Substance-Use Disorders in DSM-III-R

1987 ◽  
Vol 151 (6) ◽  
pp. 834-843 ◽  
Author(s):  
Thomas R. Kosten ◽  
Bruce J. Rounsaville ◽  
Thomas F. Babor ◽  
Robert L. Spitzer ◽  
Janet B. W. Williams

Using the newly revised DSM-III-R criteria for substance-abuse diagnoses, we examined dependence syndrome elements among 83 psychiatric patients. The sample included 14 with no history of substance abuse. The remainder abused alcohol (52), sedatives (31), hallucinogens (12), stimulants (33), cannabis (44), cocaine (52), or opiates (47). Many patients (52) had abused more than one type of drug. Ten items assessing the proposed dependence symptoms for each type of drug were factor-analysed. The dependence syndrome items formed a single factor for opiates, cocaine, and alcohol, but not for other drugs. When the items were combined into cumulative scales, they had excellent internal consistency. Furthermore, they formed good approximations of unidimensional Guttman scales on which higher scores indicated greater syndrome severity. The items associated with higher scores differed across drugs, with opiates having the most striking differences from the other substances. Medical-psychosocial consequences were relatively independent of the dependence syndrome, although alcohol and cocaine dependence had some association with other problem areas. These findings support the utility of a common dependence syndrome concept for drugs of abuse as well as alcohol, and provide empirical support for the current revision of the DSM-III diagnostic criteria.

1994 ◽  
Vol 18 (4) ◽  
pp. 209-211
Author(s):  
Robin McGilp ◽  
Brian Kidd ◽  
Cameron Stark ◽  
Tom Henderson

A retrospective investigation of case-notes compared 54 incidents of informal psychiatric in-patients being detained in hospital on an emergency basis with 66 incidents of discharge against medical advice (AMA). The characteristics of the two groups were compared. Detained patients were more likely to have been detained previously, to be suffering from a psychotic illness, and to have threats of violence or self-harm mentioned in their case-notes. AMA patients were more likely to have a history of substance abuse but were no more likely than the detained group to have been discharged AMA in the past. The results suggest that psychiatrists in this hospital are using current legislation on detention appropriately.


1993 ◽  
Vol 17 (12) ◽  
pp. 748-751 ◽  
Author(s):  
Tom Walmsley

Charles Darwin (1809–1882) enjoys an uneasy position in the history of psychiatry. In general terms, he showed a personal interest in the plight of the mentally ill and an astute empathy for psychiatric patients. On the other hand, he has generated derogatory views of insanity, especially through the writings of English social philosophers like Herbert Spencer and Samuel Butler, the Italian School of “criminal anthropology” and French alienists including Victor Magnan and Benedict Morel.


2014 ◽  
Vol 8 ◽  
pp. SART.S13254 ◽  
Author(s):  
Epaenetus A. Awuzu ◽  
Emmanuel Kaye ◽  
Patrick Vudriko

Various studies have reported that abuse of cannabis is a risk factor for psychosis. The aims of this study were to determine the prevalence of delta 9-tetrahydrocanabinol (Δ 9 -THC), a major metabolite of cannabis, in psychiatric patients in Uganda, and to assess the diagnostic capacity of two referral mental health hospitals to screen patients for exposure to cannabis in Uganda. Socio-demographic characteristics of the patients were collected through questionnaires and review of medical records. Urine samples were collected from 100 patients and analyzed using Δ 9 -THC immunochromatographic kit (Standard Diagnostics®, South Korea). Seventeen percent of the patients tested positive for Δ 9 -THC residues in their urine. There was strong association ( p < 0.05) between history of previous abuse of cannabis and presence of Δ 9 -THC residues in the urine. Alcohol, cocaine, heroin, pethidine, tobacco, khat and kuber were the other substances abused in various combinations. Both referral hospitals lacked laboratory diagnostic kits for detection of cannabis in psychiatric patients. In conclusion, previous abuse of cannabis is associated with occurrence of the residues in psychiatric patients, yet referral mental health facilities in Uganda do not have the appropriate diagnostic kits for detection of cannabis residues as a basis for evidence-based psychotherapy.


2011 ◽  
Vol 185 (1-2) ◽  
pp. 280-285 ◽  
Author(s):  
Björn Hofvander ◽  
Ola Ståhlberg ◽  
Agneta Nydén ◽  
Elisabet Wentz ◽  
Alessio degl'Innocenti ◽  
...  

