La soledad: asociación con la salud mental en un estudio poblacional / Loneliness: association with mental health in a population-based study

La soledad es un problema emergente de salud pública en países desarrollados. El objetivo es establecer la prevalencia en una muestra representativa de una gran ciudad y su relación con indicadores de salud mental. Se realizó un muestreo aleatorio estratificado (n= 8.828), se preguntó por el grado en que se había sentido sólo durante el último año y se incluyeron cuestionarios relativos a su salud mental. Un 10,2% declaró sentirse solo durante el último año. Quienes se sienten solos cuadriplican las probabilidades de desarrollar más síntomas de mala salud mental (63% vs. 16%), recibir un diagnóstico de ansiedad/depresión y de serles prescritos psicofármacos. El modelo estructural sugiere que la soledad empeora la salud mental, conllevando mayor prescripción de fármacos, lo que incrementa la sensación de soledad. La soledad suele quedar en el anonimato y la intimidad, y se aborda principalmente mediante la prescripción de psicofármacos que agravan el problema, sumiendo al sujeto en un círculo vicioso con difícil escapatoria. Los resultados obligan a ofrecer respuestas más eficaces que el mero abordaje farmacológico. (AU)

Loneliness is an emerging public health problem in developed countries. The objective was to establish the prevalence in a representative sample of a large city and its relationship with mental health indicators. Using stratified random sampling, a sample of 8,828 was obtained. The degree to which they had felt lonely during the last year and other questions and questionnaires related to their mental health were asked. A total of 10.2% reported feeling lonely during the last year. Those who felt lonely were four times more likely to develop more symptoms of poor mental health (63% vs. 16%), to receive a diagnosis of anxiety/depression, and to be prescribed psychotropic drugs. The structural model suggests thatloneliness worsens mental health, leading to greater prescription of drugs, which increases feelings of loneliness. Loneliness tends to remain in anonymity and intimacy, and is addressed mainly through the prescription of psychotropic drugs that aggravate the problem, plunging the subject into a vicious circle that is difficult to escape. The results make it necessary to offer more effective responses than a mere pharmacological approach. (AU)

Clinical validation of the Allen's Cognitive Level Screen in acquired brain injury.

BACKGROUND: The evaluation of functional cognition is a central concern in clinical practice. However, there are few standardized or validated tools, and many of them take too long, requiring screening tests. AIMS: To explore the convergent validity of the ACLS-5 with other cognitive screening test and functional independence test in a sample of people with acquired brain injury. Moreover, to examine the prediction of ACLS-5 on functioning and cognitive performance outcomes. MATERIALS AND METHODS: A cross-sectional design was applied following the guidelines of the STROBE checklist. A consecutive sample of people with acquired brain injury was recruited from rehabilitation centers. A cognitive screening test and daily living activity tests were implemented, such as ACLS-5, MoCA, Barthel, and FIM+FAM. Data were analyzed using non-parametric methods. In addition, a structural analysis and simple regression models were performed. RESULTS: Eighty patients with chronic acquired brain injury, with a mean age of 52, were recruited. All tests are significantly related to the ACLS-5 score, a moderate effect size for MoCA (ρ = 0.36), and a strong effect size for the other two (ρ > 0.50). CONCLUSIONS: ACLS-5 predicts functional and cognitive performance quickly and effectively, optimizing assessment time and avoiding mental fatigue or physical exhaustion.

El necesario cambio de paradigma en el estudio de la adicción: inconsistencias y falacias del modelo de enfermedad cerebral de la adicción / The necessary paradigm shift in the study of addiction: Inconsistencies and fallacies of the brain disease model of addiction

Este artículo pretende ser el epítome de una trayectoria, de una línea de actuación mantenida en eltiempo y enmarcada en una visión de la persona, no como objeto de tratamiento, sino como sujetoresponsable y co-constructor de la respuesta a una problemática adictiva.Transcender la adicción es el liberar la mirada de un paradigma arcaico, opresor y estigmatizante.Es, así mismo, establecer una relación horizontal, propositiva y motivante, en vez de la relaciónvertical imperante. Lo técnico no debe priorizar a lo relacional.Transcender la adicción es ir más allá de un diagnóstico; ir más allá de la consideración de enfermedadmental, para poder centrar el proceso en la persona y, fundamentalmente, en la parte sana, en laparte no contaminada, para la consecución de su ser libre, ser libre para.Siendo la identidad una necesidad afectiva, cognitiva y activa, debe constituirse en el pilar básico deltratamiento. No se trata de rehabilitar adicciones, sino generar la posibilidad de que una persona sereencuentre a sí misma en el camino de su existencia.Cierto día se oyó un lamento “yo no soy mi adicción, no me lo hagáis creer”. (AU)

This article aims to be the epitome of a trajectory, of a line of action maintained over time andframed in a vision of the person, not as an object of treatment, but as a responsible subjectand co-builder of the response to an addictive problem.Transcending addiction is freeing the gaze from an archaic, oppressive and stigmatizing paradigm. It is, likewise, to establish a horizontal, purposeful and motivating relationship, instead ofthe prevailing vertical relationship. The technical should not favor the relational.Transcending addiction is going beyond a diagnosis; go beyond the consideration of mentalillness, to be able to focus the process on the person and, fundamentally, on the healthy part,on the uncontaminated part, in order to achieve their free being.Since identity is an affective, cognitive and active need, it must become the basic pillar of treatment. It is not about rehabilitating addictions, but generating the possibility for a person torediscover themself on the path of their existence.One day a lament was heard: “I am not my addiction, don’t make me believe it” (AU)

