Relación entre la comorbilidad psicopatológica y las variables de resultados en dependientes de cocaína tratados en comunidad terapéutica

  1. Vergara Moragues, Esperanza
  2. González Saiz, Francisco
  3. Lozano Rojas, Óscar Martín
  4. Fernández Calderón, Fermín
  5. Verdejo García, Antonio
  6. Betanzos Espinosa, Patricia
  7. Bilbao Acedos, Izaskun
  8. Pérez García, Miguel
Aldizkaria:
Adicciones: Revista de socidrogalcohol

ISSN: 0214-4840

Argitalpen urtea: 2013

Alea: 25

Zenbakia: 2

Orrialdeak: 128-136

Mota: Artikulua

DOI: 10.20882/ADICCIONES.60 DIALNET GOOGLE SCHOLAR lock_openSarbide irekia editor

Beste argitalpen batzuk: Adicciones: Revista de socidrogalcohol

Garapen Iraunkorreko Helburuak

Laburpena

El ingreso en comunidad terapéutica de personas con problemas de consumo de cocaína y comorbilidad psicopatológica ha ido aumentando en los últimos años y es importante conocer más sobre el éxito de estos tratamientos. El objetivo de este trabajo es estudiar el perfil psicopatológico de los pacientes dependientes de cocaína y su asociación con las variables de resultados. Se entrevistaron mediante la Psychiatric Research Interview for Substance and Mental Disorders (PRISM-IV) y la Conners� Adult ADHD Diagnostic Interview for DSM-IV (CAADID) a una muestral total de 218 pacientes que solicitaron tratamiento en alguna de las seis comunidades terapéuticas públicas de Andalucía. Los resultados exponen que el porcentaje de retención a los tres meses es del 68.3% (149). De los cuales, el 43.5% abandona el recurso con un alta terapéutica y el 52.8 % con cambios clínicamente relevantes. Además, el 57.8% presentan comorbilidad psicopatológica. Por último, existe un mayor éxito terapéutico (medidos por días de estancias, tipo de altas y objetivos cumplido tras el tratamiento) entre las personas sin comorbilidad psicopatológica. Estos datos sugieren la necesidad de adaptar las comunidades terapéuticas en el tratamiento de personas dependientes de cocaína con comorbilidad psicopatológica y, de esta manera, mejorar el éxito terapéutico.

