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Papers by JAVIER DIDIA ATTAS
Boletín de la Academia Nacional de Medicina de Buenos Aires, 2006
Translational Psychiatry
The persistent difficulty in conceptualizing the relationship between addictive and other mental ... more The persistent difficulty in conceptualizing the relationship between addictive and other mental disorders stands out among the many challenges faced by the field of Psychiatry. The different philosophies and schools of thought about, and the sheer complexity of these highly prevalent clinical conditions make progress inherently difficult, not to mention the profusion of competing and sometimes contradictory terms that unnecessarily exacerbate the challenge. The lack of a standardized term adds confusion, fuels stigma, and contributes to a “wrong door syndrome” that captures the difficulty of not only diagnosing but also treating addictive and other mental disorders in an integrated manner. The World Association on Dual Disorders (WADD) proposes the adoption of the term “Dual Disorder” which, while still arbitrary, would help harmonize various clinical and research efforts by rallying around a single, more accurate, and less stigmatizing designation.
Frontiers in public health, 2014
International Review of Psychiatry, 2010
This paper provides a brief review of the addictions field in Latin America. Epidemiology, legal ... more This paper provides a brief review of the addictions field in Latin America. Epidemiology, legal aspects, dual pathology, treatment, prevention and future directions are discussed. This increasing disease is one of the major contributors for mental health problems in the region. Efforts have been made in treatment and prevention but results and budgets are scarce. Dual pathology, new modalities such as injected heroin in countries such as Colombia, low coverage of programmes, training resources, research and publications are important challenges. The tendency to liberalize legal terms of use would require more effort for prevention and education. Based on relevant literature and a long and current experience in the area, the authors summarize this important theme.
Adicciones, 2008
El craving, ganas compulsivas, deseo intenso o compulsión irrefrenable a consumir es uno de los s... more El craving, ganas compulsivas, deseo intenso o compulsión irrefrenable a consumir es uno de los síntomas centrales en el síndrome de dependencia y de gran importancia en las recaídas al abuso de alcohol u otras drogas. El presente trabajo revisa la relación entre la atención, los procesos atencionales y el fenómeno del craving. Se abordan los diferentes elementos integrantes de la atención y en particular de la relevancia de la atención selectiva sobre el craving y las etapas iniciales de la recaída. Se revisan las estrategias psicológicas eficaces frente al craving, en especial en el modelo cognitivo conductual de la recaída y en la terapia de prevención de recaídas. Finalmente, se discuten las características de la denominada terapia atencional, basada en el "mindfulness" o "atención consciente" y su potencial utilidad en el abordaje de los trastornos adictivos en general y en el craving en concreto.
Adicciones, 2008
Irresistible compulsion to use, or craving, is one of the key symptoms of substance dependence sy... more Irresistible compulsion to use, or craving, is one of the key symptoms of substance dependence syndrome, and of major relevance with regard to relapse in the abuse of alcohol or other drugs. In the present paper, the relationship between attention, attentional processes and the craving phenomenon is reviewed. The paper also explores the different elements of attention, and particularly the relevance of selective attention in craving and the initial stages of relapse. Those psychological strategies that have emerged as effective in the management of craving for substances are also reviewed, with particular emphasis on the cognitive-behavioral model of relapse and on relapse-prevention therapy. Finally, we discuss the characteristics of so-called attentional therapy, based on mindfulness, and its potential effectiveness in the management of addictive disorders in general and of craving in particular.
Understanding dual disorders (DDs) implies recognizing that an addiction is a mental illness and ... more Understanding dual disorders (DDs) implies recognizing that an addiction is a mental illness and therefore a brain disease. There are common brain areas involved in both addictions and other mental illnesses; it could explain the high comorbidity between drug use and other psychiatric disorders. Factors increasing the vulnerability to develop an addiction include family history, early initiation of substance use, socially stressful environments and suffering from a mental illness. In addition, lifetime diagnosis of any mental illness has been found to be associated with higher prevalence of transition from substance use to substance use disorder. Social influences are critical factors that promote experimentation or initiation which, combined with an individual vulnerability, may lead to a substance use disorder development. Historically, there has been an artificial separation between services treating addiction disorders and services treating other mental illnesses. The new paradi...
