Diagnóstico dual en médicos residentes: una revisión sistemática

Abstract

ResumenAbstract original adicciones vol. xx, nº x · 2020 El período de preparación como médico residente (en español, MIR) suele asociarse a una elevada sobrecarga emocional tanto por las nuevas exigencias profesionales como por otros factores psicosociales. El objetivo de este estudio es conocer las características del diagnóstico dual en los MIRs. Se llevó a cabo una revisión sistemática de las bases de datos MEDLINE (PubMed), Web of Science y Google Scholar, seleccionando artículos publicados en inglés y español entre 1984 y 2017. Se obtuvieron 2.415 artículos: se excluyeron 2.276 por título, 105 por el contenido del resumen y 17 por el contenido del artículo. En la revisión final se incluyeron 17 artículos. La prevalencia de clínica depresiva varía del 10,2% al 70%, de ansiedad entre 13,2% y 33,9%, de ideación suicida entre 6,7% y 25% mientras que el consumo de riesgo de alcohol se encuentra aproximadamente en torno al 20%, entre 2% y 13,4% se auto-prescriben medicamentos psicótropos y del 2,7% al 14% consumen otras sustancias. La mayoría de los estudios analizados adolecen de limitaciones metodológicas importantes lo que dificulta una adecuada comprensión del fenómeno. Las variaciones en las cifras de prevalencia tienen que ver con la disparidad de escalas y de criterios diagnósticos empleados, entre otros factores. Aún así, los estudios muestran que el consumo de alcohol y/u otras sustancias se correlacionan positivamente con el malestar emocional en los MIRs. Se hace necesario mejorar el conocimiento del diagnóstico dual en este grupo profesional para que se puedan prevenir y tratar sus consecuencias de manera más eficaz. Palabras clave: Médico residente; Trastorno por uso de sustancias; Trastornos mentales; Diagnóstico dual; Auto-tratamiento. The post-graduate period as a resident doctor (MIR, in Spanish) is usually associated with high emotional distress due to new professional demands and to other psychosocial factors. The objective of this study is to determine the characteristics of dual diagnosis among MIRs. A systematic review was carried out in MEDLINE (PubMed), Web of Science and Google Scholar databases, selecting articles published in English and Spanish between 1984 and 2017. A total of 2,415 articles were obtained: 2,276 were excluded by their title, 105 by the abstract and 17 after a complete review of the article; 17 papers were finally included. The prevalence of depressive symptoms among MIRs ranges from 10.2% to 70%, while the prevalence of anxious symptoms varies from 13.2% to 33.9%, from 6.7% to 25% reported suicidal ideation, 20% hazardous drinking, 2%-13.4% self-prescribed psychotropics, and 2.7%-14% used other drugs. Most studies present important methodological limitations, thus complicating adequate understanding of the phenomenon. High variations in prevalence data are related to differences in the psychometric scales and to disparity in diagnosis criteria, among other limitations. However, most studies report that alcohol and drug use is correlated with severe distress among MIRs...

Characteristics of resident physicians accessing a specialised mental health service: a retrospective study

“…Among medical residents, prevalence of depressive symptoms is estimated to range from 20.9% to 43.2%,16 while 7% to 22% report having suicidal ideation 17 18. With respect to substance misuse, around 20% of residents may meet criteria for hazardous drinking19 and 13% self-medicate with legal drugs to cope with stress 12. In Spain, 18% of residents are hazardous drinkers,14 and between 8% and 16% self-medicate with psychoactive drugs 13…”

Internet Addiction and Depression Among Postgraduate Residents

“…[13][14][15][16][17] Moreover, multiple systematic reviews have shown that the prevalence of depression is greater among medical residents than in the general population; in one meta-analysis of 54 studies from around the world, the overall pooled prevalence of depression among medical residents was 28.8%, with a 15.8% increase in depressive symptoms during the first year of training regardless of choice of specialty or location of training. [18][19][20][21] As such, the main objectives of this study were to quantify the prevalence of social media usage and Internet addiction among Oman Medical Specialty Board (OMSB) residents and to determine associations with sociodemographic characteristics and depression.…”