Prevalencia de síntomas de trastorno por déficit de atención con hiperactividad en adolescentes y adultos jóvenes con otros trastornos psiquiátricos refractarios a tratamientos previos / Prevalence of attention deficit/hyperactivity disorder symptoms in outpatient adolescents and young adults with other psychiatric disorders refractory to previous treatments

Introducción. El objetivo de este estudio fue evaluar la prevalencia de síntomas de trastorno por déficit de atención con hiperactividad (TDAH) en adolescentes y adultos jóvenes diagnosticados de otros trastornos psiquiátricos primarios que no habían respondido a tratamientos previos. Material y métodos. Se incluyeron 795 pacientes ambulatorios de 15-24 años. Se estudió la presencia de un TDAH según los criterios DSM-IV y la frecuencia de los síntomas utilizando la escala de valoración del TDAH de DuPaul de 18 ítems. Resultados. Se objetivó la presencia de un TDAH (criterios DSM-IV) en 48 pacientes (6%), ninguno de los cuales previamente había recibido este diagnóstico. Un total de 260 pacientes (32,7%) presentaron síntomas moderados de TDAH y en ellos la gravedad del trastorno psiquiátrico de base era mayor según la ICG-S (p = 0,007). Los factores de riesgo para tener síntomas moderados de TDAH fueron la presencia de trastornos por uso de sustancias (TUS) (odds ratio = 1,543; p = 0,01) y de trastorno límite de la personalidad (odds ratio = 2,173; p = 0,0001). Conclusiones. El TDAH no diagnosticado previamente estaba presente en el 6% de los pacientes, observándose asimismo una elevada frecuencia de síntomas moderados del trastorno (32,7%) en la muestra. Por estos motivos sería recomendable hacer un minucioso estudio del TDAH en los jóvenes refractarios al tratamiento del trastorno primario, principalmente en aquellos con trastornos por uso de sustancias, trastornos de conducta y de personalidad, debido a la elevada comorbilidad entre el TDAH y estos trastornos (AU)

Introduction. The aim of the current study was to assess the prevalence of symptoms of attention deficit/hyperactivity disorder (ADHD) in adolescents and young adults diagnosed with other primary psychiatric disorders, who had not responded to previous treatments. Material and methods. A total of 795 outpatients aged 15 to 24 years were included. The presence of ADHD was studied using DSM-IV criteria and the frequency of symptoms using the 18 item DuPaul ADHD Rating Scale. Results. ADHD (DSM-IV criteria) was present in 48 patients (6%), none of whom had previously received the diagnosis. A total of 260 patients (32.7%) met the criteria for moderate ADHD and between them, severity of primary psychiatric disorder was higher according to the CGI-S (P = .007). Risk factors for moderate ADHD symptoms were the presence of substance use disorders (SUD) (odds ratio = 1.543, P = .01) and borderline personality disorders (odds ratio = 2.173, p = .0001). Conclusion. Unrecognized ADHD was present in 6% of patients; moreover 32.7% of the sample also presented moderate symptoms of the disorder. Screening for ADHD in young patients with refractory response to primary disorder treatment, mainly those with substance use disorders, conduct and personality disorders is highly advisable, due to the high frequency of ADHD comorbidity in these psychiatric disorders (AU)

[Prevalence of attention deficit/hyperactivity disorder symptoms in outpatient adolescents and young adults with other psychiatric disorders refractory to previous treatments]. / Prevalencia de síntomas de trastorno por déficit de atención con hiperactividad en adolescentes y adultos jóvenes con otros trastornos psiquiátricos refractarios a tratamientos previos.

INTRODUCTION: The aim of the current study was to assess the prevalence of symptoms of attention deficit/hyperactivity disorder (ADHD) in adolescents and young adults diagnosed with other primary psychiatric disorders, who had not responded to previous treatments. MATERIAL AND METHODS: A total of 795 outpatients aged 15 to 24 years were included. The presence of ADHD was studied using DSM-IV criteria and the frequency of symptoms using the 18 item DuPaul ADHD Rating Scale. RESULTS: ADHD (DSM-IV criteria) was present in 48 patients (6%), none of whom had previously received the diagnosis. A total of 260 patients (32.7%) met the criteria for moderate ADHD and between them, severity of primary psychiatric disorder was higher according to the CGI-S (P=.007). Risk factors for moderate ADHD symptoms were the presence of substance use disorders (SUD) (odds ratio=1.543, P=.01) and borderline personality disorders (odds ratio =2.173, p=.0001). CONCLUSION: Unrecognized ADHD was present in 6% of patients; moreover 32.7% of the sample also presented moderate symptoms of the disorder. Screening for ADHD in young patients with refractory response to primary disorder treatment, mainly those with substance use disorders, conduct and personality disorders is highly advisable, due to the high frequency of ADHD comorbidity in these psychiatric disorders.

