Adicciones最新文献

{"title":"Smoking cessation treatment attendance among smokers with substance use disorders.","authors":"Gema Aonso-Diego, Alba González-Roz, Sara Weidberg, Gloria García-Fernández, Roberto Secades-Villa","doi":"10.20882/adicciones.1718","DOIUrl":"https://doi.org/10.20882/adicciones.1718","url":null,"abstract":"Send correspondence to: Gema Aonso Diego. Unidad Clínica de Conductas Adictivas, Fac. Psicología, Univ. Oviedo, Plaza Feijoo s/n, 33003 Oviedo, España. Tel. 985104189. Email: aonsogema@uniovi.es Attrition rates pose a considerable problem in smoking cessation intervention, especially with hard-to-treat population (Lappan, Brown & Hendricks, 2019; Lien, Bolstad & Bramness, 2021). In this sense, non-attendance to a smoking cessation treatment decreases effectiveness of these interventions (Garey et al., 2020; Martínez-Vispo, López-Durán, Rodríguez-Cano, Senra & Becoña, 2021), and also brings about several resource-related costs (e.g., therapists time, urinalysis, materials) (Brorson, Arnevik, Rand-hendriksen & Duckert, 2013; Cooper, Kline, Baier & Feeny, 2018). All of the above results in a decrease in the cost-effectiveness of smoking cessation treatments in this population (Cooper et al., 2018). Although multiple researches on dropping out of smoking cessation treatments has been examined in SUD population, to our knowledge, no previous studies have examined specific predictors associated with treatment attendance in this population. Analyzing which factors predict non-attendance is expected to be clinically informative because it will enable to improve the efficacy and cost-effectiveness of existing smoking treatments. Amid this background, this exploratory study sought to examine which baseline variables (i.e., sociodemographic, tobacco, and substance use related variables) were associated with non-attendance to the smoking cessation treatment. This is a secondary study derived from a parent randomized controlled trial (Aonso-Diego, González-Roz, Krotter, García-Pérez & Secades-Villa, 2021). The eligibility criteria were: being ≥ 18 years old, smoking at least 10 cigarettes per day within the last year, and being enrolled in an outpatient substance use treatment. Participants were excluded if they had severe mental disorders (i.e., active psychotic disorder, or suicidal ideation), current cannabis use, or were receiving any other smoking cessation treatment, either psychological or pharmacological. Out of 101 participants who were assessed in an individual baseline interview, 15 were excluded for not meeting inclusion criteria, and a total of 86 patients were assigned to smoking cessation treatment. A binary logistic regression analysis was performed with attrition groups as dependent variable. The independent variables introduced were: sociodemographic (i.e., sex, age, employment status, marital status, and educational level), smoking features (i.e., cigarettes per day, years of regular use, nicotine dependence, urine cotinine levels, previous quit attempts, and current motivation to quit), and substance use related characteristics, that is, primary substance use (cocaine, alcohol, opioids, or cannabis), days of substance abstinence, and days on substance use treatment. Treatment condition [(cognitive-behavioral treatment (CBT) or CBT + contin","PeriodicalId":55560,"journal":{"name":"Adicciones","volume":"34 4","pages":"327-330"},"PeriodicalIF":3.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10335528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Back to content-based validity.","authors":"José Ventura-León","doi":"10.20882/adicciones.1213","DOIUrl":"https://doi.org/10.20882/adicciones.1213","url":null,"abstract":"Letter to the editor.","PeriodicalId":55560,"journal":{"name":"Adicciones","volume":"34 4","pages":"323-326"},"PeriodicalIF":3.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10667847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internet, video game and mobile phone addiction in children and adolescents diagnosed with ADHD: A case-control study.","authors":"A Menéndez-García,&nbsp;A Jiménez-Arroyo,&nbsp;M Rodrigo-Yanguas,&nbsp;M Marin-Vila,&nbsp;F Sánchez-Sánchez,&nbsp;E Roman-Riechmann,&nbsp;H Blasco-Fontecilla","doi":"10.20882/adicciones.1469","DOIUrl":"https://doi.org/10.20882/adicciones.1469","url":null,"abstract":"<p><p>The use of new technologies has become widespread worldwide. There is increasing concern about \"Internet addiction disorder\" (IAD), \"Internet gaming disorder\" (IGD), and \"Mobile phone addiction\" (MPA). Attention Deficit Hyperactivity Disorder (ADHD) has been associated with IAD and IGD. However, evidence is lacking about the relationship between ADHD and MPA. Naturalistic case-control study. 