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2017, Número 6

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Salud Mental 2017; 40 (6)


Dual disorders in individuals under treatment for both alcohol and cocaine: Madrid study on the prevalence of dual disorders

Palomo JL, Arias F, Szerman N, Vega P, Basurte I, Mesías B

Idioma: Español
Referencias bibliográficas: 48
Paginas: 257-264
Archivo PDF: 164.15 Kb.


RESUMEN

Introducción. La patología dual presenta una alta prevalencia en muestras clínicas. Estos pacientes sufren mayor comorbilidad y requieren más servicios. Existen escasos datos de comorbilidad por alcohol y cocaína. Objetivo. Valorar datos sociodemográficos, prevalencias de trastorno por uso de sustancias (TUS), trastorno mental y trastornos de personalidad en pacientes con trastorno por uso de alcohol y cocaína frente a pacientes con uno de los dos TUS.Método. La muestra incluyó 837 pacientes procedentes de Centros de Salud Mental y Centros de Atención a Drogodependientes. Se realizaron dos análisis: se comparó el grupo de alcohol y cocaína (Alc + Coc, n = 366) con el grupo de alcohol (Alc, n = 162), y posteriormente con el grupo de cocaína (Coc, n = 122). Se recogieron variables sociodemográficas y sobre TUS mediante entrevista, diagnósticos de trastorno mental del eje I mediante la entrevista estructurada Mini International Neuropsychiatric Inerview (MINI) y los trastornos de personalidad mediante el Personality Disorder Questionnaire (PDQ). Resultados. Los pacientes del grupo Alc + Coc frente al grupo Alc presentaban diferencias sociodemográficas significativas, mayor prevalencia de TUS asociados, riesgo más alto de suicidio y mayor proporción de trastorno antisocial de personalidad. Además, tenían menor prevalencia de trastornos depresivos. Frente al grupo Coc presentaron mayor prevalencia de trastorno por consumo de cannabis, pero menor de opioides y mayor prevalencia de trastorno bipolar, trastorno de ansiedad generalizada y trastornos de personalidad. Discusión y conclusión. Los pacientes comórbidos para alcohol y cocaína presentaron un distinto perfil de prevalencia de algunos trastornos mentales específicos.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Arias, F., Szerman, N., Vega, P., Mesias, B., Basurte, I., Morant, C., …& Babin, F. (2013a). Estudio Madrid sobre prevalencia y características de los pacientes con patología dual en tratamiento en las redes de salud mental y de atención al drogodependiente. Adicciones, 25(2), 121-128. doi: 10.1016/j.rpsm.2012.09.002

  2. Arias, F., Szerman, N., Vega, P., Mesias, B., Basurte, I., Morant, C., … & Babin, F. (2013b). Abuso o dependencia a la cocaína y otros trastornos psiquiátricos. Estudio Madrid sobre la prevalencia de la patología dual. Revista de Psiquiatría y Salud Mental, 6(3), 121-128. doi: 10.1016/j.rpsm.2012.09.002

  3. Arias, F., Szerman, N., Vega, P., Mesias, B., Basurte, I., Morant, C., … & Babin, F. (2013c). Alcohol abuse or dependence and other psychiatric disorders. Madrid study on the prevalence of dual pathology. Mental Health and Substance Use, 6(4), 339-350. doi: 10.1080/17523281.2012.748674

  4. Brady, K. T., Sonne, S., Randall, C. L., Adinoff, B., & Malcolm, R. (1995). Features of cocaine dependence with concurrent alcohol abuse. Drug and Alcohol Dependence, 39(1), 69-71. doi: 10.1016/0376-8716(95)01128-L

  5. Brown, T. G., Seraganian, P., & Tremblay, J. (1994). Alcoholics also dependent on cocaine in treatment: Do they differ from “pure” alcoholics? Addictive Behaviors, 19(1), 105-112. doi: 10.1016/0306-4603(94)90056-6

  6. Burns, L., & Teesson, M. (2002). Alcohol use disorders comorbid with anxiety, depression and drug use disorders. Findings from the Australian National Survey of Mental Health and Well Being. Drug and Alcohol Dependence, 68(3), 299- 307. doi: 10.1016/S0376-8716(02)00220-X

  7. Calvo, N., Caseras, X., Gutiérrez, F., & Torrubia, R. (2002). Adaptación española del Personality Diagnostic Questionnaire-4+ (PDQ-4+) [Spanish version of the personality diagnostic questionnaire-4+ (PDQ-4+)]. Actas Españolas de Psiquiatría, 30(1), 7-13.

