The use of cannabis is likely to increase as regulations on its consumption are diminishing throughout the world.

to identify the prevalence of anxiety and depression symptoms in a group of cannabis users in Tunisia.

this a transversal descriptive study about 137 participants in the University Hospital Of Mahdia during 2 months.

In our study population , the consumers were young adults aged between 18 and 35 years old ,of whom 40.8% were professionally active, 23.2% had psychiatric history. Moreover, the use of other substances was regular among users as follows: tobacco among 74.6% of users, alcohol among 72.5% of users, ecstasy among 41.3% of users, cocaine among 25.4% of users. The use of cannabis was considered as a means of exultation for 66.7%, as an anxiolytic for 26.8% and as a sedative for 23.9%. Overall, the effect of cannabis use on anxiety and depression on the HAD scale showed the following results: probable anxiety in 53% of cases, probable state of depression in 72% of time.

The correlation between cannabis use, anxiety and depression remains unclear. Equally concluded, the assumption of self-medication by cannabis stills a topic of discussion.

No significant relationships.

Uterine cancer is the most common gynecologic malignant neoplasm in developed countries. While depression is up to 3-5 times more common in patients with cancer than in the general population, literature is still limited regarding the relation between Endometrial Cancer and depression.

To analyze Depression among Endometrial Cancer hospitalizations in mainland Portuguese public hospitals (2008-2015).

A retrospective observational study was conducted using administrative data from all hospitalizations in Portuguese mainland public hospitals between 2008-2015. All women’s hospitalizations(≥18 years) with a primary diagnosis of Endometrial Cancer (ICD-9-CM 182.x) were selected. Secondary diagnosis of depression was identified with ICD-9-CM 296.2x, 296.3x and 311x codes. Surgical procedures codes 68.4x, 65.6x, 40.3x, 40.5x, 68.6x, 68.9x and 68.8x were used to divide the hospitalizations into surgical vs non-surgical. Groups were compared with Pearson Chi-square test and crude odds ratio(OR) was used to estimate the association between surgery and depression.

From 10227 hospitalizations with a primary diagnosis of Endometrial Cancer, 533 had a registry of depression(5.2%). Annual depression frequency rose from 2.0% (2008) to 8.3% (2015). Among patients with a record of depression, 73.2% had surgery. Women who had surgery were significantly more likely to have registered depression (p<0.001). The OR for depression in surgical vs non-surgical patients was 1.73 (95%IC:1.42-2.10).

Patients hospitalized due to Endometrial Cancer and submitted to surgery had almost two-fold more risk of having a registry of depression. This trend reinforces the importance of early depression screening of these patients, enabling the implementation of timely therapeutic strategies before and after surgery.

No significant relationships.

People presenting first-episode psychosis (FEP) benefit from early intervention programmes, although they are scarce in low- and middle-income countries (LMICs). In Brazil, there are just a few of them unequally distributed across the country.

We aimed to describe the workings of the Ribeirão Preto Early Intervention for Psychosis Programme (Ribeirão Preto-EIP) – an outpatient service for first-episode psychosis patients residents in the Ribeirão Preto catchment area in Southeastern Brazil.

A retrospective cohort of all patients attended throughout four years (2015-2018) was analysed. We excluded patients who attended only the first consultation and those with an initial diagnosis other than a psychotic disorder. Data was obtained through retrospective analysis of medical records.

Our service had 358 new referrals during the four-year period, and 237 patients were followed on average (median) by 14 months. Most of the patients were male (64.1%), single (84.8%), with a median age of 23.5 years (age ranged from 9 to 86 years). Schizophrenia was the main diagnosis (43.4%), followed by substance-induced (25.7%) and affective psychosis (18.6%). Taking follow-up diagnoses as gold-standard, initial diagnoses of bipolar disorder and schizophrenia spectrum disorders had the highest positive predictive values, 83% and 81% respectively. Most referrals to our programme were made by tertiary care (63.7%), followed by secondary (28.5%) and primary care (7.8%).

Here we presented a large sample of FEP patients in a representation as trustworthy to the reality of our programme as possible. Our analysis suggest that Early Intervention Programmes can be successfully implemented in LMICs.

No significant relationships.

