Comorbilidad psicopatológica en consumidores de cocaína en tratamiento ambulatorio Psychopathological comorbidity in cocaine users in outpatient treatment

Autores/as

  • Pedro Araos Hospital Regional Universitario Carlos Haya-Instituto IBIMA, Málaga
  • Esperanza Vergara-Moragues Universidad Internacional de la Rioja (UNIR), Logroño
  • María Pedraz Hospital Regional Universitario Carlos Haya-Instituto IBIMA, Málaga
  • Francisco J. Pavón Hospital Regional Universitario Carlos Haya-Instituto IBIMA, Málaga
  • Rafael Campos Cloute Hospital Virgen Macarena, Sevilla
  • Montserrat Calado Hospital Regional Universitario Carlos Haya-Instituto IBIMA, Málaga Hospital Virgen Macarena, Sevilla
  • Juan Jesús Ruiz Centro de Tratamiento Ambulatorio, Málaga
  • Nuria García-Marchena Hospital Regional Universitario Carlos Haya-Instituto IBIMA, Málaga
  • Isolde Gornemann Hospital Regional Universitario Carlos Haya-Instituto IBIMA, Málaga
  • Marta Torrens Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Barcelona
  • Fernando Rodríguez de Fonseca INSTITUTO IBIMA, Hospital Carlos Haya de Málaga

DOI:

https://doi.org/10.20882/adicciones.124

Palabras clave:

comorbilidad, psicopatología, cocaína, abuso, dependencia. comorbidity, psychopathology, cocaine, abuse, dependence.

Resumen

La adicción a cocaína es un problema de salud creciente y entre sus complicaciones destaca la elevada prevalencia de comorbilidad psicopatológica. La detección temprana de los trastornos psicopatológicos asociados al consumo de cocaína es necesaria para optimizar la asistencia sanitaria y mejorar el pronóstico. El objetivo principal de este estudio es estimar la prevalencia y características de la comorbilidad psicopatológica en una población de sujetos que solicitan atención por uso de cocaína en tratamiento ambulatorio. Se reclutaron 110 consumidores de cocaína por vía nasal evaluados con la entrevista diagnóstica semiestructurada PRISM (entrevista de investigación psiquiátrica para trastornos mentales y por sustancias), que diferencia los trastornos mentales primarios de los inducidos por la droga. Esta población tuvo un 86,4% de hombres y una edad media de 36,5 años. Presentó un uso patológico de cocaína medio de 7 años, y la presencia de psicopatología se asoció a un mayor número de criterios de dependencia de cocaína según el manual DSM-IV-TR (manual diagnóstico y estadístico de los trastornos mentales, 4ª edición revisada). La prevalencia de comorbilidad psicopatológica encontrada a lo largo de la vida fue del 61,8%, destacando los trastornos del estado de ánimo (34,5%), seguidos de los trastornos de ansiedad (22,7%) y de los trastornos psicóticos (15,5%). Un 20% presentó trastorno de personalidad antisocial y un 21% trastorno límite de la personalidad. Entre los trastornos del estado de ánimo y psicóticos fueron más frecuentes los inducidos, mientras que en los trastornos de ansiedad los primarios fueron más prevalentes.
Cocaine addiction is a growing health problem and among its complications highlights the high prevalence of mental disorders co-occurring with abuse and dependence. This psychopathological comorbidity varies according to the time of consumption and the age of the patient. Early detection of psychopathological disorders associated with drug consumption is necessary to optimize health care and to improve the prognosis. The main aim of the present study was to estimate the prevalence and characteristics of psychopathological comorbidity in a population of subjects seeking outpatient treatment for cocaine use. We recruited 110 subjects using cocaine by nasal insufflations evaluated with the PRISM (Psychiatric Research Interview for Substance and Mental Disorders), a semi-structured diagnostic interview that differentiates primary mental disorders from those induced by the drug. This population presented 86.4% male and had a mean age of 36.5. They displayed a pathological use of cocaine of 7 years and the presence of psychopathology was associated with a higher number of DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders-IV-TR) criteria for substance dependence. The lifetime prevalence of some psychopathological comorbidity was 61.8%, highlighting mood disorders (34.5%), followed by anxiety disorders (22.7%) and psychotic disorders (15.5%). About 20% showed antisocial personality disorder and 21% borderline personality disorder. From among mood and psychotic disorders, the induced disorders were more frequent, while the primary disorders were more prevalent in anxiety.

Biografía del autor/a

Pedro Araos, Hospital Regional Universitario Carlos Haya-Instituto IBIMA, Málaga

Unidad de Gestión Cínica de Salud Mental

María Pedraz, Hospital Regional Universitario Carlos Haya-Instituto IBIMA, Málaga

Unidad de Gestión Cínica de Salud Mental

Francisco J. Pavón, Hospital Regional Universitario Carlos Haya-Instituto IBIMA, Málaga

Unidad de Gestión Cínica de Salud Mental

Rafael Campos Cloute, Hospital Virgen Macarena, Sevilla

Servicio de Neurología

Montserrat Calado, Hospital Regional Universitario Carlos Haya-Instituto IBIMA, Málaga Hospital Virgen Macarena, Sevilla

Unidad de Gestión Cínica de Salud Mental, Hospital Regional Universitario Carlos Haya-Instituto IBIMAServicio de Neurología, Hospital Virgen Macarena

Nuria García-Marchena, Hospital Regional Universitario Carlos Haya-Instituto IBIMA, Málaga

Unidad de Gestión Cínica de Salud Mental

Isolde Gornemann, Hospital Regional Universitario Carlos Haya-Instituto IBIMA, Málaga

Unidad de Gestión Cínica de Salud Mental

Marta Torrens, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Barcelona

Human Pharmacology and Clinical Neurosciences Research Group

Fernando Rodríguez de Fonseca, INSTITUTO IBIMA, Hospital Carlos Haya de Málaga

Unidad Clínica de Gestión de Salud Mental

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Publicado

2014-03-01

Número

Vol. 26 Núm. 1 (2014)

Sección

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