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Órgano Oficial del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz

2017, Number 6

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Salud Mental 2017; 40 (6)

Dual disorders in individuals under treatment for both alcohol and cocaine: Madrid study on the prevalence of dual disorders

Palomo JL, Arias F, Szerman N, Vega P, Basurte I, Mesías B

Language: Spanish
References: 48
Page: 257-264
PDF size: 164.15 Kb.


ABSTRACT

Introduction. Descriptive data about co-occurrence of alcohol and cocaine consumption is scarce, despite its important prevalence. Dual disordes shows high prevalence in clinical samples, and patients report worse evolution and need more health services. Objective. To compare psychopathology in patients in treatment with lifetime alcohol and cocaine (Alc + Coc) substance use disorder (SUD) with subjects with alcohol but not cocaine (Alc) lifetime SUD and cocaine but not alcohol (Coc) SUD. Method. The sample consisted of 837 outpatients from Madrid, Spain, under treatment in substance misuse or mental health units. Two analyses were made: we compared subjects in the Alc + Coc (n = 366) to the Alc group (n = 162), and then to the Coc group (n = 122). Socio-demographic variables were addressed by interview. The Mini International Neuropsychiatric Interview (MINI) was used to evaluate Axis I disorders and the Personality Disorder Questionnaire (PDQ) to evaluate Personality Disorders (PD). Results. Compared to Alc group, patients in the Alc + Coc group were younger, had different socio-demographic characteristics, had more proportion of cannabis and opioid SUD, had less proportion of major depressive disorder, obsessive and depressive PD, more proportion of antisocial PD and lower suicide risk. Compared to the Coc group, they had more cannabis SUD and lower opioid SUD, showed higher prevalence of bipolar disorder, general anxiety disorder, paranoid, histrionic and dependent PD. Discussion and conclusion. We present a cross-sectional study describing comorbidity of dual disordes on treatment-seeking concurrent alcohol and cocaine problematic users. This concurrence showed different dual disordes prevalence profile than single users in some specific mental disorders.


REFERENCES

  1. Arias, F., Szerman, N., Vega, P., Mesias, B., Basurte, I., Morant, C., …& Babin, F. (2013a). Estudio Madrid sobre prevalencia y características de los pacientes con patología dual en tratamiento en las redes de salud mental y de atención al drogodependiente. Adicciones, 25(2), 121-128. doi: 10.1016/j.rpsm.2012.09.002

  2. Arias, F., Szerman, N., Vega, P., Mesias, B., Basurte, I., Morant, C., … & Babin, F. (2013b). Abuso o dependencia a la cocaína y otros trastornos psiquiátricos. Estudio Madrid sobre la prevalencia de la patología dual. Revista de Psiquiatría y Salud Mental, 6(3), 121-128. doi: 10.1016/j.rpsm.2012.09.002

  3. Arias, F., Szerman, N., Vega, P., Mesias, B., Basurte, I., Morant, C., … & Babin, F. (2013c). Alcohol abuse or dependence and other psychiatric disorders. Madrid study on the prevalence of dual pathology. Mental Health and Substance Use, 6(4), 339-350. doi: 10.1080/17523281.2012.748674

  4. Brady, K. T., Sonne, S., Randall, C. L., Adinoff, B., & Malcolm, R. (1995). Features of cocaine dependence with concurrent alcohol abuse. Drug and Alcohol Dependence, 39(1), 69-71. doi: 10.1016/0376-8716(95)01128-L

  5. Brown, T. G., Seraganian, P., & Tremblay, J. (1994). Alcoholics also dependent on cocaine in treatment: Do they differ from “pure” alcoholics? Addictive Behaviors, 19(1), 105-112. doi: 10.1016/0306-4603(94)90056-6

  6. Burns, L., & Teesson, M. (2002). Alcohol use disorders comorbid with anxiety, depression and drug use disorders. Findings from the Australian National Survey of Mental Health and Well Being. Drug and Alcohol Dependence, 68(3), 299- 307. doi: 10.1016/S0376-8716(02)00220-X

  7. Calvo, N., Caseras, X., Gutiérrez, F., & Torrubia, R. (2002). Adaptación española del Personality Diagnostic Questionnaire-4+ (PDQ-4+) [Spanish version of the personality diagnostic questionnaire-4+ (PDQ-4+)]. Actas Españolas de Psiquiatría, 30(1), 7-13.