The necessary paradigm shift in the study of addiction: Inconsistencies and fallacies of the brain disease model of addiction / El necesario cambio de paradigma en el estudio de la adicción: inconsistencias y falacias del modelo de enfermedad cerebral de la adicción

This article aims to be the epitome of a trajectory, of a line of action maintained over time andframed in a vision of the person, not as an object of treatment, but as a responsible subjectand co-builder of the response to an addictive problem.Transcending addiction is freeing the gaze from an archaic, oppressive and stigmatizing paradigm. It is, likewise, to establish a horizontal, purposeful and motivating relationship, instead ofthe prevailing vertical relationship. The technical should not favor the relational.Transcending addiction is going beyond a diagnosis; go beyond the consideration of mentalillness, to be able to focus the process on the person and, fundamentally, on the healthy part,on the uncontaminated part, in order to achieve their free being.Since identity is an affective, cognitive and active need, it must become the basic pillar of treatment. It is not about rehabilitating addictions, but generating the possibility for a person torediscover themself on the path of their existence.One day a lament was heard: “I am not my addiction, don’t make me believe it” (AU)

Este artículo pretende ser el epítome de una trayectoria, de una línea de actuación mantenida en eltiempo y enmarcada en una visión de la persona, no como objeto de tratamiento, sino como sujetoresponsable y co-constructor de la respuesta a una problemática adictiva.Transcender la adicción es el liberar la mirada de un paradigma arcaico, opresor y estigmatizante.Es, así mismo, establecer una relación horizontal, propositiva y motivante, en vez de la relaciónvertical imperante. Lo técnico no debe priorizar a lo relacional.Transcender la adicción es ir más allá de un diagnóstico; ir más allá de la consideración de enfermedadmental, para poder centrar el proceso en la persona y, fundamentalmente, en la parte sana, en laparte no contaminada, para la consecución de su ser libre, ser libre para.Siendo la identidad una necesidad afectiva, cognitiva y activa, debe constituirse en el pilar básico deltratamiento. No se trata de rehabilitar adicciones, sino generar la posibilidad de que una persona sereencuentre a sí misma en el camino de su existencia.Cierto día se oyó un lamento “yo no soy mi adicción, no me lo hagáis creer”. (AU)

The UPPS model of impulsivity in the abuse of Information and Communication Technologies (ICT). / El modelo UPPS de impulsividad en el abuso de las Tecnologías de la Información y la Comunicación (TIC).

The UPPS model of impulsivity has recently been proposed, has been widely applied to substance abuse and is one of those recommended in the context of Research Domain Criteria, RDoC. However, its application to the abuse of information and communication technologies (ICTs) has been very limited. In the present work, a sample of n = 748 (67% females) was recruited through the Internet, and the reduced version of the UPPS-P was administered, in addition to the MULTICAGE-TIC and the Prefrontal Symptoms Inventory (PSI-20). The psychometric properties of UPPS-P were satisfactory in terms of internal consistency (0.87 > ω > 0.75) and structural validity. Impulsivity measured by UPPS-P correlated with all MULTICAGE-TIC scales, although with a very small effect size, and with greater magnitude with prefrontal dysfunction symptoms. The impulsivity dimension most related to ICT abuse was Urgency (0.3 > r > 0.2). A structural analysis of all the variables was carried out, with impulsivity appearing as a product of the prefrontal malfunction that predicted, through Positive Urgency, the abuse of ICTs. Impulsivity does not seem to be the central nucleus of ICT abuse, but rather failures in the superior control of behavior, of which impulsivity would be a consequence, but not the most important. This makes it advisable to design cognitive rehabilitation interventions that improve the functioning of superior behavior control mechanisms in the prevention and treatment of ICT abuse.

El modelo UPPS de impulsividad se ha propuesto recientemente, ha sido ampliamente aplicado al abuso de sustancias y es uno de los recomendados en el contexto de investigación Research Domain Criteria, RDoC. Sin embargo, su aplicación al abuso de tecnologías de la información y la comunicación (TIC) ha sido muy limitado. En el presente trabajo se reclutó a través de Internet una muestra de n = 748 (67% mujeres) y se administró la versión reducida de la UPPS-P, además del MULTICAGE-TIC y el Inventario de Síntomas Prefrontales (ISP-20). Las propiedades psicométricas de la UPPS-P resultaron satisfactorias en consistencia interna (0,87 > ω >0,75) y validez estructural. La impulsividad medida por la UPPS-P correlacionó con todas las escalas del MULTICAGE-TIC, aunque con un tamaño del efecto muy pequeño, y con mayor magnitud con las de síntomas de mal funcionamiento prefrontal. Las dimensiones de impulsividad más relacionadas con el abuso de las TIC fueron las de Urgencia (0,3 > r > 0,2). Se realizó un análisis estructural de todas las variables apareciendo la impulsividad como un producto del mal funcionamiento prefrontal que predecía, a través de la Urgencia Positiva, el abuso de las TIC. La impulsividad no parece ser el núcleo central del abuso de las TIC, sino los fallos en el control superior de la conducta, de los que la impulsividad sería una consecuencia, pero no la más importante. Ello hace recomendable el diseño de intervenciones de rehabilitación cognitiva que mejoren el funcionamiento de los mecanismos de control superior de la conducta en la prevención y tratamiento del abuso de las TIC.

