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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] [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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2
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Fiorentini A, Cantù F, Crisanti C, Cereda G, Oldani L, Brambilla P. Substance-Induced Psychoses: An Updated Literature Review. Front Psychiatry 2021; 12:694863. [PMID: 35002789 PMCID: PMC8732862 DOI: 10.3389/fpsyt.2021.694863] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 11/17/2021] [Indexed: 01/22/2023] Open
Abstract
Background: On the current psychopharmacological panorama, the variety of substances able to provoke an episode of acute psychosis is rapidly increasing. Such psychotic episodes are classified according to the major category of symptoms: positive, negative, or cognitive psychotic episodes. On one hand, the abuse of methamphetamines, cannabis, and cocaine plays a big role in increasing the incidence of episodes resembling a psychotic disorder. On the other hand, the progress in terms of pharmacodynamics knowledge has led to the synthesis of new drugs, such as cannabinoids and cathinone's, which have rapidly entered into the common pool of abusers' habits. Regarding these newly synthesized substances of abuse, further clinical studies are needed to understand their psychogenic properties. The topic of this review is complicated due to the frequent abuse of psychotomimetic drugs by patients affected by psychotic disorders, a fact that makes it extremely difficult to distinguish between an induced psychosis and a re-exacerbation of a previously diagnosed disorder. Methods: The present narrative review summarizes results from clinical studies, thus investigating the psychotogenic properties of abused substances and the psychotic symptoms they can give rise to. It also discusses the association between substance abuse and psychosis, especially with regards to the differential diagnosis between a primary vs. a substance-induced psychotic disorder. Findings: Our findings support the theory that psychosis due to substance abuse is commonly observed in clinical practice. The propensity to develop psychosis seems to be a function of the severity of use and addiction. Of note, from a phenomenological point of view, it is possible to identify some elements that may help clinicians involved in differential diagnoses between primary and substance-induced psychoses. There remains a striking paucity of information on the outcomes, treatments, and best practices of substance-induced psychotic episodes.
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Affiliation(s)
- Alessio Fiorentini
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Filippo Cantù
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Camilla Crisanti
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Guido Cereda
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Lucio Oldani
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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3
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Sami M, Quattrone D, Ferraro L, Tripoli G, Cascia EL, Gayer-Anderson C, Selten JP, Arango C, Bernardo M, Tarricone I, Tortelli A, Gatto G, Del Peschio S, Del-Ben CM, Rutten BP, Jones PB, van Os J, de Haan L, Morgan C, Lewis C, Bhattacharyya S, Freeman TP, Lynskey M, Murray RM, Forti MD. Association of extent of cannabis use and psychotic like intoxication experiences in a multi-national sample of first episode psychosis patients and controls. Psychol Med 2021; 51:2074-2082. [PMID: 32340643 DOI: 10.1017/s0033291720000847] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND First episode psychosis (FEP) patients who use cannabis experience more frequent psychotic and euphoric intoxication experiences compared to controls. It is not clear whether this is consequent to patients being more vulnerable to the effects of cannabis use or to their heavier pattern of use. We aimed to determine whether extent of use predicted psychotic-like and euphoric intoxication experiences in patients and controls and whether this differs between groups. METHODS We analysed data on patients who had ever used cannabis (n = 655) and controls who had ever used cannabis (n = 654) across 15 sites from six countries in the EU-GEI study (2010-2015). We used multiple regression to model predictors of cannabis-induced experiences and to determine if there was an interaction between caseness and extent of use. RESULTS Caseness, frequency of cannabis use and money spent on cannabis predicted psychotic-like and euphoric experiences (p ⩽ 0.001). For psychotic-like experiences (PEs) there was a significant interaction for caseness × frequency of use (p < 0.001) and caseness × money spent on cannabis (p = 0.001) such that FEP patients had increased experiences at increased levels of use compared to controls. There was no significant interaction for euphoric experiences (p > 0.5). CONCLUSIONS FEP patients are particularly sensitive to increased psychotic-like, but not euphoric experiences, at higher levels of cannabis use compared to controls. This suggests a specific psychotomimetic response in FEP patients related to heavy cannabis use. Clinicians should enquire regarding cannabis related PEs and advise that lower levels of cannabis use are associated with less frequent PEs.
