Comorbilidad psiquiátrica en una muestra de pacientes con dependencia de cocaína atendidos ambulatoriamente en la red drogas de la Comunidad de Madrid

• Isabel Martínez-Gras ; Francisco Ferre Navarrete ; Jesús Pascual Arriazu ; José Peñas Pascual ; Mariano de Iceta Ruiz de Gauna ; David Fraguas Herráez ; Gabriel Rubio Valladolid ; C del Álamo ^[1] ; P. Alcaraz ^[3] ; C. Aranda Martínez ; J. Artolazábal ; J. Correas ^[2] ; R. Llavero ^[4] ; José Manuel Montes Rodríguez ; J. Morante del Peral ; A. Palomares Martín
  1. [1] Hospital Infanta Cristina

     Hospital Infanta Cristina

     Parla, España

     
  2. [2] Hospital Universitario del Henares

     Hospital Universitario del Henares

     Coslada, España

     
  3. [3] Centro de Atención Integral a Drogodependientes (Parla)
  4. [4] Centro de Atención Integral a Drogodependientes (Coslada)

  Mostrar afiliaciones +
• Localización: Adicciones: Revista de socidrogalcohol, ISSN 0214-4840, Vol. 28, Nº. 1, 2016, págs. 6-18
• Idioma: español
• DOI: 10.20882/adicciones.785
• Títulos paralelos:
  • Psychiatric comorbidity in a sample of cocaine-dependent outpatients seen in the Community of Madrid drug addiction care network
• Enlaces
  • Texto completo
• Dialnet Métricas: 1 Cita
• Resumen
  • español

    El objetivo de este estudio fue estimar la prevalencia actual de trastornos psiquiátricos en pacientes dependientes de cocaína atendidos en los diferentes centros de tratamiento en la Comunidad de Madrid. Se trata de un estudio multicéntrico prospectivo realizado con una muestra de 197 sujetos con dependencia de cocaína. El instrumento de evaluación utilizado fue la Psychiatric Research Interview for Substance and Mental Disorders (PRISM-IV) (Entrevista de Investigación Psiquiátrica para Trastornos Mentales y Sustancias). La prevalencia actual de comorbilidad psiquiátrica encontrada fue del 64.0%. Los trastornos psiquiátricos más frecuentes no relacionados con el consumo fueron el trastorno por déficit de atención e hiperactividad (34,5%) y los trastornos depresivos (13,7%). El trastorno por uso de sustancias más frecuente fue la dependencia del alcohol (28.4%). Los pacientes dependientes de cocaína que presentaron un trastorno depresivo y los que presentaron dependencia del alcohol mostraron un perfil clínico de mayor gravedad y un mayor grado de psicopatología medido a través de diferentes instrumentos de evaluación en relación con los pacientes que sólo presentaban dependencia de la cocaína. Estos datos sugieren que la presencia de comorbilidad psiquiátrica podría constituir un factor de riesgo asociado a la gravedad de la dependencia de la cocaína. La heterogeneidad clínica encontrada recomienda la búsqueda de tratamientos individualizados que se ajusten de manera mas especifica a las necesidades de esta población.

  • English

    The objective of this study was to estimate the current prevalence of psychiatric disorders in cocaine-dependent patients who attend different treatment centres in the Community of Madrid. A prospective multicentre study was used, and a total of 197 cocaine- dependent subjects were assessed. The assessment instrument used for diagnosis was the Psychiatric Research Interview for Substance and Mental Disorders (PRISM-IV). The main findings of this study were a high prevalence of psychiatric comorbidity in cocaine-dependent patients seeking treatment (64.0%). The most common Non Substance Use Disorders found were attention-deficit/hyperactivity Disorders (34.5%) and depressive disorders (13.7%). The most common Substance Use Disorder was alcohol dependence (28.4%).

    Cocaine-dependent patients who had a depressive disorder and were alcohol dependent presented a more severe clinical profile and a higher degree of psychopathology, measured using different assessment tools, than the patients who were only cocaine dependent.

    These data suggest that the presence of psychiatric comorbidity could constitute a risk factor associated with the severity of cocaine dependence. The clinical heterogeneity found also indicates the need to search for individualised treatments that more specifically fit the needs of this population.

