The objective of this study is to assess the prevalence of psychiatric comorbidity in patients under treatment within the addictive disorders assistance units of Galicia (Spain).Material and MethodsA total of 64 healthcare professionals performed clinical diagnosis of mental disorders (on DSM IV-TR criteria) in 2300 patients treated throughout March 2010 in 21 addictive disorders assistance units.Results56.3% of patients with substance abuse/dependency also showed some other mental disorder, 42.2% of patients suffering from at least an Axis I condition and 20.2% from some Axis II condition. Mood and anxiety disorders and borderline and antisocial personality disorders were the most frequent disorders in both axes.ConclusionsA high comorbidity was found between mental and substance use disorders (SUD) in patients seen at the addictive disorders assistance units of Galicia.

El objetivo es describir los hábitos recreativos, uso de drogas y conductas de riesgo entre jóvenes que salen de noche durante los fines de semana, y estimar la relevancia predictiva de la vida recreativa sobre el uso de drogas legales o ilegales, teniendo en cuenta otros factores de riesgo individuales. La muestra incluye 1340 jóvenes entrevistados en cinco ciudades españolas. Casi todos abusan del tabaco y alcohol. Se ha dividido la muestra en los que consumieron (775; 58%) o no alguna droga ilegal recientemente (565; 42%). El uso de drogas ilegales aparece asociado con diversas características personales: inicio más temprano en el consumo de cannabis y alcohol, sexo masculino, menor percepción del riesgo en el uso de drogas, mayor búsqueda de sensaciones y mayor implicación en conductas -problema y desviadas socialmente. Los consumidores de drogas ilegales se distinguen también en sus hábitos recreativos (salen más, buscan contextos con mayor disponibilidad de drogas, tienen distintas motivaciones para salir). Un análisis multivariante clasificó correctamente casi cuatro de cada cinco sujetos no-consumidores o consumidores de drogas ilegales. Entre los factores estudiados, los relacionados con la vida recreativa fueron los mejores predictores del uso de drogas. Se desprende de estos datos la necesidad de estudiar en profundidad la vida recreativa de los jóvenes e integrar el contexto recreativo en los objetivos de la prevención del uso y abuso de drogas. ABSTRACTThe objective is to describe recreational habits, drug use and risk behaviours in the young going out for enjoyment the weekends, and to estimate the predictive relevance of recreational related variables on drug use, in comparison with other intrapersonal risk factors. The sample comprises 1340 young people interviewed in 5 Spanish cities. Almost all of them abused alcohol or tobacco recently. We divided the sample in two groups, using (775; 58%) any illicit substance last month or not (565; 42%). The use of illegal drugs is associated in our sample with a number of intrapersonal factors: younger ages of onset for cannabis and alcohol, male sex, lower risk perception, greater sensation seeking, involvement in risk behaviours and in problem behaviours. Illegal drug users are also distinguished by their recreational habits (greater involvement and different motivation in going out looking for different contexts in recreational nightlife). A multivariate analysis correctly classified four out of five individuals using legal or illegal drugs. Among the factors studied, recreational styles were the best predictors of drug use. It suggests the need to make an in depth study of weekend recreational habits and add them to the objectives of the prevention of drug use and misuse.

Genetic susceptibility to substance use disorders (SUDs) is partially shared between substances. Heritability of any substance dependence, estimated as 54%, is partly explained by additive effects of common variants. Comorbidity between SUDs and other psychiatric disorders is frequent. The present study aims to analyze the additive role of common variants in this comorbidity using polygenic scores (PGSs) based on genome-wide association study discovery samples of schizophrenia (SCZ), bipolar disorder, attention-deficit/hyperactivity disorder, autism spectrum disorder, major depressive disorder and anxiety disorders, available from large consortia. PGSs were calculated for 534 patients meeting DSM-IV criteria for dependence of a substance and abuse/dependence of another substance between alcohol, tobacco, cannabis, cocaine, opiates, hypnotics, stimulants, hallucinogens and solvents; and 587 blood donors from the same population, Iberians from Galicia, as controls. Significance of the PGS and percentage of variance explained were calculated by logistic regression. Using discovery samples of similar size, significant associations with SUDs were detected for SCZ PGS. SCZ PGS explained more variance in SUDs than in most psychiatric disorders. Cross-disorder PGS based on five psychiatric disorders was significant after adjustment for the effect of SCZ PGS. SCZ PGS was significantly higher in women than in men abusing alcohol. Our findings indicate that SUDs share genetic susceptibility with SCZ to a greater extent than with other psychiatric disorders, including externalizing disorders such as attention-deficit/hyperactivity disorder. Women have lower probability to develop substance abuse/dependence than men at similar PGS probably because of a higher social pressure against excessive drug use in women.

A total of 338 cases of death from acute reactions to drugs in Galicia (NW Spain) from 1 June 1992 to 31 July 1997 were examined. The average annual mortality rate was close to 70 cases. Male victims (90%) prevailed over female ones, the average age at death being 28.8 years. Most of the victims were habitual users who died in their own homes (40%) or nearby (30%). Polydrug use was the most common pattern, the most frequently detected drugs being opioids (281 cases), followed by alcohol (128 cases), benzodiazepines (92 cases) and cocaine (75 cases). Although the intravenous route prevailed (91%), oral and inhalation consumption of the drugs were also significant--the latter has grown significantly in recent times in relation to opioids and other drugs. How accurate the certificate of death can be depends on how thorough the investigation at the crime scene, autopsy room and laboratory are, as well as appropriate knowledge of the individual's history. The coordinated action of different health care institutions and use of available resources are crucial with a view to obtaining such data.

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