Assessing predictors of adequate individual buprenorphine maintenance dosage for the treatment of opioid use disorder: Listening to the patient.

OBJECTIVE: Dose optimization plays a key role in determining clinical outcomes in patients on opioid agonist treatment (OAT). The objective of this study was to identify the variables independently associated with buprenorphine/naloxone (B/N) dose adequacy in patients with opiate use disorder (OUD). METHOD: Cross-sectional study of a convenience sample of patients with OUD treated with B/N (n = 315) in four regions in Spain. The Opiate Dosage Adequacy Scale (ODAS) was used to determine B/N dose adequacy. The ODAS evaluate the six components of the "dose adequacy" construct, as follows: continued use of heroin; narcotic blockade or crossed tolerance; objective opioid withdrawal symptoms (OWS); subjective OWS; craving for heroin; and overmedication. A binomial logistic regression analysis was performed to identify the variables associated with the condition "ODAS Adequate B/N dose". Participants completed a battery of instruments to assess sociodemographic, substance use, clinical, and treatment variables. RESULTS: The B/N dose was considered adequate in 231 of the 315 participants (73.3 %). Two variables, satisfaction with B/N as a medication (OR=5.764, 95 % CI=2.211-15.030) and patient-perceived participation in B/N dose decisions (OR=1.790, 95 % CI=1221-2623), were independently, significantly, and positively associated with the "ODAS Adequate B/N dose" condition. While the severity of heroin dependence was significantly associated with buprenorphine dose adequacy in the bivariate analyses, significance was lost in the full regression model. CONCLUSION: Satisfaction with B/N as a medication and patient-perceived involvement in the dose decision are associated with clinician-assessed dose adequacy. In the context of good clinical practice, it is important to take into account both of these variables to individualize the prescribed dose through a shared decision-making process.

Reading abilities in preterm children: a systematic review and meta-analysis.

It is well recognized that children born preterm have specific learning difficulties. The objective of this study is to carry out a systematic review and meta-analysis on preterm children's reading ability performance. Of the 486 studies identified, 53 met the inclusion criteria, resulting in 143 effect sizes. 33,500 children between 5 and 18 years were included of whom 13,765 were preterm infants and 19,735 were full-term infants. Among preterm-born children without neurodevelopmental disorders significant differences and larger effect sizes were found in the reading subcategories, letter-word knowledge, reading comprehension, and spelling, whereas no significant differences were found in phonological awareness and rapid automatized naming. Extremely preterm children showed larger effect size. The present meta-analysis, which includes a much larger number of studies, shows that preterm children have lower performance than full-term children in reading and spelling. This fact underlines the need to design, develop and implement neuroeducational programs that take into account the characteristics of preterm born students.

Phonological and semantic verbal fluency test: Scoring criteria and normative data for clustering and switching strategies for Colombian children and adolescents.

