Cribaje de trastornos por uso de alcohol en pacientes psiquiátricos ambulatorios: influencia de género, edad, y diagnóstico psiquiátrico

Mónica Sánchez Autet, Marina Garriga, Francisco Javier Zamora, Idilio González, Judith Usall, Leticia Tolosa, Concepción Benítez, Raquel Puertas, Belén Arranz

Resumen


Los trastornos por uso de alcohol (TUA) son 2 veces más frecuentes en pacientes psiquiátricos que en la población general. El infradiagnóstico de patología dual puede tener diversas consecuencias negativas; una valoración precoz con herramientas de cribaje como la escala CAGE podría mejorar el pronóstico de estos pacientes. El objetivo de este estudio es valorar el riesgo de TUA en pacientes psiquiátricos ambulatorios con una CAGE modificada, considerando la influencia de edad, género, y diagnóstico psiquiátrico. Se realizó un estudio descriptivo observacional, multicéntrico. La escala CAGE de 4 ítems, camuflada en un cuestionario de vida saludable, se aplicó utilizando el punto de corte de 1. Se valoraron 559 pacientes. El 54% eran mujeres, y la edad media fue de 50,07 años. 182 pacientes presentaron una puntuación ≥1 (45,1% de los hombres y 21,9% de las mujeres). El género fue el predictor principal de un resultado positivo en la escala CAGE, siendo 3,03 veces más probable que los hombres obtengan una puntuación ≥1 (p < ,001, 95% IC: 0,22-0,49). El trastorno bipolar y los trastornos de personalidad presentaron las tasas más altas de puntuaciones ≥1 (45,2 y 44,9%, respectivamente) con una asociación significativa entre diagnóstico y un resultado positivo (p = ,002). Los pacientes de más de 60 años mostraron 2,5 veces menos probabilidades de obtener una puntuación positiva (p = ,017, 95% IC: 0,19-0,85). Cuestionarios específicos, como CAGE, pueden ser herramientas sencillas y útiles para valorar el riesgo de TUA en pacientes psiquiátricos ambulatorios. Los pacientes hombres con trastorno bipolar o de personalidad presentan un riesgo más elevado de TUA.

Palabras clave


Trastornos por uso de alcohol; CAGE; Cribaje; Patología dual; Pacientes psiquiátricos ambulatorios

Texto completo:

PDF PDF (English)

Referencias


Agabio, R., Marras, P., Gessa, G. L. y Carpiniello, B. (2007). Alcohol use disorders, and at-risk drinking in patients affected by a mood disorder, in Cagliari, Italy: sensitivity and specificity of different questionnaires. Alcohol and Alcoholism, 42, 575–581. doi:10.1093/alcalc/agm072.

Anthenelli, R. M. (2012). Overview: stress and alcohol use disorders revisited. Alcohol Research: Current Reviews, 34, 386–390.

Autonell, J., Vila, F., Pinto-Meza, A., Vilagut, G., Codony, M., Almansa, J., … Haro, J. M. (2007). One year prevalence of mental disorders comorbidity and associated socio-demographic risk factors in the general population of Spain. Results of the ESEMeD-Spain study. Actas Españolas de Psiquiatría, 35, 4–11.

Baltieri, D. A. y de Andrade, A. G. (2008). Comparing serial and nonserial sexual offenders: alcohol and street drug consumption, impulsiveness and history of sexual abuse. Revista Brasileira de Psiquiatria, 30, 25–31.

Barnaby, B., Drummond, C., McCloud, A., Burns, T. y Omu, N. (2003). Substance misuse in psychiatric inpatients: comparison of a screening questionnaire survey with case notes. British Medical Journal, 327, 783–784. doi:10.1136/bmj.327.7418.783.

Barrio, P., Miquel, L., Moreno-España, J., Martínez, A., Ortega, L., Teixidor, L., ... Gual, A. (2016). Alcohol in Primary Care. Differential characteristics between alcohol-dependent patients who are receiving or not receiving treatment. Adicciones, 28, 116-122. doi:10.20882/adicciones.779. 

Berks, J. y McCormick, R. (2008). Screening for alcohol misuse in elderly primary care patients: a systematic literature review. International Psychogeriatrics, 20, 1090–1103. doi:10.1017/S1041610208007497.