• Referencias bibliográficas
  • Agosti, V., Nunes, E., Stewart, J. W., & Quitkin, F. M. (1991). Patient factors related to early attrition from an outpatient cocaine...
  • Ahmadi, J., Kampman, K. M., Oslin, D. M., Pettinati, H. M., Dackis, C., & Sparkman, T. (2009). Predictors of treatment outcome in outpatient...
  • Allen, T. J., Moeller, F. G., Rhoades, H. M., & Cherek, D. R. (1997). Subjects with a history of drug dependence are more aggressive than...
  • American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Fourth Edition, Text Revision.Washington,...
  • Alonso, J., & Lepine, J. P. (2007). Overview of Key Data From the European Study of the Epidemiology of Mental Disorders. Journal of Clinical...
  • Alterman, A. I., McKay, J. R., Mulvaney, F. D., Cnaan, A., Cacciola, J. S., Tourian, K. A., . . . Merikle, E. P. (2000). Baseline prediction...
  • Araos, P., Vergara-Moragues, E., Pedraz, M., Pavón, F. J., Campos Cloute, R., Calado, M., . . . Rodríguez de Fonseca, F. (2014). Psychopathological...
  • Arias, F., Szerman, N., Vega, P., Mesias, B., Basurte, I., Morant, C., . . . Babin, F. (2013). Cocaine abuse or dependency and other pyschiatric...
  • Bjork, J. M., Hommer, D. W., Grant, S. J., & Danube, C. (2004). Impulsivity in abstinent alcohol-dependent patients: relation to control...
  • Bobes, J., Bascarán, M. T., Bobes-Bascarán, T., Carballo, J. L., Díaz, E. M., Flórez, G.,…Sáiz, P. A. (2007). Valoración de la gravedad de...
  • Brady, K. T., Sonne, S., Randall, C. L., Adinoff, B., & Malcolm, R. (1995). Features of cocaine dependence with concurrent alcohol abuse....
  • Brown, R. A., Monti, P. M., Myers, M. G., Martin, R. A., Rivinus, T., Dubreuil, M. E., & Rohsenow, D. J. (1998). Depression among cocaine...
  • Carroll, K. M., & Rounsaville, B. J. (1992). Contrast of treatment- seeking and untreated cocaine abusers. Archives of General Psychiatry,...
  • Carroll, K. M., Rounsaville, B. J., & Bryant, K. J. (1993). Alcoholism in treatment-seeking cocaine abusers: clinical and prognostic significance....
  • Cascella, N. G., Nagoshi, C. T., Muntaner, C., Walter, D., Haertzen, C. A., & Kumor, K. M. (1994). Impulsiveness and subjective effects...
  • Chan, Y. F., Dennis, M. L., & Funk, R. R. (2008). Prevalence and comorbidity of major internalizing and externalizing problems among adolescents...
  • Cohen, P., & Cohen, J. (1984). The clinician’s illusion. Archives of General Psychiatry, 41, 1178-1182.
  • Corruble, E., Benyamina, A., Bayle, F., Falissard, B., & Hardy, P. (2003). Understanding impulsivity in severe depression? A psychometrical...
  • Cunningham, S. C., Corrigan, S. A., Malow, R., M., & Smason, I. H. (1993). Psychopathology in inpatients dependent on cocaine or alcohol...
  • Dawe, S., Gullo, M. J., & Loxton, N. J. (2004b). Reward drive and rash impulsiveness as dimensions of impulsivity: implications for substance...
  • Dawe, S., & Loxton, N. J. (2004a). The role of impulsivity in the development of substance use and eating disorders. Neuroscience Biobehavioral...
  • Del Boca, F. K., & Darkes, J.(2003). The validity of self-reports of alcohol consumption: state of the science and challenges for research....
  • Dougherty, D. M., Bjork, J. M., Bennett, R. H., & Moeller, F. G. (1999). The effects of a cumulative alcohol dosing procedure on laboratory...
  • European Monitoring Centre for Drugs and Drug Addiction. European Drug Report: Trends and developments. Retrieved from http://www. emcdda....
  • Falck, R. S., Wang, J., Carlson, R. G., Eddy, M., & Siegal, H. A. (2002). The prevalence and correlates of depressive symptomatology among...
