Dysregulation of Plasma Growth Factors and Chemokines in Cocaine Use Disorder: Implications for Dual Diagnosis with Schizophrenia and Antisocial Personality Disorder in an Exploratory Study.

INTRODUCTION: Dual diagnosis in individuals with cocaine use disorders (CUDs) presents a mental health challenge marked by an increased susceptibility to disabling morbidities and premature mortality. Despite extensive research on depression and anxiety, other prevalent comorbidities, such as psychotic and personality disorders, have received less attention. This study explores inflammation-related mediators as potential biomarkers for CUD and dual diagnosis with schizophrenia (SCZ) or antisocial personality disorder (APD). METHODS: This exploratory study included 95 participants, comprising 40 healthy subjects and 55 abstinent patients with CUD. Lifetime CUD was diagnosed either as single diagnosis (CUD group, N = 25) or as a dual diagnosis (DD group. N = 30) with SCZ (CUD+SCZ subgroup) or APD (CUD+APD subgroup). Participants were clinically assessed, and the plasma concentrations of growth factors (i.e., G-CSF, BDNF, and VEGF-A) and chemokines (i.e., CCL11/eotaxin-1, CCL2/MCP-1, and CXCL12/SDF-1) were determined and log(10)-transformed for analysis. RESULTS: Growth factors and chemokines were dysregulated by CUD and psychiatric diagnoses. Specifically, patients in the CUD group exhibited significantly lower concentrations of G-CSF and CCL11/eotaxin-1 than the control group. In contrast, the DD group showed significantly higher concentrations of all analytes than both the CUD and control groups. Additionally, no differences in these analytes were observed between the CUD+SCZ and CUD+APD subgroups within the DD group. Regarding cocaine-related variables, significant associations were identified in the CUD group: an inverse correlation between the age at first cocaine use and the concentrations of BDNF and CCL2/MCP-1; and a positive correlation between the duration of the cocaine abstinence and the concentrations of BDNF and CCL11/eotaxin-1. Lastly, a logistic regression model incorporating all these analytes demonstrated high discriminatory power in distinguishing patients with CUD alone from those with dual diagnosis. CONCLUSIONS: Individuals with dual diagnosis of CUD exhibit elevated concentrations of growth factors and chemokines, distinguishing them from those with CUD alone. It is unclear whether the differences in these inflammatory mediators are specific to the presence of SCZ and APD. The study highlights potential biomarkers and associations, providing valuable insights into the intricate interplay of CUD and psychiatric disorders to enhance clinical diagnosis and therapeutics.

Personality traits and psychopathology in adolescents with videogame addiction. / Rasgos de personalidad y psicopatología en adolescentes con adicción a videojuegos.

Gaming disorder (GD) was recently included in the 11th edition of the International Classification of Diseases. A cross-sectional study was conducted in five secondary schools, with a final sample of 119 students. A diagnosis of GD was made in 6.4% (n = 23) of this sample. Compared with healthy subjects, adolescents with GD showed low levels of conscientiousness (F = 7.82; p = .001) and agreeableness (F = 3.31; p = .041) and scored higher in school maladjustment (SMC; F = 9.23; p < .001). Two discriminating functions were obtained that allowed us to predict patient group allocation with a success rate of 60.5% (Z1 = 0.406 × Sex + 0.560 × Conscientiousness - 0.677 × SMC; Z2 = 0.915 × Sex + 0.191 × Conscientiousness + 0.326 × SMC). Subjects with addiction differed from healthy subjects in presenting school maladjustment and low consciousness, while both groups of subjects with addiction differed in that video game addiction was proportionally higher in boys. The probability of GD was higher if subjects were male (OR [95% CI]) = 4.82 [1.17-19.81]; p = .029) and had school maladjustment (OR [95% CI] = 1.08 [1-1.17]; p = .047); while that of substance use disorder was higher if the subjects had neuroticism (OR [95% CI] = 1.07 [1-1.14]; p < .040), clinical maladjustment (OR [95% CI] = 1.10 [1.01- 1.20]; p = .020), school maladjustment (OR [95% CI] = 1.06 [1-1.13]; p = .048), low personal adjustment (OR [95% CI] = 0.94 [0.88-0.99]; p = .047) and emotional symptoms (OR [95% CI] = 0.86 [0.78-0.96]; p = .006).

