Au cours des dernières décennies, de nombreuses études ont confirmé l’existence d’une relation entre les troubles mentaux graves et persistants (TMGP) et la commission de crimes violents. Les facteurs de risque associés à la violence chez les gens atteints de TMGP sont la consommation d’alcool ou de drogues, la dépression et les troubles de personnalité. Cependant, aucune étude n’a été faite auprès des détenus des prisons québécoises, c’est-à-dire, des détenus qui purgent des sentences de courte durée, afin de voir si ces constats s’appliquent aussi à cette population. La présente étude tente de vérifier si les mêmes facteurs de risque sont liés à la violence chez les détenus psychotiques des prisons du Québec. Les dossiers de la RAMQ et du système DACOR de 121 détenus ont été analysés afin de répondre à la question de recherche. Tout d’abord, des analyses statistiques descriptives et bivariées ont été effectuées. Par la suite, des régressions logistiques ont été menées afin d’identifier les meilleurs prédicteurs de comportements violents chez les contrevenants psychotiques des prisons québécoises. Il semble que ce soit davantage les antécédents judiciaires ainsi que la médication psychotrope qui a été prescrite, plutôt que les diagnostics de troubles mentaux comorbides, qui distinguent les détenus psychotiques violents des non-violents dans les prisons québécoises. Une explication possible à cette observation est que les médecins prescriraient plus en fonction de la présence de certains symptômes spécifiques qu’en fonction des diagnostics de l’axe I ou de l’axe II. Enfin, des différences significatives sont présentes entre les hommes et les femmes. / During the past decades, many studies have confirmed the existence of a relationship between severe and persistent mental disorders (SPMD) and the commission of violent crimes. Risk factors associated with violence in mentally disordered violent offenders are: alcohol and drug consumption, depression and personality disorders. However, no study has been conducted among inmates serving short sentences in Québec’s jails, to see if these findings apply to them. Our study attempts to verify whether the same risk factors are associated with violence among psychotic inmates of Quebec’s correctional facilities. The RAMQ and DACOR files of 121 incarcerated offenders were analyzed to answer the research question. To begin, descriptive and bi-variate analyses were conducted. Then, logistic regressions were carried out to identify the best predictors of violent behaviours among Québec’s psychotic offenders. It seems that it is criminal antecedents and psychotropic drugs rather than comorbid mental disorders that distinguish the violent from the non-violent psychotic offenders in Québec’s jails. A possible explanation for this observation is that physicians prescribe drugs in function of the presence of specific symptoms rather than in function of axis I or axis II diagnosis. Moreover, significant differences were found between men and women.

Made available in DSpace on 2014-12-17T14:46:43Z (GMT). No. of bitstreams: 1 RitaCD_DISSERT.pdf: 836203 bytes, checksum: 06890e6733be4b966dd28f729516351a (MD5) Previous issue date: 2010-10-30 / Study of qualitative approach using the oral history methodology, in modality oral history of life, which aimed to: tell the stories of lives of users of psychotropic drugs for prolonged period of time, in Family Health Unit Santar?m (FHU Santar?m), Natal-RN-Brazil; identify possible causes which influence and trigger, respectively, use of psychotropic for prolonged period of time; search for greater knowledge about this problem of public health; contribute with the planning and development of nursing cares, to users of psychotropic drugs for prolonged period of time, as well as in Mental Health Care, integrally, in perspective of Family Health Strategy (FHS). It was used as a baseline survey, the coverage area of family health team, from FHU Santar?m, which belongs to Health District North II, from Municipal Health Secretariat, in Natal-RN-BR. Eight employees who use psychotropic drugs for prolonged period of time were interviewed. They volunteered to narrate their life stories, which were analyzed by using the thematic modality, since the study is focused on the question of the use of psychotropic drugs for prolonged period of time. The thematic axis crisis, prejudice and care, defined by the categorization of common elements, found through successive and careful readings of narratives, were used to analyze these stories of lives. The study found that users of psychotropic drugs for prolonged period of time are affected by mental health crisis, feeling need to be heard, as well as the existence of social prejudice towards people with