  • Falck, R. S., Wang, J., Siegal, H. A., & Carlson, R. G. (2004). The prevalence of psychiatric disorder among a community sample of crack...
  • Fillmore, M. T., Rush, C. R., & Hays, L. (2002). Acute effects of oral cocaine on inhibitory control of behavior in humans. Drug and Alcohol...
  • González-Saiz, F., & Salvador-Carulla, L. (1998). Reliability and validity study of the Severity of Dependence Scale (SDS). Adicciones,...
  • Grant, B. F., Stinson, F. S., Dawson, D. A., Chou, S. P., Dufour, M. C., Compton, W., . . . Kaplan, K. (2004). Prevalence and co-occurrence...
  • Hasin, D., Samet, S., Nunes, E., Meydan, J., Matseoane, K., & Waxman, R. (2006). Diagnosis of comorbid psychiatric disorders in substance...
  • Hedden, S. L., Malcolm, R. J., & Latimer, W. W. (2009). Differences between adult non-drug users versus alcohol, cocaine and concurrent...
  • Heil, S. H., Badger, G. J., & Higgins, S. T. (2001). Alcohol dependence among cocaine-dependent outpatients: demographics, drug use, treatment...
  • Helzer, J. E., & Pryzbeck, T. R. (1988). The co-occurrence of alcoholism with other psychiatric disorders in the general population and...
  • Herrero, M. J., Domingo-Salvany, A., Torrens, M., & Brugal, M. T. (2008). Psychiatric comorbidity in young cocaine users: induced versus...
  • Herrero, M. J., Domingo-Salvany, A., Brugal, M. T., & Torrens, M. (2011). Incidence of psychopathology in a cohort of young heroin and/or...
  • Higgins, S. T., Budney, A. J., Bickel, W. K., Foerg, F. E., & Badger, G. J. (1994). Alcohol dependence and simultaneous cocaine and alcohol...
  • Jentsch, J. D., & Taylor, J. R. (1999). Impulsivity resulting from frontostriatal dysfunction in drug abuse: implications for the control...
  • Kalayasiri, R., Sughondhabirom, A., Gueorguieva, R., Coric, V., Lynch, W. J., Morgan, P. T., . . . Malison, R. T. (2006). Self-reported paranoia...
  • Kampman, K. M., Volpicelli, J. R., McGinnis, D. E., Alterman, A. I., Weinrieb, R. M., D’Angelo, L., & Epperson, L. E. (1998). Reliability...
  • Kessler, R. C. (2004). The epidemiology of dual diagnosis. Biological Psychiatry, 56, 730-737. doi: 10.1016/j.biopsych. 2004.06.034.
  • Kessler, R. C., Adler, L., Ames, M., Demler, O., Faraone, S., Hiripi, E., . . . Walters, E. E. (2005a). The World Health Organization Adult...
  • Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2005b). Prevalence, severity, and comorbidity of 12-month...
  • Khantzian, E. J. (1985). The self-medication hypothesis of addictive disorders: focus on heroin and cocaine dependence. The American Journal...
  • Kjome, K.L., Lane, S.D., Schmitz, J.M, Green, C., Ma, L., Prasla, I., Swann, A.C.,& Moeller,F.G.(2010). Relationship between impulsivity...
  • Kleinman, P. H., Miller, A. B., Millman, R. B., Woody, G. E., Todd, T., Kemp, J., & Lipton, D. S. (1990). Psychopathology among cocaine...
  • Levin, F. R., Evans, S. M., & Kleber, H. D. (1998). Prevalence of adult attention-deficit hyperactivity disorder among cocaine abusers...
  • Levin, F. R., Evans, S. M., Vosburg, S. K., Horton, T., Brooks, D., & Ng, J. (2004). Impact of attention-deficit hyperactivity disorder...
  • LoBue, C., Cullum, C.M., Braud, J., Walker, R., Winhusen, T., Suderajan, P., & Adinoff, B. (2014). Optimal neurocognitive, personality...
  • López, A., & Becoña, E. (2007). Depression and cocaine dependence. Psychological Reports, 100, 520-524.
  • Magura, S., & Rosenblum, A. (2000). Modulating effect of alcohol use on cocaine use. Addictive Behaviors, 25, 117- 122.
  • Malow, R. M., West, J. A., Corrigan, S. A., Pena, J. M., & Lott, W. C. (1992). Cocaine and speedball users: differences in psychopathology....