BACKGROUND: Verbal fluency tests (VFT) are highly sensitive to cognitive deficits. Usually, the score on VFT is based on the number of correct words produced, yet it alone gives little information regarding underlying test performance. The implementation of different strategies (cluster and switching) to perform efficiently during the tasks provide more valuable information. However, normative data for clustering and switching strategies are scarce. Moreover, scoring criteria adapted to Colombian Spanish are missing. AIMS: (1) To describe the Colombian adaptation of the scoring system guidelines for clustering and switching strategies in VFT; (2) to determine its reliability; and (3) to provide normative data for Colombian children and adolescents aged 6-17 years. METHODS & PROCEDURES: A total of 691 children and adolescents from Colombia completed phonological (/f/, /a/, /s/, /m/, /r/ and /p/) and semantic (animals and fruits) VFT, and five scores were calculated: total score (TS), number of clusters (NC), cluster size (CS), mean cluster size (MCS) and number of switches (NS). The intraclass correlation coefficient was used for interrater reliability. Hierarchical multiple regressions were conducted to investigate which strategies were associated with VFT TS. Multiple regressions were conducted for each strategy, including as predictors age, age2 , sex, mean parents' education (MPE), MPE2 and type of school, to generate normative data. OUTCOMES & RESULTS: Reliability indexes were excellent. Age was associated with VFT TS, but weakly compared with strategies. For both VFT TS, NS was the strongest variable, followed by CS and NC. Regarding norms, age was the strongest predictor for all measures, while age2 was relevant for NC (/f/ phoneme) and NS (/m/ phoneme). Participants with higher MPE obtained more NC, and NS, and larger CS in several phonemes and categories. Children and adolescents from private school generated more NC, NS and larger CS in /s/ phoneme. CONCLUSIONS & IMPLICATIONS: This study provides new scoring guidelines and normative data for clustering and switching strategies for Colombian children and adolescents between 6 and 17 years old. Clinical neuropsychologists should include these measures as part of their everyday practice. WHAT THIS PAPER ADDS: What is already known on the subject VFT are widely used within the paediatric population due to its sensitivity to brain injury. Its score is based on the number of correct words produced; however, TS alone gives little information regarding underlying test performance. Several normative data for VFT TS in the paediatric population exist, but normative data for clustering and switching strategies are scarce. What this paper adds to existing knowledge The present study is the first to describe the Colombian adaptation of the scoring guidelines for clustering and switching strategies, and provided normative data for these strategies for children and adolescents between 6 and 17 years old. What are the potential or actual clinical implications of this work? Knowing VFT's performance, including strategy development and use in healthy children and adolescents, may be useful for clinical settings. We encourage clinicians to include not only TS, but also a careful analysis of strategies that may be more informative of the underlying cognitive processes failure than TS.

Multivariate Base Rates of Low Score on Neuropsychological Tests of Individuals with Coca Paste Use Disorder.

OBJECTIVE: The aim of this study was to determine the prevalence of low scores on eight commonly used neuropsychological tests to evaluate learning and memory, language, and executive functions in individuals with coca paste use disorders (CPUD) and to identify the differences with respect to a group of healthy nonconsuming subjects (HCs). METHODS: 162 Colombian adults with CPUD and a group of 162 Colombian adult HCs participated in this comparative study. Eight tests (eighteen test scores) were grouped into three categories: learning and memory, language, and executive functions. Each participant was categorized based on the number of low scoring tests in specific percentile cut-off groups (25th, 16th, 10th, 5th, and 2nd). RESULTS: In the learning and memory domain, 89.5% of individuals with CPUD and 55.6% of HCs scored below the 25th percentile on at least one of the five test scores, in the language domain, 80.7% of individuals with CPUD and 58% of HCs and in the executive function domain, 92% of individuals with CPUD and 67.3% of HCs. Having two or more scores below the 10th percentile or 10 or more at the 5th percentile shows an optimal cut-off for determining the sensitivity and specificity for discriminating between the two groups. CONCLUSIONS: The individuals with CPUD had a higher percentage of low scores than the HCs in the domains of learning and memory, language, and executive function. It is important for clinicians to be aware of low scores in individuals with CPUD to avoid false-positive diagnoses of cognitive impairment.

Problematic Internet use and Internet gaming disorder: Overlap and relationship with health-related quality of life in adolescents. / Uso problemático de Internet y trastorno de juego por Internet: Solapamiento y relación con la calidad de vida relacionada con la salud en adolescentes.

General Problematic Internet Use (GPIU) is a dysfunctional use of Internet handling and management in general. In contrast, Internet Gaming Disorder (IGD) is a specific behaviour linked to online videogames. Both problems are becoming common in adolescents, but they have hardly been studied simultaneously, and the joint relationship of the two constructs with Health-Related Quality of Life (HRQoL) is unknown. The general objective of this study is to analyse the relationship between GPIU and IGD and their association with HRQoL. The study is analytical and cross-sectional with 2,024 participants (46.4% boys, n = 939) from 16 schools of 7 Spanish regions. The mean age and standard deviation were 14.20±1.42, with a range of 11-18 years. The Spanish versions of the KIDSCREEN-10, the Revised Generalized and Problematic Internet Use Scale 2 and the Internet Gaming Disorder Scale were used. Of the total sample evaluated, 15.5% of the participants had high levels of GPIU, and 3.3% of video game players presented IGD. The dimensions of GPIU are strongly associated with those of IGD. HRQoL correlated significantly and negatively with all the dimensions of GPIU and IGD (p <.001). Participants who reported problems with GPIU or IGD, individually or conjointly, had significantly lower scores in HRQoL than those with no problems.

