Trastornos adictivos最新文献

{"title":"OnabotulinumtoxinA vs Sacral Neuromodulation on Refractory Urgency Urinary Incontinence in Women: A Randomized Clinical Trial.","authors":"Cindy L Amundsen, Holly E Richter, Shawn A Menefee, Yuko M Komesu, Lily A Arya, W Thomas Gregory, Deborah L Myers, Halina M Zyczynski, Sandip Vasavada, Tracy L Nolen, Dennis Wallace, Susan F Meikle","doi":"10.1001/jama.2016.14617","DOIUrl":"10.1001/jama.2016.14617","url":null,"abstract":"<p><strong>Importance: </strong>Women with refractory urgency urinary incontinence are treated with sacral neuromodulation and onabotulinumtoxinA with limited comparative information.</p><p><strong>Objective: </strong>To assess whether onabotulinumtoxinA is superior to sacral neuromodulation in controlling refractory episodes of urgency urinary incontinence.</p><p><strong>Design, setting, and participants: </strong>Multicenter open-label randomized trial (February 2012-January 2015) at 9 US medical centers involving 381 women with refractory urgency urinary incontinence.</p><p><strong>Interventions: </strong>Cystoscopic intradetrusor injection of 200 U of onabotulinumtoxinA (n = 192) or sacral neuromodulation (n = 189).</p><p><strong>Main outcomes and measures: </strong>Primary outcome, change from baseline mean number of daily urgency urinary incontinence episodes over 6 months, was measured with monthly 3-day diaries. Secondary outcomes included change from baseline in urinary symptom scores in the Overactive Bladder Questionnaire Short Form (SF); range, 0-100, higher scores indicating worse symptoms; Overactive Bladder Satisfaction questionnaire; range, 0-100; includes 5 subscales, higher scores indicating better satisfaction; and adverse events.</p><p><strong>Results: </strong>Of the 364 women (mean [SD] age, 63.0 [11.6] years) in the intention-to-treat population, 190 women in the onabotulinumtoxinA group had a greater reduction in 6-month mean number of episodes of urgency incontinence per day than did the 174 in the sacral neuromodulation group (-3.9 vs -3.3 episodes per day; mean difference, 0.63; 95% CI, 0.13 to 1.14; P = .01). Participants treated with onabotulinumtoxinA showed greater improvement in the Overactive Bladder Questionnaire SF for symptom bother (-46.7 vs -38.6; mean difference, 8.1; 95% CI, 3.0 to 13.3; P = .002); treatment satisfaction (67.7 vs 59.8; mean difference, 7.8; 95% CI, 1.6 to 14.1; P = .01) and treatment endorsement (78.1 vs 67.6; mean difference; 10.4, 95% CI, 4.3 to 16.5; P < .001) than treatment with sacral neuromodulation. There were no differences in convenience (67.6 vs 70.2; mean difference, -2.5; 95% CI, -8.1 to 3.0; P = .36), adverse effects (88.4 vs 85.1; mean difference, 3.3; 95% CI, -1.9 to 8.5; P = .22), and treatment preference (92.% vs 89%; risk difference, -3%; 95% CI, -16% to 10%; P = .49). Urinary tract infections were more frequent in the onabotulinumtoxinA group (35% vs 11%; risk difference, -23%; 95% CI, -33% to -13%; P < .001). The need for self-catheterization was 8% and 2% at 1 and 6 months in the onabotulinumtoxinA group. Neuromodulation device revisions and removals occurred in 3%.</p><p><strong>Conclusions and relevance: </strong>Among women with refractory urgency urinary incontinence, treatment with onabotulinumtoxinA compared with sacral neuromodulation resulted in a small daily improvement in episodes that although statistically significant is of uncertain clinical importance. In ","PeriodicalId":89512,"journal":{"name":"Trastornos adictivos","volume":"3 1","pages":"1366-1374"},"PeriodicalIF":29.0,"publicationDate":"2016-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5399419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78598844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La comunidad terapéutica para los trastornos por uso de sustancias en adolescentes","authors":"A. Robert,&nbsp;J.M. Illa,&nbsp;M.E. Navarro","doi":"10.1016/S1575-0973(12)70054-5","DOIUrl":"10.1016/S1575-0973(12)70054-5","url":null,"abstract":"<div><p><span><span>The residential treatment of adolescent substance abuse is a growing interest area to explore in depth. Most of the few studies conducted to date have used very specific samples, so that the generalization of results is not possible. The aim of this study is to update knowledge about </span>therapeutic communities<span> and its effectiveness, taking into account the profile of young people admitted to treatment. A systematic review<span> was conducted using Medline, PsycINFO and Cochrane Library databases. Additional references from the bibliographies of selected articles were also included to review. Despite the methodological limitations of the studies, the therapeutic community is effective in treating adolescents with moderate/severe drug consumption, who need an intensive, comprehensive and time-sustained intervention. To preserve the post-treatment benefits, and so as to prevent future relapses in drug use, continuity of care in community services is crucial.