Mindfulness e inteligencia emocional en la prevención de recaídas en personas en tratamiento: una revisión / Mindfulness and emotional intelligence in the prevention of relapses in people in treatment: a review / Mindfulness e inteligência emocional na prevenção de recaídas em pessoas em tratamento: uma revisão

OBJETIVO: analizar la evidencia empírica disponible sobre los programas de intervención de Mindfulness e Inteligencia Emocional para la prevención de recaídas en personas en tratamiento. METODOLOGÍA: en la estrategia de búsqueda se incluyeron descriptores en los idiomas inglés (Mindfulness, emotional intelligence, relapse prevention) y español (atención plena, inteligencia emocional, prevención de la recaída). RESULTADOS: se identifió efecto significativo de la práctica de Mindfulness, sobre la inteligencia eemocional al apoyar en la regulación de las emociones y su vez prevenir posibles recaídas. CONCLUSION: continuar investigando sobre el Mindfulness y sus efectos sobre la inteligencia emocional en diferentes contextos.

OBJECTIVE: to analyze the empirical evidence available on Mindfulness and Emotional Intelligence intervention programs for relapse prevention in people in treatment. METHODOLOGY: descriptors in English (Mindfulness, emotional intelligence, relapse prevention) and Spanish (mindfulness, emotional intelligence, relapse prevention) languages were included in the search strategy. RESULTS: a significant effect of Mindfulness practice was identified on emotional intelligence by supporting the regulation of emotions and preventing possible relapses. CONCLUSION: continue researching Mindfulness and its effects on emotional intelligence in different contexts.

OBJETIVO: analisar as evidências empíricas disponíveis nos programas de intervenção Mindfulness e Emotional Intelligence para prevenção de recaídas em pessoas em tratamento. METODOLOGIA: os descritores nos idiomas inglês (atenção plena, inteligência emocional, prevenção de recaídas) e espanhol (atenção plena, inteligência emocional, prevenção de recaídas) foram incluídos na estratégia de busca. RESULTADOS: um efeito significativo da prática da atenção plena foi identificado na inteligência emocional, apoiando a regulação das emoções e prevenindo possíveis recaídas. CONCLUSÃO: continuar pesquisando Mindfulness e seus efeitos na inteligência emocional em diferentes contextos.

Efficacy and safety of paliperidone palmitate 3-month formulation in Latin American patients with schizophrenia: A subgroup analysis of data from two large phase 3 randomized, double-blind studies

Objective: To analyze the efficacy and safety of paliperidone palmitate 3-monthly (PP3M) in Latin American patients with schizophrenia vs. rest-of-world (ROW). Methods: We analyzed data from two multinational, double-blind (DB), randomized, controlled phase 3 studies including patients with schizophrenia (DSM-IV-TR) previously stabilized on PP1M/PP3M (open-label [OL] phase). Patients were randomized to PP3M or PP1M (noninferiority study A) and PP3M or placebo (study B) in DB phase. The subgroup analysis included Latin American (Argentina, Brazil, Colombia, Mexico) patients. Primary efficacy endpoints were relapse-free rates (study A) and time-to-relapse (study B). Results: In study A, 63/71 (88.7%) and in study B 38/43 (88.4%) Latin American patients completed the DB phase. In study A, relapse-free percentage was similar in Latin America (PP3M: 97%, PP1M: 100%) and ROW (PP3M: 91%, PP1M: 89%). In study B, median time-to-relapse was not estimable in the Latin American subgroup for either placebo or PP3M groups, nor for the ROW PP3M group; the median time-to-relapse in the ROW placebo group was 395 days. Caregiver burden improved in patients switching from oral antipsychotics (OL baseline) to PP3M/PP1M in DB phase (Involvement Evaluation Questionnaire score mean ± SD change, -9.4±15.16; p < 0.001). Treatment emergent adverse events with PP3M during DB phase were similar in Latin America (study A: 24/34 [70.6%]; study B: 15/21 [71.4%]) and ROW (study A: 318/470 [67.7%]; study B: 84/139 [60.4%]) subgroups. Conclusion: PP3M was efficacious and showed no new safety concerns in patients with schizophrenia from Latin America, corroborating ROW findings. Clinical trial registration: NCT01515423, NCT01529515

