Comorbilidad psiquiátrica en jóvenes-adultos consumidores de cannabis
DOI:
https://doi.org/10.20882/adicciones.71Palabras clave:
cannabis, trastornos psiquiátricos, tratamiento, PRISMResumen
Este estudio transversal tiene como objetivo determinar la prevalencia vidade trastornos psiquiátricos (incluyendo los trastornos por uso de sustancias,–TUS y los otros trastornos no por uso de sustancias, –No-TUS) entre 289jóvenes (18-30 años) consumidores regulares de cannabis durante el últi- mo año, reclutados fuera del entorno asistencial en Barcelona. Se adminis- tró la versión española de la Psychiatric Interview for Substance and MentalDisorders (PRISM). Sólo el 28% de los participantes no presentó ningúntrastorno psiquiátrico, y el 65% tenía algún TUS, el más común relacionadocon el cannabis (62%). Casi el 27% presentó trastornos no-TUS. Una edadde inicio más temprana en el consumo de alcohol se asoció con la presen- cia de algún TUS. Haber consumido un número mayor de “porros” en el último mes se asoció con la presencia de trastornos psiquiátricos (TUS y no-TUS). Mientras tres cuartas partes de los pacientes con trastornos no-TUS habían recibido algún tipo de tratamiento, sólo el 28% de las per- sonas con cualquier TUS habían recibido tratamiento. Dada la baja percep- ción de necesidad de tratamiento, se hacen necesarias estrategias de pre- vención y poder ofrecer terapias adaptadas y dirigidas a los consumidores jóvenes de cannabis.Citas
Agosti, V., Nunes, E., & Levin, F. (2002). Rates of psychiatric comorbidity
among U.S. residents with lifetime cannabis dependence. American
Journal of Drug and Alcohol Abuse, 28, 643-652.
Arendt, M. & Munk-Jorgensen, P. (2004). Heavy cannabis users seeking
treatment- prevalence of psychiatric disorders. Social Psychiatry and Psychiatric Epidemiology, 39, 97-105.
Arendt, M., Rosenberg, R., Foldager, L., Perto, G., & Munk-Jorgensen, P.
(2005). Cannabis-induced psychosis and subsequent schizophreniaspectrum disorders: follow-up study of 535 incident cases. British Journal of Psychiatry, 187, 510-515.
Arendt, M., Rosenberg, R., Foldager, L., Perto, G., & Munk-Jorgensen, P.
(2007). Psychopathology among cannabis-dependent treatment seekers and association with later substance abuse treatment. Journal of Substance Abuse Treatment, 32, 113-119.
Arendt, M., Rosenberg, R., Foldager, L., Sher, L., & Munk-Jorgensen, P. (2007). Withdrawal symptoms do not predict relapse among subjects treated for cannabis dependence. American Journal on Addictions, 16, 461-467.
Astals, M., Diaz, L., Domingo-Salvany, A., Martín-Santos, R., Bulbena, A.,
& Torrens, M. (2009). Impact of Co-Occurring Psychiatric Disorders on Retention in a Methadone Maintenance Program: An 18-Month Follow-Up Study. International Journal of Environmental Research and Public Health, 6, 2822-2832.
Barea, J., Benito, A., Mateu, C., Martin, E., Lopez, N., & Haro, G. (2010).
Research on etiological aspects of dual pathology. Adicciones, 22, 15-24.
Casares-Lopez, M. J., Gonzalez-Menendez, A., Bobes-Bascaran, M. T.,
Secades, R., Martinez-Cordero, A., & Bobes, J. (2011). Need for the
assessment of dual diagnosis in prisons. Adicciones, 23, 37-44.
Caspi, A., Moffitt, T. E., Cannon, M., McClay, J., Murray, R., Harrington, H.,
… Craig, I. W. (2005). Moderation of the effect of adolescent-onset cannabis use on adult psychosis by a functional polymorphism in the catechol-O-methyltransferase gene: longitudinal evidence of a gene X environment interaction. Biological Psychiatry, 57, 1117-1127.
Codony, M., Alonso, J., Almansa, J., Vilagut, G., Domingo-Salvany, A.,
Pinto-Meza, A.,… Haro, J. M. (2007). Utilización de los servicios de salud mental en la población general española. Resultados del estudio ESEMeD-España. Actas Españolas de Psiquiatria, 35, 21-28.
De Irala, J., Ruiz-Canela, M., y Martinez-Gonzalez, M. A. (2005). Causal
relationship between cannabis use and psychotic symptoms or depression. Should we wait and see? A public health perspective. Medical Science Monitor, 11, RA355-RA358.
