Analysis of the profiles of patients with dual pathology attending addiction centers, mental health centers, and a coordinated service

  1. Mancheño-Barba, Juan José 1
  2. Navas-León, Sergio 2
  3. Gutiérrez-Lopez, María-Luisa 1
  4. de la Rosa-Cáceres, Ana 2
  5. Cáceres-Pachón, Pilar 3
  6. Lozano, Oscar Martin
  1. 1 Unidades de Salud Mental Comunitaria, Hospital Juan Ramón Jiménez, Huelva
  2. 2 Departmento de Psicología Clínica y Experimental, Universidad de Huelva
  3. 3 Departamento de Psicología Clínica y Experimental, Universidad de Huelva
Revista:
Anales de psicología

ISSN: 0212-9728 1695-2294

Año de publicación: 2019

Volumen: 35

Número: 2

Páginas: 233-241

Tipo: Artículo

DOI: 10.6018/ANALESPS.35.2.345721 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Anales de psicología

Resumen

La atención médica y psicológica de pacientes con patología dual es realizada por servicios de salud mental, adicciones, o coordinada. No obstante, es elección de los pacientes acudir a uno u otro servicio. Este trabajo tiene como objetivo analizar las semejanzas y diferencias de pacientes con patología dual que acuden a estos centros. El estudio se ha realizado con170 pacientes diagnosticados de patología dual atendidos en el Servicio Provincial de Drogodependencias de Huelva (SPDH) y Unidades de Salud Mental Comunitaria (USMC) de la provincia de Huelva. En el SPDH la prevalencia de pacientes con dependencia a heroína y cocaína es mayor (35.9% vs 2% en USMC y 16.4% en coordinado). En las USMC se observa una mayor prevalencia de pacientes con dependencia a cannabis (41.2% vs 9.4% en el CTA y 16.4% en coordinado). La odds ratio para pacientes con episodios hipomaníacos fue de 2.879 (p<0.05) en el SPDH, y de 0.483 (p<0.05) para episodios maníacos. Hay una mayor prevalencia de pacientes con trastornos psicóticos en las USMC en comparación con el SPDH (66% vs 37.5%). Las diferencias detectadas en los perfiles deben ser consideradas en la planificación asistencial de los centros que atienden a estos pacientes.

