RESUMO
Darier's disease is a rare, inherited autosomal dominant skin disorder caused by a mutation in the sarcoendoplasmatic reticulum calcium transporter (SERCA)-2-gene. In a number of pedigrees, Darier's disease closely relates with affective disorder. The most likely hypothesis for this is a susceptibility gene for affective disorder near the SERCA-2-gene. A 6.5-megabase region could be identified as a susceptibility locus. This region constitutes a susceptability locus also in affective disorder without Darier's disease. The underlying gene has not yet been identified.
Assuntos
Doença de Darier/epidemiologia , Doença de Darier/genética , Depressão/epidemiologia , Depressão/genética , Medição de Risco/métodos , Adulto , Feminino , Predisposição Genética para Doença/epidemiologia , Predisposição Genética para Doença/genética , Humanos , Incidência , Fatores de RiscoRESUMO
AIMS: This study examined general and substance-specific coping skills and their relationship to treatment climate, continuing care and 1-year post-treatment functioning among dual diagnosis patients (i.e. co-occurrence of substance use and psychiatric disorders). DESIGN: In a prospective multi-site study, dual diagnosis patients participating in substance abuse treatment were assessed at intake, discharge and at a 1-year follow-up. SETTING: Patients were recruited from 15 substance abuse treatment programs, which were selected from a larger pool of 174 inpatient treatment programs in the Department of Veterans Affairs Health Care System. PARTICIPANTS: A total of 981 male dual diagnosis patients participated in the study. MEASUREMENTS: Assessments included general and substance-specific coping skills, treatment climate, continuing outpatient care, abstinence and clinically significant psychiatric symptoms. FINDINGS: Dual diagnosis patients modestly improved on general and substance-specific coping skills over the 1-year follow-up period. Patients who were in programs with a 'dual diagnosis treatment climate' and who participated in more 12-Step self-help groups showed slightly more gains in adaptive coping. Both general and substance-specific coping were associated with abstinence, but only general coping was associated with freedom from significant psychiatric symptoms. CONCLUSIONS: Enhancing general and substance-specific coping skills in substance abuse treatment may reduce dual diagnosis patients' post-treatment substance use and improve their psychological functioning.
Assuntos
Adaptação Psicológica , Transtornos Mentais/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto , Diagnóstico Duplo (Psiquiatria) , Seguimentos , Humanos , Masculino , Transtornos Mentais/terapia , Estudos Prospectivos , Transtornos Relacionados ao Uso de Substâncias/terapia , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: This study examines a model of treatment for substance abuse and dependence for patients with substance use disorders and concomitant psychiatric disorders. The model focuses on five interrelated sets of variables (social background, intake functioning. dual diagnosis treatment orientation, patients' change on proximal outcomes, and aftercare participation) that are hypothesized to affect dual diagnosis patients' 1-year posttreatment outcomes. METHOD: A total of 981 male dual diagnosis patients completed assessment at intake, discharge and 1-year follow-up. The relative importance of each set of variables as predictors of outcome was estimated by constructing block variables and conducting path analyses. RESULTS: Dual diagnosis patients had a higher abstinence rate at follow-up (39%) than at intake (2%); they also improved on freedom from psychiatric symptoms (from 60% to 68%) and employment (from 20% to 29%). At follow-up, patients in programs with a stronger dual diagnosis treatment orientation showed a higher rate of freedom from psychiatric symptoms (71%) than did patients in weaker dual diagnosis treatment oriented programs (65%); they also were more likely to be employed (34% vs 25%). More change on proximal outcomes and more aftercare participation were also associated with better 1-year outcomes. Patients with less severe psychiatric disorders improved more and responded better to dual diagnosis oriented treatments than did patients with more severe psychiatric disorders. CONCLUSION: Treatment programs for substance use disorders that adhere to principles of dual diagnosis treatment obtain better outcomes for dual diagnosis patients, especially for patients with less severe psychiatric disorders.
Assuntos
Diagnóstico Duplo (Psiquiatria)/psicologia , Transtornos Psicóticos/terapia , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Transtornos Psicóticos/psicologia , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Resultado do TratamentoRESUMO
The purpose of this study was to evaluate a 4-month dual diagnosis inpatient treatment program that was based on integrative models for patients with substance use and psychiatric disorders. At intake and at 1-year follow-up, dual diagnosis patients (N = 52) were assessed on housing and subsistence level, substance use and psychiatric symptoms. At 1-year follow-up, dual diagnosis patients reported a higher level of housing and subsistence, and less intensive psychiatric symptoms. No change occurred on frequencies of substance use. General improvement may occur even if psychotropic substances are used. Controlled studies are needed on extended inpatient treatment for dual diagnosis patients and outcomes in longer follow-ups.
