Types of childhood maltreatment as predictors of posttraumatic stress disorder severity and complex posttraumatic stress disorder in patients with substance use disorders.

Background: Childhood maltreatment (CM) can be divided into: emotional abuse (EA), physical abuse (PA), sexual abuse (SA), emotional neglect (EN), and physical neglect (PN). CM is associated with (Complex)Posttraumatic stress disorder (PTSD/CPTSD) and substance use disorder (SUD).Objective: This cross-sectional study examined the relationships between CM-subtypes with PTSD-severity and CPTSD in patients with SUD-PTSD.Method: Participants (N = 209) were treatment-seeking SUD-PTSD patients who completed the Childhood Trauma Questionnaire-short form, the Clinician-Administered PTSD Scale for DSM-5 and the International Trauma Questionnaire. Regression analyses and a model selection procedure to select an optimal model were used to examine CM-subtypes as predictors of (C)PTSD, adjusted for sex and age.Results: Total CM and all CM-types significantly predicted PTSD-severity in the univariate regression analysis, with EA begin the strongest predictor. In the multiple regression only SA predicted PTSD-severity. Subsequently, model selection indicated that the optimal model to predict PTSD-severity included EA and SA. In the univariate analyses total CM, EA, and PN significantly predicted CPTSD-classification, and total CM and all CM-types significantly predicted CPTSD-severity. In the multiple regression for CPTSD-classification only EA and PA were significant predictors and for CPTSD-severity EA, PA and SA were significant predictors. In post-hoc multiple regression analyses, only EA was a significant predictor of CPTSD-classification and CPTSD-severity. Finally, in the model selection the most parsimonious model only included EA for both CPTSD-classification and CPTSD-severity. Sex was not a moderator in the relationship between CM and PTSD, nor in CM and CPTSD.Conclusions: These findings indicate that for SUD-PTSD patients, several CM-types have predictive value for (C)PTSD-severity, however SA and especially EA appear to contribute to these complaints. Since EA does not constitute an A-criterion, it is generally more overlooked in PTSD treatment. Its impact should therefore be underlined, and clinicians should be attentive to EA in their treatment.

All types of Childhood Maltreatment are associated with PTSD severity.Emotional Abuse and Sexual Abuse are most predictive for PTSD severity.Emotional Abuse is most predictive for CPTSD classification and symptom severity.

Experiencia Del Abordaje Multidisciplinar Aplicado En El Hospital De Día De Neuropsiquiatría Del Hospital Mare De Déu De La Mercè (Años 2015 A 2022) / [Experience of the Multidisciplinary Approach Applied in the Neuropsychiatry Day Hospital of the Mare De Déu Hospital of La Mercè (Years 2015 to 2022)]

Introducción: El hospital de día de Neuropsiquiatría del Hospital Mare de Déu de la Mercè es un recurso sanitario especializado suprasectorial de régimen diurno, que atiende a personas adultas entre los 18 y 65 años de edad, con deterioro cognitivo debido a un daño cerebral sobrevenido, a uso de sustancias, enfermedad de Huntington o demencias neurodegenerativas de inicio precoz. La duración del ingreso es de 90 días y el objetivo principal es rehabilitador. Las terapias impartidas incluyen estimulación cognitiva, manejo de agenda, adaptación al déficit, manejo de la autonomía, terapia física e inclusión social. El objetivo del manuscrito es presentar la experiencia del abordaje multidisciplinar aplicado durante los años 2015 a 2022, y describir su capacidad resolutiva, entendiéndola como la capacidad para mejorar las habilidades cognitivas, la conducta, el equilibrio físico y la funcionalidad de las personas atendidas.Métodos: La información ha sido obtenida a partir de las valoraciones realizadas según los protocolos de evaluación multidisciplinar del hospital. Se ha realizado una estadística descriptiva y se ha utilizado la prueba t para medias de dos muestras emparejadas para evaluar diferencias significativas entre las valoraciones al ingreso y al alta. La muestra es de 435 personas, con una media de edad de 51.54 años, de las cuales 185 (42.53%) son mujeres. Como instrumentos de medida se han utilizado pruebas de despistaje cognitivo, de evaluación de la conducta, de equilibrio y funcionalidad, y un cuestionario de calidad de vida. Resultados: Se incluyeron un total de 435 personas con los siguientes perfiles diagnósticos: daño cerebral sobrevenido (n = 199), deterioro cognitivo asociado a uso de sustancias (n = 103), enfermedad de Huntington (n = 41), demencias degenerativas de inicio precoz (n = 32), deterioro cognitivo asociado al VIH (n = 2) y deterioro cognitivo no especificado (n = 58). ... (AU)

Introduction: The Neuropsychiatry day hospital of the Mare de Déu de la Mercè Hospital is a specialized suprasectorial daytime health resource, which cares for adults between 18 and 65 years of age, with cognitive impairment due to acquired brain damage, substance use, Huntington's disease, and early-onset neurodegenerative dementias. The duration of admission is 90 days and the main objective is rehabilitation. The therapies provided include cognitive stimulation, agenda management, deficit adaptation, autonomy management, physical therapy and social inclusion. The objective of the manuscript is to present the experience of the multidisciplinary approach applied during the years 2015 to 2022, and describe its resolution capacity, understanding it as the ability to improve the cognitive skills, behavior, physical balance and functionality of the people cared for.Methods: The information has been obtained from the assessments carried out according to the hospital's multidisciplinary evaluation protocols. Descriptive statistics were performed and the t test for means of two paired samples was used to evaluate significant differences between the assessments at admission and at discharge. The sample consists of 435 people, with an average age of 51.54 years, of which 185 (42.53%) were women. Cognitive screening tests, behavioral assessment tests, balance and functionality tests, and a quality of life questionnaire have been used as measurement instruments. Results: A total of 435 people were included with the following diagnostic profiles: acquired brain damage (n = 199), cognitive impairment associated with substance use (n = 103), Huntington's disease (n = 41), early-onset degenerative dementias (n = 32), HIV-associated cognitive impairment (n = 2) and unspecified cognitive impairment (n = 58). ... (AU)

[Substance use disorder: Epidemiology, medical consequences and treatment]. / Trastorno por uso de sustancias: epidemiología, complicaciones médicas y tratamiento.

Substance use is a common health problem, and substance use disorder, which is its most severe presentation, is associated with multiple medical consequences and a negative impact on individual and on population health. Substance use disorder needs to be addressed as any chronic medical condition; therefore, it has to be detected at the early stages and has to be properly treated to prevent drug-related harm. Internists should be able to recognize and treat intoxication and abstinence. Internists should also be able to refer the patient to state of the art long term treatment, aimed to detoxification and treatment induction to promote abstinence and prevent relapse. In this narrative review we will discuss substance use epidemiology, its main medical consequences and its treatment, with a focus on alcohol, opiates, cocaine and other stimulants, cannabis and benzodiazepines.