El trastorno por uso de videojuegos se incluyó recientemente en la 11ª edición de la Clasificación Internacional de Enfermedades. Se realizó un estudio transversal en cinco institutos, con una muestra final de 119 alumnos. El 6,4% (n = 23) de los sujetos tenía trastorno por uso de videojuegos. Los adolescentes con trastorno por uso de videojuegos mostraron bajos niveles de consciencia (F = 7,82; p = ,001) y amabilidad (F = 3,31; p = ,041); y puntuaron más alto en inadaptación escolar (SMC; F = 9,230; p < ,001) que los sanos. Obtuvimos dos funciones discriminantes que clasificaban correctamente al 60,5% (Z1 = 0,406 × Sexo + 0,560 × Conciencia - 0,677 × SMC; Z2 = 0,915 × Sexo + 0,191 × Conciencia + 0,326 × SMC). Los sujetos con adicción se diferenciaban de los sanos en presentar inadaptación escolar y baja conciencia, mientras que ambos grupos con adicción se diferenciaban en que los alumnos con adicción a videojuegos eran en mayor proporción varones. La probabilidad de trastorno por uso de videojuegos aumentaba si el sujeto era varón (OR [CI 95%] = 4,82 (1,17-19,81); p = ,029) con inadaptación escolar (OR [IC 95%] = 1,08 (1-1,17); p = ,047); mientras que el trastorno por uso de sustancias aumentaba si el sujeto presentaba neuroticismo (OR [IC 95%] =1,07 [1-1,14]; p < ,040), desajuste clínico (OR [IC 95%] = 1,10 [1,01-1,20]; p = ,020), inadaptación escolar (OR [IC 95%] = 1,06 [1-1,13]; p = ,048), bajo ajuste personal (OR [IC 95%] = 0,94 [0,88-0,99]; p = ,047) y síntomas emocionales (OR [IC 95%] = 0,86 [0,78-0,96]; p = ,006).

Cocaine Increases Sensorimotor Gating and is Related to Psychopathy.

OBJECTIVE: Prepulse inhibition regulates sensorimotor gating and is a marker of vulnerability to certain disorders. We compared prepulse inhibition, psychopathy, and sensitivity to punishment and reward in patients with cocaine-related disorder without psychiatric comorbidities and a control group. METHODS: This was an observational study of a sample of 22 male cases with cocaine-related disorder and 22 healthy male controls. We used the Psychiatric Research Interview for Substance and Mental Disorders and Mini International Neuropsychiatric Interview; the Sensitivity to Punishment and Sensitivity to Reward Questionnaire; and the Levenson Self-Report Psychopathy Scale and Hare Psychopathy Checklist-Revised. Prepulse inhibition was evaluated at 30, 60, and 120 ms. RESULTS: Cocaine-related disorder group had a higher overall score (t = 12.556, p = .001) and primary psychopathy score (t = 3.750, p = .001) on Levenson Self-Report Psychopathy Scale, a higher score on both Hare Psychopathy Checklist-Revised factors, sensitivity to rewards (t = 3.076, p = .005) and prepulse inhibition at 30 ms (t = 2.859, p = .008). CONCLUSIONS: Cocaine use in patients without psychiatric comorbidities seems to increase sensorimotor gating. Therefore, these patients likely have an increased sensitivity to rewards, causing them to focus more on cocaine-boosting stimuli, thus explaining the psychopathic traits of these individuals.

Sensorimotor Gating in Cocaine-Related Disorder with Comorbid Schizophrenia or Antisocial Personality Disorder.