</span></span></span><span></span></p></div>","PeriodicalId":89512,"journal":{"name":"Trastornos adictivos","volume":"14 4","pages":"Pages 112-117"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1575-0973(12)70054-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56515538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Las comunidades terapéuticas como tratamiento para las drogodependencias: una revisión sistemática del seguimiento a corto plazo","authors":"O. Lopez-Fernandez,&nbsp;E. Román-Jiménez,&nbsp;N. Castello-Cullell,&nbsp;M. García-Claver","doi":"10.1016/S1575-0973(12)70055-7","DOIUrl":"10.1016/S1575-0973(12)70055-7","url":null,"abstract":"<div><h3>Objetive</h3><p>The therapeutic communities (TC) constitute one of the most extensive treatments for the drug dependencies; however, its investigation is scarce. The aim to do a systematic review to know the methodological elements of the short term follow-up studies and, at the same time, describe the consequences of the TC.<span></span></p></div><div><h3>Material and method</h3><p>It was applied the “Preferred Reporting Items for Systematic reviews and meta-Analyses” (PRISMA) for the search in Medline, PsycINFO, PsycARTICLES and PsycCRITIQUES, in order to locate short-term follow-up studies of TC between 1980 and 2010.</p></div><div><h3>Results</h3><p>The follow-up consists in an initial register and, at least, another to half year of treatment; the minimum sample contains 60 users with a greater prevalence of single men; 50% continues in follow-up and/or reaches the abstinence.</p></div><div><h3>Conclusion</h3><p>The TC seem to be beneficial for the adjustment of the consumption and other psychosocial aspects, although lacking information difficult the comparability of these findings.</p></div>","PeriodicalId":89512,"journal":{"name":"Trastornos adictivos","volume":"14 4","pages":"Pages 118-125"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1575-0973(12)70055-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56515546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Análisis de las propiedades psicométricas de la versión en español del Internet Addiction Test","authors":"D.X. Puerta-Cortés ,&nbsp;X. Carbonell ,&nbsp;A. Chamarro","doi":"10.1016/S1575-0973(12)70052-1","DOIUrl":"10.1016/S1575-0973(12)70052-1","url":null,"abstract":"<div><h3>Objective</h3><p>. The <em>Internet Addiction Test</em> (IAT) has been adapted to different languages, becoming one of the most used questionnaires to assess symptoms of Internet addiction. However, the Spanish language version lacks psychometric studies online applications. The aim of the study was to analyze the psychometric characteristics of the Spanish language version of the IAT.</p></div><div><h3>Material and method</h3><p>. 1117 users online Colombian national questionnaire completed demographic and Internet use and the IAT. Reliability was established with Cronbach's alpha coefficient and to analyze the structure of the test was applied exploratory factor analysis.</p></div><div><h3>Results</h3><p>The results showed a high internal consistency of the test. Three factors were extracted (consequences of Internet use, cognitive-emotional dimension and time control) that correlated positively with hours of daily access to the network and negatively with age.</p></div><div><h3>Conclusion</h3><p>The spanish language version of the IAT has demonstrated high reliability and is an appropriate instrument to assess the impact of Internet use on social interactions and the influence of Internet use in daily life. Further research is recommended to test the underlying dimensions.</p></div>","PeriodicalId":89512,"journal":{"name":"Trastornos adictivos","volume":"14 4","pages":"Pages 99-104"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1575-0973(12)70052-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56515507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estudio exploratorio del impacto de las creencias nucleares relacionadas con la adicción en el consumo tras la abstinencia","authors":"J.M. Martínez González ,&nbsp;A. Verdejo García ,&nbsp;E. Becoña Iglesias","doi":"10.1016/S1575-0973(12)70053-3","DOIUrl":"10.1016/S1575-0973(12)70053-3","url":null,"abstract":"<div><h3>Objetive</h3><p>The aim of this study was to determine whether there are differences in the degree to which substance abusing patients identify themselves with core addiction beliefs immediately before a consumption episode (retrospectively assessed) vs. some days afterwards.</p></div><div><h3>Material and method</h3><p>The sample was composed by 29 individuals diagnosed with alcohol or cocaine dependence (75.9 % males and 24.1 % females) that were following outpatient treatment for at least two months. We asked the patients to answer the questionnaire in a way that allowed them to implement a strategy to detect and inoculate these core beliefs that negatively impact abstinence maintenance.