RESUMO
Background: Cannabis use among young people in Chile has increased significantly in the last years. There is a consistent link between cannabis and psychosis. Aim: To compare cannabis use in patients with a first episode of psychosis and healthy controls. Material and Methods: We included 74 patients aged 20 ± 3 years (78% males) admitted to hospital with a first episode of psychosis and a group of 60 healthy controls aged 23 ± 4 years (63% males). Cannabis consumption was assessed, including age of first time use and length of regular use. Results: Patients with psychosis reported a non-significantly higher frequency of life-time cannabis use. Patients had longer periods of regular cannabis use compared with healthy subjects (Odds ratio [OR] 2.4; 95% confi-dence intervals [CI] 1.14-5.05). Patients also used cannabis for the first time at an earlier age (16 compared with 17 years, p < 0.0). The population attributable fraction for regular cannabis use associated with hospital admissions due to psychosis was 17.7% (95% CI 1.2-45.5%). Conclusions: Cannabis use is related to psychosis in this Chilean group of patients. This relationship is stronger in patients with early exposure to the drug and longer the regular use. One of every five admissions due to psychosis is associated with cannabis consumption. These data should influence cannabis legisla-tion and the public policies currently being discussed in Chile.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Transtornos Psicóticos , Cannabis , Transtornos Psicóticos/epidemiologia , Estudos de Casos e Controles , Chile/epidemiologia , Fatores de RiscoRESUMO
La esquizofrenia es una prioridad sanitaria de primer orden, debido a su alta frecuencia en relación con otras enfermedades mentales. Patologías que, por sus propias características y curso evolutivo, ponen más a prueba la solidez y consistencia de las pautas de intervención que sobre ellas se realizan. Además un porcentaje alto de familias sienten estrés y dificultades que afectan de manera significativa su funcionamiento. Desde la década de los noventa se ha postulado que aplicar intervenciones integrales, farmacológicas, psicológicas y psicosociales, en una etapa precoz de la enfermedad, sería una estrategia beneficiosa para los pacientes, logrando con ello mejores resultados en cuanto a la evolución de la enfermedad a largo plazo. Entre ellas está la Psicoeducación (PE), que también tiene la función de contribuir a la no estigmatización de los trastornos psicológicos y disminuir las barreras para el tratamiento. En este trabajo presentamos un estudio en Chile de Psicoeducación con familiares de pacientes en primer episodio de esquizofrenia, aplicada por el sector 1 del Instituto Psiquiátrico Dr. José Horwitz Barak. Los contenidos de éste se basan en las Guías Clínicas GES (2016), y se enmarcan en las políticas públicas de salud promovidas por el Ministerio de Salud.
Schizophrenia should be a health priority because of its high frequency in relation to other mental illnesses. Pathologies that, due to their own characteristics and evolutionary course, put more to the test the solidity and consistency of the intervention guidelines that are carried out on them. In addition, a high percentage of families feel stress and difficulties that significantly affect their functioning. Since the nineties it has been postulated that applying comprehensive, pharmacological, psychological and psychosocial interventions, at an early stage of the disease, would be a beneficial strategy for patients, thereby achieving better results in the evolution of the disease in the long term. Among them is Psychoeducation (PE), which also has the function of contributing to the non-stigmatization of psychological disorders and reducing barriers to treatment. In this paper we present a study in Chile of sychoeducation with family members of patients in the first episode of schizophrenia, applied by sector 1 of the Dr. José Horwitz Barak Psychiatric Institute. The contents are based on the GES Clinical Guidelines (2016), and are framed in public health policies promoted by the Ministry of Health.