Risk factors for cocaine-induced psychosis in cocaine-dependent patients.

Cocaine consumption can induce transient psychotic symptoms, expressed as paranoia or hallucinations. Cocaine induced psychosis (CIP) is common but not developed in all cases. This is the first European study on the relationship between CIP, consumption pattern variables and personality disorders. We evaluated 173 cocaine-dependent patients over 18 years; mostly males, whose average age was 33.6 years (SD=7.8). Patients attending an outpatient addictions department were enrolled in the study and subsequently systematically evaluated using SCID I and SCID II interviews for comorbid disorders, a clinical interview for psychotic symptoms and EuropASI for severity of addiction. A high proportion of cocaine dependent patients reported psychotic symptoms under the influence of cocaine (53.8%), the most frequently reported being paranoid beliefs and suspiciousness (43.9%). A logistic regression analysis was performed, finding that a model consisting of amount of cocaine consumption, presence of an antisocial personality disorder and cannabis dependence history had 66.2% sensitivity 75.8% specificity predicting the presence of CIP. In our conclusions, we discuss the relevance of evaluating CIP in all cocaine dependent-patients, and particularly in those fulfilling the clinical profile derived from our results. These findings could be useful for a clinical approach to the risks of psychotic states in cocaine-dependent patients.

Comorbilidad psiquiátrica en adolescentes consumidores de cannabis / Psychiatric comorbidity in cannabis users

El cannabis es la droga ilegal más consumida en el mundo. En los últimos años, se ha producido un aumento del consumo experimental, sobre todo en la población adolescente, y a edades cada vez más tempranas. Además del incremento del consumo, se está produciendo, especialmente en la población más joven, la disminución de la percepción de riesgo, que es mucho menor que para otras drogas. El objetivo del trabajo es describir una muestra de pacientes que realizan el seguimiento en un centro ambulatorio de dependencias para tratar un trastorno por dependencia de cannabis, y estudiar la interrelación entre el consumo de cannabis y los problemas psicosociales existentes, sobre todo en la población adolescente. Algunos estudios refieren que es difícil establecer la relación causal entre el consumo de cannabis y la existencia de consecuencias psicopatológicas; pero en lo que sí están de acuerdo varios autores es en que existe una estrecha relación entre ambos hechos. Los consumidores crónicos de cannabis presentan mayores dificultades y problemas psicosociales (AU)

Cannabis is currently the most widely consumed illegal drug. A rise in experimental use has taken place in the last years, mainly in the adolescent population. Meanwhile, the age of first use has decreased. In addition to an increase in cannabis use, a reduction in the perception of risk has been observed, in young populations specially, being much lower than for other drugs. The aim of this study is to describe a sample of outpatients with cannabis dependence disorder and to review the relationship between cannabis use and the existing psychosocial problems, mainly in the teenage population. Some studies report that causal relation between cannabis use and psychopathological consequences is difficult to establish, though many agree on the existence of a close association between both. Chronic cannabis users have greater difficulties and psychosocial problems (AU)

Cuestionario autoinformado de cribado de TDAH ASRS-v. 1.1 en adultos en tratamiento por trastorno por uso de sustancias / Adult ADHD Self-Report Scale (ASRS-v1.1) symptom checklist in patients with substance use disorders

Objetivo. Diagnosticar el trastorno por déficit de atención con hiperactividad (TDAH) en pacientes con trastorno por uso de sustancias (TUS) es un proceso complejo, en el cual un instrumento de cribado puede ser de granutilidad. Se ha analizado la validez del cuestionario autoinformado de cribado de TDAH en adultos ASRS-v1.1 en pacientes con TUS, considerando la gravedad de la adicción y la comorbilidad con los trastornos depresivo, antisocial y límite de la personalidad. Método. Se evaluaron 80 pacientes en tratamiento ambulatorio por dependencia de sustancias mediante los siguientes instrumentos: ASRS-v1.1, CAADID-II, Europ ASI, SCID-I, SCID-II. Se realizó un análisis factorial con rotación varimax para determinar la estructura de las intercorrelaciones entre los ítems y se analizó la exactitud delASRS-v1.1.Resultados. La entrevista diagnóstica CAADID utilizada como patrón de oro, indica que el 20% (intervalo de confianza [IC] del 95%: 11-29) cumple criterios para TDAH. La estructura factorial del ASRS-v1.1 está marcada por dos factores referentes a inatención e hiperactividad/impulsividad que explican el 67,7% de la varianza. ElASRS-v1.1 con punto de corte 4, presenta una sensibilidad del 87,5% y una especificidad del 68,8%. Conclusiones. El ASRS-v1.1 es un instrumento de cribado sencillo, útil y de aceptable validez para identificar TDAH entre pacientes con TUS (AU)