112 patients (51 children with and 61 children without ADHD) between 7 and 17 years old were compared regarding IAD, IGD, and MPA. We used the TEA questionnaire for the assessment of executive function and ADHD (ATENTO), and the ADITEC questionnaire to get gender-differentiated information for IAD, IGD, and MPA. Female children scored higher on MPA (Mean ± Standard Deviation, M ± SD) (25.93 ±  17.64 vs. 14.77 ±  19.43, p=0.03), while male children scored higher on IGD (30.09 ± 21.65 vs. 12.51 ± 16.61, p < 10^-3). Severity of hyperactivity/impulsivity and IGD were moderately correlated (r=0.349, p=0.013), but the correlation disappeared after controlling for the impact on the social domain as measured by the ATENTO questionnaire (r=171, p=0.250). Most parents are concerned that their children may be addicted to IAD/IGD/MPA. Female gender is associated with MPA, while male gender is associated with IGD. ADHD is a risk factor for developing IAD and IGD. Combined type and predominantly hyperactive/impulsive ADHD are each associated with IGD. Good social adjustment protects against developing IGD. There are gender vulnerabilities for IAD/IGD/MPA. ADHD is a risk factor for IGD, but good social adjustment buffers this association.</p>","PeriodicalId":55560,"journal":{"name":"Adicciones","volume":"34 3","pages":"208-217"},"PeriodicalIF":3.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10735256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addictions and COVID-19, the pandemic impact.","authors":"Antonio Varela,&nbsp;Gerardo Flórez","doi":"10.20882/adicciones.1855","DOIUrl":"https://doi.org/10.20882/adicciones.1855","url":null,"abstract":"Received: April 2022; Received: June 2022. Send correspondence to: Gerardo Flórez. Francisco Huertas no 1 6o A 32004 Ourense, Spain. Email: gerardof@mundo-r.com stress disorder, self-harm behaviour or suicide (Dubey et al., 2020; Marel et al., 2021; Shanahan et al., 2019). Studies conducted during the pandemic in the most affected countries have shown high rates of symptoms linked to moderate-severe anxiety, fear of contagion and disorders linked to trauma and depression (Marel et al., 2021; Shanahan et al., 2019). These psychiatric symptoms have been associated with risk factors such as female sex, feelings of loneliness and financial instability, among others (Marel et al., 2021; Shanahan et al., 2019). Such factors are also likely to affect other risk behaviours and generate changes in the consumption of alcohol and other addictive psychoactive substances (Clay & Parker, 2020). It has been shown that an increase in the level of stress and anxiety increases the motivation to use psychoactive substances as a coping mechanism; in this case, it is clear that the global pandemic was a highly stressful event (Marel et al., 2021; Shanahan et al., 2019). It has been argued that the increase in fear and concern regarding the rise of COVID-19 infections would generate an increase in consumption and in the age of onset, while others have suggested that trafficking of illicit drugs, and thus their sale and purchase, would be seriously disrupted during lockdown, thereby leading to a significant reduction in the use of such drugs and with it an increase in withdrawal syndromes (Cisneros & Cunningham, 2021; Dubey et al., 2020; Kumar et al., 2022; Mallet, Dubertret & Le Strat, 2021). It is also understood that COVID-19 disrupts the treatment of As was to be expected, the impact of the SARSCoV2 pandemic and the months-long lockdown it caused brought about changes in the patterns of addictive psychoactive substance use, in other non-substance addictive behaviours and in the population’s mental health (García-Álvarez, Fuente-Tomás, Sáiz, García-Portilla & Bobes, 2020). Since then, numerous studies have been conducted in an attempt to determine the consequences of these changes for the physical and mental health of the population, both general and clinical. This editorial presents the main findings and lessons of this abundant research. In March 2020, the WHO declared the outbreak of SARS-CoV2, which causes the COVID-19 disease, a global pandemic. Governments enforced isolation rules and restrictions on the movement of the population to limit the rise of cases and the associated morbidity and mortality. Spain was one of the worst affected countries and the one that imposed the tightest restrictions in Europe. These restrictions affected the entire population, but the most vulnerable, such as patients with substance use disorders (SUD) or mental health problems, were affected in a way that has not yet been fully understood (Marel, Mills & Teesson, 2021). The menta","PeriodicalId":55560,"journal":{"name":"Adicciones","volume":"34 3","pages":"183-188"},"PeriodicalIF":3.