Objective: Schizophrenia, cocaine-related disorder, antisocial personality disorder, and psychopathy share biological bases, but few studies discriminate between these disorders by means of prepulse inhibition. This work studies the phenotype of patients with cocaine-related disorders who are vulnerable to presenting a dual diagnosis of schizophrenia or antisocial personality disorder, by evaluating their prepulse inhibition, impulsivity and psychopathy personality traits. Methods: The sample (n = 38) was divided into three groups: (1) cocaine-related disorder (8 individuals diagnosed with cocaine-related disorder who did not present any other mental disorder), (2) cocaine-related disorder and schizophrenia (n = 14), and (3) cocaine-related disorder and antisocial personality disorder (n = 16). Results: The prepulse inhibition in the two groups with dual diagnosis was lower than that in the cocaine-related disorder group, F(2, 35) = 6.52, p = .004, while there was no significant differences between the two dual-diagnosis groups. Psychopathy was evaluated with the revised Hare Psychopathy Checklist and showed no correlation with the prepulse inhibition. Secondary psychopathy (impulsivity and poor behavior control), as evaluated with Levenson Self-Report Psychopathy Scale, was related to the prepulse inhibition. Two discriminating functions were obtained that allowed prediction of patient inclusion in the groups using the prepulse inhibition and the revised Hare Psychopathy Checklist with a success rate of 81.6% (cocaine-related disorder = 62.5%; cocaine-related disorder and schizophrenia = 78.6%; cocaine-related disorder and antisocial personality disorder = 93.8%). These results are discussed in regard to the neurobiological implications of prepulse inhibition in dual diagnosis. Conclusions: The results suggest that the prepulse inhibition is a promising dual-diagnosis vulnerability marker in individuals with cocaine addiction, because prepulse inhibition deficits are related both to schizophrenia and antisocial personality disorder. In addition, prepulse inhibition, which is considered a good endophenotype for studies on the genetic and neurobiological basis of cocaine-related disorder and schizophrenia, could be used in the same way in studies on antisocial personality disorder.

Creation of the TXP parenting questionnaire and study of its psychometric properties. / Creación y estudio de las propiedades psicométricas del cuestionario de socialización parental TXP.

Parenting is linked to conduct disorders (CD) and substance related disorders (SRD) in adolescents, but with differences according to cultural context. A questionnaire with two versions (parenting questionnaire TXP-A for adolescents and TXP-C  for primary caregivers) was designed using the Delphi method to evaluate parenting practices related to CD and SRD in a Spanish population. It was validated in a community sample of 631 adolescents aged between 14 and 16 and their caregivers. Results suggest a 29-item TXP-A questionnaire with bifactorial structure: affection-communication and control-structure, with high internal (Cronbach’s alpha=0.89) and test-retest (intraclass correlation coefficient=0.94) reliabilities. Both factors are related to SRD (r=0.273, p<0.001) and with most of the psychopathological dimensions studied. The total score and affection-communication are related to dissocial disorder (t=3.259, p=0.001) and its severity (r=-0,119; p=0.003). Inter-observer reliability between adolescents and caregivers is low, in part because the 16-item TXP-C has a different bifactorial structure: affection-communication and prosocial values. TXP-C’s internal (Cronbach’s alpha=0.87) and test-retest (intraclass correlation coefficient=0.94) reliabilities are high. The total score and affection-communication were related to dissocial disorder (t=2.586; p=0.010) but TXP-C did not discriminate according to SRD. In conclusion, the TXP-A questionnaire for adolescents seems to be a reliable, valid and unbiased instrument that evaluates the perception of parenting practices, relating higher affection-communication and control-structure to less psychopathology and alcohol and drug use. TXP-C also seems to be reliable and unbiased, but shows less evidence of validity regarding substance use and psychopathology. .

