Neuropsychological functioning in methadone maintenance patients with HIV / Función neuropsicológica en el tratamiento de mantenimiento con metadona en pacientes con VIH

Although highly active antiretroviral therapy (HAART) has improved survival rates of HIV patients, HIV-associated neurocognitive disorders (HAND) still exist in a highly prevalent group of persons with this disease. In this study we seek to evaluate the influence of drug use in the neuropsychological performance of seropositive drug users. We carried out an extensive neuropsychological evaluation and compared the performance of seropositive drug users (n = 90) with that of a control group of seronegative drug users (n = 48). The results reveal that methadone maintenance programmes can make the seropositive subject neuropsychologically vulnerable. Likewise, we found that giving up drugs have a protective effect in the presence of neuropsychological alterations associated with HIV. These findings lead us to suggest that seropositivity is not sufficient to explain the neuropsychological alterations of seropositive drug users, noting that these alterations are multifactorial.

Aunque la terapia antirretroviral de gran actividad (TARGA) ha mejorado los índices de supervivencia de los pacientes infectados por el VIH, los trastornos neurocognitivos asociados con el VIH (TNAV) todavía existen en un grupo de personas altamente prevalente a esta enfermedad. En este estudio buscamos evaluar la influencia del consumo de drogas en el rendimiento neuropsicológico de los usuarios de drogas seropositivos. Llevamos a cabo una amplia evaluación neuropsicológica, y el rendimiento de los usuarios de drogas seropositivos (n = 90) se comparó con la de un grupo control de usuarios de drogas seronegativos (n = 48). Los resultados demuestran que los programas de tratamiento de mantenimiento con metadona pueden convertir en vulnerable a nivel neuropsicológico al individuo seropositivo. Asimismo, descubrimos que abandonar las drogas provoca un efecto protector frente a la existencia de alteraciones neuropsicológicas asociadas con el VIH. Estos resultados nos llevan a sugerir que la seropositividad no basta para explicar las alteraciones neuropsicológicas de los usuarios de drogas seropositivos, ya que estas alteraciones al parecer son multifactoriales.

Perfiles psicopatológicos de obesos y desnutridos medidos con el CBCL/6-18 / Psychopathological profiles of obese children and malnourished measures Obesity; in CBCL/6-18

Los objetivos de este trabajo fueron definir los trastornos psicopatológicos más comunes asociados a la obesidad y a la desnutrición, así como establecer el grupo de referencia normativo al cual pertenece México en la escala Child Behavior Checklist 6-18 (CBCL/6-18). Este fue un estudio transversal de diseño cuasiexperiemental. Se utilizó la información de 125 niños de escuelas públicas de Ciudad Juárez, Chihuahua, México, en estados de desnutrición, obesidad y normopeso, obtenida mediante las 113 preguntas relacionadas con el comportamiento de niños, que contiene el CBCL 6-18. Por medio de análisis de varianzas se estudiaron las posibles diferencias entre los grupos. Encontramos que nuestra muestra mexicana, pertenece al grupo normativo de referencia tres; las diferencias más significativas se encuentran en el grupo de obesos en la escala de problemas internalizados específicamente en ansiedad/depresión, y en el total de problemas.

This paper sought to define the most common psychopathological disorders associated with obese and malnourished children, and establish the normative group to which Mexico belongs in the Child Behavior Checklist 6-18(CBCL/6-18). This was a cross-sectional study of cuasiexperimental design. CBCL/6-18 data from 125 children from public school in Ciudad Juárez, Chihuahua, México were categorized into obese, malnourished and normal nutrition states. The 113 questions related to the behavior of children of the CBCL 6-18 through variance analysis were used to explore the possible differences between groups. Our Mexican children sample belongs to the normative group three. We found that the major differences were in internalized problems, specifically in anxiety/depression, and on Total Problems with the obese group.

Alteraciones neuropsicológicas en pacientes con VIH e historia previa de consumo de sustancias. Un estudio preliminar / HIV-related neuropsychological impairment in patients with previous substance use: A preliminary study

El virus de la inmunodeficiencia humana (VIH) puede llegar a producir alteraciones cognitivas que interfieren de forma significativa en la vida diaria de las personas que lo padecen. Estos déficits pueden incrementarse cuando existe historia previa de consumo de sustancias psicoactivas. El objetivo de este trabajo es estudiar el perfil neuropsicológico de un grupo de pacientes con VIH e historia previa de consumo de drogas y compararlo con un grupo de pacientes ex drogodependientes seronegativos. Se administró una batería neuropsicológica a una muestra de 28 sujetos españoles, 14 con VIH y 14 seronegativos, donde se evaluaron los 8 dominios cognitivos que suelen estar más afectados en el VIH: atención/memoria de trabajo, velocidad de procesamiento de la información, memoria/aprendizaje, abstracción/función ejecutiva, lenguaje/verbal y habilidades motoras. Los resultados mostraron peor ejecución del grupo con VIH en todos los dominios cognitivos. El menor rendimiento neuropsicológico del grupo con VIH podría deberse presumiblemente a la acción del virus. Independientemente de cuál sea la etiología del deterioro cognitivo, lo importante es detectar los déficits neuropsicológicos de la forma más precoz posible para mejorar la calidad de vida de los pacientes mediante la intervención neuropsicológica.