El modelo UPPS de impulsividad en el abuso de lasTecnologías de la Información y la Comunicación (TIC) / The UPPS model of impulsivity in the abuse of Information and Communication Technologies (ICT)

El modelo UPPS de impulsividad se ha propuesto recientemente, hasido ampliamente aplicado al abuso de sustancias y es uno de los recomendados en el contexto de investigación Research Domain Criteria,RDoC. Sin embargo, su aplicación al abuso de tecnologías de la información y la comunicación (TIC) ha sido muy limitado. En el presentetrabajo se reclutó a través de Internet una muestra de n=748 (67%mujeres) y se administró la versión reducida de la UPPS-P, además delMULTICAGE-TIC y el Inventario de Síntomas Prefrontales (ISP-20).Las propiedades psicométricas de la UPPS-P resultaron satisfactoriasen consistencia interna (0,87>ω>0,75) y validez estructural. La impulsividad medida por la UPPS-P correlacionó con todas las escalas delMULTICAGE-TIC, aunque con un tamaño del efecto muy pequeño,y con mayor magnitud con las de síntomas de mal funcionamientoprefrontal. Las dimensiones de impulsividad más relacionadas con elabuso de las TIC fueron las de Urgencia (0,3>r>0,2). Se realizó unanálisis estructural de todas las variables apareciendo la impulsividadcomo un producto del mal funcionamiento prefrontal que predecía,a través de la Urgencia Positiva, el abuso de las TIC. La impulsividadno parece ser el núcleo central del abuso de las TIC, sino los fallos enel control superior de la conducta, de los que la impulsividad seríauna consecuencia, pero no la más importante. Ello hace recomendable el diseño de intervenciones de rehabilitación cognitiva que mejoren el funcionamiento de los mecanismos de control superior de laconducta en la prevención y tratamiento del abuso de las TIC. (AU)

The UPPS model of impulsivity has recently been proposed, has beenwidely applied to substance abuse and is one of those recommendedin the context of Research Domain Criteria, RDoC. However, its application to the abuse of information and communication technologies (ICTs) has been very limited. In the present work, a sample ofn=748 (67% females) was recruited through the Internet, and thereduced version of the UPPS-P was administered, in addition to theMULTICAGE-TIC and the Prefrontal Symptoms Inventory (PSI-20).The psychometric properties of UPPS-P were satisfactory in terms ofinternal consistency (0.87 > ω > 0.75) and structural validity. Impulsivity measured by UPPS-P correlated with all MULTICAGE-TIC scales,although with a very small effect size, and with greater magnitudewith prefrontal dysfunction symptoms. The impulsivity dimensionmost related to ICT abuse was Urgency (0.3 > r > 0.2). A structuralanalysis of all the variables was carried out, with impulsivity appearingas a product of the prefrontal malfunction that predicted, throughPositive Urgency, the abuse of ICTs. Impulsivity does not seem to bethe central nucleus of ICT abuse, but rather failures in the superiorcontrol of behavior, of which impulsivity would be a consequence, butnot the most important. This makes it advisable to design cognitiverehabilitation interventions that improve the functioning of superiorbehavior control mechanisms in the prevention and treatment of ICTabuse. (AU)

The Stimulatory Effects of Intracellular α-Synuclein on Synaptic Transmission Are Attenuated by 2-Octahydroisoquinolin-2(1H)-ylethanamine.

α-Synuclein (αSyn) species can be detected in synaptic boutons, where they play a crucial role in the pathogenesis of Parkinson's Disease (PD). However, the effects of intracellular αSyn species on synaptic transmission have not been thoroughly studied. Here, using patch-clamp recordings in hippocampal neurons, we report that αSyn oligomers (αSynO), intracellularly delivered through the patch electrode, produced a fast and potent effect on synaptic transmission, causing a substantial increase in the frequency, amplitude and transferred charge of spontaneous synaptic currents. We also found an increase in the frequency of miniature synaptic currents, suggesting an effect located at the presynaptic site of the synapsis. Furthermore, our in silico approximation using docking analysis and molecular dynamics simulations showed an interaction between a previously described small anti-amyloid beta (Aß) molecule, termed M30 (2-octahydroisoquinolin-2(1H)-ylethanamine), with a central hydrophobic region of αSyn. In line with this finding, our empirical data aimed to obtain oligomerization states with thioflavin T (ThT) and Western blot (WB) indicated that M30 interfered with αSyn aggregation and decreased the formation of higher-molecular-weight species. Furthermore, the effect of αSynO on synaptic physiology was also antagonized by M30, resulting in a decrease in the frequency, amplitude, and charge transferred of synaptic currents. Overall, the present results show an excitatory effect of intracellular αSyn low molecular-weight species, not previously described, that are able to affect synaptic transmission, and the potential of a small neuroactive molecule to interfere with the aggregation process and the synaptic effect of αSyn, suggesting that M30 could be a potential therapeutic strategy for synucleinopathies.