  • Martín-Santos, R., Fonseca, F., , Domingo-Salvany, A., Ginés , J. M., Ímaz , M. L., . . . Torrens, M. (2006). Dual diagnosis in the psychiatric...
  • McKay, J. R., Pettinati, H. M., Morrison, R., Feeley, M., Mulvaney, F. D., & Gallop, R. (2002). Relation of depression diagnoses to 2-year...
  • McLellan, A. T., Lewis, D. C., O’Brien, C. P., & Kleber, H. D. (2000). Drug dependence, a chronic medical illness: implications for treatment,...
  • Moeller, F. G., Dougherty, D. M., Barratt, E. S., Oderinde, V., Mathias, C. W., Harper, R. A., & Swann, A. C. (2002). Increased impulsivity...
  • Moeller, F. G., Dougherty, D. M., Barratt, E. S., Schmitz, J. M., Swann, A. C., & Grabowski, J. (2001). The impact of impulsivity on cocaine...
  • Morgello, S., Holzer, C. E., 3rd, Ryan, E., Young, C., Naseer, M., Castellon, S. A., . . . Singer, E. J. (2006). Interrater reliability of...
  • Oquendo, M. A., Baca-Garcia, E., Graver , R., Morales , M., Montalban, V., & Mann, J. J. (2001). Spanish adaption of the Barratt impulsiveness...
  • Patton, J. H., Stanford, M. S., & Barratt, E. S. (1995). Factor structure of the Barratt impulsiveness scale. Journal of Clinical Psychology,...
  • Petry, N. M., Stinson, F. S., & Grant, B. F. (2005). Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results...
  • Poling, J., Kosten, T. R., & Sofuoglu, M. (2007). Treatment outcome predictors for cocaine dependence. The American Journal of Drug and...
  • Ramos-Brieva, J. A., & Cordero-Villafafila, A. (1988). A new validation of the Hamilton Rating Scale for Depression. Journal of Psychiatric...
  • 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...
  • Rockville, M. (1976). ECDEU Assessment Manual for Psychopharmacology. In G. W (Ed.): US Department of Heath, Education, and Welfare Public...
  • Rounsaville, B. J., Anton, S. F., Carroll, K., Budde, D., Prusoff, B. A., & Gawin, F. (1991). Psychiatric diagnoses of treatment-seeking...
  • Rubio, G., Manzanares, J., Jimenez, M., Rodriguez-Jimenez, R., Martinez, I., Iribarren, M. M., . . . Palomo, T. (2008) . Use of cocaine by...
  • Siqueland, L., Crits-Christoph, P., Gallop, R., Barber, J. P., Griffin, M. L., Thase, M. E., . . .Gladis, M. (2002). Retention in psychosocial...
  • Sofuoglu, M., Brown, S., Babb, D. A., & Hatsukami, D. K. (2001). Depressive symptoms modulate the subjective and physiological response...
  • Sopeña, B., Rivera, A., Rodriguez-Dominguez, M., Rodriguez- Rodriguez, M., Argibay, A., Maure, B., . . . Martinez- Vazquez, C. (2008). [Complications...
  • Spanish Drug Observatory of the Government Delegation for the National Plan on Drugs. (2009). Household Survey Alcohol and Drugs in Spain...
  • Torrens, M., Serrano, D., Astals, M., Perez-Dominguez, G., & Martin-Santos, R. (2004). Diagnosing comorbid psychiatric disorders in substance...
  • Tortajada, S., Herrero, M. J., Domingo-Salvany, A., Molist, G., Barrio, G., de la Fuente, L., & Brugal, M. T. (2012). Psychiatric morbidity...
  • Vergara-Moragues, E., Gonzalez-Saiz, F., Lozano, O. M., Betanzos Espinosa, P., Fernandez Calderon, F., Bilbao- Acebos, I., . . . Verdejo Garcia,...
  • Vergara-Moragues, E., Gonzalez-Saiz, F., Lozano Rojas, O., Bilbao Acedos, I., Fernandez Calderon, F., Betanzos Espinosa, P., . . . Perez Garcia,...
  • Vonmoos, M., Hulka, L.M., Prelle, K.H., Jenni, D., Schulz, C., Baumgartner, M.R., Quednow, B.B.(2013). Differences in self-reported and behavioral...
  • Weiss, R. D., Griffin, M. L., & Mirin, S. M. (1992). Drug abuse as self-medication for depression: an empirical study. The American Journal...
  • Ziedonis, D. M., Rayford, B. S., Bryant, K. J., & Rounsaville, B. J. (1994). Psychiatric comorbidity in white and African- American cocaine...