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Psychiatric severity and treatment response in a comprehensive methadone maintenance treatment program.
No full textEfficacy of Medications Approved for the Treatment of Alcohol Dependence and Alcohol Withdrawal Syndrome in Female Patients: A Descriptive Review
No full textThe aim of this study was to evaluate whether the number of women recruited for studies to establish the efficacy of medications approved for treatment of alcohol dependence (AD) and of alcohol withdrawal syndrome (AWS) is sufficient to reveal possible gender differences in the response to these medications and in suggesting the use of different doses in female patients. Our results show that the rates of women recruited for studies evaluating the efficacy of disulfiram (1%), benzodiazepines (3%), and anticonvulsants (13%) were too low to establish possible gender differences. The rates of women recruited for studies evaluating the efficacy of acamprosate (22%), naltrexone (23%), and nalmefene (30%) were higher and allowed evaluation of data obtained for female patients. Women receive medications for treatment of AD and/or AWS for which efficacy has been demonstrated in studies in which men were more largely represented
Substance use and quality of life over 12 months among buprenorphine maintenance-treated and methadone maintenance-treated heroin-addicted patients
No full textEffect of psychiatric severity on the outcome of methadone maintenance treatment
No full textWhile psychiatric comorbidity has been shown to produce a negative impact on the outcome of opioid use disorders, longitudinal studies carried out in the context of methadone maintenance treatment programs (MMTP) to evaluate outcomes strictly linked to methadone efficacy have not demonstrated a similar negative influence. To verify whether results obtained considering psychopathology in terms of formal psychiatric diagnoses were replicated when assessing psychopathology in terms of global psychiatric severity, a retrospective cohort study was designed. 259 patients commencing methadone maintenance treatment were divided into two groups on the basis of SCL-90 severity score and compared for retention in treatment, toxicological urine test results and psychological/psychiatric status throughout a one year period of observation. The results of the study suggest that patients in MMTP with high psychiatric severity are not characterized by a lower retention in treatment or higher substance use than those with low psychiatric severity. Moreover, during treatment high severe psychiatric patient status appears to improve significantly for all psychological/psychiatric dimensions explored by SCL-90. These results are consistent with those obtained in previous studies on the efficacy of MMTP, comprehensive of psychiatric care, irrespective of the severity of psychopathology exhibited by patients at the beginning of treatment
Towards a unitary perspective between Post-Traumatic Stress Disorder and Substance Use Disorder. Heroin use disorder as case study.
No full textIs the bipolar spectrum the psychopathological substrate of suicidality in heroin addicts?
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Use of street methadone in italian heroin addicts presenting for opioid agonist treatment
No full textExploring the Depressive Syndrome of Heroin Use Disorder patients. Relationships between Worthlessness/Being Trapped, Deficit Reward and Post-Withdrawal Syndromes
No full textBackground. The Worthlessness/Being Trapped (W/BT) is a stable depressive psychopathological dimension and part of the psychopathology specific to Heroin Use Disorder (HUD) found by us in fulfilling our ten-year research plan. Methods. Selecting patients from the Pisa-Database we compared W/BT items in 504 depressed patients without a history of substance use (NSU-MD), 125 depressed HUD patients (W/BT-HUD) and 847 non-depressed ones (HUD). We analysed differences in the frequency and severity of W/BT items, at the multivariate level (multinomial logistic regression and discriminant analysis). Results: W/BT-HUD patients differed from HUD ones in having a higher frequency of the female gender and in displaying the following syndrome: 'feeling blue', 'worried about sloppiness or carelessness', 'feeling lonely', 'feeling everything is an effort', 'never feeling close to another person'. Conversely, 'worrying too much about things' was more frequent in non-depressed HUD patients. W/BT-HUD subjects differed from MD ones without substance use ones in showing more symptoms characterized by 'worried about sloppiness or carelessness', 'your feelings being easily hurt', 'feeling lonely even when you are with people', 'feelings of guilt', 'your mind going blank', 'trouble concentrating', 'unwanted thoughts, words, or ideas that won't leave your mind', 'feeling blocked in getting things done'. By contrast, NSU-MD patients were made recognisable by the following characteristics: 'feeling lonely', 'feeling of worthlessness', 'feeling tense of keyed up', 'worrying too much about things', 'loss of sexual interest or pleasure', 'blaming yourself for things', and 'feelings of being trapped or caught'. MD and W/BT-HUD patients were differentiated by the higher severity in them of the traits: 'worrying about sloppiness or carelessness', 'feeling lonely', 'difficulty in making decisions', and 'feelings of guilt'. W/BT-HUD patients feel less trapped, more dysphoric, and less sexually disinterested than depressed, drug-free patients. Conclusions: The depressive syndrome found in W/BT-HUD patients can differentiate W/BT-HUD patients from drug-free, depressed ones, so further adding weight to the hypothesis of its specificity to HUD. The lack of the usual depressive symptoms in W/BT-HUD patients can lead to an incorrect estimation of depression in HUD patients when those symptoms are not reported
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