Evaluation of a mobile application for preventing the use of alcohol and other drugs among adolescents / Evaluación de una aplicación móvil para la prevención del consumo de alcohol y otras drogas en adolescentes / Avaliação de aplicativo móvel para prevenção do uso de álcool e outras drogas por adolescentes

ABSTRACT Objective: to evaluate a mobile application developed to prevent the use of alcohol and/or other drugs among adolescent students. Method: methodological study with a quantitative approach carried out from July 2018 to July 2021 based on the stages of Contextualized Learning Design for technology development: analysis, design, development, implementation and evaluation. The content evaluation was carried out by 22 experts. The application's graphic design and usability were tested by 13 teenagers representing the target audience. Results: the mobile application "Educação Para Prevenção" [Education For Prevention] addressed the following psychoactive substances: alcohol, marijuana, cigarettes, ecstasy, crack, cocaine, inhalants (glue and poppers) and amphetamines, dealing with topics such as concepts, physiological and behavioral effects, use during adolescence, prevention and harm reduction strategies. The average Content Validity Index score was 0.87. There was a high level of agreement among adolescents regarding the graphic design and the usability (96.6%) of the application. Conclusion: the results show that the experts and the adolescents considered the application valid, and nurses will be able to use it as a facilitating instrument in health education actions in schools, aiming to prevent the use of alcohol and/or other drugs among adolescents. It is recommended that an intervention study be carried out to evaluate the effect of the technology developed.

RESUMEN Objetivo: evaluar una aplicación móvil desarrollada para prevenir el consumo de alcohol y/u otras drogas por parte de estudiantes adolescentes. Método: estudio metodológico, con enfoque cuantitativo, realizado de julio de 2018 a julio de 2021, basado en las etapas del Diseño Instruccional Contextualizado para la construcción de tecnología: análisis, diseño, desarrollo, implementación y evaluación. La evaluación del contenido se llevó a cabo por 22 expertos. El aspecto gráfico y la usabilidad de la aplicación fueron testeados por 13 adolescentes que representaban al público objetivo. Resultados: la aplicación móvil "Educação Para Prevenção" (Educación para la Prevención) abordó sustancias psicoactivas: alcohol, marihuana, cigarrillos, éxtasis, crack, cocaína, inhalantes (pegamento/lanzaperfume) y anfetaminas, abordando temas como conceptos, efectos fisiológicos y conductuales, uso durante la adolescencia, estrategias de prevención y reducción de daños. El Índice de Validación de Contenido promedio fue de 0,87. Hubo un alto nivel de acuerdo entre los adolescentes sobre el aspecto gráfico y la usabilidad (96,6%) de la aplicación. Conclusión: los resultados demuestran que expertos y adolescentes consideraron válida la aplicación, por lo que los enfermeros podrán utilizarla como instrumento facilitador en acciones de educación en salud en la escuela, con el objetivo de prevenir el uso de alcohol y/u otras drogas entre los adolescentes. Se recomienda realizar un estudio de intervención para evaluar el efecto de la tecnología desarrollada.

RESUMO Objetivo: avaliar um aplicativo móvel desenvolvido para prevenir o uso de álcool e/ou outras drogas por estudantes adolescentes. Método: estudo metodológico, de abordagem quantitativa, realizado no período de julho de 2018 a julho de 2021, baseado nas etapas do Design Instrucional Contextualizado para construção de tecnologia: análise, desenho, desenvolvimento, implementação e avaliação. A avaliação de conteúdo foi realizada por 22 especialistas. O aspecto gráfico e a usabilidade do aplicativo foram testados por 13 adolescentes representantes do público-alvo. Resultados: o aplicativo móvel "EPP: Educação Para Prevenção" abordou as substâncias psicoativas: álcool, maconha, cigarro, ecstasy, crack, cocaína, inalantes (cola e lança-perfume) e anfetaminas, tratando de temas como conceitos, efeitos fisiológicos e comportamentais, uso durante a adolescência, estratégias de prevenção e redução de danos. A média do Índice de Validação de Conteúdo foi de 0,87. Verificou-se elevado nível de concordância entre os adolescentes quanto ao aspecto gráfico e à usabilidade (96,6%) do aplicativo. Conclusão: os resultados demonstram que os especialistas e os adolescentes consideraram o aplicativo válido, e os enfermeiros poderão utilizá-lo como um instrumento facilitador nas ações de educação em saúde na escola, visando à prevenção do uso de álcool e/ou outras drogas entre adolescentes. Recomenda-se a realização de um estudo de intervenção para avaliar o efeito da tecnologia desenvolvida.

Alcohol-involved sexual assault in the US military: a scoping review.

Background: Sexual assault and alcohol use are significant public health concerns, including for the United States (US) military. Although alcohol is a risk factor for military sexual assault (MSA), research on the extent of alcohol-involvement in MSAs has not been synthesised.Objective: Accordingly, this scoping review is a preliminary step in evaluating the existing literature on alcohol-involved MSAs among US service members and veterans, with the goals of quantifying the prevalence of alcohol-involved MSA, examining differences in victim versus perpetrator alcohol consumption, and identifying additional knowledge gaps.Method: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for Scoping Reviews, articles in this review were written in English, published in 1996 or later, reported statistics regarding alcohol-involved MSA, and included samples of US service members or veterans who experienced MSA during military service.Results: A total of 34 of 2436 articles identified met inclusion criteria. Studies often measured alcohol and drug use together. Rates of reported MSAs that involved the use of alcohol or alcohol/drugs ranged from 14% to 66.1% (M = 36.94%; Mdn = 37%) among servicemen and from 0% to 83% (M = 40.27%; Mdn = 41%) among servicewomen. Alcohol use was frequently reported in MSAs, and there is a dearth of information on critical event-level characteristics of alcohol-involved MSA. Additionally, studies used different definitions and measures of MSA and alcohol use, complicating comparisons across studies.Conclusion: The lack of event-level data, and inconsistencies in definitions, measures, and sexual assault timeframes across articles demonstrates that future research and data collection efforts require more event-level detail and consistent methodology to better understand the intersection of alcohol and MSA, which will ultimately inform MSA prevention and intervention efforts.

A total of 34 of 2436 articles identified met inclusion criteria. Studies often measured alcohol and drug use together. Rates of reported military sexual assaults that involved the use of alcohol or alcohol/drugs ranged from 14% to 66.1% (M = 36.94%; Mdn = 37%) among servicemen and from 0% to 83% (M = 40.27%; Mdn = 41%) among servicewomen.More precise prevalence estimates of the intersection between alcohol and military sexual assault were limited due to inconsistencies in the definitions of sexual assault and alcohol use, measures of sexual assault and alcohol use, and timeframe for reporting across studies.Future research should standardise the measures, definitions, and timeframes of sexual assault and alcohol-involvement to allow for a more precise estimation of alcohol-involved military sexual assault. Furthermore, event-level data is needed including amount and timeframe of alcohol consumption, relationship between victim and perpetrator, location of alcohol consumption and military sexual assault, and whether the assault was opportunistic or facilitated, to inform military sexual assault prevention and intervention efforts in the military.

Association Between Suicidal Behaviour and Cannabis and Tranquilizer use, Depression, Aggression and Other Borderline Personality Traits Among Students in Sincelejo, Colombia.