Referencias bibliográficas

  • References American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th Edition). Washington, DC. (Traducción castellana: Manual diagnóstico y estadístico de los trastornos mentales DSM-5. Madrid: Panamericana, 2014).
  • Arias, F., Szerman, N., Vega, P., Mesias, B., Basurte, I., Morant, C., … Babín, F. (2013). 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, 191–200. https://doi.org/10.20882/adicciones.59
  • Balhara, Y. P. S., Lev-Ran, S., Martínez-Raga, J., Benyamina, A., Singh, S., Blecha, L. y Szerman, N. (2016). State of Training, Clinical Services, and Research on Dual Disorders Across France, India, Israel, and Spain. Journal of Dual Diagnosis, 12(3–4), 252–260. https://doi.org/10.1080/15504263.2016.1254309
  • Carmiol, N., Peralta, J. M., Almasy, L., Contreras, J., Pacheco, A., Escamilla, M. A., … Glahn, D. C. (2014). Shared genetic factors influence risk for bipolar disorder and alcohol use disorders. European Psychiatry, 29(5), 282–287. https://doi.org/10.1016/j.eurpsy.2013.10.001
  • Di Lorenzo, R., Galliani, A., Ferri, P., Landi, G. y Guicciardi, A. (2014). A retrospective analysis focusing on a group of patients with dual diagnosis treated by both mental health and substance use services. Neuropsychiatric Disease and Treatment, 10, 1479. https://doi.org/10.2147/NDT.S65896
  • Drake, R. E., Mueser, K. T. y Brunette, M. F. (2007). Management of persons with co-occurring severe mental illness and substance use disorder: program implications. World Psychiatry : Official Journal of the World Psychiatric Association (WPA), 6(3), 131–136. Recuperado de: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2174596&amp;tool=pmcentrez&amp;rendertype=abstract
  • Evans, E., Padwa, H., Li, L., Lin, V. y Hser, Y. I. (2015). Heterogeneity of Mental Health Service Utilization and High Mental Health Service Use Among Women Eight Years After Initiating Substance Use Disorder Treatment. Journal of Substance Abuse Treatment, 59, 10–19. https://doi.org/10.1016/j.jsat.2015.06.021
  • Fernández-Calderón, D., Fernández, F., Ruiz-Curado, S., Verdejo-García, A. y Lozano, Ó. M. (2015). Profiles of substance use disorders in patients of therapeutic communities: Link to social, medical and psychiatric characteristics. Drug and Alcohol Dependence, 149, 31–39. https://doi.org/10.1016/j.drugalcdep.2015.01.013
  • Ferrando, L., Gibert, J. y Lecrubier, Y. (1999). Fiabilidad y validez de la escala MINI versión CIE10. Comunicación oral. IV Congreso Nacional de Psiquiatría. Psiq Biol, 6(Suppl 2), 107.
  • Gual, A. (2007). Dual diagnosis in Spain. Drug and Alcohol Review, 26(1), 65–71. https://doi.org/10.1080/09595230601037000
  • Gutiérrez, F., Aluja, A., Peri, J. M., Calvo, N., Ferrer, M., Baillés, E., ... Krueger, R. F. (2017). Psychometric properties of the Spanish PID-5 in a clinical and a community sample. Assessment, 24(3), 326-336. htpps://doi: 10.1177/1073191115606518
  • Hasin, D. S. y Grant, B. F. (2015). The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 and 2: review and summary of findings. Social Psychiatry and Psychiatric Epidemiology, 50(11), 1609–1640. https://doi.org/10.1007/s00127-015-1088-0
  • Havassy, B. E., Alvidrez, J. y Owen, K. K. (2004). Comparisons of patients with comorbid psychiatric and substance use disorders: implications for treatment and service delivery. American Journal of Psychiatry, 161(1), 139-145. https://doi.org/10.1176/appi.ajp.161.1.139
  • Hobden, B., Bryant, J., Carey, M., Baker, A. L., Farrell, M., Oldmeadow, C., … Sanson-Fisher, R. (2018). Finding the optimal treatment model: A systematic review of treatment for co-occurring alcohol misuse and depression. Australian and New Zealand Journal of Psychiatry, 00(0). https://doi.org/10.1177/0004867418758922
  • Horsfall, J., Cleary, M., Hunt, G. E. y Walter, G. (2009). Psychosocial treatments for people with co-occurring severe mental illnesses and substance use disorders (dual diagnosis): A review of empirical evidence. Harvard Review of Psychiatry, 17(1), 24–34. https://doi.org/10.1080/10673220902724599
  • Kessler, R. y Chiu, W. (2005). Prevalence, Severity, and Comorbidity of Twelve-month DSM-IV Disorders in the National Comorbidity Survey Replication (NCS- R). Archives of General Psychiatry, 62(6), 617–627. https://doi.org/10.1001/archpsyc.62.6.617.
