The Relevance of Dual Diagnoses among Drug-Dependent Patients with Sleep Disorders
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristics | Sample | Insomnia/ Any Sleep Disorder | Delayed Sleep Induction | Sleep Fragmentation | Early Awakening | Nightmares | |
---|---|---|---|---|---|---|---|
N = 398 | N = 218 | N = 150 | N = 137 | N = 85 | N = 80 | ||
Sex | Men | 306 (76.9%) | 175 (80.3%) | 121 (80.7%) | 107 (78.1%) | 65 (76.5%) | 53 (66.2%) |
Women | 92 (23.1%) | 43 (19.7%) | 29 (19.3%) | 30 (21.9%) | 20 (23.5%) | 27 (33.8%) | |
Age 18–27 years | 22 (5.5%) | 11 (5.0%) | 9 (6.0%) | 7 (5.1%) | 4 (4.7%) | 4 (5.0%) | |
28–37 years | 60 (15.0%) | 32 (14.7%) | 23 (15.4%) | 22 (16.1%) | 8 (9.4%) | 12 (15.0%) | |
38–47 years | 128 (32.2%) | 67 (30.7%) | 45 (30.0%) | 44 (32.1%) | 28 (32.9%) | 28 (35.0%) | |
48–57 years | 138 (34.7%) | 78 (35.8%) | 57 (38.0%) | 51 (37.2%) | 37 (43.5%) | 32 (40.0%) | |
58–67 years | 39 (9.8%) | 24 (11.0%) | 14 (9.3%) | 10 (7.3%) | 7 (8.3%) | 4 (5.0%) | |
≥68 years | 11 (2.8%) | 6 (2.8%) | 2 (1.3%) | 3 (2.2%) | 1 (1.2%) | 0 (0.0%) | |
Origin | IDDDU | 198 (49.7%) | 100 (45.9%) | 58 (38.7%) | 58 (42.3%) | 32 (37.6%) | 31 (38.8%) |
ODC | 200 (50.3%) | 118 (54.1%) | 92 (61.3%) | 79 (57.7%) | 53 (62.4%) | 49 (61.3%) | |
Dual Disorder | 245 (61.6%) | 146 (67.0%) | 102 (68%) | 96 (70.1%) | 64 (75.3%) | 64 (80%) | |
Affective disorder | 154 (40.8%) | 91 (42.7%) | 65 (43.3%) | 60 (44.1%) | 42 (50.6%) | 41 (51.9%) | |
Psychotic disorder | 48 (12.7%) | 26 (12.2%) | 20 (13.3%) | 19 (14.0%) | 10 (12%) | 13 (16.5%) | |
Personality disorder | 86 (22.3%) | 53 (24.3%) | 40 (26.7%) | 39 (28.5%) | 24 (28.2%) | 30 (37.5%) | |
Previous treatment | 172 (43.2%) | 103 (49.5%) | 81 (55.9%) | 69 (53.1%) | 49 (61.3%) | 48 (62.3%) | |
Multiple drug-users | 193 (48.5%) | 117 (53.7%) | 88 (58.7%) | 78 (57.0%) | 49 (57.6%) | 50 (62.5%) | |
Occupational status | |||||||
Working | 75 (18.8%) | 31 (14.2%) | 22 (14.7%) | 18 (13.1%) | 10 (11.8%) | 6 (7.5%) | |
Unemployed | 151 (37.9%) | 96 (44.0%) | 68 (45.3%) | 66 (48.2%) | 45 (52.9%) | 46 (57.5%) | |
On leave | 43 (10.8%) | 19 (8.7%) | 11 (7.3%) | 11 (8.0%) | 5 (5.9%) | 6 (7.5%) | |
Retired | 108 (27.1%) | 61 (28.0%) | 40 (26.7%) | 24 (17.5%) | 19 (22.3%) | 20 (25.0%) | |
Other conditions | 21 (5.4%) | 11 (5.1%) | 9 (6.0%) | 18 (13.1%) | 6 (7.1%) | 2 (2.5%) | |
Pharmacological treatment on first interview | |||||||
Alprazolam | 17 (4.3%) | 9 (4.1%) | 7 (4.7%) | 8 (5.8%) | 4 (4.7%) | 2 (2.5%) | |
Disulfiram | 13 (3.3%) | 3 (1.4%) | 2 (1.3%) | 2 (1.5%) | 1 (1.2%) | 2 (3.4%) | |
Clorazepate | 7 (1.8%) | 3 (1.4%) | 2 (1.3%) | 0 (0.0%) | 0 (0.0%) | 1 (1.3%) | |
Diazepam | 13 (3.3%) | 3 (1.4%) | 1 (0.7%) | 1 (0.7%) | 0 (0.0%) | 1 (1.3%) | |
