitat Autònoma de Barcelona. CIBERSAM
| | - Laia Grau-López
- Departamento de Neurociencias, Hospital Universitario Germans Trias i Pujol
| | - Laia Rodriguez-Cintas
- Sección de Adicciones y Patología Dual, Vall d’Hebron. Hospital Universitario Vall Hebron. Universitat Autònoma de Barcelona. Agencia de Salud Pública de Barcelona Departamento de Psiquiatría, Hospital Universitario Vall d’Hebron. Universitat Autònoma de Barcelona. CIBERSAM
| | - Ángel Egido
- Sección de Adicciones y Patología Dual, Vall d’Hebron. Hospital Universitario Vall Hebron. Universitat Autònoma de Barcelona. Agencia de Salud Pública de Barcelona
| | - Miquel Casas
- Sección de Adicciones y Patología Dual, Vall d’Hebron. Hospital Universitario Vall Hebron. Universitat Autònoma de Barcelona. Agencia de Salud Pública de Barcelona Departamento de Psiquiatría, Hospital Universitario Vall d’Hebron. Universitat Autònoma de Barcelona. CIBERSAM
| | - Carlos Roncero
- Sección de Adicciones y Patología Dual, Vall d’Hebron. Hospital Universitario Vall Hebron. Universitat Autònoma de Barcelona. Agencia de Salud Pública de Barcelona Departamento de Psiquiatría, Hospital Universitario Vall d’Hebron. Universitat Autònoma de Barcelona. CIBERSAM
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Ros-Cucurull E, Daigre C, Grau-Lopez L, Barral C, Abad A, Ortiz M, Martinez-Arias R, Garcia E, Cardona C, Jacas C, Casas M, Roncero C. Related factors with substance use in old adults. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.1076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroSubstance use disorder is a growing phenomenon among the elderly. It is undervalued, misidentified, underdiagnosed and poorly treated.AimStudy prevalence, characteristics and risk factors associated with drug use among the elderly.MethodA 6-month prospective study of substance use in elderly patients (65+) who attended the addiction and dual diagnosis unit, Vall d’Hebron University Hospital.ResultsFifty-nine patients evaluated, mean age 70.04 years, 60% men. A total of 49.1% are married, 35.8% divorced and 53.8% live with a partner and/or children. A total of 67.3% have basic studies and 78.8% are pensioners. A total of 82.7% have no criminal record.Medical comorbidity presents in 90.4% of the sample, psychiatric and addictive family background in 42.3% and 37.3%. A total of 67.3% have comorbid Axis I (mainly affective disorders) and 25% Axis II (cluster B most). A total of 7.7% attempted suicide at least once.The main substance is alcohol (76.9%), followed by prescription drugs (19.3%). A total of 28.8% are multi-drug users. A total of 67.3% have used tobacco in their life and 63.5% are currently dependent. The average age of onset for a disorder for any substance consumption is 28.19, being lower for alcohol and illegal substances and higher for prescription drugs.A total of 61.5% have gone through treatment before but only 32.7% has been admitted because of addiction. The adherence rate is 90.4% and the relapse rate 8.3% at first month and 13% at 6 months.ConclusionsOld adults present differences compared to overall drug user population: prevalence by gender is almost equal, lower Axis II, less multi-drug consumption and both dropout and relapse rate are drastically lower.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Roncero C, Rodriguez-Cintas L, Daigre C, Alvarez J, Barral C, Abad A, Nina V, Herrero-Fernandez A, Grau-López L, Barral C, Pérez-Pazos J, Ros-Cucurrull E, Rodriguez-Martos L, Casas M. Risk factors for accidents among cocaine-dependent patient seeking treatment. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
IntroductionAccident rate have a high social cost. Cocaine consumption increases the risk of traffic crashes (Monras, 2011; Fierro, 2011). However, there is not extensively studies in addicts.ObjectiveCompare and analyze the history of accidents and risk behaviors while driving in cocaine dependent patients (DC) and of other substances (OtherD).MethodsOne hundred and eighty-two patients seeking treatment since January 2014 to September 2015. Sociodemographic and accident-related variables were collected, also administered the MDBQ. Descriptive analysis and bivariate analysis using Chi-square test for categorical variables and Student t test was performed for quantitative.ResultsOf women, 30.3%, and 69.7% men, mean age 43.67 years (SD = 13). 65.6% currently driving or above. 45.2% DC vs. 54.8 DOther (35.6% alcohol, cannabis 8.3%, 5.8% opioid and 5.1% other drugs).Comparing accident rate on the DC is a tendency to have suffered more accidents (χ2: 2.62 P=.072). Patients addicted to cocaine referred further potentially dangerous activities both under the influence of consumption (65.9% vs. 33.3%) and abstinence (41.7% vs. 12%).As for the results of MDBQ, it has been detected that cocaine addicts show more errors and traffic violations. No differences in the lapses identified by patients of different groups.ConclusionPatients with cocaine dependence have more accidents, reduced risk perception and recognize more mistakes and traffic violations. Cocaine implies a high risk of road accidents and exposure to high-risk situations compared to the use of other substances.References not available.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Díaz-Morán S, Palma-Álvarez RF, Grau-López L, Daigre C, Barral C, Ros-Cucurull E, Casas M, Roncero C. Self-perceived quality of life in cocaine dependents with or without dual diagnosis. sm 2015. [DOI: 10.17711/sm.0185-3325.2015.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Abstract
Introduction. Although impairment in the quality of life is common among cocaine dependent patients, there are but a few researches about the interaction between addiction and quality of life.
