Diferencias de género epidemiológicas y diagnósticas según eje I en pacientes con Patología Dual
DOI:
https://doi.org/10.20882/adicciones.160Palabras clave:
género, patología dual, mujer, adicción, trastorno por uso de sustanciasResumen
Introducción: La patología dual (PD) es la coexistencia de un trastorno por uso de sustancias (TUS) y otro trastorno mental. Se ha descrito que el género es un factor que influye en la prevalencia de las enfermedades psiquiátricas, su expresión sintomática, curso, pronóstico, demanda y respuesta al tratamiento. Material y métodos: Se revisan 40 estudios publicados en Medline, Web of Science, y Journal Citation Reports hasta diciembre de 2009 que contienen información a cerca de las diferencias de género en la prevalencia y las características clínicas de pacientes duales mayores de 18 años. Conclusiones: La distribución de los trastornos mentales del Eje I en pacientes duales, según el género, se mantiene similar a la de los trastornos mentales no duales en la población general. Existe mayor prevalencia en hombres de trastornos psicóticos y bipolares, y en mujeres mayor prevalencia de trastornos de ansiedad y afectivos. El género femenino deja de ser factor de buen pronóstico en la psicosis dual. Por otra parte, el policonsumo es más frecuente en los varones.Citas
Abram, K. M., Teplin, L. A., y McClelland, G. M. (2003). Comorbidity of
severe psychiatric disorders and substance use disorders among women in jail. American Journal of Psychiatry, 160, 1007-1010.
Baldassano, C. F., Marangell, L. B., Gyulai, L., Ghaemi, S. N., Joffe, H.,
Kim, D. R.,… Cohen, L. S. (2005). Gender differences in bipolar disorder: Retrospective data from the first 500 STEP-BD participants. Bipolar Disorders, 7, 465-470.
Brady, K. T., Grice, D. E., Dustan, L., y Randall, C. (1993). Gender differences in substance use disorders. American Journal of Psychiatry, 150, 1707-1711.
Brunette, M. F., y Drake, R. E. (1997). Gender differences in patients
with schizophrenia and substance abuse. Comprehensive Psychiatry, 38, 109-116.
Brunette, M., y Drake, R. E. (1998). Gender differences in homeless
persons with schizophrenia and substance abuse. Community Mental Health Journal, 34, 627-642.
Cantwell, R., Brewin, J., Glazebrook, C., Dalkin, T., Fox, R., Medley, I.,
y Harrison, G. (1999). Prevalence of substance misuse in firstepisode
psychosis. British Journal of Psychiatry, 174, 150-153.
Casas, M., Franco, M. D., Goikolea, J. M., Jimenez-Arriero, M. A., Martinez-Raga, J., Roncero, C., Szerman, N. (2008). Bipolar disorder associated to substance use disorders (dual diagnosis). Systematic review of the scientific evidence and expert consensus. Actas Españolas de Psiquiatría, 36, 350-361.
Chiang, S. C., Chan, H. Y., Chang, Y. Y., Sun, H. J., Chen, W. J., y Chen, C.K. (2007). Psychiatric comorbidity and gender difference among
treatment-seeking heroin abusers in taiwan. Psychiatry and Clinical Neurosciences, 61, 105-111.
Claassen, C. A., Gilfillan, S., Orsulak, P., Carmody, T. J., Battaglia, J., y Rush, A. J. (1997). Substance use among patients with a psychotic disorder in a psychiatric emergency room. Psychiatric Services, 48, 353-358.
Compton, M. T., Kelley, M. E., Ramsay, C. E., Pringle, M., Goulding, S.
M., Esterberg, M. L.,…Walker, E. F. (2009). Association of preonset cannabis, alcohol, and tobacco use with age at onset of prodrome and age at onset of psychosis in first-episode patients. American Journal of Psychiatry, 166, 1251-1257.
Comtois, K. A., y Ries, R. K. (1995). Sex differences in dually diagnosed
severely mentally ill clients in dual-diagnosis outpatient treatment. American Journal of Addiction, 4, 245-253.
Conner, K. R., Pinquart, M., y Gamble, S. A. Meta-analysis of depression and substance use among individuals with alcohol use disorders. (2009). Journal of Substance Abuse Treatment, 37, 127-137.
