Experiencias adversas en la infancia y desenlaces relacionados con el uso de sustancias en adolescentes y adultos: revisión sistematizada con síntesis narrativa estructurada y metaanálisis exploratorio
DOI:
https://doi.org/10.70577/dr8esp98Palabras clave:
experiencias adversas en la infancia; trauma infantil; trastornos relacionados con sustancias; abuso infantil; adicción; recaída.Resumen
Introducción: Las experiencias adversas en la infancia (ACE), incluido el trauma infantil, se relacionan con múltiples desenlaces vinculados al uso de sustancias. La heterogeneidad y el solapamiento entre publicaciones limitan una estimación global y justifican una síntesis por dominios. Objetivo: sintetizar críticamente la evidencia observacional sobre ACE y trastorno por uso de sustancias, iniciación, patrones de consumo, recaída, craving, severidad y comorbilidad en adolescentes y adultos. Metodología: se realizó una revisión sistematizada de publicaciones del 1 de enero de 2016 al 17 de agosto de 2026, con criterios PECO, auditoría por DOI, control de dependencia entre publicaciones, evaluación metodológica y síntesis narrativa por dominios. La auditoría reunió 200 DOI únicos; 187 publicaciones se conservaron en el mapa de evidencia y 13 se excluyeron. El corpus analítico incluyó 75 informes con evaluación metodológica documentada. No se estimó un efecto global. Se efectuó un metaanálisis exploratorio secundario de tres muestras independientes de Kristjansson et al. (2016) mediante REML y ajuste de Knapp-Hartung modificado. Resultados: el riesgo de sesgo fue moderado en 39 informes, bajo-moderado en 21, moderado-alto en 12 y alto en 3. Predominaron asociaciones positivas entre adversidad infantil y TUS, inicio temprano, patrones de consumo y severidad, junto con resultados nulos o atenuados tras ajuste. El metaanálisis exploratorio mostró asociaciones positivas para alcohol, nicotina, cannabis, estimulantes y opiáceos. Conclusión: las ACE constituyen un marcador relevante de vulnerabilidad, pero la heterogeneidad clínica y metodológica desaconseja un efecto global único y favorece una interpretación por dominios.
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Derechos de autor 2026 Miguel Armando Camino Coronel, Johanna Estefania Núñez Silva, Carlos Enrique Muñoz Cofre, Isaac Esteban Navas Trujillo, Kevyn Steev Castillo Barrera (Autor/a)
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