  8. Carroll, K. M., Rounsaville, B. J., & Bryant, K. J. (1993). Alcoholism in treatment- seeking cocaine abusers: clinical and prognostic significance. Journal of Studies on Alcohol, 54(2), 199-208. doi: 10.15288/jsa.1993.54.199

  9. Grant, B. F., & Harford, T. C. (1990). Concurrent and simultaneous use of alcohol with cocaine: results of national survey. Drug and Alcohol Dependence, 25(1), 97-104.

  10. Hedden, S. L., Malcolm, R. J., & Latimer, W. W. (2009). Differences between adult non-drug users versus alcohol, cocaine and concurrent alcohol and cocaine problem users. Addictive Behaviors, 34(3), 323-326. doi: 10.1016/j.addbeh. 2008.11.001

  11. Heil, S., Badger, G. J., & Higgins, S. T. (2001). Alcohol dependence among cocaine- dependent outpatients : Demographics, drug use, treatment outcome and other characteristics. Journal of Studies on Alcohol and Drugs, 62(1), 14-22. doi: 10.15288/jsa.2001.62.14

  12. Johnson, S. D., Cottler, L. B., O’Leary, C. C., & Abdallah, A. B. (2010). The association of trauma and PTSD with the substance use profiles of alcohol- and cocaine-dependent out-of-treatment women. American Journal on Addictions, 19(6), 490-495. doi: 10.1111/j.1521-0391.2010.00075.x

  13. Kessler, R. C., Crum, R. M., Warner, L. A., Nelson, C. B., Schulenberg, J., & 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(4), 313-321. doi: 10.1001/archpsyc. 1997.01830160031005

  14. Lecrubier, Y., Sheehan, D. V., Weiller, E., Amorim, P., Bonora, I., Harnett Sheehan, K., … & Dunbar, G. C. (1997). The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. European Psychiatry, 12(5), 224-231. doi: 10.1016/ S0924-9338(97)83296-8

  15. Moss, H. B., Goldstein, R. B., Chen, C. M., & Yi, H.-Y. (2015). Patterns of use of other drugs among those with alcohol dependence: Associations with drinking behavior and psychopathology. Addictive Behaviors, 50, 192-198. doi: 10.1016/j. addbeh.2015.06.041

  16. Regier, D. A., Farmer, M. E., Rae, D. S., Locke, B. Z., Keith, S. J., Judd, L. L., & Goodwin, F. K. (1990). Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA, 264(19), 2476-2598. doi: 10.1001/jama.1990.03450190043026

  17. Sheehan, D. V, Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., … & Dunbar, G. C. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry, 59(20), 22-33.

  18. Stinson, F. S., Grant, B. F., Dawson, D. A., Ruan, W. J., Huang, B., & Saha, T. (2005). Comorbidity between DSM-IV alcohol and specific drug use disorders in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Drug and Alcohol Dependence, 80(1), 105-116. doi: 10.1016/j.drugalcdep.2005.03.009

  19. Suttajit, S., Kittirattanapaiboon, P., Junsirimongkol, B., Likhitsathian, S., & Srisurapanont, M. (2012). Risks of major depressive disorder and anxiety disorders among Thais with alcohol use disorders and illicit drug use: Findings from the 2008 Thai National Mental Health survey. Addictive Behaviors, 37(12), 1395- 1399. doi: 10.1016/j.addbeh.2012.06.014

  20. Vanek, V. W., Dickey-White, H. I., Signs, S. A., Schechter, M. D., Buss, T., & Kulics, A. T. (1996). Concurrent use of cocaine and alcohol by patients treated in the emergency department. Annals of Emergency Medicine, 28(5), 508-514. doi: 10.1016/S0196-0644(96)70114-2

  21. Volkow, N. D. (2007). Addiction and co-ocurring mental disorders. Director’s perspective. National Institute on Drug Abuse, 21(2).