Aim. Diagnosing attention deficit/hyperactivity disorder (ADHD) in patients with substance use disorder (SUD) is a complicated process in which a screening tool may be useful. We analyzed the ASRS-v1.1 validity in patients with SUD, considering the addiction severity and comorbidity with depressive disorders, antisocial and borderline personality. Methods. Eighty outpatients with SUD were evaluated with the following instruments: ASRS-v1.1, CAAD-II, Europ ASI, SCID-I, SCID-II. A factor analysis was performed with Varimax rotation to determine the structure of the intercorrelations among the items. Accuracy of ASRS-v1.1 was also analyzed. Results. The diagnostic interview CAADID used as a gold standard indicated that 20% (95% confidence interval [CI]: 11-29) meet the criteria for ADHD. The ASRS v1.1factor structure is marked by two factors related to inattention and hyperactivity / impulsivity that account for 67.7% of the variance. ASRS-v1.1, with a 4 cut-off, showed an 87.5% sensitivity and 68.6% specificity. Conclusions. ASRS-v1.1 is a simple screening tool that is useful and has acceptable validity for the identification of ADHD among addicted patients (AU)

Adult ADHD Self-Report Scale (ASRS-v1.1) symptom checklist in patients with substance use disorders.

AIM: Diagnosing attention deficit/hyperactivity disorder (ADHD) in patients with substance use disorder (SUD) is a complicated process in which a screening tool may be useful. We analyzed the ASRS-v1.1 validity in patients with SUD, considering the addiction severity and co-morbidity with depressive disorders, antisocial and borderline personality. METHODS: Eighty outpatients with SUD were evaluated with the following instruments: ASRS-v1.1, CAAD-II, EuropASI, SCID-I, SCID-II. A factor analysis was performed with Varimax rotation to determine the structure of the intercorrelations among the items. Accuracy of ASRS-v1.1 was also analyzed. RESULTS: The diagnostic interview CAADID used as a gold standard indicated that 20% (95% confidence interval [CI]: 11-29) meet the criteria for ADHD. The ASRSv1.1 factor structure is marked by two factors related to inattention and hyperactivity / impulsivity that account for 67.7% of the variance. ASRS-v1.1, with a 4 cut-off, showed an 87.5% sensitivity and 68.6% specificity. CONCLUSIONS: ASRS-v1.1 is a simple screening tool that is useful and has acceptable validity for the identification of ADHD among addicted patients.

[Nutrition and dietary recommendations for the elderly "Public Health" Working Group of the Spanish Nutrition Society]. / Nutrición y recomendaciones dietéticas para personas mayores. Grupo de trabajo "Salud pública" de la Sociedad Española de Nutrición (SEN).

With the increase of life expectancy, the desire to maintain good health, functionality and maximum quality of life at advanced ages, for which nutrition plays a critical role, is a priority for the elderly. Though genetic factors are a determinant of life expectancy, there are several extrinsic factors which have a great influence on the quality of life of the elderly. Diet and nutritional status have a great influence, especially in the prevention and treatment of several diseases, which affect this heterogeneous and vulnerable age group. The nutritional status and needs of elderly people are associated with age-related biological, psychological and often socio-economic changes. All of these changes can increase the risk of developing a number of age-related diseases. In developed countries the elderly are the most affected by malnutrition, either because of a deficiency (energy and several nutrients) or an excess, leading to obesity and related diseases. This review highlights the most important factors affecting nutritional status in elderly people and focus on the need to maintain adequate physical activity level and an optimal physic, psychic and social functional capacity. It discusses dietary reference intakes and guidelines to improve and/or maintain adequate nutritional status in older people in order to reduce susceptibility to some illness and disease.

Nutrición y recomendaciones dietéticas para personas mayores. Grupo de trabajo "Salud pública" de la Sociedad Española de Nutrición (SEN) / Nutrition and dietary recommendations for the elderly "public health" working group of the spanish nutrition society