Prevention of Metamphetamine Use Relapse Through Improving Effective Information, Education and Communication (IEC): An Open Cluster-Randomized-Controlled Trial / Lao Medical Journal

Background and Rational@#In Lao PDR, relapse of metamphetamine use following discharge from rehabilitation center is unacceptably high (~50%). Good preparedness and IEC provision to the rehabilitated addicts before discharge from the rehabilitation center is likely to be vital to prevent relapse. Effective IEC would probably help to reduce the rate of relapse.@*Methodology@#This was an open cluster-randomized-controlled trial to assess the newly developed IEC package among metamphetamine users. The intervention group received new IEC package (education message + brochure + telephone contact number + follow-up) while the conventional advice was given to control group. The study participants were followed up for 6 months by telephone (at 1, 3, 6 months). The primary endpoint was the relapse rate.@*Result@#One hundred and eighty-one addicts were enrolled in the trial (93 in intervention and 88 in control groups). Ninety-six subjects were male. The overall mean (SD) age of the participants was 26.5 (6.1) years and the overall median (range) duration of drug use was 5 (0.5 – 26) years and these figures were not significantly different between the groups (P=0.50 and P=0.97), respectively). The proportion of the participants who were lost to follow-up was 8%. Sixty percents of the study subjects completed 6-months follow up and this was not statistically different between the groups (P=0.93). The overall percentage of relapse was 39% (65/166) [36% (31/85) in intervention and 42% (34/81) in control groups, P=0.38). The median (range) duration of relapse was 30 (1 – 160) days and this was not significantly different between the groups (P=0.38). In a multiple logistic regression model, contact with drug users following discharge from the rehabilitation center was significantly associated with relapse [AOR = 73, 95%CI = 39 – 405, P<0.001] while having a permanent job following discharge was a protective factor for relapse [AOR = 0.03 (0.004 – 0.27), P=0.002].@*Conclusion@#The relapse rate of metamphetamine use was lower in the group with new IEC package than in control group but this was not statistically significant. Further study with a larger scale is strongly recommended

Mindfulness-based intervention to prevent relapse and relevant imaging studies / 上海交通大学学报（医学版）

Drug abuse is an important issue in China, while there is no effective drug to control the craving, which is the main reason that leads to the relapse. Mindfulness-based relapse prevention, as a novel treatment approach, has been used in the treatment of drug dependence, and a number of researches on this topic have been conducted. The current paper provided a review of recent clinical researches and relevant imaging studies to discuss the application of mindfulness-based relapse prevention, which hopes to provide theoretical basis for future study.

As percepções de um usuário de substâncias psicoativas em abstinência sobre os motivos de recaída: um estudo de caso / The perceptions of a user of abstinence psychoactive substances on the reasons for relapse: a case study

Prevenção da recaída é a manutenção do processo de mudança de hábitos e automanejo. Tem como objetivo ensinar o indivíduo a lidar com seu problema e prever uma possível recaída, além disso se refere a mudança de qualquer comportamento relacionado ao problema. O objetivo deste estudo foi identificar de acordo com as percepções de um usuário em abstinência quais foram os motivos de recaída no consumo de substâncias psicoativas. Foi realizada uma pesquisa qualitativa por meio de um estudo de caso em uma instituição de apoio. A análise dos dados foi conduzida por análise de conteúdo que originou 5 categorias. Dentre elas, percepções dos motivos de recaída, a combinação de fatores de risco e proteção se mesclaram para os problemas apresentados por Gabriel e também para as resiliências que foram emergindo ao longo do percurso de vida. O processo de recuperação requer aprendizagem e manejo das adversidades que ocorrem em função dos TRSA. Neste estudo de caso, pode-se perceber que G. não se coloca em situações de risco no momento atual, pois aprimorou seus recursos de autoconhecimento e assertividade, dentre elas as estratégias de prevenção de recaída.(AU)

