ISSN:1022-6877    

DOI:10.1159/000259118

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The current research on diagnostic instruments for the assessment of psychological and behavioral disorders due to psychoactive substance use was reviewed. Recent developments are oriented towards the operational approaches of ICD-10 and DSM-IV covering the most important substance abuse disorders. A special effort was made to develop instruments covering substance-related features which are necessary for the evaluation of prevention and intervention programs.

ISSN:1022-6877    

DOI:10.1159/000259119

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

A review is given of rating scales used in the diagnostic process of alcohol dependency and related disorders. Screening and assessment are seen as the two major goals of this diagnostic process. After some comments on the question of how adequate rating scales should be construed and what kind of criteria should be applied to evaluate their usefulness, alcohol-specific as well as addiction-specific rating scales are discussed, followed by a discussion on the assessment of psychiatric comorbidity in alcohol-dependent patients by use of general measures of depression and anxiety. After some remarks on the philosophy of rating scales, a set of 10 tentative guidelines for their selection and practical application is presented from a pragmatic point of view.

ISSN:1022-6877    

DOI:10.1159/000259120

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Alcohol dependency is one of the major health problems in the western world. Alcohol abuse often causes severe psychic and/or somatic complications. However, many addicts deny any abuse. Thus, the diagnosis of addiction frequently becomes difficult. The clinical value of laboratory findings in supporting the diagnosis of alcohol abuse was investigated. The most promising laboratory parameters indicating recent alcohol abuse are carbohydrate-deficient transferrin, γ-glutamyl-transferase (γ-GT) and mean corpuscular volume of erythrocytes. However, each of these parameters shows a rather different time course. Furthermore, laboratory parameters should facilitate the prediction of the severity of the alcohol withdrawal syndrome. Clinical predictors indicating a higher risk for the development of an alcohol withdrawal syndrome are decreased serum electrolyte concentrations (i.e. chloride and potassium), elevated alanine amino transferase and γ-GT serum leve

ISSN:1022-6877    

DOI:10.1159/000259121

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The treatment programmes for drug addiction operate on a constantly growing population of subjects who have received unsuccessful treatment with various negative consequences, mainly in terms of cost/benefit (due, e.g., to low therapeutic compliance and high rates of early drop-outs). The study we present is the first long-term Italian research project on psychiatric comorbidity carried out using standardised instruments. The sample consisted of 606 opioid addicts divided into two subgroups according to the type of treatment unit they were referred to (36.8% started residential programmes and 63.2% received outpatient treatment). Diagnostic evaluation consisted of a semi-structured interview that outlined the psychopathological profile according to DSM III. Only 323 subjects were recruited and included in the follow-up study (18-36 months after the end of treatment, either completed or interrupted). Our preliminary results tend to confirm international data, both in terms of rates and disorders. An analysis of the correlation between the clusters of personality disorders and the attrition/retention rates in different treatments shows that substance users with a diagnosis in cluster B tend to prefer outpatient treatment. When outcome was considered, we always found that subjects with a diagnosis of personality disorder showed a better response to residential than to outpatient treatment.

ISSN:1022-6877    

DOI:10.1159/000259122

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The patients’ history and conventional laboratory markers are often not sensitive or specific enough to detect chronic alcohol misuse, preoperatively. We investigated whether carbohydrate-deficient transferrin (CDT), determined with a new commercially available kit, is a more sensitive and specific marker to detect chronic alcohol misuse in these patients and we compared it to a CDT research kit and to other conventional laboratory markers. 153 patients with oral, pharyngeal, laryngeal or esophageal carcinomas were evaluated regarding their drinking habits. Chronic alcohol misuse was diagnosed if the daily ethanol intake was ≧60 g and the patient met the DSM-III-R criteria for chronic alcohol abuse or dependence. CDTs and the conventional laboratory markers were sampled on admission of the patients, preoperatively, postoperatively following admission to the ICU and on day 2, 4 and 7 in the ICU. CDT was determined by microanion exchange chromatography and turbidimetry (research kit) and microanion exchange chromatography and radioimmunoassay (commercially available CDT kit), respectively. The investigators were blinded to the CDT results. For all patients admitted to the hospital the sensitivity of the CDT research kit was 74% and for the commercially available CDT kit 77%. Specificity was 100% for the CDT research kit and 97% for the commercially available CDT kit. Both CDT kits were more accurate in detecting chronic alcohol misuse than any other conventional laboratory marker over a range of cutoffs evaluated by receiver operating characteristic curves. Since the CDT values on admission were significantly correlated with the length of ICU stay (CDT research kit: rs = 0.56; p = 0.000; commercially available CDT: rs = 0.39; p = 0.009) and since investigated chronic alcoholics developed more complications in the ICU and had a prolonged ICU stay, it seems reasonable to determine serum CDT, the most sensitive and specific marker of chronic alcohol misuse. Patients with pathologically elevated CDT values should be further evaluated and managed accordin

ISSN:1022-6877    

DOI:10.1159/000259123

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The aim of this study was to examine the state of the vestibular organs of opioid addicts during a period of abstinence. Sixty-two addicts and 50 healthy people were subjected to otoneurological examinations and tests recorded by ENG. 83.9% of the patients showed damage of the vestibular organs, which pointed to lesions of the central part of the examined organs in 79.9%.

ISSN:1022-6877    

DOI:10.1159/000259124

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Since 1985 the Institutes of Forensic Medicine in Germany and in several European cities have cooperated in a multicenter study to monitor HIV-1 prevalence among drug abuse-related deaths. Data for 1993 are presented from Berlin, Frankfurt, Hamburg, Munich, Bilbao, Coimbra, Copenhagen, Edinburgh, Helsinki, Madrid, Oslo, Rome, Stockholm, Vienna and Zurich. Regional differences are obvious. HIV-1 prevalence rates are low in Scandinavia (Helsinki 0%, Oslo 6.1 %, Stockholm 6.4%, Copenhagen 6.6%) and comparatively high in the Mediterranean area (Bilbao 79%, Madrid 53.6%, Coimbra 37.5% and Rome 27.3%). The prevalence rate seems to be stabilizing in German cities at a rate of about 5–15

ISSN:1022-6877    

DOI:10.1159/000259125

出版商:S. Karger AG    

年代:1996

数据来源: Karger

ISSN:1022-6877    

DOI:10.1159/000259126

出版商:S. Karger AG    

年代:1996

数据来源: Karger

ISSN:1022-6877    

DOI:10.1159/000259127

出版商:S. Karger AG    

年代:1996

数据来源: Karger