</p></div><div><h3>Results</h3><p>Showed significant differences in the degree to which patients identify themselves with beliefs before vs. after the consumption episode. These results were significant both in regards to beliefs associated with addiction and to beliefs associated with the decision to give-up consumption.</p></div><div><h3>Conclusion</h3><p>We conclude that the existence of core addiction beliefs may predispose to consumption, with particular relevance of the beliefs associated with the decision to give-up consumption, since they are not easily verbalized thru therapy.</p></div>","PeriodicalId":89512,"journal":{"name":"Trastornos adictivos","volume":"14 4","pages":"Pages 105-111"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1575-0973(12)70053-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56515525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TDAH en pacientes con adicción a sustancias: análisis de la prevalencia y de los problemas relacionados con el consumo en una muestra atendida en un servicio de tratamiento ambulatorio","authors":"E. Torrico Linares ,&nbsp;A. Vélez Moreno ,&nbsp;E. Villalba Ruiz ,&nbsp;F. Fernández Calderón ,&nbsp;A. Hernández Cordero ,&nbsp;J. Ramírez López","doi":"10.1016/S1575-0973(12)70050-8","DOIUrl":"10.1016/S1575-0973(12)70050-8","url":null,"abstract":"<div><p>Existing comorbidity between substance use disorders and attention-deficit/hiperactivity disorder has been noted for several authors. The aim of this paper is to analyze the prevalence and severity of ADHD compared to patients without ADHD in a sample of patients treated in an outpatient drug addiction services.</p></div><div><h3>Material and methods</h3><p>Sample is composed of 162 patients from Drug Abuse Services of Huelva (Spain). The assessment tool for the severity of SUD was the semi-structured interview EuropASI. The quality of life scores were obtained by administering the TECVASP. For the screening of ADHD it was used the ASRS 1.1.</p></div><div><h3>Results</h3><p>ADHD prevalence was 27.8% in the total sample. Prevalence among alcohol consumers was 33.3%, among cocaine consumers was 42.2%, among cannabis consumers was 48.9%, and heroin consumers showed a 13.3%. ADHD patients showed worse quality of life, and greater severity in drug profile, social and familiar relationships and psychiatric statement.</p></div><div><h3>Conclusions</h3><p>The results obtained underscore the convenience of a detailed evaluation from therapist. It should be considered the complications of a potential dual diagnosis in terms of gravity of consumption, social difficulties and severity of general psychiatric statement.</p></div>","PeriodicalId":89512,"journal":{"name":"Trastornos adictivos","volume":"14 3","pages":"Pages 89-95"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1575-0973(12)70050-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56515492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a short Spanish version of the UPPS-P impulsive behaviour scale","authors":"A. Cándido ,&nbsp;E. Orduña ,&nbsp;J.C. Perales ,&nbsp;A. Verdejo-García ,&nbsp;J. Billieux","doi":"10.1016/S1575-0973(12)70048-X","DOIUrl":"10.1016/S1575-0973(12)70048-X","url":null,"abstract":"<div><h3>Aim</h3><p><span><span>Impulsivity is a multifaceted construct that has a prominent role in </span>psychiatry and especially in addiction. The objective of the current study is to develop and validate a Spanish version of the short UPPS-P impulsive behavior scale</span>¹<span>, which assesses five distinct impulsivity traits (positive urgency, negative urgency, lack of premeditation, lack of perseverance, and sensation seeking).</span></p></div><div><h3>Material and methods</h3><p>One hundred and eighty-nine participants were included in the study. Confirmatory factor analyses supported the five-factor model of the original scale.</p></div><div><h3>Results</h3><p>The results indicated good internal reliability. External validity was supported by specific relationships with a scale assessing emotion regulation strategies.</p></div><div><h3>Conclusion</h3><p>Accordingly, the short Spanish version of the UPPS-P scale presents good psychometric properties and may be considered a promising instrument for both research and clinical practice.