RESUMO
Resumen Introducción: se estima que entre un 80 % y un 90 % de la población mundial ha consumido sustancias psicoactivas (SPA), pero solo un 15 % llega a desarrollar una dependencia. El objetivo de este ensayo es describir los antecedentes epidemiológicos, los aspectos clínicos y los mecanismos neurobiológicos asociados a la dependencia de SPA. Luego, se reflexiona sobre algunas estrategias ambientales para su prevención y/o tratamiento. Proposición: la dependencia no es un simple vicio producto de la holgazanería o la falta de carácter, sino, un trastorno neuropsquiátrico que debe ser reconocido como tal. Para ello, es indispensable conocer sus factores etiológicos, así como los mecanismos neurobiológicos involucrados. Argumentos para la discusión: todas las SPA activan directa o indirectamente el sistema dopaminérgico mesolímbico, el cual, tras el abuso, produce la sensibilización del sistema motivacional y la desensibilización del sistema hedónico. Este fenómeno provoca el uso más frecuente y en mayor cantidad, a pesar de que los efectos placenteros sean cada vez menores. El malestar físico y emocional causado por el síndrome de abstinencia contribuye a dicha compulsión, la cual se sale de control producto de las alteraciones del funcionamiento ejecutivo y la corteza prefrontal. Conclusiones: la dependencia es una enfermedad del cerebro inducida por el consumo crónico de las SPA en conjunto con factores neurobiológicos y psicosociales de vulnerabilidad. El acceso a contacto social, ejercicio físico y estimulación sensorio-cognitiva podría representar una estrategia altamente eficaz para el manejo de la dependencia y el mejoramiento de la salud mental.
Abstract Introduction: It has been estimated that 80% to 90% of the population worldwide has ever consumed psychoactive substances (PAS), but only 15% will develop addiction. The goal of the current essay is to describe concisely the epidemiological background, the clinical foundations, and neurobiological mechanisms of addiction. Finally, it will briefly examine some environmental strategies aimed to prevent and/or treat addiction. Addiction is not a simple vice consequence of laziness or lack of character, but a neuropsychiatric disorder that must be recognized as such. Proposal: To attain this ultimate goal, the etiological factors and the neurobiological mechanisms of addiction must be revealed and disseminated. Arguments for discussion: All PAS directly or indirectly activate the mesolimbic dopaminergic system, which -after repeated intake- sensitizes and desensitizes the motivational and the hedonic system, respectively. This phenomenon causes PAS to be consumed more frequently and at higher doses despite their effects being progressively less rewarding. Consequently, the physical and emotional distress derived from the withdrawal syndrome exacerbates the compulsive PAS intake, while the completely loss of control results from impairments in the executive functions and the prefrontal cortex. Conclusions: Addiction is a brain disease induced by the chronic consumption of PAS combined with neurobiological and psychosocial risk factors. Exposure social contact, physical exercise, and sensory-cognitive stimulation may constitute a highly effective strategy for preventing and treating addiction and improving mental health as well.
Assuntos
Humanos , Neurobiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Costa RicaRESUMO
Developmental and social factors are known to play a crucial role in the pathogenesis of affective disorders. Although it has been demonstrated that early life aversive experiences can be a risk factor in the development of human depression, most of the investigation in animals that try to model depression do not include postnatal manipulations. Since housing represents a fundamental ethological factor which modifies behavior and brain development, this study aimed to investigate the impact of different social and structural housing conditions on the development of a depressive-like syndrome in the behavioral despair paradigm and an anxiety-like syndrome in the unconditioned anxiety paradigm. The present study uses several multivariate analyses to study the impact of housing conditions in animal models of depression and anxiety. In this study, social isolation was able to reproduce the effects found in other animals models based on stress, suggesting that only 2 months of social isolation are enough to produce effects that can be useful as behavioral model of depression. Moreover, environmental enrichment showed an antidepressive and anxiolytic like effect in animal models of depression and anxiety. This effect, which has not been reported in earlier studies, suggests that stimulation during the first stages of growth might play a "protective" role on behavior and brain development.