El Uso problemático general de Internet (GPIU) supone un uso disfuncional del manejo y la gestión de Internet en general. En cambio, el Trastorno de juego por Internet (IGD) es una conducta específica vinculada a los videojuegos en línea. Ambos problemas comienzan a ser frecuentes en adolescentes, pero apenas han sido estudiados simultáneamente ni se conoce el papel conjunto de ambos constructos sobre Calidad de vida relacionada con la salud (CVRS). El objetivo general de este estudio es analizar la relación entre el GPIU y el IGD y su asociación con la CVRS. El estudio es analítico y transversal con 2024 participantes (46,4% chicos, n = 939) procedentes de 16 colegios en 7 regiones españolas. La media de edad y desviación típica fue de 14,20±1,42 en un rango de 11-18 años. Se usaron las versiones españolas del KIDSCREEN-10, del Revised Generalized and Problematic Internet Use Scale 2 y del Internet Gaming Disorder Scale. Un 15,5% del total de la muestra evaluada reportó niveles altos de GPIU y un 3,3% de los jugadores de videojuegos presentó IGD. Las dimensiones del GPIU están altamente asociadas a las del IGD. La CVRS correlacionó significativa y negativamente con todas las dimensiones del GPIU y del IGD (p <,001). Los participantes que reportaron problemas en el GPIU o el IGD, individual o conjuntamente, presentan puntuaciones significativamente más bajas en la CVRS.

Cocaine Effect Expectancies among Patients with Cocaine Use Disorder with and without Adult Attention Deficit Hyperactivity Disorder: Are There Any Relevant Differences?

Cocaine use could be modulated by drug expectancies based on previously experienced subjective effects. Some patients perceive a paradoxical calming effect after cocaine use. This study was performed to explore cocaine effect expectancies in patients diagnosed with cocaine use disorder, with and without co-occurring adult attention deficit hyperactivity disorder (ADHD). Secondly, we sought to empirically determine the presence of this paradoxical calming effect after cocaine use in patients with co-occurring adult ADHD to identify the individuals most at risk of cocaine use and relapse. Cross-sectional study using a consecutive sampling method of patients diagnosed with cocaine use disorder (n = 221) treated at public therapeutic communities in Andalusia (Spain). Participants completed a battery of instruments to assess the following variables: cocaine effect expectancies, paradoxical calming effect, adult ADHD, and other co-occurring psychiatric disorders. A multivariate binary logistic regression analysis showed that two variables, the paradoxical calming effect and antisocial personality disorder (ASPD), were independently associated with the probability of being diagnosed with adult ADHD (OR = 3.43, 95% CI = 1.88-6.26 and OR = 3.42, 95% CI = 1.30-8.95, respectively). The presence of a paradoxical calming reaction to cocaine and/or a diagnosis of ASPD in patients with cocaine use disorder increases the diagnostic suspicion of co-occurring adult ADHD.

Reward sensitivity and hazardous alcohol consumption in women: The parallel mediation effect of self-control and impulsivity traits.

Introduction: Little research has been carried out on the associations between several individual factors and hazardous alcohol use in women. The aim of this study was first, to study the relationship between reward sensitivity (RS) and alcohol use in both women with and without hazardous drinking separately. Second, to explore the potential mediating roles of the impulsivity and self-control traits in this relationship. Method: The study was analytical and cross-sectional and included 645 female participants (mean age = 19.14; standard deviation (SD)=1.60). All women were divided into two groups (286, 44.3%, with hazardous drinking, HDW; and 359, 55.7%, with light drinking, LDW). Correlation analyses were carried out to explore the associations between the variables, and parallel mediation analyses were performed to investigate the potential mediating roles of impulsivity and self-control in the RS-alcohol use associations in each group separately. Results: A significant association was observed between RS and alcohol use in HDW, contrary to that observed in their counterparts. In addition, both higher impulsivity and less self-control mediated the association between RS and alcohol use only in HDW. Conclusions: Impulsivity and self-control differently affect alcohol use under the condition of high reward sensitivity, only in HDW, suggesting alterations of the dual top-down and bottom-up mechanisms and a possible imbalance between the competing reflexive and impulsive brain systems. More research is needed regarding the individual factors that affect women's drinking to develop sensitive measures for the assessment of alcohol use and more efficient interventions for women.