  8. Carroll, K. M., Rounsaville, B. J., & Bryant, K. J. (1993). Alcoholism in treatment- seeking cocaine abusers: clinical and prognostic significance. Journal of Studies on Alcohol, 54(2), 199-208. doi: 10.15288/jsa.1993.54.199

  9. Grant, B. F., & Harford, T. C. (1990). Concurrent and simultaneous use of alcohol with cocaine: results of national survey. Drug and Alcohol Dependence, 25(1), 97-104.

  10. Hedden, S. L., Malcolm, R. J., & Latimer, W. W. (2009). Differences between adult non-drug users versus alcohol, cocaine and concurrent alcohol and cocaine problem users. Addictive Behaviors, 34(3), 323-326. doi: 10.1016/j.addbeh. 2008.11.001

  11. Heil, S., Badger, G. J., & Higgins, S. T. (2001). Alcohol dependence among cocaine- dependent outpatients : Demographics, drug use, treatment outcome and other characteristics. Journal of Studies on Alcohol and Drugs, 62(1), 14-22. doi: 10.15288/jsa.2001.62.14

  12. Johnson, S. D., Cottler, L. B., O’Leary, C. C., & Abdallah, A. B. (2010). The association of trauma and PTSD with the substance use profiles of alcohol- and cocaine-dependent out-of-treatment women. American Journal on Addictions, 19(6), 490-495. doi: 10.1111/j.1521-0391.2010.00075.x

  13. Kessler, R. C., Crum, R. M., Warner, L. A., Nelson, C. B., Schulenberg, J., & Anthony, J. C. (1997). Lifetime co-occurrence of DSM-III-R alcohol abuse and dependence with other psychiatric disorders in the National Comorbidity Survey. Archives of General Psychiatry, 54(4), 313-321. doi: 10.1001/archpsyc. 1997.01830160031005

  14. Lecrubier, Y., Sheehan, D. V., Weiller, E., Amorim, P., Bonora, I., Harnett Sheehan, K., … & Dunbar, G. C. (1997). The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. European Psychiatry, 12(5), 224-231. doi: 10.1016/ S0924-9338(97)83296-8

  15. Moss, H. B., Goldstein, R. B., Chen, C. M., & Yi, H.-Y. (2015). Patterns of use of other drugs among those with alcohol dependence: Associations with drinking behavior and psychopathology. Addictive Behaviors, 50, 192-198. doi: 10.1016/j. addbeh.2015.06.041

  16. Regier, D. A., Farmer, M. E., Rae, D. S., Locke, B. Z., Keith, S. J., Judd, L. L., & Goodwin, F. K. (1990). Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA, 264(19), 2476-2598. doi: 10.1001/jama.1990.03450190043026

  17. Sheehan, D. V, Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., … & Dunbar, G. C. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry, 59(20), 22-33.

  18. Stinson, F. S., Grant, B. F., Dawson, D. A., Ruan, W. J., Huang, B., & Saha, T. (2005). Comorbidity between DSM-IV alcohol and specific drug use disorders in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Drug and Alcohol Dependence, 80(1), 105-116. doi: 10.1016/j.drugalcdep.2005.03.009

  19. Suttajit, S., Kittirattanapaiboon, P., Junsirimongkol, B., Likhitsathian, S., & Srisurapanont, M. (2012). Risks of major depressive disorder and anxiety disorders among Thais with alcohol use disorders and illicit drug use: Findings from the 2008 Thai National Mental Health survey. Addictive Behaviors, 37(12), 1395- 1399. doi: 10.1016/j.addbeh.2012.06.014

  20. Vanek, V. W., Dickey-White, H. I., Signs, S. A., Schechter, M. D., Buss, T., & Kulics, A. T. (1996). Concurrent use of cocaine and alcohol by patients treated in the emergency department. Annals of Emergency Medicine, 28(5), 508-514. doi: 10.1016/S0196-0644(96)70114-2

  21. Volkow, N. D. (2007). Addiction and co-ocurring mental disorders. Director’s perspective. National Institute on Drug Abuse, 21(2).