Bowman, P. T. y Gerber, S. (2006). Alcohol in the older population, Part 2: MAST you speak the truth in an AUDIT or are you too CAGE-y? The Case Manager, 17, 48–53, 59.

Bradley, K. A., Bush, K. R., McDonell, M. B., Malone, T. y Fihn, S. D. (1998). Screening for problem drinking : Comparison of CAGE and AUDIT. Journal of General Internal Medicine, 13, 379–388. doi:10.1046/j.1525-1497.1998.00118.x.

Buckley P. (2006). Prevalence and consequences of the dual diagnosis of substance abuse and severe mental illness. The Journal of Clinical Psychiatry, 67, 5-9.

Cantor-Graae, E., Nordström, L. G. & McNeil, T. F. (2001). Substance abuse in schizophrenia: a review of the literature and a study of correlates in Sweden. Schizophrenia Research, 48, 69–82.

Cardoso, B. M., Kauer Sant’Anna, M., Dias, V. V., Andreazza, A. C., Ceresér, K. M. y Kapczinski, F. (2008). The impact of co-morbid alcohol use disorder in bipolar patients. Alcohol, 42, 451–457. doi:10.1016/j.alcohol.2008.05.003.

Castells, M. A. y Furlanetto, L. M. (2005). Validity of the CAGE questionnaire for screening alcohol-dependent inpatients on hospital wards. Revista Brasileira de Psiquiatria, 27, 54–57.

Cherpitel, C. J. (1995). Analysis of cut points for screening instruments for alcohol problems in the emergency room. Journal of Studies on Alcohol, 56, 695–700.

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.

Córdoba, R., Delgado, M. T., Pico, V., Altisent, R., Fores, D., Monreal, A., … López del Val, A. (1998). Effectiveness of brief intervention on non-dependent alcohol drinkers (EBIAL): a Spanish multi-centre study. Family Practice, 15, 562–568.

Corradi-Webster, C. M., Laprega, M. R. y Furtado, E. F. (2005). Performance assessment of CAGE screening test among psychiatric outpatients. Revista Latino-Americana de Enfermagem, 13, 1213–1218. doi: S0104-11692005000800017.

Curran, T. A., Gawley, E., Casey, P., Gill, M. y Crumlish, N. (2009). Depression, suicidality and alcohol abuse among medical and business students. Irish Medical Journal, 102, 249–252.

de Oliveira, J., Kerr-Correa, F., Lima, M., Bertolote, J. y Santos, J. (2014). Validity of Alcohol Screening Instruments in General Population Gender Studies: An Analytical Review. Current Drug Abuse Reviews, 7, 59–65. doi:10.2174/1874473707666141015214708.

Derks, E. M., Vink, J. M., Willemsen, G., van den Brink, W. y Boomsma, D. I. (2014). Genetic and environmental influences on the relationship between adult ADHD symptoms and self-reported problem drinking in 6024 Dutch twins. Psychological Medicine, 44, 2673–83. doi:10.1017/S0033291714000361.

Dervaux, A., Bayle, F. J., Laqueille, X., Bourdel, M. C., Leborgne, M., Olie, J. P. y Krebs, M. O. (2006). Validity of the CAGE questionnaire in schizophrenic patients with alcohol abuse and dependence. Schizophrenia Research, 81, 151–155. doi:10.1016/j.schres.2005.09.012.

Dhalla, S. y Kopec, J. A. (2007). The CAGE questionnaire for alcohol misuse: a review of reliability and validity studies. Clinical and Investigative Medicine. Médecine Clinique et Experimentale, 30, 33–41.

Dixon, L., Weiden, P. J., Haas, G., Sweeney, J. y Frances, A. J. (1992). Increased tardive dyskinesia in alcohol-abusing schizophrenic patients. Comprehensive Psychiatry, 33, 121–122.

Drake, R. E., Osher, F. C. y Wallach, M. A. (1989). Alcohol use and abuse in schizophrenia. A prospective community study. The Journal of Nervous and Mental Disease, 177, 408–414.

Draper, B., Ridley, N., Johnco, C., Withall, A., Sim, W., Freeman, M., … Lintzeris, N. (2015). Screening for alcohol and substance use for older people in geriatric hospital and community health settings. International Psychogeriatrics/IPA, 27, 157–66. doi:10.1017/S1041610214002014.

