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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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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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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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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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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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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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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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