Synaptic dysregulation and hyperexcitability induced by intracellular amyloid beta oligomers.

Intracellular amyloid beta oligomer (iAßo) accumulation and neuronal hyperexcitability are two crucial events at early stages of Alzheimer's disease (AD). However, to date, no mechanism linking iAßo with an increase in neuronal excitability has been reported. Here, the effects of human AD brain-derived (h-iAßo) and synthetic (iAßo) peptides on synaptic currents and action potential firing were investigated in hippocampal neurons. Starting from 500 pM, iAßo rapidly increased the frequency of synaptic currents and higher concentrations potentiated the AMPA receptor-mediated current. Both effects were PKC-dependent. Parallel recordings of synaptic currents and nitric oxide (NO)-associated fluorescence showed that the increased frequency, related to pre-synaptic release, was dependent on a NO-mediated retrograde signaling. Moreover, increased synchronization in NO production was also observed in neurons neighboring those dialyzed with iAßo, indicating that iAßo can increase network excitability at a distance. Current-clamp recordings suggested that iAßo increased neuronal excitability via AMPA-driven synaptic activity without altering membrane intrinsic properties. These results strongly indicate that iAßo causes functional spreading of hyperexcitability through a synaptic-driven mechanism and offers an important neuropathological significance to intracellular species in the initial stages of AD, which include brain hyperexcitability and seizures.

Cardioform Septal Occluder for the Closure of a Peri-Device Leak After Initial Watchman Implantation.

Left atrial appendage occlusion has become a safe and effective alternative for stroke-risk reduction among patients with non-valvular atrial fibrillation (AF). Although complete closure is ideal, residual peri-device leaks (PDL) are not uncommon and have been associated with an increased residual risk of stroke. PDL closure has been proposed as an alternate strategy to allow for the safe discontinuation of oral anticoagulation. We describe the safety and feasibility of successful PDL closure using a non-fenestrated Cardioform (Gore Medical, Flagstaff, Arizona) septal occluder after initial Watchman (Boston Scientific, Marlborough, Massachusetts) implantation.

MADRID+90 study on factors associated with longevity: Study design and preliminary data.

The progressive aging of the population represents a challenge for society. In particular, a strong increase in the number of people over 90 is expected in the next two decades. As this phenomenon will lead to an increase in illness and age-related dependency, the study of long-lived people represents an opportunity to explore which lifestyle factors are associated with healthy aging and which with the emergence of age-related diseases, especially Alzheimer's type dementia. The project "Factors associated with healthy and pathologically aging in a sample of elderly people over 90 in the city of Madrid" (MADRID+90) brings together a multidisciplinary research team in neurodegenerative diseases that includes experts in epidemiology, neurology, neuropsychology, neuroimaging and computational neuroscience. In the first phase of the project, a stratified random sampling was carried out according to the census of the city of Madrid followed by a survey conducted on 191 people aged 90 and over. This survey gathered information on demographics, clinical data, lifestyles and cognitive status. Here, the main results of that survey are showed. The second phase of the project aims to characterize individual trajectories in the course of either healthy and pathological aging, from a group of 50 subjects over 90 who will undergo a comprehensive clinical examination comprised of neurological and cognitive testing, MRI and EEG. The ultimate goal of the project is to characterize the biophysical and clinical profiles of a population that tends to receive little attention in the literature. A better understanding of the rapidly increasing group of nonagenarians will also help to design new policies that minimize the impact and future social and economic consequences of rapidly aging societies.

Impulsivity-Compulsivity Axis: Evidence of Its Clinical Validity to Individually Classify Subjects on the Use/Abuse of Information and Communication Technologies.

The compulsive habit model proposed by Everitt and Robbins has accumulated important empirical evidence. One of their proposals is the existence of an axis, on which each a person with a particular addiction can be located depending on the evolutionary moment of his/her addictive process. The objective of the present study is to contribute in addressing the identification of such axis, as few studies related to it have been published to date. To do so, the use/abuse of Information and Communication Technologies (ICT) was quantified on an initial sample of 807 subjects. Questionnaires were also delivered to measure impulsivity, compulsivity and symptoms of prefrontal dysfunction. Evidence of the existence of the proposed axis was obtained by means of Machine Learning techniques, thus allowing the classification of each subject along the continuum. The present study provides preliminary evidence of the existence of the Impulsivity-Compulsivity axis, as well as an IT tool so that each patient that starts getting treatment for an addiction can be statistically classified as "impulsive" or "compulsive." This would allow the matching of each person with the most appropriate treatment depending on his/her moment in the addiction/abuse process, thus facilitating the individualized design of each therapeutic process and a possible improvement of the results of the treatment.

Boldine Attenuates Synaptic Failure and Mitochondrial Deregulation in Cellular Models of Alzheimer's Disease.