Duke, P. J., Pantelis, C. y Barnes, T. R. (1994). South Westminster schizophrenia survey. Alcohol use and its relationship to symptoms, tardive dyskinesia and illness onset. The British Journal of Psychiatry, 164, 630–636.

Eberhard, S., Nordström, G., Höglund, P. y Ojehagen, A. (2009). Secondary prevention of hazardous alcohol consumption in psychiatric out-patients: a randomised controlled study. Social Psychiatry and Psychiatric Epidemiology, 44, 1013–1021. doi:10.1007/s00127-009-0023-7.

Echeburúa, E., de Medina, R. B. y Aizpiri, J. (2005). Alcoholism and personality disorders: an exploratory study. Alcohol and Alcoholism, 40, 323–326. doi:10.1093/alcalc/agh158.

Encrenaz, G., Kovess-Masféty, V., Sapinho, D., Chee, C. C. y Messiah, A. (2007). Utilization of mental health services and risk of 12-month problematic alcohol use. American Journal of Health Behavior, 31, 392–401. doi:10.5555/ajhb.2007.31.4.392.

Escobar, F., Espí, F. y Canteras, M. (1995). Diagnostic tests for alcoholism in primary health care: compared efficacy of different instruments. Drug and Alcohol Dependence, 40, 151–158. doi:10.1016/0376-8716(95)01200-1.

Etter, M. y Etter, J. F. (2004). Alcohol consumption and the CAGE test in outpatients with schizophrenia or schizoaffective disorder and in the general population. Schizophrenia Bulletin, 30, 947–956.

Ewing, J. A. (1984). Detecting alcoholism. The CAGE questionnaire. JAMA, 252, 1905–1907.

Farren, C. K., Hill, K. P. y Weiss, R. D. (2012). Bipolar disorder and alcohol use disorder: a review. Current Psychiatry Reports, 14, 659–66. doi:10.1007/s11920-012-0320-9.

Fiellin, D. A., Reid, M. C. y O’Connor, P. G. (2000). Screening for alcohol problems in primary care: a systematic review. Archives of Internal Medicine, 160, 1977–1989.

Fowler, I. L., Carr, V. J., Carter, N. T. y Lewin, T. J. (1998). Patterns of current and lifetime substance use in schizophrenia. Schizophrenia Bulletin, 24, 443–455.

Gerding, L. B., Labbate, L. A., Measom, M. O., Santos, A. B. y Arana, G. W. (1999). Alcohol dependence and hospitalization in schizophrenia. Schizophrenia Research, 38, 71–75.

Glass, J. E., Grant, J. D., Yoon, H. Y. y Bucholz, K. K. (2015). Alcohol problem recognition and help seeking in adolescents and young adults at varying genetic and environmental risk. Drug and Alcohol Dependence, 153, 250–257. doi:10.1016/j.drugalcdep.2015.05.006.

Goldstein, R. B., Smith, S. M., Dawson, D. A. y Grant, B. F. (2015). Sociodemographic and psychiatric diagnostic predictors of 3-year incidence of DSM-IV substance use disorders among men and women in the National Epidemiologic Survey on Alcohol and Related Conditions. Psychology of Addictive Behaviors, 29, 924–932. doi:10.1037/adb0000080.

González García, Y., López Sampedro, P., Saavedra Rielo, M. C., González Arce, D., García Lavandera, L. J. y Cuesta Castro, B. (1997). The early detection of young people with alcohol-related disorders in primary care. Atención Primaria, 20, 133–136.

Grant, B. F., Hasin, D. S., Stinson, F. S., Dawson, D. A., Chou, S. P., Ruan, W. J. y Pickering, R. P. (2004a). Prevalence correlates, and disability of personality disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions. The Journal of Clinical Psychiatry, 65, 948–958.

Grant, B. F., Stinson, F. S., Dawson, D. A., Chou, S. P., Dufour, M. C., Compton, W., … Kaplan, K. (2004b). Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 61, 807–816. doi:10.1001/archpsyc.61.8.807.

Grant, B. F., Goldstein, R. B., Saha, T. D., Chou, S. P., Jung, J., Zhang, H., … Hasin, D. S. (2015). Epidemiology of DSM-5 Alcohol Use Disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions III. JAMA Psychiatry, 72, 757–766. doi:10.1001/jamapsychiatry.2015.0584.

