RESUMEN
Drug testing of patients in a psychiatric outpatient service is an effective way to identify patients who relapse into renewed use of drugs of abuse and in monitoring the effectiveness of ongoing medical and psychological therapy. Most of this testing involves the analysis of urine specimens with immunoassays. Hair testing affords an alternative specimen matrix that is easy to obtain and not readily adulterated and offers the advantage of a wider surveillance window. Hair analysis is technically demanding, and the possibility of false-positives caused by environmental contamination renders it a controversial alternative. Sweat and saliva are potentially useful testing matrices, but their usefulness in clinical practice must await validation by additional clinical and laboratory experience. The correct interpretation of drug test results is predicated on knowing the performance characteristics of the analytical method, route of administration, and pharmacokinetics of the drug. All questionable positive results need confirmation testing to verify true positivity.
Asunto(s)
Instituciones de Atención Ambulatoria , Trastornos Mentales , Detección de Abuso de Sustancias/métodos , Cabello/química , Humanos , Drogas Ilícitas/análisis , Drogas Ilícitas/sangre , Drogas Ilícitas/orina , Sudor/químicaAsunto(s)
Trastornos Relacionados con Sustancias , Consumo de Bebidas Alcohólicas/efectos adversos , Conducta Adictiva , Femenino , Humanos , Masculino , Educación del Paciente como Asunto , Embarazo , Efectos Tardíos de la Exposición Prenatal , Psicosis Inducidas por Sustancias/etiología , Factores de Riesgo , Factores Sexuales , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/terapiaRESUMEN
To evaluate the influence of weight loss on the dexamethasone suppression test (DST), we studied 61 patients with major depressive disorder as defined by the Research Diagnostic Criteria, 59 healthy normal volunteers, and 16 volunteers who lost weight by dieting. Nonsuppression on the DST was not correlated to weight loss in the depressed patients. Of the healthy volunteers, 12.5% converted to nonsuppression status. This conversion rate is not significantly different from nonsuppression rates in the normal population. Implications of these findings are discussed.