OBJECTIVE: This objective of this study is to examine the association between suicidal behaviour and substance use, depression, aggressiveness and borderline personality traits among adolescents from Sincelejo, a rural city in the north of Colombia. METHODS: This cross sectional study included 352 participants selected by purposive sampling, from a public and a private school located in Sincelejo, Sucre district, in the north of Colombia. Students ages ranged from 12 to 18 years old (mean, 15.09±1.82). The participants completed three screening tools: a socio-demographic questionnaire, a screening instrument to collect information related to the frequency of use of some substances, such as tobacco and cannabis, and a self-report inventory to assess various personality and psychopathology domains. A series of t-tests, ANOVA and linear regression analyses were conducted. RESULTS: Physical aggression (t=7.74; p <0.01), cognitive depression (t=5.03; p <0.01), affective depression (t=8.24; p <0.01), affective instability (t=3.46; p <0.01), few social relationships (t=3.36; p <0.01), self-harm (t=3.45; p<.01), cannabis and tranquilizer use (t=2.83; p <0.05; and t=2.37; p <0.05) had a significant independent relationship with suicidal behaviour. Aggression (t=2.59; p <0.05), components of depression (t=9.03; p <0.01) and borderline personality traits (t=4.12; p <0.01) also predicted suicidal behaviour. CONCLUSIONS: More longitudinal studies are needed in this area to identify the causal relations between the factors studied and the suicidal behaviour of young people in Sincelejo.

Psychological treatment of PTSD with comorbid substance use disorder (SUD): expert recommendations of the European Society for Traumatic Stress Studies (ESTSS).

Background: Post-traumatic stress disorder (PTSD) and substance use disorder (SUD) are often comorbid and difficult to treat. The availability of evidence-based treatment guidelines is very limited and there is significant uncertainty about what best practice looks like.Objective: This paper describes the methodology used to develop expert recommendations for the assessment and psychological treatment of PTSD and comorbid SUD and presents the final recommendations.Methodology: A small committee of experts in the field of PTSD and SUD was formed on behalf of the European Society for Traumatic Stress Studies (ESTSS) Board. The committee developed recommendations based on a two-stage process. In the first stage a systematic review of randomised controlled trials of psychological interventions aimed at treating PTSD-SUD comorbidity was completed, and other recent relevant reviews systematic were also considered. To complement the recommendations based on systematic review, the second stage involved the review and collation of existing guidance, good practice and consensus recommendations made in methodologically rigorous clinical practice guidelines.Results: The two-stage process resulted in 9 recommendations related to assessment and 21 recommendations related to treatment planning and delivery.Conclusions: To our knowledge, this is the first attempt to provide expert recommendations based on a systematic review of the literature and through collation of guidance provided in other authoritative and reliable sources. These expert recommendations will provide helpful guidance to clinicians and service providers in both addiction and mental health settings about appropriate clinical care for those with PTSD SUD comorbidity.

This project aimed to develop expert recommendations for the assessment and psychological treatment of PTSD and comorbid substance use disorder.Trauma-focused psychological intervention combined with treatment for SUD is the most effective treatment for PTSD symptoms and for alcohol use disorder treatment benefits appear to be strongest when combined with alcohol targeted pharmacotherapy.The presence of co-occurring SUD should not prevent or exclude individuals from receiving established evidence-based treatments for PTSD and readiness to engage in evidence-based treatment should be evaluated on an individual basis.

Post-traumatic stress disorder and drug use disorder: examination of aetiological models in a Swedish population-based cohort.

Background: There are two primary phenotypic models of comorbidity between post-traumatic stress disorder (PTSD) and drug use disorder (DUD), i.e. self-medication (PTSD precedes and causes DUD) and susceptibility (DUD precedes and causes PTSD). We sought to clarify the longitudinal relationship between PTSD and DUD, while examining sex differences.Method: We used approximately 23 years of longitudinal data from Swedish population registries to conduct two complementary statistical models: Cox proportional hazard models (N ≈ 1.5 million) and a cross-lagged panel model (N ≈ 3.8 million).Results: Cox proportional hazards models, adjusting for cohort and socioeconomic status, found strong evidence for the self-medication hypothesis, as PTSD predicted increased risk for DUD among both women [hazard ratio (HR) = 5.34, 95% confidence interval (CI) 5.18, 5.51] and men (HR = 3.65, 95% CI 3.54, 3.77), and moreover, that the PTSD to DUD association was significantly higher among women (interaction term 0.68, 95% CI 0.65, 0.71). The results of the susceptibility model were significant, but not as strong as the self-medication model. DUD predicted risk for PTSD among both women (HR = 2.43, 95% CI 2.38, 2.50) and men (HR = 2.55, 95% CI 2.50, 2.60), and HR was significantly higher in men (interaction term 1.05, 95% CI 1.02, 1.08). Investigating the pathways simultaneously in the cross-lagged model yielded support for both pathways of risk. The cross-paths instantiating the susceptibility model (0.10-0.22 in females, 0.12-0.19 in males) were mostly larger than those capturing the self-medication model (0.01-0.16 in females, 0.04-0.22 in males).Conclusions: We demonstrate that the relationship between PTSD and DUD is bidirectional, with evidence that future research should prioritize examining specific pathways of risk that may differ between men and women.

Post-traumatic stress disorder (PTSD) and drug use disorder (DUD) are highly comorbid, and few large population-based longitudinal studies have been conducted to better understand why these disorders co-occur at a rate far greater than chance.We used approximately 23 years of longitudinal data from the Swedish National Registries, in a sample of over 1.5 million people, to look at the prospective relationships between PTSD and DUD, and vice versa.We found evidence for bidirectional risk such that having one disorder increased the future risk for the other disorder, although the effect sizes were higher for PTSD's risk on future DUD, and some patterns differed by sex.

Trastorno por consumo de sustancias en adolescentes: reporte de un caso / Substance use disorders in adolescents: A case report

Introduction: Adolescence is a critical period of development during which young people are vulnerable to engaging in risky be haviors, including drug use. Early use of psychoactive substances can interfere with normal development and have both short-term and long-term social and health problems. Objectives: This case report aims to review important aspects of the substance abuse disorder treatment in teenage patients, based on the detailed description of a clinical case. Methods: Description of a clinical case of an 18-year-old patient who began using psychoactive substances at the age of 13. The information used in the review was gathered from relevant publications found through a selective search in PubMed on substance use disorders in children and adolescents. Results: This case report describes the substance use disorder of an 18-year-old female patient, who began using psychoactive substances at the age of 13. The patient had a history off loss of her mother, depressive symptoms and self-injurious behavior, which likely contributed to her increased risk for substance use. The patient’s substance use began with tobacco and gradually progressed to cannabinoids, ecstasy, opioids, and cocaine. Due to her continued substance use, she was referred for consultation at a specialized treatment team. The patient received a combination of psychotherapeutic interventions for substance use and individual therapy. The plan included also coordination with social work and psychology, and the involvement of the individual’s family in the process.Despite these efforts, the patient was ultimately hospitalized for severe self-harm behaviors and entered a therapeutic community.Discussion and Conclusion: This case highlights the complexity of substance use disorders in adolescents and the importance of addressing multiple individual and environmental factors in order...(AU)

