P.6.e Addiction – Other (clinical) P.6.e.009 Suicidal behaviour and abuse of psychoactive substance at urgent psychiatry outpatients department L. Zmuc Veranic1 ° , P. Pregelj2 . 1 University Psychiatric Hospital, Clinical Department for Clinical Psychiatry, Ljubljana – Polje, Slovenia; 2 University Psychiatric Hospital, Urgent Psychiatry Outpatients Department, Ljubljana, Slovenia It is well known that abuse of psychoactive substance (PAS) including alcohol is important risk factor for suicidal behaviour. The proportion of people with suicidal behaviour varies wildly across different countries. Slovenia with its population of 2 million has a very high suicide rate of an average 3287/100,000 per year in last three decades and very high rates of suicidal behaviour. The suicidal rate in Slovenia has remained the same despite many preventive measures and services [1]. It is long known that the prevention of suicidal behaviour starts with identification of those at risk. Objective: Our aim was to find out how strong is the relationship between abuse of PAS on one hand and suicidal behaviour, pharmacotherapy and age on the other hand between group of people who abused PAS and those, who did not. The study had been done at the Urgent Psychiatry Outpatient Department (UPOD). Methods: A total of 2760 patient’s documentation that approached the UPOD were examined. We divided patients into those who abused PAS (N = 460) and those, who did not (N = 2260). The data were statistically analysed. Chi-Square and Fisher’s exact test were used for statistical analysis. Results: There was statistically significant difference in suicidal behaviour between group of those, who abused PAS and those who did not (35.4% vs. 28.0%, N = 1753, Pearson Chi-Square Test, p < 0.001). Significantly more patients who abused PAS attempted suicide (9.5% vs. 3.5%, N = 2760, Fisher’s Exact Test, p < 0.001). However, there was no statistically significant difference observed between groups in suicidal threats and thoughts (17.2% vs. 18.0%, N = 2592, Fisher’s exact test, p = NS). The biggest share of patients who abused PAS was in the age group from 35 to 65 years (19.2%), whereas shares were lower in groups of patients under 35 and beyond 65 (15.7% and 11.6%). We compared the pharmacotherapy that has been administered before visiting UPOD by other medical doctors (general practitioners or other specialists) and substance abuse. Statistically significantly more people, whom had already been prescribed pharmacotherapy before visited UPOD, were substance abusers in comparison to those, who did not have pharmacotherapy (19.4% vs. 11.4%, N = 2592, Fisher’s Exact Test, p < 0.001). Conclusions: Our data indicate that suicidal behaviour was more often with people who abused PAS. This data are in accordance with data published by other authors [1,2]. We found the difference in attempted suicide, but we did not find out any difference in suicidal threats and thoughts between groups. Pharmacotherapy at the arrival to UPOD had been prescribed more often to patients, who abused PAS. The biggest share of PAS abused patients was between 35 and 65 old, which represent the core of working people. Special attention with effective intervention and management of those at the biggest risk for suicidal behaviour should be considered with this age group of patients, especially if they abused PAS. References [1] Ziherl S, Zalar B, 2005, Risk of suicide after attempted suicide in the population of from 1970 to 1996. Eur Psychiatry 122, 396–400.
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[2] Bradley N, et al., 2004, Screening for suicide risk in adults: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 140, 822–835.
P.6.e.010 Who are incoming cocaine consuming patients in a drug addiction centre in Milan in 2006? G. Zita ° , L. Artale, M. Vivirito, A. Burato, F. Di Cosmo, P. Vigezzi, E. Cozzolino. Asl Citt`a di Milano, Dependence, Milan, Italy Aims: To assess psychological, social and medical characteristics of incoming cocaine consuming patients (pts) in our Addiction Centre in 2006. Methods: A new checklist, with 100 detailed items exploring medical, psychological and social conditions of cocaine consuming pts was created. In this checklist diagnostic items according to DSM-IV criteria were included. Symptom Checklist-90 (Scl90), Toronto Alexithymia Scale (TAS-20) and Parental Bonding Instrument (PBI) were submitted in the initial phase of assessment. Baseline and final Global Assessment Functioning score (GAF) was assessed. Results: From January 2006 to February 2007, 65 pts (55 males and 10 females, mean age 33.8±8 yrs) were studied. Mean cocaine abusing time was 7±6.1 yrs. Occupational level was investigated and showed 27 employed pts (41.6%), 28 unemployed pts (43.1%), 9 occasionally employed pts (13.8%) and 1 pt that was not in working condition (1.5%); 52 pts (80%) arrived to the Service spontaneously while 13 pts (20%) were sent by public institutions. 30 pts (52.6%) had problems with Italian law lifetime and 24 pts (37%) nowadays. Diagnostic assessment according to the DSM-IV criteria was performed. A diagnosis of cocaine dependence, cocaine abuse and occasional/problematic cocaine use was formulated in 57, 3 and 5 pts respectively. Out of 65 pts 33 (51%) were polydrug abusers; in this group 27 pts used alcohol and/or THC. In the group of patients with an Axis I disorder (24 pts) Affective Disorders (9 pts) were the most frequent. In the group of patients having an Axis II disorder (38 pts) 34 pts belonged to Cluster B Personality Disorders (Borderline 20% and Antisocial 6.5%). In 13 pts (20%) we could not assess the diagnosis. Psychometric instruments: Alexithymia was found in 13 out of 43 pts submitted to TAS. 48 pts were submitted to PBI: 28 pts (58.3%) reached cut-off neither in Father nor in Mother Care. 32 pts (66.6%) showed high values both in Father and in Mother Overprotection. Depression, Obsessive-Compulsive and Paranoid Ideation were the most frequent symptoms occurred in the whole sample (47 pts) checked for Scl-90 with a mean value of 1.35±0.9, 1.27±0.8 and 1.18±0.8 respectively. 25 pts (38.5%) received a combined treatment: psychological and/or social and/or educational and/or medical; 37 pts (56.9%) had a single treatment while 3 (4.6%) pts dropped out before any treatment. Average length of treatment was 200 days (IC 95%: 170–230 days). Combined treatment retention rate was 65.2% while single treatment retention rate was 37.2%. Compared to single treatment combined treatments lead to higher retention (c2 : p = 0.017) and lower drop out (c2 : p = 0.006). GAF baseline mean score was 55 while final one was 62 (T-test: p = 0.009).