This study investigated the characteristics associated with treatment dropout in cocaine-dependent patients. A sample of 102 cocaine-addicted patients (89 male and 13 female) was assessed at entry to a therapeutic programme in order to collect information on socio-demographic, psychopathological (assessed by SCL-90-R), personality (assessed by MCMI-II), legal and consumption variables (assessed by EuropAsi). The rate of patients who dropped out of the intervention programme was 30.4% (N=31) of the sample. Dropouts and completers were compared on all studied variables. According to the results obtained, dropouts showed a significantly higher score on the EuropAsi variables related to alcohol consumption, family problems and need for psychological treatment, as well as on the histrionic and antisocial scales of the MCMI-II. Moreover, all patients with histrionic personality disorder dropped out of the treatment. On the other hand, completers showed a significantly higher score on the compulsive scale of the MCMI-II. The implications of these results for further research and clinical practice are commented upon. ; This study was supported by a grant (code 2/2006) from the Health Department of the Navarre Government (Spain).
En este estudio se lleva a cabo un análisis de la prevalencia del juego patológico en 112 pacientes adictos (81 alcohólicos y 31 dependientes de la cocaína) que acuden en busca de tratamiento. Para ello, se utilizaron los criterios diagnósticos del DSM-IV-TR para el juego patológico y la versión española del Cuestionario de Juego Patológico de South Oaks (SOGS). Los resultados obtenidos mostraron que el 22,3% de los pacientes drogodependientes estudiados presentaba un diagnóstico comórbido de ludopatía. Además, un 11,6% adicional obtenía una puntuación en el SOGS indicadora de juego problemático. En suma, el 33,9% de la muestra presentaba síntomas de juego clínicamente significativos. La comparación entre los pacientes adictos con y sin ludopatía asociada mostró diferencias significativas en las variables relacionadas con el consumo de alcohol (evaluado mediante el EuropASI), los síntomas psicopatológicos (evaluados mediante el SCL-90-R) y algunas variables de personalidad (evaluadas mediante el MCMI-II). En todos los casos, las puntuaciones eran significativamente más altas en los pacientes ludópatas que en los que no tenían un problema de ludopatía asociado. Se comentan las implicaciones de este estudio para la práctica clínica y la investigación futura. ; In the current paper, the prevalence of pathological gambling in 112 treatment-seeking patients with substance addiction (81 alcoholics and 31 cocaine dependents) was estimated. The DSM-IV-TR diagnostic criteria for pathological gambling and the Spanish version of the South Oaks Gambling Screen (SOGS) were used. The results showed that 22.3% of substance-addicted patients had a comorbid diagnosis of pathological gambling. Furthermore, an additional 11.6% of the sample had relevant symptoms for problem gambling. In sum, 33.9% of the sample reported clinically significant gambling-related symptoms. From a socio-demographic point of view, all substance-addicted patients with gambling-related symptoms were men. A comparison between substance-addicted patients with and without pathological gambling showed significant differences in alcohol severity (assessed by the EurapASI), psychopathological symptoms (assessed by the SCL-90-R) and personality variables (assessed by the MCMI-II). In all cases, scores were significantly higher in gamblers than in non-gamblers. Finally, the implications of these results for further research and clinical practice are commented upon. ; This study was supported by grant (code 2/2006) from the Health Department of Navarre Government (Spain).
Background and objectives: The objectives of this study were, first, to explore the prevalence of aggressors with lifetime intimate partner violence (IPV) among patients in the Proyecto Hombre of Navarra (Spain) addiction treatment programme; and second, to know the specific and differential characteristics of patients presenting IPV as aggressors. Methods: A sample of 162 patients (119 men and 43 women) was assessed. Data on socio-demographic and substance consumption characteristics, IPV variables, psychopathological symptoms, and personality variables were obtained. The profiles of patients in addiction treatment with and without a history of violence towards their partners were compared. Results: The results showed that 33.6% of people in treatment for addiction had committed violence against their partners. This prevalence was significantly higher (X2 = 15.6, p < .001) in women (63.3%) than in men (24.2%). In the 98.4% of the cases the IPV was bidirectional. Patients with a history of IPV perpetration showed greater severity in substance consumption variables, psychopathological symptoms, and personality traits. Gender, the family scale on the European version of the Addiction Severity Index (EuropASI), and the aggressive-sadistic scale on the Millon Clinical Multiaxial Inventory (MCMI-III) were the main variables related to the presence of IPV as aggressors. Discussion and conclusions: There was a differential profile in patients with IPV perpetration, showing more psychopathological and personality symptoms. Moreover, in this study being a woman was one of the main predictors of committing IPV. ; This study was supported by a grant (code PSI2009-08500) from the "Ministerio de Ciencia e Innovación" of the Spanish Government.
