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5. Problem severity profiles of substance abusing women in European Therapeutic Communities: influence of psychiatric problems

Author

De Wilde, Joke, Soyez, Veerle, Broekaert, Eric, Rosseel, Yves, Kaplan, Charles, and Larsson, Jonas

Subjects
Drug abuse -- Reports, Drug abuse -- Care and treatment, Women -- Drug use, Women -- Psychological aspects, Health
Abstract

This article aims to search for a specific female, psychiatric profile based on a large European sample of substance dependent clients (828) entering therapeutic communities. First, all six areas of functioning of the EuropASI were included, using the composite scores to search for gender differences. Next, the 'psychiatric' status section was selected for further study. A binary logistic regression was performed with gender as the dependent variable, and nine individual psychiatric items, country, and age as predictors. According to this model a number of problem variables could be identified as being reported more often by women than by men in therapeutic community treatment. Women are more likely to report serious depression, problems in understanding, concentrating or remembering, being prescribed medication, and serious thoughts about suicide; they have also attempted suicide more often than men. Women find treatment for these psychological problems more important than their male counterparts. They also have a more severe history of abuse. Women in therapeutic communities may need specific treatment interventions for their more severe psychiatric needs. Keywords: Psychiatric status; Substance abuse; Gender differences; Female psychiatric profile; Therapeutic communities

Published
2004

7. Attitudes of Flemish secondary school students towards end-of-life decisions

Author

Pousset, Geert, De Wilde, Joke, Bilsen, Johan, Deliens, Luc, Mortier, Freddy, and End-of-life Care Research Group

Subjects
Attitudes, secondary school, end-of-life
Abstract

Aim of the study In Belgium, inequalities exist in minor and adult patients' rights in end-of-life decision-making (e.g. minors cannot legally request euthanasia, even when competent). The study aimed to investigate the attitudes of minors towards acceptability of end-of-life decisions with a possible or certain life-shortening effect (ELD's) in minors, including non-treatment decisions (NTD), potentially life shortening alleviation of pain and symptoms (APS) and euthanasia. Methods Randomly selected second and fourth grade-pupils, aged 12 to 16, of 20 Flemish secondary schools in the academic year 2000-2001 completed a questionnaire, assessing their attitudes towards acceptability of requests for ELD's by 5 minor patients. All five cases included an explicit request for an ELD, by a 14 year old patient suffering from chronic disease. Type of suffering (pain, loss of dignity or deterioration of capacities), prognosis (terminal vs. not terminal) and nature of the painfulness (reversible vs. irreversible) were varied. In a sixth case, participants were asked about right and willingness to know about terminal prognosis. Main results 1769 pupils participated (52.6% female). Overall, acceptance was highest for NTD's, varying from 60% (not terminal, reversible suffering) to 69% (terminal, irreversible suffering). APS was acceptable for 49% (not terminal, irreversible suffering) to 59% (terminal, irreversible suffering) of participants. Acceptance of euthanasia varied from 17% (not terminal, irreversible suffering), to 37% (not terminal, reversible suffering), to 60% (terminal, irreversible suffering). 78.3% of participants would like to be informed about terminal prognosis when faced with a similar situation, while 90% think the minor patient has the right to know. Conclusions Minors find NTD and APS more acceptable than euthanasia. Acceptability of ELD's varies with case characteristics, with greater support for ELD's in terminal situations with irreversible suffering. The results demonstrate considerable acceptability by minor patients of autonomous end-of-life decision-making. Public health policy should continue to develop frameworks to improve and monitor autonomy of minor patients.

Published
2007

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