Nuevas dimensiones, nuevas adicciones: la adiccional al sexo en internet / New dimensions, new addictions: the internet sex adicction

La red es interminable: se puede ir a cualquier sitio, encontrar cualquier cosa, ser cualquier persona. Teclear la palabra sexo en google arroja 96 millones de resultados. La redestá cambiando nuestra forma de comunicarnos y relacionarnos, nos permite construir coordenadas espacio-temporales antes incompatibles. La adicción a Internet no está reconocida en la actualidad como un trastorno en el DSM-IV-TR ni en la CIE-10. Las dos modalidades de adicción a internet con contenido sexual serían el cibersexo y la pornografía. En el cibersexo se experimenta estimulación sexual mientras se mantiene contacto sexual con otra persona. No existe un perfil de usuario, es una conducta extendida y puede tener su aspecto positivo (para determinadas comunidades, para personas con menos habilidades sociales, para condimentar la vida sexual) y su aspecto negativo (adicción, pérdida de control, problemas de pareja y familiares). Es un sexo seguro, anónimo, sin complicaciones. La pornografía en Internet permite el voyeurismo, la visualización de cualquier tipo de prácticas, el uso de modelos reales no profesionales y el espionaje de nuestras conductas a través de los códigos IP. Estas actividades sexuales en la red parecen estar alimentadas por el motor "Triple A": accesibilidad, anonimato, asequibilidad. Hay que evaluar al individuo, a la pareja y las actividades en Internet. No hay tratamiento psicológico ni farmacológico probado pero los programas cognitivos conductuales y técnicas usadas en otras adicciones son provechosas. Existe una gran comorbilidad. El objetivo del tratamiento es el uso adaptativo de Internet. Los profesionales de la salud debemos anticiparnos y aprender sobre estas conductas, diseminar adecuadamente la información para no lanzar mensajes simplistas, proporcionando marcadores y desarrollar estudios, investigaciones y programas de prevención (AU)

The network is endless: going anywhere, finding anything, being anyone. Typing the word sex on Google gives a figure of 96 million results. The network is changing our way of communication and relation; we can construct space-time coordinates before incompatible. Internet addiction is not recognized as a disorder in DSM-IV-TR or ICD-10. Both types of Internet addiction with sexual content are cybersex and pornography. Cybersex consists in experiencing sexual stimulation while maintaining sexual contact with other person. There is no user profile, it is a widespread behaviour and might have a positive aspect(in some communities, persons with fewer social skills, to spice sex life) and a negative aspect (addiction, loss of control, marital and family problems). Sex is safe, anonymous and without complications. Internet pornography voyeurism allows the visualization of all types of practices, the use of real models not professional and to spy our behaviour through the IP code. These sexual activities on the network seems to be powered by the "Triple A" engine: accessibility, anonymity, affordability. We must assess the individual, the couples and the Internet activities. There is no proven pharmacological or psychological treatment but cognitive behavioural programs and techniques used in other addictions are helpful. There is large comorbidity. The goal of treatment refers to the adaptive use of Internet. Health professionals should be in advance and learn about this kind of behaviours, as well as to disseminate the information appropriately not launching simplistic messages, providing markers and developing studies, research and prevention programs (AU)

Evolución de alteraciones psicopatológicas en pacientes con obesidad mórbida tras cirugía bariátrica / Evolution of psychopathologycal alterations in patients with morbid obesity after bariatric surgery

Fundamento y objetivo: Los objetivos del presente estudio son conocer la prevalencia de las alteraciones psicopatológicas de los pacientes con obesidad mórbida (OM) y los criterios de cirugía bariátrica atendidos en este centro, analizar el valor pronóstico de estas alteraciones en los resultados de la cirugía y estudiar su evolución tras alcanzar la estabilización ponderal. Pacientes y método: Se incluyó en el estudio un total de 145 pacientes del Hospital Universitario Fundación Alcorcón (122 mujeres) candidatos a cirugía bariátrica (108 finalmente intervenidos). Se realizó una entrevista clínica y se aplicaron varias escalas de psicopatología precirugía y poscirugía: BDI (Beck Depression Inventory escala de depresión de Beck ), BAI (Beck anxiety inventory escala de ansiedad de Beck ), MOCI (Maudsley Obsessional-Compulsive Inventory inventario de obsesiones-compulsiones de Maudsley ), BIS (Barratt Impulsiveness Scale escala de impulsividad de Barrat ), EDI (Eating Disorders Inventory inventario de trastornos de la alimentación ), EAT (Eating Attitudes Test test de actitudes hacia la comida ), BITE (Bulimic Investigatory Test Edimburgh test de bulimia de Edimburgo ) y BSQ (Body Shape Questionnaire cuestionario sobre la figura corporal ). Se realizó una comparación de muestras emparejadas entre las puntuaciones iniciales y finales de las pruebas psicométricas y se llevó a cabo un análisis de regresión logística para valorar las variables predictivas de evolución positiva de la cirugía, definida como porcentaje de sobrepeso perdido superior al 50% e índice de masa corporal final inferior a 35kg/m2. Resultados: Se observó una mejoría en la puntuación de la BDI, la BAI y en las subescalas del EDI: EDI-DT (drive for thinness impulso a la delgadez ) y EDI-BD (body dissatisfaction insatisfacción corporal ). Para el resto de las pruebas psicométricas las diferencias no fueron estadísticamente significativas (AU)