El estilo parental de socialización se relaciona con trastornos de conducta (TC) y trastornos relacionados con sustancias (TRS) en adolescentes, con diferencias según el contexto cultural. Se diseñó mediante método Delphi un cuestionario con dos versiones (Cuestionario de socialización parental TXP-A para adolescentes y TXP-C para cuidador principal) para evaluar en población española las prácticas de socialización parental relacionadas con TC y TRS. Se validó en una muestra comunitaria de 631 adolescentes entre 14 y 16 años y sus cuidadores. Los resultados recomiendan un cuestionario TXP-A de 29 ítems y estructura bifactorial: afecto-comunicación y control-estructura, mostrando alta fiabilidad interna (alfa de Cronbach=0,89) y test-retest (coeficiente de correlación intraclase=0,94). Ambos factores correlacionan con TRS (r=0,273; p<0,001) y con la mayoría de las dimensiones psicopatológicas estudiadas. La puntuación total y afecto-comunicación se relacionan con el trastorno disocial (t=3,259; p=0,001) y su gravedad (r=-0,119; p=0,003). La fiabilidad interjueces entre adolescentes y cuidadores es baja, en parte porque el TXP-C, de 16 ítems, presenta una estructura bifactorial diferente: afecto-comunicación y valores prosociales. La fiabilidad interna (alfa de Cronbach= 0,87) y test-retest (coeficiente de correlación intraclase=0,94) del TXP-C son altas. La puntuación total y afecto-comunicación se relacionan con el trastorno disocial (t=2,586; p=0,010) pero no discrimina según el TRS. En conclusión, el cuestionario TXP-A para adolescentes parece un instrumento fiable, válido y sin sesgos que evalúa la percepción de las prácticas de socialización parental, relacionando mayores puntuaciones en afecto-comunicación y control-estructura con menor psicopatología y consumo de alcohol y drogas. El TXP-C también parece fiable y sin sesgos, pero muestra menos evidencias de validez respecto al consumo de sustancias y la psicopatología.

Analytical strategy to investigate 3,4-methylenedioxypyrovalerone (MDPV) metabolites in consumers' urine by high-resolution mass spectrometry.

The potential of high-resolution mass spectrometry (HRMS) for the investigation of human in vivo metabolism of 3,4-methylenedioxypyrovalerone (MDPV) using urine collected from a consumer (this is, in non-controlled experiments) has been investigated. As a control sample was not available, the common approach based on the comparison of a control/blank sample and samples collected after drug intake could not be used. Alternatively, an investigation based on common fragmentation pathways was applied, assuming that most metabolites share some fragments with the parent drug. An extension of this approach was also applied based on the fragmentation pathway of those metabolites identified in urine samples in the first step. The use of MS(E) experiments (sequential acquisition of mass spectra at low and high collision energy) has been crucial to this aim as it allowed promoting fragmentation in the collision cell without any previous precursor ion selection. MDPV belongs to the group of new psychoactive substances (NPS), being known as the "cannibal drug". This substance is being abused more and more and is associated with dangerous side effects. The human metabolites (both phase I and phase II) were detected and tentatively identified by accurate mass full-spectrum measurements using ultra-high performance liquid chromatography coupled to hybrid quadrupole time-of-flight mass spectrometry (UHPLC-QTOF MS). Following this strategy, up to 10 phase I metabolites, together with some glucuronides and sulphates, were detected and tentative structures were proposed. Several compounds identified in this work have not been previously reported in the literature.

Mental Health in First- and Second-Division Soccer Players: A Cross-Sectional Study.

BACKGROUND: The benefits of sport in mental health have been broadly studied. However, few studies have examined these outcomes in high-performance athletes. We aimed to analyze the state of the mental health of the Villarreal Soccer Club's first- (FD) and second-division (SD) players and the possible mediating effects of sex and professional category. METHODS: This was a cross-sectional study with an initial sample of 108 soccer players (final sample n = 54). Data from MINI, HARS, HDRS, BARRAT-11 and SCSRQ questionnaires were analyzed. RESULTS: The mean age was 23.41 years (SD = 4.56) and 61.1% (n = 33) were men. A proportion of 24.1% (n = 13) stated that they had undergone mental health treatment, 7.4% (n = 4) had taken psychotropic drugs, and 2.1% (n = 1) had made a suicide attempt. Differences were observed between the FD and SD players in terms of the sensitivity to punishment (t = -2.2; p = 0.033), overall impulsivity (t = -3.1; p = 0.003), unplanned impulsivity (t = 3.4; p = 0.001), and the HDRS (U = -110.5; p = 0.004), HARS-Total (U = -104.0; p = 0.006) and HARS-Psychological subscale scores (U = -104.0; p = 0.001). Differences were also observed between the female and male SD players for the HARS-Somatic subscale (U = 136.5; p = 0.028). CONCLUSION: The low values obtained in the clinical scales, together with the reported psychopathological histories, suggested that the Villareal players showed better mental health than the general population.