This study explored the prevalence of a history as victims of abuse among patients who sought outpatient treatment for drug addiction. A sample of 252 addicted patients was assessed. Information was collected on the patients' lifetime history of abuse (psychological, physical and/or sexual abuse), socio-demographic factors, consumption factors, psychopathological factors and personality variables. Drug-addicted patients who present a lifelong history of abuse were compared with patients who were not abused. Of the total sample, 46% of the patients (n = 115) who were addicted to drugs had been victims of abuse. There was a statistically significant difference between the victimisation rates of men (37.8%) and women (79.6%). Moreover, for some variables, significant differences were observed between patients who had been abused and those who had not. Compared with patients who had not been abused, the addicted patients with a history of victimisation scored significantly higher on several EuropASI, MCMI-II and maladjustment variables but not on the SCL-90-R. The current results indicate that patients who present a lifelong history of abuse exhibit both a more severe addiction than patients who were not abused and several comorbidities. The implications of these results for further research and clinical practice are discussed. ; This study was supported by a grant (code PSI2009-08500) from the "Ministerio de Ciencia e Innovación" of the Spanish Government.
This study explored the prevalence of violent behaviours in patients who are addicted to drugs. A sample of 252 addicted patients (203 male and 49 female) who sought outpatient treatment was assessed. Information on violent behaviours, socio-demographic factors, consumption factors (assessed by the EuropAsi), psychopathological factors (assessed by SCL-90-R) and personality variables (assessed by MCMI-II) was collected. Drug-addicted patients who were associated with violent behaviours were compared on all variables to patients who were not associated with violent behaviours. The rate of drug-addicted patients with violent behaviours in this sample was 39.68% (n=100). There were significant differences between the numbers of patients who did and did not demonstrate violence on some variables. Patients with violence problems were younger than those without violence problems and were more likely to report having been a victim of abuse. Moreover, they were significantly more likely to have experienced an overdose and showed a significantly higher score on several EuropAsi, SCL-90-R and MCMI-II variables. According to these results, patients with violence control problems present with both a more severe addiction and several comorbid problems. The implications of these results for further research and clinical practice are discussed. ; This study was supported by a grant (code PSI2009 -08500) from the "Ministerio de Ciencia e Innovación" of the Spain Government.
This study explored the characteristics associated with treatment dropout in substance dependence patients. A sample of 122 addicted patients (84 treatment completers and 38 treatment dropouts) who sought outpatient treatment was assessed to collect information on socio-demographic, consumption (assessed by EuropAsi), psychopathological (assessed by SCL-90-R) and personality variables (assessed by MCMI-II). Completers and dropouts were compared on all studied variables. According to the results, dropouts scored significantly higher on the EuropAsi variables measuring employment/support, alcohol consumption and family/social problems, as well as on the schizotypal scale of MCMI-II. Because most of significant differences were found in EuropAsi variables, three clusters analyses (2, 3 and 4 groups) based on EuropAsi mean scores were carried out to determine clinically relevant information predicting dropout. The most relevant results were obtained when four groups were used. Comparisons between the four groups derived from cluster analysis showed statistically significant differences in the rate of dropout, with one group exhibiting the highest dropout rate. The distinctive characteristics of the group with highest dropout rate included the presence of an increased labour problem combined with high alcohol consumption. Furthermore, this group had the highest scores on three scales of the MCMI-II: phobic, dependent and schizotypal. The implications of these results for further research and clinical practice are discussed. ; This study was supported by a grant (code 2/2006) from the Health Department of the Navarre Government (Spain).