Gual, A., Arbesú, J.Á., Zarco, J., López Pelayo, H., Miquel, L. y Bobes, J. (2016). Alcoholism and its treatment approach from a citizen perspective. Adicciones, 28, 163-173. doi:10.20882/adicciones.742. 

Gum, A. M., King-Kallimanis, B. y Kohn, R. (2009). Prevalence of mood, anxiety, and substance-abuse disorders for older Americans in the national comorbidity survey-replication. American Journal of Geriatric Psychiatry, 17, 769–781. doi:10.1097/JGP.0b013e3181ad4f5a.

Hasin, D. S., Stinson, F. S., Ogburn, E. y Grant, B. F. (2007). Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 64, 830–842. doi:10.1001/archpsyc.64.7.830.

Hasin, D. y Kilcoyne, B. (2012). Comorbidity of psychiatric and substance use disorders in the United States: current issues and findings from the NESARC. Current Opinion in Psychiatry, 25, 165–171. doi: 10.1097/YCO.0b013e3283523dcc.

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, 1609–1640. doi:10.1007/s00127-015-1088-0.

Hearne, R., Connolly, A. y Sheehan, J. (2002). Alcohol abuse: prevalence and detection in a general hospital. Journal of the Royal Society of Medicine, 95, 84–87.

Hulse, G. K. y Tait, R. J. (2002). Six-month outcomes associated with a brief alcohol intervention for adult in-patients with psychiatric disorders. Drug and Alcohol Review, 21, 105–112. doi:10.1080/09595230220138993.

Jones, T. V, Lindsey, B. A., Yount, P., Soltys, R. y Farani-Enayat, B. (1993). Alcoholism screening questionnaires: are they valid in elderly medical outpatients? Journal of General Internal Medicine, 8, 674–678.

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.

Keyes, K. M., Grant, B. F. y Hasin, D. S. (2008). Evidence for a closing gender gap in alcohol use, abuse, and dependence in the United States population. Drug and Alcohol Dependence, 93, 21–29. doi:10.1016/j.drugalcdep.2007.08.017.

Khan, S., Okuda, M., Hasin, D. S., Secades-Villa, R., Keyes, K., Lin, K.-H., … Blanco, C. (2013). Gender differences in lifetime alcohol dependence: results from the national epidemiologic survey on alcohol and related conditions. Alcoholism, Clinical and Experimental Research, 37, 1696–1705. doi: 10.1111/acer.12158.

Kim, B., Shin, W.S., Kim, M.K. y Lee, S.H. (2016). White matter microstructural changes are associated with alcohol use in patients with panic disorder. Journal of Affective Disorders, 199, 65–72. doi:10.1016/j.jad.2016.03.055.

Klimkiewicz, A., Klimkiewicz, J., Jakubczyk, A., Kieres-Salomoński, I. y Wojnar, M. (2015). Comorbidity of alcohol dependence with other psychiatric disorders. Part I. Epidemiology of dual diagnosis. Psychiatria Polska, 49, 265–275. doi:10.12740/PP/25704.

Lai, H. M. X., Cleary, M., Sitharthan, T. y Hunt, G. E. (2015). Prevalence of comorbid substance use, anxiety and mood disorders in epidemiological surveys, 1990-2014: A systematic review and meta-analysis. Drug and Alcohol Dependence, 154, 1–13. doi:10.1016/j.drugalcdep.2015.05.031.

Lejoyeux, M., Gastal, D., Bergeret, A., Casalino, E., Lequen, V. y Guillermet, S. (2012). Alcohol use disorders among patients examined in emergency departments after a suicide attempt. European Addiction Research, 18, 26–33. doi:10.1159/000332233.

Lejoyeux, M., Nivoli, F., Basquin, A., Petit, A., Chalvin, F. y Embouazza, H. (2013). An investigation of factors increasing the risk of aggressive behavior among schizophrenic inpatients. Frontiers in Psychiatry, 4, 97. doi:10.3389/fpsyt.2013.00097.

Lejoyeux, M., Basquin, A., Koch, M., Embouazza, H., Chalvin, F. y Ilongo, M. (2014). Cannabis Use and Dependence among French Schizophrenic Inpatients. Frontiers in Psychiatry, 5, 82. doi:10.3389/fpsyt.2014.00082.

