Perceived burdensomeness, thwarted belongingness, and hopelessness as predictors of future suicidal ideation in Spanish university students.

The Interpersonal Theory of Suicide (IPTS) has received support for its role in understanding suicidal thoughts and behaviors. However, few longitudinal studies have focused on testing this theory in university students. The present study aimed to confirm the theoretical model of the IPTS in a sample of 225 Spanish university students, using path analysis in a longitudinal study. We assessed thwarted belongingness and perceived burdensomeness at T1 and hopelessness and suicidal ideation at T2, 12-14 weeks later. Moreover, we assessed suicidal ideation weekly for 14 weeks. Path analyses confirmed the Interpersonal Theory of Suicide model, with thwarted belongingness and perceived burdensomeness as direct and indirect predictors of suicidal ideation through hopelessness. Providers of guidance and clinical services in university settings should be trained to identify perceived burdensomeness, social belongingness, hopelessness, and suicidal ideation when screening for suicide prevention.

Comparison of Hematocrit Change in Testosterone-deficient Men Treated With Intranasal Testosterone Gel vs Intramuscular Testosterone Cypionate: A Randomized Clinical Trial.

PURPOSE: Our primary aim was to compare changes in hematocrit in testosterone-deficient men treated with intranasal testosterone gel vs intramuscular testosterone cypionate. MATERIALS AND METHODS: This 2-arm, open-label, randomized trial recruited men with testosterone deficiency at the University of Miami between August 2020 and October 2022. Men with 2 total testosterone levels <350 ng/dL and hypogonadal symptoms, aged 18-75 years were randomly assigned to receive either intranasal testosterone gel 11 mg 3 times daily or intramuscular testosterone cypionate 200 mg every 2 weeks. The primary outcome was change in hematocrit after 4 months of treatment. Secondary outcomes were changes in serum testosterone, estradiol, prostate-specific antigen, 17-hydroxyprogesterone, and the 6-item International Index of Erectile Function. RESULTS: Of the 81 men randomized, 54 completed treatment (intranasal n=23; intramuscular n=31). The mean age was 47.5 vs 49.5 years, with mean baseline testosterone of 244.6 vs 240.7 ng/dL and mean hematocrit of 44.4% vs 42.7% in intranasal vs intramuscular groups, respectively. Men who received intramuscular injections had a significant increase after 4 months of treatment in mean hematocrit from 42.7% to 46.6% (P < .0001), but there was no significant change in men who received intranasal gel (P = .233). Men in both groups experienced significantly increased serum testosterone levels throughout the study period, though a larger increase was seen in men treated with intramuscular injections (mean change 511 vs 283, P = .025). Men who received injections also experienced an increase in estradiol (mean change 22.9, P < .001), decrease in 17-hydroxyprogesterone (mean change -39.8, P < .0001), and increase in the 6-item International Index of Erectile Function score (mean change 4.8, P = .015); men treated with intranasal gel experienced no such changes. Prostate-specific antigen levels were stable in both groups. CONCLUSIONS: Intranasal testosterone gel does not appear to significantly affect hematocrit levels. Men who wish to avoid polycythemia or changes in estradiol or 17-hydroxyprogesterone levels may benefit from short-acting testosterone therapy formulations such as intranasal gel.

National Adherence to Guidelines for Antimicrobial Prophylaxis for Patients Undergoing Radical Cystectomy.

