A Systematic Review and Meta-analysis of Psychosocial Interventions to Reduce Drug and Sexual Blood Borne Virus Risk Behaviours Among People Who Inject Drugs.

Opiate substitution treatment and needle exchanges have reduced blood borne virus (BBV) transmission among people who inject drugs (PWID). Psychosocial interventions could further prevent BBV. A systematic review and meta-analysis examined whether psychosocial interventions (e.g. CBT, skills training) compared to control interventions reduced BBV risk behaviours among PWID. 32 and 24 randomized control trials (2000-May 2015 in MEDLINE, PsycINFO, CINAHL, Cochrane Collaboration and Clinical trials, with an update in MEDLINE to December 2016) were included in the review and meta-analysis respectively. Psychosocial interventions appear to reduce: sharing of needles/syringes compared to education/information (SMD -0.52; 95% CI -1.02 to -0.03; I2 = 10%; p = 0.04) or HIV testing/counselling (SMD -0.24; 95% CI -0.44 to -0.03; I2 = 0%; p = 0.02); sharing of other injecting paraphernalia (SMD -0.24; 95% CI -0.42 to -0.06; I2 = 0%; p < 0.01) and unprotected sex (SMD -0.44; 95% CI -0.86 to -0.01; I2 = 79%; p = 0.04) compared to interventions of a lesser time/intensity, however, moderate to high heterogeneity was reported. Such interventions could be included with other harm reduction approaches to prevent BBV transmission among PWID.

Could Periodontitis Increase the Risk of Suffering from Pancreatic Cancer?-A Systematic Review.

(1) Background: The relationship between periodontitis and systemic pathologies continues to grow. Recently, the presence of periodontal pathogens has been linked to an increased risk of pancreatic cancer (PC) and its mortality. Thus, a systematic review is needed to identify whether an association between the two diseases can be established. The objective of this review is to elucidate the mechanisms responsible for this association. (2) Methods: A systematic review was carried out using three databases (PubMed, Embase and Scopus) with the following keywords "Periodontitis AND pancreatic cancer". A total of 653 articles were retrieved; before selection and screening, the inclusion and exclusion criteria were defined, resulting in a total of 13 articles being included in the review. (3) Results: The increase in low-grade systemic inflammation, pH changes, and the cytotoxicity of certain periodontopathogenic bacteria were found in the scientific literature reviewed as mechanisms linking periodontitis with the risk of PC. (4) Conclusions: Through this systematic review, we have seen how periodontitis can be related to PC and how it worsens its prognosis. Knowing the behavior of periodontopathogenic bacteria and the influence they have on our immune and inflammatory system may help to achieve an interdisciplinary approach to both pathologies.

[Dual diagnosis and personality traits: current situation and future research directions]. / Patología dual y rasgos de personalidad: situación actual y líneas futuras de trabajo.

Dual diagnosis (DD) is the co-occurrence, in the same person, of a mental disorder (MD) and a substance use disorder (SUD). Nowadays, the study of the personality with DD is realized mainly from a categorical view, focusing on the detection of personality disorders and not on the traits associated to DD and the possible differential profile compared to those patients with only MD or SUD. Studies analyzing personality traits of patients with DD and their possible differential profile are very limited. However, existing data indicates that DD patients show higher levels of Sensation Seeking, Impulsivity, Harm Avoidance and Neuroticism; and lower levels of Persistence, Self-Direction, Self-Transcendence and Cooperation. Therefore, DD is associated to personality characteristics that suggest more disruptive behaviors, fewer resources for recovering and keeping abstinent and worse prognosis compared to those with only one disorder. Progress in the characterization of personality traits in DD, taking into consideration the methodological aspects to be improved could allow better adaptation of the integrated treatment of these patients in the future.

Personality Profile and Clinical Correlates of Patients With Substance Use Disorder With and Without Comorbid Depression Under Treatment.

Background: Among patients with substance use disorder (SUD), major depressive disorder (MDD) is highly prevalent. Even though, personality plays an important role in treatment outcomes for individuals with SUD and SUD + MDD, few studies have explored personality characteristics in these samples. This study aims to describe personality for patients with SUD taking into account the comorbid MDD, using the Alternative Five Factor Model (AFFM). We also aim to compare SUD + MDD patients with population norms and to elucidate possible personality clinical correlates. Methods: For our study, 116 male patients undergoing for SUD treatment were divided in two groups: SUD only (N = 58) and SUD + MDD (N = 58). To examine personality, we used the Zuckerman-Kuhlman Personality Questionnaire and multiple analyses of covariance were performed to identify differences. In a first analysis, age was introduced as a covariate whereas in a second analysis the continuous variables that showed to have a discriminant value for the groups were added as covariates. Variables predicting the presence of dual diagnosis and personality clinical correlates were analyzed by logistic and linear regression models, respectively. We observed that patients with SUD + MDD show distinctive personality characteristics compared with patients with SUD only and population norms. Results: According to the AFFM, SUD + MDD patients are characterized by higher Neuroticism-Anxiety (positively associated to depressive symptoms) and Impulsivity; and by lower Parties and Friends. Moreover, the probability of having a dual depressive disorder was represented by the amount of medications and substances used. The preference for hard work and the energy self-reported levels (Work Activity trait) are linked to these clinical variables rather than to the presence/absence of a dual depressive disorder. Conclusions: Even when controlling clinical variables related to a higher probability of having a dual depressive disorder, the Neuroticism-Anxiety is a personality trait that strongly differentiates between SUD only and SUD + MDD patients. Further investigation is needed to explore the role of this personality trait as endophenotype in dual depressive men. Our results underline the importance of a dimensional understanding of personality and its clinical correlates among patients with SUD + MDD; this approach could provide us information on specific treatment strategies to improve the prognosis of patients.