RESUMO
The persistent difficulty in conceptualizing the relationship between addictive and other mental disorders stands out among the many challenges faced by the field of Psychiatry. The different philosophies and schools of thought about, and the sheer complexity of these highly prevalent clinical conditions make progress inherently difficult, not to mention the profusion of competing and sometimes contradictory terms that unnecessarily exacerbate the challenge. The lack of a standardized term adds confusion, fuels stigma, and contributes to a "wrong door syndrome" that captures the difficulty of not only diagnosing but also treating addictive and other mental disorders in an integrated manner. The World Association on Dual Disorders (WADD) proposes the adoption of the term "Dual Disorder" which, while still arbitrary, would help harmonize various clinical and research efforts by rallying around a single, more accurate, and less stigmatizing designation.
Assuntos
Comportamento Aditivo , Transtornos Mentais , Psiquiatria , Transtornos Relacionados ao Uso de Substâncias , Comportamento Aditivo/diagnóstico , Diagnóstico Duplo (Psiquiatria) , Humanos , Transtornos Mentais/terapia , Transtornos Relacionados ao Uso de Substâncias/complicaçõesRESUMO
Drug use among youth has increased in recent years dramatically during adolescence, a key phase in the integral development of the individual. The main aim of this cross-sectional, descriptive study was to assess the current drug use trends, as a function of age and gender among secondary education students from representative centers in the Valencia province during the school year 2009-2010. A total of 328 adolescents, 44.8% (n=147) males and 55.2% (n=181) females, with a mean age of 15.61 (SD 2.5) years, divided in three age groups: 12-14 years old (n=134, 40.9%), 14-18 years old (n=123, 37.5%), and older than 18 years of age (n=71, 21.6%) participated in the study. Alcohol and tobacco, followed by cannabis, were the substances more commonly used by the secondary education students. There were statistically significant differences between the three age groups in lifetime use of tobacco, alcohol, cannabis, cocaine, amphetamines and tranquilizers. The highest prevalences were observed in students older than 18 years of age, therefore evidencing a common pattern of increase in substance use with age. Alcohol and tobacco use were significantly higher among girls compared to boys, while males more commonly used inhalants and opioids. Therefore, it appears essential to promote prevention campaigns at earlier ages, when adolescents are more vulnerable to initial substance use, and adapted to the specific needs of the diverse populations of school age children.
Assuntos
Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Espanha/epidemiologia , EstudantesRESUMO
Drug use among youth has increased in recent years dramatically during adolescence, a key phase in the integral development of the individual. The main aim of this cross-sectional, descriptive study was to assess the current drug use trends, as a function of age and gender among secondary education students from representative centers in the Valencia province during the school year 2009-2010. A total of 328 adolescents, 44.8
(n=147) males and 55.2
(n=181) females, with a mean age of 15.61 (SD 2.5) years, divided in three age groups: 12-14 years old (n=134, 40.9
), and older than 18 years of age (n=71, 21.6
) participated in the study. Alcohol and tobacco, followed by cannabis, were the substances more commonly used by the secondary education students. There were statistically significant differences between the three age groups in lifetime use of tobacco, alcohol, cannabis, cocaine, amphetamines and tranquilizers. The highest prevalences were observed in students older than 18 years of age, therefore evidencing a common pattern of increase in substance use with age. Alcohol and tobacco use were significantly higher among girls compared to boys, while males more commonly used inhalants and opioids. Therefore, it appears essential to promote prevention campaigns at earlier ages, when adolescents are more vulnerable to initial substance use, and adapted to the specific needs of the diverse populations of school age children.
