RESUMEN
UNLABELLED: A pilot study of the prevalence of substance abuse disorders was completed on the only open unit of the only state psychiatric hospital in Hawaii to address the following questions: 1) What were the substances of abuse and dependence in this population? 2) What was the pattern of abuse and/or dependence in this sample? 3) How did these patterns compare to the patterns observed in the published literature? 4) What was the predominant Stage of Change of these patients? 5) Was the staff perception that these patients were in denial an accurate perception? METHODOLOGY: All patients admitted to the unit between 1st June and 31st August 1999 comprised the sample, N = 35. Each patient was assigned diagnoses based upon the DSM-IV criteria and level of change was assessed. RESULTS: The demographic characteristics of the sample follow: 60% were ages 20-39, 89% were male; 92% were currently single, 71% had an education of high school or college, and 66% had a diagnosis of schizophrenia or schizoaffective disorder. The racial composition reflected the diversity of Hawaii. Although 20% of the sample had no substance abuse problem, 66% of the remaining patients were multiply dependent upon alcohol, cannabis, crystal methamphetamine, or cocaine with 48% of these patients in the Precontemplative Stage of Change (denial). The patterns of multiple substances of abuse and dependence were higher than in the reported literature. Further studies are needed.
Asunto(s)
Trastornos Relacionados con Sustancias/epidemiología , Adulto , Estudios Transversales , Diagnóstico Dual (Psiquiatría) , Etnicidad/estadística & datos numéricos , Femenino , Hawaii/epidemiología , Hospitales Psiquiátricos/estadística & datos numéricos , Hospitales Públicos/estadística & datos numéricos , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Proyectos Piloto , Trastornos Relacionados con Sustancias/etnologíaRESUMEN
We present a case of primary caffeine dependence based on the exclusive use of over-the-counter caffeine tablets. Caffeine has recently undergone scrutiny as a co-morbid risk factor with other substance dependencies, and in other medical and psychiatric conditions. Caffeine withdrawal also is briefly discussed with attention given to personality factors and the use of nicotine. Although caffeine generally is considered safe in usual doses, it is a substance potentially able to result in serious dependence. We cite a case which also illustrates that a supportive inpatient milieu may be necessary in order to interrupt a cycle of heavy caffeine use resulting in marked dependence.