ABSTRACT
Addictive behaviors are not limited to drugs use, but also include certain daily behaviors that can cause gratification. Their progression to more severe pathological patterns entails grave consequences for the individual, including multiple psychopathological manifestations. The early detection of this type of behavior is of concern to primary health care. Therefore, in order to detect risk at early stages, reliable and valid tools for daily practice are essential. The MULTICAGE CAD-4 questionnaire is a screening tool for simultaneously detecting addictive behaviors. This study includes a new scale for the detection of smartphone abuse. The objective is to evaluate the adequacy of its psychometric properties. A sample of 2,074 subjects that were recruited from primary care centers ofMadrid(Spain) completed the MULTICAGE CAD-4 questionnaire. A confirmatory factor analysis, using unweighted least squares method, was performed. The test showed good internal consistency both at item and scale levels. The questionnaire structure was consistent with theoretical expectations. The MULTICAGE CAD-4, including the new smartphone scale, is a robust, reliable tool with a valid structure for assessing the presence of dysfunctional or potentially addictive behaviors, and especially useful in primary health care services
Los comportamientos adictivos no se limitan al uso de drogas, sino que también incluyen ciertos comportamientos diarios que pueden causar gratificación. Su progresión a patrones patológicos más severos conlleva graves consecuencias para el individuo, incluidas múltiples manifestaciones psicopatológicas. La detección temprana de este tipo de comportamiento es de interés para la atención primaria de salud. Por lo tanto, para detectar riesgos en etapas tempranas, las herramientas confiables y válidas para la práctica diaria son esenciales. El cuestionario MULTICAGE CAD-4 es una herramienta de detección para detectar simultáneamente conductas adictivas. Este estudio incluye una nueva escala para la detección del abuso de teléfonos inteligentes. El objetivo es evaluar la adecuación de sus propiedades psicométricas. Una muestra de 2.074 sujetos reclutados en centros de atención primaria de Madrid (España) completó el cuestionario MULTICAGE CAD-4. Se realizó un análisis factorial confirmatorio, utilizando el método de mínimos cuadrados no ponderados. La prueba mostró una buena consistencia interna tanto a nivel del ítem como de las escalas. La estructura del cuestionario fue consistente con las expectativas teóricas. El MULTICAGE CAD-4, incluida la nueva escala para teléfonos inteligentes, es una herramienta robusta y confiable con una estructura válida para evaluar la presencia de comportamientos disfuncionales o potencialmente adictivos, y especialmente útil en servicios de atención primaria de salud
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Adult , Aged , Aged, 80 and over , Middle Aged , Behavior, Addictive/epidemiology , Behavior, Addictive/psychology , Psychometrics/methods , Smartphone/trends , Primary Health Care , Surveys and Questionnaires , Factor Analysis, Statistical , Cross-Sectional Studies , Data Analysis , Middle AgedABSTRACT
BACKGROUND: Anxiety is a common mental health problem seen in primary care. However, its management in clinical practice varies greatly. Clinical practice guidelines (CPGs) have the potential to reduce variations and improve the care received by patients by promoting interventions of proven benefit. However, uptake and adherence to their recommendations can be low. METHOD/DESIGN: This study involves a community based on cluster randomized trial in primary healthcare centres in the Madrid Region (Spain). The project aims to determine whether the use of implementation strategy (including training session, information, opinion leader, reminders, audit, and feed-back) of CPG for patients with anxiety disorders in primary care is more effective than usual diffusion. The number of patients required is 296 (148 in each arm), all older than 18 years and diagnosed with generalized anxiety disorder, panic disorder, and panic attacks by the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). They are chosen by consecutive sampling. The main outcome variable is the change in two or more points into Goldberg anxiety scale at six and twelve months. Secondary outcome variables include quality of life (EuroQol 5D), and degree of compliance with the CPG recommendations on treatment, information, and referrals to mental health services. Main effectiveness will be analyzed by comparing the patients percentage improvement on the Goldberg scale between the intervention group and the control group. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in this analysis. DISCUSSION: There is a need to identify effective implementation strategies for CPG for the management of anxiety disorders present in primary care. Ensuring the appropriate uptake of guideline recommendations can reduce clinical variation and improve the care patients receive. TRIAL REGISTRATION: ISRCTN: ISRCTN83365316.