Cornelius, J. R., Jarrett, P. J., Thase, M. E., Fabrega, H. Jr., Haas, G. L.,
Jones-Barlock, A.,…Ulrich, R. F. (1995). Gender effects on the clinical presentation of alcoholics at a psychiatric hospital. Comprehensive Psychiatry, 36, 435-440.
Denier, C. A., Thevos, A. K., Latham, P. K., y Randall, C. L. (1991).
Psychosocial and psychopathology differences in hospitalized male and female cocaine abusers: A retrospective chart review. Addictive Behaviors, 16, 489-496.
DiNitto, D. M., Webb, D. K., y Rubin, A. (2002). Gender differences in dually-diagnosed clients receiving chemical dependency treatment. Journal of Psychoactive Drugs, 34, 105-117.
Dunne, F. J., Galatopoulos, C., y Schipperheijn, J. M. (1993). Gender
differences in psychiatric morbidity among alcohol misusers. Comprehensive Psychiatry, 34, 95-101.
Fischer, E. H., y Goethe, J. W. (1998). Anxiety and alcohol abuse in patients in treatment for depression. American Journal of Drug and Alcohol Abuse, 24, 453-463.
Frye, M. A., Altshuler, L. L., McElroy, S. L., Suppes, T., Keck, P. E., Denicoff, K.,…Post, R. M. (2003). Gender differences in prevalence, risk,
and clinical correlates of alcoholism comorbidity in bipolar disorder. American Journal of Psychiatry, 160, 883-889.
Gearon, J. S., y Bellack, A. S. (2000). Sex differences in illness presentation, course, and level of functioning in substanceabusing
schizophrenia patients. Schizophrenia Research, 43, 65-70.
Gearon, J. S., Kaltman, S. I., Brown, C., y Bellack, A. S. (2003a). Traumatic life events and PTSD among women with substance use disorders and schizophrenia. Psychiatric Services, 54, 523-528.
Gearon, J. S., Nidecker, M., Bellack, A., y Bennett, M. (2003b). Gender
differences in drug use behavior in people with serious mental illnesses. American Journal on Addictions, 12, 229-241.
Gual, A. (2007). Dual diagnosis in Spain. Drug and Alcohol Review, 26,
-71.
Hanna, E. Z., y Grant, B. F. (1997). Gender differences in DSM-IV alcohol use disorders and major depression as distributed in the general population: Clinical implications. Comprehensive Psychiatry, 38, 202-212.
Hesselbrock, M. N., Meyer, R. E., y Keener, J. J. (1985). Psychopathology
in hospitalized alcoholics. Archives of General Psychiatry, 42, 1050-1055.
Kessler, R. C., Crum, R. M., Warner, L. A., Nelson, C. B., Schulenberg,
J., y 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, 313-321.
Krakow, D. S., Galanter, M., Dermatis, H., y Westreich, L. M. (1998). HIV
risk factors in dually diagnosed patients. American Journal of addiction, 7, 74-80.
Landheim, A. S., Bakken, y Vaglum, P. (2003). Gender differences in
the prevalence of symptom disorders and personality disorders among poly-substance abusers and pure alcoholics. Substance abusers treated in two countries in Norway. European Addiction Research, 9, 8-17.
Montoya, I. D., Covarrubias, L. D., Patek, J. A., y Graves, J. A. (2003).
Posttraumatic stress disorder among hispanic and africanamerican drug users. American Journal of Drug and Alcohol Abuse, 29, 729-741.
Mowbray, C. T., Ribisl, K. M., Solomon, M., Luke, D. A., y Kewson, T. P.
(1997). Characteristics of dual diagnosis patients admitted to an urban, public psychiatric hospital: An examination of individual, social, and community domains. American Journal of Drug and Alcohol Abuse, 23, 309-326.
Mueser, K. T., Yarnold, P. R., y Bellack, A. S. (1992). Diagnostic and
demographic correlates of substance-abuse in schizophrenia and major affective-disorder. Acta Psychiatrica Scandinavica, 85, 48-55.