Human immunodeficiency virus (HIV) can result in cognitive disorders that significantly interfere with the daily activities of HIV patients. These disorders may be worse when there is a history of psychoactive substance use. Our objective is to assess the neuropsychological profile in a group of HIV patients with previous drug use compared to a group of HIV-negative patients with a history of drug use. The study included a total of 28 Spanish adult subjects, of which 14 were HIV-infected and 14 were HIV-negative. The subjects were assessed using a neuropsychological test battery to evaluate the following 8 most commonly affected cognitive domains in people with HIV: attention and working memory, speed of information processing, memory and learning capacity, abstract thinking and executive functions, speech and language skills, and psychomotor skills. The results showed a worse performance in all the cognitive areas among HIV patients as compared to HIV-negative patients. The worse performance of this group could be a result of the viral infection. Regardless of the cognitive impairment a etiology, the key task here is to diagnose neuropsychological deficits as soon as possible in order to improve the quality of life of HIV patients through neuropsychological intervention.

Adaptación al castellano de la Centrality of Event Scale (CES) / Adaptation of Centrality of Event Scale (CES) to Spanish

La "Centrality of Event Scale" (CES) es un instrumento utilizado para evaluar la centralidad que tiene una determinada experiencia en la persona. Estudios previos muestran que la centralidad es un constructo altamente relacionado con el estrés post-traumático, la depresión o el duelo complicado. El objetivo de este estudio fue realizar su adaptación al castellano y caracterizar su fiabilidad y validez. Participaron dos muestras compuestas por 208 y 320 estudiantes universitarios que completaron la CES y medidas de depresión (BDI), ansiedad (STAI) y sintomatologia de estrés post-traumático (PSS). Los resultados coinciden con los obtenidos con la versión original de la CES, tanto en consistencia interna (alfa de Cronbach de 0.92 y 0.94, para cada muestra), como en test-retest a los dos meses (r=0.803, p<0.01). El análisis de componentes principales muestra un único factor explicativo que daba cuenta del 45% de la varianza. Finalmente las puntuaciones de la CES muestran relaciones con diversos indices de psicopatologia, siendo además un predictor, junto con las medidas de ansiedad y depresión, del 32% de la sintomatologia de estrés post-traumático. La adaptación al castellano de la escala CES parece ser una medida válida y fiable sobre centralidad del evento.

The "Centrality of Event Scale" (CES) is an instrument used to assess the centrality that a particular event has in the person. Previous studies show that centrality is a construct highly relevant for post-traumatic stress symptomatho-logy, depression and complicated grief. The aim of this study was to adapt into Spanish the CES and obtain evidences of reliability and validity. Two samples consisting of208 and 320 college students participated in the study. They completed the CES and measures of depression (BDI), anxiety (STAI) and symptoms of post-traumatic stress (PSS). The results agree with those obtained by the original version of the CES, showing high internal consistency (Cronbach's alpha of 0.92 and 0.94, for each sample) and acceptable test-retest reliability at two months (r = 0.803, p < 0.01). The principal component analysis shows a single explanatory factor that accounted for 45% of the variance. Finally, CES scores show significative relationships with various indicators of psychopatholo-gy, and is also a predictor, along with measures of anxiety and depression, of the 32% of the symptoms of post-traumatic stress disorder. The Spanish version of the CES seems to be a valid and reliable measure of the centrality of the event.

