Estudiante de pregrado de Medicina, Universidad CES, Medellín, Colombia.
Médica psiquiatra, docente de pre y posgrado, Universidad CES, psiquiatra Hospital General de Medellín, Medellín, Colombia.
Rev Colomb Psiquiatr (Engl Ed). 2021 Apr-Jun;50(2):130-137. doi: 10.1016/j.rcpeng.2021.05.001. Epub 2021 May 20.
Epidemiological studies have shown a high prevalence and concurrence between depression and substance use. This is known as "dual diagnosis" and is associated with a worse prognosis for patients.
To establish the comorbidity between depressive symptoms and substance abuse in patients admitted with acute or chronic diseases to a public hospital.
A descriptive, cross-sectional study of prevalence which included 296 patients aged 18-65, to whom the PHQ-9 and ASSIST 3.0 scales were applied to determine the prevalence of depressive symptoms and substance abuse. Other clinical and sociodemographic variables were also taken into account.
50.7% were women with a median age of 41 and an interquartile range of 27 years. Moderate-to-severe depressive symptoms were found in 27.4% of the patients. Alcohol was the substance with the highest consumption in the previous 3 months with 53.7%, followed by cigarettes (47.6%), marijuana (26.7%) and cocaine (14.5%). A significant association was found between severe depressive symptoms PHQ-9 ≥ 20 and problematic use of alcohol, marijuana and cocaine (ASSIST score >26); alcohol (RP 27.30, 95% CI [2.37-314.16], P = 0.01); marijuana (RP 15.00, 95% CI [3.46-64.96], P = 0.001) and cocaine (RP 10.65, 95% CI [2.23-51.10], P = 0.01).
A high prevalence of depressive symptoms and substance use was found in patients hospitalised for non-psychiatric medical conditions, which worsens the prognosis of the underlying medical condition.
To provide better hospital care for patients, we need to give visibility to the problem of dual pathology. This could be achieved by conducting more related research in these clinical scenarios.
流行病学研究表明，抑郁和物质使用之间存在高患病率和同时存在。这被称为“双重诊断”，并与患者的预后更差相关。
确定在因急性或慢性疾病住院的患者中，抑郁症状与物质滥用之间的共病情况。
这是一项描述性、横断面患病率研究，共纳入 296 名年龄在 18-65 岁之间的患者，他们接受了 PHQ-9 和 ASSIST 3.0 量表评估，以确定抑郁症状和物质滥用的患病率。还考虑了其他临床和社会人口学变量。
女性占 50.7%，中位年龄为 41 岁，四分位距为 27 岁。患者中有 27.4%存在中重度抑郁症状。在过去 3 个月中，酒精的消耗量最高，为 53.7%，其次是香烟（47.6%）、大麻（26.7%）和可卡因（14.5%）。发现 PHQ-9≥20 存在严重抑郁症状与酒精、大麻和可卡因的问题使用之间存在显著关联（ASSIST 评分>26）；酒精（RR 27.30，95%CI [2.37-314.16]，P=0.01）；大麻（RR 15.00，95%CI [3.46-64.96]，P=0.001）和可卡因（RR 10.65，95%CI [2.23-51.10]，P=0.01）。
在因非精神科医疗状况住院的患者中，发现抑郁症状和物质使用的患病率较高，这会使潜在医疗状况的预后恶化。
为了为患者提供更好的医院护理，我们需要关注双重病理问题。这可以通过在这些临床情况下进行更多相关研究来实现。