Objective: This article evaluates the treatment effectiveness of an integrated intervention compared to addiction treatment as usual (TAU) in reducing intimate partner violence perpetration (IPV-P) among patients in a drug-addiction intervention programme. Method: A parallel, randomized, controlled trial was carried out with repeated measures of assessment (pre-treatment, post-treatment and 6-month follow-up). A sample of 227 consecutive patients was assessed, and 70 patients with IPV-P were selected to participate in the study and then divided into two groups: treatment (n = 34) and control (n = 36). The treatment group participated in an integrated intervention programme for addiction and IPV-P, and the control group received the TAU without intervention for IPV-P. Treatment success was defined as the complete absence of IPV-P episodes, both physical and psychological. Results: At the follow-up, the patients in the treatment group showed an IPV-P success rate (60.7%) that was significantly higher (X2 = 3.85; p < .05) than that of the patients in the control group (31.6%). Moreover, both groups achieved statistically significant improvements in associated variables. Conclusions: The presence of IPV-P should be assessed in drug addiction treatment programmes. The combined treatment for addiction and IPV-P seems to be effective. ; This project was supported by a grant (code PSI2009-08500) from the "Ministerio de Ciencia e Innovación" of the Spanish Government.
The aim of this study was to develop a new assessment tool to predict intimate partner femicide and severe violence. The sample for this study consisted of 1,081 men who were reported to the police station (Basque Country, Spain), because of having committed intimate partner violence. First, the most significant differences between the severe violence group (n=269) and the less severe violence group (n=812) in sociodemographic variables were determined. Results showed that both the perpetrators and the victims of the severe violence group had a higher rate of immigration. Second, the proposed 20-item scale derived from a larger 58-item scale, where only the most discriminative items between severe and non-severe intimate partner violence were taken into account. Psychometric properties of reliability and validity were rather good. Cut-off scores have been proposed according to sensitivity and specificity. This structured professional judgment (an easy-to-use tool) appears to be suitable to the requirements of criminal justice professionals and is intended for use as the basis of safety planning. Implications of these results for further research are commented upon. ; This study was developed through an agreement between the Basque Institute of Criminology (University of the Basque Country) and the Home Council of the Basque Government, within the framework of an investigation funded by the Spanish Ministry of Education and Science (Code SEJ2005-09170-C04-02/PSIC).
En este estudio se lleva a cabo un análisis de la prevalencia de conductas delictivas en pacientes adictos en tratamiento. Para ello se cuenta con una muestra de 252 pacientes adictos (203 hombres y 49 mujeres) que acudieron en busca de tratamiento ambulatorio a un centro especializado. En la evaluación se recogió información sobre las conductas delictivas, las características sociodemográficas, las variables de consumo (evaluadas con el EuropASI), la sintomatología psicopatológica (evaluada con el SCL-90-R) y las variables de personalidad (evaluada con el MCMI-II). Los pacientes que presentaban conductas delictivas fueron comparados con los que no las presentaban en todas las variables estudiadas. La tasa de pacientes adictos implicados en actos delictivos fue del 60,3% (n = 150). Las conductas delictivas se relacionaban principalmente con delitos de conducción, seguido por delitos de tráfico de drogas. Se observaron diferencias significativas entre los pacientes con y sin conductas delictivas. Los pacientes con actos delictivos eran principalmente hombres y solteros. Además, era más probable que presentaran policonsumo de sustancias. Asimismo, se observaron diferencias significativas en varias variables del EuropASI, SCL-90-R y MCMI-II. Con arreglo a estos resultados, los pacientes con conductas delictivas asociadas presentaban una mayor gravedad en su adicción. Se discuten las implicaciones de estos resultados para la práctica clínica y la investigación futura. ; This study explores the prevalence of criminal behaviour in patients addicted to drugs who are in treatment. A sample of 252 addicted patients (203 male and 49 female) who sought outpatient treatment at a specialized centre was assessed. Information on criminal behaviours, socio-demographic factors, consumption factors (assessed by the EuropAsi), psychopathological factors (assessed by SCL-90-R) and personality variables (assessed by MCMI-II) was collected. Patients presenting criminal behaviour were compared with those who were not associated with crime for all the variables studied. The rate of drug-addicted patients with criminal behaviour in this sample was 60.3% (n = 150), and it was mainly related to traffic offenses, followed by drug dealing offenses. Significant differences were observed between patients with and without criminal behaviour. Patients with criminal problems were mostly men and single. Moreover, they were more likely to report poly-consumption. Furthermore, significant differences were observed on several variables: EuropAsi, SCL-90-R and MCMI-II. According to these results, patients with associated criminal behaviour presented a more severe addiction problem. The implications of these findings for clinical practice and future research are discussed. ; This study was supported by grant (Res. 359/2012) from the Health Department of Navarre Government (Spain).