  22. Walsh, D. C., Hingson, R. W., Merrigan, D. M., Cupples, L. A., Levenson, S. M., & Coffman, G. A. (1991). Associations between alcohol and cocaine use in a sample of problem-drinking employees. Journal of Studies on Alcohol and Drugs, 52(1), 17-25. doi: 10.15288/jsa.1991.52.17

  23. Weaver, T., Madden, P., Charles, V., Stimson, G., Renton, A., Tyrer, P., … & Ford, C. (2003). Comorbidity of substance misuse and mental illness in community mental health and substance misuse services. The British Journal of Psychiatry, 183(4), 304-313.

  24. Windle, M., & Miller-Tutzauer, C. (1991). Antecedents and correlates of alcohol, cocaine, and alcohol-cocaine abuse in early adulthood. Journal of Drug Education, 21(2), 133-148. doi: 10.2190/F497-8GKY-0U31-XMJJ

  25. Arias, F., Szerman, N., Vega, P., Mesias, B., Basurte, I., Morant, C., …& Babin, F. (2013a). Estudio Madrid sobre prevalencia y características de los pacientes con patología dual en tratamiento en las redes de salud mental y de atención al drogodependiente. Adicciones, 25(2), 121-128. doi: 10.1016/j.rpsm.2012.09.002

  26. Arias, F., Szerman, N., Vega, P., Mesias, B., Basurte, I., Morant, C., … & Babin, F. (2013b). Abuso o dependencia a la cocaína y otros trastornos psiquiátricos. Estudio Madrid sobre la prevalencia de la patología dual. Revista de Psiquiatría y Salud Mental, 6(3), 121-128. doi: 10.1016/j.rpsm.2012.09.002

  27. Arias, F., Szerman, N., Vega, P., Mesias, B., Basurte, I., Morant, C., … & Babin, F. (2013c). Alcohol abuse or dependence and other psychiatric disorders. Madrid study on the prevalence of dual pathology. Mental Health and Substance Use, 6(4), 339-350. doi: 10.1080/17523281.2012.748674

  28. Brady, K. T., Sonne, S., Randall, C. L., Adinoff, B., & Malcolm, R. (1995). Features of cocaine dependence with concurrent alcohol abuse. Drug and Alcohol Dependence, 39(1), 69-71. doi: 10.1016/0376-8716(95)01128-L

  29. Brown, T. G., Seraganian, P., & Tremblay, J. (1994). Alcoholics also dependent on cocaine in treatment: Do they differ from “pure” alcoholics? Addictive Behaviors, 19(1), 105-112. doi: 10.1016/0306-4603(94)90056-6

  30. Burns, L., & Teesson, M. (2002). Alcohol use disorders comorbid with anxiety, depression and drug use disorders. Findings from the Australian National Survey of Mental Health and Well Being. Drug and Alcohol Dependence, 68(3), 299- 307. doi: 10.1016/S0376-8716(02)00220-X

  31. Calvo, N., Caseras, X., Gutiérrez, F., & Torrubia, R. (2002). Adaptación española del Personality Diagnostic Questionnaire-4+ (PDQ-4+) [Spanish version of the personality diagnostic questionnaire-4+ (PDQ-4+)]. Actas Españolas de Psiquiatría, 30(1), 7-13.

  32. Carroll, K. M., Rounsaville, B. J., & Bryant, K. J. (1993). Alcoholism in treatment- seeking cocaine abusers: clinical and prognostic significance. Journal of Studies on Alcohol, 54(2), 199-208. doi: 10.15288/jsa.1993.54.199

  33. Grant, B. F., & Harford, T. C. (1990). Concurrent and simultaneous use of alcohol with cocaine: results of national survey. Drug and Alcohol Dependence, 25(1), 97-104.

