Estudio sobre aspectos etiológicos de la patología dual

Autores/as

  • Juan Barea Unidad de Conductas Adictivas de Moncada. Valencia.
  • Ana Benito Unidad de Salud Mental. Hospital Provincial Plá. Alicante.
  • Matias Real Unidad de Salud Mental Infantil. Consorcio Hospital Provincial de Castellón.
  • César Mateu Fundación de Investigación del Hospital Clínico Universitario de Valencia.
  • Eva Martín Servicio de Psiquiatría. Hospital Clínico Universitario de Valencia.
  • Nuria López Servicio de Psiquiatría. Hospital Clínico Universitario de Valencia.
  • Gonzalo Haro Programa de Patología Dual Grave. Consorcio Hospital Provincial de Castellón. Enviar correspondencia a: Dr. Gonzalo Haro. Programa de Patología Dual Grave. Hospital Provincial de Castellón. Calle Dr. Clará, 19 – 12002 Castellón

DOI:

https://doi.org/10.20882/adicciones.210

Palabras clave:

Dual Pathology, Substance-use Disorders, Personality Disorders, Family Dynamics, Behaviour Disorders, Family Psychopathologic History

Resumen

Introducción: Es importante evaluar la interacción entre los antecedentes psicopatológicos familiares (AF), la dinámica familiar (DF), los trastornos de conducta, los trastornos por uso de sustancias y los trastornos de personalidad (TP). Metodología: Estudio transversal con 350 drogodependientes evaluados los AF psiquiátricos, de alcoholismo y de drogodependencias; la DF; consumo de sustancias; y la presencia de TP, los problemas de conducta (PC) en la adolescencia y el trastorno disocial (TD). Las variables correlacionadas fueron incluidas en varios modelos de regresión logística. Resultados: Una edad de inicio en el consumo más temprana se relaciona con AF de drogodependencia y peor DF. Los AF de alcoholismo, drogodependencias y psiquiátricos se relacionan con peor DF. Edad de inicio en el consumo más temprana, los AF y una peor DF se relacionan con los PC y el TD. Edad de inicio en el consumo más temprana, tener AF, una peor DF, los PC y el TD se relacionan con la presencia de algún TP. Permiten predecir la presencia de algún TP la edad de inicio en el consumo de metadona (IC(95):1,005/3,222; p=0,048) y de otros opiáceos (IC(95):0,233/0,894; p=0,022). La puntuación en AF de alcoholismo permite predecir la presencia de TP límite (IC(95):1,137-2,942; p=0,013), y la edad de inicio en el consumo de cocaína permite predecir la presencia de TP antisocial (IC(95):0,864/0,992; p=0,028). Conclusiones: Los AF de consumo de sustancias y el consumo propio, predicen la presencia de algunos TP.

Biografía del autor/a

Juan Barea, Unidad de Conductas Adictivas de Moncada. Valencia.

Citas

Hill J. Early identification of individuals at risk for antisocial personality disorder. Br J Psychiatry 2003; 44: 11-4.

Kim-Cohen J, Caspi A, Moffitt TE, Harrington H, Milne BJ, Poulton R. Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort. Arch Gen Psychiatry 2003; 60: 709-17.

Ramklint M, von Knorring Al, von Knorring L, Ekselius L. Personality disorders in former child psychiatric patients. Eur Child Adolesc Psychiatry 2002; 11: 289-95.

Vizard E, French L, Hickey L, Blandon E. Severe personality disorder

emerging in childhood: a proposal for a new developmental disorder. Crim Behav Ment Health 2004; 14: 17-28.

Boys A, Farrell M, Taylor C, Marsden J, Goodman R, Brugha T et al. Developmental, family, and ethnic influences on adolescent alcohol usage: a growth curve approach. J Fam Psychol 2001; 15: 301-14.

Clark DB, Pollock N, Bukstein OG, Mezzich AC, Bromberger JT, Donovan JE. Gender and comorbid psychopathology in adolescents with alcohol dependence. Addict Behav 1997; 36:1195-203.

Casas M, Guardia J. Patología psiquiátrica asociada al alcoholismo.

Adicciones 2002; 14: 195-219.

Clark DB, Kirisci L, Moss HB. Early adolescent gateway drug use in

sons of fathers with substance use disorders. Addict Behav 1998; 23: 561-6.

