Medición de la comorbilidad depresiva en drogodependientes: Validez y eficacia diagnóstica del Inventario de Depresión de Beck (BDI-II) en dominicanos con múltiple consumo de sustancias

Zoilo Emilio García-Batista, Kiero Guerra-Peña, Antonio Cano-Vindel, Luisa Marilia Cantisano-Guzmán, Pablo Ezequiel Flores-Kanter, Leonardo Adrián Medrano

Resumen


Abstract: Measurement of depressive comorbidity in drug dependents: Validity and diagnostic efficiency of Beck's Depression Inventory (BDI-II) in Dominicans with multiple substance consumption. The present study proposed two main objectives, a) evaluate the validity of BDI-II for the identification of comorbid depressive symptoms in people with multiple substance abuse (i.e. Known-Groups Validity); and b) verify the diagnostic efficacy of the inventory for the distinction between general population and clinical drug dependents. From a two-stage sampling, a total of 116 Dominicans was selected, of whom 50% were drug-dependent. Analysis of differences between groups and analysis of COR curves were applied. The results show statistically significant and large effect size differences in depression levels in favor of the substance abuse group. In addition, COR curve analyses indicate that depression scores derived from BDI-II have adequate diagnostic performance indices. In short, evidence is provided in favor of the appropriateness and validity of the BDI-II to be applied in a population of drug dependents. 

Keywords: Drug dependents; depression; BDI-II; comorbidity; known-groups validity; COR curves; Dominican Republic.  

Resumen: El presente estudio se propuso como objetivos, a) evaluar la validez del BDI-II para la identificación de sintomatología depresiva comórbida en personas con múltiple abuso de sustancias (i.e. Known-Groups Validity); y b) verificar la eficacia diagnóstica del inventario para la distinción entre población general y drogodependientes clínicos. A partir de un muestreo bietapico, se seleccionó un total de 116 dominicanos de los cuales el 50% era drogodependiente. Se aplicaron análisis de diferencias entre grupos y análisis de curvas COR. Los resultados muestran diferencias estadísticamente significativas, y de tamaño del efecto grande, en los niveles de depresión en favor del grupo de personas con problemática de abuso de sustancias. Además, los análisis de curvas COR indican que los puntajes de depresión derivados del BDI-II presentan índices de rendimiento diagnóstico adecuados. En suma, se aporta evidencia a favor de la adecuación y validez del BDI-II para ser aplicado en población de drogodependientes. 

 Palabras clave: Drogodependencia; depresión; BDI-II; comorbilidad; known-groups validity; curvas COR; República Dominicana.


Palabras clave


Drogodependencia; Depresión; BDI-II; Comorbilidad; Caso-Control; Curvas COR.

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Referencias


American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders. (4th ed., text revision). Washington, DC: American Psychiatric Association.

Amico, K. R., Mugavero, M., Krousel-Wood, M. A., Bosworth, H. B., & Merlin, J. S. (2017). Advantages to Using Social-Behavioral Models of Medication Adherence in Research and Practice. Journal of General Internal Medicine, 33(2), 207–215. doi:10.1007/s11606-017-4197-5

Baggio, S., N'Goran, A. A., Deline, S., Studer, J., Dupuis, M., Henchoz, Y.,... Gmel, G. (2014). Patterns of cannabis use and prospective associations with health issues among young males. Addiction, 109(6), 937-945. doi: 10.1111/add.12490

Beaulieu, T., Ti, L., Milloy, M., Nosova, E., Wood, E., & Hayashi, K. (2018). Major depressive disorder and access to health services among people who use illicit drugs in Vancouver, Canada. Substance Abuse Treatment, Prevention, And Policy, 13(1), [8 pantallas]. doi: 10.1186/s13011-018-0142-9

Beck, A., Steer, R., & Brown, G. (1996). Beck Depression Inventory (second edition) [Inventario de depresión de Beck (segunda edición)]. San Antonio, TX: Psycho-logical Corporation.