Subject(s)
Anxiety Disorders/therapy , Panic Disorder/therapy , Primary Health Care/organization & administration , Adult , Aged, 80 and over , Anxiety Disorders/psychology , Cluster Analysis , Diagnostic and Statistical Manual of Mental Disorders , Female , Guidelines as Topic , Humans , Male , Middle Aged , Panic Disorder/psychology , Spain , Young AdultSubject(s)
Influenza A virus , Influenza, Human/epidemiology , Pandemics , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Spain/epidemiology , Time Factors , Urban Health , Young AdultABSTRACT
OBJECTIVE: To find out the frequency of specific disorders within the general population using primary healthcare relating to the control of impulses with addictive risk. DESIGN: A cross-sectional descriptive study. LOCATION: Urban health centre, Area 9 of the Madrid Health Service (Spain). PARTICIPANTS: A total of 457 patients who came to primary care (PA) were selected by consecutive sampling. METHOD: Self-completion of the MULTICAGE-CAD4 survey (which measure eight scales for the risky behaviour being studied). RESULTS: There was a risk in at least one of the scales in 46.4% of the sample, of which 17.3% (13.7-20.9) showed risky behaviour on the alcohol scale; 9% (6.2-11.7) for other drugs; 4.4% (2.4-6.4) for gambling; 9.4% (6.6-12.2) for addiction to the Internet; 4.8% (2.7-6.7) for addiction to videogames; 18.8% (15.1-22.5) for eating disorders; 16% (12.5-19.4) for compulsive shopping and 5.5% (3.3-7.7) for addiction to sex. The occurrence of addiction to alcohol, gambling and sex were higher for men, while eating disorders were more prevalent in women. CONCLUSIONS: We are facing a widespread set of problems related to addictions that are often hidden; this study shows that these addictions can be detected within primary healthcare by effective screening tools such as MULTICAGE CAD-4, which is both economic, and easy to implement within primary healthcare centres.
Subject(s)
Behavior, Addictive/diagnosis , Surveys and Questionnaires , Adolescent , Adult , Cross-Sectional Studies , Early Diagnosis , Female , Humans , Male , Middle Aged , Primary Health Care , Young AdultABSTRACT
Objetivo: conocer las frecuencias de determinados trastornos de control de los impulsos con riesgo adictivo en la población consultante en atención primaria. Diseño: estudio descriptivo transversal. Emplazamiento: centro de salud urbano del Área 9 del Servicio Madrileño de Salud. Participantes: 457 pacientes que acudieron a consultas de atención primaria (AP) seleccionados mediante muestreo consecutivo. Mediciones principalesautocumplimentación de la encuesta MULTICAGE-CAD4 (que mide ocho escalas correspondientes a los comportamientos de riesgo que se estudian). Resultados: el 46,4% tenía al menos una de las escalas alterada. Mostró comportamiento de riesgo en la escala del alcohol el 17,3% (13,7-20,9) y en la de otras drogas, el 9% (6,2-11,7); en el juego, el 4,4% (2,4-6,4); en la de internet, el 9,4% (6,6-12,2) y en los videojuegos, el 4,8% (2,7-6,9); en la conducta alimentaria, el 18,8% (15,1-22,5); en el gasto compulsivo, el 16% (12,5-19,4) y en el sexo compulsivo, el 5,5% (3,3-7,7). Las escalas de alcohol, ludopatía y adicción al sexo están más frecuentemente alteradas entre los varones y los trastornos de la alimentación más entre las mujeres. Conclusiones: los comportamientos de riesgo adictivo son frecuentes en la población consultante; casi la mitad de la muestra tiene puntuaciones con criterio para estimar como problemática al menos una de las conductas exploradas. Las conductas de riesgo más frecuentes fueron los trastornos de la alimentación, el consumo de alcohol y el gasto compulsivo. Entre los jóvenes menores de 25 años, el gasto compulsivo y el abuso de internet(AU)
Objective: To find out the frequency of specific disorders within the general population using primary healthcare relating to the control of impulses with addictive risk. Design: A cross-sectional descriptive study. Location: Urban health centre, Area 9 of the Madrid Health Service (Spain). ParticipantsA total of 457 patients who came to primary care (PA) were selected by consecutive sampling. Method: Self-completion of the MULTICAGE-CAD4 survey (which measure eight scales for the risky behaviour being studied). Results: There was a risk in at least one of the scales in 46.4% of the sample, of which 17.3% (13.7-20.9) showed risky behaviour on the alcohol scale; 9% (6.2-11.7) for other drugs; 4.4% (2.4-6.4) for gambling; 9.4% (6.6-12.2) for addiction to the Internet; 4.8% (2.7-6.7) for addiction to videogames; 18.8% (15.1-22.5) for eating disorders; 16% (12.5-19.4) for compulsive shopping and 5.5% (3.3-7.7) for addiction to sex. The occurrence of addiction to alcohol, gambling and sex were higher for men, while eating disorders were more prevalent in women. Conclusions: We are facing a widespread set of problems related to addictions that are often hidden; this study shows that these addictions can be detected within primary healthcare by effective screening tools such as MULTICAGE CAD-4, which is both economic, and easy to implement within primary healthcare centres(AU)