Análisis de las diferencias entre indicación y prescripción de gastroprotección en pacientes con factores de riesgo tratados con antiinflamatorios no esteroideos: estudio GAP / Analysis of differences between indication and prescription of gastroprotection in patients with risk factors treated with nonsteroidal anti-inflammatory agents: The GAP study

ResumenSe ha señalado que las medidas de prevención en pacientes tratados con antiinflamatorios no esteroideos (AINE) estan infrautilizadas. El objetivo de este estudio es analizar las diferencias entre indicación y prescripción real de gastroprotección con inhibidores de bomba de protones en pacientes con factores de riesgo para complicaciones gastrointestinales en tratamiento con AINE.MétodosEstudio observacional, transversal y multicéntrico. Recogida retrospectiva de datos a partir de historias clínicas y cumplimentación de un cuestionario sobre factores de riesgo e indicación de gastroprotección.ResultadosUn total de 432 facultativos recogieron datos de 2.160 pacientes tratados con AINE. Un 90,4% de pacientes recibían prescripción de gastroprotección con inhibidores de bomba de protones. El tratamiento con AINE a largo plazo frente a corto plazo (<1 mes) mostraba una asociación con gastroprotección (odds ratio=2,37; intervalo de confianza del 95%: 1,779–3,171). La media de factores de riesgo por paciente fue de 2±0,16 (rango: 0–7), se observó una asociación significativa entre número de factores de riesgo y porcentaje de pacientes en gastroprotección. Aun así, la proporción de pacientes con factores de riesgo sin gastroprotección fue del 3% para historia previa de enfermedad ulcerosa o hemorragia digestiva por AINE y del 7–10% para los demás factores. Se observaron diferencias entre indicación y gastroprotección prescrita entre las diferentes especialidades, los especialistas de radioterapia son los que presentaron menor grado de gastroprotección.ConclusionesEstos resultados reflejan que en la práctica clínica diaria las diferencias entre indicación y prescripción real de gastroprotección en pacientes con factores de riesgo tratados con AINE son pequeñas en nuestro país(AU)

AbstractPreventive measures in patients treated with nonsteroidal anti-inflammatory drugs (NSAIDS) have been reported to be underused. The aim of the present study was to analyze differences between the indication and prescription of gastroprotection with proton pump inhibitors (PPI) in patients treated with NSAIDS and with risk factors for gastrointestinal complications.MethodsWe performed an observational, cross-sectional, multicenter study. Data were gathered retrospectively from medical records and from a questionnaire on risk factors and indication for gastroprotection.ResultsA total of 432 physicians gathered data from 2,160 patients treated with NSAIDs. Nearly all (90.4%) of the patients were prescribed gastroprotection with a PPI. Long-term versus short-term (<1 month) NSAID treatment was associated with gastroprotection (OR=2.37; 95% CI 1.779–3.171). The mean number of risk factors per patient was 2±0.16 (range 0–7), and a significant association was found between the number of risk factors and the percentage of patients receiving gastroprotection. Nevertheless, the proportion of patients with risk factors not receiving gastroprotection was 3% for those with a prior history of ulcer and/or gastrointestinal bleeding due to NSAIDS and 7–10% for the remaining factors. Differences were found between the indication for gastroprotection and the gastroprotection prescribed among the various specialties. The specialists prescribing gastroprotection the least were radiotherapy specialists.ConclusionsThese results demonstrate that, in daily clinical practice, differences between the indication and prescription of gastroprotection in patients treated with NSAIDS and with risk factors are small in Spain(AU)

[Analysis of differences between indication and prescription of gastroprotection in patients with risk factors treated with nonsteroidal anti-inflammatory agents: the GAP study]. / Análisis de las diferencias entre indicación y prescripción de gastroprotección en pacientes con factores de riesgo tratados con antiinflamatorios no esteroideos: estudio GAP.

UNLABELLED: Preventive measures in patients treated with nonsteroidal anti-inflammatory drugs (NSAIDS) have been reported to be underused. The aim of the present study was to analyze differences between the indication and prescription of gastroprotection with proton pump inhibitors (PPI) in patients treated with NSAIDS and with risk factors for gastrointestinal complications. METHODS: We performed an observational, cross-sectional, multicenter study. Data were gathered retrospectively from medical records and from a questionnaire on risk factors and indication for gastroprotection. RESULTS: A total of 432 physicians gathered data from 2,160 patients treated with NSAIDs. Nearly all (90.4%) of the patients were prescribed gastroprotection with a PPI. Long-term versus short-term (<1 month) NSAID treatment was associated with gastroprotection (OR=2.37; 95% CI 1.779-3.171). The mean number of risk factors per patient was 2+/-0.16 (range 0-7), and a significant association was found between the number of risk factors and the percentage of patients receiving gastroprotection. Nevertheless, the proportion of patients with risk factors not receiving gastroprotection was 3% for those with a prior history of ulcer and/or gastrointestinal bleeding due to NSAIDS and 7-10% for the remaining factors. Differences were found between the indication for gastroprotection and the gastroprotection prescribed among the various specialties. The specialists prescribing gastroprotection the least were radiotherapy specialists. CONCLUSIONS: These results demonstrate that, in daily clinical practice, differences between the indication and prescription of gastroprotection in patients treated with NSAIDS and with risk factors are small in Spain.