PURPOSE: The sentinel reference for antibiotic prophylaxis for radical cystectomy with ileal conduit in the AUA Guidelines reports data from 2003-2013 and has not been updated in the interim. Here, we assess adherence to antibiotic prophylaxis guidelines among patients undergoing radical cystectomy with ileal conduit for bladder cancer using a large national database. As a secondary objective, we assess the association between antimicrobial use and postoperative infection during the index admission following cystectomy. MATERIALS AND METHODS: The Premier Healthcare Database was queried for all patients undergoing cystectomy with ileal conduit with diagnosis of bladder cancer between 2015 and 2020. Antibiotics used and the duration of use was determined by charge codes and grouped as guidelines-based or not according to 2019 AUA Guidelines. Association with infectious complications was assessed by logistic mixed effects regression models. RESULTS: Among 6,708 patients undergoing cystectomy with ileal conduit, only 28% (1,843/6,708) were given prophylaxis according to AUA guidelines; 1.8% (121/6,708) of patients received an antifungal and 37% (2,482/6,708) received extended duration prophylaxis beyond postoperative day 1. Patients who received guidelines-based prophylaxis were less likely to be diagnosed with a urinary tract infection (21% vs 24%, P = .04), pyelonephritis (5.1% vs 7.7%, P < .001), bacterial infection (24% vs 27%, P = .03), or pneumonia (12% vs 17%, P < .001). There was no statistically significant difference in clostridium difficile infection between guidelines-based and nonguidelines-based prophylaxis (3.2% vs 3.7%, P = .32). In a multivariable logistic regression adjusting for age, race, insurance, and hospital and provider characteristics, nonguideline antibiotic prophylaxis (OR 1.27 [1.12, 1.43], P < .001) was associated with an increased odds of infectious events, whereas a robotic approach (OR 0.82 [0.73, 0.92], P < .001) was associated with lower odds. CONCLUSIONS: Seventy-three percent of patients fail to receive guideline-based antibiotic prophylaxis when undergoing radical cystectomy with conduit, which was largely driven by extended duration antibiotic use. Despite the shorter duration of antibiotics, we found that guideline-based prophylaxis was associated with a 25% decrease in the odds of infectious complications. While residual confounding is possible, these data support current AUA guidelines and suggest a need for outreach to improve guideline adherence.

Evaluation and management of male genital tract infections in the setting of male infertility: an updated review.

PURPOSE OF REVIEW: Male infertility may be secondary to male genital tract infection (MGTI) in an estimated 15% of cases. In the absence of overt clinical signs, evaluation for MGTI beyond semen analysis is not well established. Therefore, we review the literature on the evaluation and management of MGTI in the setting of male infertility. RECENT FINDINGS: A set of international guidelines recommends semen culture and PCR testing, but the significance of positive results remains unclear. Clinical trials evaluating anti-inflammatory or antibiotic treatment report improvements in sperm parameters and leukocytospermia, but data on the effect on conception rates are lacking. Human papillomavirus (HPV) and the novel coronavirus (SARS-CoV-2) have been associated with poor semen parameters and decreased conception rates. SUMMARY: The finding of leukocytospermia on semen analysis prompts further evaluation for MGTI, including focused physical examination. The role of routine semen culture is controversial. Treatment options include anti-inflammatories; frequent ejaculation; and antibiotics, which should not be used in the absence of symptoms or microbiological infection. SARS-CoV-2 represents a subacute threat to fertility that should be screened for in the reproductive history along with HPV and other viruses.

The evolving landscape of COVID-19 and post-COVID condition in patients with chronic lymphocytic leukemia: A study by ERIC, the European research initiative on CLL.

In this retrospective international multicenter study, we describe the clinical characteristics and outcomes of patients with chronic lymphocytic leukemia (CLL) and related disorders (small lymphocytic lymphoma and high-count monoclonal B lymphocytosis) infected by SARS-CoV-2, including the development of post-COVID condition. Data from 1540 patients with CLL infected by SARS-CoV-2 from January 2020 to May 2022 were included in the analysis and assigned to four phases based on cases disposition and SARS-CoV-2 variants emergence. Post-COVID condition was defined according to the WHO criteria. Patients infected during the most recent phases of the pandemic, though carrying a higher comorbidity burden, were less often hospitalized, rarely needed intensive care unit admission, or died compared to patients infected during the initial phases. The 4-month overall survival (OS) improved through the phases, from 68% to 83%, p = .0015. Age, comorbidity, CLL-directed treatment, but not vaccination status, emerged as risk factors for mortality. Among survivors, 6.65% patients had a reinfection, usually milder than the initial one, and 16.5% developed post-COVID condition. The latter was characterized by fatigue, dyspnea, lasting cough, and impaired concentration. Infection severity was the only risk factor for developing post-COVID. The median time to resolution of the post-COVID condition was 4.7 months. OS in patients with CLL improved during the different phases of the pandemic, likely due to the improvement of prophylactic and therapeutic measures against SARS-CoV-2 as well as the emergence of milder variants. However, mortality remained relevant and a significant number of patients developed post-COVID conditions, warranting further investigations.

