RISULTATI RICERCA

DSM V has conceptualized for the fi rst time the Gambling Disorder which is sorted amongst the addictions, within the category of “non related with substances”; as of the previous release of DSM it was classified as “urges control disorder”.Meanwhile there is a rising interest upon the subject between clinicians and scholars to improve conceptualizing, understanding and therefore indentify the best treatment options.It is thus essential to consider the gambling disorder in all its complexity; paying also attention on the recent growth of online gambling.Nowadays most of the patients accessing public and private Services with a diagnosis of gambling disorder tend to prefer online play and thus the clinician is set on new challenges and must rethink and modify the intervention.The purpose of this article is to introduce the gambling disorder phenomenon, with due attention on its online declination, and successively postulate a course of treatment given its peculiarities.

The research had as its object of study psychoactive substances, specifi cally cocaine addiction which today has a prevalence of 1.8% worldwide.In collaboration with the Onlus Incontro Community, all those subjects who undertook a residential therapeutic-rehabilitative path for a Cocaine Use Disorder, sometimes with psychiatric comorbidity, were evaluated longitudinally, in order to carry out an in-depth characterization from the point of sociodemographic, clinical and psychopathological view.The primary objective was to identify, within these clinical and psychopathological variables, the possible predictive factors of out-come in subjects affected by DUC.Furthermore, the objective was to verify how, following a three-month community journey matured from the moment of entry into the Community, the depressive symptoms, the hedonic-volitional drive, the levels of craving and the general state of health change according to the time spent in the Structure.The present was a prospective observational study that included a sample of 70 patients with a primary diagnosis of Cocaine Use Disorder, recruited consecutively at the study facility, between November 2021 and May 2022.The study envisaged, in an initial phase – within a maximum of two weeks of hospitalization – the compilation of a medical history form for the collection of socio-demographic information.Seventy patients with Cocaine Use Disorder were evaluated, of whom 49 completed the three-month followup.The sample is therefore composed of 54 male subjects (77.1%), 16 female subjects (22.9%) with an average age of 39.6 ± 10.1 years. 77.1% of the sample is unmarried, 21.4% is separated and only 1.4% is married.70% of patients live with their family of origin/spouse and 30% live alone.The level of schooling was 9.41 ± 3.70, this means that on average, the sample completed lower secondary school and attended the fi rst year of high school. 52.9% of the sample has a job, while 47.1% is unemployed.With regard to the type of occupation, 2.9% study, 21.4% perform occasional jobs and the remainder work regularly. 74.3% of the sample smoke cigarettes, with an average of 12.9 ± 9.18 per day. Furthermore, 1/3 of the sample presented legal problems.

Nell’articolo viene presentato il documento conclusivo del gruppo di lavoro che ha visto gli autori coordinare il gruppo di lavoro costituito da tutti i direttori/responsabili delle UO dipendenze di Regione Lombardia. Il prodotto conclusivo declina il Percorso Diagnsotico, Terapeutico Assistenziale per i consumatori di sostanze che afferiscono ai SerD e per la popolazione detenuta. Nel disegnare il PDTA si sono considerati quattro elementi principali Il percorso ideale rappresentato dal Point of Care che permette diagnosi e cura nei luoghi di accesso dei pazienti favorendo sia l’emersione del dato epidemiologico che il trattamento precoce dell’infezione da HCV. Il contesto epidemiologico variabile in relazione al contesto in cui opera un servizio (area metropolitana, capoluoghi di provincia, aree montane etc.). La prevalenza della popolazione che afferisce ai singoli servizi (consumatori per via endovenosa o per altre vie, persone con consumo di alcol a rischio etc.). I contesti organizzativi valutando l’elemento critico più importante legato alla mancanza di personale dei SerD e della Sanità Penitenziaria. Per questo motivo il PDTA prevede un percorso di base ed uno avanzato e sono applicabili in ogni contesto organizzativo

Patients with addiction treated in specialized services, also those who have Judicial Authority restrictions, are frequently little compliant to scheduled appointment. Standardised psychoeducational group intervention organized in modules is a new approach for Substance Use Disorder patients designed to promote their involvement in a treatment plan working on insight development. Group method: the method provides 90 minutes theme meetings 8 times a week run by a conductor and a co-conductor for a closed group of 8 people. For each meeting some theme work units are established, to increase self-awareness (insight) both recognising and managing emotions and recognising and setting practical and personal goals using problem solving. Meetings are divided in three parts: assigned exercises assessment, topic to be treated and next excercise assigment. Materials and methods: Two groups of 8 participants each were conducted, with 90 minutes meetings every week. All patients were subjected to legal measures and attended Addiction treatment service discontinuosly, only to take replacement and/or simptomatic therapy. Some outcomes that indicated an increased insight were assessed: toxicological supervision compliance, constant and operative group attendance and compiling training sheets at home, and patient request to start an individual treatment after the 8 group meetings. Results: Treatment outcome assessment shows a positive effect on the indicators considered. All the 12 compleeters compiled training sheets at home and were compliant with toxicological supervision having negative drug test results, and 6 requests for starting an individual psychotherapy treatment and 2 requests for an educational treatment were received. Follow-up outcomes confirm that if the ability of reflecting on emotions, thoughts and experiences increases, than a higher awareness of needing care and a better treatment adherence can be achieved.

We report here the experimentation of a group of cocaine users facing two SERDP offi ces in the province of Bologna enlisted by the reference operators on a “smart” Skills training program of 10 meetings.The candidates were 8 male, with a fl uctuating relationship with substances characterized by periods of abstinence and periods of resumption of use often in conjunction with relationship diffi culties or emotional crises.All the candidates were socially integrated with a regular job, 3 of them were married with offspring and all had contacted the Relationship Service with a partner or a family member who was the fi rst to see the urgency of asking for help for the dysfunctional behavior of the relative. 4 out of 8 patients were in individual psychotherapy with the group leader who suspended individual interviews in favor of skills training for the entire duration of the group, the others benefi ted from psycho-social and educational support from a professional educator.All patients underwent the PID 5 test in the diagnostic phase and the pre-treatment phase was treated in terms of opportunity and commitment.After the 10 skills sessions, the patients will be followed up individually by taking the dbt forms and group follow-ups will be organized at 3 and 6 months.The results we report are in terms of frequency (average 66.6%), active participation and evaluation of the experience by problem consumers.