Evaluación del tratamiento psicoterapéutico integrado del alcoholismo con apoyo de Alcohólicos Anónimos frente al manejo sin terapia grupal Hospital Regional del IESS Dr Teodoro Maldonado Carbo 2006 - 2009
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2011
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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El alcoholismo es una enfermedad que ha alcanzado tal frecuencia que actualmente se considera un verdadero problema de salud pública para países desarrollados y en vías de desarrollo como el Ecuador en donde alcanza una prevalencia del 23%. Es una patología de etiología multifactorial y en tal sentido requiere un manejo complejo. Muchas terapias han sido empleadas, la mayoría con tasas altas de fallas, sin embargo actualmente se plantea la psicoterapia integrada como la de mejores resultados coste-beneficio. El hospital Regional del IESS “Dr. Teodoro Maldonado Carbo”, viene utilizando desde hace mucho tiempo reuniones con alcohólicos anónimos (AA) y tratamiento farmacológico. Sin embargo el valor de estas intervenciones no ha sido establecido ya que no se la ha comparado con formas clásicas de manejo psiquiátrico. Con el objetivo de evaluar si existen diferencias entre estos tipos de terapéutica se realizó un estudio de tipo observacional – correlacional, de diseño no experimental- longitudinal retrospectivo en el que se incorporaron 54 casos atendidos en terapia con alcohólicos anónimos y 50 pacientes tratados mediante terapia convencional, entre el 1 de enero de 2006 a 31 de diciembre de 2009. Para la comparación de los resultados se utilizaron la prueba de Chi2, prueba exacta de Fisher, razón de exceso, aumento absoluto del riesgo. Los grupos fueron similares en cuanto a las características de la población. Los resultados mostraron que cuando se usa terapia con AA se logra una reducción significativa del número de recaídas (9,3% y 56%) (P < 0.00001), una disminución del riesgo absoluto (RRA: 46,74%; IC 95% 30,96% - 61,52%.) y una reducción del número de casos de recaídas (OR, 12,4 IC 95% 4,25-36,5) en relación a los logros con una terapia tradicional.
Alcoholism is a disease that has reached such a frequency that is now considered a real public health problem for developed and developing countries such as Ecuador, where it reaches a prevalence of 23%. It is a disease of multifactorial etiology and in that sense requires complex management. Many therapies have been used, most with high failure rates, but now there is the integrated psychotherapy as the best cost-benefit results. In Teodoro Maldonado Hospital, has been used long meetings with Alcoholics Anonymous (AA) and pharmacological treatment. However, the value of these interventions has not been established because it has not been compared with traditional forms of psychiatric management. In order to assess whether there are differences between these types of therapeutic performed an observational study - correlation of longitudinal-experimental design is not retrospective in which 54 cases were included in therapy attended Alcoholics Anonymous and 50 patients treated with conventional therapy , between 1 January 2006 to December 31, 2009. For comparison of the results were used Chi2 test, Fisher exact test, because of excess absolute risk increase. The groups were similar in the characteristics of the population. The results showed that when using AA therapy achieved a significant reduction in the number of relapses (9.3% and 56%) (P <0.00001), an absolute risk reduction (ARR: 46.74%, 95% 30.96% - 61.52%.) and a reduction in the number of relapses (OR, 95% CI 4.25 to 36.5 12.4) compared to the gains with traditional therapy
Alcoholism is a disease that has reached such a frequency that is now considered a real public health problem for developed and developing countries such as Ecuador, where it reaches a prevalence of 23%. It is a disease of multifactorial etiology and in that sense requires complex management. Many therapies have been used, most with high failure rates, but now there is the integrated psychotherapy as the best cost-benefit results. In Teodoro Maldonado Hospital, has been used long meetings with Alcoholics Anonymous (AA) and pharmacological treatment. However, the value of these interventions has not been established because it has not been compared with traditional forms of psychiatric management. In order to assess whether there are differences between these types of therapeutic performed an observational study - correlation of longitudinal-experimental design is not retrospective in which 54 cases were included in therapy attended Alcoholics Anonymous and 50 patients treated with conventional therapy , between 1 January 2006 to December 31, 2009. For comparison of the results were used Chi2 test, Fisher exact test, because of excess absolute risk increase. The groups were similar in the characteristics of the population. The results showed that when using AA therapy achieved a significant reduction in the number of relapses (9.3% and 56%) (P <0.00001), an absolute risk reduction (ARR: 46.74%, 95% 30.96% - 61.52%.) and a reduction in the number of relapses (OR, 95% CI 4.25 to 36.5 12.4) compared to the gains with traditional therapy
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Alcoholismo, Psicoterapia de grupo, Salud pública, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador, Evaluación, Alcohólicos Anónimos