Substance Addiction in Adolescents: Influence of Parenting and Personality Traits.

BACKGROUND: Substance use in adolescents has been separately related to personality traits and parental socialization styles; in this study, our objective was to study these variables in an integrated way. METHODS: A cross-sectional observational study was conducted in five institutes in a final sample of 331 students, excluding those with gaming disorder. The sample was stratified into three subgroups: 'no addiction', 'low risk', and 'high risk' of Substance Use Disorders (SUD). RESULTS: 12.9% of the adolescents presented a low risk of SUD, while 18.3% showed a high risk, with both being older (F = 9.16; p < 0.001) than the no addiction group. Adolescents with high risk scored lower in control and structure variables and higher in maternal and paternal indifference factors. Non-addicted subjects presented higher scores in conscientiousness, extraversion, and agreeableness and lower scores in neuroticism. The probability of SUD increased with age (OR = 2.187; p = 0.022), sensation seeking (OR = 1.084; p < 0.001), and neuroticism (OR = 1.049; p = 0.042), while conscientiousness was a protective factor (OR = 0.930; p = 0.008). CONCLUSIONS: These results reflect that personality traits are directly related to the development of substance abuse in adolescents.

Relationship of DRD5 and MAO-B VNTR polymorphisms with paranoid and antisocial personality disorders in polydrug users.

Although multiple studies have shown the role genetics plays in personality disorders and in addictions, few have studied the genetic aspects of their comorbidity. Here, we carried out a cross-sectional study in a sample comprising 303 Caucasian polydrug-consuming patients. The presence of personality disorders was evaluated using the International Personality Disorder Examination, and genes related to dopamine, serotonin and monoamine oxidase (MAO) were genotyped. A significant relationship was observed between the bp 279 DRD5 variable number of tandem repeat (VNTR) polymorphism and paranoid personality disorder OR 95 % CI = 2.186 1.074 ; 4.449 ; p = 0.006 . The bp 182 OR 95 % CI = 0.407 0.178 ; 0.931 ; p = 0.033 and bp 184 OR 95 % CI = 0.391 0.188 ; 0.813 ; p = 0.012 alleles of the MAOB VNTR were also associated with antisocial personality disorder. Among patients with addictions, paranoid personality disorder should also be considered in addition to the importance of antisocial and borderline personality disorders. The higher frequency of the bp 279 DRD5 VNTR allele found in patients with paranoid personality disorder, as well as the associations between alleles of the MAOB VNTR and antisocial personality disorder, support the monoaminergic bases of these personality disorders, especially when dealing with patients with addictions.

Evolution of psychopathology, purpose in life, and moral courage in healthcare workers during the COVID-19 pandemic: a longitudinal study.

