Patología dual en pacientes inmigrantes con Trastorno por Uso de Alcohol: seguimiento tras dos años de tratamiento / Dual pathology in immigrant patients with Alcohol Use Disorder: follow-up after two years of treatment

Introducción: Existe una elevada prevalencia de trastornos psiquiátricos en el trastorno por uso de alcohol. Lapresencia de patología dual en el paciente disminuye el mantenimiento de la abstinencia y aumenta la probabilidad derecaída, lo que complica el tratamiento. Los objetivos de esteestudio son: Analizar la evolución a dos años de tratamiento de una población de pacientes inmigrantes con trastorno por uso de alcohol asociado a trastornos psiquiátricos,comparándola con una muestra de pacientes inmigrantes sinpatología dual e investigar los diagnósticos de patología psiquiátrica asociada al trastorno por uso de alcohol.Metodología. Se compararon dos poblaciones de pacientes inmigrantes con trastorno por uso de alcohol (DSM-5),una con trastornos psiquiátricos asociados, compuesta por219 pacientes y otra de 169 pacientes sin patología dual.Resultados y conclusiones. Los trastornos psiquiátricosmás frecuentes asociados al trastorno por uso de alcoholson el de personalidad (51,6%), el adaptativo y depresivo(22,8%), los de ansiedad (15,5%), los de conducta alimentaria y obsesivos compulsivos (5,9%), el bipolar (5%) y el deesquizofrenia (2,3%). El seguimiento a 2 años de tratamientopresenta que el 27% de la población inmigrante con patología dual se mantiene en abstinencia frente al 41,4% de la quesolo padece trastorno por uso de alcohol: Se constata unapeor evolución en los pacientes con patología dual. (AU)

Introduction: There is a high prevalence of comorbidpsychiatric disorders in alcohol abuse disorder. The presenceof dual diagnosis in patients decreases the maintenance ofabstinence and increases the likelihood of relapse, whichmakes treatment more complicated. The aims of thisstudy are: to investigate the progression along two yearsof treatment of a sample of migrant patients affected byalcohol abuse disorder associated with psychiatric disorders,comparing it with a sample of migrant patients withoutdual diagnosis and investigating the diagnoses of comorbidpsychiatric pathology with alcohol abuse disorder.Methods. Two populations of migrant patients withalcohol abuse disorder (DSM-5) were compared, one withcomorbid psychiatric disorders consisting of 219 patientsand the other of 169 patients without dual diagnosis.Results and conclusions. The most frequent psychiatricdisorders associated with alcohol use disorder are personalitydisorders (51,6%), adjustment and depressive disorders(22,8%), anxiety disorders (15,5%), eating disorders andobsessive-compulsive disorders (5,9%), bipolar disorders(5%) and schizophrenia (2,3%). The two-year follow-uptreatment shows that 27% of immigrant sample with dualdiagnosis remains in abstinence compared to 41,4% of thosewho only suffer from alcohol use disorder: Worse outcomesare observed in patients with dual diagnosis. (AU)

Dual diagnosis in immigrant patients with alcohol use disorder: 2-years of follow-up treatment.

There is a high prevalence of comorbid psychiatric disorders in alcohol abuse disorder. The presence of dual diagnosis in patients decreases the maintenance of abstinence and increases the likelihood of relapse, which makes treatment more complicated.

Alcohol Use Disorder in immigrant patients: 2-years of follow-up treatment.

In recent decades the immigrant population has increased significantly in Western countries, which not only influences the former culturally but also in their alcohol consumption patterns. The course of immigration can cause social stress, which can lead to uprooting, frustration of their expectations or marginality, which are risk factors for an increase in alcohol consumption, possibly in order to face their different problems. The aims of this study are: to investigate the progression along two years of treatment of a sample of immigrant patients with Alcohol Use Disorder, to compare it with a sample of Spanish natives and to analyze the evolution of immigrant patients according to the geographical area of origin.

Trastorno por Uso de Alcohol enpacientes inmigrantes: seguimiento a2 años de tratamiento / Alcohol Use Disorder in immigrant patients: 2-years of follow-up treatment

Introducción: En las últimas décadas, la poblacióninmigrante ha aumentado sensiblemente en los paísesoccidentales, que no solo les influye culturalmente sinotambién en su patrón de consumo de alcohol. El transcursode la inmigración puede originar estrés social, que es posibleque cause desarraigo, frustración de sus expectativas omarginalidad, que son factores de riesgo para un aumentodel consumo de alcohol, posiblemente con el fin de afrontarsus diferentes problemas. Los objetivos de este trabajo son:investigar la evolución a dos años de tratamiento de unapoblación de pacientes inmigrantes con Trastorno por Uso deAlcohol, comparándola con una muestra de origen español,y analizar la evolución de los pacientes inmigrantes según elárea geográfica de origen.Metodología. Se compararon dos poblaciones conTrastorno por Uso de Alcohol (DSM-V), una de inmigrantescompuesta por 388 pacientes y otra de control, de origenespañol, compuesta por 262 pacientes. Asimismo, se estudióla evolución de los pacientes según el área geográfica a laque pertenecen.Resultados y conclusiones. El 45,4 % de los pacientes dela población española se mantiene en abstinencia a los 2 añosde tratamiento frente al 33,8 % de la población inmigrante.Los pacientes que consiguen una mayor abstinencia sonlos de origen árabe (52,3 %). Sin embargo, hay una mayoradherencia en América del Sur/Cono Sur (67,7 %). Los paísesque tienen una peor evolución en la abstinencia son los deAmérica del Sur/Países del Norte (26,2 %) y los que procedende Europa Oriental (29,1 %). (AU)