Objective. To study different parameters of quality of life in a sample of cocaine dependent patients and to compare patients with or without dual diagnosis. Also, to promote the importance of subjectivity in the quality of life and to propose to incorporate patients’ self-perception into their treatment.
Method. Three diagnostic interviews were administered (SCID-I, SCID-II and PRISM) and a quality of life questionnaire (SF-36) was applied between two different patient groups: Group I (cocaine dependent patients) and Group II (cocaine dependent patients with other mental disorder).
Results. Patients diagnosed with dual disorders (Group II) showed broader differences in perceptions of their quality of life in comparison with their clinicians. The perception of quality of life may vary depending on the presence and severity of mental disorders, and these different appreciations may explain the difficulties that clinicians face in understanding their patients’ expectations and motivations.
Discussion and conclusion. A systematic evaluation of the subjective quality of life should be included in the management of cocaine dependent patients in order to more accurately understand the patients’ perception of their treatment, motivations and expectations.
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Bachiller D, Grau-López L, Barral C, Daigre C, Alberich C, Rodríguez-Cintas L, Valero S, Casas M, Roncero C. Grupo motivacional en unidad hospitalaria desintoxicación, su influencia en mantenimiento de la abstinencia y retención al tratamiento tras alta. Adicciones 2015. [DOI: 10.20882/adicciones.696] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Bachiller D, Grau-López L, Barral C, Daigre C, Alberich C, Rodríguez-Cintas L, Valero S, Casas M, Roncero C. Motivational interviewing group at inpatient detoxification, its influence in maintaining abstinence and treatment retention after discharge. Adicciones 2015; 27:109-118. [PMID: 26132300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The relapse rate after discharge from inpatient detoxification is high. The objective of this pilot study is to assess the sociodemographic, clinical and therapeutic factors associated with maintaining abstinence in patients who participated in a brief motivational interviewing group during admission for detoxification. A total of 46 patients, diagnosed substance dependent according to DSM -IV, and admitted to the Hospital Detoxification Unit, participated in a brief motivational interviewing group. Sociodemographic, clinical, motivation to change (University of Rhode Island Change Assessment, URICA) and satisfaction with the treatment group (Treatment Perceptions Questionnaire, CPT) data were collected. Abstinence and treatment retention two months after discharge were assessed by weekly telephone calls. A survival analysis was performed. Being male, having more cognitions of the maintenance stage of change at discharge, being satisfied with group therapy and therapist during hospitalization are associated with longer abstinence after discharge. The brief motivational interviewing group approach with patients admitted for detoxification is related to greater likelihood of maintaining abstinence and subsequent treatment retention.
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Affiliation(s)
- Diana Bachiller
- CAS Vall d´Hebron. Servicio de Psiquiatría. Hospital Universitario Vall d'Hebron. - ASPB. Barcelona, España. Servicio de Psiquiatría. Hospital Universitario Vall d'Hebron, Barcelona, España - CIBERSAM. Departamento de Psiquiatría. Universidad Autónoma de Barcelona, España..
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Daigre C, Roncero C, Rodríguez-Cintas L, Ortega L, Lligoña A, Fuentes S, Pérez-Pazos J, Martínez-Luna N, Casas M. Adult ADHD screening in alcohol-dependent patients using the Wender-Utah Rating Scale and the adult ADHD Self-Report Scale. J Atten Disord 2015; 19:328-34. [PMID: 24743975 DOI: 10.1177/1087054714529819] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim was to analyze the psychometric properties of two screening instruments, Wender-Utah Rating Scale (WURS) that evaluates childhood ADHD and Adult ADHD Self-Report Scales (ASRS) that assesses symptoms in adulthood, in alcohol-dependent patients. METHOD A total of 355 outpatients were included. Conners' adult ADHD diagnostic interview results were used as a gold standard in childhood and adulthood ADHD. RESULTS The WURS with a 41 cutoff had a sensitivity of 79.6% and a specificity of 60.3%. The ASRS with a 14 cutoff had a sensitivity of 86.7% and specificity of 66.1%. Analyzing both rating scales in combination, it was observed that patients with positive ASRS and WURS presented a sensitivity of 92.3%. Patients with positive ASRS, but negative WURS, presented a specificity of 73.6%. CONCLUSION WURS and ASRS are useful tools in the diagnosis of adult ADHD in alcohol-dependent patients; with the use of both instruments, the psychometric properties are substantially improved.