Efficacy of the Therapeutic Game "Trisquel" in the Treatment of Patients With Substance-Related Disorders Randomized Clinical Study.

Substance-related disorders (SRD) have been consistently associated with alterations both in cognitive and executive functions, which affect to patients' quality of life. The main objective of this work was to test the beneficial cognitive effects on patients with SRD after the implementation of "Trisquel," an intervention program in board game format. To check the effectiveness of Trisquel program, a group of people diagnosed with SRD was randomly assigned either to the experimental group or to the control group. The experimental group performed Trisquel structured sessions twice a week during 3 months, while the control group performed routinely conventional therapeutic activities with the same frequency and duration. Neuropsychological tests were done to both groups before and after the intervention. After the 3 months of intervention the experimental group showed the following statistically significant improvements for WAIS-III subtests: number key, symbol search, arithmetic, direct digits, inverse digits, total digits, letters-numbers in the processing speed index and in the working memory index. Regarding STROOP tests, statistically significant progress was observed in the phonetic fluency letter P, phonetic fluency letter M, phonetic fluency letter R subtests, word-reading and word-color subtests. The control group only obtained improvements for WAIS-III subtests of arithmetic, letters-numbers and in the working memory index. The results of this study confirm that "Trisquel" is an effective intervention program for people diagnosed with SRD, getting improvements in processing speed (psychomotor and reading), attentional subprocesses (focused and sustained) and executive functions (updating and inhibition).

Assessment of executive functions as a measure of impairments in everyday functioning in persons with HIV.

Persons with HIV can often present cognitive disorders such as those related to executive functioning, which could affect the daily life activities. The present study was designed to explore the predictive relationship between executive functions according to Miyake's model and the basic and instrumental skills of everyday functioning in a group of persons with HIV (PWH). Participants were recruited from outpatient treatment Hospital and assessed using a neuropsychological battery, a modified version of the Lawton and Brody basic and instrumental activities of daily life (ADL) scale and the Hospital Anxiety and Depression Scale (HADS). The results showed a low score in the executive function and significant relationship between executive functioning and the instrumental skills of the patients, with set-shifting being one of the most powerful predictors. The processes of executive functioning, particularly set-shifting, are related to the level of functioning in the skills required for independent living in the community, but not the skills of independent living in the home. This study seems to suggest the utility of assessing executive functions as a preventive measure for the development of dependencies in normal daily instrumental skills and as the focus of interdisciplinary interventions.

In-Treatment Changes in Quality of Life-Related Variables in Therapeutic Communities for Cocaine Abusers: Are These Changes Associated with Clinical Outcomes?

BACKGROUND: Few studies have explored changes in quality of life during the first three months of admission to a therapeutic community for addictions. The objective of this study was to determine the relationship between these changes and treatment outcomes at discharge. METHODS: We undertook a prospective longitudinal study of 142 cocaine-dependent patients treated at a therapeutics community. All of these patients reached the 3-month evaluation and were subsequently followed until discharge. All participants completed the following measures: Health-Related Quality of Life for Drug Abusers Test; Beck Depression Inventory; State-Trait Anxiety Inventory; Opiate Treatment Index; Dual Diagnosis and Discharge Checklist. RESULTS: At the 3-month assessment, scores on the Health-Related Quality of Life for Drug Abusers Test had increased significantly (Cohen's d: 0.92), while scores on the Opiate Treatment Index (Cohen's d: 0.86) and Beck Depression Inventory (Cohen's d: 0.20) scales both decreased significantly. A higher proportion of the patients considered to have achieved "clinically relevant" treatment outcomes at discharge versus those without clinically relevant outcomes were considered "recovered" according to the Reliable Change Index. CONCLUSIONS: An improvement in quality of life-related variables from baseline to the 3-month assessment was associated with better outcomes at discharge from the therapeutic community. The findings of this study may help us to optimise therapeutic interventions.