Bolton, J. M., Robinson, J. & Sareen, J. (2009). Self-medication of mood disorders with alcohol and drugs in the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Affective Disorders, 155(3), 367–375. doi: 10.1016/j.jad.2008.10.003

Budhwani, H., Hearld, K. R., Milner, A. N., McGlaughlin, E., Charow, R., Rodriguez-Lauzurique, R. M.,… Paulino-Ramirez, R. (2017). Transgender Women’s Drug Use in the Dominican Republic. Transgender Health, 2(1), 188–194. doi: 10.1089/trgh.2017.0032

Castellanos, Y., Ricardo, J., Rodríguez, D., Lugo, A., Hernández, J., & Zouain, J. (2015). Prevalencia de trastornos psiquiátricos a través del MINI en pacientes consumidores de drogas ilícitas y/o alcohol. Anales de Medicina PUCMM, 5(1), 73-82.

Cole, D. A., & Maxwell, S. E. (2003). Testing Mediational Models With Longitudinal Data: Questions and Tips in the Use of Structural Equation Modeling. Journal of Abnormal Psychology, 112(4), 558–577. doi:10.1037/0021-843x.112.4.558

Consejo Nacional para el VIH y el SIDA. (2012). Segunda Encuesta de Vigilancia de Comportamiento con Vinculación Serológica en Poblaciones Claves. Recuperado de http://countryoffice.unfpa.org/dominicanrepublic/drive/CONAVIHSIDASegundaEncuestaVigiliancia.pdf

Crnić, K. B., Todorović, M. M., Marković, S. Z., Kastratović, D. A., & Timotijević, I. P. (2016). Addiction and depression comorbidity approaches. Hospital Pharmacology: International Multidisciplinary Journal, 3(3), 440-446. doi: 10.5937/hpimj1603440C

Dembo, R., M. Krupa, J., Wareham, J., Schmeidler, J., & DiClemente, R. J. (2017). A Multigroup, Longitudinal Study of Truant Youths, Marijuana Use, Depression, and STD-Associated Sexual Risk Behavior. Journal Of Child & Adolescent Substance Abuse, 26(3), 192-204. doi: 10.1080/1067828X.2016.1260510

Ekinci, S., & Kandemir, H. (2015). Childhood trauma in the lives of substance-dependent patients: The relationship between depression, anxiety and self-esteem. Nordic Journal of Psychiatry, 69(4), 249-253. doi: 10.3109/08039488.2014.981856.

El-Hadidy, M. A., & Helaly, A. N. (2015). Medical and psychiatric effects of long-term dependence on high dose of tramadol. Substance Use & Misuse, 50(5), 582-589. doi: 10.3109/10826084.2014.991406

Ersöğütçü, F., & Karakaş, S. A. (2016). Social Functioning and Self-Esteem of Substance Abuse Patients. Archives of Psychiatric Nursing, 30(5), 587–592. doi:10.1016/j.apnu.2016.03.007

Etienne, C. F. (2018). Mental health as a component of universal health. Rev Panam Salud Publica.;42:e140. https://doi.org/10.26633/RPSP.2018.140.

Fooladia, N., Jirdehib, R., & Mohtasham-Amiri, Z. (2014). Comparison of depression, anxiety, stress and quality of life in drug abusers with normal subjects. Procedia-Social and Behavioral Sciences, 159, 712–717.

Gajewski, P. A., Turecki, G., & Robison, A. J. (2016). Differential expression of FosB proteins and potential target genes in select brain regions of addiction and depression patients. PLoS One, 11(8), 1-14. doi: 10.1371/journal.pone.0160355

García-Batista, Z. E., Guerra-Peña, K., Cano-Vindel, A., Herrera-Martínez, S.X., & Medrano, L. A. (2018). Validity and reliability of the Beck Depression Inventory (BDI-II) in general and hospital population of Dominican Republic. PLoS ONE, 13(6), e0199750. doi: 10.1371/journal.pone.0199750

García García, V., Luque, B., Santos Ruiz, M., & Tabernero, C. (2017). La autorregulación emocional en la depresión y el deterioro cognitivo de consumidores de sustancias psicoactivas. Health & Addictions/Salud y Drogas, 17(2), 125-136.

Gönen, M. (2007). Analyzing Receiver Operating Characteristic Curves with SAS. EEUU: SAS Publishing.