Clark DB, Kirisci L, Tarter RE. Adolescent versus adult onset and

the development of substance use disorders in males. Drug Alcohol Depend 1998; 49: 115-21.

Coffey C, Carlin JB, Lynskey M, Li N, Patton GC. Adolescent precursors of cannabis dependence: findings from the Victorian Adolescent Health Cohort Study. Br J Psychiatry 2003; 182: 330-6.

Ensminger ME. Sexual activity and problem behavior among black, urban adolescents. Child Development 1990; 61: 2032-46.

Hser YI, Grella CE, Collins C, Teruya C. Drug-use initiation and conduct disorder among adolescents in drug treatment. J Adolesc 2003; 26: 331-45.

Modestin J, Matutat B, Wurmle O. Antecedents of opiod dependence and personality disorder: attention-deficit/hyperactivity disorder and conduct disorder. Eur Arch Psychiatry Clin Neurosci 2001; 251: 42-7.

Donovan JE, Jessor R. Structure of problem behavior in adolescence and young adulthood. J Consult Clin Psychol 1985; 53: 890-904.

Donovan JE, Jessor R, Costa FM. Syndrome of problem behavior in

adolescence: A replication. J Consult Clin Psychol 1988; 56: 762-65.

Widom CS. The cycle of violence. Science 1989; 244: 160-6.

Rutter M, Giller H, Hagell A. Antisocial Behavior by Young people.

Cambridge: Cambridge University Press, 1998.

Bray JH, Adams GJU, Getz JG, Baer PE. Developmental, family, and

ethnic influences on adolescent alcohol usage: a growth curve approach. J Fam Psychol 2001; 15: 301-14

Holmes SE, Slaughter JR; Kashani J. Risk factors that lead to the development of conduct disorder and antisocial personality disorder. Child Psychiatry Hum Dev 2001; 31: 183-91.

Mandel HP. Conduct Disorder and under-achievement: risk factors, assessment, treatment, and prevention. New York: John Wiley & Sons Inc, 1997.

Sanz M, Iraurgi I, Martinez-Pampliega A, Cosgaya L. Conflicto marital y consumo de drogas en los hijos. Adicciones 2006; 18:39-48.

Dishion TJ, Bullock BM, Granic I. Pragmatism in modeling peer influence: dynamics, outcomes, and change processes. Dev Psychol 2002; 14: 966-81

Prinstein MJ, Boegers J, Spirito A. Adolescents and their friends’ health-risk bahavior: factors that alter or add to peer influence. J Pediatr Psychol 2001; 26: 287-98.

Duncan SC, Duncan TE, Biglan A, Ary D. Contributions of the social context to the development of adolescent substance use: a multivariate latent growth modeling approach. Drug Alcohol Depend 1998; 50: 57-71.

Mandel HP, Mandel DE). Along the path: Case histories of differentially diagnosed underachievers. Toronto: York University, ed., 1995.

Mandel HP, Marcus SI, Dean L. Could do better: Why children underachieve and what to do about it. New York: Wiley, 1995.

Olson SL. Development of conduct problems and peer rejection in preschool children: A social systems analysis. J Abnorm Child Psychol 1992; 20: 327-50.

Keenan K, Loeber R, Zhang Q, Stouthamer-Loeber M. The influence of deviant peers on the development of boys’ disruptive and delinquent behavior: A temporal analysis. Dev Psychopathol 1995; 7: 715-26.

Asher SR, Erdley CA, Gabriel SW. Peer relations. En: Rutter M, Hay L, eds. Development through life: A handbook for clinicians. Oxford: Blackwell Scientific, 1994. pp. 456-87.

Coie JD, Dodge KA. Aggression and antisocial behavior. En: Damon

W, Eisenberg N, eds. Handbook of child psychology, vol. 3: Social, emotional, and personality development, 5th ed. New York: Wiley, 1997. p. 779-862.

Dishion TJ, Patterson GR, Stoolmiller M, Skinner ML. Family, school, and behavioral antecedents to early adolescent in involvement with antisocial peers. Dev Psychol 1991; 27: 172-80.

Parker JG, Asher SR. Peer relations and later personal adjustment:

Are low-accepted children at risk? Psychol Bull 1987; 102: 357-89.

Roeser RW, Eccles JS. Schooling and mental health. En: Sameroff AJ, Lewis M, eds. Handbook of development psychopathology, 2nd ed. New York: Kluwe Academic/Plenum Press, 2000. p. 135-56.