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Affiliation(s)
- Musa Sami
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
- Institute of Mental Health, Jubilee Campus, University of Nottingham, Nottingham, UK
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Laura Ferraro
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 9012 9Palermo, Italy
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Erika La Cascia
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 9012 9Palermo, Italy
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Health Care, Sandifortdreef 19, 2333 ZZLeiden, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MDMaastricht, The Netherlands
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM (CIBERSAM), C/Doctor Esquerdo 46, 28007Madrid, Spain
| | - Miguel Bernardo
- Department of Medicine, Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Ilaria Tarricone
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126Bologna, Italy
| | - Andrea Tortelli
- Etablissement Public de Santé Maison Blanche, Paris, 75020, France
| | - Giusy Gatto
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126Bologna, Italy
| | - Simona Del Peschio
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126Bologna, Italy
| | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MDMaastricht, The Netherlands
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Forvie Site, Robinson Way, Cambridge, CB2 0SZ, UK
- CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, CB21 5EF, UK
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MDMaastricht, The Netherlands
- Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZAmsterdam, The Netherlands
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Cathryn Lewis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Tom P Freeman
- Department of Psychology, Addiciton and Mental Health Group (AIM), University of Bath, BA2 7AY, UK
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 4 Windsor Walk, LondonSE5 8BB, UK
| | - Michael Lynskey
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 4 Windsor Walk, LondonSE5 8BB, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
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4
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Karsinti E, Labaeye M, Piani K, Fortias M, Brousse G, Bloch V, Romo L, Vorspan F. Network analysis of psychotic manifestations among cocaine users. J Psychiatr Res 2020; 130:300-305. [PMID: 32866679 DOI: 10.1016/j.jpsychires.2020.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 07/17/2020] [Accepted: 08/14/2020] [Indexed: 10/23/2022]
Abstract
Psychotic experiences can be described along a continuum ranging from no psychotic experience at all, to clinical psychotic disorder. Any individual in the general population may encounter psychotic experiences under certain circumstances. Transient Cocaine Induced Psychotic Symptoms (TCIPS) are a well described model of such circumstances. Therefore, our aim was to use a network analysis to get a better knowledge on the architecture of previously described risk factors and how they contributed to two different measures of psychosis (psychosis proneness and transient cocaine induced psychotic symptoms) This study is a secondary analysis conducted among 180 cocaine users in addiction care centers in Paris and Paris suburb, who were evaluated with the PDI (Peters Delusion Inventory) and the SAPS-CIP (Scale for the Assessment of Psychotic Symptoms - Cocaine Induced Psychosis). Schizophrenia diagnosis was extracted from medical record. Relevant variables significantly associated with SAPS-CIP total score or PDI at the first step were included in a network analysis to better figurate their respective associations. The network centrality measures showed that the product preferentially used (crack vs cocaine) was related to TCIPS, psychosis proneness and, to a lesser extent, schizophrenia. Secondly, in this model TCIPS is a mediator between intensive cocaine use and psychosis proneness. Thirdly, this study refines the previous knowledge on heavy cannabis use being a risk factor for TCIPS. The observed link is not direct but mediated by psychosis proneness.
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Affiliation(s)
- Emily Karsinti
- Assistance Publique Hôpitaux de Paris, Hôpital Fernand Widal, Département Universitaire de Psychiatrie et de Médecine Addictologique, 200 rue du Faubourg Saint Denis, Paris, France; INSERM UMR-S 1144, 75006 Paris, Université Paris Descartes, 75006 Paris, Sorbonne Paris Cité, Université Paris Diderot, 75013, Paris, France; Laboratoire CliPsyD, EA4430, Université Paris Nanterre, 200 Avenue de la République, 92001, Cedex Nanterre, France.