Vertex, 2013
Drug use among youth has increased in recent years dramatically during adolescence, a key phase i... more Drug use among youth has increased in recent years dramatically during adolescence, a key phase in the integral development of the individual. The main aim of this cross-sectional, descriptive study was to assess the current drug use trends, as a function of age and gender among secondary education students from representative centers in the Valencia province during the school year 2009-2010. A total of 328 adolescents, 44.8% (n=147) males and 55.2% (n=181) females, with a mean age of 15.61 (SD 2.5) years, divided in three age groups: 12-14 years old (n=134, 40.9%), 14-18 years old (n=123, 37.5%), and older than 18 years of age (n=71, 21.6%) participated in the study. Alcohol and tobacco, followed by cannabis, were the substances more commonly used by the secondary education students. There were statistically significant differences between the three age groups in lifetime use of tobacco, alcohol, cannabis, cocaine, amphetamines and tranquilizers. The highest prevalences were observ...
![Research paper thumbnail of [Post-traumatic stress disorder and substance use disorder: treatment intervention]](https://attachments.academia-assets.com/77584827/thumbnails/1.jpg)
](Vertex, 2005
There is an increasing interest to find efficacious treatments for patients with post-traumatic s... more There is an increasing interest to find efficacious treatments for patients with post-traumatic stress disorder (PTSD) and comorbid substance use disorder (SUD). Therefore, in this paper the studies published on the psychological and pharmacological treatment for the management of comorbid PTSD and SUD will be discussed, as these are highly prevalent and shown in part I. The few studies published to date suggest that patients benefit most form an integrated treatment approach for the comorbid disorders. Psychological treatments based on cognitive behavioural strategies appear to be useful for patients with PTSD and comorbid SUD disorder. Medications such as SSRIs and particularly sertraline that efficacious for PTSD, seem to be as well for this dual disorder. In addition, pharmacological options, among them quetiapine or bupropion have shown promising results in preliminary studies.
Boletín de la Academia Nacional de Medicina de Buenos Aires, 2006
Translational Psychiatry
The persistent difficulty in conceptualizing the relationship between addictive and other mental ... more The persistent difficulty in conceptualizing the relationship between addictive and other mental disorders stands out among the many challenges faced by the field of Psychiatry. The different philosophies and schools of thought about, and the sheer complexity of these highly prevalent clinical conditions make progress inherently difficult, not to mention the profusion of competing and sometimes contradictory terms that unnecessarily exacerbate the challenge. The lack of a standardized term adds confusion, fuels stigma, and contributes to a “wrong door syndrome” that captures the difficulty of not only diagnosing but also treating addictive and other mental disorders in an integrated manner. The World Association on Dual Disorders (WADD) proposes the adoption of the term “Dual Disorder” which, while still arbitrary, would help harmonize various clinical and research efforts by rallying around a single, more accurate, and less stigmatizing designation.
Frontiers in public health, 2014
International Review of Psychiatry, 2010
This paper provides a brief review of the addictions field in Latin America. Epidemiology, legal ... more This paper provides a brief review of the addictions field in Latin America. Epidemiology, legal aspects, dual pathology, treatment, prevention and future directions are discussed. This increasing disease is one of the major contributors for mental health problems in the region. Efforts have been made in treatment and prevention but results and budgets are scarce. Dual pathology, new modalities such as injected heroin in countries such as Colombia, low coverage of programmes, training resources, research and publications are important challenges. The tendency to liberalize legal terms of use would require more effort for prevention and education. Based on relevant literature and a long and current experience in the area, the authors summarize this important theme.