Erreferentzia bibliografikoak

  • Agostini, V., Nunes, E., Stewart, J. W. y Quitkin, F. M. (1991). Patient factors related to early attrition from an outpatient cocaine research clinic: A preliminary report. International Journal of the Addictions, 26, 327–334.
  • Arenas, F., del Valle, M., López, R., Martín, J. y Tirado, P. (2003). Programa de Intervención. Comunidad Terapéutica en Andalucía. Sevilla: Consejería de Asuntos Sociales. Comisionado para las Drogodependencias. Junta de Andalucía.
  • Alterman, A. I., Rutherford, M. J. , Cacciola, J. S., McKay, J. R. y Woody, G. E.. (1996). Response to Methadone Maintenance and Counseling in Antisocial Patients with and without Major Depression. Journal of Nervous and Mental Disease, 184, 695-670.
  • Broome, K. M., Flynn, P. M. y Simpson, D. D. (1999). Psychiatric comorbidity measures as predictors of retention in drug abuse treatment programs. Health Services Research, 34, 791–806.
  • Bunt, G., Muehlbach, B. y Moed, C. (2008). The therapeutic Community: an international perspective. Substance Abuse, 29, 81-87. doi: 10.1080/08897070802218844.
  • Condelli, W. S. (1994). Domains of variables for understanding and improving retention in therapeutic communities. International Journal of the Addictions, 29, 593-607.
  • Condelli, W. S. y Hubbard, R. L. (1994). Relationship between time spent in treatment and client outcomes from therapeutic communities. Journal Substance Abuse Treatment, 11, 25-33.
  • Condelli, W.S. y Dunteman, G.H. (1993). Issues to consider when predicting retention in therapeutic communities. Journal of Psychoactive Drugs, 25, 239-244.
  • Condelli, WS. y De Leon, G. (1993). Fixed and Dynamic Predictors of Client Retention in therapeutic communities. Journal Substance Abuse Treatment, 10, 11-16.
  • Conners, C. K. , Erhardt, D. y Sparrow, E. (1999). Conners adult ADHD rating scales. North Tonawanda, Nueva York: Multi-Health Systems.
  • Darke, S., Campbell, G. y Popple, G. (2012). Retention, early dropout and treatment completion among therapeutic community admissions. Drug and Alcohol Review , 31 , 64–71. doi: 10.1111/j.14653362.2011.00298
  • De Leon, G., Sacks, S., Staines, G. y McKendrick, K. (2000). Modified therapeutic community for homeless mentally ill chemical abusers: treatment outcomes. American Journal of Drug and Alcohol Abuse, 26,461–480.
  • De Leon, G. (1991). Retention in drug-free therapeutic communities. En R.W. Pickens, C.G. Leukefeld y C.R.Schuster (Eds.), Improving drug abuse treatment. NIDA Research Monograph Series, nº 106. Rockville, MD: US. Department of Health and Human Services.
  • Dekel, R., Benbenishty, R., y Amram, Y. (2004). Therapeutic communities for drug addicts: prediction of long-term outcomes. Addictive Behaviors, 29, 833-837.
  • European Monitoring Centre for Drugs and Drug Addiction (2011). Annual Report 2009: Annual report on the state of the drugs problem in Europe. Recuperado de: http://www.emcdda.europa.eu/ publications/annual-report/2011.
  • Falck, R.S., Wang, J., Siegal, H.A. y Carlson, R.G. (2004). The prevalence of psychiatric disorder among a community sample of crack cocaine users: an exploratory study with practical implications. Journal of Nervous and Mental Disease ,192, 503-507.
  • Fernández-Hermida, J. R. , Secades-Villa, R. , Fernández-Ludeña , J. J. y Marina-González, P, A. (2002). Effectiveness of a therapeutic community treatment in Spain: a long-term follow-up study. European Addiction Research, 8, 22-29.
  • Gossop, M., Marsden, J., Stewart, D., y Rolfe, A. (1999).Treatment retention and 1 year outcomes for residential programmes in England. Drug Alcohol & Dependence, 57, 89–98.
  • Greenfield, L., Burgdorf, K., Chen, X., Porowsk, A., Roberts, T., y Herrell, J. (2004). Effectiveness of long-term residential substance abuse treatment for women: findings from three national studies. American Journal of Drug and Alcohol Abuse, 30, 537–550.
  • Gilchrist, G., Langohr, K., Fonseca, F., Muga, R. y Torrens, M. (2012). Factors associated with discharge against medical advide from and alcohol and drug inpatient detoxification unit in Barcelona between 1993 and 2006. Heroin Addiction and Related Clinical Problems, 14, 35-44.
  • Hasin, D., Trautman, K., Miele, G., Samet, S., Smith, M., y 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., Brugal, M. T., Torrens, M. y Itinere Investigators. (2011). Incidence of psychopathology in a cohort of young heroin and/or cocaine users. Journal of Substance Abuse Treatment, 41, 55-63. doi: 10.1016/j.jsat.2011.01.013