</p></div>","PeriodicalId":89512,"journal":{"name":"Trastornos adictivos","volume":"14 3","pages":"Pages 73-78"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1575-0973(12)70048-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56515470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impulsividad, comorbilidad e impacto de los tratamientos: del desarrollo de instrumentos a la satisfacción del usuario","authors":"A. Verdejo-García ,&nbsp;Ó. Lozano","doi":"10.1016/S1575-0973(12)70046-6","DOIUrl":"10.1016/S1575-0973(12)70046-6","url":null,"abstract":"","PeriodicalId":89512,"journal":{"name":"Trastornos adictivos","volume":"14 3","pages":"Page 65"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1575-0973(12)70046-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56515446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Encuesta sobre la satisfacción de los pacientes dependientes de heroína de la Comunidad de Valencia con los centros de tratamiento con metadona","authors":"J. Pérez de los Cobos ,&nbsp;J.C. Valderrama ,&nbsp;S. Valero ,&nbsp;N. Sánchez ,&nbsp;I. Gich ,&nbsp;J. Trujols","doi":"10.1016/S1575-0973(12)70047-8","DOIUrl":"10.1016/S1575-0973(12)70047-8","url":null,"abstract":"<div><h3>Objective</h3><p>To multidimensionally assess heroin-dependent patients’ satisfaction with methadone treatment centres from Valencia Region (Spain).</p></div><div><h3>Method</h3><p>An independent interviewer recruited 278 consecutively arriving patients from 12 randomly selected centres (9 conventional centres and 3 mobile methadone clinics) to participate in a survey that included the Verona Service Satisfaction Scale for Methadone Treatment (VSSS-MT).</p></div><div><h3>Results</h3><p>One hundred sixty-six (59.7%) patients agreed to participate. Mean overall VSSS-MT score was 3.5 (SD<!--> <!-->=<!--> <!-->0.6), on a 1–5 point scale (1 = terrible; 5 = excellent). The percentage of patients who felt satisfied (VSSS-MT scores &gt; 3) was, by category: overall satisfaction, 82.4%; basic interventions, 80.6%; specific interventions, 59.2%; social worker skills, 66.3%; psychologist skills, 71.6%. In a multiple regression analysis, methadone take-home privileges, lower number of days from the last dose adjustment, and being treated in a conventional (not mobile) methadone clinic appeared as independent predictors of satisfaction with methadone maintenance treatment. This regression model accounted for 9% of the variance in VSSS-MT overall scores.</p></div><div><h3>Conclusions</h3><p>The survey results show that heroin-dependent patients from Valencia Region are slightly satisfied with methadone treatment centres. The variables most strongly related to this satisfaction accounted for only a limited amount of the variance in VSSS-MT overall scores.</p></div>","PeriodicalId":89512,"journal":{"name":"Trastornos adictivos","volume":"14 3","pages":"Pages 66-72"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1575-0973(12)70047-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56515459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medida de la eficiencia técnica de programas de tratamiento con opiáceos: utilidad del modelo Data Envelopment Analysis (DEA)","authors":"F. González-Saiz ,&nbsp;T. García-Valderrama","doi":"10.1016/S1575-0973(12)70049-1","DOIUrl":"10.1016/S1575-0973(12)70049-1","url":null,"abstract":"<div><h3>Aim</h3><p>To assess the usefulness of the mathematical model Data Envelopment Analysis (DEA) to measure the efficiency of opioid substitution programs (OSP).</p></div><div><h3>Material and Methods</h3><p>A simulation study was conducted based on a series of assumptions that are tested using non-real data imputed from theoretical background. Fifteen hypothetical OSP are compared to estimate their relative efficiency. We obtained six variables from each program, three of which are considered input indices (therapists/patients ratio, number of treatment units and proportion of patients with adequate opioid doses), and the other three are considered output indices (number days of heroin abstinence in the last month, retention rates and degree of recovery from drug-use related problems). The data set was subjected to DEA analyses.</p></div><div><h3>Results</h3><p>The DEA model ranked the OSP as a function of their efficiency levels. Programs P8, P9, P11, P5 and P6 were considered inefficient and the magnitude of the input and output variables were far from optimal achievement. In these analyses, the output variable that yielding a greater efficiency was the number days of heroin abstinence in the last month and the input variable providing greater inefficiency was the proportion of patients with adequate opioid doses.</p></div><div><h3>Conclusion</h3><p>The DEA model yields can be useful to measure the relative efficiency of the OSP. The information provided by the model may be used by OSPs managers to introduce changes in therapeutic processes with the aim of increasing their quality.</p></div>","PeriodicalId":89512,"journal":{"name":"Trastornos adictivos","volume":"14 3","pages":"Pages 79-88"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1575-0973(12)70049-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56515482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}