Treatment of drug dependence in Switzerland.
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Biomedical subjects
Publications and source records attributed to D Ladewig.
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In order to provide an estimation of the degree of drug and/or alcohol dependency the authors designed a questionnaire. In this paper the basic steps of item analysis, factor analysis and calculation of reliability (split-half-method) are reported. After elimination of 6 items out of 65 the item-metric and factorial characteristics as well as the reliability of the instrument could be judged as satisfactory. On the item level two factor analytical solutions were interpreted. The first one showed one factor covering the general concept of dependency, the second one suggested a 3- dimensional differentiation in terms of 1. negative self-concept, 2. obsessional traits, and 3. addictive illness behavior.
Alcohol was administered in a dose of 0.77 g per kg bodyweight to 16 healthy male subjects in a cross-over-design. A study was made of a number of psychological and physiological variables to determine the modifications that accompany the alcohol-induced changes in the orienting response to an auditory stimulus. Five determinations were made at intervals following a dose of alcohol and five in a control session when no alcohol was given. The results obtained for the psychological variables (self-ratings of the intensity of intoxication and the degree of being startled by the first stimulus; and self-assessment of mood) show alcohol to have stimulant as well as depressant effects. Some of the variables show stimulant effects, mainly at the beginning of the absorption phase, whereas other variables show depressant effects, both in the absorption phase and the postabsorption phase. Changes in physiological variables (such as parameters of electrodermal activity and of the heart rate response) support these findings. The simultaneous presence of both stimulant and depressant effects is pointed out as well as the difficulties in describing these findings in terms of a unidimensional model of activation.
Using a standardised psychological questionnaire (self-estimation scale, personality-inventory FPI of Fahrenberg and Selg) and serial examinations, the effectiveness of a therapeutic concept combining drug, environmental and group therapy was tested. The psychological parameters objectified stabilisation of the psychological-autonomic and emotional areas as well as ego functions. The follow-up study extended over an average of five years and included 101 former drug addicts (14 could not be interviewed, 10 had died). Social stability was observed in 63% (satisfactory working performance, reduction of sexual problems, contacts with friends). 36% of the group had abstained from further drug taking, 27% were taking them periodically, 32% had to be treated again and 5% had deteriorated (trend towards invalidism).
Old patterns of education are being replaced in some European countries by the different ideological norms of the various groups composing modern society. Youth has lost the sure feeling to belong to a certain culture. Drug abuse primarily represents an attempt to get over this insecurity. In an inquiry in Swiss military schools, recruits were questioned about drug and alcohol use and cigarette smoking, and this was related to the home situation. Juveniles who do not have enough affective support in the primary group seem to be more subject to the conflicts of norms going on in our society. Three general factors seem to be responsible for the drug use among juveniles: (1) the family situation of childhood, (2) the conflicts of norms of the society in which they are involved, and (3) the milieu provocation.
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The Freiburg Personality Inventory (FPI) was mailed to a group of 880 female industrial workers who were participating in a 5-year prospective study aimed at elucidating eventual renal toxity of phenacetin-containing analgesics. 338 completely filled in test-sheets were returned. The study sample was divided into five sub-groups according to the amount of drug which could be located. 1. Consumers who had a positive test for analgesic-intake in at least one urine sample (paracetamol = N-acetyl-p-aminophenol as principal metabolit of phenacetin),N = 65.2. "High intakers", paracetamol values over 0.499 o.D. (o.D. = optical density in the spectrophotometric determination of paracentamol [total of three tests]), N = 73.3. "Medium intakers", paracetamol values 0.200-0.499 o.D. (total of three tests), N = 25.4. "Low intakers", paracetamol values 0.049-0.199 oD., N = 84.5. "None-consumers" with negative urine tests, N = 199. It was shown that for some personality features, consumers could be distinguished from non-consumers and "high intakers" from "low intakers", but not "low intakers" from non-consumers nor "high intakers" from "medium intakers". The areas contributing mainly to differentiation were general psychosomatic disturbance, irritability tinged with dysphoria, psychosocial and emotional immaturity, and lability. The importance of early registration is consequently demonstrated.
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The authors report on schizophreniform states in juvenile drug consumers. The following psychodiagnostic instruments have been used in this investigation: a list of complaints, a self-estimation scale, a psychosis-depression-neurosis inventory (v. Zerssen), the Freiburg personality inventory (FPI, Fahrenberg, Selg and Hampel). According to clinical-psychopathological data in the course of psychosis, three groups of patients (N = 21) have been formed and defined as schizophrenia-, borderline-, intoxication-psychosis-groups. The report describes the procedure of two discriminant analyses by which the said three groups have been selected. In addition to methods of a cross section approach, the necessity of longitudinal observations is discussed by means of an own clinical example, considering also observations described in the literature.
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