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ResumenHazardous alcohol consumption is a common diagnosis among people living with HIV infection. The relationship between alcohol consumption and poor adherence to antiretroviral therapy has been highlighted in different studies, yet few of them performed a parallel analysis of other substance use. In Spain, alcohol consumption is frequently associated with other substance use, mainly cannabis and cocaine. The aim of this study is to assess the influence of hazardous alcohol consumption both combined with other substances (cocaine, heroin, methadone and/or cannabis) or alone on antiretroviral therapy adherence in our social environment. We performed an observational case-control study including 119 HIV+ individuals. We recruited 40 non-adherent patients, defined by less than 90% compliance according to hospital pharmacy refill data, and corroborated by the

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This study aims to analyze the variables on which depends therapeutic discharge, in patients with a severe dual diagnosis admitted to a professional therapeutic community where their pathology is treated. 325 patients admitted between June 2000 and June 2009 to the therapeutic community. This is a retrospective, cross-sectional study with no control group, based on the detailed analysis of the information collected in a model of semi-structured clinical interview designed in the therapeutic community. The 29.5% of the individuals included in the sample were therapeutically discharged. Of all the variables introduced in this analysis the most significant ones were gender, age at the beginning of treatment, education level, opiate dependence, polidrug abuse, and the presence of psychotic disorders and borderline personality disorder. In our study, gender determines the type of discharge, being therapeutic discharge more frequent among women. A higher educational also increases a better prognosis with a higher rate of therapeutic discharge among individuals with higher education level. A later age at the beginning of the treatment reduces the likelihood of therapeutic discharge. Likewise, polidrug abuse, diagnosis of psychotic disorders and borderline personality disorder are associated to a lower rate of therapeutic discharge.Recognizing these characteristics will allow the early identification of those patients more at risk of dropping treatment hastily, while trying to prevent it by increasing the therapeutic intensity.Key words: abuse drugs, severe mental disorder, severe dual diagnosis, therapeutic community, therapeutic discharge. Se trata de un estudio retrospectivo y transversal sin grupo control, basado en el análisis detallado de la información recogida en un modelo de entrevista clínica semi-estructurada diseñado en la CTP.El 29,5% de la muestra recibió alta terapéutica. De todas las variables estudiadas han resultado significativas el género, la edad al inicio del tratamiento, el nivel de estudios del paciente, la dependencia de opiáceos, el "policonsumo", la presencia de trastornos psicóticos y la de trastorno límite de personalidad. En nuestro estudio, el género condiciona el tipo de alta, encontrándose mayores porcentajes de alta terapéutica para las mujeres. El mayor nivel de estudios incrementa también el mejor pronóstico entendido como mayor frecuencia de alta terapéutica en individuos con estudios superiores. La edad más tardía al inicio del tratamiento disminuye la probabilidad de alta terapéutica. Del mismo modo, el policonsumo, el diagnóstico de trastornos psicóticos y de trastorno límite de personalidad se relacionan con peores resultados obteniéndose menores porcentajes de altas terapéuticas. Reconocer estas características permitirá la identificación precoz de los pacientes que tienen más riesgo de abandonar precipitadamente el tratamiento, para tratar de prevenirlo aumentando la intensidad terapéutica.Palabras clave: abuso de sustancias, trastorno mental grave, patología dual grave, comuni...