| | - Marion Labaeye
- Assistance Publique Hôpitaux de Paris, Hôpital Fernand Widal, Département Universitaire de Psychiatrie et de Médecine Addictologique, 200 rue du Faubourg Saint Denis, Paris, France
| | - Kristel Piani
- Assistance Publique Hôpitaux de Paris, Hôpital Fernand Widal, Département Universitaire de Psychiatrie et de Médecine Addictologique, 200 rue du Faubourg Saint Denis, Paris, France
| | - Maeva Fortias
- Assistance Publique Hôpitaux de Paris, Hôpital Fernand Widal, Département Universitaire de Psychiatrie et de Médecine Addictologique, 200 rue du Faubourg Saint Denis, Paris, France; INSERM UMR-S 1144, 75006 Paris, Université Paris Descartes, 75006 Paris, Sorbonne Paris Cité, Université Paris Diderot, 75013, Paris, France
| | - Georges Brousse
- EA NPsy-Sydo, Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Vanessa Bloch
- Assistance Publique Hôpitaux de Paris, Hôpital Fernand Widal, Département Universitaire de Psychiatrie et de Médecine Addictologique, 200 rue du Faubourg Saint Denis, Paris, France; INSERM UMR-S 1144, 75006 Paris, Université Paris Descartes, 75006 Paris, Sorbonne Paris Cité, Université Paris Diderot, 75013, Paris, France
| | - Lucia Romo
- Laboratoire CliPsyD, EA4430, Université Paris Nanterre, 200 Avenue de la République, 92001, Cedex Nanterre, France; GHU Paris Psychiatrie et Neurosciences, CMME, INSERM UMR1266, France
| | - Florence Vorspan
- Assistance Publique Hôpitaux de Paris, Hôpital Fernand Widal, Département Universitaire de Psychiatrie et de Médecine Addictologique, 200 rue du Faubourg Saint Denis, Paris, France; INSERM UMR-S 1144, 75006 Paris, Université Paris Descartes, 75006 Paris, Sorbonne Paris Cité, Université Paris Diderot, 75013, Paris, France; FHU NOR-SUD, Paris, France
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5
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de Azevedo Cardoso T, Jansen K, Mondin TC, Pedrotti Moreira F, de Lima Bach S, da Silva RA, de Mattos Souza LD, Balanzá-Martínez V, Frey BN, Kapczinski F. Lifetime cocaine use is a potential predictor for conversion from major depressive disorder to bipolar disorder: A prospective study. Psychiatry Clin Neurosci 2020; 74:418-423. [PMID: 32306467 DOI: 10.1111/pcn.13012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 04/03/2020] [Accepted: 04/15/2020] [Indexed: 12/24/2022]
Abstract
AIM We aimed to identify whether lifetime cocaine use is a risk factor for conversion from major depressive disorder (MDD) to bipolar disorder (BD) in an outpatient sample of adults. METHODS This prospective cohort study included 585 subjects aged 18 to 60 years who had been diagnosed with MDD as assessed by the Mini International Neuropsychiatric Interview (MINI-Plus) at baseline (2012-2015). Subjects were reassessed a mean of 3 years later (2017-2018) for potential conversion to BD as assessed by the MINI-Plus. Lifetime cocaine use was assessed using the Alcohol, Smoking, and Substance Involvement Screening Test. RESULTS In the second wave, we had 117 (20%) losses, and 468 patients were reassessed. The rate of conversion from MDD to BD in 3 years was 12.4% (n = 58). A logistic regression analysis showed that the risk for conversion from MDD to BD was 3.41-fold higher (95% confidence interval, 1.11-10.43) in subjects who reported lifetime cocaine use at baseline as compared to individuals who did not report lifetime cocaine use at baseline, after adjusting for demographic and clinical confounders. CONCLUSION These findings showed that lifetime cocaine use is a potential predictor of conversion to BD in an MDD cohort. Further studies are needed to assess the possible underlying mechanisms linking exposure to cocaine with BD conversion.