Only three population-based observational human studies provided evidence that benzodiazepines (BZD) are associated with clinically adverse respiratory outcome. Striking was the finding that BZD drug exposure was associated with a 32% significantly increased adjusted risk of all-cause mortality, including, of note, the subgroup of individuals with no comorbidities. Causation, however, cannot be inferred in observational study design and, highly likely, recipients received BZD’s in these studies to help treating anxiety related to inter alia pre-existing respiratory symptoms.

Based on one fatal particular case, authors of current rapport explain what can go wrong when BZD’s are given in patient with respiratory impairment.

Authors provide a model on how an increase in carbon dioxide can lead to impaired cerebral autoregulation in a person with pre-existing respiratory decompensation. Discussion of integrative metabolic and vascular physiology.

Case rapport of a 18 y.o. otherwise healthy man, who was hospitalized with a novel episode of diabetic ketoacidosis accompanied by profound hypocapnia and anxiety, and who deteriorated and died shortly after airway management because of a clinically important acid-base balance disturbance caused by increased carbon dioxide. All the blood tests and results of respiratory monitoring were collected and carefully assessed.

Current case suggests that the P(CO(2))--HCO(3) hypothesis is consistent with known data on impaired cerebral autoregulation in diabetic ketoacidosis, driven mainly by increased levels of pCO2. In our opinion, it indicates the recommendation not to administrate BZD’s in patients with pre-existing compensatory hyperventilation as it may counter to the logic of adaptive physiology.

No significant relationships.

Drug poisonings is a continuous public health problem in Russia and worldwide.

The objective of the study was to provide characteristics of lethal drug poisonings in a northern Russian region.

The data on deaths from drug poisoning that occurred between 2018 and September 2021, systematically collected by the Regional Center on the Organization of the Narcological and Psychiatric service of the Khanty-Mansi Autonomous Okrug of Russia, was analyzed.

Among 220 cases of fatal drug poisoning the overwhelming majority (90.4%) occurred among males. The number of cases increased annually from 27 in 2018 to 71 in 2020. The average age of death increased from 33.6 years in 2018 to 38.2 years in 2021. Over two thirds of deceased (70.9%) had complete secondary or vocational secondary level of education, almost one third (30.0%) were skilled workers, and slightly less than half (44.1%) were unemployed. The most common causes of death were methadone poisoning (34.5%), poisoning with other opioids (21.8%), other synthetic drugs (17.3%), other unspecified drugs (11.8%), and psychostimulants (10.0%). Alcohol intoxication was identified as a concomitant cause of death in every fourth case (26.0%), of which 98% were among males. Most often, alcohol was present in the blood at a concentration of 120 mg/ml and above. Every fourth deceased (23.6%) was registered with narcology health service for drug addiction.

Fatal poisonings with narcotic drugs and psychotropic substances is a growing public health problem in a northern industrial region of Russia, which affects predominantly working-age males and requires comprehensive multisectoral response.

No significant relationships.

Little is known regarding how the risk of suicide in refugees relates to their host country. Specifically, to what extent, inter-country differences in structural factors between the host countries may explain the association between refugee status and subsequent suicide is lacking in previous literature.

We aimed to investigate the risk of suicide among refugees in Sweden and Norway according to their sex, age, region/country of birth and duration of residence.

Each suicide case between the age of 18-64 years during 1998 and 2018 (17,572 and 9,443 cases in Sweden and Norway, respectively) was matched with up to 20 population-based controls, by sex and age. Multivariate-adjusted conditional logistic regression models yielding adjusted odds ratios (aORs) with 95% confidence intervals (95% CI) were used to test the association between refugee status and suicide.

The aORs for suicide in refugees in Sweden and Norway were 0.5 (95% CI: 0.5-0.6) and 0.3 (95% CI: 0.3-0.4), compared with the Swedish-born and Norwegian-born individuals, respectively. Stratification by region/country of birth showed similar statistically significant lower odds for most refugee groups in both host countries except for refugees from Eritrea (aOR 1.0, 95% CI: 0.7-1.6) in Sweden. The risk of suicide did not vary much across refugee groups by their duration of residence, sex and age.

The findings of almost similar suicide mortality advantages among refugees in two host countries may suggest that resiliency and culture/religion-bound attitudes could be more influential for suicide risk among refugees than other post-migration environmental and structural factors in the host country.

No significant relationships.

Parkinson’s disease (PD) is a neurologic degenerative condition with complex neuropsychiatric manifestations which can be challenging to manage and greatly impact quality of life and prognosis.

