RESUMEN
BACKGROUND: Baseline patients' characteristics are critical for treatment planning, as these can be moderators of treatment effects. In Mexico, information on treatment seekers with substance use disorders is scarce and limited to demographic characteristics. OBJECTIVE: This paper presents and analyses demographic characteristics, substance use related problems, clinical features, and addiction severity in a sample of treatment seekers from the first multi-site randomized clinical trial implemented in the Mexican Clinical Trials Network on Addiction and Mental Health. METHODS: A total of 120 participants were assessed prior randomization. Chi square or F-tests were used to compare sites across variables. Spearman correlation was used to associate negative consequences of substance use and motivation to change. RESULTS: The majority of participants were men, and the most prevalent substances reported were alcohol, marijuana, and cocaine. Participants were predominantly on the contemplation or action stage of change, and this was correlated with the perception of the negative consequences associated with substance use. Participants reported a high prevalence of substance use related problems. CONCLUSIONS: Substance use related problems, clinical features, and addiction severity reported by treatment seekers are important characteristics to take into account when planning treatment as they facilitate tailoring treatment to meet patients' needs.
Asunto(s)
Aceptación de la Atención de Salud/estadística & datos numéricos , Centros de Tratamiento de Abuso de Sustancias/estadística & datos numéricos , Trastornos Relacionados con Sustancias/terapia , Adulto , Alcoholismo/epidemiología , Alcoholismo/psicología , Alcoholismo/terapia , Trastornos Relacionados con Cocaína/epidemiología , Trastornos Relacionados con Cocaína/psicología , Trastornos Relacionados con Cocaína/terapia , Femenino , Humanos , Masculino , Abuso de Marihuana/epidemiología , Abuso de Marihuana/psicología , Abuso de Marihuana/terapia , México/epidemiología , Motivación , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicologíaRESUMEN
Alcohol expectancies are the anticipations that a person makes to the effects that this substance will cause. This construct has proven to be useful in explaining alcohol consumption; however they have been scarcely measured in clinical population. The aim of this study was to develop and evaluate the psychometric properties of a test measuring these expectations in Mexican people with severe alcohol consumption under inpatient treatment. The final version of the test has a high Cronbach's alpha (.857) with three factors with a theoretical foundation explaining 61.5% of the variance: these properties are superior to those shown by other evidence. For future studies is suggested to include a greater number of women in the sample in order to confirm its psychometric properties.
Asunto(s)
Consumo de Bebidas Alcohólicas/psicología , Encuestas y Cuestionarios , Adulto , Femenino , Humanos , Pacientes Internos , Masculino , México , PsicometríaRESUMEN
According to epidemiologic reports, the harmful use of alcohol and illicit drugs has increased among the Mexican population. This use is associated to several risks and issues that affect public health and the public well-being of the country. In this article it is acknowledged the need for development of treatment models and interventions whose therapeutic value is demonstrated by scientific evidence, that respond to the attention needs of the population affected by substance use in our country and that can be generalized in community clinical practice. In clinical research, randomized controlled clinical trials (RCT's) are the "gold standard" to demonstrate the effect of a therapeutic intervention. A randomized controlled clinical trial is a prospective study in which the effect, value and safety of one or various experimental interventions are tested against a "control" intervention in human subjects. Acknowledging that in Mexico there is a lack of research on addiction treatment that is compliant with all the requirements to be considered as an RCT, this article presents some methodological and ethical considerations that are neccesary for their design and conduction. These considerations include from the establishment of a relevant research question and objectives, adequate study design, development of strategies for data management, statistical analysis, monitoring of interventions, safety monitoring and research quality assurance and protection of human subjects.
Según reportes epidemiológicos, el consumo nocivo de alcohol y drogas ilegales dentro de la población mexicana ha ido en aumento, lo que se asocia a varios riesgos o problemáticas que afectan la salud y bienestar públicos del país. Se reconoce la necesidad de desarrollar modelos de tratamiento e intervenciones cuyo valor terapéutico esté respaldado por la evidencia científica, que respondan a las necesidades de atención de la población afectada por el consumo de sustancias en nuestro país y que puedan generalizarse en la práctica clínica comunitaria. Dentro de la investigación clínica, el "estándar de oro" para demostrar el efecto de una intervención terapéutica son los ensayos clínicos controlados aleatorizados (ECCA). Un ECCA es un estudio prospectivo en el cual se prueba el efecto, valor y seguridad de una o varias intervenciones experimentales contra una intervención "control" en sujetos humanos. Reconociendo que en México hay una falta de investigaciones sobre tratamientos para las adicciones que cumplan con todos los requisitos para ser considerados ECCA, en este artículo se presentan distintas consideraciones metodológicas y éticas que deben tomarse en cuenta para su diseño y conducción en la materia; abarcando aspectos que parten desde el establecimiento de una pregunta y objetivos relevantes hasta el diseño adecuado del estudio y el desarrollo de estrategias para la administración de datos, análisis estadístico, monitoreo de las intervenciones, monitoreo de seguridad y aseguramiento de la calidad de la investigación y protección de los sujetos humanos que participan.