  • Maples, J. L., Carter, N. T., Few, L. R., Crego, C., Gore, W. L., Samuel, D. B., … Miller, J. D. (2015). Testing whether the DSM-5 personality disorder trait model can be measured with a reduced set of items: An item response theory investigation of the personality inventory for DSM-5. Psychological Assessment, 27(4), 1195–1210. https://doi.org/10.1037/pas0000120
  • McGovern, M. P., Lambert-Harris, C., Gotham, H. J., Claus, R. E. y Xie, H. (2014). Dual diagnosis capability in mental health and addiction treatment services: An assessment of programs across multiple state systems. Administration and Policy in Mental Health and Mental Health Services Research, 41(2), 205–214. https://doi.org/10.1007/s10488-012-0449-1
  • Najt, P., Fusar-Poli, P. y Brambilla, P. (2011). Co-occurring mental and substance abuse disorders: A review on the potential predictors and clinical outcomes. Psychiatry Research, 186(2–3), 159–164. https://doi.org/10.1016/j.psychres.2010.07.042
  • Padwa, H., Guerrero, E. G., Braslow, J. T. y Fenwick, K. M. (2015). Barriers to Serving Clients With Co-occurring Disorders in a Transformed Mental Health System. Psychiatric Services, 66(5), 547–550. https://doi.org/10.1176/appi.ps.201400190
  • Preti, E., Prunas, A., Ravera, F. y Madeddu, F. (2011). Polydrug abuse and personality disorders in a sample of substance-abusing inpatients. Mental Health and Substance Use: Dual Diagnosis, 4(3), 256–266. https://doi.org/10.1080/17523281.2011.577751
  • Priester, M. A., Browne, T., Iachini, A., Clone, S., DeHart, D. y Seay, K. D. (2016). Treatment Access Barriers and Disparities Among Individuals with Co-Occurring Mental Health and Substance Use Disorders: An Integrative Literature Review. Journal of Substance Abuse Treatment, 61, 47–59. https://doi.org/10.1016/j.jsat.2015.09.006
  • Radhakrishnan, R., Wilkinson, S. T. y D’Souza, D. C. (2014). Gone to pot–a review of the association between cannabis and psychosis. Frontiers in psychiatry, 5, 54. https://doi.org/10.3389/fpsyt.2014.00054
  • Roncero, C., Barral, C., Rodríguez-Cintas, L., Pérez-Pazos, J., Martinez-Luna, N., Casas, M., … Grau-López, L. (2016). Psychiatric comorbidities in opioid-dependent patients undergoing a replacement therapy programme in Spain: The PROTEUS study. Psychiatry Research, 243, 174–181. https://doi.org/10.1016/j.psychres.2016.06.024
  • Roncero, C., Gómez-Baeza, S., Vázquez, J. M., Terán, A., Szerman, N., Cases, M. y Bobes, J. (2013). Perception of Spanish professionals on therapeutic adherence of dual diagnosis patients. Actas Espanolas de Psiquiatria, 41(6), 319–329. Recuperado de: https://www.ncbi.nlm.nih.gov/pubmed/24203504
  • San, L., Arranz, B., Guide, E. G. for D. P. C. P., Arrojo, M., Becoña, E., Bernardo, M., … Zorrilla, I. (2016). Guía de práctica clínica para el tratamiento de la patología dual en población adulta. Adicciones, 28(1), 3–5. https://doi.org/10.20882/adicciones.784
  • 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(Suppl 20), 22-33. Recuperado de: https://www.ncbi.nlm.nih.gov/pubmed/9881538
  • Simpson, D. D., Joe, G. W., Rowan-Szal, G. A. y Greener, J. M. (1997). Drug abuse treatment process components that improve retention. Journal of Substance Abuse Treatment, 14(6), 565–572. https://doi.org/10.1016/S0740-5472(97)00181-5
  • Szerman, N., Vega, P., Grau-López, L., Barral, C., Basurte-Villamor, I., Mesías, B., … Roncero, C. (2014). Dual diagnosis resource needs in Spain: A national survey of professionals. Journal of Dual Diagnosis, 10(2), 84–90. https://doi.org/10.1080/15504263.2014.906195
  • Torrens, M., Mestre-Pintó, J. y Domingo-Salvany, A. (2015). Comorbidity of substance use and mental disorders in Europe. EMCDDA Insight. Recuperado de: http://www.emcdda.europa.eu/system/files/publications/1988/TDXD15019ENN.pdf.Comorbidity of substance use and mental disorders in Europe
  • Vega, P., Szerman, N., Roncero, C., Grau-López, L., Mesíasl, B., Barral, B., … Casas, M. (2015). Libro Blanco Recursos y Necesidades Asistenciales en Patología Dual. Madrid: Sanidad y Ediciones, S.L. Recuperado de: http://www.patologiadual.es/docs/libro-blanco-recursos-asistenciales-pdual2015.pdf
  • Wise, E. A., Streiner, D. L. y Gallop, R. J. (2017). Predicting Change in an Integrated Dual Diagnosis Substance Abuse Intensive Outpatient Program. Substance Use and Misuse, 52(7), 848–857. https://doi.org/10.1080/10826084.2016.1264970