The description of this case aims to highlight the complex interaction between PD, drug-abuse and impulse control disorder (ICD).

Clinical information was obtained through patient interviewing and medical records consulting. A literature review on the topic was conducted.

We report the case of a 52-years-old male with PD diagnosed at the age of 45, presenting with rigidity of right limbs and freezing of gait. He had a history of multiple substance-abuse: hashish, heroin and cocaine, with cessation of all substances by the age of 40. The patient responded well to antiparkinsonian medication initially, but needed frequent adjustments and developed ICD secondary to dopamine agonists, presenting pathological gambling and hypersexuality. At 47 he restarted using cocaine stating that it diminished the motor symptoms. Motor symptoms worsened and became partially responsive to medication. Pharmacologic options were limited due to ICD. He developed dopamine dysregulation syndrome, abusing dopaminergic drugs and requesting multiple prescriptions. Deep brain stimulation surgery was proposed, but the patient was deemed unfit for the procedure after two separate psychiatric evaluations, mainly because of behaviour and social problems in relation to sustained cocaine abuse and personality disorder. Attempts to stop drug abuse were unsuccessful despite several interventions by addiction psychiatry.

Co-occurrence of PD, substance-abuse and personality disorder poses as a therapeutic challenge conditioned by pharmacological iatrogenesis and behavioural disturbances, requiring a multidisciplinary and individualized approach.

No significant relationships.

Aggression and violent incidents are a major concern in psychiatric inpatient care. Nutritional supplementation was found to reduce aggressive incidents and rule violations in forensic populations and in children with behavioral problems.

To assess whether multivitamin, mineral, and n-3 PUFA supplementation would reduce the number of aggressive incidents among long-stay psychiatric inpatients.

The trial was a pragmatic, multicenter, randomized, double-blind, placebo-controlled study. Data were collected from 25 July 2016 through 29 October 2019 at 8 local sites for mental healthcare in the Netherlands and Belgium. Participants were randomized (1:1) to receive either three supplements containing multivitamins, minerals, and n-3 PUFA or placebo for 6 months. The primary outcome was the number of aggressive incidents using the Staff Observation Aggression Scale – Revised (SOAS-R). Secondary outcomes were the patients’ quality of life, affective symptoms, and adverse events.

In total, 176 participants were randomized (supplements, n = 87; placebo, n = 89). Participants were on average 49.3 years old (SD = 14.5), and 64.2% were male. Most patients had a psychotic disorder (60.8%). The primary outcome of SOAS-R incidents was similar in those assigned to supplements (1.03 incidents per month; 95% confidence interval [CI]: 0.74-1.37) and placebo (0.90; 95% CI: 0.65-1.19), with a rate ratio of 1.08 (95% CI: 0.67-1.74; p = .75). Differential effects were not found in sensitivity analyses on the SOAS-R or on secondary outcomes.

Six months of nutritional supplementation did not reduce aggressive incidents among long-stay psychiatric inpatients.

No significant relationships.

Non-suicidal Self-Injury (NSSI) refers to causing damage on body tissue without attending to death. It is mostly presented among the youths and not approved by the society. Studies nowadays have explored the perspectives, feelings or experience of the youths or healthcare professionals. However, negative feelings and misunderstandings toward each other remain from both sides.

The aim was to explore the encountering experience of the youths with NSSI and the healthcare professionals during the same hospitalization in a psychiatric acute ward.

Qualitative study was employed by using narrative approach. In-depth interview was conducted for the youths with NSSI and their primary nurse and resident from a medical center in southern Taiwan.

Narratives from the patients and healthcare professionals showed that the youths seemed to be comfortable as encountering with the healthcare professionals’ caring. In contrast, the healthcare professionals’ struggles had been hidden inside and remained uneasy and unsolved. Two extreme experiences have been reported by the youths with NSSI: felt satisfied and understood about being cared vs. felt numbness and not been understood. Four kinds of experience were identified as: struggling on caring them, feeling confused and helpless, keeping a safe distance, and having contradicted values.

This study found that the healthcare professionals suffer from varied aspects when encountering the youths with NSSI, which they often hid inside without expressing. Future improvement such as care guideline or staff’s support system should be built to decrease the negative effects inside the healthcare professionals’ mind.

No significant relationships.

Attention-Deficit/Hyperactivity Disorder (ADHD) was classically considered a childhood-onset neurodevelopmental condition. Over the past 40 years, it became evident that it can persist during adulthood.