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Affiliation(s)
- Constanza Daigre
- Hospital Universitari Vall d'Hebron, Barcelona, Spain Vall d'Hebron Hospital and Barcelona Public Health Agency (ASPB), Barcelona, Spain Universitat Autònoma de Barcelona, Spain
| | - Carlos Roncero
- Hospital Universitari Vall d'Hebron, Barcelona, Spain Vall d'Hebron Hospital and Barcelona Public Health Agency (ASPB), Barcelona, Spain Universitat Autònoma de Barcelona, Spain Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Laia Rodríguez-Cintas
- Hospital Universitari Vall d'Hebron, Barcelona, Spain Vall d'Hebron Hospital and Barcelona Public Health Agency (ASPB), Barcelona, Spain Fundació Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Lluisa Ortega
- Institut Clinic de Neurociències (ICN), Barcelona, Spain Unitat de Conductes Adictives, Barcelona, Spain
| | - Anna Lligoña
- Institut Clinic de Neurociències (ICN), Barcelona, Spain Unitat de Conductes Adictives, Barcelona, Spain
| | - Sonia Fuentes
- Vall d'Hebron Hospital and Barcelona Public Health Agency (ASPB), Barcelona, Spain
| | - Jesús Pérez-Pazos
- Hospital Universitari Vall d'Hebron, Barcelona, Spain Vall d'Hebron Hospital and Barcelona Public Health Agency (ASPB), Barcelona, Spain
| | - Nieves Martínez-Luna
- Hospital Universitari Vall d'Hebron, Barcelona, Spain Vall d'Hebron Hospital and Barcelona Public Health Agency (ASPB), Barcelona, Spain
| | - Miguel Casas
- Hospital Universitari Vall d'Hebron, Barcelona, Spain Universitat Autònoma de Barcelona, Spain Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
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Roncero C, De Miguel A, Fumero A, Grau-López L, Martin R, Rodriguez-Cintas L, Bethencourt J, Bachiller D, Tarifa N, Beneria A, Casas M, Martínez C, Daigre C. Anxiety and Depression in Drug-dependents Patients with Cluster C Personality Disorders. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)32061-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Corominas-Roso M, Roncero C, Daigre C, Grau-Lopez L, Ros-Cucurull E, Rodríguez-Cintas L, Sanchez-Mora C, Lopez MV, Ribases M, Casas M. Changes in brain-derived neurotrophic factor (BDNF) during abstinence could be associated with relapse in cocaine-dependent patients. Psychiatry Res 2015; 225:309-14. [PMID: 25592977 DOI: 10.1016/j.psychres.2014.12.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 12/06/2014] [Accepted: 12/14/2014] [Indexed: 01/08/2023]
Abstract
Brain-derived neurotrophic factor (BDNF) is involved in cocaine craving in humans and drug seeking in rodents. Based on this, the aim of this study was to explore the possible role of serum BDNF in cocaine relapse in abstinent addicts. Forty cocaine dependent subjects (DSM-IV criteria) were included in an inpatient 2 weeks abstinence program. Organic and psychiatric co-morbidities were excluded. Two serum samples were collected for each subject at baseline and at after 14 abstinence days. After discharge, all cocaine addicts underwent a 22 weeks follow-up, after which they were classified into early relapsers (ER) (resumed during the first 14 days after discharge,) or late relapsers (LR) (resumed beyond 14 days after discharge). The only clinical differences between groups were the number of consumption days during the last month before detoxification. Serum BDNF levels increased significantly across the 12 days of abstinence in the LR group (p=0.02), whereas in the ER group BDNF remained unchanged. In the ER group, the change of serum BDNF during abstinence negatively correlated with the improvement in depressive symptoms (p=0.02). These results suggest that BDNF has a role in relapse to cocaine consumption in abstinent addicts, although the underlying neurobiological mechanisms remain to be clarified.
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Affiliation(s)
- Margarida Corominas-Roso
- Department of Psychiatry, Vall d׳Hebron University Hospital (CIBERSAM), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.
| | - Carlos Roncero
- Department of Psychiatry, Vall d׳Hebron University Hospital (CIBERSAM), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Constanza Daigre
- Department of Psychiatry, Vall d׳Hebron University Hospital (CIBERSAM), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Lara Grau-Lopez
- Department of Psychiatry, Vall d׳Hebron University Hospital (CIBERSAM), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Elena Ros-Cucurull
- Department of Psychiatry, Vall d׳Hebron University Hospital (CIBERSAM), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Laia Rodríguez-Cintas
- Department of Psychiatry, Vall d׳Hebron University Hospital (CIBERSAM), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Cristina Sanchez-Mora
- Department of Psychiatry, Vall d׳Hebron University Hospital (CIBERSAM), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Madrid, Spain; Psychiatric Genetics Unit, Vall d׳Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Maria Victoria Lopez
- Department of Psychiatry, Vall d׳Hebron University Hospital (CIBERSAM), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Marta Ribases
- Department of Psychiatry, Vall d׳Hebron University Hospital (CIBERSAM), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Madrid, Spain; Psychiatric Genetics Unit, Vall d׳Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Miguel Casas
- Department of Psychiatry, Vall d׳Hebron University Hospital (CIBERSAM), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
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