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Effectiveness of methamphetamine abuse treatment: Predictors of treatment completion and comparison of two residential treatment programs
Erscheinung: 2019 / Drug and Alcohol Dependence
Background: There is an increasing demand of evidence-based treatment options for methamphetamine users, but research in this field is limited. This study therefore evaluates the efficacy of two residential treatment programs for methamphetamine users.Method:A total of 108 patients with a history of methamphetamine abuse from two inpatient rehabilitation centers were studied for psychiatric symptoms, craving, psychosocial resources, and cognitive functioning at the start and end of therapy. Patients from one center (“amphetamine type stimulant group”) received conventional group therapy plus an additional 10 h of group therapy focusing on stimulant use. Patients from the other center (“treatment as usual”) received conventional group therapy only. Predictors of drop-out were estimated.Results: A drop-out rate of 40.7% was observed without a significant difference between both centers. Patients remained significantly longer in treatment as usual compared to amphetamine type stimulant treatment. Irrespective of treatment program, craving and psychiatric symptoms significantly decreased while psychosocial resources, processing speed, and cognitive flexibility improved over time. Other cognitive measures yielded mixed results. History of injection drug use was a significant predictor for treatment drop-out.Conclusions:Existing treatments are effective in reducing craving and psychiatric symptoms. Additional stimulant specific groups do not appear to influence treatment completion and secondary outcome measures. Institutions should therefore offer treatment for methamphetamine users, even if they do not provide a therapy content focusing on methamphetamine. History of injection drug use should receive attention in treatment to prevent drop-out. Changes in cognitive functioning need to be further explored.
Erscheinung: 2019 / Lambertus
Mit der Herausforderung leben. Konsum - Sucht - Abstinenz
Erscheinung: 2019 / Freundeskreis-Journal
Palliativmedizinische Behandlung in der neurologischen Frührehabilitation
Erscheinung: 2019 / Neurologie & Rehabilitation
Cisplatin-Gabe: Nephrotoxizität durch Verlangsamung der intravenösen Applikation vermeiden
Erscheinung: 2019 / Journal Onkologie
Cisplatin is an effective cytotoxic drug with nephrotoxic effects for the treatment of solid tumors. An optimal prophylactic measure is not yet known. Prolongation of the infusion time may help prevent nephrotoxicity, which is characterized by reduction of the glomerular ﬁ ltration rate (GFR), hypomagnesaemia and hypokalaemia. In the casuistry, gemcitabine + cisplatin is infused over 2 hours, resulting in severe vomiting. After the second chemotherapy cycle, the duration of infusion was extended to 8 hours, which was only associated with moderate nausea and creatinine level indicated a reduction of nephrotoxicity. Clinical trails are recommended to analyze whether prolonging the infusion time and dilution of cisplatin may reduce the nephrotoxic effect of cisplatin.
Methamphetamine withdrawal and the restoration of cognitive functions – a study over a course of 6 months abstinence
Erscheinung: 2019 / Psychiatry Research
A continuously rising consumption of methamphetamine (MA) has been suggested to be associated with increasing cognitive dysfunction. The objective of this study was to investigate associations between cognitive functions and gender, drug using patterns and treatment-attending profiles of recently abstinent MA users over the course of six months abstinence. Data were collected from 108 participants in two inpatient rehabilitation centers. The mean duration of MA use was 11.5 years. Interviews and cognitive tests (cognitrone, Stroop, TMT, nback) were performed right after the withdrawal and again after approx. six months of abstinence. Comparisons and explorative analyses between the groups (gender, primary MA/ multidrug users, early dropouts/ completers) regarding cognitive variables were performed. At baseline a significant decline in general neuropsychological functioning and attention/concentration after ongoing years of consumption were found. After a period of six months abstinence, cognitive performances remained stable or improved significantly for cognitrone percentile and cognitive flexibility. Normal cognitive functions were measured in former MA users after acute withdrawal which remained stable and partly improved in those patients who refrained from substance abuse over six months. Continued long-term MA intake was the only identified indicator of poorer cognitive performance. These results point towards a regain of cognitive performance in patients abstinent from MA.
