Depression, Suicidal Ideation, and Consumption of Psychotropic Drugs During Lockdown by COVID-19 According to Gender and Age.

The objective was to analyze the relationship between depression and suicidal ideation and psychotropic drugs use during COVID-19 lockdown in adult population considering gender and age. The method used is a descriptive and non-probabilistic study, with a convenience sampling of 3780 participants (70.1% female), aged 18-64 years (M = 37.8). 18.3% participants presented depression and 5.1% exhibited suicidal ideation. The depression rate for female was double (21.4%) than male and 5 times higher (30.2%) for the youngest participants (18-24 years old) compared to oldest (55-64 years old), being this rate triple in suicidal ideation (9%). Depression correlated positively with tranquilizers and sleeping pills' consumption; and suicidal ideation did so with tranquilizers and sedatives. The rate of tranquilizer users was 8 times higher for severe depression compared to those who did not present depression, 5 times higher for sleeping pills, and 6 times higher for sedatives. The rate of tranquilizer users exhibiting suicidal ideation was more than triple than those who did not present suicidal ideation, between 3 and 4 times higher for sleeping pills, and almost 7 times higher for sedatives. The higher the level of depression and suicidal ideation during lockdown, the greater the consumption of psychotropic drugs. The consumption of psychotropic drugs should be monitored in people with depression and suicidal ideation during periods of crisis.

The Virtual Cooking Task: A Preliminary Comparison Between Neuropsychological and Ecological Virtual Reality Tests to Assess Executive Functions Alterations in Patients Affected by Alcohol Use Disorder.

Alcohol use disorder (AUD) is a major global problem. Neuropsychological studies have shown that AUD causes deficits in executive functions (EFs), a set of higher order cognitive skills that govern individual behavior in everyday situations. Many standardized neuropsychological tests are used to evaluate EF. These are reliable and valid but have limitations in predicting real-life performance. To address this, we present a preliminary study to test the virtual cooking task (VCT) as an alternative to standardized neuropsychological tests. The VCT includes four subtasks developed to assess attentional, planning, and cognitive shifting abilities; it was tested in an immersive three-dimensional environment. To evaluate the VCT performance and standardized neuropsychological tests, data were gathered from a sample of healthy subjects (control group [CG]; n = 23) and AUD patients (n = 18). The standardized neuropsychological measures used consisted of questionnaires (Attentional Control Scale, Barratt Impulsiveness Scale, and Cognitive Flexibility Scale) and specific tests (Dot-probe task, Go/No-go test, Stroop test, the trail making test, and Tower of London test). The results showed significant higher correlations for AUD patients than for the CG for the VCT, questionnaires, and specific tests, mainly related to planning and cognitive shifting abilities. Furthermore, comparative analyses of the VCT performance showed that the AUD patients made more errors and had higher latency times than the CG. The present study provides initial evidence that a more ecologically valid assessment can be a useful tool to detect cognitive impairments in many neuropsychological and mental disorders, affecting daily activities.

Computerized cognitive remediation therapy, REHACOM, in first episode of schizophrenia: A randomized controlled trial.

Patients with schizophrenia show cognitive impairments that have been linked to poor social functioning. Computerized cognitive remediation therapy has shown to be effective in improving both cognition and functioning in chronic schizophrenia, but relatively little is known about how these approaches improve cognition and functioning when applied to early stages of psychosis. Eighty-six participants with a first episode of psychosis, undergoing a specific program for early stages of schizophrenia, undertook either the REHACOM computerized cognitive remediation intervention (n = 36), or an active control condition (n = 50) consisting in 24 one-hour sessions addressed twice a week. Clinical features, cognition and functioning were assessed at baseline, post-treatment and six months after finishing the intervention. A significant progressive improvement in neurocognition and functioning was globally shown with no differences observed between the experimental and control group at post training or follow up. All cognitive domains but Social Cognition improved between 0.5 and 1 S.D. through the study period. The computerized cognitive remediation therapy REHACOM has not proved to be effective on improving cognition nor functioning compared to controls in outpatients with a first episode of schizophrenia.

[Validation of the Psychiatric Diagnostic Screening Questionnaire (PDSQ) in a Spanish sample of alcoholic patients]. / Validación del Psychiatric Diagnostic Screening Questionnaire (PDSQ) en una muestra de pacientes alcohólicos españoles.