The purpose of the authors is to describe the characteristics of ADHD in adults and the specific comorbidities, proposing an approach to these patients.

A brief non-systematized review is presented, using the literature available on PubMed and Google Scholar.

Only 40-50% of children and adolescents with ADHD will have symptoms that persist into adulthood (estimated adult prevalence of 2.8% across 20 countries; 25% in prisons). A more subtle presentation in adults and the difficulty to access past medical history, lead to diagnosis and treatment rates of lower than 20% (versus 50% in children). Well-characterized core symptoms in children evolve into a predominance of inattention symptoms. They became adults with marked disorganization, difficulties in completing tasks and managing time. Emotional dysregulation is a very prevalent symptom in this population. The comorbidities rate increase over time (reaching 75% of patients).

Adults (or even older subjects) with cognitive and/or behavioural complaints should be submitted to systematic screening for ADHD. Non-treated ADHD symptoms in adulthood are associated with severe impairment, therefore adjustments in the health care system to support the transition from child to adult services are needed.

No significant relationships.

Burden among family caregivers of patients with mental illness can be mediated by resilience and perceived social support.

The present study aimed to explore the relationship between perceived social support and resilience levels among caregivers of patients with mental illness and to identify its associated factors.

This was a cross-sectional, descriptive and analytical study conducted on caregivers of patients followed in the outpatient psychiatry department at the university hospital of Sfax (Tunisia), during septembre 2021. Resilience was assessed with the Connor–Davidson Resilience Scale and the social support with the social provisions scale. High scores indicate high resilience and support.

We have involved 34 family caregivers with an average age of 47.47 years(SD=12.4 years). The mean resilience score of caregivers was 42.85 and the mean social support score was 28.09(SD=5.54). The score of resilience correlated positively with the score of social support among family caregivers of patients (r= 0.76 ; p=0.0001). Furthermore, resilience and social support were significantly lower among caregivers with a history of chronic illness (p=0.0001 and 0.002 respectively). Regarding clinical factors, the scores of social support and resilience decreased significantly with the duration of providing care to patients (r=-0.60; p=0.0001 and r=-0.75; p=0.0001 respectively). Similarly, they decreased significantly with the number of hospitalizations of patients (r=-0.53; p=0.001 and r=-0.62; p=0.0001 respectively).

The findings suggests that high social support promotes better resilience among family caregivers of patients with mental illness. So, a better adjustement to the role of caregiver can be effectively achieved by improving the perceived social support.

No significant relationships.

There is a widely known stereotype about medical majors repeated by generations of medical practitioners called ,,medical student disease”. It’s based on a belief that unexperienced students are prone to develop pathological fear of medical conditions they are studying about.

The aim of the study was to examine two populations of students - medical and non-medical ones in order to compare their level of hypochondriacal behavior and health-related anxiety. Moreover we looked for other factors which might have had an influence on hypochondria and nosophobia among them.

The proprietary questionnaire was completed by 606 students (303 medical students of the Medical University of Silesia in Katowice and 293 students of the 3 largest non-medical universities in Katowice).

The results show that medical students receive same scores on a nosophobia scale as students of non-medical universities (p=0,5). The analysis of hypochondriacal behavior showed significantly higher results in non-medical students group (p=0,02) .The higher medical students were at the stages of academic education, the higher the results of nosophobia they obtained. In the entire study group female received higher score in relation to the fear of illness (p = 0.001). People with mental disorders achieve significantly higher results of nosophobia (p <0.001 in the entire group) and of hypochondria (p <0.001 for the entire cohort).

Our study challenges the widespread belief that medical students, compared to their peers, are overly anxious about their own health. Gender and having a mental illness are predictors of hypochondria and nosophobia.

No significant relationships.

The role of sensitivity to punishment on aggression is controversial, both positive and negative relationships have been observed in previous literature.

The aim of this research was to clarify the role of sensitivity to punishment in different types of aggression and provide a better understanding of the influence of emotional regulation on this relationship.

Two hundred and twenty-nine participants took part in the study (130 women; average age = 21.52 years). All of them were assessed for levels of verbal aggression, physical aggression, anger, and hostility (by Buss-Perry Aggression Questionnaire), levels of sensitivity to punishment (by SPSRQ–20), and emotional regulation ability (by MSCEIT).

