Centre d'Atenció i Seguiment a les Drogodependències (CASD), Hospital de Mataró, Mataró, Barcelona, Spain; Unitat d'Aguts de Psiquiatria, Hospital de Mataró, Mataró, Barcelona, Spain.
Centre d'Atenció i Seguiment a les Drogodependències (CASD), Hospital de Mataró, Mataró, Barcelona, Spain.
Rev Colomb Psiquiatr (Engl Ed). 2022 Jan-Mar;51(1):76-80. doi: 10.1016/j.rcpeng.2020.09.002. Epub 2022 Feb 21.
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）在物质滥用障碍人群中很常见，对患者的日常生活有强烈的影响。这种情况会增加物质滥用障碍和冲动导致的风险行为的风险。目前还没有研究将 ADHD 与新出现的性化学现象联系起来，即通过静脉注射物质在性派对中使用的行为，目的是最大限度地延长性行为时间和性体验。在这些会议中，使用了不同类型的药物，例如合成卡西酮或美沙酮，可能导致各种医疗和精神并发症，如精神病、攻击性和自杀意念。
我们报告了一例 44 岁男性的病例，他因在抑郁发作期间两次使用静脉注射甲基苯丙胺和一种溶剂酸自杀风险高而被收入精神病院，在此之前，他几乎每个周末都在进行性化学会议，同时口服、静脉内和直肠内使用精神活性物质。该患者还因使用这些药物出现了精神病症状。当我们在住院期间采访该患者时，我们观察到他可能存在注意力和多动缺陷的症状，这通过 ASRS-V1.1 和 WURS 量表的研究得到了证实。三周后，患者的抑郁症状和自杀意念明显改善，病情明显好转。
在物质滥用障碍患者中寻找“隐匿”的症状。重要的是不要延迟重要的诊断测试，以防止并发症。与性化学有关的精神和医学状况已在几个欧洲城市报告，并最近在西班牙报告，西班牙是一个新兴现象，也是一个涉及医疗和政治机构的问题。我们报告的病例中，静脉注射甲基苯丙胺和酸的自杀企图、抑郁和精神病症状、成瘾、自杀企图和医疗并发症均有描述。
