[Pilot study on the prevalence of dual pathology in community mental health and substance misuse services in Madrid]. / Estudio piloto sobre la prevalencia de patología dual en pacientes en tratamiento en la Comunidad de Madrid.

AIM: To evaluate retrospectively the comorbidity of mental and addictive disorders in community mental health and substance misuse services in Madrid. METHODS: The medical records of 400 patients from mental health and substance misuse services in Madrid were evaluated. Records were examined for the last 20 patients from each service unit. RESULTS: Dual pathology was constituted when a current diagnosis of mental and addictive disorders, excluding nicotine addiction, appeared on the patient's records. Prevalence of dual pathology was 34%. There were differences in the prevalence figures for the two kinds of service: 36.78% in substance misuse services, and 28.78% in mental health services. There was an association of dual diagnosis with alcohol or cocaine dependence, but not with opioid dependence. The mental disorders more prevalent in dually diagnosed than in non-dually diagnosed patients were mood disorders, personality disorders, and schizophrenia. CONCLUSION: There is a high prevalence of dual pathology in those seeking treatment, being higher in substance misuse services than in mental health services, and higher in patients with alcohol or cocaine dependence. These findings could be of help in the planning of care resource policies for these patients.

[Compulsive alcoholics and serotoninergic function]. / Alcohólicos compulsivos y función serotoninérgica.

OBJECTIVE: Different alcoholism subtypes from Jellinek's modified typology reviewed by Babor of gamma and delta alcoholics and former one group (compulsive alcoholics) relationships with serotonergic function are the main purpose of this work, presenting in that sense our study with sertraline at obsessive compulsive disorder treatment doses. METHOD: Open label multicenter six month study with 91 alcohol dependent patients (53% gamma, 20% delta, 27% mixed) treated with sertraline 200 mg to evaluate its effectiveness and tolerance in both subgroups, focusing specially on compulsive alcoholics. Obsessive Compulsive Drinking Scale (OCDS), Barratt Impulsivity Scale (BIS), Craving Evaluation and Clinical Global Impression of Severity (CGI S). CONCLUSIONS: Gamma patients showed a slight tendency to recovery than delta, without statistical significance. These results could reflect a statistical bias, as few delta patients were included. According to neurobiological hypotheses, future studies should try to evaluate these types of alcoholism. Improvement (CGI-I) were the measures employed. RESULTS: CGI S and CGI I showed a statistically significant improvement. Seventy six per cent of patients were responders. No statistically significant differences were observed between gamma and delta groups.