Mueser, K. T., Yarnold, P. R., Levinson, D. F., Singh, H., Bellack, A. S.,
Kee, K.,…Yadalam, K. G. (1990). Prevalence of substance abuse in schizophrenia: Demographic and clinical correlates. Schizophrenia Bulletin, 16, 31-56.
Regier, D. A., Farmer, M. E., Rae, D. S., Locke, B. Z., Keith, S. J., Judd, L.
L., y Goodwin, F. K. (1990). Comorbidity of mental disorders with alcohol and other drug abuse. results from the epidemiologic catchment area (ECA) study. Journal of the American Medical Association, 264, 2511-2518.
Reynolds, M., Mezey, G., Chapman, M., Wheeler, M., Drummond, C., y Baldacchino, A. (2005). Co-morbid post-traumatic stress disorder in a substance misusing clinical population. Drug and Alcohol Dependence, 77, 251-258.
Rodriguez-Jimenez, R., Aragues, M., Jimenez-Arriero, M. A., Ponce, G., Munoz, A., Bagney, A.,…Palomo, T. (2008). Dual diagnosis in psychiatric inpatients: Prevalence and general characteristics [Patologia dual en pacientes psiquiatricos hospitalizados: prevalencia y caracteristicas generales]. Investigacion Clinica, 49, 195-205.
Rounsaville, B. J. (2007). DSM-V research agenda: Substance abuse/
psychosis comorbidity. Schizophrenia Bulletin, 33, 947-952.
Salloum, I. M., Cornelius, J. R., Mezzich, J. E., Kirisci, L., Daley, D. C.,
Spotts, C. R., …, Zuckoff, A. (2001). Characterizing female bipolar
alcoholic patients presenting for initial evaluation. Addictive Behaviors, 26, 341-348.
Sanabria, M. A., Díaz, O., Varela, J., y Brana, T. (2002). Relevancia para
el tratamiento de la sintomatología depresiva de los pacientes adictos. Adicciones, 14, 25-31.
Seedat, S., Scott, K. M., Angermeyer, M. C., Berglund, P., Bromet, E. J.,
Brugha, T. S.,…Kessler, R. C. (2009). Cross-national associations between gender and mental disorders in the world health organization world mental health surveys. Archives of General Psychiatry, 66, 785-795.
Schutte, K. K, Hearst, J., y Moss, R. H. (1997). Gender differences in the relations between depressive symptoms and drinking behavior among problem drinkers: a three-wave study. Journal of Consulting and Clinical Psychology, 65, 392-404.
Tomasson, K., y Vaglum, P. (1995). A nationwide representative sample of treatment-seeking alcoholics - a study of psychiatric comorbidity. Acta Psychiatrica Scandinavica, 92, 378-385.
Tucker, P., y Westermeyer, J. (1995). Substance abuse in patients with
comorbid anxiety disorder. American Journal of Addiction, 4, 226-233.
Vesga-Lopez, O., Schneier, F. R., Wang, S., Heimberg, R. G., Liu, S. M., Hasin, D. S., y Blanco, C. (2008). Gender differences in generalized anxiety disorder: Results from the national epidemiologic survey on alcohol and related conditions (NESARC). Journal of Clinical Psychiatry, 69, 1606-1616.
Westermeyer, J., Tucker, P., y Nugent, S. (1995). Comorbid anxiety
disorder among patients with substance abuse disorders. risk factors on initial evaluation. American Journal of Addiction, 4, 97-106.
Westreich, L., Guedj, P., Galanter, M., y Baird, D. (1997). Differences
between men and women in dual-diagnosis treatment. American Journal on Addictions, 6, 311-317.
Wheaton, M., Timpano, K. R., Lasalle-Ricci, V. H., y Murphy, D. (2008).
Characterizing the hoarding phenotype in individuals with OCD: Associations with comorbidity, severity and gender. Journal of Anxiety Disorders, 22, 243-252.
Zlotnick, C., Clarke, J. G., Friedmann, P. D., Roberts, M. B., Sacks, S.,
y Melnick, G. (2008). Gender differences in comorbid disorders among offenders in prison substance abuse treatment programs. Behavioral Science and the Law, 26, 403-412.