Introducción: La adolescencia es un período crítico del desarrollo durante el cual los jóvenes son vulnerables a adoptar conductas de riesgo, incluyendo el consumo de drogas. El uso temprano de sustancias psicoactivas puede interferir con el desarrollo normal y tener problemas sociales y de salud, tanto a corto como a largo plazo.Metas: Este reporte de caso tiene como objetivo revisar aspectos fundamentales del tratamiento del trastorno por abuso de sustancias en pacientes adolescentes, a partir de la descripción detallada de un caso clínico.Métodos: Descripción de un caso clínico de una paciente de 18 años que empezó a consumir sustancias psicoactivas a partir de los 13 años. La información utilizada en esta revisión se obtuvo de publicaciones relevantes encontradas mediante una búsqueda selectiva, en la plataforma PubMed, sobre trastornos por consumo de sustancias en niños y adolescentes.Resultados: Este reporte de caso describe el trastorno por consumo de sustancias de una paciente de sexo femenino de 18 años, que empezó a consumir sustancias psicoactivas a partir de los 13 años. La paciente tenía antecedentes de pérdida de su madre, síntomas depresivos y comportamiento autoagresivo, que probablemente contribuyó a su mayor riesgo de consumo de sustancias. El consumo de sustancias de la paciente empezó con el tabaco y progresó gradualmente a cannabinoides, éxtasis, opioides y cocaína.Debido al consumo continuado de sustancias, fue derivada a consulta, a un equipo de tratamiento especializado. La paciente recibió una combinación de intervenciones psicoterapéuticas para el uso de sustancias y terapia individual. El plan incluía también la coordinación con trabajo social y psicología, y la participación de la familia en el proceso. A pesar de estos esfuerzos, la paciente finalmente fue hospitalizada por conductas autolesivas severas y ingresó a una comunidad terapéutica.(AU)

Association Between Suicidal Behaviour and Cannabis and Tranquilizer use, Depression, Aggression and Other Borderline Personality Traits Among Students in Sincelejo, Colombia

Objective: This objective of this study is to examine the association between suicidal behaviour and substance use, depression, aggressiveness and borderline personality traits among adolescents from Sincelejo, a rural city in the north of Colombia. Methods: This cross sectional study included 352 participants selected by purposive sampling, from a public and a private school located in Sincelejo, Sucre district, in the north of Colombia. Students ages ranged from 12 to 18 years old (mean, 15.09 ± 1.82). The participants completed three screening tools: a socio-demographic questionnaire, a screening instrument to collect information related to the frequency of use of some substances, such as tobacco and cannabis, and a self-report inventory to assess various personality and psychopathology domains. A series of t-tests, ANOVA and linear regression analyses were conducted. Results: Physical aggression (t = 7.74; p < 0.01), cognitive depression (t = 5.03; p < 0.01), affective depression (t = 8.24; p <0.01), affective instability (t = 3.46; p <0.01), few social relationships (t = 3.36; p < 0.01), self-harm (t = 3.45; p< .01), cannabis and tranquilizer use (t = 2.83; p < 0.05; and t = 2.37; p <0.05) had a significant independent relationship with suicidal behaviour. Aggression (t = 2.59; p <0.05), components of depression (t = 9.03; p <0.01) and borderline personality traits (t = 4.12; p <0.01) also predicted suicidal behaviour. Conclusions: More longitudinal studies are needed in this area to identify the causal relations between the factors studied and the suicidal behaviour of young people in Sincelejo.

Objetivo: El objetivo de este estudio es examinar la asociación del comportamiento suicida con el consumo de sustancias, síntomas depresivos, agresividad y rasgos de personalidad límite en adolescentes de Sincelejo (Sucre), una ciudad rural del norte de Colombia. Métodos: Este estudio transversal incluyó a 352 participantes seleccionados por muestreo intencional de una escuela pública y privada ubicada en Sincelejo, distrito de Sucre, en el norte de Colombia. Las edades de los estudiantes oscilaron entre los 12 y los 18 anos (media, 15,09 ± 1,82). Los participantes completaron 3 instrumentos de cribado: uno de datos sociodemográficos, uno sobre consumo de algunas sustancias, tales como tabaco y cannabis, y su frecuencia y un instrumento de autoinforme para evaluar varios dominios de la personalidad y algunas psicopatologías. Se realizaron una serie de pruebas de la t, ANOVA y análisis de regresión lineal. Resultados: La agresión física (t = 7,74; p <0,01), el componente cognitivo de la depresión (t = 5,03; p <0,01), el componente afectivo de la depresión (t = 8,24; p <0,01), la inestabilidad afectiva (t = 3,46, p < 0,01), las pocas relaciones sociales (t = 3,36, p < 0,01), las autolesiones (p <0,01; t = 3,45, p <0,01), el cannabis (t = 2,83; p <0,05) y la toma de tranquilizantes (t = 2,37; p <0,05), se asociaron con el comportamiento suicida. La agresión (t = 2,59; p <0,05), los componentes de la depresión (t = 9,03; p <0,01) y los rasgos de personalidad límite (t = 4,12, p <0,01) predijeron el comportamiento suicida. Conclusiones: Se requieren más estudios longitudinales en esta área con el fin de identificar las relaciones causales entre los factores estudiados y el comportamiento suicida de los jóvenes en Sincelejo.

Una visión clínica de los síntomas psicóticos inducidos por sustancias en una sala de venopunción supervisada: Una década de experiencia / A clinical view of substance-induced psychotic symptoms in a supervised venipuncture room: A decade of experience

Introducción. Las salas de venopunción supervisadas (MSIR) son centros extremadamente importantes para las personas que usan drogas intravenosas (PWID), ya que las MSIR brindan un lugar sanitariamente seguro para el consumo de sustancias psicoativas ilícitas, teniendo un impacto importante en las tasas de sobredosis y las infecciones virales transmitidas por vía sanguínea. Métodos. Descripción de los síntomas psicóticos inducidos observados en una MSIR y su relación con la sustancia utilizada. El análisis se realizó con datos recopilados entre el 01/01/2009 y el 31/08/2021. Resultados. Se registraron 3731 autoinyecciones (68,7% heroína, 29,1% cocaína, 2,1% speedball y 0,2% otra sustancia) durante el período estudiado. Los síntomas psicóticos solo se observaron en el 7,1% del total de autoinyecciones. Sin embargo, se detectaron grandes diferencias entre las sustancias: el 23,2% de los consumos de cocaína estuvieron relacionados con síntomas psicóticos, el 20,8% de las inyecciones de speedball presentaron síntomas psicóticos y solo el 0,3% de las venopunciones de heroína se relacionaron con síntomas psicóticos (X2 =604.99; p<0.001). Además, algunas variables señalan que los síntomas psicóticos inducidos por sustancias pueden estar asociados con una mayor gravedad clínica. Conclusiones. Los sujetos con consumo de cocaína o speedball que acuden a MSIR pueden presentar síntomas psicóticos inducidos por sustancias, siendo esto un criterio de mayor gravedad clínica. Por lo tanto, los protocolos de las MSIR deben analizarse y adaptarse en función de la sustancia utilizada y la inducción de síntomas psicóticos. Además, se necesita más investigación en esta área. (AU)