Lorazepam | 24 (6.0%) | 15 (6.9%) | 10 (6.7%) | 8 (5.8%) | 8 (9.4%) | 6 (7.5%) | |
Lormetazepam | 1 (0.3%) | 5 (2.3%) | 4 (2.7%) | 2 (1.5%) | 3 (3.5%) | 2 (2.5%) | |
Methadone | 2 (0.5%) | 1 (0.6%) | 1 (0.7%) | 2 (1.5%) | 0 (0.0%) | 0 (0.0%) | |
Mirtazapine | 8 (2.0%) | 6 (2.8%) | 6 (4.0%) | 3 (2.2%) | 3 (3.5%) | 3 (3.8%) | |
Olanzapine | 9 (2.3%) | 7 (3.2%) | 4 (2.7%) | 5 (3.6%) | 2 (2.4%) | 3 (3.8%) | |
Pregabalin | 4 (1.0%) | 4 (1.8%) | 3 (2.0%) | 3 (2.2%) | 0 (0.0%) | 2 (2.5%) | |
Quetiapine | 12 (3.0%) | 4 (1.8%) | 2 (1.3%) | 1 (0.7%) | 2 (2.4%) | 2 (2.5%) | |
Tiapride | 12 (3.0%) | 7 (3.2%) | 5 (3.3%) | 4 (2.9%) | 4 (4.7%) | 4 (5.0%) | |
Trazodone | 10 (2.5%) | 7 (3.2%) | 5 (3.3%) | 5 (3.6%) | 4 (4.7%) | 3 (3.8%) |
Type of Consumers | Sample N = 398 | Insomnia/any Sleep Disorder N = 218 | Delayed Sleep Induction N = 150 | Sleep Fragmentation N = 137 | Early Awakening N = 85 | Nightmares N = 80 |
---|---|---|---|---|---|---|
N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | |
Cannabis Consumers | 115 (28.9%) | 65 (29.8%) | 50 (33.3%) | 43 (31.4%) | 23 (27.0%) | 25 (31.2%) |
Quantity of Cannabis | ||||||
1–5 U | 95 (23.9%) | 55 (25.2%) | 42 (28.0%) | 36 (26.3%) | 20 (23.5%) | 22 (27.5%) |
6–10 U | 2 (0.5%) | 1 (0.5%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) |
11–15 U | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) |
16–30 U | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) |
31 U or more | 18 (4.5%) | 9 (4.1%) | 8 (5.3%) | 7 (5.1%) | 3 (3.5%) | 3 (3.8%) |
Cannabis withdrawal | 38 (9.9%) | 22 (10.1%) | 17 (11.3%) | 18 (13.1%) | 7 (8.2%) | 9 (11.3%) |
Cocaine consumers | 113 (28.4%) | 83 (38.1%) | 67 (44.7%) | 49 (64.2%) | 30 (35.3%) | 36 (45.0%) |
Quantity of Cocaine | ||||||
1 g/week | 30 (7.5%) | 19 (9.5%) | 13 (9.6%) | 13 (10.1%) | 6 (7.6%) | 9 (12.3%) |
2 g/week | 21 (5.3%) | 13 (6.5%) | 11 (8.1%) | 9 (7.0%) | 3 (3.8%) | 3 (4.1%) |
3 g/week | 9 (2.3%) | 7 (3.5%) | 6 (4.4%) | 4 (3.1%) | 4 (5.1%) | 4 (5.5%) |
4 g/week | 11 (2.8%) | 6 (3.0%) | 5 (1.5%) | 1 (0.8%) | 1 (1.3%) | 3 (5.5%) |
5 g/week | 7 (1.0%) | 4 (2.0%) | 2 (1.5%) | 4 (3.1%) | 3 (3.8%) | 1 (1.4%) |
6 g/week or more | 35 (8.8%) | 17 (8.5%) | 15 (11.1%) | 10 (7.8%) | 7 (8.9%) | 9 (12.3%) |
Alcohol consumers | 236 (66.1%) | 142 (65.1%) | 93 (62.0%) | 87 (63.5%) | 57 (67.1%) | 47 (58.7%) |
Quantity of Alcohol | ||||||
1–20 units/day | 220 (55.3%) | 117 (53.7%) | 77(53.1%) | 71 (51.8%) | 47 (55.3%) | 38 (47.5%) |
21–40 units/day | 36 (9.0%) | 21 (9.6%) | 14 (9.3%) | 14 (10.2%) | 8 (9.4%) | 8 (10.0%) |
41 units/day or more | 7 (1.8%) | 3 (1.4%) | 2 (1.3%) | 2 (1.5%) | 2 (2.4%) | 1 (1.3%) |
CIWA–Ar ≥ 10 | 169 (44.1%) | 94 (43.1%) | 58 (38.7%) | 55 (40.1%) | 30 (35.3%) | 25 (31.3%) |