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10702395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between the socio-economic gradient and cigarette consumption in Spain.","authors":"Juan Manuel Martín Álvarez,&nbsp;Jorge Barrientos Marín,&nbsp;José María Millán","doi":"10.20882/adicciones.1403","DOIUrl":"https://doi.org/10.20882/adicciones.1403","url":null,"abstract":"<p><p>The objective of the study was to analyze the relationship between individual socioeconomic characteristics and cigarette consumption in Spain. The sample consisted of 19,931 individuals aged 15 or older who completed the European Health Interview Survey for Spain (EHSS-2014). Variables: prevalence and intensity of cigarette consumption. Multivariate ordered logistic regression analysis was performed with the following socioeconomic variables: social classes, educational attainment, main activity, economic situation and, for the working population, the activity sector. Other control variables were sociodemographic variables and healthy lifestyle habits (physical exercise, diet and alcohol consumption). The factors that relate to greater prevalence are: lower social class, not having university studies, being unemployed, having worse economic situation and working in hospitality industry. On the other hand, the variables related to higher intensity of cigarette consumption of the smoking population are: lower social class, not having university studies, and being neither a student nor on a permanent contract. Regarding control variables, those regressors associated with a higher prevalence and intensity of cigarette consumption are: being male, being aged between 36 and 65, being divorced, having fewer children at home and having worse lifestyle habits.</p>","PeriodicalId":55560,"journal":{"name":"Adicciones","volume":"34 2","pages":"94-109"},"PeriodicalIF":3.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25531401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical practice guideline on pharmacological and psychological management of adult patients with bipolar disorder and comorbid substance use.","authors":"Ana González-Pinto,&nbsp;José Manuel Goikolea,&nbsp;Iñaki Zorrilla,&nbsp;Miquel Bernardo,&nbsp;Manuel Arrojo,&nbsp;Ruth Cunill,&nbsp;Xavi Castell,&nbsp;Elisardo Becoña,&nbsp;Ana López,&nbsp;Marta Torrens,&nbsp;Judit Tirado-Muñoz,&nbsp;Francina Fonseca,&nbsp;Belén Arranz,&nbsp;Marina Garriga,&nbsp;Pilar A Sáiz,&nbsp;Gerardo Flórez,&nbsp;Luis San","doi":"10.20882/adicciones.1528","DOIUrl":"https://doi.org/10.20882/adicciones.1528","url":null,"abstract":"<p><p>This review synthesizes the pharmacological and psychosocial interventions that have been conducted in comorbid bipolar disorder (BD) and substance use disorders (SUDs) while also providing clinical recommendations about which intervention elements are helpful for addressing substance use versus mood symptoms in patients with these co-occurring conditions. The best evidence from randomized controlled trials was used to evaluate treatment options. The strength of recommendations was described using the GRADE approach. Very few of the randomized trials performed so far have provided consistent evidence for the management of both mood symptoms and substance use in patients with a BD. No clinical trials are available for bipolar patients using cannabis. Some treatments have shown benefit for mood symptoms without benefits for alcohol or illicit substance use. Our results suggest that 1) we can (weakly) recommend the use of adjuvant valproate or naltrexone to improve symptoms of alcohol use disorder; 2) Lamotrigine add-on therapy seems to reduce cocaine-related symptoms and is therefore recommended (moderate strength); and 3) Varenicline is (weakly) recommended to improve nicotine abstinence. Integrated group therapy is the most-well validated and efficacious approach on substance use outcomes if substance use is targeted in an initial treatment phase.</p>","PeriodicalId":55560,"journal":{"name":"Adicciones","volume":"34 2","pages":"142-156"},"PeriodicalIF":3.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39027134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical practice guideline on pharmacological and psychological management of adult patients with schizophrenia spectrum disorders and a comorbid substance use.","authors":"Belen Arranz,&nbsp;Marina Garriga,&nbsp;Miquel Bernardo,&nbsp;Ana González-Pinto,&nbsp;Manuel Arrojo,&nbsp;Marta Torrens,&nbsp;Judith Tirado-Muñoz,&nbsp;Francina Fonseca,&nbsp;Pilar A Sáiz,&nbsp;Gerardo Flórez,&nbsp;Jose Manuel Goikolea,&nbsp;Iñaki Zorrilla,&nbsp;Ruth Cunill,&nbsp;Xavi Castells,&nbsp;Elisardo Becoña,&nbsp;Ana López,&nbsp;Luis San","doi":"10.20882/adicciones.1504","DOIUrl":"https://doi.org/10.20882/adicciones.1504","url":null,"abstract":"<p><p>Although correct diagnosis and management of patients with schizophrenia and a comorbid substance use disorder (SUD) would determine a decrease in morbidity and mortality in these patients, development of efficient therapeutic strategies is still pending. We present recommendations on the pharmacological and psychological management of these patients following the 'PICO' structure (Patient-Intervention-Comparison-Outcomes). Evaluation of the quality of studies and summary of the evidence for each question was performed following the recommendations of the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) working group. Our results suggest: 1) In patients with schizophrenia and cannabis use disorder, it is not possible to recommend one antipsychotic drug over another (between olanzapine, risperidone or haloperidol) for improving psychotic symptoms, reducing cannabis use, or improving pragmatic variables (weak recommendation). Clozapine cannot be recommended to reduce cannabis use (weak recommendation). 