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Affiliation(s)
- Taiane de Azevedo Cardoso
- Mood Disorders Program, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Canada.,Department of Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Karen Jansen
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Thaise C Mondin
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil.,Federal University of Pelotas, Pelotas, Brazil
| | - Fernanda Pedrotti Moreira
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Suelen de Lima Bach
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Ricardo A da Silva
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Luciano D de Mattos Souza
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | | | - Benicio N Frey
- Mood Disorders Program, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Canada
| | - Flavio Kapczinski
- Mood Disorders Program, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Canada.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
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6
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Su MF, Liu MX, Li JQ, Lappin JM, Li SX, Wu P, Liu ZM, Shi J, Lu L, Bao Y. Epidemiological Characteristics and Risk Factors of Methamphetamine-Associated Psychotic Symptoms. Front Psychiatry 2018; 9:489. [PMID: 30369888 PMCID: PMC6194209 DOI: 10.3389/fpsyt.2018.00489] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 09/19/2018] [Indexed: 11/29/2022] Open
Abstract
Objective: To explore the epidemiological characteristics and the risk factors for methamphetamine (MA)-associated psychotic symptoms among MA users in China. Methods: A cross-sectional study was conducted between April, 2012 and October, 2015 among individuals for whom MA was the principal drug of use in a Compulsory Drug Detoxification Center in Beijing, Guangdong Province. Demographic, drug use and psychological characteristics were examined using a specifically-designed questionnaire, the Positive and Negative Syndrome Scale, Barratt Impulsive Scale, Hamilton Anxiety Scale and Beck Depression Inventory. Logistic regression was performed to explore the risk factors for MA-associated psychotic symptoms. Results: A total of 1685 participants were included. Participants were predominantly aged 30 or above, unemployed, and were unmarried Han Chinese men, with limited education. The duration of MA use was more than 3 months in 72.3%. 47.8% reported that the dose of MA use was ≥ 0.2 g per occasion of use. 11.5% had used two or more synthetic drugs. The prevalence of MA-associated psychotic symptoms was 17.0% among MA users during periods of abstinence. Multiple logistic regression analyses showed that a higher dose (≥0.2 g per time), a longer duration of MA use (>3 months) a history of heroin use and a history of tobacco use were associated with MA-associated psychotic symptoms, with adjusted odds ratios (ORs) of 1.96 (95% confidence interval [CI]: 1.40-2.76), 1.98 (95% CI: 1.33-2.96) and 2.45 (95% CI: 1.67-3.60), 1.78 (95% CI: 1.27-2.49) respectively. MA-associated psychotic symptoms were less common among married/cohabitating than unmarried (OR = 0.56; 95% CI: 0.39-0.81), and unemployed than employed (OR = 0.65; 95% CI: 0.47-0.92) individuals. MA users with anxiety and depression symptoms had significantly greater risk for MA-associated psychotic symptoms by 9.70 (6.92-13.59) and 1.90 (1.36-2.65) times respectively. Individuals with higher impulsivity were more likely to have MA-associated psychotic symptoms than those with lower (OR = 2.19; CI:1.50-3.20). Conclusion: MA-associated psychotic symptoms occurred frequently among MA users in China. The efforts that facilitate drug users' attempts to reduce MA use, abstain from poly-drug use, and control associated psychiatric symptoms and impulsivity should be supported because of their potential contribution to MA-associated psychotic symptoms in this population.
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Affiliation(s)
- Meng-Fan Su
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.,School of Public Health, Peking University, Beijing, China
| | - Mo-Xuan Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.,School of Public Health, Peking University, Beijing, China
| | - Jin-Qiao Li
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.,School of Public Health, Peking University, Beijing, China
| | - Julia M Lappin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Su-Xia Li
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Ping Wu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.,School of Public Health, Peking University, Beijing, China
| | - Zhi-Min Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Lin Lu
- Key Laboratory of Mental Health and Peking University Sixth Hospital, National Clinical Research Center for Mental Disorders, Institute of Mental Health, Peking University, Beijing, China.,Peking-Tsinghua Center for Life Sciences and IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Yanping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
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7
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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] [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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8
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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] [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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9
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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] [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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Roncero C, Daigre C, Grau-López L, Barral C, Pérez-Pazos J, Martínez-Luna N, Casas M. An international perspective and review of cocaine-induced psychosis: a call to action. Subst Abus 2015; 35:321-7. [PMID: 24927026 DOI: 10.1080/08897077.2014.933726] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Cocaine use can induce transient psychotic symptoms that include suspiciousness, paranoia, hallucinations, and other cocaine-related behaviors. In this commentary, the authors provide an international perspective while reviewing the recent advances in epidemiology, clinical features, and risk factors related to cocaine-induced psychosis exhibited by patients with cocaine use disorders. In some settings, the occurrence of cocaine-induced psychosis has been shown to be as high as 86.5%. Many risk factors have been linked with cocaine-induced psychosis, including the quantity of cocaine consumed, lifetime amount of cocaine use, onset of cocaine dependence, years of use, routes of administration, other substance use disorder comorbidity, weight, gender, comorbidity with other medical and mental health disorders, genetics, and pharmacological interactions. Research has shown that the evaluation of cocaine-induced psychosis in patients with cocaine use is clinically relevant, especially in those patients who consume high amounts of cocaine, have a cannabis dependence history, have antisocial personality disorder, use administration routes other than intranasal, or exhibit attention-deficit/hyperactivity disorder (ADHD) comorbidity. Currently, the literature lacks information regarding the evolution of cocaine dependence or cocaine-dependent patients' risk for developing schizophrenia or other psychotic disorders. Furthermore, clinicians still do not have an evidence-based pharmacological approach to management of cocaine dependence available to them. Additional research is also needed regarding risk factors such as neurobiological markers and personality traits. Finally, we recommend the development of an integrative model including all of the risk factors and protective factors for cocaine-induced psychosis.