Background and objectives: This study explored the characteristics of a representative sample of patients who were addicted to drugs and analyzed the differential profile of addicted women and men. Methods: A sample of 195 addicted patients (95 female and 100 male) who sought outpatient treatment in a Spanish clinical center was assessed. Information on sociodemographic, consumption and associated characteristics was collected using the European Addiction Severity Index (EuropASI). Results: The results showed statistically significant differences between groups. Demographically, the differences were centered on employment, with more labor problems in the female group. Regarding addiction severity, the EuropASI results showed statistically significant differences in both the Interviewer Severity Ratings (ISR) and Composite Scores (CS). Women experienced more severe impacts in the medical, family social and psychiatric areas. By contrast addicted men had more severe legal problems than addicted females did. Conclusions: According to these results, women who seek outpatient treatment in a clinical center presented with a more severe addiction problem than men did. Moreover, they reported more significant maladjustment in the various aspects of life explored. ; This study was supported by a grant from the Health Department of the Government of Navarra, Spain (Res. 359/2012).
Objective. This study explored the differential profile of addicted patients who re-enter treatment programmes. Method. A sample of 252 addicted patients (203 male and 49 female) who sought outpatient treatment was assessed. Data regarding socio-demographic factors, drug consumption factors (assessed using the EuropAsi), psychopathological factors (assessed using the Symptom Checklist 90 Revised [SCL-90-R]), and personality variables (assessed using the Millon Clinical Multiaxial Inventory II [MCMI-II]) were collected. Results. 65.9% (n=166) of drug-addicted patients were re-admitted into treatment programmes. All of the variables for which we collected data were compared between these treatment repeaters and patients who were admitted for the first time. Significant differences between the two groups of patients were found for some of the variables that we examined. Treatment repeaters were generally older and had a poorer employment situation than first-time admits. Treatment repeaters were also more likely to report poly-consumption and to have sought treatment for alcohol abuse. Moreover, some of the scores for several EuropAsi, SCL-90-R, and MCMI-II variables were statistically significantly different from those of the first-time admits. Conclusions. According to these results, patients who re-enter treatment programmes often present with more severe addiction problems. The implications of these results for further research and clinical practice are discussed. ; This study was supported by a grant (code 359/2012) from the Health Department of the Government of Navarra (Spain).
Patients with substance dependence have a great risk of suicidal ideation and attempts. The study of the specific risk characteristics of patients with substance use disorders who present with suicidal ideation and/or attempts becomes a crucial clinical issue in order to develop prevention strategies. The main goals of this study were to determine the prevalence rate of both suicidal ideation and attempts among patients receiving treatment for substance use disorder and to analyse the differential characteristics between these patients with and without suicidal behaviours. A sample of 334 patients (263 men-71 women) who sought treatment for substance use disorder in a Spanish clinical centre was assessed. In total, 43.7% of the patients presented with lifetime suicidal ideation (8.7% in the last month) and 17.7% with suicide attempts (1.5% in the last month). Patients with suicidal ideation or attempts showed a more severe addiction profile (assessed by the EuropASI), and more psychopathological symptoms (assessed by the SCL-90-R). Moreover the rate of suicidal ideation and attempts was significantly higher in inpatients than in outpatients. According to these results, systematic screening of suicidal risk in patients seeking treatment for substance use disorders is recommended, especially in those with a greater addiction severity. ; This study was supported by a grant (code PSI2016-76511-R) from the Agencia Estatal de Investigación (AEI) of the Spanish Government and Fondo Europeo de Desarrollo Regional of the European Union (FEDER, EU)
This is an accepted manuscript of an article published by Taylor & Francis in The American Journal of Drug and Alcohol Abuse on 09 Sep 2019, available online: https://doi.org/10.1080/00952990.2019.1660886 ; Background: Few studies have analyzed the specific characteristics related to uni/bidirectional intimate partner violence (IPV) in patients with addiction problems. Knowing the specific profiles of these patients would allow the development of effective tailored interventions. Objective: This study assessed gender differences in unidirectional and bidirectional IPV among patients undergoing drug addiction treatment. Method: We sampled 122 patients (91 male and 31 female) who sought treatment in an addiction treatment center, and collected cross-sectional self-reported data on violent behaviors (physical, sexual and psychological violence), sociodemographic factors, distorted thoughts about women and violence, impulsiveness, and anger. Results: Ninety-one percent of participants reported experience of IPV (any type and any direction). Sixty-three percent of participants reported bidirectional violence, which was more common among women (83.9%) than men (56.1%). Unidirectional (perpetration only) IPV was reported in 28.7% of participants, and it was more common among men (34.1%) than women (12.9%). No one reported unidirectional (victimization-only) IPV. When only physical and/or sexual violence was considered, bidirectional violence affected 32.0% of the sample; 23.8% were only victims, and 3.3% were only perpetrators (all of them men). Participants who reported bidirectional violence had higher scores for impulsiveness, anger, and distorted thoughts. Conclusions: Bidirectional IPV is commonly reported among patients seeking treatment for addiction, particularly among women, and should be considered in future research and clinical practice. ; This project was supported by a grant (code PSI2016–76511- R) from the Agencia Estatal de Investigación (AEI) of the Spanish Government and Fondo Europeo de Desarrollo Regional of the European Union (FEDER, EU).