  34. Hedden, S. L., Malcolm, R. J., & Latimer, W. W. (2009). Differences between adult non-drug users versus alcohol, cocaine and concurrent alcohol and cocaine problem users. Addictive Behaviors, 34(3), 323-326. doi: 10.1016/j.addbeh. 2008.11.001

  35. Heil, S., Badger, G. J., & Higgins, S. T. (2001). Alcohol dependence among cocaine- dependent outpatients : Demographics, drug use, treatment outcome and other characteristics. Journal of Studies on Alcohol and Drugs, 62(1), 14-22. doi: 10.15288/jsa.2001.62.14

  36. Johnson, S. D., Cottler, L. B., O’Leary, C. C., & Abdallah, A. B. (2010). The association of trauma and PTSD with the substance use profiles of alcohol- and cocaine-dependent out-of-treatment women. American Journal on Addictions, 19(6), 490-495. doi: 10.1111/j.1521-0391.2010.00075.x

  37. Kessler, R. C., Crum, R. M., Warner, L. A., Nelson, C. B., Schulenberg, J., & Anthony, J. C. (1997). Lifetime co-occurrence of DSM-III-R alcohol abuse and dependence with other psychiatric disorders in the National Comorbidity Survey. Archives of General Psychiatry, 54(4), 313-321. doi: 10.1001/archpsyc. 1997.01830160031005

  38. Lecrubier, Y., Sheehan, D. V., Weiller, E., Amorim, P., Bonora, I., Harnett Sheehan, K., … & Dunbar, G. C. (1997). The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. European Psychiatry, 12(5), 224-231. doi: 10.1016/ S0924-9338(97)83296-8

  39. Moss, H. B., Goldstein, R. B., Chen, C. M., & Yi, H.-Y. (2015). Patterns of use of other drugs among those with alcohol dependence: Associations with drinking behavior and psychopathology. Addictive Behaviors, 50, 192-198. doi: 10.1016/j. addbeh.2015.06.041

  40. Regier, D. A., Farmer, M. E., Rae, D. S., Locke, B. Z., Keith, S. J., Judd, L. L., & Goodwin, F. K. (1990). Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA, 264(19), 2476-2598. doi: 10.1001/jama.1990.03450190043026

  41. Sheehan, D. V, Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., … & Dunbar, G. C. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry, 59(20), 22-33.

  42. Stinson, F. S., Grant, B. F., Dawson, D. A., Ruan, W. J., Huang, B., & Saha, T. (2005). Comorbidity between DSM-IV alcohol and specific drug use disorders in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Drug and Alcohol Dependence, 80(1), 105-116. doi: 10.1016/j.drugalcdep.2005.03.009

  43. Suttajit, S., Kittirattanapaiboon, P., Junsirimongkol, B., Likhitsathian, S., & Srisurapanont, M. (2012). Risks of major depressive disorder and anxiety disorders among Thais with alcohol use disorders and illicit drug use: Findings from the 2008 Thai National Mental Health survey. Addictive Behaviors, 37(12), 1395- 1399. doi: 10.1016/j.addbeh.2012.06.014

  44. Vanek, V. W., Dickey-White, H. I., Signs, S. A., Schechter, M. D., Buss, T., & Kulics, A. T. (1996). Concurrent use of cocaine and alcohol by patients treated in the emergency department. Annals of Emergency Medicine, 28(5), 508-514. doi: 10.1016/S0196-0644(96)70114-2

  45. Volkow, N. D. (2007). Addiction and co-ocurring mental disorders. Director’s perspective. National Institute on Drug Abuse, 21(2).

  46. Walsh, D. C., Hingson, R. W., Merrigan, D. M., Cupples, L. A., Levenson, S. M., & Coffman, G. A. (1991). Associations between alcohol and cocaine use in a sample of problem-drinking employees. Journal of Studies on Alcohol and Drugs, 52(1), 17-25. doi: 10.15288/jsa.1991.52.17

  47. Weaver, T., Madden, P., Charles, V., Stimson, G., Renton, A., Tyrer, P., … & Ford, C. (2003). Comorbidity of substance misuse and mental illness in community mental health and substance misuse services. The British Journal of Psychiatry, 183(4), 304-313.

  48. Windle, M., & Miller-Tutzauer, C. (1991). Antecedents and correlates of alcohol, cocaine, and alcohol-cocaine abuse in early adulthood. Journal of Drug Education, 21(2), 133-148. doi: 10.2190/F497-8GKY-0U31-XMJJ




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