mental disorders, and non-completion of development of managed care, by the family health team, and particularly, the nursing care to people suffering from mental disorders and users of psychotropic drugs for prolonged period of time. It is proposed that, in the search of development and planning of nursing care to users of psychotropic drugs for prolonged period of time, and in mental health care, integrally, in FHS, the nurse can think and make a drawing about manners of performing nursing care to this clientele through the use of consultation of nursing, conducting home visits, collective construction of spaces for listening and socialization, which can be used as possible paths for the construction of such care / Estudo de abordagem qualitativa, atrav?s da metodologia hist?ria oral, na modalidade hist?ria oral de vida, o qual teve como objetivos: narrar as hist?rias de vidas de usu?rios de medicamentos psicof?rmacos por tempo prolongado, na Unidade de Sa?de da Fam?lia Santar?m (USF Santar?m), Natal-RN-Brasil; identificar as poss?veis causas que influenciam e desencadeiam, respectivamente, o uso de psicof?rmacos por tempo prolongado; buscar um maior conhecimento sobre essa problem?tica de sa?de p?blica; contribuir com o planejamento e desenvolvimento dos cuidados de enfermagem, aos usu?rios de medicamentos psicof?rmacos por tempo prolongado, bem como na Aten??o ? Sa?de Mental, de forma integral, na perspectiva da Estrat?gia Sa?de da Fam?lia. Utilizou-se, como cen?rio de pesquisa, a ?rea de abrang?ncia de uma equipe de sa?de da fam?lia, da USF Santar?m, pertencente ao Distrito Sanit?rio Norte II, da Secretaria Municipal de Sa?de, no munic?pio de Natal-RN-BR. Foram entrevistados oito colaboradores que utilizam psicof?rmacos por tempo prolongado, os quais se dispuseram a narrar as suas hist?rias de vidas, as quais foram analisadas atrav?s da utiliza??o da modalidade tem?tica, visto que o estudo encontra-se centrado no tema da utiliza??o de medicamentos psicof?rmacos por tempo prolongado. Os eixos tem?ticos crise, preconceito e cuidado, definidos atrav?s da categoriza??o dos elementos comuns, encontrados por interm?dio das sucessivas e cuidadosas leituras das narrativas, foram utilizados para a an?lise dessas hist?rias de vidas. O estudo identificou que os usu?rios de psicof?rmacos por tempo prolongado s?o acometidos por crise em sa?de mental, sentem necessidade de serem escutados, bem como a exist?ncia do preconceito social para com as pessoas com transtornos mentais, e a n?o realiza??o do desenvolvimento da gest?o de cuidados, pela equipe de sa?de da fam?lia, e, particularmente, dos cuidados de enfermagem ?s pessoas acometidas por transtornos mentais e aos usu?rios de psicof?rmacos por tempo prolongado. Prop?e-se que, na busca do planejamento e desenvolvimento dos cuidados de enfermagem aos usu?rios de psicof?rmacos por tempo prolongado, e na aten??o ? sa?de mental, de forma integral, na Estrat?gia Sa?de da Fam?lia, o enfermeiro poder? pensar e fazer um desenho sobre os modos de realiza??o dos cuidados de enfermagem a essa clientela, atrav?s da utiliza??o da consulta de enfermagem, da realiza??o da visita domiciliar, da constru??o coletiva de espa?os para escuta e socializa??o, que poder?o ser utilizados como caminhos poss?veis para a constru??o desses cuidados

INTRODUÇÃO: A dependência de álcool é um grave problema de saúde publica no Brasil. Seu tratamento ainda é um desafio, mesmo para os melhores programas terapêuticos disponíveis. Esta dificuldade ocorre pelo pequeno número de medicamentos aprovados para o uso e também pela elevada taxa de abandono, próximo a 50%. A ondansetrona tem surgido como uma medicação promissora para o tratamento de alcoolistas. A identificação de pacientes com maior risco de desistência do tratamento é uma estratégia para reverter essa taxa. Os objetivos deste estudo são: (a) avaliar a eficácia e segurança da ondansetrona na dose de 16 mg/dia; (b) investigar variáveis clínicas e psicossociais capazes de prever maior aderência ao tratamento; (c) desenvolver uma tipologia para alcoolistas com características presentes no início do tratamento; (d) testar se os diferentes tipos podem prever o abandono ao tratamento. METODOS: Trata-se de estudo realizado em três etapas. Na primeira foi realizado ensaio clinico randomizado duplo-cego placebo controlado, com ondansetrona, por 12 semanas, desenvolvido na Universidade de São Paulo - Brasil. A amostra era composta por 102 dependentes de álcool com idade entre 18 - 60 anos. A análise foi realizada com os dados brutos e com os dados imputados. Na segunda etapa, foi combinado o banco de dados deste estudo com os de outros dois ensaios realizados no mesmo local (acamprosato versus placebo e naltrexona, topiramato versus placebo), com