Longitudinal evolution of meaning in life and its relationship with coping strategies in Spanish patients with a breast cancer diagnosis.

BACKGROUND: Changes in Meaning in life (MIL) have been shown to be particularly important when people face very stressful events such as receiving a cancer diagnosis and treatment. Active coping strategies have been related to higher levels of MIL in people with a diagnosis of cancer. OBJECTIVE: To explore the evolution of MIL in a sample of cancer patients at the time of their diagnosis and three, six, and nine months after surgery, and identify the association between coping strategies three months after diagnosis (T2) and levels of MIL at the different moments in the cancer process (T1-T4). METHODS: We assessed MIL at diagnosis and three, six, and nine months after surgery, and coping strategies (fighting spirit, anxious preoccupation, hopelessness, fatalism, and cognitive avoidance) three months after surgery, in 115 women with a diagnosis of Stage I-III breast cancer. RESULTS: We found higher levels of MIL nine months after surgery, compared to previous stages. MIL correlated significantly and positively with a fighting spirit and cognitive avoidance, and negatively with hopelessness and anxious preoccupation. CONCLUSIONS: Results highlight the importance of coping in relation to meaning-making processes in cancer. Meaning-centred interventions could help patients who are in the process of coping with cancer to make sense of their lives and the experience.

Risk factors for adverse outcomes following paraesophageal hernia repair among obese patients.

BACKGROUND: Although obesity is an established risk factor for adverse outcomes after paraesophageal hernia repair (PEHR), many obese patients nonetheless receive PEHR. The purpose of this study was to explore risk factors for adverse outcomes of PEHR among this high-risk cohort. We hypothesized that obese patients may have other risk factors for adverse outcomes following PEHR. METHODS: A retrospective study of adult obese patients who underwent minimally invasive PEHR from 2017 to 2019 was performed. Patients were excluded for BMI < 30 or if they had concomitant bariatric surgery at time of PEHR. The primary outcome of interest was a composite adverse outcome (CAO) defined as having any of the four following outcomes after PEHR: persistent GERD > 30 d, persistent dysphagia > 30 d, recurrence, or reoperation. Chi-square and t-test analysis was used to compare demographic and clinical characteristics. Multivariable logistic regression analysis was used to evaluate independent predictors of CAO. RESULTS: In total, 139 patients met inclusion criteria with a median follow-up of 19.7 months (IQR 8.8-81). Among them, 51/139 (36.7%) patients had a CAO: 31/139 (22.4%) had persistent GERD, 20/139 (14.4%) had persistent dysphagia, 24/139 (17.3%) had recurrence, and 6/139 (4.3%) required reoperation. On unadjusted analysis, patients with a CAO were more likely to have a history of prior abdominal surgery (86.3% vs 70.5%, p = 0.04) and were less likely to have undergone a preoperative CT scan (27.5% vs 45.5%, p = 0.04). On multivariable analysis, previous abdominal surgery was independently associated with an increased likelihood of CAO whereas age and preoperative CT scan had a decreased likelihood of CAO. CONCLUSIONS: Although there were adverse outcomes among obese patients, minimally invasive PEHR may be feasible in a subset of patients at specialized centers. These findings may help guide the appropriate selection of obese patients for PEHR.

Developing a Physician-Led Model for Research Mentorship in Academic Urology.

PURPOSE OF REVIEW: Quality mentorship is difficult to attain amidst the conflicting demands of academic medicine. In this review, we sought to characterize mentor-mentee relationships and discuss their optimization towards productivity in the research team setting. RECENT FINDINGS: A high-value mentor, defined by exceptional commitment to both research productivity and mentoring, naturally attracts prospective mentees, who can demonstrate their interest by shadowing and completing delegated tasks. Once fully initiated, the mentee establishes expectations with the mentor, identifies their roles within the research team, and, over time, takes ownership of the mentor-mentee relationship and collaborates with near-peers. Mentorship is a dynamic, reciprocal relationship that enhances career development of both participants. In the research team setting, episodic virtual research meetings and prudent delegation orient the entire team, while the mentor-mentee relationship is upheld by embracing a culture of responsiveness, feedback, and collaboration.