Preventing relapse is the maintenance of the process of changing habits and self management. It aims to teach the individual to deal with their problem and predict a possible relapse, in addition it refers to changing any behavior related to the problem. The objective of this study was to identify according to the perceptions of a user in abstinence what were the reasons for relapse in the consumption of psychoactive substances. A qualitative research was carried out by means of a case study in a support institution. The analysis of the data was conducted by content analysis that originated 5 categories. Among them, perceptions of the reasons for relapse. The combination of risk and protection factors blended into the problems presented by Gabriel and also to the resiliencies that have emerged along the course of life. The recovery process requires learning and managing the adversities that occur due to TRSA. In this case study, one can see that G. does not place himself in situations of risk at the present moment, since he has improved his resources of self-knowledge and assertiveness, among them the relapse prevention strategies.(AU)

Nuevos retos en el tratamiento del juego patológico / New challenges in the treatment of disordered gambling

En este artículo se señalan los avances y retos de futuro en el tratamiento del juego patológico. El objetivo terapéutico (abstinencia o juego moderado) es actualmente objeto de controversia. Los tratamientos para la ludopatía incluyen la terapia hospitalaria, los tratamientos cognitivo-conductuales individuales o grupales, Jugadores Anónimos y la farmacoterapia, así como la prevención de recaídas. La terapia cognitivo-conductual presenta unas tasas de éxito del 50 por ciento al 80 por ciento de los casos tratados en un seguimiento a largo plazo. La farmacoterapia es un complemento cuando los pacientes tienen un estado de ánimo deprimido o un elevado nivel de impulsividad. El juego controlado puede ser una alternativa terapéutica para los jugadores jóvenes o que no presentan aún una dependencia severa. Se requiere más información sobre el tratamiento del juego on-line y de poblaciones específicas (mujeres y jóvenes). Se comentan las implicaciones de esta revisión para la práctica clínica y para las investigaciones futuras.

This paper deals with the new developments in the treatment of disordered gambling, as well as with the challenges for further research. Abstinence versus moderated gambling is an issue that raises many concerns and that needs to be addressed. Current treatment for disordered gambling involves a number of different options, including inpatient treatments, individual and group cognitive-behavioral options, Gamblers Anonymous and pharmacotherapy, as well as an intervention in relapse prevention. Cognitive-behavioral therapy may have asuccess rate ranging from 50 percent to 80 percent of treated patients in a long-term follow-up. Psychopharmacological therapy may have incremental benefit when patients have comorbid depression or high impulsivity. Responsible gambling may be a therapeutic option for young gamblers or people without a severe dependence. Further information is required about treatment for online gambling addictions and for dealing with specific populations (women and young people). Unanswered questions for future research in this field are commented upon.

Treating and preventing relapse of drug abuse by healthcare providers

Drug abuse by healthcare providers is a serious public problem affecting not only the providers themselves but also their families, colleagues, and patients. It is not a new problem, but the medical community has historically been unwilling to accept and publicly acknowledge the problem, particularly a problem of its own members. Therefore, drug abuse by healthcare providers has either gone unnoticed or has been treated punitively, which has led to high prevalence and mortality. In South Korea, drug-abusing healthcare providers are considered criminals rather than patients. However, many studies have reported that punitive action alone is ineffective. This article describes the treatment principles, prognosis, and possibilities of returning to practice for drug-abusing healthcare providers. Early detection of drug abuse is key to subsequent treatment and prognosis. Furthermore, why relapse prevention as well as treatment is significant and which factors intensify the risk of relapse will be discussed. The use of opioids, coexisting psychiatric illness, and a family history of drug abuse are statistically significant factors. Finally, continuous and close monitoring is effective for relapse prevention, so it is considered another kind of therapy. An organized system for treating drug abuse is currently lacking in South Korea, not only for the general population but also for healthcare providers. In the future, a systematic approach and management by the medical community is necessary to resolve drug abuse by healthcare providers.

