In a consecutive series of 257 alcoholics from an out-patient department 53 were judged as assaultive and 38 as suicidally inclined at the clinical examination 20 years ago. At the follow-up the assaultive alcoholics had a 3.3 times increased mortality rate, the suicidally inclined 1.9 times and the others 1.7 times compared with the general population. The assaultive alcoholics had an increased rate of suicides, intoxications and other alcohol-related deaths compared with other alcoholics. Repeated assaultive behaviour was uncommon. It is concluded that a skilled psychiatric evaluation of assaultive behaviour in alcoholism has an important predictive value.
Eleven patients with a psychosis in connection with cannabis abuse admitted to two mental hospitals during 1 year were examined. Patients with a pre-existent psychosis or a mixed abuse were excluded. The patients were divided into three groups: acute, subacute and chronic. The features of the disease were essentially similar in all patients, with a mixture of affective and schizophrenia-like symptoms, confusion and a pronounced aggressiveness. The course as a rule was self-limiting leaving no residual symptoms. There was almost no heredity of severe mental disease. The symptoms were very similar to those seen in cycloid psychosis, and a possible relationship between the two diseases is discussed. As regards the widespread abuse of cannabis we conclude that psychosis is a rare complication but that in unclear psychotic states it is recommended to actively search for a cannabis psychosis.
This paper reports the results of a 10-year follow-up of a pioneer group of 36 opiate addicts treated at a detoxification unit at St Lars Hospital in Lund in the years 1971-72. Sixteen of them are now ex-addicts. Their way out of addiction is described. The results show that there exists a turning process during which some kind of therapeutic action could be of considerable value. The ex-addicts go through a period in which they show signs of an identity conflict. During this period women seem more inclined to relapse than men. This stresses the importance of long-term therapeutic strategies.
A sample of 524 young drug addicts consecutively treated at a special hospital ward has been followed by registers for an average of 10 years. A total of 62 were found to have died drug-related deaths at an average age of 28 years; 19 of them had committed suicide. Representativeness of the sample is investigated. Sex and choice of drugs were predictive factors behind fatal outcome: male opiate addicts died 5.4 times and male amphetamine abusers 2.5 times as often as expected. The males were exposed to greater risk than the females. Those who committed suicide had an hereditary disposition for mental disturbances, especially affective disorders. Lethal substances proved to be opiates, barbiturates and alcohol and/or other psychotropic preparations. Signs of heart disease were often found in the overdose cases. Most of the addicts who died were in a compulsive stage of the drug career, but some were abstaining or trying to abstain from drugs. A critical period seems to be at 26-28 years of age, a period when the abuse seems to be most intense and compulsive, the suicide risk is high and the efforts to abstain from drugs most serious and hazardous.