A higher reactivity to punishment had a direct negative effect on physical and verbal aggression. However, a higher reactivity to punishment also showed a positive indirect effect on verbal and physical aggression through an increase in anger and hostility. In addition, ability in regulating emotions moderated the indirect effects of sensitivity to punishment on physical aggression.

Our results suggest that sensitivity to punishment can act both as a protective factor and as a risk factor for aggression. This relationship depended on the type of aggression studied and the emotional regulation abilities. These findings can help to inform the design of programs aimed at reducing aggressive behaviour. This work was funded by Junta de Andalucía (projects: EMERGIA20_00056 and UMA18-FEDERJA-137) to Alberto Megías Robles.

No significant relationships.

Conspiracy theories are popular during the COVID-19 pandemic. Conspiratorial thinking is characterised by the strong conviction that a certain situation that one sees as unjust is the result of a deliberate conspiracy of a group of people with bad intentions. Conspiratorial thinking appears to have many similarities with paranoid delusions.

To explore the nature, consequences, and social-psychological dimensions of conspiratorial thinking, and describe similarities and differences with paranoid delusions.

Critically assessing relevant literature about conspiratorial thinking and paranoid delusions.

Conspiratorial thinking meets epistemic, existential, and social needs. It provides clarity in uncertain times and connection with an in-group of like-minded people. Both conspiratorial thinking and paranoid delusions involve an unjust, persistent, and sometimes bizarre conviction. Unlike conspiracy theorists, people with a paranoid delusion are almost always the only target of the presumed conspiracy, and they usually stand alone in their conviction. Furthermore, conspiracy theories are not based as much on unusual experiences of their inner self, reality, or interpersonal contacts.

Conspirational thinking is common in uncertain circumstances. It gives grip, certainty, moral superiority and social support. Extreme conspirational thinking seems to fit current psychiatric definitions of paranoid delusions, but there are also important differences. To make a distinction with regard to conspiratorial thinking, deepening of conventional definitions of delusions is required. Instead of the strong focus on the erroneous content of delusions, more attention should be given to the underlying idiosyncratic, changed way of experiencing reality.

No significant relationships.

Depression and anxiety are very frequent and associated with high societal costs, much suffering and functional impairment. Employment is essential and pivotal recovery after sick-leave. In many countries, health care interventions are delivered separately from vocational rehabilitation services. This fragmented placement of interventions often implies lack of coordination, creating despair among sick-listed persons.

The aim of this trial was to investigate an integrated mental health care and vocational rehabilitation intervention to improve and hasten the return-to-work process among people sick-listed with anxiety or depression.

In this RCT, participants were randomly allocated to A) integrated interventions (INT), B) improved mental health care (MHC) or B) service as usual (SAU). Primary outcome was time to return-to-work during 12-month. Secondary outcomes were time to return-to-work at 6-month follow-up; levels of anxiety, depression, stress symptoms and social and occupational functioning at 6-month follow-up; and return-to-work measured as proportion in work at 12-month follow-up.

631 individuals randomized. INT showed higher proportion in work compared with both SAU and MHC at the 12-month follow-up. We found no differences regarding return-to-work time at either the 6- or 12-month follow-up. No differences in symptoms between SAU, MCH or INT were detected, but MHC and INT showed lower scores on Cohen’s perceived stress scale compared with SAU at 12-month follow-up.

Although INT did not hasten return-to-work, it yielded higher proportion in work compared with MHC and SAU.

No significant relationships.

People with autism spectrum disorder (ASD) frequently need support due to the elevated prevalence of psychiatric and medical comorbidities. The Covid-19 outbreak has severely affected the routinary functioning of healthcare services, thus causing severe consequences for autistic people and their caregivers, an already fragile population prone to mental health diseases.

1. To compare the levels of psychological well-being, insomnia, and family distress perceived by caregivers of autistic people to those perceived by caregivers of people with other types of disability. 2. To evaluate predictors of individual and family distress reported by caregivers of autistic individuals.

We collected data through a cross-sectional web-based observational study from April 19 to May 3, 2020. Socio-demographic information were collected, and psychopathological variables were assessed using the General Health Questionnaire-12, the Insomnia Severity Index, the Brief Resilient Coping Scale, and the Family Distress Index.

No significant differences emerged between the two groups of caregivers in terms of well-being, sleep quality, family distress, and level of resilience. The risk of individual distress during the pandemic was higher in people caring for younger autistic people. Lower levels of resilience predicted higher levels of individual distress among caregivers of autistic people.