  22. Walsh, D. C., Hingson, R. W., Merrigan, D. M., Cupples, L. A., Levenson, S. M., & Coffman, G. A. (1991). Associations between alcohol and cocaine use in a sample of problem-drinking employees. Journal of Studies on Alcohol and Drugs, 52(1), 17-25. doi: 10.15288/jsa.1991.52.17

  23. Weaver, T., Madden, P., Charles, V., Stimson, G., Renton, A., Tyrer, P., … & Ford, C. (2003). Comorbidity of substance misuse and mental illness in community mental health and substance misuse services. The British Journal of Psychiatry, 183(4), 304-313.

  24. Windle, M., & Miller-Tutzauer, C. (1991). Antecedents and correlates of alcohol, cocaine, and alcohol-cocaine abuse in early adulthood. Journal of Drug Education, 21(2), 133-148. doi: 10.2190/F497-8GKY-0U31-XMJJ

  25. Arias, F., Szerman, N., Vega, P., Mesias, B., Basurte, I., Morant, C., …& Babin, F. (2013a). Estudio Madrid sobre prevalencia y características de los pacientes con patología dual en tratamiento en las redes de salud mental y de atención al drogodependiente. Adicciones, 25(2), 121-128. doi: 10.1016/j.rpsm.2012.09.002

  26. Arias, F., Szerman, N., Vega, P., Mesias, B., Basurte, I., Morant, C., … & Babin, F. (2013b). Abuso o dependencia a la cocaína y otros trastornos psiquiátricos. Estudio Madrid sobre la prevalencia de la patología dual. Revista de Psiquiatría y Salud Mental, 6(3), 121-128. doi: 10.1016/j.rpsm.2012.09.002

  27. Arias, F., Szerman, N., Vega, P., Mesias, B., Basurte, I., Morant, C., … & Babin, F. (2013c). Alcohol abuse or dependence and other psychiatric disorders. Madrid study on the prevalence of dual pathology. Mental Health and Substance Use, 6(4), 339-350. doi: 10.1080/17523281.2012.748674

  28. Brady, K. T., Sonne, S., Randall, C. L., Adinoff, B., & Malcolm, R. (1995). Features of cocaine dependence with concurrent alcohol abuse. Drug and Alcohol Dependence, 39(1), 69-71. doi: 10.1016/0376-8716(95)01128-L

  29. Brown, T. G., Seraganian, P., & Tremblay, J. (1994). Alcoholics also dependent on cocaine in treatment: Do they differ from “pure” alcoholics? Addictive Behaviors, 19(1), 105-112. doi: 10.1016/0306-4603(94)90056-6

  30. Burns, L., & Teesson, M. (2002). Alcohol use disorders comorbid with anxiety, depression and drug use disorders. Findings from the Australian National Survey of Mental Health and Well Being. Drug and Alcohol Dependence, 68(3), 299- 307. doi: 10.1016/S0376-8716(02)00220-X

  31. Calvo, N., Caseras, X., Gutiérrez, F., & Torrubia, R. (2002). Adaptación española del Personality Diagnostic Questionnaire-4+ (PDQ-4+) [Spanish version of the personality diagnostic questionnaire-4+ (PDQ-4+)]. Actas Españolas de Psiquiatría, 30(1), 7-13.

  32. Carroll, K. M., Rounsaville, B. J., & Bryant, K. J. (1993). Alcoholism in treatment- seeking cocaine abusers: clinical and prognostic significance. Journal of Studies on Alcohol, 54(2), 199-208. doi: 10.15288/jsa.1993.54.199

  33. Grant, B. F., & Harford, T. C. (1990). Concurrent and simultaneous use of alcohol with cocaine: results of national survey. Drug and Alcohol Dependence, 25(1), 97-104.