Opioids consumers | 72 (18.1%) | 48 (22.0%) | 40 (26.7%) | 32 (23.4%) | 21 (24.7%) | 17 (21.2%) |
Quantity of Opioids | ||||||
1–10 g/week | 72 (18.1%) | 48 (22.0%) | 40 (26.7%) | 32 (23.4%) | 21 (24.7%) | 17 (21.2%) |
Benzodiazepines consumers | 93 (23.7%) | 61 (28.0%) | 48 (32.0%) | 46 (33.6%) | 30 (35.3%) | 31 (38.7%) |
1–10 mg/day | 47 (11.8%) | 32 (14.7%) | 24 (16.0%) | 23 (16.8%) | 15 (17.6%) | 15 (12.4%) |
11–21 mg/day | 12 (3.0%) | 8 (3.7%) | 7 (4.7%) | 8 (5.8%) | 5 (5.9%) | 4 (5.0%) |
22–31 mg/day | 1 (0.3%) | 1 (0.5%) | 1 (0.7%) | 1 (0.7%) | 1 (1.2%) | 0 (0.0%) |
32 mg or more | 33 (8.3%) | 20 (9.2%) | 16 (10.7%) | 14 (10.2%) | 9 (10.6%) | 12 (15.0%) |
Characteristics | Insomnia/Any Sleep Disorder (n = 218) | Delayed Sleep Induction (n = 150) | Sleep Fragmentation (n = 216) | Early Awakening (n = 85) | Nightmares (n = 80) | |||||
---|---|---|---|---|---|---|---|---|---|---|
χ2 | p | χ2 | p | χ2 | p | χ2 | p | χ2 | p | |
Sex | 3.023 | 0.082 | 1.781 | 0.182 | 0.121 | 0.728 | 0.016 | 0.898 | 7.069 | 0.008 * |
Age | 2.585 | 0.764 | 2.758 | 0.737 | 1.322 | 0.93 | 5.313 | 0.379 | 5.346 | 0.375 |
IDDDU/ODC | 2.092 | 0.148 | 10.48 | 0.010 * | 3.456 | 0.063 | 5.598 | 0.018 * | 3.898 | 0.048 * |
Dual Disorder | 4.267 | 0.039 * | 2.877 | 0.090 | 4.862 | 0.027 * | 7.554 | 0.006 * | 12.988 | 0.000 * |
Previous treatment | 2.442 | 0.118 | 9.291 | 0.002 * | 4.180 | 0.041 * | 9.913 | 0.002 * | 10.814 | 0.001 * |
Affective disorder | 1.935 | 0.380 | 1.365 | 0.505 | 1.579 | 0.454 | 4.640 | 0.098 | 5.598 | 0.061 |
Psychotic disorder | 0.122 | 0.727 | 0.056 | 0.813 | 247 | 0.619 | 0.033 | 0.855 | 1.353 | 0.254 |
Personality disorder | 1.592 | 0.207 | 1.84 | 0.175 | 4.475 | 0.034 * | 2.183 | 0.140 | 13.596 | 0.000 * |
Multiple drug- users | 4.254 | 0.039 * | 9.368 | 0.002 * | 5.469 | 0.019 * | 3.532 | 0.060 | 7.603 | 0.006 * |
Unemployed | 13.557 | 0.019 * | 8.867 | 0.14 * | 12.438 | 0.029 * | 12.823 | 0.025 * | 25.732 | 0.000 * |
Pharmacological treatment on first interview | 29.55 | 0.009 * | 24.06 | 0.064 | 28.737 | 0.017 * | 19.306 | 0.2 | 13.295 | 0.579 |
Amount of cannabis consumed | 16.935 | 0.390 | 22.760 | 0.120 | 11.728 | 0.762 | 7.919 | 0.951 | 19.666 | 0.236 |
Cannabis withdrawal | 0.016 | 0.898 | 0.490 | 0.484 | 2.345 | 0.126 | 0.401 | 0.527 | 0.255 | 0.614 |
Amount of alcohol consumed | 1.447 | 0.695 | 2.018 | 0.569 | 1.491 | 0.684 | 0.589 | 0.899 | 2.827 | 0.419 |
CIWA-Ar ≥ 10 | 0.208 | 0.649 | 2.805 | 0.094 | 1.257 | 0.262 | 3.511 | 0.061 | 6.488 | 0.011 * |
Amount of cocaine consumed | 3.852 | 0.697 | 9.53 | 0.16 | 7.294 | 0.294 | 5.99 | 0.424 | 8.41 | 0.21 |