A systematic review of the effectiveness of meaning-centred psychotherapies in depressed participants.

Depression is a mental disorder that is associated with low quality of life, increased risk of suicide and a high economic cost for society. Meta-analyses indicate that Meaning Centred Psychotherapies (MCP) are an efficacious psychotherapy to reduce depression in participants with chronic illness and cancer. However, to date, no systematic review has analysed the effectiveness of MCP in depressed participants who do not have a physical illness or cancer. The objective of this study was to carry out a systematic review to analyse the effectiveness of MCP in participants with depression and no physical illness. The search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). Six studies (two randomised controlled trials and four quasi-experimental studies) were included in the systematic review. The results indicate that MCP is more effective than a control group as waitlist (four studies), psychoeducation group (one study), and cognitive behavioural therapy (CBT, one study), in reducing depressive symptoms, improving meaning in life and reducing anxiety in participants without physical illness. MCP would be considered a probably efficacious treatment for depression. However, further research with better experimental designs will be necessary to confirm the effectiveness of MCP for depression.

[Vaccination against the herpes zoster virus]. / Vacunación frente al virus del herpes zóster.

OBJECTIVE: To review the latest published evidence on the vaccine used in our country against the herpes zoster virus, breaking down the results according to the efficacy, efficiency, effectiveness and safety of the vaccine. Include the current recommendations for vaccination. DESIGN: Secondary review. Descriptive qualitative review. Review using the search term "herpes zoster vaccine" and "Adjuvanted recombinant Herpes Zoster subunit vaccine". Retrospective observational study. DATA SOURCES: Embase, Medline and Google Scholar. Selection of studies Search criterion with the terms "Shingrix vaccine" and "Adjuvanted Herpes Zoster Subunit Vaccine". Search period 2013-2023. Studies classified as clinical trials or randomized clinical trials were selected. 21 published studies were evaluated. There were no exclusions. RESULTS: The evaluated studies were found to be coherent and in all of them efficacy in adult individuals in preventing viral reactivation and in preventing complications was higher than 80%. The effectiveness of the vaccine after two doses was also higher than 80%. Cost-effectiveness studies were always favourable in adults, immunodepressed patients and individuals with chronic pathology. The safety of the vaccine was evaluated in the pivotal studies and in the post-commercialization studies that were undertaken (although there were few of the latter due to the short period of time studied). The safety profile of the vaccine is very high and in the case of severe adverse effects, their frequency was similar to that of a placebo. CONCLUSIONS: We have a safe and effective vaccine against the herpes zoster virus that allows us to protect the most vulnerable population groups against this virus.

Practice Comparison and Cost Analysis of Direct-to-Consumer Telemedicine Platforms Offering Testosterone Therapy.

BACKGROUND: Direct-to-consumer telemedicine platforms have expanded their reach to include services for the evaluation and treatment of testosterone deficiency. AIM: We aim to (i) evaluate the treatment practices and costs associated with receiving testosterone therapy through direct-to-consumer telemedicine platforms; (ii) compare these practices to the American Urological Association guidelines; and (iii) compare the cost of receiving similar care at a tertiary center. METHODS: Google was queried to identify telemedicine platforms offing testosterone therapy. Websites were analyzed for information regarding the initial consultation, initial laboratory evaluation, follow up, treatment monitoring regimen, and associated costs of receiving testosterone therapy. The costs for similar services at a tertiary care center were estimated using a single institution's online cost estimator for a patient with no insurance, private insurance, or Medicare. OUTCOMES: Evaluation and treatment practices of each platform were compared to the American Urological Association guidelines, and a cost analysis was completed for the cost of (i) undergoing an initial evaluation, and (ii) receiving 12 months of treatment through each platform and at a tertiary center. RESULTS: Three online platforms met inclusion criteria: Hone, Regenex Health, and TRT Nation. The initial evaluation and follow up of patients on TTh were similar between the online platforms and practice guidelines. The costs of the initial consultation were lowest for the patient with Medicare at a tertiary center and via the telemedicine platforms. Conversely, the cost of 12 months of intramuscular testosterone treatment was highest via the telemedicine platforms, ranging from $1,586 to $4,200, as compared to the tertiary center, which ranged from $134.01 to $1,333.04 with varying insurance models. Costs of ongoing treatment with transdermal testosterone are similarly higher via DTC platforms. CLINICAL IMPLICATIONS: Patients with private insurance or Medicare should be counseled that ongoing treatment through telemedicine platforms will likely incur a greater cost than receiving such care at a tertiary center that can utilize insurance coverage. STRENGTHS & LIMITATIONS: Practice and cost comparisons include accurate, up-to-date information based on each platform's website. Limitations include the analysis of only three telemedicine platforms, and the ability to describe only the information provided on each website. In addition, cost estimates for the tertiary center only include a single type of private and public insurance, limiting generalizability. CONCLUSION: This observational study indicates that direct-to-consumer telemedicine platforms are largely following practice guidelines in the evaluation and treatment of testosterone, however, there is a high cost associated with ongoing treatment. Jesse E, Sellke N, Rivero M-J, et al. Practice Comparison and Cost Analysis of Direct-to-Consumer Telemedicine Platforms Offering Testosterone Therapy. J Sex Med 2022;19:1608-1615.