Background and objective: The aims of this study were to know the prevalence of the psychopathological alterations among patients with morbid obesity (MO) candidates for bariatric surgery in our centre, to analyze its predictive value on the surgical outcome and to study the evolution after weight stabilization was achieved. Patients and methods: One hundred and forty five patients of the University Hospital Foundation Alcorcón (122 women) candidates for bariatric surgery (108 finally operated) were included in the study. A clinical interview was carried and several scales of psychopathology were applied before and after surgery: Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Maudsley Obsessive-compulsive Interview (MOCI), Barrat Impulsiveness Scale (BIS), Eating Disorder Inventory (EDI), Eating Attitudes Test (EAT), Bulimic Investigation Test Edinburg (BITE), and Body Shape Questionnaire (BSQ). A comparison of means between the initial and final scores of the psychometric tests and a logistic regression analysis to identify the predictive variables of positive evolution after surgery (defined as percentage of lost overweight> 50% and final IMC <35) were performed. Results: An improvement in the scores of BDI, BAI and in the subscales of EDI, Impulse to the thinness (EDI-DT) and corporal Dissatisfaction (EDI-BD) was observed. The differences were not significant for the rest of the psychometric tests. The multivariate analysis identified 3 predictive factors for postsurgical evolution: BDI (OR 0.91, IC95% 0.82 1.02), BIS (OR 1.08, IC 95% 1.0 1.16) y EDI-DT (OR 1.18, IC 95% 1.0 1.39). Conclusions: In our study, the scales of depression, anxiety, impulse to thinness and corporal dissatisfaction improved in patients with MO after bariatric surgery. Some baseline psychometric variables may predict a favourable postsurgical evolution of these patients (AU)

[Evolution of psychopathological alterations in patients with morbid obesity after bariatric surgery]. / Evolución de alteraciones psicopatológicas en pacientes con obesidad mórbida tras cirugía bariátrica.

BACKGROUND AND OBJECTIVE: The aims of this study were to know the prevalence of the psychopathological alterations among patients with morbid obesity (MO) candidates for bariatric surgery in our centre, to analyze its predictive value on the surgical outcome and to study the evolution after weight stabilization was achieved. PATIENTS AND METHODS: One hundred and forty five patients of the University Hospital Foundation Alcorcón (122 women) candidates for bariatric surgery (108 finally operated) were included in the study. A clinical interview was carried and several scales of psychopathology were applied before and after surgery: Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Maudsley Obsessive-compulsive Interview (MOCI), Barrat Impulsiveness Scale (BIS), Eating Disorder Inventory (EDI), Eating Attitudes Test (EAT), Bulimic Investigation Test Edinburg (BITE), and Body Shape Questionnaire (BSQ). A comparison of means between the initial and final scores of the psychometric tests and a logistic regression analysis to identify the predictive variables of positive evolution after surgery (defined as percentage of lost overweight> 50% and final IMC <35) were performed. RESULTS: An improvement in the scores of BDI, BAI and in the subscales of EDI, Impulse to the thinness (EDI-DT) and corporal Dissatisfaction (EDI-BD) was observed. The differences were not significant for the rest of the psychometric tests. The multivariate analysis identified 3 predictive factors for postsurgical evolution: BDI (OR 0.91, IC95% 0.82-1.02), BIS (OR 1.08, IC 95% 1.0-1.16) y EDI-DT (OR 1.18, IC 95% 1.0-1.39). CONCLUSIONS: In our study, the scales of depression, anxiety, impulse to thinness and corporal dissatisfaction improved in patients with MO after bariatric surgery. Some baseline psychometric variables may predict a favourable postsurgical evolution of these patients.