Amount of opioids consumed | 0.122 | 0.727 | 0.056 | 0.813 | 0.247 | 0.619 | 0.33 | 0.855 | 1.353 | 0.245 |
Amount of benzodiazepines consumed | 9.848 | 0.043 * | 15.21 | 0.04 * | 16.924 | 0.002 * | 13.316 | 0.010 * | 18.980 | 0.001 * |
Dependent Variable | Wald | p | OR | IC 95% |
---|---|---|---|---|
Insomnia/any sleep disorder | ||||
Benzodiazepine use disorder | 4.779 | 0.029 | 0.354 | 0.140–0.898 |
Dual Disorder | 4.246 | 0.039 | 1.553 | 1.022–2.361 |
Treatment with trazodone | 4.626 | 0.031 | 0.129 | 0.020–0.834 |
Treatment with pregabalin | 4.626 | 0.031 | 0.129 | 0.020–0.834 |
Delayed sleep induction | ||||
Origin: ODC/IDDDU | 10.364 | 0.001 | 1.991 | 1.309–3.027 |
Previous treatment | 9.198 | 0.002 | 0.519 | 0.34–0.793 |
Benzodiazepine use disorder | 7.189 | 0.007 | 0.319 | 0.138–0.735 |
Treatment with pregabalin | 3.857 | 0.05 | 0.091 | 0.008–0.995 |
Sleep fragmentation | ||||
Dual Disorder | 4.824 | 0.028 | 0.606 | 0.388–0.948 |
Previous treatment | 4.158 | 0.041 | 0.639 | 0.515–0.983 |
Benzodiazepine use disorder | 4.567 | 0.033 | 0.423 | 0.192–0.931 |
Treatment with pregabalin | 3.857 | 0.05 | 0.091 | 0.008–0.995 |
Personality disorder | 4.426 | 0.035 | 0.590 | 0.361–0.965 |
Early awakening | ||||
Dual Disorder | 7.353 | 0.007 | 0.470 | 0.273–0.811 |
Origin: ODC/IDDDU | 5.519 | 0.019 | 1.810 | 1.103–2.970 |
Previous treatment | 9.657 | 0.002 | 0.447 | 0.269–0.743 |
Benzodiazepine use disorder | 3.900 | 0.048 | 0.433 | 0.189–0.994 |
Nightmares | ||||
Origin: ODC/IDDDU | 3.856 | 0.050 | 1.656 | 1.001–2.741 |
Previous treatment | 10.490 | 0.001 | 0.425 | 0.254–0.714 |
Dual Disorder | 12.256 | 0.000 | 0.346 | 0.191–0.627 |
Benzodiazepine use disorder | 9.455 | 0.002 | 0.278 | 0.123–0.629 |
Personality disorder | 4.426 | 0.035 | 0.590 | 0.361–0.965 |
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Roncero, C.; García-Ullán, L.; Bullón, A.; Remón-Gallo, D.; Vicente-Hernández, B.; Álvarez, A.; Caldero, A.; Flores, A.; Aguilar, L. The Relevance of Dual Diagnoses among Drug-Dependent Patients with Sleep Disorders. J. Clin. Med. 2020, 9, 2862. https://doi.org/10.3390/jcm9092862
Roncero C, García-Ullán L, Bullón A, Remón-Gallo D, Vicente-Hernández B, Álvarez A, Caldero A, Flores A, Aguilar L. The Relevance of Dual Diagnoses among Drug-Dependent Patients with Sleep Disorders. Journal of Clinical Medicine. 2020; 9(9):2862. https://doi.org/10.3390/jcm9092862
Chicago/Turabian StyleRoncero, Carlos, Llanyra García-Ullán, Alberto Bullón, Diego Remón-Gallo, Begoña Vicente-Hernández, Ana Álvarez, Amaya Caldero, Andrea Flores, and Lourdes Aguilar. 2020. "The Relevance of Dual Diagnoses among Drug-Dependent Patients with Sleep Disorders" Journal of Clinical Medicine 9, no. 9: 2862. https://doi.org/10.3390/jcm9092862