Family connections vs treatment at usual optimized in the treatment of relatives of people with suicidal behavior disorder: study protocol of a randomized control trial.

BACKGROUND: Relatives of people diagnosed with suicidal behavior disorder (SBD) feel guilty, afraid, hopeless, depression and anxiety. It is necessary to help the relatives of people with SBD to reduce their discomfort and burden. Family Connections (FC) is a program that has been shown to be effective in reducing burden, depression, and anxiety, and increasing dominance and validating behaviors in relatives of people with borderline personality disorder. However, there are no RCTs that demonstrate the efficacy of the FC program in patients with SBD. Our research team adapted FC for relatives of people with SBD for delivery in the Spanish population (FC-SBD). The FC-SBD program contains 12 two-hour sessions held once a week. The first aim is to verify the efficacy of the FC-SBD intervention for relatives of people diagnosed with SBD in a randomized control trial with a Spanish sample. The second objective is to analyze the feasibility and acceptance of FC-SBD in relatives. The third aim is to analyze whether the changes produced in the psychological variables in the relatives after the intervention are related to changes in the psychological variables of the patients. This paper presents the study protocol. METHODS: The study design consists of a two-arm randomized controlled trial with two conditions: FC-SBD or Treatment as usual optimized (TAU-O). Participants will be relatives of patients who meet DSM-5 criteria for SBD. The caregivers` primary outcome measures will be the BAS. Secondary outcomes will be DASS-21, FES, DERS, QoL. The patient's primary outcome measures will be the frequency of critical incidents with the family member with SBD. Secondary measures will be the INQ, PHQ-9, OASIS. Participants will be assessed at pretreatment, post-treatment, and 6-month follow-up. The intention-to-treat principle will be used when analyzing the data. DISCUSSION: This study will provide results that confirm the efficacy of the FC-SBD in relatives of people with SBD. These results will also confirm its good acceptance by family members and help us to find out whether it is a good program to improve the prevention of suicidal behaviors in the family environment. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT05157607 . Registered 15 December 2021.

[Infectious Disease Prevention Group: Update on vaccines, 2022]. / Prevención de las enfermedades infecciosas. Actualización en vacunas PAPPS 2022.

The update of the preventive activities for this year 2022 in the field of infectious diseases is of special relevance due to the importance that prevention has gained and more specifically, vaccination as a tool to control the pandemic caused by the SARS-CoV-2 virus declared on March 11, 2020. The pandemic has focused much of the prevention efforts on its containment, but the importance of maintaining high vaccination coverage of the rest of the recommended vaccines to maintain good control of vaccine-preventable diseases and avoid complications in particularly vulnerable patients should not be forgotten. In this year's review we present a practical document with the aim of providing tools to primary care professionals who work with adults, to make the indication of each vaccine whether it is systematically recommended or if it is because the patient belongs to some risk group due to their condition or underlying pathology. In this way, throughout the document, we will comment on the most innovative aspects of systematic vaccination (flu, pneumococcus, meningococcal vaccines and vaccines against the human papillomavirus [HPV]), the new vaccines (pandemic vaccines against COVID-19, vaccines against herpes zoster of subunits, vaccines against monkeypox) and the recommended vaccines according to risk condition (pregnancy and lactation, travelers, patients with immunosuppression or underlying pathology).

