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Licit and illicit substances abused by alcoholics
s14
Poster A. Clinical
The most pronounced differences were found in subgroup of patients: they had significantly prolonged latencies and smaller amplitudes. In groups of parents and sibs we observed similar tendencies but only for amplitudes. The level of significance was reached only in centro-temporal and in a smaller degree-pruietal zones of left hemisphere. The data are in line with the hypothesis on selective attention deficit in relatives of schizophrenics and can be used for development of neurophysiological markers of predisposition to schizophrenia.
I A-l 9
Comorbidity of the borderline personality disorder and depression
D. Lecic-Tosevski. I I 000 Belgrade,
Instirute for Mentul Health, The School of Medicine, Yugoslavia
Recent studies have shown that borderline personality disorder and depressive disorders are frequently comorbid and that this comorbidity is often resistant to treatment. The relationship between these two disorders as well as the borderline personality disorder itself are still controversial. Some authors (Svrakic et al., 1993) have shown that most symptoms considered typical of the borderline personality characterize other severe personality disorders as well, i.e. borderline level of functioning is a common dimension of dysfunction of personality disorders. The aim of our study was to show or determine the comorbidity between severe personality disorders and chronic depression. One hundred and twenty patients who met DSM-III criteria for dysthymic disorder were included in the study. 61.6% of them were diagnosed as having personality disorder (by Structured Interview for Personality DisordersSIDP, Millon Clinical Multiaxial Inventory-MCMI, Diagnostic Interview for Borderlines-DIB, and Tridimensional Personality QuestionnaireTPQ). The most frequently comorbid with dysthymia were personality disorders from the second and third cluster. The observed depression was intermittent, started early and was primary. The whole sample had a high Harm Avoidance dimension, which is associated with dysfunction of serotonergic activity. There was no statistically significant difference between the subgroups of personality disorders and personality traits regarding this and other TPQ dimensions which is in accordance with the dimensional concept of personality disorders. Our findings suggest that chronic depression with occasional “double depression” is associated with the diagnosis of personality disorders, especially with those organized around impulsiveness which function on the borderline level. We have also found that borderline level of personality functioning is intermittent, except in the “core” borderline personality. The regression to borderline level of functioning is often triggered by depression, major or minor, i.e. the borderline level may be a manifestation of depression (Lecic-Tosevski and Divac-Jovanovic, 1996). Furthermore, symptoms widely regarded as typical for borderline personality characterize other personality disorders as well at the times of depressive decompensation. This may be associated with serotonergic dysfunction shown to interact with motivated behaviour, and is in accordance with the finding of a good response to antidepressant treatment of borderline patients (Kontaxakis et al., 1995). Our findings also indicate that treatment of comorbidity should be integrative, and should include pharmacotberapy.
References Kontaxakis, V.P., Christodoulou, G.N., Markianos, M., Stefanis, C., (1995). Pharmacotherapeutic response of DST-positive borderline patients. Eur Psychiatry, 5, 10, 159-160. Lecic-Tosevski, D., Divac-Jovanovic, M. (1996). Effects of dysthymia on personality assessment. Eur Psychiatry, 11, 244-248. Svrakic, D., Divac-Jovanovic, M., Lecic-Tosevski, D. (1993). Personality disorders: Model for conceptual approach and classification. Part I: general model. Am J Psychotherapy, 47, 4, 558-571.
A 20 ITI.
Licit and illicit substances abused by alcoholics
J. Liappas, E. Peppas, E. Anastasopoulou, V. Pomini, P. Papavasiliou, G.N. Christodoulou. Athens University Medical School, Department of Psychiatry, Eginition Hospital, Greece Objective: The aim of this study is to describe the use of licit and illicit substances in a sample of 127 Greek alcohol abusers.
Material-Method: 127 alcoholics recruited from the specialized drug free outpatient drug addiction clinic of Eginition Hospital, fulfilling the DSM-III-R criteria for alcohol abuse/dependence. The subjects were treated on an inpatient or outpatient basis. The dependent individuals have been interviewed for a total of 13 classes of medical and non-medical substances. Sociodemographic, psychological, behavioural characteristics and the pattern of alcohol consumption were assessed by a structured interview. Depression-like symptomatology was measured by the CES-D scale. Results: The mean age of the sample was 42.1 -f-11.8 years and 86.6% of the users were males. The mean duration of alcohol consumption was 21.42 11.7years and the mean duration of alcohol abuse with coexistent somatic problems was 10.329.5 years. 28.3% of the sample reported cannabis use in their lifetime, 14.2% having used cannabis during the last year and 6.3% during the last month. 7.9% and 7.1% of the subjects reported experience with heroine and cocaine in their lifetime respectively. 8.7% and 12.6% reported experience with hallucinogens and atropinelike drugs in their lifetime. 19.7% and 11.8% of the sample reported use of sedative and hypnotic benzodiazepines in their lifetime respectively: 10.2% and 2.4% had used sedative and hypnotic benzodiazepines during the last year and 7.1% and 1.6% during the last month Also 11.8% and 6.3% of the alcoholics had used analgesics and opiates in their lifetime respectively. Although the mean score in CES-D scale was 28 (71.7% of the sample exceeding the cut-off point for depression; score>l6), only 5.5% used antidepressants in their lifetime and 3.1% during the last month. Conclusion: A close association has been found between alcohol abuse and consumption of other licit and illicit psychoactive substances. The above finding supports the view that alcohol and drug abuse may consist different expressions of a common underlying disturbance.