RESUMEN
Smoker's craving is one of the most important problems in tobacco cessation treatment. The aim of this study was to elaborate a self report questionnaire to assess smoking urge. Development process was carried out in two parts: construction of items using a natural modified semantic networks method. It was administered to 42 smokers; after that, the first version of the questionnaire was answered by 222 smokers. Internal consistency was obtained and an analysis of discrimination was conducted on the items; then, a factorial analysis with varimax rotation using principal components method was carried out, resulting in 12 items on three factors that explain 76% of the variance and 0.92 Chronbach's alpha.
El craving en fumadores es uno de los problemas principales del tratamiento del tabaquismo. El presente trabajo tuvo como objetivo la elaboración de un cuestionario de autorreporte del deseo de fumar. El proceso de desarrollo se llevó a cabo en dos etapas: construcción de reactivos por medio del método de redes semánticas naturales modificadas, el cual se aplicó a 42 fumadores; posteriormente se aplicó la primera versión del cuestionario a 222 fumadores. Se obtuvo la consistencia interna y se realizó un análisis de discriminación de reactivos; posteriormente se realizó un análisis factorial con rotación ortogonal con un método de componentes principales. Los resultados arrojaron 12 reactivos en tres factores, que explican 76% de la varianza total y un alfa de Chronbach=0.92.
RESUMEN
This study aimed for the validation of the General Cocaine Craving Questionnaire (CCQ-G) in Mexican population. To achieve this, the scale was applied by interviewing 233 cocaine users, of which 214 met inclusion criteria for the final analysis. This study's inclusion criterion was: not having a psychotic episode and/or manic or depressive or cognitive damage that could impede adequate test solving. The sample consisted entirely of male participants, aged between 18 and 59 years (M = 27, SD = 9.2). All participants met DSM-IV-TR criteria for substance abuse and dependence. 83% of the sample were polydrug users, but reported cocaine as their main drug of use. 74.8% of the sample reported previously having attended treatment for cocaine dependence. At the time of the study, all of the sample was under residential treatment between their 4th and 12th week and was distributed in 5 different institutions whose treatment model is grounded in the philosophy of Alcoholics Anonymous. After factor analysis was performed, the model was adjusted to three factors. Factor 1 referred to intention to use cocaine, factor 2 expressed desire for cocaine consumption, and factor 3 referred to positive expectancies for cocaine consumption. The instrument showed good internal consistency with an α=.87.
El presente estudio tuvo como objetivo validar en la población mexicana la escala Cocaine Craving Questionnaire General (CCQ-G). Para conseguir tal objetivo, se entrevistó y aplicó la escala a una N = 233 consumidores de cocaína que decidieron participar voluntariamente en el estudio. Los criterios para ingresar al estudio fueron los siguientes: no sufrir un episodio psicótico, maniaco, depresivo o daño cognitivo que impidiera resolver adecuadamente la escala. La muestra estuvo constituida por participantes masculinos, que reunían los criterios del DSM-IV-TR para abuso y dependencia a sustancias, con edades comprendidas entre 18 y 59 años (M=27, SD=9.2). En el momento de las entrevistas estaban bajo tratamiento residencial entre la cuarta y duodécima semanas en cinco diferentes instituciones cuyo tratamiento se basa en el modelo de Alcohólicos Anónimos. El análisis factorial que se realizó señaló que el modelo se ajustaba a tres factores. El Factor 1 hacía referencia a la intención de uso de cocaína; el Factor 2 expresaba deseos de consumo de cocaína; el Factor 3 hacía referencia a las expectativas positivas del consumo de cocaína. El instrumento también mostró una adecuada consistencia interna con un α=.87.