Adicciones, 2008
El craving, ganas compulsivas, deseo intenso o compulsión irrefrenable a consumir es uno de los s... more El craving, ganas compulsivas, deseo intenso o compulsión irrefrenable a consumir es uno de los síntomas centrales en el síndrome de dependencia y de gran importancia en las recaídas al abuso de alcohol u otras drogas. El presente trabajo revisa la relación entre la atención, los procesos atencionales y el fenómeno del craving. Se abordan los diferentes elementos integrantes de la atención y en particular de la relevancia de la atención selectiva sobre el craving y las etapas iniciales de la recaída. Se revisan las estrategias psicológicas eficaces frente al craving, en especial en el modelo cognitivo conductual de la recaída y en la terapia de prevención de recaídas. Finalmente, se discuten las características de la denominada terapia atencional, basada en el "mindfulness" o "atención consciente" y su potencial utilidad en el abordaje de los trastornos adictivos en general y en el craving en concreto.
Adicciones, 2008
Irresistible compulsion to use, or craving, is one of the key symptoms of substance dependence sy... more Irresistible compulsion to use, or craving, is one of the key symptoms of substance dependence syndrome, and of major relevance with regard to relapse in the abuse of alcohol or other drugs. In the present paper, the relationship between attention, attentional processes and the craving phenomenon is reviewed. The paper also explores the different elements of attention, and particularly the relevance of selective attention in craving and the initial stages of relapse. Those psychological strategies that have emerged as effective in the management of craving for substances are also reviewed, with particular emphasis on the cognitive-behavioral model of relapse and on relapse-prevention therapy. Finally, we discuss the characteristics of so-called attentional therapy, based on mindfulness, and its potential effectiveness in the management of addictive disorders in general and of craving in particular.
Understanding dual disorders (DDs) implies recognizing that an addiction is a mental illness and ... more Understanding dual disorders (DDs) implies recognizing that an addiction is a mental illness and therefore a brain disease. There are common brain areas involved in both addictions and other mental illnesses; it could explain the high comorbidity between drug use and other psychiatric disorders. Factors increasing the vulnerability to develop an addiction include family history, early initiation of substance use, socially stressful environments and suffering from a mental illness. In addition, lifetime diagnosis of any mental illness has been found to be associated with higher prevalence of transition from substance use to substance use disorder. Social influences are critical factors that promote experimentation or initiation which, combined with an individual vulnerability, may lead to a substance use disorder development. Historically, there has been an artificial separation between services treating addiction disorders and services treating other mental illnesses. The new paradi...
Vertex, 2013
Drug use among youth has increased in recent years dramatically during adolescence, a key phase i... more Drug use among youth has increased in recent years dramatically during adolescence, a key phase in the integral development of the individual. The main aim of this cross-sectional, descriptive study was to assess the current drug use trends, as a function of age and gender among secondary education students from representative centers in the Valencia province during the school year 2009-2010. A total of 328 adolescents, 44.8% (n=147) males and 55.2% (n=181) females, with a mean age of 15.61 (SD 2.5) years, divided in three age groups: 12-14 years old (n=134, 40.9%), 14-18 years old (n=123, 37.5%), and older than 18 years of age (n=71, 21.6%) participated in the study. Alcohol and tobacco, followed by cannabis, were the substances more commonly used by the secondary education students. There were statistically significant differences between the three age groups in lifetime use of tobacco, alcohol, cannabis, cocaine, amphetamines and tranquilizers. The highest prevalences were observ...
Vertex, 2005
There is an increasing interest to find efficacious treatments for patients with post-traumatic s... more There is an increasing interest to find efficacious treatments for patients with post-traumatic stress disorder (PTSD) and comorbid substance use disorder (SUD). Therefore, in this paper the studies published on the psychological and pharmacological treatment for the management of comorbid PTSD and SUD will be discussed, as these are highly prevalent and shown in part I. The few studies published to date suggest that patients benefit most form an integrated treatment approach for the comorbid disorders. Psychological treatments based on cognitive behavioural strategies appear to be useful for patients with PTSD and comorbid SUD disorder. Medications such as SSRIs and particularly sertraline that efficacious for PTSD, seem to be as well for this dual disorder. In addition, pharmacological options, among them quetiapine or bupropion have shown promising results in preliminary studies.