Alzheimer's disease (AD) is the most common cause of senile dementia worldwide, characterized by both cognitive and behavioral deficits. Amyloid beta peptide (Aß) oligomers (AßO) have been found to be responsible for several pathological mechanisms during the development of AD, including altered cellular homeostasis and synaptic function, inevitably leading to cell death. Such AßO deleterious effects provide a way for identifying new molecules with potential anti-AD properties. Available treatments minimally improve AD symptoms and do not extensively target intracellular pathways affected by AßO. Naturally-derived compounds have been proposed as potential modifiers of Aß-induced neurodysfunction and cytotoxicity based on their availability and chemical diversity. Thus, the aim of this study was to evaluate boldine, an alkaloid derived from the bark and leaves of the Chilean tree Peumus boldus, and its capacity to block some dysfunctional processes caused by AßO. We examined the protective effect of boldine (1-10 µM) in primary hippocampal neurons and HT22 hippocampal-derived cell line treated with AßO (24-48 h). We found that boldine interacts with Aß in silico affecting its aggregation and protecting hippocampal neurons from synaptic failure induced by AßO. Boldine also normalized changes in intracellular Ca2+ levels associated to mitochondria or endoplasmic reticulum in HT22 cells treated with AßO. In addition, boldine completely rescued the decrease in mitochondrial membrane potential (ΔΨm) and the increase in mitochondrial reactive oxygen species, and attenuated AßO-induced decrease in mitochondrial respiration in HT22 hippocampal cells. We conclude that boldine provides neuroprotection in AD models by both direct interactions with Aß and by preventing oxidative stress and mitochondrial dysfunction. Additional studies are required to evaluate the effect of boldine on cognitive and behavioral deficits induced by Aß in vivo.

Reliability and Validity of the Spanish Version of the Executive Function Performance Test (EFPT) in Assessing People in Treatment for Substance Addiction.

IMPORTANCE: Assessing people's executive function (EF) during addiction treatment makes it possible to design individualized occupational goals. OBJECTIVE: To determine the reliability and validity of the Spanish version of the Executive Function Performance Test (EFPT) in the occupational assessment of people being treated for substance addiction. DESIGN: Cross-sectional, observational study to determine the EFPT's internal consistency as well as its convergent and discriminant validity with complementary tests. SETTING: A public, free addiction treatment center operated by Madrid Salud (Madrid City Council, Spain). PARTICIPANTS: Fifty-two people referred to an occupational therapy department for evaluation and intervention. Inclusion was based on Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision) criteria for substance abuse or dependence; the exclusion criterion consisted of any circumstances that made it difficult for a person to understand or perform the test. OUTCOMES AND MEASURES: The EFPT, other occupational tests (Allen Cognitive Level Screen-5, Lowenstein Occupational Therapy Cognitive Assessment), and a battery of neuropsychological EF tests. RESULTS: The EFPT had an unequivocal unifactorial structure and showed strong correlations between its components and adequate consistency with the scales and the complete test. As expected, the EFPT correlated with the neuropsychological tests with a considerable effect size (-.40 < r < -.60). CONCLUSIONS AND RELEVANCE: The EFPT's psychometric properties are adequate to assess the EF of people being treated for substance addiction from an occupational perspective using real activities of daily living (ADLs). WHAT THIS ARTICLE ADDS: The results show that the EFPT can be used to assess performance of ADLs without needing to use tests from disciplines other than occupational therapy. Further studies in different sociocultural settings are needed to generalize the results.

Management of peri-device leak following left atrial appendage closure: A systematic review.

OBJECTIVE: This study aimed to examine the cumulative experience of peri-device leak (PDL) closure following left atrial appendage (LAA) closure. BACKGROUND: The management of PDL following LAA closure remains controversial. While PDL closure has been proposed, procedural features and clinical outcomes have not been well established. METHODS: A systematic review of all published cases of PDL closure with available anatomical, procedural, and clinical outcomes was performed. RESULTS: We identified 18 indexed publications and 110 cases between April 2013 and March 2020. 71 patients (mean age 72 ± 8 yrs), met study criteria and were included. PDL closure was most common in males, bilobar LAA morphology, and after Watchman procedures. The mean PDL size was 7.6 ± 5.8 mm (range 2-26 mm). Leaks were classified according to size: small (<5 mm; 45%), moderate (≥5-9 mm; 25%), and large (≥10 mm; 30%). Endovascular coils and endovascular plugs were used to close both small and moderate sized leaks, and second LAA closure devices were exclusively used for large PDLs. Successful PDL closure occurred in 90%, and was similar between PDL sizes and types of occluder used. Procedural complication rates were uncommon (2.8%). No strokes were reported following PDL closure at 6 months. CONCLUSIONS: In patients with PDL for whom discontinuation of OAC may be considered unsafe, percutaneous closure using a tailored approach with either endovascular coils, plugs, or second occluder represents a safe, and feasible alternative associated with favorable clinical outcomes.

Obsession and compulsion in mobile phone use/abuse: OCDUS-ICT. / Obsesión y compulsión en el uso/abuso del móvil: el OCDUS-TIC.

