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Comparación entre los autoinformes y las medidas biológicas del consumo de alcohol, tabaco y drogas en enfermos psiquiátricos hospitalizados

Published online by Cambridge University Press:  01 April 2008

Renaud de Beaurepaire ,
Michael Lukasiewicz ,
Patrick Beauverie ,
Sophie Castéra ,
Odile Dagorne ,
Renaud Espaze ,
Bruno Falissard ,
Patrick Giroult ,
Michéle Houery  and
Georges Mahuzier
...Show all authors
Renaud de Beaurepaire
Affiliation:
CH Paul Guiraud, 54 avenue de la République, 94806Villejuif, Francia INSERM U-5I3, 94010Crétell, Francia
Michael Lukasiewicz
Affiliation:
INSERM U-669, PSIGIAM, 97 boidevard de Port-Royal, 75679París cedex 14, Francia
Patrick Beauverie
Affiliation:
CH Paul Guiraud, 54 avenue de la République, 94806Villejuif, Francia
Sophie Castéra
Affiliation:
CH Paul Guiraud, 54 avenue de la République, 94806Villejuif, Francia
Odile Dagorne
Affiliation:
CH Paul Guiraud, 54 avenue de la République, 94806Villejuif, Francia
Renaud Espaze
Affiliation:
INSERM U-669, PSIGIAM, 97 boidevard de Port-Royal, 75679París cedex 14, Francia
Bruno Falissard
Affiliation:
CH Paul Guiraud, 54 avenue de la République, 94806Villejuif, Francia
Patrick Giroult
Affiliation:
CH Paul Guiraud, 54 avenue de la République, 94806Villejuif, Francia
Michéle Houery
Affiliation:
CH Paul Guiraud, 54 avenue de la République, 94806Villejuif, Francia
Georges Mahuzier
Affiliation:
CH Paul Guiraud, 54 avenue de la République, 94806Villejuif, Francia
Isabelle Matheron
Affiliation:
CH Paul Guiraud, 54 avenue de la République, 94806Villejuif, Francia
Philippe Niel
Affiliation:
CH Paul Guiraud, 54 avenue de la République, 94806Villejuif, Francia
Pierre Padovani
Affiliation:
CH Paul Guiraud, 54 avenue de la République, 94806Villejuif, Francia
Nicole Poisson
Affiliation:
CH Paul Guiraud, 54 avenue de la République, 94806Villejuif, Francia
Jean-Paul Richier
Affiliation:
CH Paul Guiraud, 54 avenue de la République, 94806Villejuif, Francia
Jérome Rocher
Affiliation:
CH Paul Guiraud, 54 avenue de la République, 94806Villejuif, Francia
Odile Ruetsh
Affiliation:
CH Paul Guiraud, 54 avenue de la République, 94806Villejuif, Francia
Didier Touzeau
Affiliation:
CH Paul Guiraud, 54 avenue de la République, 94806Villejuif, Francia
André Visinoni
Affiliation:
CH Paul Guiraud, 54 avenue de la République, 94806Villejuif, Francia
Robert Molimard
Affiliation:
CH Paul Guiraud, 54 avenue de la République, 94806Villejuif, Francia
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Resumen

Antecedentes.

Preguntar a los enfermos psiquiátricos hospitalizados sobre su consumo de drogas no suele dar resultados fiables, en particular, cuando existe consumo de alcohol y de estupefacientes. El objetivo principal de este estudio fue comparar los autoinformes espontáneos sobre consumo de drogas en enfermos psiquiátricos hospitalizados con las medidas biológicas del mismo. Un objetivo secundario fue determinar qué factores personales se asociaban con el consumo de tabaco, alcohol y drogas indicado por estas medidas biológicas.

Métodos.

El consumo de sustancias se investigó realizando medidas biológicas [cotinina, cannabis, opiáceos, cocaína, anfetaminas y barbitúricos en orina; transferrina deficiente en carbohidratos (TDC) y gamma-glutamil transferasa (GGT) en sangre] en 486 enfermos psiquiátricos ingresados consecutivamente, un día después de su hospitalización. Se registraron los autoinformes de los pacientes sobre consume de alcohol, tabaco y drogas. También se registraron los datos socio-profesionales y familiares.

Resultados.

Los resultados demuestran que hay una correlación baja entre las medidas biológicas y la autodescripción del consume de alcohol y drogas. El 52% de los pacientes describieron un consumo de drogas inferior a la realidad (kappa = 0,47). Los pacientes con esquizofrenia y trastornos de personalidad tenían más probabilidades de revelar su consumo de drogas que los pacientes con dependencia del alcohol y trastornos del ánimo. El 56% de los pacientes describieron un consumo de alcohol inferior a la realidad, evaluado por TDC (kappa = 0,2) y el 37% describieron un consumo inferior a la realidad usando la medida de TDC + GGT como indicador. El tabaquismo se describió adecuadamente. En el estudio observamos una correlación negativa fuerte entre el consumo de cannabis y la edad, una correlación fuerte entre el tabaco y el consumo de cannabis y correlaciones entre el consumo de tabaco, cannabis y alcohol.

Conclusión.

Este estudio es el primero que comparó los autoinformes y las medidas biológicas de alcohol, tabaco y consumos de drogas en una muestra numerosa de enfermos hospitalizados que padecen varios tipos de enfermedades psiquiátricas, teniendo en cuenta las comparaciones diagnósticas cruzadas.

Keywords

Medidas biológicasEnfermos psíquicosAutoinformesCotininaCannabisTDCGGT
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 15 , Issue 3 , April 2008 , pp. 115 - 124
Copyright
Copyright © European Psychiatric Association 2008

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