  34. Hedden, S. L., Malcolm, R. J., & Latimer, W. W. (2009). Differences between adult non-drug users versus alcohol, cocaine and concurrent alcohol and cocaine problem users. Addictive Behaviors, 34(3), 323-326. doi: 10.1016/j.addbeh. 2008.11.001

  35. Heil, S., Badger, G. J., & Higgins, S. T. (2001). Alcohol dependence among cocaine- dependent outpatients : Demographics, drug use, treatment outcome and other characteristics. Journal of Studies on Alcohol and Drugs, 62(1), 14-22. doi: 10.15288/jsa.2001.62.14

  36. Johnson, S. D., Cottler, L. B., O’Leary, C. C., & Abdallah, A. B. (2010). The association of trauma and PTSD with the substance use profiles of alcohol- and cocaine-dependent out-of-treatment women. American Journal on Addictions, 19(6), 490-495. doi: 10.1111/j.1521-0391.2010.00075.x

  37. Kessler, R. C., Crum, R. M., Warner, L. A., Nelson, C. B., Schulenberg, J., & 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(4), 313-321. doi: 10.1001/archpsyc. 1997.01830160031005

  38. Lecrubier, Y., Sheehan, D. V., Weiller, E., Amorim, P., Bonora, I., Harnett Sheehan, K., … & Dunbar, G. C. (1997). The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. European Psychiatry, 12(5), 224-231. doi: 10.1016/ S0924-9338(97)83296-8

  39. Moss, H. B., Goldstein, R. B., Chen, C. M., & Yi, H.-Y. (2015). Patterns of use of other drugs among those with alcohol dependence: Associations with drinking behavior and psychopathology. Addictive Behaviors, 50, 192-198. doi: 10.1016/j. addbeh.2015.06.041

  40. Regier, D. A., Farmer, M. E., Rae, D. S., Locke, B. Z., Keith, S. J., Judd, L. L., & Goodwin, F. K. (1990). Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA, 264(19), 2476-2598. doi: 10.1001/jama.1990.03450190043026

  41. Sheehan, D. V, Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., … & Dunbar, G. C. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry, 59(20), 22-33.

  42. Stinson, F. S., Grant, B. F., Dawson, D. A., Ruan, W. J., Huang, B., & Saha, T. (2005). Comorbidity between DSM-IV alcohol and specific drug use disorders in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Drug and Alcohol Dependence, 80(1), 105-116. doi: 10.1016/j.drugalcdep.2005.03.009

  43. Suttajit, S., Kittirattanapaiboon, P., Junsirimongkol, B., Likhitsathian, S., & Srisurapanont, M. (2012). Risks of major depressive disorder and anxiety disorders among Thais with alcohol use disorders and illicit drug use: Findings from the 2008 Thai National Mental Health survey. Addictive Behaviors, 37(12), 1395- 1399. doi: 10.1016/j.addbeh.2012.06.014

  44. Vanek, V. W., Dickey-White, H. I., Signs, S. A., Schechter, M. D., Buss, T., & Kulics, A. T. (1996). Concurrent use of cocaine and alcohol by patients treated in the emergency department. Annals of Emergency Medicine, 28(5), 508-514. doi: 10.1016/S0196-0644(96)70114-2

  45. Volkow, N. D. (2007). Addiction and co-ocurring mental disorders. Director’s perspective. National Institute on Drug Abuse, 21(2).

  46. Walsh, D. C., Hingson, R. W., Merrigan, D. M., Cupples, L. A., Levenson, S. M., & Coffman, G. A. (1991). Associations between alcohol and cocaine use in a sample of problem-drinking employees. Journal of Studies on Alcohol and Drugs, 52(1), 17-25. doi: 10.15288/jsa.1991.52.17

  47. Weaver, T., Madden, P., Charles, V., Stimson, G., Renton, A., Tyrer, P., … & Ford, C. (2003). Comorbidity of substance misuse and mental illness in community mental health and substance misuse services. The British Journal of Psychiatry, 183(4), 304-313.

  48. Windle, M., & Miller-Tutzauer, C. (1991). Antecedents and correlates of alcohol, cocaine, and alcohol-cocaine abuse in early adulthood. Journal of Drug Education, 21(2), 133-148. doi: 10.2190/F497-8GKY-0U31-XMJJ




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