Compulsiveness has been considered one of the core characteristics of addictive behaviours. One of the abusive behaviours that has acquired importance in recent times involves the use of mobile phones. The aim of this study is to obtain a version of the Obsessive-Compulsive Drug-Use Scale (OCDUS) to study the compulsivity associated with mobile phone abuse, its basic psychometric properties and the results of its application. The OCDUS-ICT was created and administered over the Internet, through instant messaging programs, social networks and e-mail, and anonymous and voluntary participation was requested. Additionally, MULTICAGE-ICT and the Inventory of Prefrontal Symptoms were administered. A sample of n=748 subjects, 33% males and 94% born and resident in Spain was obtained. The test obtained adequate values of internal consistency, applying different estimators. Confirmatory factor analysis of the theoretical scales yielded adequate fit indices. Obsessive-compulsive components were observed to become stronger as mobile phone use increased and approached abuse levels. OCDUS-ICT scales showed large correlations with prefrontal malfunction symptoms, especially Thoughts-Interference (r>0.80). In conclusion, OCDUS-ICT explores with psychometric accuracy the obsessive-compulsive components of mobile use/abuse, which are closely related to malfunctions in daily life attributable to the prefrontal cortex. If impulsivity has so far been the focus in the study of mobile phone abuse, the data from the present study suggest that greater attention should be paid to compulsivity as a factor in maintaining abuse.

La compulsividad ha sido considerada una de las características nucleares de las conductas adictivas. Uno de los comportamientos abusivos que ha adquirido importancia en tiempos recientes es el uso del teléfono móvil. El objetivo del presente trabajo es obtener una versión de la Escala de Uso Obsesivo-Compulsivo de Drogas (OCDUS) para estudiar la compulsividad asociada al abuso del móvil, conocer sus propiedades psicométricas básicas y resultados de su aplicación. Se creó y administró el OCDUS-TIC por Internet, mediante mensajería instantánea, redes sociales y correo electrónico, solicitándose la participación anónima y voluntaria. Adicionalmente se administraron el MULTICAGE-TIC y el Inventario de Síntomas Prefrontales (ISP). Se obtuvo una muestra de n=748 sujetos, 33% varones y 94% nacidos y residentes en España. El test obtuvo adecuados valores de consistencia interna, aplicando diferentes estimadores. Se realizó un análisis factorial confirmatorio sobre las escalas teóricas, alcanzando adecuados estimadores de ajuste. Se observó que los componentes obsesivo-compulsivos son de mayor magnitud a medida que se incrementa la implicación en el uso y su progresión al abuso del móvil. Las escalas del OCDUS-TIC mostraron correlaciones de gran magnitud con los síntomas de mal funcionamiento prefrontal, especialmente la de Pensamiento-Interferencia (r>0,80). En conclusión, el OCDUS-TIC explora con garantías psicométricas los componentes obsesivo-compulsivos del uso/abuso del móvil, que se relacionan estrechamente con fallos cotidianos de origen prefrontal. Si la impulsividad ha centrado el interés en el estudio del abuso del móvil, los datos del presente estudio aconsejan prestar mayor atención a la compulsividad como factor de mantenimiento del abuso.

Opiate drug use in the city of Madrid: Associated health and sociodemographic factors. / Consumo de fármacos opiáceos en la ciudad de Madrid: Factores sanitarios y sociodemográficos asociados.

The use of opiate analgesics has led to a health and social emergency in the United States. In Spain, according to official data, the prescription of these drugs has risen dramatically in the last decade. This study explores the prevalence of the use of these drugs and the health and socio-demographic characteristics of their consumers in the city of Madrid. A telephone survey was carried on a stratified, randomised sample, asking about the use of these drugs and whether or not they were medically prescribed. The sample consisted of n=8,845 subjects aged between 15 and 98 years. Sixteen percent stated that they had used these drugs in the last year and 9.1% had taken them in the last two weeks. Consumption was more frequent among women, lower social class and lower level of education. Among the youngest group (15-29 years old) 12.5% had already used it. Those who use opioids report worse perceived health, lower quality of life, more mental health problems, more loneliness, more use of other psychoactive drugs, more frequent daily use of tobacco and less problematic consumption of alcohol. Ten percent of those who use them do so without a doctor's prescription. Combining these data with the prescription data offered by the Ministry of Health, it is necessary to pay attention to a problem that may become apparent in the coming years, and the adoption of urgent measures to tackle it before it brings the Spanish situation closer to that already well known in countries of our socio-political environment is advised.

El consumo de analgésicos opiáceos ha provocado una situación de emergencia sanitaria y social en Estados Unidos. En España, según datos oficiales, la prescripción de estos fármacos ha experimentado un espectacular ascenso en la última década. Este estudio explora la prevalencia del uso de estos fármacos y las características sanitarias y sociodemográficas de sus consumidores en la ciudad de Madrid. Se realizó una encuesta telefónica aplicando un muestreo estratificado y aleatorizado, en la que se preguntó por el uso de estos fármacos y si fueron médicamente prescritos o no. La muestra estuvo compuesta por n= 8.845 sujetos de edades entre 15 y 98 años. Un 16,0% declara haber usado estos fármacos en el último año y un 9,1 los toma en las dos últimas semanas. El consumo es más frecuente en mujeres, clase social baja y menor nivel de estudios. El grupo más joven (15-29 años) ya lo usa en el 12,5%. Quienes usan opioides refieren peor salud percibida, menor calidad de vida, más problemas de salud mental, más soledad no deseada, más uso de otros psicofármacos, más frecuente uso diario de tabaco y menos consumo problemático de alcohol. Un 10% de quienes los usan lo hacen sin prescripción médica. Combinando estos datos con los de prescripción ofrecidos por el Ministerio de Sanidad, resulta necesario prestar atención a un problema que puede hacerse patente en los próximos años, aconsejando la adopción de medidas urgentes para atajarlo antes de que aproxime la situación española a la ya bien conocida en otros países.