OBJECTIVE: This study evaluates the psychometric properties of the Psychiatric Diagnostic Screening Questionnaire (PDSQ) in alcohol-dependent Spanish population as a means of detecting psychiatric comorbidity. METHODS: The PDSQ (Zimmerman, 2001) is a self-administered questionnaire with 125 items which can be applied in just 15 minutes, enabling rapid and effective screening of the psychiatric disorders (Axis I) most commonly found among substance abusers. After linguistic adaptation (translation/back-translation) and verification of its content validity, the PDSQ was administered to 156 alcohol-dependent patients (DSM-IV criteria; women = 36%), treated consecutively in an alcohol-disorders treatment setting. Its psychometric properties (reliability and validity) were determined, applying the DSM-IV criteria as a "gold standard", by means of SCID interview. RESULTS: Using the original cut-off points, the PDSQ showed excellent internal reliability (Alfa = 0.68-0.96) and diagnostic validity, with mean sensitivity = 99.6% (range: 96.6%-100%), specificity = 69.5% (range: 51.9%- 94.6%) and NPV = 99.8% (range: 98.6%-100%). Diagnostic efficiency with the original cut-off points was 73.2%, rising to 91.6% using new cut-off points for certain scales, with a degree of agreement with DSM-IV criteria of Kappa = .303 -. 896. CONCLUSIONS: The PDSQ is a reliable and valid instrument for detecting psychiatric comorbidity in alcoholic individuals. Its psychometric properties and the added value of self-administration and short application time make it a recommended instrument for use in routine clinical settings.

[Post-traumatic stress disorder and substance use disorder: treatment intervention]. / Trastorno por estrés post-traumático y trastorno por uso de sustancias: abordaje terapéutico.

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.

[Post-traumatic stress disorder and substance use disorder: epidemiology, nature and neurobiology]. / Trastorno por estrés post-traumático y Trastorno por uso de sustancias: epidemiología, naturaleza y neurobiología.

Post-traumatic stress disorder (PTSD) is frequently associated with other psychiatric diagnoses, being substance use disorder (SUD) one of the most prevailing. Comorbid disorders in general and SUD in particular frequently complicate the course and outcome of PTSD, and vice versa. As with other dual disorders, comorbidity of PTSD and SUD is complex, having been proposed different theoretical models to explain it that will be discussed in the present paper, the first of a series of two. In addition, the present paper reviews data from epidemiological studies, as well as the clinical characteristics, the relevance of stressful life events as a vulnerability factor to PTSD as well as to SUD and the neurobiological basis of the association of both disorders with the aim of gaining a better understanding of this comorbidity, so that the treatment of this dual disorder will be discussed in the second part.

Trastorno por estrés post-traumático y Trastorno por uso de sustancias: epidemiología, naturaleza y neurobiología. / [Post-traumatic stress disorder and substance use disorder: epidemiology, nature and neurobiology]

Post-traumatic stress disorder (PTSD) is frequently associated with other psychiatric diagnoses, being substance use disorder (SUD) one of the most prevailing. Comorbid disorders in general and SUD in particular frequently complicate the course and outcome of PTSD, and vice versa. As with other dual disorders, comorbidity of PTSD and SUD is complex, having been proposed different theoretical models to explain it that will be discussed in the present paper, the first of a series of two. In addition, the present paper reviews data from epidemiological studies, as well as the clinical characteristics, the relevance of stressful life events as a vulnerability factor to PTSD as well as to SUD and the neurobiological basis of the association of both disorders with the aim of gaining a better understanding of this comorbidity, so that the treatment of this dual disorder will be discussed in the second part.

Trastorno por estrés post-traumático y trastorno por uso de sustancias: abordaje terapéutico. / [Post-traumatic stress disorder and substance use disorder: treatment intervention]

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.