McBurnett K, Kerckhoff C, Capasso L, Pfiffner LJ, Rathouz PJ, McCord M et al. Antisocial personality, substance abuse, and exposure to parental violence in males referred for domestic violence. Violence Vict 2001; 16: 491-506.

Greene RW, Biederma J, Zerwas S, Monuteaux MC, Goring JC, Faraone SV. Psychiatric comorbidity, family dysfunction, and social impairment in referred youth with oppositional defiant disorder. Am J Psychiatry 2002; 159: 1214-24.

Jouriles EN, Murphy CM, O´Leary. Interspousal aggression, marital

discord and child problems. J Consult Clin Psychol 1989; 57: 453-5.

Lahey BB, Hartdagen SE, Frick PJ, McBurnett K, Connor R, Hynd

GW. Conduct disorder: Parsing the confounded relation of parental divorce and antisocial personality. J Abnorm Psychol 1988; 97: 334-7.

Moss HB, Baron DA, Hardie TL, Vanyukov MM. Preadolescent children of substance-dependent fathers with antisocial personality disorder: psychiatric disorders and problem behaviours. Am J Addict 2001; 10: 269-78.

Granic I, Patterson GR. Toward a comprehensive model of antisocial development: a dynamic systems approach. Psychol Rev 2006; 113: 101-31.

Farrington DP, Hawkins JD. Predicting participation, early-onset and later persistence in officially recorded offending. Crim Behav Ment Health 1991; 1: 1-33.

McCord J. Questioning the value of punishment. Soc Probl 1991; 38: 167-79.

Haro G, Mateu C, Martinez-Raga J, Valderrama JC, Castellano M,

Cervera G. The role of personality disorders on drug dependence treatment outcomes following inpatient detoxification. Eur Psychiatry 2004; 19: 187-92.

Mateu G, Astals M, Torrens M. Comorbilidad psiquiátrica y trastorno

por dependencia de opiáceos: del diagnóstico al tratamiento. Adicciones, 2005; 17: 111-121.

Fernández JJ, Gutiérrez E. Trastornos de personalidad y dependencia

de heroína: una relación por determinar. Adicciones 2005; 17: 95-110.

Loranger AW, Sartorius N, Anfreoli A, Berger P, Buchheim P, Channabasavanna SN et al. The International Personality Disorder Examination. The World Health Organization/Alcohol, Drug Abuse, and Mental Health Administration international pilot study of personality disorders. Arch Gen Psychiatry, 1994; 51: 215-24.

Parra GR, O’Neill SE, Sher KJ. Reliability of self-reported age of substance involvement onset. Psychol Addict Behav 2003; 17: 211-8.

Tremeau F, Darreye A, Leroy B, Renckly V, Ertle S, Weibel H et al.

Personality changes in opioid-dependent subjects in a methadone maintenance treatment program. Encephale 2003; 29: 285-92.

Cacciola JS, Rutherford MJ, Alterman AI, McKay JR, Mulvaney FD.

Long-term test-retest reliability of personality disorder diagnoses in opiate dependent patients. J Personal Disord 1998; 12: 332-7.

Keller PS, Cummings EM, Davies PT. The role of marital discord and parenting in relations between parental problem drinking and child adjustment. J Child Psychol Psychiatry 2005; 46: 943-51.

Fuller BE, Chermack ST, Cruise KA, Kirsch E, Fitzgerald HE, Zucker

RA. Predictors of aggression across three generations among sons of alcoholics: relationships involving grandparental and parental alcoholism, child aggression, marital aggression and parenting practices. J Stud Alcohol 2003; 64: 472-83.

Windle M. On the discriminative validity of a family history of problem drinking index with a national sample of young adults. J Stud Alcohol 1996; 57: 378-86.

Nurnberger JJ, Wiegand R, Bucholz K, O’Connor S, Meyer ET, Reich T et al. A family study of alcohol dependence: coaggregation of multiple disorders in relatives of alcohol-dependent probands. Arch Gen Psychiatry 2004; 61: 1246-56.

Hicks BM, Krueger RF, Iacono WG, McGue M, Patrick CJ. Family

transmission and heritability of externalizing disorders: a twinfamily study. Arch Gen Psychiatry 2004; 61: 922-8.

Merikangas KR, Stolar M, Stevens DE, Goulet J, Preisig MA, Fenton

B et al. Familial transmission of substance use disorders. Arch Gen Psychiatry 1998; 55: 964-5.