Assuntos
Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Criança , Espanha/epidemiologia , Estudantes , Estudos Transversais , Feminino , Humanos , MasculinoRESUMO
Drug use among youth has increased in recent years dramatically during adolescence, a key phase in the integral development of the individual. The main aim of this cross-sectional, descriptive study was to assess the current drug use trends, as a function of age and gender among secondary education students from representative centers in the Valencia province during the school year 2009-2010. A total of 328 adolescents, 44.8
(n=147) males and 55.2
(n=181) females, with a mean age of 15.61 (SD 2.5) years, divided in three age groups: 12-14 years old (n=134, 40.9
), 14-18 years old (n=123, 37.5
), and older than 18 years of age (n=71, 21.6
) participated in the study. Alcohol and tobacco, followed by cannabis, were the substances more commonly used by the secondary education students. There were statistically significant differences between the three age groups in lifetime use of tobacco, alcohol, cannabis, cocaine, amphetamines and tranquilizers. The highest prevalences were observed in students older than 18 years of age, therefore evidencing a common pattern of increase in substance use with age. Alcohol and tobacco use were significantly higher among girls compared to boys, while males more commonly used inhalants and opioids. Therefore, it appears essential to promote prevention campaigns at earlier ages, when adolescents are more vulnerable to initial substance use, and adapted to the specific needs of the diverse populations of school age children.
Assuntos
Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Espanha/epidemiologia , EstudantesRESUMO
Irresistible compulsion to use, or craving, is one of the key symptoms of substance dependence syndrome, and of major relevance with regard to relapse in the abuse of alcohol or other drugs. In the present paper, the relationship between attention, attentional processes and the craving phenomenon is reviewed. The paper also explores the different elements of attention, and particularly the relevance of selective attention in craving and the initial stages of relapse. Those psychological strategies that have emerged as effective in the management of craving for substances are also reviewed, with particular emphasis on the cognitive-behavioral model of relapse and on relapse-prevention therapy. Finally, we discuss the characteristics of so-called attentional therapy, based on mindfulness, and its potential effectiveness in the management of addictive disorders in general and of craving in particular.
Assuntos
Atenção , Transtornos Disruptivos, de Controle do Impulso e da Conduta/diagnóstico , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Terapia Cognitivo-Comportamental/métodos , Transtornos Disruptivos, de Controle do Impulso e da Conduta/prevenção & controle , Humanos , Prevenção SecundáriaRESUMO
El craving, ganas compulsivas, deseo intenso o compulsión irrefrenable a consumir es uno de los síntomas centrales en el síndrome de dependencia y de gran importancia en las recaídas al abuso de alcohol u otras drogas. El presente trabajo revisa la relación entre la atención, los procesos atencionales y el fenómeno del craving. Se abordan los diferentes elementos integrantes de la atención y en particular de la relevancia de la atención selectiva sobre el craving y las etapas iniciales de la recaída. Se revisan las estrategias psicológicas eficaces frente al craving, en especial en el modelo cognitivo conductual de la recaída y en la terapia de prevención de recaídas. Finalmente, se discuten las características de la denominada terapia atencional, basada en el mindfulness o atención consciente y su potencial utilidad en el abordaje de los trastornos adictivos en general y en el craving en concreto
Irresistible compulsion to use, or craving, is one of the key symptoms of substance dependence syndrome, and of major relevance with regard to relapse in the abuse of alcohol or other drugs. In the present paper, the relationship between attention, attentional processes and the craving phenomenon is reviewed.The paper also explores the different elements of attention, and particularly the relevance of selective attention in craving and the initial stages of relapse. Those psychological strategies that have emerged as effective in the management of craving for substances are also reviewed, with particular emphasis on the cognitive-behavioral model of relapse and on relapse-prevention therapy. Finally, we discuss the characteristics of so-called attentional therapy, based on mindfulness, and its potential effectiveness in the management of addictive disorders in general and of craving in particular
Assuntos
Humanos , Masculino , Feminino , Recidiva , Dependência Psicológica , Codependência Psicológica , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/psicologia , Cognição , Síndrome de Abstinência a Substâncias/epidemiologia , Síndrome de Abstinência a Substâncias/psicologia , Transtornos da Consciência/psicologia , Inconsciência/psicologia , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologiaAssuntos
Humanos , Masculino , Feminino , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Diagnóstico Duplo (Psiquiatria) , Acontecimentos que Mudam a Vida , Neurobiologia/tendências , PersonalidadeRESUMO
There is an increasing interest to find efficacious treatments for patients with post-traumatic stress disorder (PTSD) and comorbid substance use disorder (SUD). Therefore, in this paper the studies published on the psychological and pharmacological treatment for the management of comorbid PTSD and SUD will be discussed, as these are highly prevalent and shown in part I. The few studies published to date suggest that patients benefit most form an integrated treatment approach for the comorbid disorders. Psychological treatments based on cognitive behavioural strategies appear to be useful for patients with PTSD and comorbid SUD disorder. Medications such as SSRIs and particularly sertraline that efficacious for PTSD, seem to be as well for this dual disorder. In addition, pharmacological options, among them quetiapine or bupropion have shown promising results in preliminary studies.