León-Muñoz, L. M., Galán, I., Donado-Campos, J., Sánchez-Alonso, F., López-García, E., Valencia-Martín, J. L., … Rodríguez-Artalejo, F. (2015). Patterns of Alcohol Consumption in the Older Population of Spain, 2008-2010. Journal of the Academy of Nutrition and Dietetics, 115, 213–224. doi:10.1016/j.jand.2014.08.017.

Luoto, K. E., Koivukangas, A., Lassila, A. y Kampman, O. (2016). Outcome of patients with dual diagnosis in secondary psychiatric care. Nordic Journal of Psychiatry, 70, 470–476. doi:10.3109/08039488.2016.1160149.

Malet, L., Schwan, R., Boussiron, D., Aublet-Cuvelier, B. y Llorca, P.-M. (2005). Validity of the CAGE questionnaire in hospital. European Psychiatry, 20, 484–489. doi:10.1016/j.eurpsy.2004.06.027.

Mansell, D., Spiro, A., Lee, A. y Kazis, L. (2006). Validation of the primary care alcohol severity measure. The Journal of Ambulatory Care Management, 29, 87–97.

Masur, J. y Monteiro, M. G. (1983). Validation of the “CAGE” alcoholism screening test in a Brazilian psychiatric inpatient hospital setting. Revista Brasileira de Pesquisas Médicas e Biológicas, 16, 215–218.

Mathalon, D. H., Pfefferbaum, A., Lim, K. O., Rosenbloom, M. J. y Sullivan, E. V. (2003). Compounded brain volume deficits in schizophrenia-alcoholism comorbidity. Archives of General Psychiatry, 60, 245–252.

Mayfield, D., McLeod, G. y Hall, P. (1974). The CAGE questionnaire: validation of a new alcoholism screening instrument. The American Journal of Psychiatry, 131, 1121–1123. doi:10.1176/ajp.131.10.1121.

Miquel L., Barrio P., Moreno-España J., Ortega L., Manthey J. Rehm J. y Gual A. (2016). Detection and prevalence of alcohol use disorders in primary health care in Catalonia. Atención Primaria, 48, 175-182. doi:10.1016/j.aprim.2015.04.006.

McCreadie, R. G. (2002). Use of drugs, alcohol and tobacco by people with schizophrenia: case-control study. The British Journal of Psychiatry, 181, 321–325.

McGarry, K. A. y Cyr, M. G. (2005). Women and alcohol. Comprehensive Therapy, 31, 83–93.

Mellos, E., Liappas, I. y Paparrigopoulos, T. (2010). Comorbidity of personality disorders with alcohol abuse. In Vivo, 24, 761–769.

Mitchell, A. J., Bird, V., Rizzo, M., Hussain, S. y Meader, N. (2014). Accuracy of one or two simple questions to identify alcohol-use disorder in primary care: a meta-analysis. The British Journal of General Practice, 64, 408-418. doi:10.3399/bjgp14X680497.

Moore, A. A., Gould, R., Reuben, D. B., Greendale, G. A., Carter, M. K., Zhou, K. y Karlamangla, A. (2005). Longitudinal patterns and predictors of alcohol consumption in the United States. American Journal of Public Health, 95, 458–465. doi:10.2105/AJPH.2003.019471.

Moos, R. H., Schutte, K. K., Brennan, P. L. y Moos, B. S. (2009). Older adults’ alcohol consumption and late-life drinking problems: a 20-year perspective. Addiction, 104, 1293–1302. doi:10.1111/j.1360-0443.2009.02604.x.

Morojele, N. K., Saban, A. y Seedat, S. (2012). Clinical presentations and diagnostic issues in dual diagnosis disorders. Current Opinion in Psychiatry, 25, 181–186. doi:10.1097/YCO.0b013e328351a429.

Mueser K. T., Drake R. y Wallach M. (1998). Dual diagnosis: a review of etiological theories. Addictive Behaviors, 23, 717-734.

Mueser, K. T., Yarnold, P. R., Rosenberg, S. D., Swett, C., Miles, K. M. y Hill, D. (2000). Substance use disorder in hospitalized severely mentally ill psychiatric patients: prevalence, correlates, and subgroups. Schizophrenia Bulletin, 26, 179–192.

Mukamal, K. J., Kawachi, I., Miller, M. y Rimm, E. B. (2007). Drinking frequency and quantity and risk of suicide among men. Social Psychiatry and Psychiatric Epidemiology, 42, 153–160. doi:10.1007/s00127-006-0144-1.

