P.0312 Treatment of bipolar i disorder and alcohol use disorder dual diagnosis using opioid antagonists

Background:The increasing attention given to dual diagnosis does not correlate with well defined and consensual therapeutic interventions. This issue is particularly evident in the case of comorbid severe personality disorders with clear indication for psychotherapy.Aim:To report a case of comorbid borderline personality disorder and alcohol abuse disorder, underlining the impact of dysfunctional personality traits in a specific dangerous pattern of alcohol abuse. To present and discuss a combined psychotherapeutic and pharmocotherapeutic approaches in a dual diagnosis case.Methods:Case study and review of the literature.Results:A 37 year old woman with a history of alcohol abuse and self-destructive behaviour was referred to an alcohol treatment unit. She had a personal history of childhood parental sexual abuse, alcohol abuse since adolescence and a high risk self-destructive behaviour. A brief psychotherapeutic intervention (weekly 4 months sessions) was started, along with treatment as usual (psychiatric consultation and psychopharmacological treatment). The psychotherapeutic intervention (Person-Centered therapy) focused on her relational difficulties, corresponding to her request - “dealing with unresolved issues in my life”. After the psychotherapeutic intervention, she was able to stop the episodes of alcohol abuse and to reorganize her life at several levels.Discussion:Choosing a psychotherapeutic and pharmacological approach for comorbid addiction disorder and personality disorder cases, presents difficulties due to lack of empirical evidence on dual diagnosis treatment. This case of combined psychotherapeutic and pharmacotherapeutic interventions had acknowledged success, in contrast to several prior treatment attempts focused mainly on the alcohol use disorder.

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Cognitive impairment in dual diagnosis inpatients with schizophrenia and alcohol use disorder

Schizophrenia Research ◽

10.1016/j.schres.2009.05.020 ◽

2009 ◽

Vol 114 (1-3) ◽

pp. 98-104 ◽

Cited By ~ 37

Author(s):

Victoria Manning ◽

Shai Betteridge ◽

Shamil Wanigaratne ◽

David Best ◽

John Strang ◽

...

Keyword(s):

Cognitive Impairment ◽

Alcohol Use ◽

Dual Diagnosis ◽

Alcohol Use Disorder

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DSM-5 alcohol use disorder features among treatment-seeking older adults

SUCHT - Zeitschrift für Wissenschaft und Praxis / Journal of Addiction Research and Practice ◽

10.1024/0939-5911/a000550 ◽

2018 ◽

Vol 64 (4) ◽

pp. 185-196 ◽

Cited By ~ 2

Author(s):

Silke Behrendt ◽

Barbara Braun ◽

Randi Bilberg ◽

Gerhard Bühringer ◽

Michael Bogenschutz ◽

...

Keyword(s):

Older Adults ◽

Alcohol Use ◽

Alcohol Use Disorder ◽

The Elderly ◽

Treatment Seeking ◽

Controlled Clinical Trial ◽

Dsm 5 ◽

Wide Range ◽

And Gender ◽

International Multicenter

Abstract. Background: The number of older adults with alcohol use disorder (AUD) is expected to rise. Adapted treatments for this group are lacking and information on AUD features in treatment seeking older adults is scarce. The international multicenter randomized-controlled clinical trial “ELDERLY-Study” with few exclusion criteria was conducted to investigate two outpatient AUD-treatments for adults aged 60+ with DSM-5 AUD. Aims: To add to 1) basic methodological information on the ELDERLY-Study by providing information on AUD features in ELDERLY-participants taking into account country and gender, and 2) knowledge on AUD features in older adults seeking outpatient treatment. Methods: baseline data from the German and Danish ELDERLY-sites (n=544) were used. AUD diagnoses were obtained with the Mini International Neuropsychiatric Interview, alcohol use information with Form 90. Results: Lost control, desired control, mental/physical problem, and craving were the most prevalent (> 70 %) AUD-symptoms. 54.9 % reported severe DSM-5 AUD (moderate: 28.2 %, mild: 16.9 %). Mean daily alcohol use was 6.3 drinks at 12 grams ethanol each. 93.9 % reported binging. More intense alcohol use was associated with greater AUD-severity and male gender. Country effects showed for alcohol use and AUD-severity. Conclusion: European ELDERLY-participants presented typical dependence symptoms, a wide range of severity, and intense alcohol use. This may underline the clinical significance of AUD in treatment-seeking seniors.

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Persönliche vs. computerbasierte Alkoholintervention für Krankenhauspatienten: Studiendesign

SUCHT - Zeitschrift für Wissenschaft und Praxis / Journal of Addiction Research and Practice ◽

10.1024/0939-5911.a000394 ◽

2015 ◽

Vol 61 (6) ◽

pp. 347-355 ◽

Cited By ~ 2

Author(s):

Jennis Freyer-Adam ◽

Sophie Baumann ◽

Inga Schnuerer ◽

Katja Haberecht ◽

Ulrich John ◽

...

Keyword(s):

Public Health ◽

Alcohol Use ◽

Alcohol Use Disorder ◽

Identification Test ◽

Disorder Identification

Zusammenfassung. Ziel: Persönliche Beratungen können bei stationären Krankenhauspatienten Alkoholkonsum und Mortalität reduzieren. Sie sind jedoch mit hohen Kosten verbunden, wenn aus Public-Health-Erfordernis viele Menschen einer Bevölkerung erreicht werden müssen. Computerbasierte Interventionen stellen eine Alternative dar. Jedoch ist ihre Wirksamkeit im Vergleich zu persönlichen Beratungen und im Allgemeinkrankenhaus noch unklar. Eine quasi-randomisierte Kontrollgruppenstudie „Die Bedeutung der Vermittlungsform für Alkoholinterventionen bei Allgemeinkrankenhauspatienten: Persönlich vs. Computerisiert“ soll dies untersuchen. Design und Methoden werden beschrieben. Methode: Über 18 Monate sind alle 18- bis 64-jährigen Patienten auf Stationen der Universitätsmedizin Greifswald mittels Alcohol Use Disorder Identification Test (AUDIT) zu screenen. Frauen/Männer mit AUDIT-Consumption ≥ 4/5 und AUDIT < 20 werden einer von drei Gruppen zugeordnet: persönliche Intervention (Beratungen zur Konsumreduktion), computerbasierte Intervention (individualisierte Rückmeldebriefe und Broschüren) und Kontrollgruppe. Beide Interventionen erfolgen im Krankenhaus sowie telefonisch bzw. postalisch nach 1 und 3 Monaten. In computergestützten Telefoninterviews nach 6, 12, 18 und 24 Monaten wird Alkoholkonsum erfragt. Schlussfolgerung: Das Studienvorhaben, sofern erfolgreich umgesetzt, ist geeignet die längerfristige Wirksamkeit einer persönlichen und computerbasierten Intervention im Vergleich zu untersuchen.

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