Gómez-Coronado, N., Sethi, R., Bortolasci, C. C., Arancini, L., Berk, M., & Dodd, S. (2018). A review of the neurobiological underpinning of comorbid substance use and mood disorders. Journal of Affective Disorders, 241, 388–401. doi: 10.1016/j.jad.2018.08.041

Hair, J. F., Black, W. C., Babin, B. J., Anderson, R. E., & Tatham, R. L. (2006). Multivariate data analysis. EEUU: Uppersaddle River.

Hammond, E. R., Lai, S., Wright, C. M., & Treisman, G. J. (2016). Cocaine use may be associated with increased depression in persons infected with HIV. AIDS and Behavior, 20(2), 345-352. doi: 10.1007/s10461-015-1187-7

Hodgson, K., Almasy, L., Knowles, E. M., Kent, J. J., Curran, J. E., Dyer, T. D.,... Glahn, D. C. (2017). The genetic basis of the comorbidity between cannabis use and major depression. Addiction, 112(1), 113-123. doi: 10.1111/add.13558

Johnson, M. E., Neal, D. B., Brems, C., & Fisher, D. G. (2006). Depression as measured by the Beck Depression Inventory-II among injecting drug users. Assessment, 13(2), 168-177. doi: 10.1177/1073191106286951

Kennett, J., Matthews, S., & Snoek, A. (2013). Pleasure and addiction. Frontiers in Psychiatry, 4. doi: 10.3389/fpsyt.2013.00117

Khalid, S., & Kausar, R. (2016). Protective factors, drug use and depression in young drug users. Journal of Behavioural Sciences, 26(2), 116-134.

Kohn R, Ali A, Puac-Polanco V, Figueroa C, López-Soto V, Morgan K, et al. (2018). Mental health in the Americas: an overview of the treatment gap. Rev Panam Salud Publica.;42:e165. https://doi. org/10.26633/RPSP.2018.165

Koenig-Dzialowski, M., Wainberg, M., Halpern, M., Norcini Pala, A., Matic, R., & Galvez-Castro, W. (2016). Depression, substance abuse and antiretroviral non-adherence among adults with HIV in care at the Clínica de Familia in La Romana, Dominican Republic. The Journal of Global Health, [19 pantallas]. Recuperado de http://www.ghjournal.org/depression-substance-abuse-and-antiretroviral-non-adherence-among-adults-with-hiv-in-care-at-the-clinica-de-familia-in-la-romana-dominican-republic/#

Lai, H. M. X., Cleary, M., Sitharthan, T., & Hunt, G. E. (2015). Prevalence of comorbid substance use, anxiety and mood disorders in epidemiological surveys, 1990–2014: A systematic review and meta-analysis. Drug and alcohol dependence, 154, 1-13.

Lakens, D. (2013). Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Frontiers in Psychology, 4. doi:10.3389/fpsyg.2013.00863

Li, W., & Caltabiano, N. (2017). Prevalence of substance abuse and socio-economic differences in substance abuse in an Australian community-dwelling elderly sample. Health Psychology Open, 4(1), 1-7. doi: 10.1177/2055102917708136

Lister, J. J., Ledgerwood, D. M., Lundahl, L. H., & Greenwald, M. K. (2015). Causal pathways between impulsiveness, cocaine use consequences, and depression. Addictive Behaviors, 41, 411-416. doi: 10.1016/j.addbeh.2014.09.017

Moitra, E., Anderson, B. J., & Stein, M. D. (2016). Reductions in cannabis use are associated with mood improvement in female emerging adults. Depression and Anxiety, 33(4), 332-338. doi: 10.1002/da.22460

Moore, A. A., Neale, M. C., Silberg, J. L., & Verhulst, B. (2016). Substance use and depression symptomatology: Measurement invariance of the Beck Depression Inventory (BDI-II) among non-users and frequent-users of alcohol, nicotine and cannabis. Plos ONE, 11(4), 1-13. doi: 10.1371/journal.pone.0152118

Obasi, E. M., Brooks, J. J., & Cavanagh, M. (2016). The relationship between psychological distress, negative cognitions, and expectancies on problem drinking: exploring a growing problem among university students. Behavior Modification, 40(1-2), 51-69. doi: 10.1177/0145445515601793