Noordsy, D. L., Drake, R. E., Teague, G. B., Osher, F. C., Hurlbut, S. C., Beaudett, M. S. y Paskus, T. S. (1991). Subjective experiences related to alcohol use among schizophrenics. The Journal of Nervous and Mental Disease, 179, 410–414.

Oe, M., Fujii, S., Maeda, M., Nagai, M., Harigane, M., Miura, I., … Abe, M. (2016). Three-year trend survey of psychological distress, post-traumatic stress, and problem drinking among residents in the evacuation zone after the Fukushima Daiichi Nuclear Power Plant accident [The Fukushima Health Management Survey]. Psychiatry and Clinical Neurosciences, 70, 245–252. doi:10.1111/pcn.12387.

Ogborne, A. C. (2000). Identifying and treating patients with alcohol-related problems. Canadian Medical Association Journal, 162, 1705–1708.

Organización Mundial de la Salud. (1992). Clasificación Internacional de Enfermedades, Rev. 10, Trastornos mentales y del comportamiento: descripciones clínicas y pautas (The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines). Ginebra.

Paz Filho, G. J., Sato, L. J., Tuleski, M. J., Takata, S. Y., Ranzi, C. C., Saruhashi, S. Y. y Spadoni, B. (2001). Use of the CAGE questionnaire for detecting alcohol use disorders in the emergency room. Revista Da Associação Médica Brasileira, 47, 65–69.

Peen, J., Schoevers, R. A., Beekman, A. T. y Dekker, J. (2010). The current status of urban-rural differences in psychiatric disorders. Acta Psychiatrica Scandinavica, 121, 84–93. doi:10.1111/j.1600-0447.2009.01438.x.

Pristach, C. A., Smith, C. M. y Perkins, C. (1993). Reliability of the Self-Administered Alcoholism Screening Test (SAAST) in psychiatric inpatients. Journal of Addictive Diseases, 12, 77–88. doi:10.1300/J069v12n04_06.

Pulido, J., Indave-Ruiz, B. I., Colell-Ortega, E., Ruiz-García, M., Bartroli, M. y Barrio, G. (2014). Population-based studies on alcohol-related harm in Spain. Revista Española de Salud Pública, 88, 493–513. doi:10.4321/S1135-57272014000400005.

Ratta-Apha, W., Sitdhiraksa, N., Pariwatcharakul, P., Saisavoey, N., Limsricharoen, K., Thongchot, L., … N., Ketumarn, P. (2014). Under-recognized alcohol-related disorders in psychiatric outpatient unit. Journal of the Medical Association of Thailand, 97, 439–446.

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. JAMA, 264, 2511–2518.

Rehm J., Rehm M.X. Shield K.D., Gmel G. y Gual A. (2013). Alcohol consumption, alcohol dependence and related harms in Spain, and the effect of treatment-based interventions on alcohol dependence. Adicciones, 25, 11-18. doi:10.20882/adicciones.67.

Rehm J., Anderson P., Barry J., Dimitrov P., Elekes Z., Feijão F., … Gmel G. (2015). Prevalence of and potential influencing factors for alcohol dependence in Europe. European Addiction Research, 21, 6-18. doi:10.1159/000365284.

Rodríguez-Martos, A. (1986). Validación de los cuestionarios KFA (CBA) y CAGE para el diagnóstico del alcoholismo. Drogalcohol, 11, 132-139.

Rodríguez Fernández, E., Gómez Moraga, A. y García Rodríguez, A. (1997). Relationship between family perception and alcohol consumption. Atención Primaria, 19, 117–121.

Rosenberg, S. D., Drake, R. E., Wolford, G. L., Mueser, K. T., Oxman, T. E., Vidaver, R. M., … Luckoor, R. (1998). Dartmouth Assessment of Lifestyle Instrument (DALI): a substance use disorder screen for people with severe mental illness. The American Journal of Psychiatry, 155, 232–238. doi:10.1176/ajp.155.2.232.

San L., Arranz B., Arrojo M., Becoña E., Bernardo M., Caballero L., … Zorrilla I. (2016). Clinical guideline for the treatment of dual pathology in the adult population. Adicciones, 28, 3-5. doi:10.20882/adicciones.784.

