Análisis comparativo de las publicaciones sobre drogodependencias en las revistas de psicología clínica y psiquiatría iberoamericanas indexadas en el Journal Citation Reports

Zusammenfassung

Introduction Drug consumption has become a social problem requiring political, social, and educational intervention in its prevention and treatment. In Latin America, the drug problem is highly related to the violence and the social exclusion of the metropolis. Forty percent of the 15–year–olds already smoke. On average, each person in the general population consumes approximately 6 kg of alcohol per year: the highest value in the less developed world. Meanwhile, in Spain, over a million people experience significant difficulties related to drug consumption (not including the effects of tobacco) in relation to health, family, labor, and social issues. In 2006, one out of 10 young people between the ages 14 and 18 consumed alcohol in an abusive manner more than four or five days per month. Drug consumption is a very complex, multi–factor issue with multiple economic, social, cultural, and personal implications. The most visible negative effects are observed in health issues and personal relationships. In the public scope, the most negative effects are related to important direct and indirect economic expenses, including the treatment and prevention of drug dependency, the reduction in labor productivity, the increase in charity, the fight against the delinquency, and the trafficking of drugs. The present study examines whether or not there is a correspondence between the social, public health, and political importance of drug dependency and the basic and applied research in Spanish and Latin American scientific literature. There are two objectives for this investigation: first, to quantify the scientific investigation of drug dependency in the last four years in Latin American clinical psychology and psychiatry journals, included in the Journal Citation Reports (JCR). The second objective is to state the differences between the journals in relation to the applied methodology, the type of sample used, and the principal topic of discourse. Method The units of analysis were articles published by journals selected between the years 2005 and 2008. The following journals were included: Revista Internacional de Psicología Clínica y de la Salud / International Journal of Clinical and Health Psychology, Salud Mental, Revista Argentina de Clínica Psicológica, Revista Latinoamericana de Psicopatología Fundamental, Actas Españolas de Psiquiatría, Arquivos de Neuro–Psiquiatria, Revista Brasileira de Psiquiatria, and Revista de Psiquiatria Clinica. All articles of theoretical or empirical character whose title indicated the topic of drug dependency were included in this descriptive study of document analysis. The articles were analyzed and compared on the basis of five variables: the number and proportion of articles on drug dependency and substance abuse in relation to the total number of articles published by each journal during the given time period; the type of methodology; the type of sample; the type of drug studied; and the central findings. Results Out of 2246 articles published between the years 2005 and 2008 by the eight journals analyzed, 152 were about drug dependency. This value represents 6.77% of the total of the documents published. Of these 152 articles, 133 came from psychiatry journals and 19 came from clinical psychology journals. These findings imply that, out of the total of the articles published, 5.92% correspond to articles on drug dependency in the psychiatry journals and 0.85% in the clinical psychology journals. Among the clinical psychology journals, it is observed that the International Journal of Clinical and Health Psychology has published the most articles on drug dependency, with 8%. With regards to the psychiatry journals, the most articles related to drug dependency were found in the Revista de Psiquiatría Clínica, with 21.65%. The methodology most used in the total 152 articles was ex post facto (34.21%), followed by theoretical studies (30.26%), and surveys with probabilistic samples (12.50%). In turn, in the field of psychiatry and in clinical psychology, the methodology used most was ex post facto studies. The type of sample used most in all of the articles was formed by people who consumed some kind of drug (including alcohol and tobacco) (32.24%), followed by studies without samples (such as theoretical revisions) (26.32%). Generally, alcohol was the drug most studied (33.08%), followed by tobacco (15.04%), and cocaine (9.02%). It is necessary to emphasize that 38.16% of these studies did not concentrate on a single type of substance/drug; on the contrary, they analyzed general drug dependency. The central topics of these articles related drug dependency to treatment, comorbid psychopathology, epidemiology, associated beliefs and attitudes, neurological risks of drug consumption, delinquency, gender differences, and psychological variables of personality. Discussion The results obtained indicate a disconnection between the amount of Latin American scientific research on drug dependency in the fields of psychiatry and clinical psychology and the relevance of drug addictions in the present public health context. Only seven out of every 100 articles published and indexed in Spanish and Latin American journals in the JCR are dedicated to the study of drug dependency. In this case, basic and applied investigation in psychiatry and clinical psychology does not correspond to the social, public health, and educational needs of the population with respect to drug dependency. Consequently, political action would be weakly based on scientific models of prevention and intervention, thus explaining why its expected effectiveness and efficiency would be very low. When the two areas of knowledge are examined separately, the numbers vary slightly. In the clinical psychology journals, one out of every 100 articles focus on drug dependency. In the psychiatry journals, five out of every 100 documents refer to drug dependence. With respect to methodology, ex post facto has been used the most. The greatest contribution of this type of study comes from clinical psychology journals. Meanwhile, the psychiatry journals have contributed more towards studies of theoretical character. The most common type of sample in these publications is constituted by consumers of some type of substance. The low percentage of studies carried out with a risk population (adolescents) in the psychiatry journals in comparison to that percentage in the clinical psychology journals should be noted. The most studied aspect of drug dependency was treatment. Given the high level of national investment of resources in the prevention and treatment of addiction, the verification of therapy effectiveness should be a high–priority subject of investigation. It should be brought to attention that there are not studies that evaluate the effectiveness of prevention strategies for drug dependency. Most articles discuss drugs in general or refers to several substances. When the study concerns a particular drug, alcohol has been investigated the most. Although alcohol is a more socially acceptable and easily accessible drug, it can be very detrimental for consumers. In conclusion, the present bibliographical study demonstrates that the publication of scientific articles regarding drug dependency in Spanish and Latin American journals of psychiatry and clinical psychology is relatively low in relation to the social, public health, and political repercussions of the topic. The results call attention to the high degree of theorizing in psychiatric investigation and, to a lesser extent, in psychological research, in which empirical studies were represented by a majority of ex post facto studies. Alcohol is the drug most studied; and although it can have very negative consequences, these effects are usually ignored. The most investigated topic is the treatment of addiction, but investigators have ignored the development and evaluation of preventive strategies.