Cocaine and depressive disorders: When standard clinical diagnosis is insufficient. / Trastorno por uso de cocaína y depresión: Cuando el diagnóstico clínico no es suficiente.

BACKGROUND: Cocaine use is a growing global health problem and patients with cocaine use disorders (CUD) present several complications, including high rates of major depression. These subjects present two types of major depressive disorder (MDD): primary major depressive disorder (P-MDD) and cocaine-induced major depressive disorder (CI-MDD). To improve treatment, it is necessary to distinguish between both types. The aim of this study was to assess the differences in depressive symptomatology criteria (P-MDD vs CI-MDD) in CUD patients. METHODS: Secondary data analysis was carried out with a cross-sectional sample of 160 patients presenting CUD and MDD. Clinical assessment was performed using the Psychiatric Research Interview for Substance and Mental Disorders (PRISM). A differential diagnosis was obtained between P-MDD and CI-MDD. RESULTS: Men represented 80% of the sample, the mean age was 38.61 years, and 64.5% had elementary studies. CI-MDD diagnosis (61.3%) was more frequent than P-MDD (38.7%). There was a younger age of CUD onset in CI-MDD patients. In addition, 79.4% of the patients had another substance use disorder diagnosis. The criterion "Changes in weight or appetite" was more prevalent (57.1%) in P-MDD group. CONCLUSIONS: We found differences in the criterion "Changes in weight or appetite". Further research is needed in this field to establish a differential diagnosis and thus provide better treatment for CUD patients.

Antecedentes: El consumo de cocaína es un creciente problema de salud en todo el mundo. Además, los pacientes con trastorno por consumo de cocaína (TCC) presentan una alta comorbilidad con el trastorno depresivo mayor (TDM). Estos pacientes pueden presentar dos tipos de TDM: trastorno depresivo mayor primario (TDM-P) y trastorno depresivo mayor inducido por cocaína (TDM-IC). El objetivo de este estudio es evaluar las diferencias en la sintomatología depresiva (TDM-P vs. TDM- IC) en los pacientes con TCC para mejorar su tratamiento. Métodos: Se llevó a cabo un análisis secundario en una muestra transversal de 160 pacientes que presentaban TCC y algún TDM. La evaluación clínica, así como el diagnóstico diferencial entre TDM-P y TDM-IC, se realizó utilizando la entrevista PRISM. Resultados: Los hombres representaron el 80% de la muestra con una edad media de 38,61 años y el 64,5% sólo tenía estudios primarios. El diagnóstico de TDM-IC (61,3%) fue más frecuente que el de TDM-P (38,7%). Los pacientes con TDM-IC mostraron una edad de aparición más temprana para el TCC. El 79,4% de los pacientes cumplían criterios para otro trastorno por consumo de sustancias. Únicamente el criterio "Cambios en el peso o en el apetito" fue estadísticamente más prevalente (57,1%) en los pacientes con TDM-P. Conclusiones: Existen diferencias en el criterio "Cambios en el peso o en el apetito" entre TDM-P y TDM-IC. Se necesita más investigación a fin de obtener un diagnóstico diferencial entre los dos tipos de depresión y proporcionar un mejor tratamiento para los pacientes con TCC.

Music Therapy Interventions in Palliative Care: A Systematic Review.