número total de 332 dependentes de álcool. A partir da análise de quatro fatores clínicos (idade de início dos problemas com uso do álcool, alcoolismo familiar, gravidade da dependência do álcool e intensidade de sintomas depressivos) foi realizada a análise de cluster tipo K-Means e, após a identificação dos tipos, foi avaliada a associação destes com a adesão ao tratamento. Na última etapa, analisando apenas os participantes avaliados quanto ao desejo pelo álcool (257 alcoolistas) foi realizada uma regressão logística, com variáveis clínicas e psicossociais, para analisar a influência dessas na retenção ao tratamento. RESULTADO: A ondansetrona foi capaz de retardar o tempo para o primeiro consumo de álcool (54,7 versus 40,9 dias) e, também, o primeiro consumo pesado de álcool (58,4 versus 45,4 dias) quando comparado ao placebo. Essa droga não influenciou a percentagem de dias bebidos durante o estudo, mas esteve associada com menor percentagem de dias com consumo pesado de álcool (7,8% versus 11,7%), quando comparado ao placebo, na análise de dados imputados. Na análise de tipologia foram identificados dois grupos de alcoolistas. O tipo de alcoolista caracterizado pelo início precoce dos problemas com álcool, maior histórico familiar de dependência, elevada gravidade de alcoolismo e poucos sintomas depressivos esteve associado a maior chance de descontinuar o tratamento, independente da medicação usada e da participação nos alcoólicos anônimos (AA). Entre as variáveis clínicas e psicossociais estudadas, ter idade mais elevada, participar do AA e o consumo preferencial pela cerveja foram fatores independentes associados a maior adesão ao tratamento. Maiores escores de depressão aumentaram o risco de abandono. CONCLUSÃO: A ondansetrona mostrou ser segura e bem tolerada na dose de 16mg/dia. Foi mais eficaz que o placebo em retardar o primeiro consumo e primeiro consumo pesado de álcool, deixou dúvida sobre seu efeito na percentagem de dias bebidos e de consumo pesado de álcool. O tipo de alcoolista com idade precoce de problemas com álcool, elevada dependência dessa substância, mais história familiar de alcoolismo e menos sintomas depressivos, esteve associado ao maior risco de abandono. Idade mais elevada, frequentar o AA e ter preferência pela cerveja aumenta a chance de completar o tratamento proposto / INTRODUCTION: Alcohol dependence is a serious public health problem in Brazil. Its treatment remains a challenge, even for the best available treatment programs. This difficulty is due to the small number of drugs approved for use and also the high dropout rates, close to 50%. Ondansetron has emerged as a promising drug for the treatment of alcoholics. The identification of patients with increased risk of treatment discontinuation is a strategy to reverse these rates. The aims of this study are: (a) to evaluate the efficacy and safety of ondansetron in a dose of 16 mg/day; (b) to investigate clinical and psychosocial variables that could predict treatment retention, (c) to develop a typology of alcoholics based on clinical factors present at the beginning of the treatment; and (d) to test if different types of alcoholics could predict the higher withdrawal from treatment. METHODS: This study was conducted in three stages. Firstly, a randomized, double-blind, placebo- controlled clinical trial was conducted with ondansetron for 12 weeks, developed at the University of São Paulo - Brazil. The sample consisted of 102 alcoholics aged between 18 and 60 years old. The analysis was performed by using only the sample of adherents and an imputed sample. Secondly, the database of this study was combined with two other clinical trials that were carried out in the same setting (acamprosate versus placebo, and topiramate, naltrexone versus placebo), with a final sample size of 332 alcohol dependents. From the analysis of four clinical factors (problem drinking onset age, family alcoholism, severity of alcohol dependence and intensity of depressive symptoms) a K-means cluster analysis was performed to identify types of alcoholics. In addition, the association between the resulting types of alcoholics and treatment retention was verified. Thirdly, using only the participants who were evaluated for craving on alcohol (257 alcoholics), a logistic regression analysis was run with clinical and psychosocial variables as independent variables to analyze their influence on treatment retention. RESULTS: Ondansetron was able to delay the first alcohol consumption (54.7 versus 40.9 days) and the first heavy alcohol consumption (58.4 versus 45.4 days) compared to placebo. Ondansetron did not have effect on the percentage of drinking days. However, ondansetron was associated with a lower percentage of days with heavy alcohol