Building a network of TP53 and IGHV testing reference centers across Spain: the Red53 initiative.

Among the different biomarkers predicting response in chronic lymphocytic leukemia (CLL), the most influential parameters are the mutational status of the IGHV genes and the presence of TP53 gene disruptions. Nevertheless, these important assessments are not readily available in most centers dealing with CLL patients. To provide this molecular testing across the country, the Spanish Cooperative Group on CLL (GELLC) established a network of four analytical reference centers. A total of 2153 samples from 256 centers were analyzed over a period of 30 months. In 9% of the patients, we found pathological mutations in the TP53 gene, whereas 48.96% were classified as IGHV unmutated. Results of the satisfaction survey of the program showed a Net Promoter Score of 85.15. Building a national network for molecular testing in CLL allowed the CLL population a broad access to complex biomarkers analysis that should translate into a more accurate and informed therapeutic decision-making.

Resilience as a predictor of quality of life in participants with borderline personality disorder before and after treatment.

BACKGROUND: Studies have suggested that psychotherapy improves the Quality of Life (QoL) of participants with Borderline Personality Disorder (BPD). However, there are no studies on the differential efficacy of treatments on the QoL of participants with BPD. Moreover, the relationship between QoL and resilience has rarely been studied in participants with BPD. OBJECTIVES: a) to examine whether people with BPD have worse QoL than the non-clinical population; b) to examine whether there are statistically significant differences between Dialectical Behavioural Therapy (DBT), Systems Training for Emotional Predictability and Problem Solving (STEPPS), or Cognitive Behavioural Therapy-Treatment at Usual (CBT-TAU) in the improvement of QoL; c) to examine whether participants show clinically significant improvements in QoL after treatment; d) to analyse whether resilience is associated with QoL before and after the BPD treatment; e) to analyse whether resilience is a predictor of QoL at pre-treatment and posttreatment. METHOD: The sample comprised 403 participants (n = 202 participants diagnosed with BPD and n = 201 non-clinical). Participants filled out the Quality of Life Index, Resilience Scale, and Beck Depression Inventory. The clinical participants received one of these possible treatments, DBT, STEPPS, or CBT-TAU. MANOVA and regression analyses were performed. RESULTS: a) participants diagnosed with BPD had statistically significant lower resilience than the non-clinical population; b) all three forms of psychotherapy statistically improved QoL, but there were no statistically significant differences between DBT, STEPPS, and CBT-TAU in the improvement of QoL; c) participants did not show clinically significant improvements in QoL after treatment; d) resilience was associated with QoL before and after treatment; and e) resilience was a predictor of QoL before and after treatment. CONCLUSION: It is necessary to assess QoL and Resilience in studies on psychotherapy with BPD patients.

Meaning-making as a mediator of anxiety and depression reduction during cognitive behavioral therapy intervention in participants with adjustment disorders.

There is a consensus among researchers about the link between low meaning in life and anxiety and depressive symptoms. One unanswered question is whether meaning-making is a mediator of the change in anxiety and depression symptoms in participants with adjustment disorders during cognitive behavioural therapy (CBT) treatment. The aims of this study were (a) to analyse whether there was meaning-making during the application of the CBT, (b) to analyse whether meaning-making was a mediator of anxiety psychopathology and (c) to analyse whether meaning-making was a mediator of depressive symptoms. The sample was composed of 115 patients who satisfied the full Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 criteria for adjustment disorder as their primary diagnosis and completed CBT treatment in a primary care mental health service: 74.78% women, n = 86, and 25.22% men, n = 29, with a mean age of 41.89 (standard deviation [SD] = 10.39) years. The diagnosis was established using the Structured Clinical Interview for DSM-5 (SCID-5), and participants filled out the Beck Anxiety Inventory, the Beck Depression Inventory and Purpose in Life questionnaires. The therapists were clinical psychologists with experience in clinical assessment. A repeated-measures analysis of variance (ANOVA) and two mediation analyses using the bootstrap method were performed. The results indicated that (a) There was meaning-making during the CBT because the treated sample showed a statistically significant improvement in meaning in life, and (b) meaning-making during the CBT was a partial mediator between anxiety symptoms and depressive symptoms before and after the treatment. The present study suggests that meaning in life could be an important variable in the psychopathology of adjustment disorders.