Assuntos
Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos Relacionados ao Uso de Substâncias/terapia , HumanosRESUMO
Post-traumatic stress disorder (PTSD) is frequently associated with other psychiatric diagnoses, being substance use disorder (SUD) one of the most prevailing. Comorbid disorders in general and SUD in particular frequently complicate the course and outcome of PTSD, and vice versa. As with other dual disorders, comorbidity of PTSD and SUD is complex, having been proposed different theoretical models to explain it that will be discussed in the present paper, the first of a series of two. In addition, the present paper reviews data from epidemiological studies, as well as the clinical characteristics, the relevance of stressful life events as a vulnerability factor to PTSD as well as to SUD and the neurobiological basis of the association of both disorders with the aim of gaining a better understanding of this comorbidity, so that the treatment of this dual disorder will be discussed in the second part.
Assuntos
Sistema Hipotálamo-Hipofisário/fisiopatologia , Sistema Hipófise-Suprarrenal/fisiopatologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Feminino , Humanos , Masculino , PrevalênciaRESUMO
Post-traumatic stress disorder (PTSD) is frequently associated with other psychiatric diagnoses, being substance use disorder (SUD) one of the most prevailing. Comorbid disorders in general and SUD in particular frequently complicate the course and outcome of PTSD, and vice versa. As with other dual disorders, comorbidity of PTSD and SUD is complex, having been proposed different theoretical models to explain it that will be discussed in the present paper, the first of a series of two. In addition, the present paper reviews data from epidemiological studies, as well as the clinical characteristics, the relevance of stressful life events as a vulnerability factor to PTSD as well as to SUD and the neurobiological basis of the association of both disorders with the aim of gaining a better understanding of this comorbidity, so that the treatment of this dual disorder will be discussed in the second part.
RESUMO
There is an increasing interest to find efficacious treatments for patients with post-traumatic stress disorder (PTSD) and comorbid substance use disorder (SUD). Therefore, in this paper the studies published on the psychological and pharmacological treatment for the management of comorbid PTSD and SUD will be discussed, as these are highly prevalent and shown in part I. The few studies published to date suggest that patients benefit most form an integrated treatment approach for the comorbid disorders. Psychological treatments based on cognitive behavioural strategies appear to be useful for patients with PTSD and comorbid SUD disorder. Medications such as SSRIs and particularly sertraline that efficacious for PTSD, seem to be as well for this dual disorder. In addition, pharmacological options, among them quetiapine or bupropion have shown promising results in preliminary studies.
RESUMO
Post-traumatic stress disorder (PTSD) is frequently associated with other psychiatric diagnoses, being substance use disorder (SUD) one of the most prevailing. Comorbid disorders in general and SUD in particular frequently complicate the course and outcome of PTSD, and vice versa. As with other dual disorders, comorbidity of PTSD and SUD is complex, having been proposed different theoretical models to explain it that will be discussed in the present paper, the first of a series of two. In addition, the present paper reviews data from epidemiological studies, as well as the clinical characteristics, the relevance of stressful life events as a vulnerability factor to PTSD as well as to SUD and the neurobiological basis of the association of both disorders with the aim of gaining a better understanding of this comorbidity, so that the treatment of this dual disorder will be discussed in the second part.
RESUMO
There is an increasing interest to find efficacious treatments for patients with post-traumatic stress disorder (PTSD) and comorbid substance use disorder (SUD). Therefore, in this paper the studies published on the psychological and pharmacological treatment for the management of comorbid PTSD and SUD will be discussed, as these are highly prevalent and shown in part I. The few studies published to date suggest that patients benefit most form an integrated treatment approach for the comorbid disorders. Psychological treatments based on cognitive behavioural strategies appear to be useful for patients with PTSD and comorbid SUD disorder. Medications such as SSRIs and particularly sertraline that efficacious for PTSD, seem to be as well for this dual disorder. In addition, pharmacological options, among them quetiapine or bupropion have shown promising results in preliminary studies.