A-21 El
The relationship between alexithymia and depressionlike symptomatology in drug users
J. Liappas, E. Peppas, A.D. Rabavilas, T. Paparrigopoulos, P. Papavasiliou, G.N. Chrisitodoulou. Athens University Medical School, Department of Psychiatry, Eginition Hospital, Greece Although alexitbymia and depression have been suggested to be distinct and nonoverlapping entities, previous studies have shown a positive correlation between alexithymia and depression. Objective: The aim of the present study is to examine tbe prevalence of alexithymia and depression-like symptomatology and their relationship in a sample of 48 drug abusers. Material-Method: The sample was recruited from the specialized drug free outpatient drug addiction clinic at Eginition Hospital. All subjects fulfilled the DSM-III-R diagnostic criteria for drug abuse/dependence. Sociodemographic, psychosocial, behavioural and drug using characteristics were assessed by a structured interview. Alexithymia was measured with the Schalling-Sifneos scale (revised version). We separated the subjects into two groups: non-alexithymics with a total score 510 and alexithymics with a total score > 10. Depression-like symptomatology was measured by the CES-D scale. Results: The mean age of the sample was 27.426.0 years (range: 17-47 years). 87.5% of the users were males, 87.5% were multiple drug users, 72.9% were mainly heroin users, 66.7% were mainly intravenous users, 58.3% were daily users. The mean duration of drug use was 4.223.6 years (range: l-16 years). The prevalence of alexithymia was 27.1% (N= 13), whereas that of depression-like symptomatology was 77. I % (N=37). There was no significant correlation between alexithymia and depression-like symptomatology. Alexithymic subjects differed significantly from nonalexithymics in regard to their mean score in the CES-D scale (p=.O3). Thus, alexithymics exceeded the cut-off point for depression (score>l6) in a higher percentage (92.3%) than nonalexithymics (71.6%). Conclusion: The above findings seem to support the view that alexithymia is positively linked to depression-like symptomatology. Also that the prevalence of alexithymia (27.1%) in our sample of drug abusers is higher compared to the general population (5.2%-10%) but lower than that reported by previous studies on mixed substance abusers (41.7%50%). In contrast. measures of depression-like symptomatology in our sample were higher than previously reported by other studies.
Poster A. Clinical
The most pronounced differences were found in subgroup of patients: they had significantly prolonged latencies and smaller amplitudes. In groups of parents and sibs we observed similar tendencies but only for amplitudes. The level of significance was reached only in centro-temporal and in a smaller degree-pruietal zones of left hemisphere. The data are in line with the hypothesis on selective attention deficit in relatives of schizophrenics and can be used for development of neurophysiological markers of predisposition to schizophrenia.
I A-l 9
Comorbidity of the borderline personality disorder and depression
D. Lecic-Tosevski. I I 000 Belgrade,
Instirute for Mentul Health, The School of Medicine, Yugoslavia
Recent studies have shown that borderline personality disorder and depressive disorders are frequently comorbid and that this comorbidity is often resistant to treatment. The relationship between these two disorders as well as the borderline personality disorder itself are still controversial. Some authors (Svrakic et al., 1993) have shown that most symptoms considered typical of the borderline personality characterize other severe personality disorders as well, i.e. borderline level of functioning is a common dimension of dysfunction of personality disorders. The aim of our study was to show or determine the comorbidity between severe personality disorders and chronic depression. One hundred and twenty patients who met DSM-III criteria for dysthymic disorder were included in the study. 61.6% of them were diagnosed as having personality disorder (by Structured Interview for Personality DisordersSIDP, Millon Clinical Multiaxial Inventory-MCMI, Diagnostic Interview for Borderlines-DIB, and Tridimensional Personality QuestionnaireTPQ). The most frequently comorbid with dysthymia were personality disorders from the second and third cluster. The observed depression was intermittent, started early and was primary. The whole sample had a high Harm Avoidance dimension, which is associated with dysfunction of serotonergic activity. There was no statistically significant difference between the subgroups of personality disorders and personality traits regarding this and other TPQ dimensions which is in accordance with the dimensional concept of personality disorders. Our findings suggest that chronic depression with occasional “double depression” is associated with the diagnosis of personality disorders, especially with those organized around impulsiveness which function on the borderline level. We have also found that borderline level of personality functioning is intermittent, except in the “core” borderline personality. The regression to borderline level of functioning is often triggered by depression, major or minor, i.e. the borderline level may be a manifestation of depression (Lecic-Tosevski and Divac-Jovanovic, 1996). Furthermore, symptoms widely regarded as typical for borderline personality characterize other personality disorders as well at the times of depressive decompensation. This may be associated with serotonergic dysfunction shown to interact with motivated behaviour, and is in accordance with the finding of a good response to antidepressant treatment of borderline patients (Kontaxakis et al., 1995). Our findings also indicate that treatment of comorbidity should be integrative, and should include pharmacotberapy.