Mindfulness-based relapse prevention for female incarcerated substance abusers with protracted withdrawal syndromes / 中华行为医学与脑科学杂志

Objective To evaluate effects of mindfulness-based relapse prevention treatment in female incarcerated substance abusers with protracted withdrawal syndromes.Methods 120 female incarcerated substance abusers were selected from compulsory rehabilitation/treatment center,they were randomly assigned by throwing coin to either treatment group or control group.All participants in treatment group got mindfulness-based relapse prevention treatment.At pre- and post-session assessment points,all participants completed the Five Factor Mindfulness Questionnaire and Opiate Protracted Abstinent Symptoms Scale.Two sample t -test and chi-square were used to examine the baselines,repeated measures ANOVA for assessing changes of mindfulness and protracted abstinent syndromes between and within groups.Results No differences between-group were found on mindfulness and protracted abstinent syndromes.Group x Time effects emerged for observe facet (F=27.87,P=0.000),describe facet(F=15.10,P=0.000) and total scores of mindfulness (F =12.05,P=0.001 ),the same as craving symptoms(F=7.53,P=0.007) and sleeping symptoms (F=4.40,P=0.038) of protracted abstinent symptoms.On sleep symptoms,participants in treatment group got(5.7 ±4.0) score before treatment points,got (3.5 ±3.1 )after treatment points.Participants in control group got (4.3 ± 3.6) at pre-session assessment,got (3.7 ± 3.5 ) at post-session assessment,participants in treatment group got better improvement in sleeping symptoms.Physical symptom score of protracted abstinent symptoms among treatment group participants showed a downward trend over time(F=14.89,P =0.000).Conclusion Mindfulness-based relapse prevention treatment can increase mindfulness scores,and improve physical and sleeping problems.Compulsory rehabilitation center is helpful for substance abusers.

Effects of Women Focused Relapse Prevention Program on Abstinence Self-efficacy and Depression in Alcoholic Women / 정신간호학회지

PURPOSE: This study was done to assess effects of women focused relapse prevention program on abstinence self-efficacy and depression in alcoholic women. METHODS: This study was a non-equivalent control group non-synchronized design with two groups, an experimental group (13 patients) and a control group (16 patients). The instruments were the Situational Confidence Questionnaire (SCQ-39) and the Beck depression Inventory (BDI). Data collection was done between July and December, 2008, during which a pre-test, the total of 8 group sessions for four weeks, and a post-test were given to alcoholic women who were admitted to K hospital in U city and D hospital in G city. The collected data were analyzed using descriptive statistics, Fisher's exact test, Mann-Whitney U test and ANCOVA with SPSS/WIN program. RESULTS: The scores for abstinence self-efficacy were significantly higher and for depression lower, for the experimental group after the women focused relapse prevention program. CONCLUSION: This study shows that the women focused relapse prevention program can be applied as an effective nursing intervention by clinical nurses.

Análisis psicométrico del inventario situacional para consumidores de tabaco / Psychometric properties of the situational inventory for tobacco consumers

El conocimiento de las situaciones relacionadas con dejar de fumar y la abstinencia prolongada permite que se puedan llevar a cabo tratamientos específicos que eviten las recaídas y mantengan la efectividad del tratamiento a largo plazo. A pesar de su importancia, no existe una escala que permita identificar las situaciones asociadas al consumo. En esta investigación se presenta las propiedades psicométricas del Inventario Situacional para Consumidores de Tabaco (ISCT) que se construye a partir de un estudio inicial con grupos focales y un análisis de expertos; está constituido por 46 ítems que se aplican a una muestra de 342 sujetos. Los resultados mostraron que el banco de ítems tiene una fiabilidad alta (a= 0,96). Se presentan los índices clásicos y se realiza un análisis con la Teoría de la Respuesta al Ítem, y el modelo demuestra un ajuste adecuado (X²= 749,539, gl=709, p=0,141). Adicionalmente, se realizó un análisis de validez concurrente con los resultados del Cuestionario de Fagerström para la Dependencia a la nicotina en el que se muestra, a partir de un análisis de regresión, que el nivel de dependencia explica un porcentaje amplio de la varianza del ISCT (R²= 43.8). Por lo tanto, se considera que el inventario permite dirigir a los especialistas en la planeación de un tratamiento específico a las situaciones de consumo de cada individuo.