Introduction: In recent decades the immigrant populationhas increased significantly in Western countries, which notonly influences the former culturally but also in their alcoholconsumption patterns. The course of immigration can causesocial stress, which can lead to uprooting, frustration oftheir expectations or marginality, which are risk factors foran increase in alcohol consumption, possibly in order toface their different problems. The aims of this study are: toinvestigate the progression along two years of treatment ofa sample of immigrant patients with Alcohol Use Disorder,to compare it with a sample of Spanish natives and toanalyze the evolution of immigrant patients according tothe geographical area of origin.Methods. Two samples of individuals with AlcoholUse Disorder (DSM-V) were compared: one sample of 388immigrant patients and a control sample composed of262 Spanish patients. Likewise, the patients were studiedaccording to the geographical area to which they belong.Results and conclusions. 45.4% of patients in theSpanish sample remain in abstinence after 2 years oftreatment compared to 33.8% in the immigrant sample.Patients who achieve greater abstinence are those of Araborigin (52.3%). However, there is a better adherence in SouthAmerica/Southern Cone (67.7%). The countries with theworst outcomes in abstinence are those in South America/Northern countries (26.2%) and those in Eastern Europe(29.1%). (AU)

A Multisite, Randomized Controlled Clinical Trial of Computerized Cognitive Remediation Therapy for Schizophrenia.

The effectiveness of cognitive remediation therapy (CRT) for the neuropsychological deficits seen in schizophrenia is supported by meta-analysis. However, a recent methodologically rigorous trial had negative findings. In this study, 130 chronic schizophrenic patients were randomly assigned to computerized CRT, an active computerized control condition (CC) or treatment as usual (TAU). Primary outcome measures were 2 ecologically valid batteries of executive function and memory, rated under blind conditions; other executive and memory tests and a measure of overall cognitive function were also employed. Carer ratings of executive and memory failures in daily life were obtained before and after treatment. Computerized CRT was found to produce improvement on the training tasks, but this did not transfer to gains on the primary outcome measures and most other neuropsychological tests in comparison to either CC or TAU conditions. Nor did the intervention result in benefits on carer ratings of daily life cognitive failures. According to this study, computerized CRT is not effective in schizophrenia. The use of both active and passive CCs suggests that nature of the control group is not an important factor influencing results.

Análisis de variables socioculturales en la atención en una unidad hospitalaria de rehabilitación psiquiátrica: A propósito de un caso / No disponible

La necesidad de competencias culturales específicas en los profesionales de salud mental ha aumentado en las últimas décadas, dada la creciente demanda por parte de la población inmigrante. El objetivo del presente estudio es profundizaren las variables socioculturales que influyen en el proceso de tratamiento y rehabilitación de pacientes inmigrantes y analizarlas barreras socioculturales percibidas y las dificultades de manejo que se plantean en un equipo multidisciplinar ante estos casos, así como las estrategias de afrontamiento implementadas. Para ello, primero se hizo un estudio descriptivo de las características sociodemográficas la muestra de pacientes inmigrantes ingresados en la Unidad Hospitalaria de Tratamiento y Rehabilitación de la Clínica San Miguel (Madrid) y se seleccionó un caso clínico de origen rumano y etnia gitana para estudiar los factores socioculturales más relevantes. Paralelamente, se administró un cuestionario estructurado para estudiar la percepción subjetiva del equipo multidisciplinar en cuanto a barreras socioculturales percibidas ante el caso clínico descrito y estrategias de afrontamiento puestas en marcha para abordar dichas dificultades de manejo, siendo respondido por todos los integrantes del equipo. los resultados ponen de manifiesto la importancia de la dimensión sociocultural en el abordaje de este tipo de pacientes, así como la vivencia subjetiva del equipo multidisciplinar ante ellos, tratando de perfilar modos de actuación que faciliten su proceso de trata-miento, rehabilitación y reinserción

There is an ever-increasing need for mental health professionals to have specific cultural abilities due to the increased demand from immigrants. The aim of this study is to thoroughly research the sociocultural variables that influence the treatment and rehabilitation process of immigrant patients and to analyse the perceived sociocultural barriers which arise in their management by a multi-disciplinary team, as well as the strategies that have been put in place to tackle them. Firstly, a descriptive study of the sociodemographic characteristics of the sample immigrant patients from the Hospital Treatment and Rehabilitation Unit (San Miguel Clinic, Madrid). A clinical case of Rumanian origin and gypsy ethnicity was selected in order to study the most relevant sociocultural factors. At the same time, a structured questionnaire was carried out to study the subjective perception of the multidisciplinary team regarding sociocultural barriers relating to the clinical case described and the strategies for tackling said barriers that had been implemented to deal with such difficulties. The questionnaire was answered by all team members. The results clearly demonstrate the importance of the sociocultural dimension in the approach of this type of patient, as well as the subjective team experience and trying to profile action plans which will facilitate treatment, rehabilitation and reintegration