RESUMO

El trastorno por déficit de atención con hiperactividad (TDAH) es un trastorno del neurodesarrollo crónico, complejo y multifactorial asociado con elevadas tasas de concurrencia con otros trastornos psiquiátricos, junto con problemas y repercusiones en diferentes áreas del funcionamiento del individuo. El TDAH no es exclusivo de la edad infanto-juvenil, estimándose una persistencia del 40-60% en la edad adulta, de modo que entre 2.5 y 5% de adultos continúan presentando este trastorno. La adolescencia es una etapa en la que se producen grandes y continuos cambios y que se asocia con una menor adherencia al tratamiento, una mayor vulnerabilidad a la aparición de problemas académicos, más conductas de riesgo, el inicio en el consumo de sustancias y la aparición de otros trastornos comórbidos. Se produce también la transición a los servicios o unidades de adultos, siendo necesaria una mayor coordinación entre los servicios infanto-juveniles y de adultos para asegurar una continuidad de la intervención en una etapa d e la vida en la que el paciente es especialmente vulnerable. Como en el caso de los niños y adolescentes, el tratamiento recomendado en el adulto con TDAH es el abordaje multimodal y multidisciplinar, que combina la medicación con estrategias psicológicas o psicosociales, como la psicoeducación, la terapia cognitivo conductual o el coaching, adaptadas a las necesidades individuales de cada paciente. Los fármacos psicoestimulantes son considerados de primera elección en adultos por las guías clínicas.

Attention deficit hyperactivity disorder (ADHD) is a chronic, complex and multifactorial neurodevelopmental disorder associated with high rates of concurrent psychiatric disorders, along with problems and complications on different areas of individual functioning. ADHD is not exclusively a childhood disorder, 40-60% persisting into adulthood with an estimated prevalence of 2.5-5%. Adolescence is a stage where great and continuous changes occur, associated with a lower adherence to treatment, a greater vulnerability to the emergence of academic problems, more risk-behaviors, the onset of substance use and higher rates of other comorbid disorders. The transition to adult services or units also occurs at this stage, requiring greater coordination between child/adolescent and adult services to ensure continuity of care in a phase of life in which the patient is particularly vulnerable. As in the case of children and adolescents, the recommended treatment for adults with ADHD is the multimodal and multidisciplinary approach, that combines medication with psychological or psychosocial strategies, such as psycho-education, cognitive behavioral therapy or coaching, adapted to the individual needs of each patient. Clinical guidelines recommend psycho-stimulant drugs as first-line treatments for adult patients with ADHD.

Assuntos

RESUMO

Attention deficit hyperactivity disorder (ADHD) is a chronic, complex and multifactorial neurodevelopmental disorder associated with high rates of concurrent psychiatric disorders, along with problems and complications on different areas of individual functioning. ADHD is not exclusively a childhood disorder, 40-60% persisting into adulthood with an estimated prevalence of 2.5-5%. Adolescence is a stage where great and continuous changes occur, associated with a lower adherence to treatment, a greater vulnerability to the emergence of academic problems, more risk-behaviors, the onset of substance use and higher rates of other comorbid disorders. The transition to adult services or units also occurs at this stage, requiring greater coordination between child/adolescent and adult services to ensure continuity of care in a phase of life in which the patient is particularly vulnerable. As in the case of children and adolescents, the recommended treatment for adults with ADHD is the multimodal and multidisciplinary approach, that combines medication with psychological or psychosocial strategies, such as psycho-education, cognitive behavioral therapy or coaching, adapted to the individual needs of each patient. Clinical guidelines recommend psycho-stimulant drugs as first-line treatments for adult patients with ADHD.

El trastorno por déficit de atención con hiperactividad (TDAH) es un trastorno del neurodesarrollo crónico, complejo y multifactorial asociado con elevadas tasas de concurrencia con otros trastornos psiquiátricos, junto con problemas y repercusiones en diferentes áreas del funcionamiento del individuo. El TDAH no es exclusivo de la edad infanto-juvenil, estimándose una persistencia del 40-60% en la edad adulta, de modo que entre 2.5 y 5% de adultos continúan presentando este trastorno. La adolescencia es una etapa en la que se producen grandes y continuos cambios y que se asocia con una menor adherencia al tratamiento, una mayor vulnerabilidad a la aparición de problemas académicos, más conductas de riesgo, el inicio en el consumo de sustancias y la aparición de otros trastornos comórbidos. Se produce también la transición a los servicios o unidades de adultos, siendo necesaria una mayor coordinación entre los servicios infanto-juveniles y de adultos para asegurar una continuidad de la intervención en una etapa d e la vida en la que el paciente es especialmente vulnerable. Como en el caso de los niños y adolescentes, el tratamiento recomendado en el adulto con TDAH es el abordaje multimodal y multidisciplinar, que combina la medicación con estrategias psicológicas o psicosociales, como la psicoeducación, la terapia cognitivo conductual o el coaching, adaptadas a las necesidades individuales de cada paciente. Los fármacos psicoestimulantes son considerados de primera elección en adultos por las guías clínicas.

Assuntos

RESUMO

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

RESUMO

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

RESUMO

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

Assuntos

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.

Assuntos

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.

Assuntos

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.

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.