Satre, D., Wolfe, W., Eisendrath, S. y Weisner, C. (2008). Computerized screening for alcohol and drug use among adults seeking outpatient psychiatric services. Psychiatric Services, 59, 441–444. doi:10.1176/ps.2008.59.4.441.

Shaner, A., Khalsa, M. E., Roberts, L., Wilkins, J., Anglin, D. y Hsieh, S. C. (1993). Unrecognized cocaine use among schizophrenic patients. The American Journal of Psychiatry, 150, 758–762. doi:10.1176/ajp.150.5.758.

Sheidow, A. J., McCart, M., Zajac, K. y Davis, M. (2012). Prevalence and impact of substance use among emerging adults with serious mental health conditions. Psychiatric Rehabilitation Journal, 35, 235–243. doi:10.2975/35.3.2012.235.243.

Smith, C. M. y Pristach, C. A. (1990). Utility of the Self-Administered Alcoholism Screening Test (SAAST) in schizophrenic patients. Alcoholism, Clinical and Experimental Research, 14, 690–694.

Soyka, M. (2000). Substance misuse, psychiatric disorder and violent and disturbed behaviour. The British Journal of Psychiatry, 176, 345–350.

Soyka, M., Albus, M., Immler, B., Kathmann, N. y Hippius, H. (2001). Psychopathology in dual diagnosis and non-addicted schizophrenics--are there differences? European Archives of Psychiatry and Clinical Neuroscience, 251, 232–238.

Sullivan, L. E., Fiellin, D. A. y O’Connor, P. G. (2005). The prevalence and impact of alcohol problems in major depression: a systematic review. The American Journal of Medicine, 118, 330–341. doi:10.1016/j.amjmed.2005.01.007.

Suominen, K., Isometsä, E., Haukka, J. y Lönnqvist, J. (2004). Substance use and male gender as risk factors for deaths and suicide -a 5-year follow-up study after deliberate self-harm. Social Psychiatry and Psychiatric Epidemiology, 39, 720–724. doi:10.1007/s00127-004-0796-7.

Tang, V. K., Pato, M. T., Sobell, J. L., Hammond, T. C., Valdez, M. M., Lane, C. J. y Pato, C. N. (2016). Substance use associated with short sleep duration in patients with schizophrenia or schizoaffective disorder. American Journal of Medical Genetics, 171, 525–533. doi:10.1002/ajmg.b.32374.

Teitelbaum, L. y Mullen, B. (2000). The validity of the MAST in psychiatric settings: a meta-analytic integration. Michigan Alcoholism Screening Test. Journal of Studies on Alcohol, 61, 254–261.

Torrens M., Mestre-Pintó J.I., Montanari L., Vicente J. y Domingo-Salvany A. (2017). Dual diagnosis: a European perspective. Adicciones, 29, 3-5. doi:10.20882/adicciones.933.

Urbanoski, K. A., Cairney, J., Adlaf, E. y Rush, B. (2007). Substance abuse and quality of life among severely mentally ill consumers: a longitudinal modelling analysis. Social Psychiatry and Psychiatric Epidemiology, 42, 810–818. doi:10.1007/s00127-007-0236-6.

Vorspan, F., Mehtelli, W., Dupuy, G., Bloch, V. y Lépine, J. P. (2015). Anxiety and substance use disorders: co-occurrence and clinical issues. Current Psychiatry Reports, 17, 4. doi:10.1007/s11920-014-0544-y.

Weisner, C. y Matzger, H. (2003). Missed opportunities in addressing drinking behavior in medical and mental health services. Alcoholism, Clinical and Experimental Research, 27, 1132–1141. doi:10.1097/01.ALC.0000075546.38349.69.

Worthington, J., Fava, M., Agustin, C., Alpert, J., Nierenberg, A. A., Pava, J. A. y Rosenbaum, J. F. (1996). Consumption of alcohol, nicotine, and caffeine among depressed outpatients. Relationship with response to treatment. Psychosomatics, 37, 518–522. doi:10.1016/S0033-3182(96)71515-3.

Wu, L. T. y Blazer, D. G. (2014). Substance use disorders and psychiatric comorbidity in mid and later life: a review. International Journal of Epidemiology, 43, 304–317. doi:10.1093/ije/dyt173.




DOI: https://doi.org/10.20882/adicciones.885

Enlaces refback

  • No hay ningún enlace refback.