Therapieerfolg in zwei deutschen Suchtfachkliniken nach sechsmonatiger stationärer Methamphetamin- Entwöhnung
Erscheinung: 2019 / Poster
In den letzten Jahren ist sowohl in Teilen Deutschlands wie auch weltweit ein wachsender Konsum von Methamphetamin (MA) zu beobachten, einhergehend mit einem steigenden Therapiebedarf der Konsumenten (EMCDDA, 2018). Die bisherige Forschung zu Therapiemöglichkeiten bei MA-Abhängigkeit ist in Deutschland jedoch noch unzureichend. Die vorliegende Langzeitstudie evaluiert mittel- und langfristige Effekte zweier stationärer Therapiekonzepte für MA-Konsumenten und analysiert mögliche Prädiktoren des Therapieerfolgs.
Associations between methamphetamine use, psychiatric comorbidities and treatment outcome in two inpatient rehabilitation centers
Erscheinung: 2019 / Psychiatry Research
The use of methamphetamine is spreading globally and provokes the need for effective treatment options. Previous research showed increased psychiatric comorbidities in methamphetamine users, but its impact on treatment success is still unclear. This study investigates data from two German addiction rehabilitation centers including 108 methamphetamine using individuals. The participants were tested and interviewed at the beginning of the addiction treatment program and at the end of treatment after about six months. In total, 95% of the participants had at least another psychiatric diagnosis. At admission, substance related comorbid diagnoses (meaning abuse or addiction of other substances than methamphetamine) showed a significant effect on treatment dropout. Within the substance related diagnoses, the majority of participants (62%) suffered from cannabinoid dependency. Non-substance related comorbidities and the total number of comorbid diagnoses did not have an impact on treatment outcome. The most frequent non substance specific diagnosis at admission was a depressive disorder (15%). Diagnoses patients had at discharge did not show any effects on the treatment completion. Comparing diagnoses at admission and discharge revealed slight differences, which may rise from a better assessment at discharge due to the fact that clinicians got to know the patients better during the therapeutic process.
Defining spasticity: a new approach considering current movement disorders terminology and botulinum toxin therapy
Erscheinung: 2018 / Journal of Neurology
Spasticity is a symptom occurring in many neurological conditions including stroke, multiple sclerosis, hypoxic brain damage, traumatic brain injury, tumours and heredodegenerative diseases. It affects large numbers of patients and may cause major disability. So far, spasticity has merely been described as part of the upper motor neurone syndrome or defined in a narrowed neurophysiological sense. This consensus organised by IAB—Interdisciplinary Working Group Movement Disorders wants to provide a brief and practical new definition of spasticity—for the first time—based on its various forms of muscle hyperactivity as described in the current movement disorders terminology. We propose the following new definition system: Spasticity describes involuntary muscle hyperactivity in the presence of central paresis. The involuntary muscle hyperactivity can consist of various forms of muscle hyperactivity: spasticity sensu strictu describes involuntary muscle hyperactivity triggered by rapid passive joint movements, rigidity involuntary muscle hyperactivity triggered by slow passive joint movements, dystonia spontaneous involuntary muscle hyperactivity and spasmscomplex involuntary movements usually triggered by sensory or acoustic stimuli. Spasticity can be described by a documentation system grouped along clinical picture(axis 1), aetiology (axis 2), localisation (axis 3) and additional central nervous system deficits (axis 4). Our new definition allows distinction of spasticity components accessible to BT therapy and those inaccessible. The documentation sheet presented provides essential information for planning of BT therapy.
Schwierigkeiten der Emotionsregulation bei alkoholabhängigen Patienten mit komorbiden posttraumatischen Belastungsstörungen
Erscheinung: 2018 / Suchttherapie