Kaplow JB, Curran PJ, Dodge KA. Conduct Problems Prevention Research Group. Child, parent, and peer predictors of early-onset substance use: a multisite longitudinal study. J Abnorm Child Psychol 2002; 30: 199-216.

Caudill BD, Hoffman JA, Hubbard RL, Flynn PM, Luckey JW. Parental history of substance abuse as a risk factor in predicting crack smokers’ substance use, illegal activities, and psychiatric status. Am J Drug Alcohol Abuse 1994; 20: 341-54.

Nickell AD, Waudby CJ, Trull TJ. Attachment, parental bonding and borderline personality disorder features in young adults. J Personal Disord 2002; 16: 148-59.

Golomb A, Ludolph P, Westen D, Block MJ, Maurer P, Wiss FC. Maternal empathy, family chaos, and the etiology of borderline personality disorder. J Am Psychoanal Assoc 1994; 42: 525-48.

De Bellis MD. Developmental traumatology: a contributory mechanism for alcohol and substance use disorders. Psychoneuroendocrinology

; 27: 155-70.

Brems C, Namyniuk L. The relationship of childhood abuse history

and substance use in an Alaska sample. Subst Use Misuse 2002; 37: 473-94.

Lobbestael J, Arntz A, Sieswerda S. Schema modes and childhood

abuse in borderline and antisocial personality disorders. J Behav Ther Exp Psychiatry 2005; 36: 240-53.

Zanarini MC. Childhood experiences associated with the development of borderline personality. Psychiatr Clin North Am 2000; 23: 89-101.

Brown GR, Anderson B. Psychiatric morbidity in adult inpatients with childhood histories of sexual and physical abuse. Am J Psychiatry 1992; 149: 578.

Kuritarne IS. Childhood trauma in the etiology of borderline personality disorder. Psychiatr Hung 2005; 20: 256-70.

Schubiner H, Tzelepis A, Milberger S, Lockhart N, Kruger M, Kelley BJ et al. Prevalence of attention-deficit/hyperactivity disorder and conduct disorder among substance abusers. J Clin Psychiatry 2000; 61: 244-51.

King SM, Iacono WG, McGue M. Childhood externalizing and internalizing psychopathology in the prediction of early substance use. Addiction 2004; 99: 1548-59.

Hahesy AL, Wilens TE, Biederman J, Van Patten SL, Spencer T. Temporal association between childhood psychopathology and substance use disorders: findings from a sample of adults with opioid or alcohol dependency. Psychiatry Res 2002; 109: 245-53.

Taylor J, Malone S, Iacono WG, McGue M. Development of substance dependence in two delinquency subgroups and nondelinquents from a male twin sample. J Am Acad Child Adolesc Psychiatry 2002; 41: 386-93.

Kuperman S, Schlosser SS, Kramer JR, Bucholz K, Hesselbrock V,

Reich T et al. Developmental sequence from disruptive behavior diagnosis to adolescent alcohol dependence. Am J Psychiatry 2001; 158: 2022-6.

Muñoz-Rivas MJ, Graña JL, Peña ME, Andreu JM. Influencia de la conducta antisocial en el consumo de drogas ilegales en población adolescente. Adicciones 2003; 3:313-320.

Franken IH, Hendriks VM. Early-onset of illicit substance use is associated with greater axis-II comorbidity, not with axis-I comorbidity. Drug Alcohol Depend 2000; 59: 305-8.

Gasperini M, Battaglia M, Scherillo P, Sciuto G, Diaferia G, Bellodi L. Morbidity risk for mood disorders in the families of borderline patients. J Affect Disord 1991; 21: 265-72.

Suzuki K. Psychiatric illnesses in adolescents of alcoholic parents.

Seishin Shinkeigaku Zasshi 1990; 92: 79-88.

Haver B. Female alcoholics. The relationship between family history of alcoholism and outcome 3-10 years after treatment. Acta Psychiatr Scand 1987; 76: 21-7.

Loranger AW, Tulis EH. Family history of alcoholism in borderline

personality disorder. Arch Gen Psychiatry 1985; 42: 153-7.

Ridenour TA, Cottler LB, Robins LN, Compton WM, Spitznagel EL,

Cunningham-Williams RM. Test of the plausibility of adolescent substance use playing a causal role in developing adulthood antisocial behavior. J Abnorm Psychol 2002; 111: 144-55.

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2010-03-01

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