Degenhardt, L., Dierker, L., Chiu, W. T., Medina-Mora, M. E., Neumark,
Y., Sampson, N.,... Kessler, R. C. (2010). Evaluating the drug use “gateway” theory using cross-national data: consistency and associations of the order of initiation of drug use among participants in the WHO World Mental Health Surveys. Drug and Alcohol Dependence, 108, 84-97.
Degenhardt, L., Hall, W., & Lynskey, M. (2003). Exploring the association
between cannabis use and depression. Addiction, 98, 1493-1504.
Delegación del Gobierno para el Plan Nacional sobre Drogas y Ministerio
de Sanidad y Consumo (2006). Cannabis II. Informes de la comisión
clínica. Madrid: Ministerio de Sanidad y Política Social.
Gonzalvo, B., Barral, C., Grau-López, L., Esteve, O., y Roncero, C. (2012).
Comorbilidad psiquiátrica en adolescentes consumidores de cannabis. Trastornos Adictivos, 13, 109-112.
Grant, B. F. & Pickering, R. (1998). The relationship between cannabis
use and DSM-IV cannabis abuse and dependence: results from the National Longitudinal Alcohol Epidemiologic Survey. Journal of Substance Abuse Treatment, 10, 255-264.
Grant, B. F., Stinson, F. S., Dawson, D. A., Chou, S. P., & Ruan, W. J.
(2005). Co-occurrence of DSM-IV personality disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Comprehensive Psychiatry, 46, 1-5.
Grella, C. E., Hser, Y. I., Joshi, V., & Rounds-Bryant, J. (2001). Drug
treatment outcomes for adolescents with comorbid mental and substance use disorders. Journal of Nervous and Mental Disease, 189, 384-392.
Guillem, E., Pelissolo, A., Vorspan, F., Bouchez-Arbabzadeh, S., y Lépine,
J. P. (2009). Facteurs sociodémographiques, conduites addictives et comorbidité psychiatrique des usagers de cannabis vus en consultation spécialisée. L’Encéphale, 35, 226-233.
Haro, J. M., Alonso, J., Pinto-Meza, A., Vilagut Saiz, G., Fernández, F.,
Codony, M.,…Autonell, J. (2008). The Epidemiology of Mental Disorders in the General Population of Spain. Chapter 19. Part II.
Country-Specific Chapters. In e.Ronald C.Kessler y T.Bedirhan Üstün (Eds.), The WHO World Mental Health Surveys: global Perspectives on the Epidemiology of Mental Disorders. (pp. 406-430). New York: Cambridge University Press.
Hasin, D. S., Trautman, K. D., Miele, G. M., Samet, S., Smith, M., &
Endicott, J. (1996). Psychiatric Research Interview for Substance and Mental Disorders (PRISM): reliability for substance abusers. American Journal of Psychiatry, 153, 1195-1201.
Herrero, M. J., Domingo-Salvany, A., Torrens, M., Brugal, M. T., & the
ITINERE Investigators. (2008). Psychiatric comorbidity in young cocaine users: induced versus independent disorders. Addiction, 103, 284-293.
Lee, S., Tsang, A., Breslau, J., Aguilar-Gaxiola, S., Angermeyer, M., Borges, G.,… Kessler, R. C. (2009). Mental disorders and termination of
education in high-income and low- and middle-income countries:
epidemiological study. British Journal of Psychiatry, 194, 411-417.
Lynskey, M. & Hall W (2000). The effects of adolescent cannabis use on
educational attainment: a review. Addiction, 95, 1621-1630.
Macleod, J. & Hickman, M. (2010). How ideology shapes the evidence
and the policy: what do we know about cannabis use and what should we do? Addiction, 105, 1326-1330.
Martin-Santos, R., Torrens, M., Poudevida, S., Langohr, K., Cuyas, E.,
Pacifici, R.,… de la Torre, R. (2009). 5-HTTLPR polymorphism, mood
disorders and MDMA use in a 3-year follow-up study. Addiction biology, 15, 15-22.
Miller, P. G. & Sonderlund, A. L. (2010). Using the internet to research
hidden populations of illicit drug users: a review. Addiction, 105, 1557-1567.
Moore, T. H., Zammit, S., Lingford-Hughes, A., Barnes, T. R., Jones, P. B.,
Burke, M. & Lewis, G. (2007). Cannabis use and risk of psychotic or
affective mental health outcomes: a systematic review. The Lancet,
, 319-328.
