sábado, 23 de junho de 2007

Tipologias da dependência do álcool e o seu significado para a terapêutica médica

Serviço de Psiquiatria do Hospital de Santa Maria e Clínica Psiquiátrica de Viena
Dvorak A, Pombo S, Ismail F, Barbosa A, Cardoso JM, Figueira ML, Walter H, Lesch OM (2006)
Acta Psiquiátrica Portuguesa. Vol.52; Num. 2, pp:1693-1705.

Abstract

Considerando a heterogeneidade dos comportamentos alcoólicos, a necessidade de definir subgrupos de dependentes do álcool torna-se indispensável ao nível da investigação básica (pré-clínica) e da intervenção terapêutica (clínica). A influência dos factores de personalidade, o tipo de comorbilidade e a dimensão dos problemas ligados ao álcool, têm que se encontrar reflectidos na planificação terapêutica. Embora não haja uma tipologia da dependência do álcool universalmente aceite, com razoável
exactidão e validade prognóstica, existem algumas tipologias que alcançaram preponderância no campo da investigação básica e terapêutica. Destacam-se as tipologias de Jellinek,
Cloninger et al., Babor et al., Schuckit et al., Lesch et al., e a NAT de Cardoso et al.
Os autores avaliaram a bibliografia disponível no que respeita à qualidade metodológica dos estudos e coligiram os resultados dos métodos terapêuticos aplicados à dependência do álcool.
Tais achados e o tipo de reacção às várias terapias demonstram que, para a terapia medicamentosa de dependentes do álcool torna-se indispensável a definição de subgrupos específicos.

NETER Alcoholic 5 Subtypes: Validity with Lesch 4 Evolutionary Subtypes


Samuel Pombo, R Reizinho, F Ismail, A Barbosa, M Figueira, Cardoso, OM Lesch

Psychiatric Service of Santa Maria University Hospital
(International Journal of Psychiatry in Clinical Practice, 2007, 1-10).

Objective।validate NETER’s Alcoholic Typology (NAT), taking into account the differentiated distribution of the measures used as external criteria in the alcohol dependent sub-groups and its relationship with Lesch’s Alcoholic Typology (LAT). Method. A sample of 133 alcohol-dependent patients integrated in the alcoholism unit (NETER) of the Psychiatric Service of Santa Maria University Hospital were included in the study. Results and Conclusions. Convergent validity was assured by the agreement between the subtypes of the two typologies (NETER and Lesch), considering the same underlying model of alcoholism development: Anxiopathic subtype of NETER and Type II (Model of anxiety, alcohol as conflict solution) of Lesch and the Tymopathic subtype of NETER and type III (Model of Depression, alcohol as antidepressant) of Lesch. Discriminant analysis (external criteria) showed significant differences between the subtypes in the following variables: gender; tobacco; beer and whisky consumption; daily average of drinks; clinical conditions as Delirium Tremens, alcoholic blackouts and seizures; alcohol related problems severity; psychological dimensions as psychological maturity and extroversion; and suicidal ideation during the alcohol consumption period. A more exhaustive description of alcoholic sub-groups may improve alcoholism genetic studies and adequate the alcoholic patient to a specific therapeutical protocol.
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segunda-feira, 4 de junho de 2007

NETER ALCOHOLIC TYPOLOGY (NAT)*

CARDOSO, A BARBOSA, F ISMAIL and SAMUEL POMBO
* Alcohol and Alcoholism, November 28, 2005

Aims: To establish an alcohol-dependent drinker's clinical typology, based on patients attending the Alcoholism Unit of Santa Maria's General Hospital in Lisbon, Portugal। Methods: A multivariate statistical analysis was used to extract the typology solution. Results: We obtained five factors: Anxiopathic, typifies anxious functioning; Heredopathic, congregates familiar and genetic influences on alcoholism; Thimopathic, typified by affective symptomatology; Sociopathic, characterized by disruptive behaviours under alcohol influence; and Adictopathic, isolates younger individuals who consume alcohol and other types of psychoactive substances. Conclusions: There are increasingly alcoholic polymorphic subtypes derived from the interactive complexity between genetic/family and psychosocial factors.