Garcia-Fuentes Daniel, Fernández-Fernández Ester Paula, Planet Nielsen Núria, Batlle De Santiago Enric, Giné-Servén Eloi, Cañete Crespillo Jose
Centre d'Atenció i Seguiment a les Drogodependències (CASD), Hospital de Mataró, Mataró, Barcelona, España; Unitat d'Aguts de Psiquiatria, Hospital de Mataró, Mataró, Barcelona, España.
Centre d'Atenció i Seguiment a les Drogodependències (CASD), Hospital de Mataró, Mataró, Barcelona, España.
Rev Colomb Psiquiatr (Engl Ed). 2020 Nov 22. doi: 10.1016/j.rcp.2020.09.002.
Undiagnosed attention deficit and hyperactivity disorder (ADHD) is frequent in the substance abuse disorder population, and has an intense repercussion in the daily life of the patients. That condition increases the risk of substance abuse disorders and risk conducts derived from impulsivity. There are not yet studies linking ADHD and the new emergent phenomenon of chemsex, that is, the action of use the intravenous injection of substances in sex parties, with the objective of maximising the practising time and sexual experience. In these sessions, different types of drug are used, for example, synthetic cathinone or mephedrone, and may lead to diverse medical and psychiatric complications like psychosis, aggressiveness and suicide ideation.
We report the case of a 44-year-old man admitted into a psychiatric unit, presenting with 2 time suicidal high risk attempt using intravenous methamphetamine and a dissolvent acid in the context of a depressive episode, after practising chemsex sessions almost every weekend with psychoactive substances taken orally, intravenously and intrarectally. The patient also presented psychotic symptoms from the use of these drugs. When we interviewed the patient during his hospital stay, we observed that there were symptoms of a possible attention and hyperactivity deficit, which was confirmed by study with ASRS-V1.1 and WURS scales. After three weeks, the patient improved substantially as his depressive symptoms and autolytic ideation disappeared.
Look for "hidden" symptoms in substance abuse disorder patients. It is important not to delay important diagnostic tests and to prevent complications. Psychiatric and medical conditions related to chemsex have been reported in several European cities, and recently in Spain where it is an emergent phenomenon and a problem concerning medical and political institutions. The suicide attempt with metamphetamine and acid taken intravenously in the case we report, depressive and psychotic symptoms, addiction, suicide attempts and medical complications are described.
未确诊的注意力缺陷多动障碍（ADHD）在物质使用障碍人群中很常见，并且对患者的日常生活有严重影响。这种情况会增加物质使用障碍的风险以及冲动行为衍生的风险。目前尚无研究将ADHD与新出现的“化学性行为”现象联系起来，即在性派对中静脉注射物质以延长性行为时间和提升性体验。在这些活动中，会使用不同类型的药物，例如合成卡西酮或甲麻黄碱，这可能导致各种医学和精神科并发症，如精神病、攻击性和自杀念头。
我们报告一例44岁男性患者，该患者因几乎每个周末都进行涉及口服、静脉注射和直肠内使用精神活性物质的化学性行为，在抑郁发作期间出现两次使用静脉注射甲基苯丙胺和一种溶解酸的高自杀风险尝试后，入住精神科病房。该患者还因使用这些药物出现了精神病症状。在患者住院期间对其进行访谈时，我们观察到可能存在注意力和多动缺陷症状，这通过ASRS-V1.1和WURS量表的评估得到了证实。三周后，随着抑郁症状和自伤念头消失，患者病情大幅好转。
在物质使用障碍患者中寻找“隐藏”症状。重要的是不要延迟重要的诊断测试并预防并发症。在欧洲几个城市都报告过与化学性行为相关的精神和医学状况，最近在西班牙，这也是一个新出现的现象，成为了医学和政治机构关注的问题。我们报告的病例中出现了静脉注射甲基苯丙胺和酸导致的自杀未遂、抑郁和精神病症状、成瘾、自杀未遂以及医学并发症。