Knowledge of the situations related to smoking withdrawal and / or prolonged abstinence, makes possible the development of specific treatments in order to prevent relapse and to maintain the effectiveness of long-term treatments. Despite its importance, an instrument that identifies the situations related to consumption does not yet exist. Therefore, this paper presents the psychometric properties of the Situational Inventory for Tobacco Consumers (ISTC) that was constructed from an initial study with focus groups and expert analysis. The instrument consists of 46 items that were applied to a sample of 342 people. The results showed that the item bank has a high reliability (a= 0,96). We present the classic indexes along with the analysis based on an item response theory model, where the inventory showed an appropriate fit (X²= 749,539, df = 709, p = 0,141). Aditionally, evidence for the concurrent validity of the proposed test was obtained through a regression analysis where the scores from the Test for Nicotine Dependence were able to explain a large amount of the ISCT score variance (R²= 43.8). It is therefore considered that this inventory is able to guide the specialists in the planning of specific treatments catered to the consumption situations of each individual.

Repensando las adicciones: el paradigma cognitivo y el trastorno por dependencia / Rethinking addictions: the cognitive paradigm and substance dependence disorder

El objetivo del siguiente trabajo es revisar algunas estrategias psicoterapéuticas utilizadas para el trastorno por dependencia de sustancias. Desde el paradigma cognitivo se estudian diferentes creencias distorsionadas frecuentes en nuestro medio. Éstas denotan la dificultad de abordar el problema de las drogas desde el conocimiento científico basado en la evidencia. Se plantean problemáticas como el modelo de enfermedad, la alianza terapéutica, la ilegalidad, el objetivo del tratamiento, la medicación, las ideologías y las implicancias para las intervenciones sociales. Se repasan estrategias que han demostrado eficacia: Estrategias Motivacionales, Prevención de Recaídas, Manejo de Contingencias, Terapia Cognitiva Estándar y Reducción del Daño. Se concluye con la importancia de aplicar el conocimiento científico actual en los programas de tratamiento y en las políticas preventivas

The aim of this task is to review some psychotherapeutic strategies used for the treatment of Substance Dependence Disorder. Different distorted beliefs, from the cognitive paradigm, which are usually assumed in our society, are studied here. These beliefs reveal difficulty in facing the drug problem, from the scientific knowledge based on evidence. Different problems are set up, such us the illness pattern, therapeutic alliance, treatment aims, unlawful acts, medication, ideologies and implications for the social interventions. Different strategies that have proved effectiveness are reviewed. Motivational Interview, Contingencies Management, Standard Cognitive Therapy and Harm Reduction have been pointed out. We come to an end with the recommendation to use the scientific knowledge for the treatment programs and preventive policies

Psychologizing Alcoholism

The psychological understanding of alcoholism requires understanding of the treatment modalities of alcoholism since the beginning of the last century. With its emphasis on the 12-step recovery principles, the movement of Alcoholic Anonymous (AA) and its relative treatment success in outcomes has maintained an unrivaled position in the treatment of alcoholics. AA has also created an anti-medical and depsychologizing tradition that has left little room today for medicine and psychiatry to intervene. Medical services have provided treatment and care only for the physical and mental complications of alcoholism, leaving addiction itself to the hands of AA. In addiction and recovery processes, however, psychological factors exert significant influences. The addictive personality that comes from typical cognitive, emotional, perceptive, and behavioral addictive changes is a challenging obstacle in every recovery process. It is vitally important for the recovering addicts to receive psychological help for their emotional vulnerabilities from drinking of long duration, and also for various problems in their personal characteristics that had existed before addiction. Relapse, in particular, depends largely on the failure of psychological adjustment. It is time to repsychologize alcoholism and to bring the treatment of alcoholism back to medicine. Psychiatry must develop comprehensive treatment strategies of a biopsychosociospiritual model for alcoholic patients.