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Affiliation(s)
- Carlos Roncero
- a Outpatient Drug Clinic (CAS), Vall Hebron Psychiatry Department , University Hospital Vall d'Hebron-Barcelona Public Health Agency (ASPB) , Barcelona , Spain
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11
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Psychopathology in Substance Use Disorder Patients with and without Substance-Induced Psychosis. JOURNAL OF ADDICTION 2015; 2015:843762. [PMID: 26417473 PMCID: PMC4568375 DOI: 10.1155/2015/843762] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 08/23/2015] [Indexed: 12/23/2022]
Abstract
Background. Substance-induced psychotic disorder (SIPD) is a diagnosis constructed to distinguish substance-induced psychotic states from primary psychotic disorders. A number of studies have compared SIPD persons with primary psychotic patients, but there is little data on what differentiates substance use disorder (SUD) individuals with and without SIPD. Here, we compared psychopathology, sociodemographic variables, and substance use characteristics between SUD patients with and without SIPD. Methods. A retrospective chart review was conducted on newly admitted patients at a rehabilitation centre between 2007 and 2012. Results. Of the 379 patients included in the study, 5% were diagnosed with SIPD (n = 19) and 95% were diagnosed with SUDs without SIPD (n = 360). More SIPD patients reported using cannabis and psychostimulants, and fewer SIPD patients reported using alcohol than SUDs patients without SIPD. SIPD patients scored higher on the “schizophrenia nuclear symptoms” dimension of the SCL-90R psychoticism scale and exhibited more ClusterB personality traits than SUD patients without SIPD. Discussion. These data are consistent with previous studies suggesting that psychopathology, substance type, and sociodemographic variables play important role in the development of SIPD. More importantly, the results highlight the need for paying greater attention to the types of self-reported psychotic symptoms during the assessment of psychotomimetic effects associated with psychoactive substances.
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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] [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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13
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Roncero C, Daigre C, Barral C, Ros-Cucurull E, Grau-López L, Rodríguez-Cintas L, Tarifa N, Casas M, Valero S. Neuroticism associated with cocaine-induced psychosis in cocaine-dependent patients: a cross-sectional observational study. PLoS One 2014; 9:e106111. [PMID: 25254365 PMCID: PMC4177812 DOI: 10.1371/journal.pone.0106111] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 07/24/2014] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Cocaine consumption can induce transient psychotic symptoms, which has been correlated with more severe addiction and aggressive behavior. However, little is known about the nature of the relationship between personality traits and psychotic symptoms in cocaine-dependent patients. This study examined the relationship between neuroticism and cocaine-induced psychosis. METHODS A total of 231 cocaine-dependent patients seeking treatment were recruited to the study. Personality was evaluated by the Zuckerman-Kuhlman Personality Questionnaire. Cocaine-induced psychosis questionnaire, SCID-I, and SCID-II were used to evaluate comorbidity and clinical characteristics. Data analysis was performed in three steps: descriptive, bivariate, and multivariate analyses. RESULTS Cocaine-induced psychosis was reported in 65.4% of the patients and some personality disorder in 46.8%. Two personality dimensions (Neuroticism-Anxiety and Aggression-Hostility) presented a significant effect on the risk of experiencing psychotic symptoms (t(229) = 2.69, p = 0.008; t(229) = 2.06, p = 0.004), and patients with psychotic symptoms showed higher scores in both variables. On the multivariate analysis, only Neuroticism remained as a significant personality factor independently associated with psychotic symptoms (Wald = 7.44, p<0.05, OR = 1.08, CI 95% 1.02-1.16) after controlling for age, gender and number of consumption substances. CONCLUSIONS An association between high neuroticism scores and presence of psychotic symptoms induced by cocaine has been found, independently of other consumption variables. Personality dimensions should be evaluated in cocaine-dependent patients in order to detect high scores of neuroticism and warn patients about the risk of developing cocaine-induced psychotic symptoms.
