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BACKGROUND: The use of cannabinoids in mental health has gained strength in recent years due to emerging scientific evidence and the lifting of prohibitionist laws that prevailed for years in many countries, including Colombia. This study describes the results of a survey of Colombian psychiatrists on some aspects of medicinal cannabis, such as attitudes towards its potential use, perceived knowledge, and beliefs surrounding its regulation and safety. METHODS: We conducted a cross-sectional survey of 145 psychiatrists in 14 territories of Colombia between November 2019 and July 2020. The survey consisted of 28 items on topics related to medicinal cannabis, including attitudes and clinical experience (4 items), perceived knowledge (4 items), indications for use in psychiatric pathologies (6 items), indications for use in nonpsychiatric pathologies (8 items), and concerns and awareness about safety and efficacy (6 items). The results were summarized using descriptive statistics. In addition, possible associations among variables were examined using Fisher's exact test. RESULTS: Eighty-two percent of the psychiatrists agreed that medical cannabis should be available for different medical conditions, and 73.1% stated that they wanted to be able to prescribe it. However, 66.2% said they did not know how to help their patients legally access it, and only 25% understood the legal status of medicinal cannabis in the country. The mental health indications that received the highest approval levels for cannabis use were insomnia (35.2%), anxiety disorders (29%), and agitation in dementia (18.6%). The greatest disapproval of cannabis use was indicated for schizophrenia, with 66.9%. The most approved nonpsychiatric medical conditions were cancer-related chronic pain (87.6%), chemotherapy-related nausea and vomiting (78.6%), and chronic pain not associated with cancer (72.4%). Multinomial stepwise logistic regression analysis showed that female psychiatrists who did not agree with MC to treat psychiatric symptoms were more likely to agree with non-psychiatric use. CONCLUSIONS: Our results showed that this sample of Colombian psychiatrists have a favorable attitude towards the prescription of medicinal cannabis; however, there is a serious lack of knowledge of the legal status of medicinal cannabis in the country and the methods through which patients can gain access to government-regulated products. Most of them approve the use of MC for nonpsychiatric conditions and, in general, disapprove of its use in mental illnesses. They generally consider medicinal cannabis as a safe treatment compared to other psychotropic drugs and medications with potential risk of dependence, such as opioids and/or benzodiazepines.
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RESUMEN La psicosis en enfermedad de Parkinson es una entidad recientemente descrita cuya importancia radica en su alta morbilidad y mal pronóstico asociados. Su diagnóstico y manejo representan un reto clínico cotidiano. Sin embargo, el conocimiento de su definición y criterios diagnósticos, el uso de determinadas escalas de severidad y seguimiento y el ejercicio terapéutico riguroso permitirán al clínico abordar en forma sistemática y exitosa este tipo de paciente.
SUMMARY Psychosis in Parkinson's disease is a recently described entity, whose importance lies in the high morbidity associated. Its diagnosis and management represent a daily clinical challenge. However, knowledge of its definition and diagnostic criteria, use of certain scales of severity and follow-up, besides rigorous therapeutic exercise will allow the clinician to systematically and successfully address this type of patient.
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Movilidad en la CiudadRESUMEN
RESUMEN El uso de neuroimágenes en distonía es bastante extenso en el campo de la investigación, no obstante, el uso clínico práctico en términos de diagnóstico se centra en el estudio de potenciales causas secundarias.
SUMMARY The use of neuroimaging in dystonia is widely disseminated in research fields. In everyday clinical context, the main role of these technologies is to help the clinician to rule out secondary causes of dystonia.