Confirmatory factor analysis and psychometric properties of the Emotion Regulation Questionnaire in participants with personality disorders.

Emotional dysregulation is a key symptom in participants with personality disorders. The Emotional Regulation Questionnaire (ERQ) has been studied with nonclinical samples; however, it is necessary to confirm the factorial structure of the ERQ in participants with personality disorders. The aims of the present study were to confirm the factorial structure of the Spanish version of the ERQ and analyse its psychometric properties as well as the association between the ERQ and the Borderline Symptoms List (BSL-23) and the Difficulties in Emotion Regulation Scale (DERS). The overall sample was composed of 250 patients with personality disorders, of whom 195 met the criteria for borderline personality disorder. Confirmatory factor analysis was conducted. The two-factor model showed an acceptable fit, similar to the original structure, in the participants with personality disorders and with borderline personality disorder. Cognitive reappraisal was negatively correlated with the DERS and BSL-23, and expressive suppression was positively correlated with the BSL-23. The ERQ is a reliable and valid instrument to evaluate emotional dysregulation in participants with personality disorders and participants with borderline personality disorder.

Isolation, reactivity, pharmacological activities and total synthesis of hispanolone and structurally related diterpenes from Labiatae plants.

Hispanolone is a furolabdane diterpene isolated from Ballota hispanica, whose natural product chemistry has been summarized and updated here, including several aspects associated with the isolation, structure determination, hemisynthesis, total synthesis, and pharmacology, and related hispanolone diterpenoids that have attracted the interest of different laboratories from diverse perspective and expertise in the last forty-two years.

Confirmatory factor analysis of the Inventory of Statements About Self-injury in a Spanish clinical sample.

OBJECTIVES: The main aim of the present study was to confirm the two-factor structure of the Inventory of Statements About Self-injury- Part II (ISAS-II), analyze its psychometric properties and test-retest reliability of Parts I and II of the ISAS. METHOD: The sample was composed of 355 Spanish participants diagnosed with eating disorders or borderline personality disorder (mean age 27.89, standard deviation = 13.31; 315 women, 40 men). Two models proposed for the ISAS-II were analyzed by means of confirmatory factorial analysis. RESULTS: A two-factor model was confirmed, and a model with self-care included in the intrapersonal factor was preferable. The ISAS-II showed positive correlations with emotional dysregulation. Test-retest reliability showed statistically significant correlations at 7 months (n = 123). CONCLUSION: The ISAS-II is a valid instrument to assess nonsuicidal self-injury in Spanish populations, making it possible to assess these behaviors, which require valid and reliable measures worldwide.

Meaning in life moderates hopelessness, suicide ideation, and borderline psychopathology in participants with eating disorders: A longitudinal study.

Participants with eating disorders (EDs) experience identity problems, hopelessness, and suicide ideation. Research has confirmed the link between the experience of low meaning in life (MIL) and psychopathology. However, there is a lack of research focusing on MIL in ED. OBJECTIVES: The objectives of this study are as follows: (a) to analyze whether MIL at baseline moderates the association between ED psychopathology at baseline and borderline symptoms, hopelessness, and suicide ideation at follow-up and (b) to analyze whether MIL moderates the association between suicide ideation, hopelessness, and borderline symptoms at baseline and at the 7-month follow-up. METHOD: The sample was composed of 300 participants with ED at baseline and 122 at the 7-month follow-up. The participants filled out the Purpose in Life, Eating Attitude Test, Borderline Symptoms List, Hopelessness Scale, and Suicide Ideation Scale. RESULTS: (a) MIL at baseline moderated the association between ED psychopathology at baseline and borderline symptoms, hopelessness, and suicide ideation at the follow-up; (b) MIL moderated the association between suicide ideation, hopelessness, and borderline symptoms at baseline and at the 7-month follow-up. CONCLUSION: MIL could be a relevant variable in the ED psychopathology.