Obsesión y compulsión en el uso/abuso del móvil: el OCDUS-TIC / Obsession and compulsion in mobile phone use/abuse: OCDUS-ICT

La compulsividad ha sido considerada una de las características nucleares de las conductas adictivas. Uno de los comportamientos abusivos que ha adquirido importancia en tiempos recientes es el uso del teléfono móvil. El objetivo del presente trabajo es obtener una versión de la Escala de Uso Obsesivo-Compulsivo de Drogas (OCDUS) para estudiar la compulsividad asociada al abuso del móvil, conocer sus propiedades psicométricas básicas y resultados de su aplicación. Se creó y administró el OCDUS-TIC por Internet, mediante mensajería instantánea, redes sociales y correo electrónico, solicitándose la participación anónima y voluntaria. Adicionalmente se administraron el MULTICAGE-TIC y el Inventario de Síntomas Prefrontales (ISP). Se obtuvo una muestra de n=748 sujetos, 33% varones y 94% nacidos y residentes en España. El test obtuvo adecuados valores de consistencia interna, aplicando diferentes estimadores. Se realizó un análisis factorial confirmatorio sobre las escalas teóricas, alcanzando adecuados estimadores de ajuste. Se observó que los componentes obsesivo-compulsivos son de mayor magnitud a medida que se incrementa la implicación en el uso y su progresión al abuso del móvil. Las escalas del OCDUS-TIC mostraron correlaciones de gran magnitud con los síntomas de mal funcionamiento prefrontal, especialmente la de Pensamiento-Interferencia (r > 0,80). En conclusión, el OCDUS-TIC explora con garantías psicométricas los componentes obsesivo-compulsivos del uso/abuso del móvil, que se relacionan estrechamente con fallos cotidianos de origen prefrontal. Si la impulsividad ha centrado el interés en el estudio del abuso del móvil, los datos del presente estudio aconsejan prestar mayor atención a la compulsividad como factor de mantenimiento del abuso

Compulsiveness has been considered one of the core characteristics of addictive behaviours. One of the abusive behaviours that has acquired importance in recent times involves the use of mobile phones. The aim of this study is to obtain a version of the Obsessive-Compulsive Drug-Use Scale (OCDUS) to study the compulsivity associated with mobile phone abuse, its basic psychometric properties and the results of its application. The OCDUS-ICT was created and administered over the Internet, through instant messaging programs, social networks and e-mail, and anonymous and voluntary participation was requested. Additionally, MULTICAGE-ICT and the Inventory of Prefrontal Symptoms were administered. A sample of n=748 subjects, 33% males and 94% born and resident in Spain was obtained. The test obtained adequate values of internal consistency, applying different estimators. Confirmatory factor analysis of the theoretical scales yielded adequate fit indices. Obsessive-compulsive components were observed to become stronger as mobile phone use increased and approached abuse levels. OCDUS-ICT scales showed large correlations with prefrontal malfunction symptoms, especially Thoughts-Interference (r>0.80). In conclusion, OCDUS-ICT explores with psychometric accuracy the obsessive-compulsive components of mobile use/abuse, which are closely related to malfunctions in daily life attributable to the prefrontal cortex. If impulsivity has so far been the focus in the study of mobile phone abuse, the data from the present study suggest that greater attention should be paid to compulsivity as a factor in maintaining abuse

Consumo de fármacos opiáceos en la ciudad de Madrid: Factores sanitarios y sociodemográficos asociados / Opiate drug use in the city of Madrid: Associated health and sociodemographic factors

El consumo de analgésicos opiáceos ha provocado una situación deemergencia sanitaria y social en Estados Unidos. En España, segúndatos oficiales, la prescripción de estos fármacos ha experimentadoun espectacular ascenso en la última década. Este estudio explora laprevalencia del uso de estos fármacos y las características sanitarias ysociodemográficas de sus consumidores en la ciudad de Madrid. Serealizó una encuesta telefónica aplicando un muestreo estratificadoy aleatorizado, en la que se preguntó por el uso de estos fármacos ysi fueron médicamente prescritos o no. La muestra estuvo compuestapor n= 8.845 sujetos de edades entre 15 y 98 años. Un 16,0% declara haber usado estos fármacos en el último año y un 9,1 los tomaen las dos últimas semanas. El consumo es más frecuente en mujeres, clase social baja y menor nivel de estudios. El grupo más joven(15-29 años) ya lo usa en el 12,5%. Quienes usan opioides refierenpeor salud percibida, menor calidad de vida, más problemas de saludmental, más soledad no deseada, más uso de otros psicofármacos, másfrecuente uso diario de tabaco y menos consumo problemático dealcohol. Un 10% de quienes los usan lo hacen sin prescripción médica. Combinando estos datos con los de prescripción ofrecidos por elMinisterio de Sanidad, resulta necesario prestar atención a un problema que puede hacerse patente en los próximos años, aconsejando laadopción de medidas urgentes para atajarlo antes de que aproxime lasituación española a la ya bien conocida en otros países. (AU)