Assuntos
Hospitalização , Transtornos Mentais/terapia , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Comorbidade , Diagnóstico Duplo (Psiquiatria) , Feminino , Seguimentos , Pessoas Mal Alojadas/estatística & dados numéricos , Humanos , Renda , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Educação de Pacientes como Assunto , Psicoterapia , Psicoterapia de Grupo , Projetos de Pesquisa , Características de Residência , Índice de Gravidade de Doença , Apoio Social , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Suíça/epidemiologia , Resultado do Tratamento , DesempregoAssuntos
Hospitais Psiquiátricos/organização & administração , Transtornos Mentais/complicações , Transtornos Mentais/terapia , Planejamento de Assistência ao Paciente/organização & administração , Psicoterapia/métodos , Adulto , Distribuição de Qui-Quadrado , Comorbidade , Diagnóstico Duplo (Psiquiatria) , Seguimentos , Humanos , Transtornos da Personalidade/complicações , Transtornos da Personalidade/terapia , Avaliação de Programas e Projetos de Saúde , Esquizofrenia/complicações , Esquizofrenia/terapia , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/terapia , Suíça , Resultado do TratamentoRESUMO
The accuracy of a quantitative polymerase chain reaction assay in quantifying the DNA of trichothecene-producing F. culmorum and F. graminearum within harvested wheat grains and head tissue was evaluated in comparison with incidences of infected kernels and deoxynivalenol levels. In a first experiment, six durum and bread wheat varieties were grown in randomized plots for a 2-year period, and inoculated with Fusarium macroconidia at six growth stages between heading and dough ripening, to obtain a wide range of Fusarium head blight incidences. There was a close relationship between fungal DNA and the amount of deoxynivalenol, and this relationship was consistent over Fusarium species, wheat species and varieties, and over a wide range of Fusarium head blight infection. In a second experiment potted wheat plants were grown under environmentally controlled conditions and inoculated with the two Fusarium species at full flowering; head samples were collected before inoculation and after 6 h to 12 days, and processed by the quantitative polymerase chain reaction assay. This assay made it possible to detect the dynamic of fungal invasion in planta after infection had occurred, and to single out the presence of infection before the onset of the disease symptoms: A robust detection of the infection occurred within 18-24 h for F. culmorum, and within 2-9 days for F. graminearum.
Assuntos
Fusarium/isolamento & purificação , Doenças das Plantas/microbiologia , Reação em Cadeia da Polimerase/métodos , Tricotecenos/biossíntese , Triticum/microbiologia , Grão Comestível/genética , Grão Comestível/microbiologia , Contaminação de Alimentos/análise , Microbiologia de Alimentos , Fusarium/crescimento & desenvolvimento , Análise de Regressão , Especificidade da Espécie , Tricotecenos/análise , Triticum/genéticaRESUMO
This review focuses on two aspects of research on sexual child abuse during the last ten years, namely prevalence and long-term effects. Differing results for prevalence (6-62% for female subjects) have been found depending on the concept of sexual child abuse (incest vs. extra-familial child sexual abuse, child sexual abuse with or without physical contact, child sexual abuse with or without violence and sexual actions between adults and children) and depending on the method, and features of the subject. Long-term effects are complex (affective, somatic, eating and sleeping disorders, dissociations, disorders in interpersonal relationships, problems in sexuality and social functioning). The main syndrome seems to be a pattern of affective disorders.
Assuntos
Adaptação Psicológica , Abuso Sexual na Infância/psicologia , Incesto/psicologia , Criança , Abuso Sexual na Infância/diagnóstico , Abuso Sexual na Infância/prevenção & controle , Seguimentos , Humanos , Incesto/prevenção & controle , Desenvolvimento da PersonalidadeRESUMO
A special group of psychiatric patients appeared during the last few years; patients who confront their therapists with many diagnostical and therapeutic problems, namely patients with dual diagnosis. These patients suffer from a severe psychiatric illness (such as schizophrenia) and at the same from an addition (e.g. an alcohol-dependency). The management for patients with dual diagnosis is inappropriate as well in psychiatric units as in specialized addition units. Today specialized units for patients with dual diagnosis are non-existent in Switzerland. The following review presents theoretical implications, empirical data and therapeutic possibilities for patients with dual diagnosis.
Assuntos
Transtornos Mentais/reabilitação , Equipe de Assistência ao Paciente , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Terapia Combinada , Comorbidade , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Suíça/epidemiologiaRESUMO
Sexual contacts between nurses and patients in psychiatric hospitals have not been investigated systematically. The aim of the present study was to determine the frequency of nurse-patient sexual relationships and their prominent characteristics on the one hand and the nurses' attitudes towards these contacts on the other. A questionnaire was mailed to 714 nurses employed at two psychiatric hospitals. Although 94% of the 279 respondents considered sexual contact (defined as "physical contact between a patient and a nurse, in which sexual arousal occurred in the nurse") to be inappropriate, 17% of the male and 11% of the female responding nurses reported having had such contacts with patients.