RESUMO
Comorbidity between a substance use disorder (SUD) and another psychiatric disorder is known as dual diagnosis. It is of great relevance due to its important clinical consequences and costs of care. There are practically no published studies on dual diagnosis prevalence in patients admitted to psychiatric hospitalization units in general hospitals (PHUGH) in our country. The objectives were to estimate the prevalence of dual diagnosis in psychiatric inpatients admitted consecutively to a Psychiatric Hospitalization Unit (Hospital Universitario 12 de Octubre, Madrid, Spain) in one year, to compare clinical and sociodemographic variables between the dual diagnosis group (DD group) and the group with a psychiatric disorder but no SUD (PD group), and to study the types of substances used. This is a retrospective study, based on the review of the clinical charts of the 257 patients admitted to this PHUGH in one year. The results showed that, excluding nicotine dependence, 24.9% of our inpatients had a SUD as well as another psychiatric disorder. A statistically significant predominance of men was found in the DD group, as well as a younger age at the time of the study, at the beginning of their psychiatric attention and on their first psychiatric admission, and they had received diagnoses of schizophrenia or related psychoses more often than the PD group, who had mostly affective disorders. The substances most frequently used in the DD group were alcohol (78.1%), cannabis (62.5%), and cocaine (51.6%). Due to the high prevalence and repercussions of dual diagnosis, it would be advisable to have specialized therapeutic programs for its treatment.
Assuntos
Diagnóstico Duplo (Psiquiatria)/estatística & dados numéricos , Pacientes Internados/psicologia , Transtornos Mentais/epidemiologia , Unidade Hospitalar de Psiquiatria/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Alcoolismo/epidemiologia , Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Estudos de Coortes , Comorbidade , Diagnóstico Duplo (Psiquiatria)/psicologia , Feminino , Hospitais Universitários/estatística & dados numéricos , Humanos , Pacientes Internados/estatística & dados numéricos , Masculino , Abuso de Maconha/epidemiologia , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Prevalência , Transtornos Psicóticos/epidemiologia , Estudos Retrospectivos , Esquizofrenia/epidemiologia , Fatores Sexuais , Espanha/epidemiologiaRESUMO
La comorbilidad entre un trastorno por uso de sustancias (TUS) y otros trastornos psiquiátricos es conocida como patología dual. Tiene gran relevancia por su repercusión clínica y coste asistencial. Apenas existen estudios en nuestro medio sobre prevalencia de patología dual en pacientes ingresados en unidades de hospitalización psiquiátrica de hospitales generales (UHPHG). Los objetivos de este trabajo fueron determinar la presencia de patología dual en los pacientes ingresados consecutivamente durante un año en una Unidad de hospitalización Psiquiátrica (Hospital Universitario 12 de Octubre, Madrid, España), comparar variables sociodemográficas y clínicas entre el grupo de patología dual (grupo PD) y el grupo de trastorno mental sin TUS concurrente (grupo TM), y estudiar el tipo de sustancias consumidas. Se trata de un estudio retrospectivo, basado en la revisión de las historias clínicas de los 257 pacientes ingresados en dicha UHPHG durante un año. Los resultados mostraron que el 24,9 por ciento de los pacientes ingresados presentó un TUS (excluyendo dependencia a nicotina) concurrente a otro trastorno psiquiátrico. De manera significativa los pacientes del grupo PD fueron predominantemente varones y más jóvenes. Además, tenían menor edad en el primer ingreso psiquiátrico y al inicio de recibir atención psiquiátrica, y presentaban más diagnósticos de esquizofrenia o psicosis esquizofreniforme que el grupo TM, este último caracterizado por mayor frecuencia de diagnósticos afectivos. Las sustancias más frecuentemente consumidas en el grupo PD fueron alcohol (78,1 por ciento), cannabis (62,5 por ciento) y cocaína (51,6 por ciento). La elevada prevalencia de la patología dual y su repercusión asistencial hacen aconsejable disponer de programas terapéuticos especializados para su tratamiento.
Assuntos
Humanos , Masculino , Feminino , Comorbidade , Pacientes , Prevalência , Transtornos Relacionados ao Uso de Substâncias , Patologia , PsiquiatriaRESUMO
Steele-Richardson-Olszewski syndrome (SROS) is a neurodegenerative disorder of unknown aetiology, most frequently sporadic. Familial cases of SROS have been described. An intronic polymorphism of the tau gene is associated with sporadic SROS and mutations of the tau gene are present in atypical cases of SROS. The role of tau has been excluded in other families with pathology proven SROS, suggesting that this syndrome may have multiple causes. An 82-year-old patient, father of 3 children with autosomal recessive juvenile parkinsonism due to combined heterozygous mutations of the parkin gene, developed clinical features of SROS 2 years before death. The diagnosis was confirmed by pathology. He carried the C212Y mutation of the parkin gene and was homozygous for the A0 polymorphism and for the H1 haplotype. The role of parkin in the processing of tau is discussed.