Organización Mundial de la Salud. (2016). Substance abuse. Recuperado el 7 de mayo de 2018 de http://www.who.int/topics/substance_abuse/en/

Organización Mundial de la Salud. (2017). Depression and Other Common Mental Disorders: Global Health Estimates. Ginebra: Organización Mundial de la Salud. Recuperado de: http://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER2017.2eng.pdf;jsessionid=357B97A8DD5476990F5778CF6807DAD4?sequence=1

Organización Mundial de la Salud. (2018). Depresión [Nota descriptiva]. Recuperado de http://www.who.int/es/news-room/fact-sheets/detail/depression

Oficina de Naciones Unidas contra la Droga y el Delito. (2015). World Drug Report 2015. (Publicación de las Naciones Unidas, No. E.15.XI.6). Recuperado de www.who.int/bulletin/volumes/82/9/editorial20904html/en

Pordanjani, S. R., Zadeh, H. F., Mousavi, M., Khazaei, S., Sohrabivafa, M., Momenabadi, V.,…Khazaei, Z. (2018). Prevalence and reasons for psychoactive drugs use among university students of Medical Sciences in Yazd, Iran. Iranian Journal of Psychiatry and Behavioral Sciences, 12(1). doi: 10.5812/ijpbs.9384

Rao, U. (2006). Links between depression and substance abuse in adolescents: Neurobiological mechanisms. American Journal of Preventive Medicine, 31(6S1), 161-174. doi: 10.1016/j.amepre.2006.07.002

Seignourel, P. J., Green, C., & Schmitz, J. M. (2008). Factor structure and diagnostic efficiency of the BDI-II in treatment-seeking substance users. Drug and Alcohol Dependence, 93(3), 271–278. doi:10.1016/j.drugalcdep.2007.10.016

Skule, C., Ulleberg, P., Dallavara Lending, H., Berge, T., Egeland, J., Brennen, T., & Landrø, N. I. (2014). Depressive symptoms in people with and without alcohol abuse: factor structure and measurement invariance of the Beck Depression Inventory (BDI-II) across groups. PLoS One, 9(2), e88321. doi: 10.1371/journal.pone.0088321

Sloan, E., Hall, K., Moulding, R., Bryce, S., Mildred, H., & Staiger, P. K. (2017). Emotion regulation as a transdiagnostic treatment construct across anxiety, depression, substance, eating and borderline personality disorders: A systematic review. Clinical Psychology Review, 57, 141-163. doi: 10.1016/j.cpr.2017.09.002

Tabachnick, B. G., & Fidell, L. S. (2007). Using Multivariate Statistics. New York, EEUU: Pearson Education.

Thalheimer, W., & Cook, S. (2002). How to calculate effect sizes from published research: A simplified methodology. Work-Learning Research, 1. Recuperado de www.work-learning.com/effect_sizes.htm.

Webb, E., Ashton, C. H., Kelly, P. & Kamali, F. (1996). Alcohol and drug use in UK university students. The Lancet, 348(9032), 922-925. doi:10.1016/S0140-6736(96)03410-1

Woodward, M. (2014). Epidemiology. Study Design and Data Analysis. New York, E.U.: CRC Press.

Youden, W. J. (1950). Index for rating diagnostic tests. Cancer, 3(1), 32-35.

Yuodelis-Flores, C., & Ries, R. K. (2015). Addiction and suicide: A review. The American Journal On Addictions, 24(2), 98-104. doi: 10.1111/ajad.12185

Zhang, X., Xu, H., Gu, J., Lau, J. F., Hao, C., Zhao, Y., ... Hao, Y. (2016). Depression, suicidal ideation, and related factors of methadone maintenance treatment users in Guangzhou, China. AIDS Care, 28(7), 851-856. doi: 10.1080/09540121.2015.1124981

Zimmerman, D. W. (1998). Invalidation of Parametric and Nonparametric Statistical Tests by Concurrent Violation of Two Assumptions. The Journal of Experimental Education, 67(1), 55–68. doi:10.1080/00220979809598344




DOI: https://doi.org/10.5944/rppc.24111

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