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Affiliation(s)
- Carlos Roncero
- Outpatient Drug Clinic, 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
- Outpatient Drug Clinic, 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
| | - Carmen Barral
- Outpatient Drug Clinic, 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
- Outpatient Drug Clinic, 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
| | - Lara Grau-López
- Outpatient Drug Clinic, 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
| | - Laia Rodríguez-Cintas
- Outpatient Drug Clinic, 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
| | - Nuria Tarifa
- Outpatient Drug Clinic, Department of Psychiatry, Vall d’Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain
| | - Miguel Casas
- Department of Psychiatry, Vall d’Hebron University Hospital, CIBERSAM, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sergi Valero
- Department of Psychiatry, Vall d’Hebron University Hospital, CIBERSAM, Barcelona, Spain
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Roncero C, Vega P, Martínez-Raga J, Barral C, Basurte-Villamor I, Rodríguez-Cintas L, Mesías B, Grau-López L, Casas M, Szerman N. Professionals' perceptions about healthcare resources for co-occuring disorders in Spain. Int J Ment Health Syst 2014; 8:35. [PMID: 25206926 PMCID: PMC4158069 DOI: 10.1186/1752-4458-8-35] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Accepted: 08/17/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since provision of integrated services for patients with dual pathology or dual disorders (coexistence of an addictive disorder and other psychiatric disorders) constitutes an important challenge, this study compared the perceptions of health-care professionals with the existing, current state of specific resources for patients with dual pathology in Spain. METHODS Epidemiological, observational, cross-sectional, multicenter study with a large, representative sample of health care professionals attending patients with dual pathology in treatment resources throughout Spain. Participants completed a specifically designed ad-hoc on-line questionnaire about their perceptions on the existence of available resources and treatment needs for patients with dual pathology. To compare professionals' perceptions with existing available resources, the same on-line questionnaire was also completed by commissioners and managers responsible for national and regional healthcare plans on drug abuse. RESULTS A total of 659 professionals, mostly psychologists (43.40%) or psychiatrists (32.93%) agreed to participate in the study. The highest degree of concordance between the perceptions of professional and the actual situation was found regarding the existence of mental health and addiction networks (either separately or unified) (74.48%), followed by specific workshops (73.08%) and sub-acute inpatient units (67.38%), specific hospitalization units (66.26%), detoxification units (63.15%) and outpatient programs (60.73%). We detected a lower degree of agreement regarding specific occupational rehabilitation centers (59.34%) day hospitals (58.93%), day centers (57.88%), outpatient intermediate resources (48.87%), psychiatric acute admission units (46.54%) and therapeutic communities (43.77%). In addition, on average, health care professionals underestimated the number of resources present in their respective communities. CONCLUSIONS Relevant differences exist between the perceptions of professional and existing available resources for dual pathology patients in Spain, thus supporting the need of additional efforts and strategies to establish a registry and clearly inform about available resources for patients with dual diagnosis.