Procesamiento emocional en maltratadores de género mediante el Test de Expresiones Faciales de Ekman y la Tarea Stroop Emocional / Emotional processing in batterers as assessed by Test Ekman Facial Expressions and Emotional Stroop Task in intimate partner violence situations

La investigación actual en el campo de la violencia de pareja es escasa en lo que se refiere al papel del procesamiento emocional de los maltratadores. Sin embargo, ningún estudio ha investigado en la misma muestra la capacidad de reconocer las emociones y la influencia de las emociones en los aspectos atencionales. El objetivo de este estudio es investigar en una muestra de maltratadores la capacidad de reconocer las emociones de fotografías estandarizadas y analizar la interferencia de las palabras con contenido emocional en una tarea atencional. La muestra consistió en 90 hombres condenados por violencia de pareja y 77 hombres condenados por otros delitos. Se evaluaron las características sociodemográficas asociadas a nuestra muestra y el procesamiento emocional de las expresiones faciales con la prueba de Ekman y la Tarea Stroop Emocional, diseñada específicamente para evaluar el procesamiento emocional en situaciones de violencia contra la pareja. Los resultados mostraron un mejor reconocimiento emocional de los maltratadores en las emociones faciales de enfado y sorpresa. Para el procesamiento de palabras con contenido emocional, las diferencias no fueron estadísticamente significativas.

Current research in the field of intimate partner violence has been scarce as regards the role of emotional processing in abusers. Nevertheless, no study has investigated the ability to recognize emotions and the influence of emotions on attention-related aspects among the same sample. The aim of this study is to investigate the ability to recognize emotions in standardized photographs, and to analyze the interference that words with emotional content exert on an attention task in a sample of abusers. The sample consisted of 90 men convicted of intimate partner violence and 77 men convicted of other crimes. Demographic characteristics associated to the sample were evaluated, as were emotional processing of facial expressions with the Ekman Test and the Emotional Stroop task, specifically designed to assess emotional processing in situations of intimate partner violence. The results showed better emotional recognition among abusers in the recognition of facial emotions of anger and surprise. As for the processing of words with emotional content, differences were not statistically significant.

Personality disorders and emotional variables in patients with lupus / Trastornos de personalidad y variables emocionales en pacientes con lupus

Summary Introduction: Systemic lupus erythematosus (SLE), a prototype of the autoimmune diseases, is a multi-systemic disease characterized by an alteration in the immunological response, where the production of antibodies is directed against nuclear antigens, thus affecting many organs and systems. The course of this disease includes a wide range of clinical manifestations, different anatomo-pathological findings, and a series of immunological abnormalities. It is characterized by outbreaks and remissions. SLE can be manifested by general malaise, fever, fatigue, weight loss, skin rashes or joint inflammation, anemia, inflammation of the lymphatic glands, lowering of the defenses against infection, and cardiac, kidney, pulmonary and neurological alterations. In chronic dermatological lupus, only the skin is affected; this condition can present rash erythemas, etc. The recent introduction of new immunological diagnostic methods (antinuclear antibodies, anti-DNA antibodies, complementary fraction, etc.) has made it possible to recognize less severe forms of the disease, as well as its outbreaks and therapeutic guidelines. Different psychological variables have been associated with the exacerbation of the disease; one of the most notable is stress, and many patients with lupus also suffer diverse psychiatric and personality disorders associated with the disease, with a prevalence oscillating between 20% and 60%. Furthermore, these alterations have been associated with a lower quality of life, poorer evolution and psychiatric antecedents. In the specific case of personality alterations, previous research has found the existence of a "triad of personality" characteristics in patients with lupus. Depression, hysteria and hypochondria are the factors making up this triad. However, it has not been shown whether these personality disorders are just another symptom of the disease or a consequence of the emotional disorders produced by it. The purpose of this study was to test the possible existence of personality disorders and their relationship with other affective disorders in SLE. Methods: In order to do this, we studied 30 patients with lupus and evaluated their possible personality disorders with the MMPI and their levels of depression and anxiety with the BDI and STAI, respectively. Then, after analyzing the results obtained on the tests administered, three groups were established: patients with lupus who had no emotional disorders, patients with lupus who presented clinical anxiety, and patients with lupus who presented clinical depression. These categories were represented graphically. In order to test the effects of anxiety and depression in the psychopathological personality profile, 10 between-group univariate variance analyses (ANOVA) were carried out, one for each subscale of the MMPI. The variable "presence or non-presence of emotional disorders" was the two-level factor. Results: In the graphic representation of the personality patterns of the three groups, it can be seen that patients with lupus who did not present emotional disorders (neither depression or anxiety) did not show any alterations in their personality patterns. However, this pattern was altered in those who presented depression or anxiety. Later, the results found show statistically significant differences on the subscales of Hypochondria [F=9.795, df=1, 29, ±0.004)], Psychasthenia [F=15.266, df=1, 29, p±0.001], and Schizophrenia [F=4.97, df=1, 29, p±0.001)] among those patients who presented emotional disorders and those who did not present any emotional disorder, with the latter receiving higher scores. Conclusion: We can state that the development of personality disorders in patients with lupus is associated with emotional alterations, which probably relate more to processes of adaptation to the disease than to the disease itself.

resumen está disponible en el texto completo