1999 ◽  
Vol 79 (2) ◽  
pp. 163-181 ◽  
Author(s):  
THOMAS E. HANLON ◽  
DAVID N. NURCO ◽  
RICHARD W. BATEMAN ◽  
KEVIN E. O'GRADY

This study examined the 1-year parole outcomes of 504 newly released parolees with a history of heroin and/or cocaine abuse who were randomly assigned, within gender, race, and primary drug of choice, to one of the following three interventions: a program of “social support,” combining weekly urine monitoring with counseling, case management, and case advocacy; weekly urine monitoring alone; and routine parole. Results indicated a superiority of social support treatment over the other two comparison conditions, particularly urine monitoring alone. Supplemental analyses indicated a general superiority of substance abuse treatment over no treatment, whether or not treatment was delivered within the social support framework.


2020 ◽  
Vol 1 (1) ◽  
pp. 01-05
Author(s):  
Saeed Shafti

Introduction: while some of scholars believe that combining adult and adolescent suicidal behavior findings can result in misleading conclusions, some of researchers have stated that suicidal behavior may be a different phenomenon in adolescents than in adults. Hence, in the present study, the clinical profile of suicidal behavior among adult and child & adolescent psychiatric inpatients, has been compared with each other, to assess their resemblances or variances, in a non-western, local patient population. Methods: five acute academic wards, which have been specified for admission of first episode adult psychiatric patients, and five acute non-academic wards, which have been specified for admission of recurrent episode adult psychiatric patients, had been selected for current study. In addition, child & adolescent section of Razi psychiatric hospital was the field of appraisal concerning its specific age-group. All inpatients with suicidal behavior (successful suicide and attempted suicide, in total), during the last five years (2013-2018), had been included in the present investigation. Besides, clinical diagnosis was based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Intra-group and between-group analyses had been performed by ‘comparison of proportions’. Statistical significance as well, had been defined as p value ≤0.05. Results: As said by results, during a sixty months period, sixty-three suicidal behaviors among adult patients, including one successful suicide and sixty-two suicide attempts, and fourteen suicide attempts among child & adolescent patients, without any successful one, had been recorded by the security board of the hospital. While among adults and child & adolescent patients no significant gender-based difference was evident, with respect to suicidal conduct, among adults, the most frequent mental illness was bipolar I disorder, which was significantly more prevalent in comparison with other mental disorders. The other disorders included schizophrenia, major depressive disorder, personality disorders (borderline & antisocial), substance abuse disorders, and adjustment disorder. Among child & adolescent subjects, the most frequent mental illness was, once more, bipolar I disorder, followed by conduct disorder, and substance abuse disorder. Moreover, no significant difference was evident between the first admission and recurrent admission cases in adults or child & adolescents. While self-mutilation, self poisoning and hanging were the preferred methods of suicide among both groups, self-mutilation was significantly more prevalent than the other ways. Conclusion: While the annual incidence of suicidal behavior in inpatient adults and child & adolescents was comparable, bipolar disorder was the most frequent serious mental illness among suicidal subjects of both groups. Moreover, self-mutilation was the preferred method of suicide in adult and child & adolescent psychiatric inpatients.


1968 ◽  
Vol 114 (516) ◽  
pp. 1425-1428 ◽  
Author(s):  
W. M. Millar ◽  
R. E. Mackie ◽  
J. D. Gomersall

In recent years British psychiatric training has received interested scrutiny from the other side of the Atlantic, and there has been appreciation of the broad based approach in dealing with the larger community of psychiatric patients, which as Keir (1964) has pointed out is beginning to occupy the attention of our American colleagues. It has been noted by Cameron (1965), Lesse (1966) and others that there are disadvantages in the predominant approach in American training—which focuses on dynamics, inference and formulation—in that this has produced a neglect of clinical observation and accurate description, giving little knowledge of syndromes or the natural history of psychiatric conditions.


1973 ◽  
Vol 4 (1) ◽  
pp. 73-84 ◽  
Author(s):  
John R. Kinsinger

Female subjects who had threatened but never attempted suicide were compared by means of psychological tests to other suicidal and nonsuicidal criterion groups. These included a group who had attempted suicide and nonsuicidal control groups of psychiatric patients and normals. Individuals who had attempted suicide and nonsuicidal psychiatric patients were found to be very similar. However, individuals who had a history of suicide threats but no attempts were discriminated from all other criterion groups by means of the MMP1 and Leary Interpersonal Check List. It is hypothesized that persons who threaten suicide but do not carry out these threats may be characterologically different from the other criterion groups.


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