IntroductionNowadays, 30% of the Spanish population suffers from some form of sleep disorder, occupying much of the visits to a psychiatrist. Sleep disorders are not a serious condition by itself, but have serious implications in daily life: physical exhaustion, poor performance, daytime sleepiness. Insomnia is a most common sleep disorder, however, hypersomnia must also be considered due to the limitations that it causes.ObjectiveBy the description of case report, we will carry out a review of the syndrome Kleine Levine.MethodsCase report.ResultsA case of Kleine–Levin syndrome in a 23-year-old male is described. The episodic disorder was characterized by excessive sleep, voracious appetite, hyper-sexuality, irritability and memory loss. Among its history, he included a psychotic episode in childhood and an episode of behavioral disorder caused by a stressful situation. His partner refers a similar episode of hypersomnia last year that was self-limiting in 15 days and he did not go to the doctor. Patients often act normal between episodes. Remission was spontaneous. Prospects, for organic aetiology, differential diagnosis. However, arises additional tests (analytical, brain CT, EEG…) resulted no pathological. Patient fulfilled the criteria for KLS, but due to the rarity of the disorder he was previously diagnosed as psychosis not otherwise specified.ConclusionsThis case report aim to highlight that KLS though considered a rare disorder but not uncommon and lack of enough available research data is likely to be responsible for missed or erroneous diagnosis; thus we require more systematic studies regarding etiologies and treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionSubstance use disorders (SUD) with psychiatric co-morbidity (dual diagnosis) represent a challenge for both mental health and addiction networks. Dual patients present greater disorder severity and worse prognosis than those with SUD or psychiatric disorders alone. There is a lack of consensus regarding which treatment model (sequential, parallel or integrated) is the most appropriate for them. Despite integrated treatment is seen as the model of excellence, it is a standard difficult to achieve.Objectives/AimsTo describe the presence of dual diagnosis and treatment model received in a sample recruited from a drug abuse community center in Barcelona (CAS Barceloneta).MethodsCross-sectional descriptive analysis of an outpatient center for SUD clinical sample regarding psychiatric co-morbidity (DSM-IV-TR criteria), social-demographic characteristics and treatment model received.ResultsIn the moment of this study, a total of 574 SUD patients are attended at CAS Barceloneta. Of them, 300 (52%) present a dual diagnosis, 64% men, mean age = 48 (SD = 11.29). Thirteen percent (n = 40) of dual patients have psychotic disorder (PsyD) diagnosis and their SUD comorbidities are: alcohol-UD (12.5%, n = 5), cocaine-UD (7.5%, n = 3), cannabis-UD (15%, n = 6), opioids-UD (17.5%, n = 7) and multiple SUD (47.5%, n = 19). Half of dual patients with PsyD (n = 20) are attended in parallel in community mental health centers.ConclusionsOur results suggest there is an important percentage of SUD patients that present psychiatric co-morbidity treated in drug abuse community centers. Parallel treatment is mainly for PsyD patients and sometimes they get lost in the gaps. We would need to develop specific dual programs to give these patients an integrated assistance.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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