consumption (7.8% versus 11.7%) in an imputed sample, when compared to placebo. Two types of alcoholics were identified. The type characterized by earlier problem drinking onset age, more family alcoholism, high severity of alcoholism, and fewer depressive symptoms, was associated with a greater chance of discontinuing treatment regardless of medication used and participation in alcoholic anonymous groups (AA). Out of the clinical and psychosocial variables, older age, AA attendance, and beer preference drinkers were independent factors associated with higher treatment retention. Higher scores on depression also increased the risk of dropout. CONCLUSION: Ondansetron showed to be safe and well tolerated at the dose of 16mg/day. It was more effective than placebo in delaying both the first use and the first heavy alcohol consumption. In addition, ondansetron was not effective in decreasing the percentage of drinking days throughout this study. The type of alcoholics characterized by earlier problem drinking onset age, more family alcoholism, high severity of alcoholism and fewer depressive symptoms, was associated with greater risk of dropout. Separately, the variables higher age, AA attendance, and beer preference increased the chance of completing the proposed treatments

Background: There is a widespread and increasing use of psychoactive prescription drugs, such as opioid analgesics, anxiolytics, hypnotics and anti-epileptics, but their use is associated with a risk of drug use disorder, misuse and abuse. Today, these are globally recognized and emerging public health concerns. Aim: The aim of this thesis is to estimate the prevalence of psychoactive prescription drug (PPD) use disorders, misuse and abuse, and to investigate the association with some potential risk factors. Methods: A study using register data from forensic cause of death investigations investigated and described cases of fatal unintentional intoxication with tramadol (Study I). Based on register data on spontaneously reported adverse drug reactions (ADRs) reported cases of tramadol dependence were investigated and summarised (Study II). In a study in suspected drug-impaired drivers with a toxicology analysis confirming the intake of one out of five pre-specified PPDs, the prevalence of non-prescribed use was assessed and associated factors were investigated (Study III). From a cohort of patients initiating prescribed treatment with pregabalin, using data on prescription fills, a study investigated longitudinal utilisation patterns during five years with regards to use of the drug above the maximum approved daily dose (MAD), and factors associated with the utilisation patterns (Study IV). Results: In the first study, 17 cases of unintentional intoxications were identified, of which more concerned men, the median age was 44 years and the majority used multiple psychoactive substances (alcohol, illicit drugs and prescription drugs). The second study identified 104 spontaneously reported cases of tramadol dependence, in which more concerned women, the median age was 45 years, and a third reported a history of substance abuse and 40% of past psychoactive medication use. In the third study, more than half of the individuals suspected of drug-impaired driving used the drug without a recent prescription. Non prescribed use was most frequent in users of benzodiazepines and tramadol, and was more likely in younger individuals and in multiple-substance users. In the last paper five longitudinal utilisation patterns were found in pregabalin users, with two patterns associated with a particularly high risk of doses above the maximum approved dosing recommendation. This pattern of use was associated with male sex, younger age, non-urban residency and a recent prescribed treatment with an antiepileptic or opioid analgesic drug. Conclusions: This thesis shows that psychoactive prescription drug use disorders, misuse and abuse occur and may have serious and even fatal consequences. The prevalence varies between different drugs and populations. Abuse and misuse seem to be more common in young people. Fatal intoxications and misuse of prescribed drugs may be more common in men, while drug use disorders following prescribed treatment may be more common in women and non-prescribed use equally distributed between women and men. Individuals with a history of mental illness, substance use disorder or abuse, or of past use of psychoactive medications are likely important risk groups. In summary, the findings suggest a potential for improvements in the utilisation of psychoactive prescription drugs. The results may be useful in the planning of clinical and regulatory preventive interventions to promote the rational, individualised and safe use of such drugs.