BACKGROUND: Palliative care is an interdisciplinary medical approach for people with illnesses that are unresponsive to curative treatment. Music therapy has been gaining ground in this field since the 1970s, with a not-always-standardized range of interventions and musical techniques. OBJECTIVE: The purpose of this systematic review is to analyze interventions with music therapy and new developments in this area in the field of palliative care. METHODS: The primary source of data for this review was the online database Web of Science (WOS). We also used other databases such as Medline and Scopus. A systematic search was performed of the past 6 years following the PRISMA criteria. RESULTS: From a selection of 310 documents, we reviewed 54 completed articles and included 19 studies in the review. The percentage of agreement in the selection of articles was 87.5% and the Cohen Kappa index of inter-rater reliability was 0.727. In 5 of the articles, the musical interventions were not specified. However, in the remaining 14 they were, including new developments such as use of the monochord and the body tambura, and adaptation of the RBL (Rhythm, Breath & Lullaby) method. CONCLUSIONS: There has been notable improvement in the specification of musical interventions during music therapy sessions in palliative care. However, articles in this field need to describe how these techniques are carried out and any new developments. All this without forgetting that the patient's musical preferences are a fundamental aspect when performing music therapy sessions.

Effectiveness of the “Trisquel” board game intervention program for patients with schizophrenia spectrum disorders.

Schizophrenia spectrum disorders present emotional, cognitive and/or behavioural alterations relat- ed to daily functioning. Therefore, it is necessary to develop intervention programs focused on the improvement of these constructs. The aim of this work is to analyse the effect of the intervention program “Trisquel” on cognitive functioning, symptomatologic perception and psychosocial functioning.

Towards a common metric for assessing heroin-dependent patient satisfaction with medications: Testing methadone and buprenorphine-naloxone.

BACKGROUND: Patient satisfaction with methadone or buprenorphine-naloxone can be multidimensionally and specifically assessed by using, respectively, the Scale to Assess Satisfaction with Medications for Addiction Treatment-Methadone for Heroin addiction (SASMAT-METHER) or the SASMAT-Buprenorphine-Naloxone for Heroin addiction (SASMAT-BUNHER). The factor structures of the SASMAT-METHER and SASMAT-BUNHER show substantial commonalities. The objective of the present study is to evaluate the replicability of the SASMAT-METHER factor structure using data from the SASMAT-BUNHER development study in order to obtain an instrument that can be used to compare patient satisfaction with methadone vs. buprenorphine-naloxone. METHOD: Secondary analysis of SASMAT-BUNHER data provided by 205 participants in the original validation study of that scale (Pérez de los Cobos et al., 2018). Using the SASMAT-METHER component solution (17 items, 3 factors) as the target structure, a principal component analysis was performed on the data set comprised of the corresponding 17 SASMAT-BUNHER items using an oblique semi-specified Procrustean rotation. Additionally, Tucker congruence coefficients were computed to examine the correspondence between the two solutions. RESULT: The factor structures of SASMAT-METHER and the 17-item version of the SASMAT-BUNHER can be considered equal given that the overall Tucker's congruence coefficient of factorial similarity was 0.972, with individual component congruencies ranging from 0.960 to 0.995. CONCLUSIONS: The SASMAT-METHER component solution can serve as a single common tool to compare methadone vs. buprenorphine-naloxone in terms of patient satisfaction. This finding supports the feasibility of using a common metric to specifically assess satisfaction with medications to treat heroin dependence.

Prevalence of Low Scores on Executive Functions Tests in a Spanish-Speaking Pediatric Population from 10 Latin American Countries and Spain.

Pediatric neuropsychologists and researchers commonly interpret a low score as a cognitive weakness. The purpose of the study was to determine the prevalence of low scores for three neuropsychological tests used to evaluate executive function in 4,595 healthy children from Latin-America and Spain. Results showed that low scores are common when multiple neuropsychological outcomes are evaluated in healthy individuals. Clinicians should consider the higher probability of low scores in a given individual when evaluating executive functions using various sets of scores to reduce false-positive diagnoses of cognitive deficits in a child.

Predictive Outcome Validity of General Health Questionnaire (GHQ-28) in Substance Abuse Patients Treated in Therapeutic Communities.