Introduction. Medically supervised injecting rooms (MSIRs) are extremely important facilities for people who inject drugs (PWID) as MSIRs provide a safe place for the consumption of street-sourced drugs, impacting overdose rates and viral transmitted infections. Methods. The current paper describes more than 10 years of our MSIR experience regarding psychotic symptoms and their relationship with the substance used. The analysis was performed using data collected between 01/01/2009 and 08/31/2021. Results. 3731 self-injections (68.7% heroin, 29.1% cocaine, 2.1% speedball, and 0.2% other substance) were recorded during the studied period. Psychotic symptoms were only observed in 7.1% of the total self-injections. However, large differences were detected among substances: 23.2% of cocaine consumptions were related to psychotic symptoms, 20.8% of speedball injections presented psychotic symptoms, and only 0.3% of heroin consumptions had psychotic symptoms (X2=604.99; p<0.001). Also, some other variables highlight that psychotic symptoms induced by substances may be associated with higher clinical severity. Conclusions. subjects with cocaine or speedballuse who attend MSIRs may present substance-induced psychotic symptoms, having higher clinical severity. Thus, MSIRs’ protocols should be analyzed and adapted in terms of the substance used and the induction of psychotic symptoms. Moreover, further research is necessary on this critical issue. (AU)

Reframing caring for parents who struggle with substance-use disorders.

Nancy Suchman and the colleagues she influenced have produced ground-breaking and attitude-challenging work in understanding how parenting and substance use come together. Dr Suchman and her colleagues make the claim that there is nothing about a substance-use disorder that precludes effective and sensitive caring for children especially with interventions that focus on the parent-child relationship. Suchman's legacy is to highlight how substance use as an illness pulls individuals away from important, caring relationships and limits their giving themselves to those relationships. Restoring the salience of caring relationships and of the individual's ability to care may be as impactful on their substance use as a strict focus on the reduction of drug use and achieving abstinence.

Nancy Suchman y los colegas sobre quienes ella ha ejercido influencia han producido un trabajo innovador y de reto a las actitudes sobre la comprensión de cómo la crianza y el uso de sustancias conviven juntas. La doctora Suchman y sus colegas insisten en el hecho de que no hay nada acerca del trastorno de uso de sustancias que no permita el cuidado eficaz y sensible para niños, especialmente con intervenciones que se enfocan en la relación progenitor-niño. El legado de Suchman es enfatizar cómo el uso de sustancias como enfermedad aleja a los individuos de relaciones importantes y afectuosas y les limita en el proceso de entregarse a tales relaciones. Restaurar la importancia de relaciones afectuosas y de la habilidad del individuo para mantener una relación afectuosa pudiera ser tan impactante en su uso de sustancias como un enfoque estricto para reducir el uso de drogas y lograr el estado de abstinencia.

Nancy Suchman, et les collègues qu'elle a influencés, a fait un travail novateur et généreusement combatif pour la compréhension de la manière dont le parentage et la toxicomanie se rassemblent. Le docteur Suchman et ses collègues soutiennent qu'il n'y a rien dans un trouble lié à l'usage d'une substance qui empêche le soin efficace et sensible aux enfants, surtout avec des interventions qui se focalisent sur la relation parent-enfant. L'héritage légué par Suchman consiste à mettre en lumière la façon dont la toxicomanie en tant que maladie détache les individus de relations importantes et attentionnées et limite le don qu'ils font d'eux-mêmes à ces relations. Le fait de restaurer la prépondérance de relations attentionnées et la capacité de l'individu à prendre soin peut avoir autant d'impact sur leur toxicomanie qu'une attention stricte à la réduction d'utilisation des drogues et l'atteinte de l'abstinence.

Bringing a mentalizing framework to understanding mothers with addiction: The groundbreaking work of Nancy E. Suchman.

Nancy Suchman is remembered as a pioneer whose mentalization-based intervention-Mothering from the Inside Out (MIO)-transformed the treatment of parents struggling with substance use disorders. Specifically, Suchman's work highlighted the neural mechanisms underlying substance use disorders and identified the promotion of parental mentalizing as a key therapeutic focus in enhancing early parent-child relationships. Her work transformed parenting support models for this population of parents. Several randomized controlled trials (RCT) show the effectiveness of MIO in promoting parental reflective functioning (PRF) and positive relational outcomes in parents with substance use disorders and their children. Suchman's MIO model has since been extended to parenting in many contexts. She is also remembered as a generous colleague, a gifted researcher and clinician, and an inspiration to generations of researchers and practitioners working with parents who aspire to raise healthy, secure children despite multiple challenges and adversities. This special issue compiles the work of researchers inspired by Suchman as they carry on her legacy in examining aspects of parental mentalization. Collectively, the research presented yields confirmation of MIO core assumptions, offers new insights into roles of positive sentiment and savoring in mentalization processes, and presents evaluations of MIO in multiple contexts and with new adaptations.

A Nancy Suchman se le recuerda como una pionera cuya intervención basada en la mentalización-Cuidados Maternales de Dentro hacia Afuera (MIO)- transformó el tratamiento de progenitores luchando con trastornos de uso de sustancias. Específicamente, el trabajo de Suchman enfatizó los mecanismos neurales subyacentes en los trastornos de uso de sustancias e identificó el promover la mentalización del progenitor como un enfoque terapéutico clave para mejorar las tempranas relaciones progenitor-niño. Su trabajo transformó los modelos de apoyo a la crianza para este grupo de progenitores. Varios ensayos controlados al azar muestran la eficacia del MIO en cuanto a promover el funcionamiento con reflexión del progenitor y los resultados de una positiva relación en progenitores con trastornos de uso de sustancias y sus niños. El modelo MIO de Suchman desde su creación ha sido expandido a la crianza en muchos contextos. A ella también se le recuerda como una colega generosa, una investigadora y profesional clínica talentosa y como una inspiración para generaciones de investigadores y practicantes profesionales que trabajan con progenitores que aspiran a criar niños saludables y seguros, a pesar de múltiples retos y circunstancias adversas. Este número especial recopila el trabajo de investigadores inspirados por Suchman a medida que ellos continúan el legado en cuanto a examinar aspectos de la mentalización del progenitor. Colectivamente, la investigación presentada aporta la confirmación de las suposiciones centrales del MIO, ofrece nuevas ideas acerca del papel del sentimiento positivo y el aprecio detenido en los procesos de mentalización, y presenta evaluaciones del MIO en contextos múltiples y con nuevas adaptaciones.