Trastorno por estrés post-traumático y Trastorno por uso de sustancias: epidemiología, naturaleza y neurobiología / [Post-traumatic stress disorder and substance use disorder: epidemiology, nature and neurobiology]

Post-traumatic stress disorder (PTSD) is frequently associated with other psychiatric diagnoses, being substance use disorder (SUD) one of the most prevailing. Comorbid disorders in general and SUD in particular frequently complicate the course and outcome of PTSD, and vice versa. As with other dual disorders, comorbidity of PTSD and SUD is complex, having been proposed different theoretical models to explain it that will be discussed in the present paper, the first of a series of two. In addition, the present paper reviews data from epidemiological studies, as well as the clinical characteristics, the relevance of stressful life events as a vulnerability factor to PTSD as well as to SUD and the neurobiological basis of the association of both disorders with the aim of gaining a better understanding of this comorbidity, so that the treatment of this dual disorder will be discussed in the second part.

Trastorno por estrés post-traumático y trastorno por uso de sustancias: abordaje terapéutico / [Post-traumatic stress disorder and substance use disorder: treatment intervention]

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.

Add-on gabapentin in the treatment of opiate withdrawal.

Gabapentin is an antiepileptic drug shown to be effective in the treatment of pain disorders and appears to be useful as well for several psychiatric disorders, including bipolar disorder, anxiety disorders, alcohol withdrawal and cocaine dependence. Gabapentin, at a dose of 600 mg three times a day, was evaluated as an add-on medication to a standard detoxification regime in seven heroin dependent individuals undergoing outpatient opiate withdrawal treatment. All seven patients successfully completed opiate detoxification and commenced opiate antagonist treatment with naltrexone on day five of withdrawal treatment, as scheduled. No adverse event was noted. Gabapentin appeared to lead a reduction in symptomatic medication and an overall beneficial effect on symptoms of heroin withdrawal.

Treatment of nicotine dependence with bupropion SR: review of its efficacy, safety and pharmacological profile.

Bupropion hydrochloride, an atypical antidepressant, is the first non-nicotine product that, in its sustained release form (bupropion SR), has been licensed as an aid for smoking cessation. The specialized literature on bupropion SR and smoking cessation is critically reviewed. The pharmacological profile, dosage and administration, contraindications, as well as the clinical efficacy, safety and tolerability data of bupropion are discussed. Recent reports suggest that its mode of actions might be different to what had originally been proposed. When prescribed appropriately, it appears to be a safe, well-tolerated and effective medication in combination with smoking cessation counselling--for a wide range of smokers, as shown in several multicentre double-blind, placebo-controlled clinical trials. Further research is needed on aspects such as the optimal duration of treatment, the potential role of combination therapy with NRT and psychological interventions, and to establish its effectiveness in smokers with other psychiatric disorders or when used with only minimal support by general practitioners.

Complicaciones físicas del consumo de drogas recreativas / Physical complications of recreational drug use

A lo largo de los últimos años se ha observado un aumento de las publicaciones en la literatura científica sobre las reacciones tóxicas, las complicaciones físicas y los fallecimientos asociados con el consumo de drogas recreativas, paralelo al aumento en la prevalencia de consumo de estas sustancias. Junto con las reacciones adversas que aparecen asociadas a la intoxicación aguda, el consumo de estas sustancias puede provocar complicaciones a nivel cardiovascular, accidentes cerebrovasculares, convulsiones, un cuadro de hiponatremia con edema cerebral o importantes alteraciones a nivel hepático. Sin embargo una de las complicaciones más graves que pueden desarrollarse es el de un síndrome hipertérmico que puede provocar coagulación intravascular diseminada, rabdomiolisis, e insuficiencia renal aguda. En el tratamiento de la intoxicación aguda o ante la ausencia de un antídoto específico el abordaje es fundamentalmente de tipo sintomático y de soporte (AU)

In recent years there has been an increase in the publications in the scientific literature on the toxic reactions, physical complications and deaths associated with “recreations drug” use, parallel to increase in the prevalence of this drug consumption. In addition to the adverse reactions that can be observed associated with acute intoxication, use of these substances may cause cardiovascular complications, cerebrovascular accidents, convulsions, hyponatremia leading to cerebral aedema, as well as important hepatotoxic effects. However, one of the most severe complications that may develop is a hyperthermic syndrome that may evolve to diseminated intravascular coagulation, rhabdomyolysis, and acute renal failure. The treatment of acute intoxication, in light of the absence of a specific antidote the management is primarily symptomatic and supportive (AU)