Objective: The use of psychoactive substances has been one of the most important global public health problems over the last few decades. Among the problems associated with substance use, dual diagnosis is one of the most relevant. This study aims to investigate the predictive validity of the GHQ-28 (General Health Questionnaire-28; "probable psychiatric cases") in relation to poor treatment outcome measured by (a) "early treatment dropout" and (b) "nonclinically relevant improvement at discharge." Methods: A longitudinal prospective design was used. A sample of 219 substance use disorder patients, who received treatment in a therapeutic community, was selected. Patients were assessed using the GHQ-28 and the outcome variables were registered. A hierarchical logistic regression model was performed to identify factors independently associated with the outcome measure ("early treatment dropout" and "nonclinically relevant improvement at discharge"). Results: Of the total sample, 79 subjects (36%) were considered "early treatment dropouts" and 56.6% (102) presented a "nonclinically relevant improvement at discharge." The two hierarchical logistic regression results show that being classified as a "probable psychiatric case" was significantly and directly associated with "early treatment dropout" and "nonclinically relevant improvement at discharge," as a poor in-treatment outcome indicator. Conclusions: The results of this study support the notion that the probable psychiatric cases identified by the GHQ-28 scale have a greater probability of "early treatment dropout" and have a greater probability of "nonclinically relevant improvement in discharge" of the therapeutic community. These data indicate that GHQ-28 is a suitable clinical instrument for predicting dropout and treatment effect in residential substance use disorder treatment.

Profile and neuropsychological differences in adolescent students with and without dyslexia / Perfil y diferencias neuropsicológicas en alumnos adolescentes con y sin dislexia

Abstract Dyslexia is a problem of increasing prevalence in school-age students. The latest experiences in the application of neuropsychology to education are interesting because they allow for the evaluation of different neuropsychological variables to obtain a better understanding of the learning processes of students in this population for specific subsequent interventions. The purpose of this study was to explore the following neuropsychological variables related to reading in adolescent students with and without dyslexia. The sample consisted of 60 students between 13 and 15 years of age, 30 with dyslexia and 30 without. The King Devick test was used to assess the saccadic eye movements, specifically the fast and automated denomination of digits; the Harris laterality test was used to evaluate functional laterality, and the ENFEN test for executive functions. The results revealed significant differences between the two groups. Students with dyslexia scored lower on the three neuropsychological skills assessed. These findings suggest that students with dyslexia may manifest poorer performance in those neuropsychological skills that are key to reader development.

Resumen La dislexia es un problema que cada vez afecta más al alumnado en edad escolar. Las últimas experiencias de aplicación de la neuropsicología al ámbito educativo resultan interesantes porque van a permitir evaluar distintas variables neuropsicológicas con el objeto de comprender mejor los procesos de aprendizaje del alumnado para plantear posteriormente intervenciones específicas en esta población. El propósito de este estudio fue explorar variables neuropsicológicas relacionadas con la lectura y escritura en estudiantes con y sin dislexia. La muestra estuvo compuesta por 60 estudiantes de entre 13 y 15 años, 30 con dislexia y treinta sin dislexia. La prueba King Devick fue utilizada para valorar los movimientos oculares sacádicos, la prueba de la lateralidad de Harris para evaluar la lateralidad y la prueba ENFEN para las funciones ejecutivas. Los resultados revelaron diferencias significativas entre los dos grupos. Los estudiantes con dislexia obtuvieron puntuaciones más bajas en las tres habilidades neuropsicológicas evaluadas. Estos hallazgos sugieren que los niños con dislexia podrían manifestar un peor desempeño en habilidades neuropsicológicas que son clave para el desarrollo lector y escritor.

Objective memory as an indicator of functional impairment in native Spanish-speaking patients with HIV infection.

Objective memory is one of the most affected cognitive areas in patients with HIV and perhaps one of the best predictors of daily functioning problems. Its relationship with biological markers, mood symptoms, and cognitive complaint is unclear and has received little attention in native Spanish-speakers. The goal of this study is to explore the relationships between the above-mentioned variables and their prediction of objective memory performance in native Spanish-speakers. HIV-related biological markers, mood symptoms, cognitive complaint, and objective memory were assessed in a sample native Spanish-speaking HIV patient with possible cognitive impairment. The results revealed deficit in short- and long-term memory while recognition was retained. Hierarchical regression analysis showed that the combination of independent variables significantly predicted performance in recognition, indicating that the pattern of impairment in short- and long-term memory is related to a difficulty to learn new information discriminately. The non-prediction of short- and long-term memory performance may be related to the inability to estimate the deficit in objective memory. These results show the need to perform specific interventions in mnesic processes, in view of the relation between this cognitive process and patients' daily functioning.