National Survey on Drug Use and Health. (2008). Substance Abuse and Mental Health Services Administration, Office of Applied Studies. Results from the 2007 National Survey on Drug Use and Health: National Findings (NSDUH Series H-34, DHHS Publication No.SMA08-4343). Rockville, MD. Retrived from http://oas.samhsa. gov/nsduh/2k7nsduh/2k7results.cfm.
Nocon, A., Berge, D., Astals, M., Martin-Santos, R., & Torrens, M. (2007).
Dual diagnosis in an inpatient drug-abuse detoxification unit. European Addiction Research, 13, 192-200.
Observatorio Español de Drogas (2009). Informe 2009. Situación y tendencias de los problemas de drogas en España. Madrid: Ministerio de Sanidad y Política Social.
Observatorio Europeo de las Drogas y las Toxicomanías. (2011). Informe
anual 2010. El problema de la drogodependencia en Europa. Luxemburgo: Oficina de Publicaciones de la Unión Europea.
Observatorio Europeo de las Drogas y Toxicomanías (2009). Informe
Anual 2009. El problema de la drogodependencia en Europa. Luxemburgo: Oficina de Publicaciones de la Unión Europea.
Palmer, R. H., Young, S. E., Hopfer, C. J., Corley, R. P., Stallings, M. C.,
Crowley, T. J.,…Hewitt, J. K. (2009). Developmental epidemiology of drug use and abuse in adolescence and young adulthood: Evidence of generalized risk. Drug and Alcohol Dependence, 102, 78-87.
Rodriguez-Llera, M. C., Domingo-Salvany, A., Brugal, M. T., Silva, T. C.,
Sanchez-Niubo, A., & Torrens, M. (2006). Psychiatric comorbidity in young heroin users. Drug and Alcohol Dependence, 84, 48-55.
Roncero, C., Daigre, C., Gonzalvo, B., Valero, S., Castells, X., Grau-Lopez,
L.,… Casas, M. (2011). Risk factors for cocaine-induced psychosis in cocaine-dependent patients. European psychiatry : the journal of the Association of European Psychiatrists. doi.org/10.1016/j.bbr.2011.03.031
Rounsaville, B. J., Kranzler, H. R., Ball, S., Tennen, H., Poling, J., & Triffleman, E. (1998). Personality disorders in substance abusers: relation to substance use. Journal of Nervous and Mental Disease, 186, 87-95.
Skinner, R., Conlon, L., Gibbons, D., & McDonald, C. (2011). Cannabis use and non-clinical dimensions of psychosis in university students presenting to primary care. Acta Psychiatrica Scandinavica, 123, 21-27.
Solowij N, Stephens RS, & Roffman RA (2002). Cognitive functioning of
long-term heavy cannabis users seeking treatment. Journal of the American Medical Association, 287, 1123-1131.
Stinson, F. S., Ruan, W. J., Pickering, R., & Grant, B. F. (2006). Cannabis
use disorders in the USA: prevalence, correlates and co-morbidity.
Psychological Medicine, 36, 1447-1460.
Szerman, N., Arias, F., Vega, P., Babín, F., Mesías, B., Basurte, I.,… Poyo
Calvo, F. (2011). Pilot study on the prevalence of dual pathology in community mental health and substance misuse services in Madrid. Adicciones, 23, 249-255.
Tims, F. M., Dennis, M. L., Hamilton, N., Buchan, J., Diamond, G., Funk, R. & Brantley, L. B. (2002). Characteristics and problems of 600 adolescent cannabis abusers in outpatient treatment. Addiction, 97 Suppl 1, 46-57.
Torrens, M., Serrano, D., Astals, M., Perez-Dominguez, G., & Martin-
Santos, R. (2004). Diagnosing comorbid psychiatric disorders in substance abusers: validity of the Spanish versions of the Psychiatric Research Interview for Substance and Mental Disorders and the Structured Clinical Interview for DSM-IV. American Journal of Psychiatry, 161, 1231-1237.
Veen, N. D., Selten, J. P., van, d. T., I, Feller, W. G., Hoek, H. W., & Kahn, R. S. (2004). Cannabis use and age at onset of schizophrenia. American
Journal of Psychiatry, 161, 501-506.
Weiner, M. D., Sussman, S., McCuller, W. J., & Lichtman, K. (1999). Factors in marijuana cessation among high-risk youth. Journal of Drug Education, 29, 337-357.
Winstock, A. R., Ford, C., & Witton, J. (2010). Assessment and management of cannabis use disorders in primary care. British Medical Journal, 340, c1571.