Diferencias epidemiológicas entre dos grupos de pacientes con patología dual grave, unos con esquizofrenia y otros con psicopatologías

Zusammenfassung

Introduction: The term �Dual Pathology� encompasses the comorbidity between one or more severe mental disorders that need psychiatric and psychotherapeutic therapies and pharmacological treatment, associated with the dependency of one or several substances of abuse. Although since the large study in the general population in the United States was done numerous works have been published in different resources of health care networks, it does not happen the same in therapeutic communities aimed at detoxification and rehabilitation of drug addicts who include a high percentage of psychopathology. Objectives: To analyze the social demographic differences, the consumption of abusive substances and psychiatric comorbidity between two groups of drug dependant patients. All have been diagnosed with severe dual pathology, some with schizophrenia and others with different psychopathologies, within a professional therapy community designed to care for their detoxification and rehabilitation. Patients and methods: From June 2000 to June 2009, the professional therapy community �Hacienda de Toros�, Marbella, took in 805 patients of whom 325 met with the established criteria for severe dual diagnosis. We carried out a retrospective and transversal study using the analysis of the information collected in a special model of semi- structured clinical interviews and psychiatric screening. Results: 99 patients, out of a total of 325, diagnosed with severe dual pathology, have schizophrenia, which means 30, 46% of the sample group. 91, 9% of them are men and only 8,1% are women. The sex, the age at the commencement of the study, at which they began to consume substances, the number of hospital admissions, dependence on cannabis, absence of psychopathologies and type of hospital discharge are important differentials in this group of patients with schizophrenia compared with those who do not show this diagnosis. Conclusions: In an adjusted analysis of logistic regression, the men show a greater risk factor, in comparison to the women, of being diagnosed with schizophrenia. Moreover the level of schooling relates to the diagnosis in an inverse way. Those with a higher level of education were less lightly to be diagnosed with psychosis