摘要:

The authors sought to determine whether early assessment of newly abstinent alcoholic/addicted patients can help identify those patients at risk for later anxiety disorder (AD). Diagnoses of AD were made after 3 weeks. From a sample of 642 consecutive outpatients and inpatients, 294 were assessed as having only substance‐related disorders (SRD) and 36 had both an SRD and an AD. The remaining 312 patients had other comorbid conditions with SRD. After 3 weeks of abstinence (Time 2), a psychiatrist made a current DSM‐III‐R diagnosis based on all available data. This study revealed that the following characteristics at Time 1 (intake) were associated with diagnosis of an AD at Time 2: female sex, history of panic attacks or suicidal ideation, previous outpatient care, previous antidepressant or neuroleptic medication, and higher scores on most of the self‐rated scales and all of the psychiatric

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1995.tb00440.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Diagnosis of comorbid psychiatric disorders in substance abuse patients is complicated by the fact that many abused substances induce transient symptoms that mimic independent disorders. The authors applied criteria designed to distinguish “independent” comorbid disorders from those that may have been “substance‐induced,” to determine the impact on rates of diagnosis and on concurrent and predictive validity. Of those with symptoms sufficient to meet criteria for comorbid depression (12%) or anxiety diagnoses (26%), fewer than one‐fourth were considered to have independent disorders, and these patients did not constitute a category of greater severity. Current guidelines for defining independent diagnoses were not supported. Further work is required to identify criteria that will provide a clinically meaningful

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1995.tb00441.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The authors studied the influences of multiple and specific drug use on needle‐sharing in a cohort of male injection drug users (IDUs). Subjects were 294 male IDUs, 41% of whom were HIV‐positive. Subjects were given individually administered interviews using questionnaires. The authors used logistic regression analysis and found a relationship between more frequent cocaine and heroin use and needle‐sharing behavior. As the total number of drugs used increased, the risk of needle‐sharing with both familiar people and strangers increased. This effect of the number of drugs used was modified by family protective factors. Heroin and cocaine use, and multiple‐drug use, were identified as risk factors for needle‐sharing behavior amon

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1995.tb00442.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The authors performed a retrospective analysis of medical records and death certificates for 99 consecutive patients who had an alcohol‐related medical problem that prompted a petition for court‐ordered alcohol treatment. Ninety percent voluntarily participated in initial evaluation. Two appeared to be alcoholfree 6 months after treatment. The number of alcohol‐related hospital visits was not different before and after intervention. Death certificates revealed that at least 12% of the patients had died within 2 years of the petition. Court‐ordered alcohol treatment for patients for serious medical sequelae of alcoholism does not appear to be suc

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1995.tb00443.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The authors compared catecholamine concentrations measured on 2‐hour urine collections of recently hospitalized cocaine abusers (CAs; n = 17) with those of detoxified alcoholic patients (APs; n = 10) and staff normal‐control subjects (NCs; n = 13). CAs had been abstinent for 6–8 days; APs had been abstinent for 9–53 days. Compared with NCs, the recently abstinent CAs had a decrease in the dopamine metabolite, 3,4‐dihydroxyphenylacetic acid (DOPAC), and a decrease in Sum dopamine/Sum norepinephrine (the molar sum of dopamine and its metabolites/the molar sum of norepinephrine and its metabolites). The dopamine metabolite, 3‐methoxytyramine (3‐MT) was increased. The detoxified APs had increases in the norepinephrine metabolites normetanephrine and 3‐methoxy‐4‐hydroxyphenylglycol in addition to elevated 3‐MT. Sum dopamine/Sum norepinephrine was decreased in APs compared with NCs. The authors discuss differences in light of other findings related to recent abstinence after coca

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1995.tb00444.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The authors used individual and group‐level variables within age and sex to predict drinking patterns over time among individuals. Eight longitudinal samples of persons age 21–30 years were analyzed separately. Drinking patterns at final measurement were regressed simultaneously on both individual and group‐level variables. The first model tested for marital and drinking status along with group‐level mean change in drinking. The second model tested for marital and drinking status along with group‐percent married. The third model tested for marital and drinking status along with percent newly married. Using meta‐analysis, the authors demonstrated significant and homogeneous effects for the three models tested and for grouplevel mean differences in the

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1995.tb00445.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The authors identified 1,836 male veterans who were seeking treatment for various medical disorders at a walk‐in (triage) clinic and screened these patients for the presence of alcohol problems by administering a brief interview and the CAGE questionnaire. Patients who screened positive for alcohol problems and who had little or no prior treatment for these problems were then interviewed using a structured psychiatric interview to establish the presence of alcohol dependence and co‐occurring psychiatric disorders. The rate of alcohol dependence and co‐occurring disorders was substantial, and the pattern was consistent with studies of veteran patients surveyed in other clinical set

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1995.tb00446.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The authors compared physicians admitted for psychiatric or substance use disorders on demographic, clinical, and gender variables. The records of 92 physicians admitted to a private psychiatric hospital over a 6‐year period were reviewed to compare characteristics of those admitted for psychiatric disorders with those admitted for substance abuse problems, and to compare female and male physician‐patients. Of physicians who presented for substance abuse treatment, 58% had an additional Axis I psychiatric disorder, whereas 22% of physicians admitted for psychiatric treatment had substance use disorder; 59% of this sample of physicians received a personality disorder diagnosis. “Dual disorder” is a common clinical presentation in physicians. Male (n= 76) and female (n= 16) physicians were similar on compared variables except that they showed differing patterns of substance abuse. Compared with previous studies of treated physicians, the percentage of female physicians and the overall percentage of physicians with substance abuse diagnoses are inc

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1995.tb00447.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The authors examined treatment patterns for two groups of dually diagnosed psychiatric inpatients, those with a) co‐occurring, but independent mental and substance use disorders (IMD + PSUD); and b) substance‐induced organic mental disorders (PSUD‐OMD). Assessments included the Addiction Severity Index for perceived service needs, discharge records for recommended treatments, and the Quality of Life Interview for follow‐up treatment utilization. As expected, the groups differed on treatment patterns. Both received fewer services than needed during the 1‐year follow‐up. In particular, the IMD + PSUD patients utilized few substance abuse services and the PSUD‐OMD utilized few psychia

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1995.tb00448.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

To determine the prevalence of “hazardous drinkers,” 1,064 Mexican inpatients (ages 18–59 years) from nine general hospitals answered an Alcohol Use Disorders Identification Test (AUDIT) questionnaire, previously validated by the World Health Organization. When subjects scored positive, a clinical screening procedure and a serum gamma‐glutamyl‐trans‐peptidase (GGT) test were carried out. An AUDIT score ≥ 8 (hazardous drinking) was found in 23.4% of the sample (43.2% in men vs. 3.6% in women). Patients' answers were positively correlated in 83.3% with those of their next of kin. The clinical screening procedure and serum GGT levels correlated with AUDIT scores ≥ 8 in 55%. Data support the recommendation of routine screening for alcohol consumption in a general hospital population and the usefulness of the AUDIT application as a screening instrument for early phases of hazardous

ISSN:1055-0496    

DOI:10.1111/j.1521-0391.1995.tb00449.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY