RESUMEN
The Substitution Treatment National Registry provided from mid 2006 till mid 2009 an exhaustive documentation on all patients being prescribed methadone or buprenorphine in Belgium. This endeavour was possible through cooperation of all community pharmacies and their representative organizations was supported at the time by the former Health federal minister. The Liberal belgian opiate medical substitution process authorizes untill now de facto any doctor to prescribe methadone and pharmacists are supported to dispense it. Results show the regional, provincial and county numbers of professionals and patients prevalence in the population. Nationwide, n = 16974 patients (prevalence for population aged 20-64: 26/10000) have been offered substitution from mid 2008 till mid 2009, n = 3390 pharmacies 164,4% of all pharmacies) and n = 2937 MDs (16,75% of all MDs) have been involved. Subutex or Suboxone have been dispensed to 11,1% of substitution patients with 7,4% receiving only buprenorphine on a yearly basis. Number of substitution patients by MD and prevalence by gender, age group and region are presented. Important variations are observed locally, possibly mirroring heroin addiction due to widespread access to substitution treatment. Younger patients are more prevalent in semi rural or border areas. The exhaustivity of available data enables also to observe patients quitting substitution altogether and a strong difference of maintenance rate is observed favoring methadone over buprenorphine.
Asunto(s)
Tratamiento de Sustitución de Opiáceos , Trastornos Relacionados con Opioides/epidemiología , Adulto , Factores de Edad , Analgésicos Opioides/uso terapéutico , Bélgica/epidemiología , Buprenorfina/uso terapéutico , Femenino , Dependencia de Heroína/epidemiología , Dependencia de Heroína/rehabilitación , Humanos , Masculino , Persona de Mediana Edad , Antagonistas de Narcóticos/uso terapéutico , Dolor/tratamiento farmacológico , Dolor/etiología , Farmacias , Médicos , Prevalencia , Factores Sexuales , Adulto JovenRESUMEN
PURPOSE: Adverse social experiences are frequently invoked to explain the higher rate of psychosis among migrant groups. The aim of the present study was to establish the socio-environmental factors distinguishing migrant psychotic patients from autochthonous patients. SUBJECTS AND METHOD: We conducted a cross-sectional survey involving 341 migrant psychotic patients matched for age and gender with 341 autochthonous psychotic patients. RESULTS: Migrant patients lived more often with their parental family, were less often enrolled with a referral psychiatrist, presented a lower rate of employment, a lower percentage of alcohol misuse and of suicide attempts. DISCUSSION: Our findings add to the growing body of results showing that more attention needs to be focused on socio-environmental variables in psychosis research. However, several limitations have to be taken into account, particularly with regard to selection biases and age of onset of the psychotic illness. CONCLUSION: Our results are compatible with the hypothesis that unemployment is a contributing factor in the risk for psychosis among migrant groups. Migrants' families are an important keystone in the mental health care process of their sick relatives. Our service models need to be adapted with the aim to make the treatment easier for migrant patients.
Asunto(s)
Emigración e Inmigración , Trastornos Psicóticos/etnología , Trastornos Psicóticos/psicología , Medio Social , Adulto , Distribución por Edad , Bélgica/epidemiología , Estudios Transversales , Familia , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Modelos Logísticos , Masculino , Servicios de Salud Mental/estadística & datos numéricos , Marruecos/etnología , Psicología , Trastornos Psicóticos/epidemiología , Derivación y Consulta/estadística & datos numéricos , Factores de Riesgo , Distribución por Sexo , Trastornos Relacionados con Sustancias/epidemiología , Intento de Suicidio/estadística & datos numéricos , Desempleo/estadística & datos numéricosRESUMEN
PURPOSE: Clinically, one of the most consistent clinical findings among migrant patients is an increase in the rate of psychosis. The aim of the present study was to confirm this finding in Belgium by comparing second-generation Moroccan migrant patients with Belgian patients, matched for the variables of age and gender. SUBJECTS AND METHOD: We conducted a cross-sectional survey on 272 patients admitted in a psychiatric emergency unit during the year 1998. We used univariate and multivariate analyses to compare the two subgroups. RESULTS: Multivariate analyses showed that migrant patients lived more often with their parental family and that they presented a higher rate of admission for psychotic disorders and a lower rate of employment. DISCUSSION: Our findings add to the growing body of results showing increased incidence of psychosis among immigrants to European countries, but several factors have to be taken into account, particularly with regard to selection biases and differences in help-seeking behaviour and in family perception of the mental illness. CONCLUSION: Our results are compatible with the hypothesis that unemployment is a contributing factor in the risk for psychosis among migrant groups. Further studies would be needed to better explain some of our results, particularly the role played by the families of migrant patients.
Asunto(s)
Servicios de Urgencia Psiquiátrica , Emigración e Inmigración/estadística & datos numéricos , Trastornos Mentales/etnología , Trastornos Mentales/rehabilitación , Adulto , Distribución por Edad , Bélgica/epidemiología , Estudios Transversales , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Incidencia , Masculino , Trastornos Mentales/psicología , Marruecos/etnología , Factores de Riesgo , Distribución por Sexo , Factores Socioeconómicos , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología , Encuestas y Cuestionarios , Desempleo/psicología , Desempleo/estadística & datos numéricosRESUMEN
The authors report a follow-up study about 73 ex-addicted patients who have been through a 6-months stay in a therapeutic community. The results analysed and discussed demonstrate the importance of the duration of the in-patients period and point out some patient features that are correlated to the current success or failure of treatment.