Our study confirmed that caregivers’ mental health is worthy of attention and that people with disabilities may benefit for well-organized healthcare support networks (e.g. in-home services). The non-significant differences found between caregivers of ASD and non-ASD individuals may be related to the severe distress that Covid pandemic caused on the entire population.

No significant relationships.

This work represents the continuation of the studies presented in two e-posters during the EPA 2021 conference (De Filippi et al., 2021; Rignanese et al., 2021), which addressed the physical pain-suicidality association (k=44 studies).

The aim of this meta-analysis is to provide an update of those studies, integrating data relating to adolescents, adults, and olders.

We started with the analysis of three papers, in particular a meta-analysis (Calati et al., 2015) and two systematic reviews (Hinze et al., 2019; Santos et al., 2019). After searching on Pubmed (until September 2020), data were extracted from articles comparing the rates of current and lifetime suicidal thoughts and behaviours (death wish, suicidal ideation, suicidal planning, suicide attempt and suicide death: DW, SI, SP, SA, and SD) in adolescents, adults, and olders with any type of physical pain and in individuals who did not report this condition. Data were analysed using Comprehensive Meta-Analysis Software (CMA) version 2.

67 studies were included, of which 16 on adolescents, 29 on adults, 16 on olders, and 6 on mixed ages. Although quite high between-study heterogeneity was detected in most analyses, results suggested that individuals with physical pain are more likely to report any form of suicidal outcome if compared to those not affected by pain.

Collected data are therefore in line with previous literature on this topic, which considered physical pain an extremely predictive risk factor for suicidal thoughts and behaviours. However, further research on this topic would be extremely useful.

No significant relationships.

Emigration is the act of leaving one’s country of nationality or habitual residence to settle in another nation. In Tunisia, this phenomenon is increasing in particular for doctors.

Evaluating the intentionality of emigration among interns and medical residents in Tunisia while studying the factors related to it.

We conducted a cross-sectional, descriptive and analytical study of interns and medical residents who participated in our study through the social network ’Facebook’ by an anonymous self-questionnaire. The level of satisfaction with the different aspects of life were assessed by a 5-point Likert scale, from “not at all satisfied” to “very satisfied”.

The total number of participants was 56 of which 64.3% were medical residents. More than 50% of the participants expressed dissatisfaction with the distribution of tasks and organization of work (66.1%), safety at work (53.6%), comfort (57.2%), time allocated to personal life (53.6%) and salary (69.6%). The political, health and educational situation in the country was considered unsatisfactory by the majority of participants (90% to 95%). Among our participants, 44.6% regretted having chosen the profession of medicine and 53.6% had plans to immigrate to work abroad. The intentionality of immigration was significantly higher among men (p=0.02), those with siblings abroad (p=0.047) and those without dependent relatives (p=0.040).

Young physicians are strongly looking for emigration. This decision could emanate from professional, personal and political factors. Further studies seem to be necessary to explain this emigration phenomenon.

No significant relationships.

Several studies describe that the coexistence of a substance use disorder with another psychiatric condition or “dual disorder” (DD) is associated with a worse evolution at all levels, including a greater burden of medical illnesses and greater mortality.

To describe the presence of DD and related factors in patients admitted to a General Hospital that required assessment by a psychiatry service.

A descriptive study that includes patients admitted to the Hospital del Mar in Barcelona for all medical-surgical reasons and attended by the specific addiction psychiatry consultation service between January 2016 and October 2021. Sociodemographic and clinical data are collected including the history of consumption and the diagnosis of dual disorder. Chi-square test was used for comparison between groups.

The sample was 1796 patients (Women: 345. Mean age: 50.3 years; SD: 12.6). 43.7% of the sample presented DD, with axis 1 disorders being the most frequent. There was an association of DD to factors as: being woman (54 vs 41.2% p <0.001), HIV positive serologies (54 vs 42.7% p <0.001), being homeless (49 vs 31.7% p <0.001) and cocaine consumption compared to other substances (53.4 vs 39.8% p <0.001).

In our sample, almost half of patients had DD. The representation of women was significantly lower, however they presented a higher proportion of DD. In this study we describe an association of DD with other biopsychosocial problems, and further studies are necessary to determine in which sense they are related and optimize patient care.

No significant relationships.

No significant relationships.