2) In patients with schizophrenia and cocaine use disorder we recommend haloperidol over olanzapine to reduce craving (moderate recommendation), and olanzapine over haloperidol to improve motor side effects in these patients (moderate recommendation). 3) In patients with schizophrenia and alcohol use disorder while naltrexone is recommended to reduce alcohol use (in terms of reducing alcohol craving) (weak recommendation), there is insufficient evidence to make any recommendation on the use of adjuvant acamprosate (weak recommendation). 4) In patients with schizophrenia and nicotine use disorder, adjuvant bupropion and varenicline are recommended for reducing nicotine use and nicotine abstinence (strong/moderate recommendation). 5) In patients with schizophrenia and polydrug use disorder, second-generation over first-generation antipsychotic drugs and olanzapine over other second-generation antipsychotics are recommended to improve psychotic symptoms (moderate/weak recommendation).</p>","PeriodicalId":55560,"journal":{"name":"Adicciones","volume":"34 2","pages":"110-127"},"PeriodicalIF":3.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25528277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical practice guideline on pharmacological and psychological management of adult patients with attention deficit and hyperactivity disorder and comorbid substance use.","authors":"Ruth Cunill,&nbsp;Xavier Castells,&nbsp;Ana González-Pinto,&nbsp;Manuel Arrojo,&nbsp;Miquel Bernardo,&nbsp;Pilar A Sáiz,&nbsp;Gerardo Flórez,&nbsp;Marta Torrens,&nbsp;Judit Tirado-Muñoz,&nbsp;Francia Fonseca,&nbsp;Belén Arranz,&nbsp;Marina Garriga,&nbsp;Jose Manuel Goikolea,&nbsp;Iñaki Zorrilla,&nbsp;Elisardo Becoña,&nbsp;Ana López,&nbsp;Luis San","doi":"10.20882/adicciones.1569","DOIUrl":"https://doi.org/10.20882/adicciones.1569","url":null,"abstract":"<p><p>Substantial evidence has confirmed the high comorbidity between Attention-Deficit/Hyperactivity Disorder (ADHD) and a substance use disorder (SUD). This review synthesizes the pharmacological and psychosocial interventions conducted in ADHD and SUDs, and provides clinical recommendations using the GRADE approach. Our results suggest: 1) In patients with ADHD and alcohol use, atomoxetine is recommended to reduce ADHD symptoms (weak recommendation) and alcohol craving (weak recommendation). 2) In patients with ADHD and cannabis use disorder, atomoxetine is recommended to improve ADHD symptoms (weak recommendation), not to reduce cannabis use (weak recommendation). 3) In patients with ADHD and cocaine use disorder, methylphenidate is not recommended to improve ADHD symptoms or to reduce cocaine use (weak recommendation). 4) In patients with ADHD and comorbid nicotine use disorder, methylphenidate is recommended to improve ADHD symptoms (weak recommendation). Psychoestimulants, such as methylphenidate or lisdexamfetamine dimesylate, are not recommended to reduce nicotine use (weak recommendation). 5) Regarding patients with ADHD and any SUD, the use of psychostimulants is recommended to improve ADHD symptoms (weak recommendation), not to reduce substance use (weak recommendation) or to improve retention to treatment (strong recommendation). In these patients, the use of atomoxetine is recommended to improve ADHD symptoms (weak recommendation), not to decrease substance use (weak recommendation) or to improve retention to treatment (strong recommendation). Atomoxetine and psychostimulants appear to be safe in patients with any SUD (strong recommendation). Our review suggests the need for more research in this area and for larger, multisite, randomized studies to provide more definite and conclusive evidence.</p>","PeriodicalId":55560,"journal":{"name":"Adicciones","volume":"34 2","pages":"168-178"},"PeriodicalIF":3.