Diferencias entre hombres y mujeres en los procesos de toma de decisiones en pacientes con trastornos relacionados con sustancias / Differences between men and women in decision-making processes in patients with substance-related disorders

Resumen Los trastornos relacionados con sustancias (TRS) pueden cursar con alteraciones neuropsicológicas que afectan las actividades de la vida diaria de una persona. El objetivo principal de este trabajo es estudiar el proceso de la toma de decisiones en pacientes con TRS y analizar si hay diferencias entre hombres y mujeres. Se administró una versión computarizada de la Iowa Gambling Task (IGT) a una muestra total de 101 pacientes con TRS que solicitaron tratamiento ambulatorio, 81 hombres (80,2%) y 20 mujeres (19,8%). Los resultados muestran una alteración en la toma de decisiones. Asimismo, se observó un peor rendimiento en el grupo de los hombres en la toma de decisiones en comparación con el grupo de las mujeres. Estos datos comprueban la importancia de tener en cuenta el sexo a la hora del diagnóstico e intervención en personas con TRS. Se precisan estudios futuros que profundicen en estas diferencias.

Abstract Substance-related disorders (TRS) can cause neuropsychological alterations that affect the activities of a person's daily life. The main objective of this work is to study the process of decision making in patients with TRS and to analyze if there are differences between men and women. A computerized version of the Iowa Gambling Task (IGT) was administered to a total sample of 101 patients with TRS who requested outpatient treatment, 81 men (80.2%) and 20 women (19.8%). The results obtained show an alteration in the decision making. Likewise, a worse performance was observed in the group of men in decision making compared to the group of women. These data point to the importance of taking into account sex at the time of diagnosis and intervention in people with SDB. Future studies are needed to delve into these differences.

A cluster-analytic profiling of heroin-dependent patients based on level, clinical adequacy, and patient-desired adjustment of buprenorphine dosage during buprenorphine-naloxone maintenance treatment in sixteen Spanish centers.

BACKGROUND: Buprenorphine dosage is a crucial factor influencing outcomes of buprenorphine treatment for heroin use disorders. Therefore, the aim of the present study is to identify naturally occurring profiles of heroin-dependent patients regarding individualized management of buprenorphine dosage in clinical practice of buprenorphine-naloxone maintenance treatment. METHODS: 316 patients receiving buprenorphine-naloxone maintenance treatment were surveyed at 16 Spanish centers during the stabilization phase of this treatment. Patients were grouped using cluster analysis based on three key indicators of buprenorphine dosage management: dose, adequacy according to physician, and adjustment according to patient. The clusters obtained were compared regarding different facets of patient clinical condition. RESULTS: Four clusters were identified and labeled as follows (buprenorphine average dose and percentage of participants in each cluster are given in brackets): "Clinically Adequate and Adjusted to Patient Desired Low Dosage" (2.60 mg/d, 37.05%); "Clinically Adequate and Adjusted to Patient Desired High Dosage" (10.71 mg/d, 29.18%); "Clinically Adequate and Patient Desired Reduction of Low Dosage" (3.38 mg/d, 20.0%); and "Clinically Inadequate and Adjusted to Patient Desired Moderate Dosage" (7.55 mg/d, 13.77%). Compared to patients from the other three clusters, participants in the latter cluster reported more frequent use of heroin and cocaine during last week, lower satisfaction with buprenorphine-naloxone as a medication, higher prevalence of buprenorphine-naloxone adverse effects and poorer psychological adjustment. CONCLUSIONS: Our results show notable differences between clusters of heroin-dependent patients regarding buprenorphine dosage management. We also identified a group of patients receiving clinically inadequate buprenorphine dosage, which was related to poorer clinical condition.