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Affiliation(s)
- Carlos Roncero
- Sociedad Española de Patología Dual. Londres, 17 28028 Madrid, EU Spain ; Department of Psychiatry, Outpatient Drug Clinic, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM. Passeig de la Vall d'Hebrón, 119-129, 08035 Barcelona, EU Spain ; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Plaça Cívica, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, EU Spain
| | - Pablo Vega
- Sociedad Española de Patología Dual. Londres, 17 28028 Madrid, EU Spain ; Instituto de Adicciones, C/ Juan Esplandiú, 11-13, 28007 Madrid, EU Spain
| | - Jose Martínez-Raga
- Sociedad Española de Patología Dual. Londres, 17 28028 Madrid, EU Spain ; Unidad Docente de Psiquiatría y Psicología Medica, Hospital Universitario Dr. Peset y Universidad de Valencia, & Universidad CEU-UCH, 46017 Valencia, EU Spain
| | - Carmen Barral
- Sociedad Española de Patología Dual. Londres, 17 28028 Madrid, EU Spain ; Department of Psychiatry, Outpatient Drug Clinic, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM. Passeig de la Vall d'Hebrón, 119-129, 08035 Barcelona, EU Spain ; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Plaça Cívica, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, EU Spain
| | - Ignacio Basurte-Villamor
- Sociedad Española de Patología Dual. Londres, 17 28028 Madrid, EU Spain ; Department of Psychiatry, Hospital Universitario Gregorio Marañón, Calle Doctor Esquerdo, 46, 28007, EU Madrid, Spain
| | - Laia Rodríguez-Cintas
- Sociedad Española de Patología Dual. Londres, 17 28028 Madrid, EU Spain ; Department of Psychiatry, Outpatient Drug Clinic, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM. Passeig de la Vall d'Hebrón, 119-129, 08035 Barcelona, EU Spain
| | - Beatriz Mesías
- Sociedad Española de Patología Dual. Londres, 17 28028 Madrid, EU Spain ; Instituto de Adicciones, C/ Juan Esplandiú, 11-13, 28007 Madrid, EU Spain
| | - Lara Grau-López
- Sociedad Española de Patología Dual. Londres, 17 28028 Madrid, EU Spain ; Department of Psychiatry, Outpatient Drug Clinic, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM. Passeig de la Vall d'Hebrón, 119-129, 08035 Barcelona, EU Spain ; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Plaça Cívica, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, EU Spain
| | - Miguel Casas
- Sociedad Española de Patología Dual. Londres, 17 28028 Madrid, EU Spain ; Department of Psychiatry, Outpatient Drug Clinic, Vall d'Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM. Passeig de la Vall d'Hebrón, 119-129, 08035 Barcelona, EU Spain ; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Plaça Cívica, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, EU Spain
| | - Nestor Szerman
- Sociedad Española de Patología Dual. Londres, 17 28028 Madrid, EU Spain ; Department of Psychiatry, Hospital Universitario Gregorio Marañón, Calle Doctor Esquerdo, 46, 28007, EU Madrid, Spain
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Clinical differences between cocaine-induced psychotic disorder and psychotic symptoms in cocaine-dependent patients. Psychiatry Res 2014; 216:398-403. [PMID: 24629712 DOI: 10.1016/j.psychres.2014.01.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 01/13/2014] [Accepted: 01/16/2014] [Indexed: 11/23/2022]
Abstract
The aim of this study is to compare the clinical characteristics of three groups of patients in treatment for cocaine dependence: patients without any psychotic symptoms (NS), patients with transient psychotic symptoms (PS) and patients with cocaine-induced psychotic disorder (CIPD). An observational and retrospective study of 150 cocaine-dependent patients undergoing treatment in the Drug Unit of the Psychiatry Department of University Hospital Vall d׳Hebron in Barcelona (Spain) using these three groups, NS, PS and CIPD, was performed. All patients were evaluated with the PRISM interview. ANOVA, χ2 tests and multivariate multinomial regression analysis were used to perform statistical analyses. Seven patients with a primary psychotic disorder were discharged. Forty-six patients (32.1%) did not report any psychotic symptoms. Ninety-seven patients (67.9%) presented with a history of any cocaine-induced psychotic symptom and were considered as the cocaine-induced psychotic (CIP) group. Among them, 39 (27.3%) were included in the PS group and 58 (40.6%) were included in the CIPD group. A history of imprisonment was found significantly more frequently in the PS group than in the NS group. The distribution of age at onset of dependence, lifetime cannabis abuse or dependence and imprisonment were significantly different between the NS and CIPD groups. We conclude that in cocaine-dependent patients, clinicians should be advised about the risk of development of psychotic symptoms. The presence of some psychotic symptoms could increase the potential risks of disturbing behaviours.
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