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39027137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical practice guideline on pharmacological and psychological management of adult patients with depression and a comorbid substance use disorder.","authors":"Marta Torrens,&nbsp;Judit Tirado-Muñoz,&nbsp;Francina Fonseca,&nbsp;Magi Farré,&nbsp;Ana González-Pinto,&nbsp;Manuel Arrojo,&nbsp;Miquel Bernardo,&nbsp;Belén Arranz,&nbsp;Marina Garriga,&nbsp;Pilar A Sáiz,&nbsp;Gerardo Flórez,&nbsp;José Manuel Goikolea,&nbsp;Iñaki Zorrilla,&nbsp;Ruth Cunill,&nbsp;Xavier Castells,&nbsp;Elisardo Becoña,&nbsp;Ana López,&nbsp;Luis San","doi":"10.20882/adicciones.1559","DOIUrl":"https://doi.org/10.20882/adicciones.1559","url":null,"abstract":"<p><p>Co-occurrence of depression and a substance use disorder (SUD) in patients who present dual diagnoses has been long recognized as an important consideration in clinical practice. This review synthesizes the evidence of pharmacological and psychosocial interventions for comorbid depressive disorders and SUDs while providing clinical recommendations about the best interventions to address these patients. The best evidence from randomized controlled trials was used to evaluate treatment options. The strength of recommendations was described using the GRADE approach. Our results suggest that 1) In patients with depression and alcohol consumption, the administration of non-selective serotonin reuptake inhibitor (SSRI) antidepressants instead of SSRI is recommended for improvement of depressive symptoms (strong recommendation). Neither SSRI (strong recommendation) nor non-SSRI (weak recommendation) antidepressants are recommended for reduction in alcohol consumption. 2) In patients with depression and cannabis use, the use of venlafaxine is not recommended (weak recommendation). 3) In patients with depression and cocaine consumption, the use of SSRI antidepressants for improving depressive symptoms (weak recommendation) or to reduce cocaine use is not recommended (strong recommendation). The use of non-SSRI antidepressants is only recommended for improving depressive symptoms (strong recommendation). 4) The administration of bupropion to reduce nicotine consumption is not recommended (strong recommendation). 5) Regarding psychological treatment, in patients with depression and co-occurring alcohol disorder, both pharmacotherapy and cognitive behavioural therapy have positive effects on internalizing symptoms and in reducing alcohol consumption (weak recommendation). Our review suggests the need for more research in this area and for larger, multisite, randomized studies to provide more definite evidence.</p>","PeriodicalId":55560,"journal":{"name":"Adicciones","volume":"34 2","pages":"128-141"},"PeriodicalIF":3.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25517734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical practice guideline on pharmacological and psychological management of adult patients with an anxiety disorder and comorbid substance use.","authors":"Pilar A Sáiz,&nbsp;Gerardo Flórez,&nbsp;Manuel Arrojo,&nbsp;Miquel Bernardo,&nbsp;Ana González-Pinto,&nbsp;José Manuel Goikolea,&nbsp;Iñaki Zorrilla,&nbsp;Ruth Cunill,&nbsp;Xavier Castells,&nbsp;Elisardo Becoña,&nbsp;Ana López,&nbsp;Marta Torrens,&nbsp;Francina Fonseca,&nbsp;Judit Tirado-Muñoz,&nbsp;Belén Arranz,&nbsp;Marina Garriga,&nbsp;Luis San","doi":"10.20882/adicciones.1548","DOIUrl":"https://doi.org/10.20882/adicciones.1548","url":null,"abstract":"<p><p>This review synthesizes the pharmacological and psychosocial interventions that have been conducted in comorbid anxiety disorders and SUDs while also providing clinical recommendations about which intervention elements are helpful for addressing substance use versus anxiety symptoms in patients with these co-occurring conditions. The best evidence from randomized controlled trials was used to evaluate treatment options. The strength of recommendations was described using the GRADE approach. Clinical trials are only available for posttraumatic stress disorder (PTSD) and for social anxiety. Concerning the comorbid substance use, all the studies have included patients with alcohol use, none of them have dealt with cocaine, cannabis or nicotine use. Although some treatments have shown benefit for anxiety symptoms without benefits for alcohol or other substance use, only limited pharmacological approaches have been assayed (sertraline, desipramine, paroxetine, buspirone, naltrexone and disulfiram). Our results suggest that 1) we can (weakly) recommend the use of desipramine over paroxetine to alleviate symptoms of anxiety in patients with a PTSD and alcohol use; 2) In these patients, the use of naltrexone to reduce symptoms of anxiety is also recommended (weak strength); and 3) SSRI antidepressants vs placebo can be recommended to reduce alcohol use (weak recommendation). Our review highlights the need for more research in this area and for larger, multisite studies with generalizable samples to provide more definite guidance for clinical practice.</p>","PeriodicalId":55560,"journal":{"name":"Adicciones","volume":"34 2","pages":"157-167"},"PeriodicalIF":3.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39027136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}