Nous honorons et nous souvenons de Nancy Suchman en tant que pionnière dont l'intervention basée sur la mentalisation - le Maternage de l'Intérieur, en anglais Mothering from the Inside Out (MIO) - a transformé le traitement de parents aux prises avec la toxicomanie. Plus particulièrement le travail de Suchman a mis en lumière les mécanismes neuronaux sous-jacents aux troubles lié à l'usage d'une substance et il a aussi identifié la promotion de la mentalisation parentale comme une cible thérapeutique clé pour l'amélioration des relations précoces parent-enfant. Son travail a transformé les modèles de soutien parental pour cette population de parents. Plusieurs essais contrôlés randomisés montrent l'efficacité du MOI pour la promotion du fonctionnement de réflexion parental et des résultats relationnels positifs pour des parents ayant un trouble lié à l'usage d'une substance et leurs enfants. Le modèle MOI de Suchman a depuis été étendu au parentage dans de nombreux contextes. Nous nous souvenons aussi de Nancy Suchman comme étant une collègue généreuse, une chercheuse et une clinicienne talentueuse et une inspiration pour des générations de chercheurs et professionnels travaillant avec des parents qui aspirent à élever des enfants sécures, en bonne santé, malgré de grands défis et l'adversité à laquelle ils peuvent faire face. Ce numéro spécial compile le travail de chercheurs du monde entier, inspiré par Suchman, alors qu'ils perpétuent son héritage en examinant des aspects de la mentalisation parentale. Collectivement ces recherches compilées ici proposent la confirmation des hypothèses principales du MOI, offrent de nouvelles perspectives quant aux rôles du sentiment positif et du fait de savourer dans les processus de mentalisation et présentent des évaluations du MOI dans des contextes multiples et avec de nouvelles adaptations.

Asociaciones longitudinales entre el rasgo de mindfulness y conductas adictivas en adolescentes / Longitudinal associations between dispositional mindfulness and addictive behaviors in adolescents

La adolescencia es un período vulnerable para el desarrollo de conductas adictivas. El uso de sustancias (US) y el uso problemático deInternet (UPI) generalmente comienzan durante esta etapa de desarrollo. El mindfulness rasgo (MD) se ha propuesto como un factorprotector para los y las adolescentes frente a numerosos problemaspsicológicos. Estudios previos sugieren que la faceta Observar de MDpuede moderar los roles de las otras facetas. El objetivo del presenteestudio fue analizar longitudinalmente si las facetas de MD podíanpredecir niveles más bajos de UPI y US entre los y las adolescentes, yevaluar si la faceta Observar moderaba las asociaciones entre las otrasfacetas de MD y las conductas adictivas. Un total de 836 participantesde entre 11 y 18 años completaron medidas de UPI, US y las cincofacetas de MD. Los resultados indicaron que Actuar con concienciapredijo niveles más bajos de US, Describir predijo un aumento tantode UPI como de US y No juzgar predijo marginalmente niveles másbajos de UPI. Además, la faceta Observar fue beneficiosa frente a UPIcuando se combinó con altos niveles de Actuar con conciencia, perono fue beneficiosa cuando se combinó con altos niveles de Describir.Se discuten las implicaciones y direcciones futuras para el estudio empírico de MD frente a conductas adictivas. (AU)

Adolescence is a vulnerable period for the development of addictivebehaviors, and substance use (SU) and problematic Internet use(PIU) typically start during this developmental stage. DispositionalMindfulness (DM) has been proposed as a protective factor for adolescents against numerous psychological problems. Previous studieshave suggested that the Observing facet of DM may moderate theother facets’ roles. The objective of this study was to longitudinallyanalyze whether the facets of DM could predict lower levels of PIUand SU among adolescents, and to assess whether the Observing facetmoderated the associations between the other facets of DM and addictive behaviors. A total of 836 participants aged 11 to 18 completedmeasures of PIU, SU, and the five facets of DM. The results indicatedthat Acting with Awareness predicted lower SU, Describing predictedan increase in both PIU and SU, and Non-judging marginally predicted lower PIU. Furthermore, Observing was beneficial against PIUwhen combined with high levels of Acting with Awareness, but wasnot when combined with high levels of Describing. The implicationsand future directions for the empirical study of DM against addictivebehaviors are discussed. (AU)

Síndrome de abstinencia asociado al uso recreativo de fentanilo: serie de dos casos / Withdrawal syndrome associated with recreational use of fentanyl: case series

El abuso de sustancias como los opioides ha venido en aumento durante la última década, siendo responsable de gran número de muertes en Estados Unidos. El consumo especialmente de fentanilo se ha convertido en una epidemia que afecta la salud pública y el bienestar socioeconómico de algunos países. Colombia no es ajena a este panorama, y en los últimos años se han descrito casos de consumo de fentanilo como droga de abuso. En este artículo se presentarán dos reportes de casos de uso de fentanilo recreativo parenteral que desarrollaron síndrome de abstinencia y requirieron manejo intrahospitalario en la ciudad de Medellín-Colombia. (AU)

The abuse of substances such as opioids has been increasing over the last decade, being responsible for a large number of deaths in the United States. The consumption, especially of fentanyl, has become an epidemic that affects public health and the socioeconomic well-being of some countries. Colombia is no stranger to this panorama; in recent years, cases of fentanyl consumption as a drug of abuse have been described. In this article, two case reports of parenteral recreational fentanyl use that developed withdrawal syndrome and required in-hospital management in the city of Medellín-Colombia will be presented. (AU)

Adolescentes usuarios de sustancias ingresados en tratamiento: Características y factores asociados a la duración del tratamiento / Substance-using adolescents admitted to inpatient treatment: Characteristics and factors associated with length of time in treatment

Los estudios sobre adolescentes ingresados para tratamiento de uso de sustancias son limitados. Analizamos las características de adolescentes ingresados para tratamiento en un hospital psiquiátrico en Brasil y los factores asociados con la duración de su tratamiento. Métodos: estudio observacional retrospectivo. Analizamos los registros electrónicos de tratamiento de 172 jóvenes (hasta los 17 años de edad) ingresados para tratamiento por uso de sustancias en el Hospital Lacan en Brasil. Resultados: La edad media de los participantes era 15,18 años (SD = 1,39). La muestra era mayoritariamente masculina (68,60%), cuyo ingreso fue involuntario (80,81%), sin escolarizar (89,82%), involucrada en el sistema de justicia penal (59,88%) y proveniente de una familia con problemas relacionados con el uso de sustancias (74,67%). La readmisión como paciente a tratamiento por problemas de uso de sustancias era frecuente. Como media, los adolescentes estuvieron ingresados para tratamiento durante 3 meses. La duración del tratamiento estaba asociada con: admisión involuntaria al tratamiento, reingreso hospitalario para tratamiento, solicitudes de alta del tratamiento por parte de familiares/cuidadores, nivel de estudios, abandono escolar debido a conducta agresiva, y uso de cocaína. Conclusión: Los hallazgos destacan los perfiles complejos de los adolescentes ingresados para tratamiento por el uso de sustancias en Brasil. Es necesaria una colaboración entre los sistemas de salud mental, educación y servicios de justicia para tratar el uso de sustancias entre adolescentes. (AU)

