RESUMEN

AIMS: To investigate whether inclusion of self-help groups into the hospital treatment programme improves the prognosis of alcohol dependence through the treatment period; and to examine therapeutic adherence and prognosis during continuing care. METHOD: Patients attending the treatment programme at the 'Hospital 12 de Octubre' were randomized into two groups. In Group A (n = 123), patients received the usual treatment included in our programme, whereas in Group B (n = 126), patients also attended self-help groups. Patients were assessed with psychological scales at baseline, at the end of the treatment period and after completing the continuing care visits. Data were collected over a total of 6 years. RESULTS: During the treatment period, patients in Group B accumulated more months of abstinence and dropped out less. During continuing care, patients in Group B accumulated more months of abstinence and therapeutic adherence was higher. Variables that were associated with these results during the continuing care period were: visits to the GP, scores on anxiety, impulsivity and meaning of life scales, and belonging to the group that attended the alcoholic associations. CONCLUSIONS: Mutual help groups incorporated into a public treatment programme appear to improve outcomes during treatment and on into continuing care. This experience supports cooperation between public health centres and alcoholic associations in treating alcoholism. SHORT SUMMARY: Including alcoholic associations into the public treatment programme for alcoholism of the 'Hospital 12 de Octubre' in Madrid was shown to be associated with better outcomes in terms of months of accumulated abstinence, dropout rates and therapeutic adherence, during the treatment and continuing care periods.

Asunto(s)

RESUMEN

Introducción. La inmigración es un fenómeno con una repercusión importante en la salud mental. Los objetivos de este estudio fueron describir características asistenciales, evolución temporal, diferencias entre inmigrantes, y diagnósticos asociados a las nuevas consultas psiquiátricas ambulatorias en inmigrantes en Segovia. Material y métodos. Se realizó un estudio descriptivo de nuevas consultas con variables sociodemográficas, asistenciales y clínicas procedentes del registro informático del Centro de Salud Mental «Antonio Machado» para 2001-2002 y 2008 comparando población inmigrante y española. Se calcularon incidencias poblacionales por sexo, regiones geográficas y países de origen. Mediante análisis multivariante de regresión logística se estudió la asociación entre los diagnósticos CIE-10 y la inmigración. Resultados. Los inmigrantes tuvieron una edad media 10 años menor que los españoles. La tasa de incidencia de nuevas consultas fue siempre más alta en mujeres, disminuyó en inmigrantes y aumentó en españoles entre 2001 y 2008. Centro-suramericanos y europeos orientales presentaron las mayores y menores tasas de nuevas consultas, respectivamente. Bulgaria, Marruecos, Rumania y Polonia fueron los países más representativos en 2008, con bajas incidencias. Los trastornos neuróticos y somatomorfos fueron los más frecuentes con independencia del origen del paciente. Los trastornos psicóticos y de personalidad se asociaron positivamente a la inmigración en el análisis multivariante. Conclusiones. La atención de inmigrantes en salud mental en Segovia se caracteriza por una edad joven, una menor incidencia de nuevas consultas con diferencias importantes entre regiones, y una asociación diagnóstica con procesos más graves, lo que puede reflejar fenómenos de infrautilización e infradiagnóstico(AU)

Introduction. Immigration is a phenomenon with a significant impact on mental health. The aims of this study were to describe health care characteristics, time trends, differences among inmigrant, and diagnoses associated with new outpatient psychiatric consultation inmigrants in Segovia. Methods. A descriptive study of new consultations with sociodemographic, health care and clinical variables computerized records from the «Antonio Machado» Mental Health Center for 2001-2002 and 2008 comparing immigrant and Spanish population. Population incidences were calculated by sex, geographic regions and countries of origin. By multivariate logistic regression assessed the relationship between ICD-10 diagnoses and immigration. Results. Immigrants had an average age 10 years younger than the Spanish. Incidence rate of new consultation was always higher in women, decreased in immigrants and increased in the Spanish between 2001 and 2008. South Central Americans and Eastern Europeans had the highest and lowest rates of new visits, respectively. Bulgaria, Morocco, Romania and Poland were the countries most representative in 2008, with low incidences. Neurotic and somatoform disorders were the most common regardless of the origin of the patient. Psychotic and personality disorders were positively associated with immigration in the multivariate analysis. Conclusions. The attention of mental health immigrants in Segovia is characterized by young age, lower incidence of new queries with important variations between regions, and diagnostic association with processes more severe, which may reflect underdiagnosis and underutilization phenomena(AU)

Asunto(s)

RESUMEN

INTRODUCTION: Immigration is a phenomenon with a significant impact on mental health. The aims of this study were to describe health care characteristics, time trends, differences among Immigrant, and diagnoses associated with new outpatient psychiatric consultation Immigrant in Segovia. METHODS: A descriptive study of new consultations with sociodemographic, health care and clinical variables computerized records from the «Antonio Machado¼ Mental Health Center for 2001-2002 and 2008 comparing immigrant and Spanish population. Population incidences were calculated by sex, geographic regions and countries of origin. By multivariate logistic regression assessed the relationship between ICD-10 diagnoses and immigration. RESULTS: Immigrants had an average age 10 years younger than the Spanish. Incidence rate of new consultation was always higher in women, decreased in immigrants and increased in the Spanish between 2001 and 2008. South Central Americans and Eastern Europeans had the highest and lowest rates of new visits, respectively. Bulgaria, Morocco, Romania and Poland were the countries most representative in 2008, with low incidences. Neurotic and somatoform disorders were the most common regardless of the origin of the patient. Psychotic and personality disorders were positively associated with immigration in the multivariate analysis. CONCLUSIONS: The attention of mental health immigrants in Segovia is characterized by young age, lower incidence of new queries with important variations between regions, and diagnostic association with processes more severe, which may reflect underdiagnosis and underutilization phenomena.

Asunto(s)

RESUMEN

No disponible

Asunto(s)

RESUMEN

BACKGROUND/RATIONALE: Impulsivity has been associated with alcohol dependence, but impulsivity in alcohol-dependent subjects with a Cluster-B personality disorder (PD) has not been well characterized. Using a variety of laboratory measures of impulsivity, we assessed whether alcohol-dependent patients (ADP) with borderline personality disorder (BPD) exhibited the same pattern of behavioral impulsivity than ADP with antisocial personality disorder (AntPD). Also, differences between ADP without PDs and healthy controls were assessed. METHODS: A cross-sectional patient survey with a community comparison group. Diagnoses were made using the Structured Interview for DSM-IV. Sustained attention and rapid-response impulsivity were assessed using the continuous performance test. Inhibitory control was measured by the stop-signal task. Ability to delay reward task was assessed using differential reinforcement for low-rate responding (DRLR). A final sample of 247 males with alcohol-dependence recruited from 2 alcoholism treatment centers was compared with a matched nonsubstance-abusing comparison group (n = 96). RESULTS: Alcohol-dependent patients with BPD made more omission errors than ADP with AntPD, but individuals with AntPD exhibited the poorest efficiency in DRLR. ADPs with a Cluster-B PD displayed more impairment across all behavioral measures than ADP without PD and than controls. In contrast, with respect to controls ADP without a Cluster-B PD showed more impairment only in DRLR. CONCLUSIONS: Our findings support the suggestion of 2 paradigms in alcohol dependence. The first, based on inability to delay gratification, might be a vulnerability marker for alcohol dependence. The second was related to inhibitory control and might be specific for AntPD and BPDs.

Asunto(s)