Comorbidity patterns in dual diagnosis across seven European sites

Background and Objectives: Psychiatric inpatients with substance use disorders are a significant public health concern due to grave consequences including increased risk of self harm, homicide as well as poor clinical outcome. The present study aims to examine and compare patterns of comorbidity (i.e. concurrent substance use disordersand severe mental illness) among psychiatric inpatients across seven European sites. Methods: 352 patients were included consecutively from psychiatric inpatients units at7 European sites and interviewed with the Mini- International Neuropsychiatric Interview and the European version of the Addiction Severity Index questionnaires. For analysis the psychiatric diagnostic groups were organized into broader categories. Results: Concurrent alcohol use disorder and mood disorder was found to be the most prevalent comorbidity pattern (30.8%) across Europe. Alcohol or drug use disorder combined with mood disorder was most prevalent among females and in the older age group where as mixed substance use and psychosis was more frequent among males and younger participants. Finally, differences in comorbidity patterns were found at different European sites. Conclusions: The prevalence of different comorbidity patterns varied across European clinical settings. Significant differences between comorbidity subgroups were found with regard to age and gender(AU)

Determinants of current HIV risk behaviour among injecting drug users in Warsaw, Poland.

Of the injecting drug users (IDUs), 24% had borrowed, and 37% had passed on syringes in the previous 6 months. In logistic regression analysis, current borrowing of syringes was significantly associated with a shorter duration of injecting drug use, a higher number of drug-injecting sex partners in the previous 6 months, and with current lending of syringes. A majority of the IDUs have modified previous HIV risk behaviour but these modifications are insufficient and not sustained over time. Intensified AIDS prevention measures for IDUs in Poland are needed.

[Mortality of narcotic addicts using injections]. / Umieralnosc osób uzaleznionych od narkotyków przyjmowanych w iniekcjach.

The paper presents and discusses results of a longitudinal study on mortality of injecting drug users from detoxification unit of the Institute of Psychiatry and Neurology, Warsaw, Poland. The study was a part of an international project initiated by the World Health Organization and co-ordinated by Department of Epidemiology Lazio Region, Rome, Italy. Nine centers from six countries participated in the project. All infecting drug users attending treatment in the 1983-1992 period were enrolled. In Warsaw cohort, direct mortality rate for men was 25.7 per 1000 person-years and 14.3 per 1000 person-years for women. As compared with general population the risk of death was 11 times higher among males and 20 times higher among female drug users. Poisson's regression model showed that risk of dyeing (rate ratio) is particularly high during first year after last treatment. Almost 40% of deaths were classified as sudden deaths, cause unknown (code 798 of ICD IX) while close to one third as injuries and poisonings (800-999).