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Vol. 50. Issue 2.
Pages 130-137 (April - June 2021)
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Vol. 50. Issue 2.
Pages 130-137 (April - June 2021)
Original article
DOI: 10.1016/j.rcpeng.2021.05.001
Comorbidity between depressive symptoms and substance use in-patients hospitalized for non-psychiatric diseases
Comorbilidad entre síntomas depresivos y consumo de sustancias en pacientes hospitalizados por enfermedades no psiquiátricas
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Carolina Campuzano-Cortinaa, Luisa María Feijoó-Fonnegraa, Karen Manzur-Pinedaa, María Palacio-Muñoza, Julián Rendón-Fonnegraa, Laura Montoyab, Marie Claire Berrouetc, Diana Restrepod,
Corresponding author
dianarestrepobernal@gmail.com

Corresponding author.
a Estudiante de pregrado de Medicina, Universidad CES, Medellín, Colombia
b Médica psiquiatra, docente de pre y posgrado, Universidad CES, psiquiatra Hospital General de Medellín, Medellín, Colombia
c Médica toxicóloga, Hospital General de Medellín, docente de pre y posgrado de Toxicología, Universidad CES, Medellín, Colombia
d Docente de Psiquiatría pre y posgrado, Universidad CES, Medellín, Colombia
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Tables (4)
Table 1. Sociodemographic characteristics of the study population.
Table 2. Prevalence of lifetime, last three months and daily substance use in hospitalised patients.
Table 3. Intervention required according to substance and score in the ASSIST 3.0 test.
Table 4. Proportion of patients requiring intervention for substance use according to severe depressive symptoms.
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Abstract
Introduction

Epidemiological studies have shown a high prevalence and concurrence between depression and substance use. This is known as “dual diagnosis” and is associated with a worse prognosis for patients.

Objective

To establish the comorbidity between depressive symptoms and substance abuse in patients admitted with acute or chronic diseases to a public hospital.

Methods

A descriptive, cross-sectional study of prevalence which included 296 patients aged 18–65, to whom the PHQ-9 and ASSIST 3.0 scales were applied to determine the prevalence of depressive symptoms and substance abuse. Other clinical and sociodemographic variables were also taken into account.

Results

50.7% were women with a median age of 41 and an interquartile range of 27 years. Moderate-to-severe depressive symptoms were found in 27.4% of the patients. Alcohol was the substance with the highest consumption in the previous 3 months with 53.7%, followed by cigarettes (47.6%), marijuana (26.7%) and cocaine (14.5%). A significant association was found between severe depressive symptoms PHQ-9 ≥ 20 and problematic use of alcohol, marijuana and cocaine (ASSIST score >26); alcohol (RP 27.30, 95% CI [2.37–314.16], P = 0.01); marijuana (RP 15.00, 95% CI [3.46–64.96], P = 0.001) and cocaine (RP 10.65, 95% CI [2.23–51.10], P = 0.01).

Discussion

A high prevalence of depressive symptoms and substance use was found in patients hospitalised for non-psychiatric medical conditions, which worsens the prognosis of the underlying medical condition.

Conclusions

To provide better hospital care for patients, we need to give visibility to the problem of dual pathology. This could be achieved by conducting more related research in these clinical scenarios.

Keywords:
Symptoms
Depression
Substance use
Comorbidity
Dual diagnosis
Resumen
Introducción

Los estudios epidemiológicos muestran una alta prevalencia y concurrencia entre la depresión y el consumo de sustancias, lo cual es denominado «patología dual»; esta comorbilidad implica un peor pronóstico para los pacientes.

Objetivo

Determinar la comorbilidad entre síntomas depresivos y consumo de sustancias en pacientes hospitalizados por enfermedades agudas y crónicas en un hospital público.

Metodología

Estudio descriptivo, transversal, de prevalencia con 296 pacientes con edades entre 18 a 65 años a quienes se les aplicó el PHQ-9 y el ASSIST 3.0 para determinar la prevalencia de síntomas depresivos y consumo de sustancias psicoactivas; además, se tomaron otras variables sociodemográficas y clínicas.

Resultados

El 50,7% fueron mujeres con una edad mediana de 41 años y rango intercuartílico de 27 años. Se encontraron síntomas depresivos moderados-severos en el 27,4% de los pacientes. El alcohol fue la sustancia de mayor consumo en los últimos 3 meses con un 53,7%, seguido por el cigarrillo (47,6%), la marihuana (26,7%) y la cocaína (14,5%). Se encontró asociación significativa entre síntomas depresivos graves PHQ-9 ≥ 20 y uso problemático de alcohol, marihuana y cocaína (puntuación ASSIST > 26); alcohol (RP 27,30, IC del 95%, 2,37-314,16; p = 0,01); marihuana (RP 15,00 IC del 95%, 3,46-64,96; p = 0,001) y cocaína (RP 10,65, IC del 95%, 2,23-51,10; p = 0,01).

Discusión

Se encontró alta prevalencia de síntomas depresivos y uso de sustancias en pacientes hospitalizados por condiciones médicas no psiquiátricas, lo cual empeora el pronóstico de la condición médica de base.

Conclusiones

Para brindar un mejor cuidado hospitalario de los pacientes, se requiere hacer visible el problema de la patología dual, lo cual podría lograrse a partir de más investigación relacionada en estos escenarios clínicos.

Palabras clave:
Síntomas
Depresión
Uso de sustancias
Comorbilidad
Patología dual

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