L’urbanisation croissante et la propagation des activités humaines entrainent l’augmentation de l’apport de nombreux micropolluants dans le milieu aquatique. Le compartiment aquatique est alors défini comme le réceptacle ultime de la pollution environnementale apportée par diverses sources : les effluents municipaux et industriels, les lixiviats des sites d’élimination des déchets solides, le ruissellement des eaux urbaines et des eaux des sites agricoles. Parmi les contaminants retrouvés dans l’eau, il y a les psychotropes (benzodiazépines, antidépresseurs,antiépileptiques, etc…) qui appartiennent à la grande famille des médicaments. Ce sont des molécules biologiquement actives, ubiquistes, qui sont principalement d’origine urbaine, qui sont apportées continuellement dans l’environnement aquatique et qui sont fortement consommées au niveau mondial. Depuis quelques années, les scientifiques commencent à s’intéresser à cette famille thérapeutique mais il existe encore un réel manque de connaissance sur l’intégralité du problème de diffusion des psychotropes,de leur passage en station d’épuration à leur présence dans l’environnement et enfin à leur impact sur les organismes aquatiques. Ces travaux de thèse cherchent donc à documenter ce point en se focalisant sur l’étude de la présence, du devenir et de l’impact des psychotropes dans la Garonne estuarienne (France) et le fleuve Saint Laurent (Québec, Canada). Dans un premier temps, une méthode analytique multi-résidus permettant l’analyse de 47 psychotropes dans les eaux usées et les eaux de surface a été développée et validée. Des échantillonneurs passifs de type POCIS (Polar Organic Chemical Integrative Sampler) ont été calibrés et validés afin de permettre le suivi intégratif et continu des psychotropes dans les eaux de surface.Dans un second temps, les effluents d’entrée et de sortie de station d’épuration des agglomérations de Bordeaux en France et de Repentigny et Montréal au Québec ont été caractérisés. Les résultats de cette étude montrent que les traitements épuratoires de chacune des stations d’épurations étudiées ont une efficacité limitée pour éliminer les psychotropes dans les eaux usées. Par la suite, le suivi effectué dans la Garonne estuarienne et dans le fleuve Saint Laurent a mis en évidence la présence de psychotropes dans l’environnement qui sont majoritairement apportés par l’amont des villes de Bordeaux et Montréal.La comparaison des résultats obtenus pour la France et le Québec montre qu’il existe bien des habitudes de prescriptions et de consommations différentes entre les deux pays. Même si les procédés d’épuration sont différents entre les deux pays (traitement secondaire en France et primaire au Québec),l’efficacité d’élimination sur la famille thérapeutique des psychotropes reste insuffisante. Enfin ila été observé que le débit du milieu récepteur jouait un rôle important dans la dilution et le devenir des composés.Dans un troisième et dernier temps, des études in vitro et in vivo ont montré que certains psychotropes pouvaient avoir un impact toxique sur les bivalves d’eau douce étudiés (Elliptio complanata et Corbiculafluminea) lors d’exposition de composés seuls ou en mélange à des concentrations de l’ordre du mg.L-1 (concentrations expérimentales) et même du ng.L-1 (concentrations environnementales). / Increasing urbanization and human activities cause an increase of micropollutant input in the aquatic environment. The water compartment is then defined as the ultimate receptacle of environmental pollution originating from various sources: municipal and industrial wastewaters, leachates from solidwaste disposal sites, waters of urban and agricultural runoff.Among the contaminants found in the water, there are psychotropic drugs (benzodiazepines, antidepressantsor antiepileptics) belonging to the family of pharmaceuticals. These are biologically active molecules, ubiquitous, which are mainly of urban origin, which are continuously introduced into the aquatic environment and are heavily consumed around the world.In recent years, scientists have begun to show interest for this therapeutic family, but there is still areal lack of knowledge about the full psychotropic diffusion problem; from their presence in wastewater treatment plant to their presence in the environment and finally to their impact on aquatic organisms.In this global perspective these thesis works seek to document the presence, fate and impact of psychotropic drugs in the Garonne estuarine (France) and the St. Lawrence River (Quebec, Canada).Firstly, a multi-residue analytical method for the analysis of 47 psychotropic drugs in wastewater and surface waters has been developed and validated. POCIS passive samplers were calibrated and validated for continuous integrative monitoring of psychotropic drugs in surface waters.Secondly, the treatment plant influents and effluents of Bordeaux in France and Repentigny and Montreal in Quebec have been characterized. The results of this study show that treatment processes ofstudied wastewater treatment plants have limited performances to remove psychotropic drugs in wastewaters. There after, the monitoring performed in the Garonne estuarine and in the St. Lawrence River has highlighted that the presence of psychotropic drug in the environment is mainly related toupstream input of Bordeaux and Montréal.Comparison of the results obtained in the two countries surveyed show that there are many different patterns of prescriptions and consumption between the two countries. Although the treatment processes are different between the two countries (secondary treatment in France and primary in Quebec), their removal efficiency is still insufficient for psychotropic drugs. Finally it was observed that theflow rate of the receiving environment plays an important role in the dilution and the fate of the compounds.In a third and final stage, in vitro and in vivo studies have shown that some psychotropic drugs could have a toxic impact on the studied freshwater bivalves (Elliptio complanata and Corbicula fluminea) upon exposure alone or in mixture with concentrations in the order of mg.L-1 (tests concentrations) and even ng.L-1 (environmental concentrations).