Objective: To evaluate the effectiveness (in terms of retention) of an intervention aimed at treating the consequences of lifetime physical and/or sexual abuse among patients who are also seeking substance use disorder treatment (SUD-T) in a clinical centre. Method: A parallel, randomized, controlled clinical trial using an experimental design (with one treatment group and one control group) with repeated measures (pretreatment, posttreatment and 6-month follow-up) was carried out. The sample consisted of 57 patients in SUD-T who had experienced lifetime physical and/or sexual abuse. All patients received a cognitive-behavioural SUD-T. In addition, the treatment group (n = 29) received physical and/or sexual abuse treatment (PSA-T). Results: The treatment group presented a lower SUD-T dropout rate (37.9%; n = 11) than the control group (50.0%; n = 14), but this difference was not statistically significant (χ2 = 0.8; p = .359; Phi = .122). The main variable related to SUD-T success (therapeutic discharge after completing the 40 outpatient sessions or 12 inpatients months and maintained abstinence) was the completion of PSA-T. Conclusions: The completion of this trauma-centred treatment improved the retention rate of SUD-T in patients with histories of physical and/or sexual abuse. This is a promising result because of the high SUD-T dropout rate shown by patients with victimization. ; This study was supported by a grant (code PSI2016-76511-R) from the Agencia Estatal de Investigación (AEI) of the Spanish Government and Fondo Europeo de Desarrollo Regional of the European Union (FEDER, EU).
Background and aims: Patients with addictions have a great risk of suicidal ideation and attempts. Suicidal behaviour is a continuum that begins with ideation and may continue with planning, attempts and suicide completion. Investigating the specific risk characteristics for suicidal attempts in patients with addiction pro- blems who present with suicidal ideation is crucial for developing prevention strategies. The main aims of this study were to determine the prevalence rate of suicide attempts among patients with lifetime suicidal ideation receiving treatment for addiction, and o explore the differential characteristics for suicide ideators with and without suicide attempts. Methods: A sample of 149 patients with suicidal ideation (110 male and 39 female) who sought treatment for addiction in a Spanish clinical centre was assessed. Measurements: Information concerning socio-demographic characteristics, addiction severity, and psycho- pathological symptoms was obtained. Results: In total, 39.6% of the patients had attempted suicide (95% Confidence Interval: 32.1%–47.6%). Although all patients with suicidal behaviours presented a high severity in their addiction, patients with both suicidal ideation and suicide attempts showed a more severe addiction profile and more maladjustment to ev- eryday life than patients with only suicidal ideation. Specifically, three psychopathological variables were re- lated to suicide attempts: worse psychiatric state, previous hospitalization for psychological problems, and history of delirium. Conclusions: According to the results, a systematic screening of suicidal risk in patients seeking treatment for addiction problems is recommended. Addiction treatment centres should develop treatment strategies to prevent suicidal ideators from attempting suicide, mainly in those cases with a worse lifetime psychiatric condition. ; This project was supported by a grant (code PSI2016—76511-R) from the Agencia Estatal de Investigacion (AEI)-Spanish Government; Fondo Europeo de Desarrollo Regional of the European Union (FEDER, EU).
