Comorbidade entre dependência de substâncias psicoativas e transtornos alimentares: perfil e evolução de mulheres em um tratamento específico para dependência química / Comorbidity between psychoactive substance dependence and eating disorders: profile and outcome of women in a specific treatment for chemical dependence

AUTOR(ES)
DATA DE PUBLICAÇÃO

2005

RESUMO

The association between eating disorders and psychoactive substance dependence has often been described in both chemical dependence and eating disorders treatment programs. As studies show great result variability it has been suggested that substance dependent individuals would have frequently associated partial or subclinical eating syndromes. There is virtually no research exploring the impact of such comorbidity in the treatment outcome of chemical dependent individuals. The present study aimed at comparing three groups of psychoactive substance dependent women - those with comorbid clinical eating disorders, those with comorbid subclinical eating condition and those with no comorbid disorder - and describing their outcome in a program targeted for chemical dependent women. METHODS: A total of 80 alcohol and drug dependent women who sought treatment at the Drug Dependent Women Treatment Center (PROMUD) of Clínicas Hospital?s Psychiatry Institute of the University of São Paulo Medical School were studied. Sociodemographic and psychoactive substance use data were collected using a standardized questionnaire. The clinical diagnosis was made using the Structured Clinical Interview for the DSM-IV (SCID) and subclinical diagnosis was made using the Eating Attitude Test (EAT) and the Bulimic Inventory Test of Edinburgh (BITE). Body self-image was assessed using the Body Shape Questionnary (BSQ) and treatment outcome was assessed using the Addiction Severity Index (ASI) and Alcohol Dependence Follow-up Scale (AFS-M and AFS-Drugs). RESULTS: Twenty-seven (33.75%) patients had clinical eating disorders, 17 (21.25%) had subclinical eating condition and 36 (45%) had no comorbid condition. The clinical eating disorder group showed to be significantly younger and had more severe alcohol and drug use. The subclinical group had only a poorer occupational status when compared to the other two groups. One-year follow-up showed significant behavior and eating pattern changes in the subclinical group and body self-image changes in the clinical eating disorder group. No differences were seen as for the length of stay in treatment during the course of a year in the three groups and all patients improved significantly substance use after a 12-month-period, though clinical eating disorder patients had a much slower progress. CONCLUSIONS: The study findings don?t support the assumption that the association between eating disorders affects treatment outcome among substance dependent women, suggesting that a comprehensive approach focusing on the individual?s personal needs and delivered in a customized manner would be more likely to succeed.

ASSUNTO(S)

comorbilidade women. mulheres. substance use disorders transtornos relacionados ao uso de substâncias comorbidity transtornos da alimentação eating disorders resultados de tratamento treatment outcome

ACESSO AO ARTIGO

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