Asturian Mental Health Service Area V- Hospital Univ. Cabueñes, Servicio de Salud del Principado de Asturias (SESPA), Gijón, Spain.
Asturian Institute on Health Research (Instituto para la Investigación Sanitaria del P° de Asturias-ISPA), Oviedo, Spain.
Arch Womens Ment Health. 2023 Oct;26(5):639-650. doi: 10.1007/s00737-023-01353-w. Epub 2023 Aug 4.
The co-occurrence of substance use disorders (SUD) and other mental disorders (OMD) is assumed to be high, but the details are uncertain in Spain. The objective of the present study was to know the prevalence of this comorbidity, as well as the pharmacological treatment, both in specific addiction treatment networks and in mental health networks, with a gender perspective. Observational, multicenter study, with a randomized sample, of patients under treatment for SUD or OMD in Spain (N = 1783). A specific questionnaire, collecting sociodemographic and clinical variables, diagnosed SUD and OMD, and prescribed psychotropic drugs, was completed by treating clinicians. Differences between females and males were searched. A high prevalence of OMD was found in those patients treated for their SUD (71%), and also of diagnoses of SUD (59%) in people treated for OMD. Significant relationships between addiction to certain substances and specific mental disorders were found (with no main differences between women and men). The treatments for OMD were very common in the addiction treatment networks, but that of SUDs in those patients treated in the mental health networks was less than expected. A high prescription of benzodiazepines was found. Women were less frequently diagnosed with cannabis, opioid, and especially cocaine use disorders, and they had fewer psychotic disorders and more affective, anxiety, sleep, and eating disorders, with the rest being the same, including personality disorders. Women had fewer treatments with agonists and more with antagonists, and more prescriptions of anxiolytics and antidepressants. This study provides preliminary information on the coexistence in routine clinical practice of addictive disorders and other mental disorders in Spain, and on the treatment provided, and shows differences in prevalence and clinical characteristics, and especially in treatment approaches between women and men. Thus, should be useful to adapt the treatment response with greater precision, and with a gender perspective.
物质使用障碍（SUD）和其他精神障碍（OMD）的同时发生被认为是高的，但在西班牙，其细节尚不确定。本研究的目的是了解这种共病的患病率，以及在特定的成瘾治疗网络和精神卫生网络中，从性别角度来看，同时治疗这两种疾病的情况。这是一项观察性、多中心研究，采用随机样本，对在西班牙接受 SUD 或 OMD 治疗的患者（N=1783）进行研究。由治疗临床医生填写专门的问卷，收集社会人口学和临床变量，诊断 SUD 和 OMD，并开出处方精神药物。研究了女性和男性之间的差异。在接受 SUD 治疗的患者中发现 OMD 的患病率很高（71%），在接受 OMD 治疗的患者中也发现 SUD 的诊断率很高（59%）。发现某些物质成瘾与特定精神障碍之间存在显著关系（女性和男性之间没有主要差异）。在成瘾治疗网络中，治疗 OMD 的方法非常常见，但在精神卫生网络中治疗 SUD 的方法却低于预期。发现苯二氮䓬类药物的处方量很高。女性被诊断为大麻、阿片类药物和可卡因使用障碍的频率较低，而患有精神病性障碍和情感、焦虑、睡眠和饮食障碍的频率较高，其他情况相同，包括人格障碍。女性接受的激动剂治疗较少，拮抗剂治疗较多，接受的抗焦虑药和抗抑郁药处方较多。这项研究提供了关于西班牙在常规临床实践中并存的成瘾障碍和其他精神障碍以及所提供的治疗的初步信息，并显示了男女之间在患病率和临床特征方面的差异，特别是在治疗方法方面的差异。因此，应该有助于更精确地调整治疗反应，并从性别角度考虑。