Studies of adolescents receiving inpatient substance use treatment remain limited. We explored the characteristics of adolescents who received substance use treatment as inpatients in a psychiatric hospital in Brazil and factors associated with length of time in this treatment. Methods: A retrospective observational study was performed. Electronic treatment records of 172 young people (aged 17 and below) receiving substance use treatment at Hospital Lacan in Brazil were analysed. Results: The mean age of participants was 15.18 years (SD = 1.39). The sample was characterised as predominately male (68.60%), who entered treatment involuntarily (80.81%), were out of school (89.82%), were involved with the criminal justice system (59.88%) and came from a family with substance use problems (74.67%). Re-admission to inpatient treatment for substance use problems was common. On average, adolescents received inpatient treatment for 3 months. Length of time in treatment was associated with: involuntary admission to treatment, re-admission to inpatient treatment, requests of discharge from treatment by a relative/caretaker, education level, leaving school due to aggressive behaviours and cocaine use. Conclusion: Findings highlight the complex profiles of adolescents receiving substance use treatment in Brazil. Cross-system collaboration between mental health, educational and justice services are needed to treat adolescents’ substanceuse. (AU)

Rasgos de personalidad y psicopatología en adolescentes con adicción a videojuegos / Personality traits and psychopathology in adolescents with videogame addiction

El trastorno por uso de videojuegos se incluyó recientemente en la 11ªedición de la Clasificación Internacional de Enfermedades. Se realizó un estudio transversal en cinco institutos, con una muestra final de 119 alumnos. El 6,4% (n = 23) de los sujetos tenía trastorno por uso de videojuegos. Los adolescentes con trastorno por uso de videojuegos mostraron bajos niveles de consciencia (F = 7,82; p = ,001) y amabilidad (F = 3,31; p = ,041); y puntuaron más alto en inadaptación escolar (SMC; F = 9,230; p < ,001)que los sanos. Obtuvimos dos funciones discriminantes que clasificaban correctamente al 60,5% (Z1 = 0,406 × Sexo + 0,560 × Conciencia - 0,677× SMC; Z2 = 0,915 × Sexo + 0,191 × Conciencia + 0,326 × SMC). Los sujetos con adicción se diferenciaban de los sanos en presentar inadaptación escolar y baja conciencia, mientras que ambos grupos con adicción se diferenciaban en que los alumnos con adicción a videojuegos eran en mayor proporción varones. La probabilidad de trastorno por uso de videojuegos aumentaba si el sujeto era varón (OR [CI 95%] = 4,82 (1,17-19,81); p =,029) con inadaptación escolar (OR [IC 95%] = 1,08 (1-1,17); p = ,047);mientras que el trastorno por uso de sustancias aumentaba si el sujeto presentaba neuroticismo (OR [IC 95%] =1,07 [1-1,14]; p < ,040), desajuste clínico (OR [IC 95%] = 1,10 [1,01-1,20]; p = ,020), inadaptación escolar(OR [IC 95%] = 1,06 [1-1,13]; p = ,048), bajo ajuste personal (OR [IC95%] = 0,94 [0,88-0,99]; p = ,047) y síntomas emocionales (OR [IC 95%]= 0,86 [0,78-0,96]; p = ,006). (AU)

Gaming disorder (GD) was recently included in the 11th edition of theInternational Classification of Diseases. A cross-sectional study was conducted in five secondary schools, with a final sample of 119 students. A diagnosis of GD was made in 6.4% (n = 23) of this sample. Compared with healthy subjects, adolescents with GD showed low levels of conscientiousness(F = 7.82; p = .001) and agreeableness (F = 3.31; p = .041) and scored higherin school maladjustment (SMC; F = 9.23; p < .001). Two discriminating functions were obtained that allowed us to predict patient group allocation with a success rate of 60.5% (Z1 = 0.406 × Sex + 0.560 × Conscientiousness− 0.677 × SMC; Z2 = 0.915 × Sex + 0.191 × Conscientiousness + 0.326 ×SMC). Subjects with addiction differed from healthy subjects in presenting school maladjustment and low consciousness, while both groups of subjectswith addiction differed in that video game addiction was proportionally higher in boys. The probability of GD was higher if subjects were male (OR[95% CI]) = 4.82 [1.17-19.81]; p = .029) and had school maladjustment(OR [95% CI] = 1.08 [1-1.17]; p = .047); while that of substance use disorder was higher if the subjects had neuroticism (OR [95% CI] = 1.07[1-1.14]; p < .040), clinical maladjustment (OR [95% CI] = 1.10 [1.01-1.20]; p = .020), school maladjustment (OR [95% CI] = 1.06 [1-1.13]; p =.048), low personal adjustment (OR [95% CI] = 0.94 [0.88-0.99]; p = .047)and emotional symptoms (OR [95% CI] = 0.86 [0.78-0.96]; p = .006). (AU)

Problemas de comportamento, habilidades sociais, abuso de substâncias e práticas educativas em adolescentes / Behavior problems, social skills, substance abuse and educational practices in adolescents / Problemas de conducta, habilidades sociales, abuso de sustancias y prácticas educativas en adolescentes

A literatura aponta relações entre comportamentos de adolescentes e práticas educativas, mas poucos estudos discriminam o tipo de problema, bem como examinam múltiplas variáveis simultaneamente O objetivo da presente pesquisa foi comparar as habilidades sociais, as práticas educativas e o uso de substâncias de adolescentes com problemas exclusivamente internalizantes ou externalizantes e com comorbidades (internalizante e externalizante) com um grupo de adolescentes sem problemas, em amostras separadas pelo sexo. Os adolescentes foram alocados nos grupos clínico e não clínico a partir do YSR, as variáveis sociais foram investigadas pelo IHSA, o uso abusivo de drogas pelo DUSI, e as práticas educativas pelo IEP. Para comparar os grupos, utilizou-se o Teste Mann Whitney e o qui-quadrado. As variáveis estaticamente significativas foram: habilidades sociais e práticas educativas (para meninos e meninas dos grupos externalizante e comorbidade), uso de drogas (meninas e externalizante); somente práticas educativas (para meninos e meninas do grupo internalizante)

The literature points out relationships between adolescent behavior and educational practices, but few studies specify the type of problem or examine multiple variables simultaneously. The objective was to compare social skills, educational practices and substance use of adolescents with internalizing, externalizing and comorbidity problems with a group of adolescents without problems, in samples separated by sex. The inclusion criteria for the clinical and non-clinical groups was obtained from the YSR, social variables from the SSI-Del-Prette, drugs from the DUSI, and educational practices from the IEP. To compare groups, we used the Mann-Whitney and chisquared tests. The statistically significant variables were: social skills and educational practices (for boys and girls from the externalizing and comorbidity groups), use of drugs (girls and externalizing); only educational practices (for boys and girls from the internalizing group)

La literatura señala relaciones entre los comportamientos de los adolescentes y las prácticas educativas, pero pocos estudios ni discriminan el tipo de problema ni examinan múltiples variables simultáneamente. El objetivo fue comparar habilidades sociales, prácticas educativas, habilidades sociales y consumo de sustancias de adolescentes con problemas de conducta internalización, externalización, comorbilidad, con un grupo de adolescentes sin problemas, en muestras separadas por sexo. El criterio de inclusión para adolescentes en los grupos clínico y no clínico se obtuvo del YSR, las variables sociales del IHSA-Del-Prette, los medicamentos del DUSI y las prácticas educativas del IEP. Para comparar los grupos, se utilizaron las pruebas de Mann-Whitney y chi cuadrado. Las variables estadísticamente significativas fueron: habilidades sociales y prácticas educativas (para niños y niñas de los grupos de externalización y comorbilidad), consumo de drogas (niñas y externalización); solo prácticas educativas (para niños y niñas del grupo internalización)