Con el incremento de la esperanza de vida, el deseo de mantener una buena salud, funcionalidad y una máxima calidad de vida en edades avanzadas constituye una prioridad en las personas mayores. Aunque la genética es un determinante de esta expectativa de vida, existen otros factores extrínsecos directamente implicados en la calidad de vida del anciano, entre los que cabe destacar la alimentación. La dieta y el estado nutricional tienen gran influencia, particularmente en la prevención o tratamiento de diversas enfermedades que afectan a este grupo, uno de los más heterogéneos y vulnerables de la población de los países desarrollados con un mayor riesgo de sufrir desequilibrios, carencias y problemas nutricionales. Esto es debido, por un lado, a que las necesidades de algunos nutrientes pueden ser mayores que en etapas anteriores y, por otro, a su menor capacidad para regular todos los procesos relacionados con la ingesta de alimentos como consecuencia del progresivo deterioro de casi todas las funciones biológicas. Los numerosos cambios físicos, psíquicos y sociales que acompañan al envejecimiento y la mayor prevalencia de enfermedades crónicas, también contribuyen a esta situación. Diversos estudios han puesto de manifiesto el riesgo de ingestas inadecuadas y de malnutrición proteico-energética, aumentando la vulnerabilidad a otras enfermedades. En este trabajo se hace una revisión de los principales condicionantes del estado nutricional en el anciano, de la importancia de la capacidad funcional física, psíquica y social y de la actividad física y de su repercusión en el estado nutricional. Se describen las ingestas de referencia y las recomendaciones dietéticas más actuales, tratando de establecer las condiciones dietéticas y de estilo de vida que pueden contribuir a preservar las funciones corporales y minimizar las enfermedades crónicas en las personas de edad (AU)

With the increase of life expectancy, the desire to maintain good health, functionality and maximum quality of life at advanced ages, for which nutrition plays a critical role, is a priority for the elderly. Though genetic factors are a determinant of life expectancy, there are several extrinsic factors which have a great influence on the quality of life of the elderly. Diet and nutritional status have a great influence, especially in the prevention and treatment of several diseases, which affect this heterogeneous and vulnerable age group. The nutritional status and needs of elderly people are associated with age-related biological, psychological and often socio-economic changes. All of these changes can increase the risk of developing a number of age-related diseases. In developed countries the elderly are the most affected by malnutrition, either because of a deficiency (energy and several nutrients) or an excess, leading to obesity and related diseases. This review highlights the most important factors affecting nutritional status in elderly people and focus on the need to maintain adequate physical activity level and an optimal physic, psychic and social functional capacity. It discusses dietary reference intakes and guidelines to improve and/or maintain adequate nutritional status in older people in order to reduce susceptibility to some illness and disease (AU)

Alimentos funcionales: Indicaciones / Functional food: indications

Los alimentos funcionales tienen efectos probablemente beneficiosos para una o varias de las funciones corporales; y pueden ser tanto naturales como con componentes agregados, removidos, o modificados. Se describen sus principales características, consideraciones de seguridad, área de crecimiento, e indicaciones sobre su efecto en diferentes áreas del organismo

Alimentos funcionales: Indicaciones / Functional food: indications

Los alimentos funcionales tienen efectos probablemente beneficiosos para una o varias de las funciones corporales; y pueden ser tanto naturales como con componentes agregados, removidos, o modificados. Se describen sus principales características, consideraciones de seguridad, área de crecimiento, e indicaciones sobre su efecto en diferentes áreas del organismo

School meals in Catalonia: surveillance and quality control.

The Education Council of the Catalonian government drew up a programme to improve the quality control of school canteens in Catalonia. The objectives of this programme were to contribute to developing healthier eating habits in school children through school canteens and to improve school canteen services considering other aspects such as service, operation, management, end-users, frontline staff and supervisors of menu planning. This paper deals with two programme components aiming at introducing Nutrition in the school syllabus and school menu assessment. Various departments, organisations and associations were involved in programme development and implementation. Initial analysis was based on information collected from formal administrative reports completed by a survey on 100 primary schools. From this preliminary analysis it was concluded that problem identification needs to be completed by an understanding of underlying reasons in order to design adequate solutions and guarantee implementation.

Striatal dopaminergic D(2) receptor density measured by [(123)I]iodobenzamide SPECT in the prediction of treatment outcome of alcohol-dependent patients.

OBJECTIVE: The authors' goal was to study striatal dopaminergic dopamine 2 (D(2)) receptors as a biological marker of early relapse in detoxified alcoholic patients by using [(123)I]iodobenzamide ([123I]IBZM) single photon emission computed tomography (SPECT). METHOD: The authors performed [(123)I]IBZM SPECT on 21 alcohol-dependent inpatients during detoxification and on nine healthy volunteers, using the ratios of basal ganglia to occipital lobes for SPECT quantification. Depending on treatment outcome 3 months after hospital discharge, patients were determined to be relapsers or nonrelapsers. RESULTS: Alcohol-dependent subjects with early relapse (within 3 months after hospital discharge) showed a higher uptake of [(123)I]IBZM in the basal ganglia during detoxification (mean ratio=1.83, SD=0.9) than patients who did not have early relapse (mean ratio=1.69, SD=0.11). CONCLUSIONS: These results suggest that low levels of dopamine, or an increased density of free striatal dopaminergic D(2) receptors, could be related to early relapse in alcohol-dependent patients. Therefore, [(123)I]IBZM SPECT could become a biological marker of vulnerability to relapse for alcoholic patients in recovery.