  • Joe, G.W., Simpson, D.D. y Broome, K. M. (1998). Effects of readiness for drug abuse treatment on client retention and assessment of process. Adicction, 93, 1177-1190.
  • Levin, F. R., Evans, S. M., Vosburg, S. K., Horton, T., Brooks, y D., Ng, J. (2004). Impact of attention-deficit hyperactivity disorder and other psychopathology on treatment retention among cocaine abusers in a therapeutic community. Addiction Behaviour, 29, 1875–1882.
  • Lewis, B.J. y Ross, R. (1994). Retention in therapeutic communities: challenges for the nineties. En F. M. Tims., G. De Leon y N. Jainchill (Eds.), Therapeutic community: advances in research and application. NIDA Research Monograph 144.
  • Maglione, M., Chao, B. y Anglin, D. (2000). Residential treatment of methamphetamine users: correlates of drop-out from the California Alcohol and Drug Data Systems (CADDS), 1994–1997. Addiction Research, 8, 65–79.
  • Malivert, M., Fatséas, M., Denis, C., Langlois, E. y Auriacombe, M. (2012). Effectiveness of therapeutic communities: a systematic review. European Addiction Research, 18, 1-11. doi: 10.1159/000331007
  • Messina, N., Wish, E. y Nemes, S. (2000). Predictors of treatment outcomes in men and women admitted to a therapeutic community. American Journal of Drug and Alcohol Abuse, 26,207–227.
  • Mulder, R., Frampton, C. M., Peka, H., Hampton, G. y Marsters, T. (2009). Predictors of 3-month retention in a drug treatment therapeutic community. Drug and Alcohol Review, 28, 366-371. doi: 10.1111/j.1465-3362.2009.00050.x
  • Nielsen, AL. y Scarpitti, FR. (2002). Predicting Retention in a Therapeutic Community for Incarcerated Substance Abusers Journal of Offender Rehabilitation, 34, 47-65.
  • Ramos-Quiroga, J. A., Bosch, R., Richarte, V., Velero, S., Gómez-Barros, N., Nogueira, M., Palomar, G., Corrales, M., Sáez-Francàs, N., Corominas, M., Real, A., Vidal, R., Chalita, P. J. y Casas, M. (2012). Validación de criterio y concurrente de la versión española de la Conners Adult ADHD Diagnostic Interview for DSM-IV. Revista de Psiquiatría y Salud Mental, 5, 229-235. doi: 10.1016/j.rpsm.2012.05.004.
  • Sacks, S., McKendrick, K., Sacks, J. Y. y Cleland, C. M. (2010). Modified therapeutic community for co-occurring disorders: single investigator meta analysis. Substance Abuse, 31, 146-161. doi: 10.1080/08897077.2010.495662
  • Sacks, S., Banks, S., McKendrick, K., y Sacks, J. Y. (2008a). Modified therapeutic community for co-occurring disorders: a summary of four studies. Journal Substance and Abuse Treament, 34, 112-122.
  • Sacks, S., McKendrick, K., Sacks, J. Y., Banks, S., y Harle, M. (2008b). Enhanced outpatient treatment for co-occurring disorders: main outcomes. Journal Substance and Abuse Treament, 34, 48-60.
  • Secades-Villa, R. y Fernández-Hermida, J. R. (2000). Cómo mejorar las tasas de retención en los tratamientos de drogodependenicas. Adicciones, 12, 353-363.
  • Secades-Villa, R. y Benavente, M. (2000). Predictores de la retención en una Comunidad Terapéutica para Drogodependientes. Adicciones, 12, 365-371.
  • Torrens, M., Serrano, D., Astals, M., Perez-Dominguez, G., y MartinSantos, 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.
  • Tull, M. T. y Gratz, K. L. (2012). The impact of borderline personality disorder on residential substance abuse treatment dropout among men. Drug Alcohol & Dependence, 1, 121, 97-102. doi: 10.1016/j. drugalcdep.2011.08.014
  • Van Stelle, K. R., Blumer, C. y Moberg, D. P. (2004).Treatment retention of dually diagnosed offenders in an institutional therapeutic community. Behavioral Sciences & The Law, 22, 585-97.
  • Vergara-Moragues, E., González-Saiz, F., Lozano Rojas, O. M., Betanzos Espinosa, P., Fernández Calderón, F., Bilbao Acedos, I., Pérez García, M., Verdejo-García, A. (2012). Psychiatric Comorbidity in cocaine users treated in therapeutic community: Substance-induced versus independent disorders. Psychiatry Research, 200, 734-41. doi: 10.1016/j.psychres.2012.07.043
  • Vergara-Moragues, E. (2010). Comorbilidad psicopatológica en pacientes con dependencia de cocaína tratados en comunidad terapéutica. Tesis Doctoral en Psicología. Granada: Facultad de Psicología. Universidad de Granada.
  • Wise, B. K., Cuffe, S. P. y Fischer, T. (2001). Dual diagnosis and successful participation of adolescents in substance abuse treatment. Journal of Substance Abuse Treatment, 21, 161–165.
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