Análisis factorial confirmatorio dela escala de alexitimia de toronto de20 ítems en pacientes españoles contrastorno por uso de sustancias / Confirmatory factor analysis of 20-item toronto alexithymia scale in spanish patients with substance use disorder

La alexitimia es altamente prevalente en pacientes con trastorno por uso de sustancias (TUS) y ha sido relacionado conla patogénesis y la evolución del TUS. Sin embargo, el instrumento más frecuentemente usado para la medición de laalexitimia (la Escala de Alexitimia de Toronto de 20 ítems- TAS-20) ha sido poco estudiado en cuanto a sus propiedades psicométricas en pacientes con TUS. Solamente cincoestudios han evaluado las características psicométricas de laTAS-20 en pacientes con TUS y ninguno en población española con TUS. Por lo anterior, se realizó un análisis factorialconfirmatorio y de fiabilidad en una muestra de pacientesespañoles con TUS (n=126; 75,4% hombres; edad media de43,7±14,6 años). El análisis factorial confirmatorio se realizóconsiderando que la TAS-20 tiene una estructura de tres factores (Dificultad para Identificar Sentimientos [DIF]; Dificultad para Describir Sentimientos [DDF]; Pensamiento Orientado hacia lo Externo [EOT]). En general, la TAS-20 tiene unaspropiedades psicométricas adecuadas en pacientes españolescon TUS. Sin embargo, el modelo clásico de tres factores dela TAS-20 se ajusta solo moderadamente bien en pacientesespañoles con TUS, siendo los factores DIF y DDF los constructos fiables y válidos, mientras que el factor EOT necesitamás investigación y debe analizarse con cautela en pacientescon adicciones. (AU)

Alexithymia is highly prevalent in patients withsubstance use disorders (SUDs) and has been implied inSUD pathogenesis and treatment outcomes. However, thepsychometric properties of the most-used instrument forevaluating alexithymia (the 20-item Toronto AlexithymiaScale, TAS-20) have been scarcely studied in relation toSUD patients. Specifically, only five psychometric studieshave been performed with samples of SUD patients, andno studies have focused exclusively on Spanish patientswith SUDs. Therefore, the aim of the present study was toexamine the internal accuracy and reliability of the TAS20 with a sample of Spanish SUD patients (n = 126; 75.4%male; mean age 43.7 ± 14.6 years). A reliability analysis and aconfirmatory factor analysis were executed, considering thatTAS-20 has a three-factor structure (difficulty identifyingfeelings [DIF]; difficulty describing feelings [DDF]; externallyoriented thinking [EOT]). The results indicated that TAS20’s psychometric properties are acceptable for assessingalexithymia in Spanish patients with SUDs. However,the three-factor model of TAS-20 was found to fit onlymoderately well with the patient sample, with DIF and DDFbeing the most reliable and valid constructs. In contrast, theEOT factor needs further research and should be cautiouslyanalyzed in the context of patients with addictions. (AU)

Consumo de alcohol y otras drogas en una muestra de soldados del Ejército Brasileño / Consumo de álcool e outras drogas em uma amostra de militares do Exército brasileiro / Alcohol and drug use in a sample of Brazilian Army soldiers

Objective: To identify the pattern of use of alcohol and other drugs and its related sociodemographic variables in a sample of Brazilian Army soldiers. Materials and method: Cross-sectional study conducted with 229 soldiers from an infantry battalion at the Brazilian Army. Data were collected in 2019 with the application of a sociodemographic and employment instrument, the Alcohol Smoking and Substance Involvement Screening Test (ASSIST), and the Pearson correlation test. Results: The prevalence of alcohol use was present in more than half of the studied sample, followed by tobacco and cannabis sativa. Regarding the pattern of use, alcohol (22.2%), tobacco (31%), and cannabis sativa (9.7%) reported significant results. The sociodemographic variables of the individuals in the sample, their educational level (years of schooling), and economic-related issues were the main variables associated to alcohol and drug use. Conclusions: The consumption of alcohol and other drugs by the military is lower than that identified for the general population in the Brazilian territory. The use of psychoactive substances in the military context is often part of an attempt to deal with stress. Therefore, it is necessary to implement strategies aimed at preventing alcohol and drug use and promoting mental health among this population.

Objetivo: identificar el patrón de consumo de alcohol y otras drogas, y sus variables sociodemográficas relacionadas, dentro de una muestra de soldados del Ejército Brasileño. Materiales y método: estudio transversal realizado con 229 soldados de un batallón de infantería. Los datos fueron recolectados en 2019 mediante la aplicación de un instrumento sociodemográfico y laboral, el Alcohol Smoking and Substance Involvement Screening Test (ASSIST) y el test de correlación de Pearson. Resultados: la prevalencia del consumo de alcohol estuvo presente en más de la mitad de la muestra estudiada, seguido del consumo de tabaco y de cannabis sativa. En cuanto al patrón de consumo, destacan el alcohol (22,2%), el tabaco (31%) y el cannabis sativa (9,7%). Las variables sociodemográficas de los individuos de la muestra, su nivel de educación (años de estudio) y determinados aspectos económicos fueron las principales variables asociadas al uso de alcohol y otras drogas. Conclusiones: el consumo de alcohol y otras drogas por parte de militares es menor que el reportado para la población general en Brasil. El uso de sustancias psicoactivas en el contexto de la milicia es generalmente un mecanismo para lidiar con el estrés. Por lo tanto, es necesario implementar estrategias para prevenir el uso de alcohol y otras drogas, así como promover la salud mental en esta población.

Objetivo: identificar o padrão de consumo de álcool e outras drogas e as variáveis sociodemográficas relacionadas em uma amostra de militares do Exército brasileiro. Materiais e método: estudo transversal realizado com 229 militares de um batalhão de infantaria. Os dados foram coletados em 2019 com a aplicação de um instrumento sociodemográfico e laboral, o Alcohol Smoking and Substance Involment Screening Test (ASSIST) e o teste de correlação de Pearson. Resultado: a prevalência do uso de álcool mostrou-se presente em mais da metade da amostra estudada, seguido do tabaco e do uso de cannabis sativa. Com relação ao padrão do uso, foi significativo para as substâncias álcool (22,2%), tabaco (31%) e cannabis sativa (9,7%). As variáveis sociodemográficas, o nível educacional (anos de estudos) e as questões econômicas foram as que apresentaram maior relação com o uso de álcool e outras drogas. Conclusões: o consumo de álcool e outras drogas por militares é menor do que o encontrado na população geral em território brasileiro. O uso de substâncias psicoativas no contexto militar, por vezes, faz parte da tentativa de lidar com o estresse vivenciado. Assim, faz-se implementar estratégias de prevenção do uso de álcool e outras drogas, bem como promover a saúde mental dessa população.