References Kontaxakis, V.P., Christodoulou, G.N., Markianos, M., Stefanis, C., (1995). Pharmacotherapeutic response of DST-positive borderline patients. Eur Psychiatry, 5, 10, 159-160. Lecic-Tosevski, D., Divac-Jovanovic, M. (1996). Effects of dysthymia on personality assessment. Eur Psychiatry, 11, 244-248. Svrakic, D., Divac-Jovanovic, M., Lecic-Tosevski, D. (1993). Personality disorders: Model for conceptual approach and classification. Part I: general model. Am J Psychotherapy, 47, 4, 558-571.
A 20 ITI.
Licit and illicit substances abused by alcoholics
J. Liappas, E. Peppas, E. Anastasopoulou, V. Pomini, P. Papavasiliou, G.N. Christodoulou. Athens University Medical School, Department of Psychiatry, Eginition Hospital, Greece Objective: The aim of this study is to describe the use of licit and illicit substances in a sample of 127 Greek alcohol abusers.
Material-Method: 127 alcoholics recruited from the specialized drug free outpatient drug addiction clinic of Eginition Hospital, fulfilling the DSM-III-R criteria for alcohol abuse/dependence. The subjects were treated on an inpatient or outpatient basis. The dependent individuals have been interviewed for a total of 13 classes of medical and non-medical substances. Sociodemographic, psychological, behavioural characteristics and the pattern of alcohol consumption were assessed by a structured interview. Depression-like symptomatology was measured by the CES-D scale. Results: The mean age of the sample was 42.1 -f-11.8 years and 86.6% of the users were males. The mean duration of alcohol consumption was 21.42 11.7years and the mean duration of alcohol abuse with coexistent somatic problems was 10.329.5 years. 28.3% of the sample reported cannabis use in their lifetime, 14.2% having used cannabis during the last year and 6.3% during the last month. 7.9% and 7.1% of the subjects reported experience with heroine and cocaine in their lifetime respectively. 8.7% and 12.6% reported experience with hallucinogens and atropinelike drugs in their lifetime. 19.7% and 11.8% of the sample reported use of sedative and hypnotic benzodiazepines in their lifetime respectively: 10.2% and 2.4% had used sedative and hypnotic benzodiazepines during the last year and 7.1% and 1.6% during the last month Also 11.8% and 6.3% of the alcoholics had used analgesics and opiates in their lifetime respectively. Although the mean score in CES-D scale was 28 (71.7% of the sample exceeding the cut-off point for depression; score>l6), only 5.5% used antidepressants in their lifetime and 3.1% during the last month. Conclusion: A close association has been found between alcohol abuse and consumption of other licit and illicit psychoactive substances. The above finding supports the view that alcohol and drug abuse may consist different expressions of a common underlying disturbance.
A-21 El
The relationship between alexithymia and depressionlike symptomatology in drug users
J. Liappas, E. Peppas, A.D. Rabavilas, T. Paparrigopoulos, P. Papavasiliou, G.N. Chrisitodoulou. Athens University Medical School, Department of Psychiatry, Eginition Hospital, Greece Although alexitbymia and depression have been suggested to be distinct and nonoverlapping entities, previous studies have shown a positive correlation between alexithymia and depression. Objective: The aim of the present study is to examine tbe prevalence of alexithymia and depression-like symptomatology and their relationship in a sample of 48 drug abusers. Material-Method: The sample was recruited from the specialized drug free outpatient drug addiction clinic at Eginition Hospital. All subjects fulfilled the DSM-III-R diagnostic criteria for drug abuse/dependence. Sociodemographic, psychosocial, behavioural and drug using characteristics were assessed by a structured interview. Alexithymia was measured with the Schalling-Sifneos scale (revised version). We separated the subjects into two groups: non-alexithymics with a total score 510 and alexithymics with a total score > 10. Depression-like symptomatology was measured by the CES-D scale. Results: The mean age of the sample was 27.426.0 years (range: 17-47 years). 87.5% of the users were males, 87.5% were multiple drug users, 72.9% were mainly heroin users, 66.7% were mainly intravenous users, 58.3% were daily users. The mean duration of drug use was 4.223.6 years (range: l-16 years). The prevalence of alexithymia was 27.1% (N= 13), whereas that of depression-like symptomatology was 77. I % (N=37). There was no significant correlation between alexithymia and depression-like symptomatology. Alexithymic subjects differed significantly from nonalexithymics in regard to their mean score in the CES-D scale (p=.O3). Thus, alexithymics exceeded the cut-off point for depression (score>l6) in a higher percentage (92.3%) than nonalexithymics (71.6%). Conclusion: The above findings seem to support the view that alexithymia is positively linked to depression-like symptomatology. Also that the prevalence of alexithymia (27.1%) in our sample of drug abusers is higher compared to the general population (5.2%-10%) but lower than that reported by previous studies on mixed substance abusers (41.7%50%). In contrast. measures of depression-like symptomatology in our sample were higher than previously reported by other studies.