The use of opiate analgesics has led to a health and social emergencyin the United States. In Spain, according to official data, the prescription of these drugs has risen dramatically in the last decade. This studyexplores the prevalence of the use of these drugs and the health andsocio-demographic characteristics of their consumers in the city ofMadrid. A telephone survey was carried on a stratified, randomisedsample, asking about the use of these drugs and whether or not theywere medically prescribed. The sample consisted of n=8,845 subjectsaged between 15 and 98 years. Sixteen percent stated that they hadused these drugs in the last year and 9.1% had taken them in the lasttwo weeks. Consumption was more frequent among women, lower social class and lower level of education. Among the youngest group (15-29 years old) 12.5% had already used it. Those who use opioids reportworse perceived health, lower quality of life, more mental health problems, more loneliness, more use of other psychoactive drugs, morefrequent daily use of tobacco and less problematic consumption ofalcohol. Ten percent of those who use them do so without a doctor’sprescription. Combining these data with the prescription data offeredby the Ministry of Health, it is necessary to pay attention to a problem that may become apparent in the coming years, and the adoptionof urgent measures to tackle it before it brings the Spanish situationcloser to that already well known in countries of our socio-politicalenvironment is advised (AU)

Eje impulsividad-compulsividad en el abuso de tecnologías de la información y la comunicación (TIC) desde la perspectiva del Proyecto de criterios de dominio de investigación (RDoC) / Impulsivity-compulsivity axis in the abuse of information and communication technologies (ICT) from the perspective of the Research Domain Criteria Project (RDoC)

El modelo de formación de hábitos de la adicción implica la transición desde una fase inicial en la que la corteza prefrontal deja de controlar el comportamiento, a una fase en la que el control se transfiere al estriado dorsal, pasando al consumo compulsivo. Este modelo ampliamente apoyado por la evidencia empírica, implica que cada sujeto se encuentra en un determinado punto del continuo de impulsividad-compulsividad. Mediante dos cuestionarios recomendados en el marco del Proyecto de criterios de dominio de investigación (RDoC), que miden la impulsividad y la compulsividad, se ratificar la existencia de ese eje bipolar, aplicado al abuso de las tecnologías de la información y las comunicaciones (TIC). Los resultados de este estudio encuentran apoyo empírico para la existencia de este eje. El abuso de las TIC parece tener muchos más componentes compulsivos que impulsivos, excepto en el caso de los videojuegos, poco relacionados con ambos conceptos. Estos resultados tienen importantes implicaciones clínicas, en la medida en que existen enfoques terapéuticos muy diferentes para la impulsividad que para la conducta compulsiva (AU)

The habit formation model to explain addiction involves the transition from an initial phase in which the prefrontal cortex ceases to control the behavior, to a phase in which control is transferred to the dorsal striatum, progressing towards compulsive consumption. This model, widely supported by empirical evidence, implies that each subject is at a certain point in the impulsivity-compulsivity continuum. Using two questionnaires recommended within the framework of the Research Domain Criteria Project which measure impulsivity and compulsivity, an attempt was made to confirm the existence of such a bipolar axis, applied to the abuse of information and communication technologies (ICT). The results of this study provide empirical support for the existence of this axis. The abuse of ICT seems to have many more compulsive components than impulsive ones, except in the case of video games, which are little related to both concepts. These results have important clinical implications, since there are very different therapeutic approaches for impulsivity and compulsive behavior (AU)

Gabapentin Inhibits Multiple Steps in the Amyloid Beta Toxicity Cascade.

Oligomeric ß-amyloid peptide (Aß) is one of the main neurotoxic agents of Alzheimer's disease (AD). Oligomers associate to neuronal membranes, forming "pore-like" structures that cause intracellular calcium and neurotransmitter dyshomeostasis, leading to synaptic failure and death. Through molecular screening targeting the C terminal region of Aß, a region involved in the toxic properties of the peptide, we detected an FDA approved compound, gabapentin (GBP), with neuroprotective effects against Aß toxicity. At micromolar concentrations, GBP antagonized peptide aggregation over time and reduced the Aß absorbance plateau to 28% of control. In addition, GBP decreased Aß association to membranes by almost half, and the effects of Aß on intracellular calcium in hippocampal neurons were antagonized without causing effects on its own. Finally, we found that GBP was able to block the synaptotoxicity induced by Aß in hippocampal neurons, increasing post-synaptic currents from 1.7 ± 0.9 to 4.2 ± 0.7 fC and mean relative fluorescence intensity values of SV2, a synaptic protein, from 0.7 ± 0.09 to 1.00 ± 0.08. The results show that GBP can interfere with Aß-induced toxicity by blocking multiple steps, resulting in neuroprotection, which justifies advancing toward additional animal and human studies.