No description available.

No description available.

The objective of the thesis is based on statistical data to assess the degree of risk of abuse of psychotropic substances in transport. The work is divided into two parts. The theoretical part is mainly a search, dealing with the issue. The practical part has analyzed statistical data and the questionnaire survey, whose results are compared with the results of statistical data.

No description available.

Les résidus de médicaments font partie des polluants dits « émergents » pour lesquels il n’existe actuellement pas de réglementation quant à leur présence dans l’environnement. Afin d’anticiper un risque éventuel pour l’Homme et les milieux aquatiques il est, entre autres, nécessaire de réaliser un état des lieux de la contamination des systèmes aquatiques par ce type de micropolluants. Dans ce contexte, disposer de données de mesures de qualité (traçables et comparables) constitue un prérequis indispensable pour décider au mieux des politiques à conduire dans ce domaine. L’étude des psychotropes présente un enjeu important d’autant plus qu’il s’agit de molécules abondamment consommées.Les travaux conduits lors de cette thèse avaient deux objectifs principaux. Le premier était de caractériser l’occurrence environnementale de composés psychotropes. Le second objectif était de proposer des outils métrologiques permettant d’assurer l’exactitude, la traçabilité, la comparabilité mais également la représentativité des résultats de mesure.Dans un premier temps, une méthode multi-résidus par SPE-LC-MS² a été développée pour une sélection de composés psychotropes et d’autres médicaments de consommation courante. Les limites de quantification de la méthode étaient de l’ordre du ng.L-1. Cela a permis de caractériser leur occurrence dans différents cours d’eau et rejets de station d’épuration en France. En parallèle, une approche par échantillonnage intégratif a été développée et déployée dans différents sites. Cette stratégie complémentaire a permis d’établir les niveaux d’occurrence des 68 psychotropes et traceurs sélectionnés et de conduire une démarche de hiérarchisation dans le but d’établir une liste restreinte de composés d’intérêt. Enfin, une méthode de référence associant la dilution isotopique à la spectrométrie de masse (DI-MS) a été développée pour l’analyse de 24 psychotropes dans les eaux de surface. Elle se caractérise par des incertitudes élargies (k=2) inférieures à 10%. La mise en oeuvre de cette méthode dans des études environnementales a permis de mettre en évidence l’importance de la contribution de l’incertitude liée à l’échantillonnage par rapport à l’incertitude totale de mesure. / Pharmaceuticals and their residues belong to the so-called “emerging” pollutants for which no current regulation is applied regarding their presence in the environment. Monitoring the contamination of aquatic resources by these kinds of micropollutants is a necessity in order to anticipate potential effects regarding human health and ecosystems. In this context, data quality (traceability and comparability) is compulsory so as to take better decisions regarding policies to be driven. Psychotropic compounds, which are widely consumed, display a great concern in that field.This thesis aimed at characterizing occurrence of psychotropic compounds in the environment and putting forward metrological tools insuring accuracy, traceability, comparability as well as representativity of the measurement results.To that purpose, a SPE-LC-MS² multi-residue method has been developed for a selection of psychotropic compounds and other commonly consumed drugs. Method limits of quantification were in the range of ng.L-1 which enabled to characterize their occurrence in several surface waters and treated wastewaters. Concurrently, usage of integrative samplers was evaluated and applied on the field in different locations. Occurrence levels of 68 selected compounds were established by implementation of this complementary strategy in aquatic systems. Furthermore, results from measurement campaigns were used to rank studied compounds into a short list of interest. Finally, a reference method using isotopic dilution and mass spectrometry (DI-MS) was developed for the characterization of 24 psychotropic compounds in surface waters. Expanded uncertainties (k=2) inferior to 10% were obtained. Last be not least, implementing this method to environmental analysis emphasized the importance of sampling related uncertainties regarding to global measurement uncertainties.