Introduction: Almost 2 years and five infection waves after the COVID-19 pandemic started, healthcare workers continued dealing with the pandemic situation and facing the health consequences and the mental health disorders it caused. This study aimed to evaluate the onset and progression of psychopathology as well as the role of predictor variables such as purpose in life and moral courage among healthcare workers during this time. Materials and methods: This was a longitudinal prospective study carried out with 45 Spanish healthcare workers who answered two questionnaires, the first questionnaire in April-May 2020 (T1) and the second questionnaire in September-October 2021 (T2). Results: Although 29.5% of the sample considered that their mental health had improved over this time, almost half of them (47.7%) said it had not changed, while 22.7% reported a decline in their mental health from the first time they were asked. Specifically, 46.8% presented anxiety, 23.4% depression, and 42.6% acute stress at T1, and 38.3% had anxiety, 17% depression, and 27.7% post-traumatic stress disorder at T2. Despite this, there were no differences between T1 and T2 anxiety scores (p = 0.53), although there was a decrease in depression (p = 0.03) and acute stress (p = 0.02) scores. Predictor variable outcomes such as purpose in life (p = 0.88) and moral courage (p = 0.86; p = 0.38) did not change over time, but when modelling the data, purpose in life predicted psychopathology at T1, which in turn affected the psychopathology results at T2. Conclusion: This study showed that, although psychopathology decreased over the months, its prevalence remained high. Even though the purpose in life predicted psychopathology at T1, it seems that once the psychopathology is established (T2), the factors that would improve it would be different from the protective factors that prevented its establishment, which become secondary.

Treatment of dissociative symptoms with opioid antagonists: a systematic review.

BACKGROUND: The clinical guidelines for the treatment of dissociation focus primarily on psychotherapy. However, different psychoactive drugs are used in clinical practice. The use of opioid antagonists has been proposed as a therapeutic option based on the theory that dissociation might be a phenomenon mediated by dysregulation of the endogenous opioid system. OBJECTIVE: To review and meta-analyse the available evidence on the efficacy of the opioid antagonists naltrexone, naloxone, and nalmefene as treatments for dissociative symptoms and disorders. METHOD: The PRISMA guidelines were followed, and this review was registered in Prospero with reference number CRD42021280976. The search was performed in the PubMed, Scopus, Web of Science, EMBASE, PsycINFO, and PubPsych databases. RESULTS: 1,798 citations were obtained. After removing duplicates and applying inclusion and exclusion criteria, we included 5 comparative studies with 9 dissociation measures that had included a total of 154 participants, of whom 134 had been treated with an opioid antagonist. The results of the meta-analysis showed a treatment effect for dissociation when using opioid antagonists [pooled d = 1.46 (95% CI: 0.62-2.31)]. However, the studies we included were very heterogeneous [Q = 66.89 (p < .001)] and there may have been publication bias. CONCLUSIONS: Although more research is needed and the results must be interpreted with caution because of the limited amount of data and heterogeneity in the studies and their methodological qualities, opioid antagonists (particularly naltrexone) are promising candidates for the treatment of dissociative symptoms and showed a moderate - large effect size in reducing these symptoms.

The results of the meta-analysis showed a treatment effect for dissociation when using opioid antagonists [pooled d = 1.46 (95% CI: 0.62­2.31)].The results must be interpreted with caution because of the limited amount of data and heterogeneity in the studies and their methodological qualities.Opioid antagonists (particularly naltrexone) are promising candidates for the treatment of dissociative symptoms and showed a moderate ­ large effect size in reducing these symptoms.

Relationship of Gaming Disorder with parenting based on low affection-communication and personality trait of neuroticism in adolescents.

Background: Gaming Disorder is increasingly common in adolescents. We aimed to evaluate the relationship between parenting, personality traits, and Gaming Disorder. Methods: An observational and cross-sectional study in six secondary schools of Castelló, obtaining a final sample of 397 students. Results: Adolescents with Gaming Disorder had lower scores in Adolescent Affection-Communication (F = 8.201; p < 0.001), Father's Warmth (F = 3.459; p = 0.028), and Father's Acceptance/Involvement (F = 5.467; p = 0.003), and higher scores in Mother's Revoking Privileges (F = 4.277; p = 0.034) and Father's Indifference (F = 7.868; p = 0.002) than healthy participants. Male sex was a risk factor for Gaming Disorder (OR = 12.221; p = 0.004), while Adolescent Affection-Communication (OR = 0.908; p = 0.001) and Agreeableness (OR = 0.903; p = 0.022) were protective factors. Data modeling described the protective effect that Adolescent Affection-Communication had on Gaming Disorder, which was both directly (B = -0.20; p < 0.001) and indirectly mediated by Neuroticism (B = -0.20; p < 0.001), while Neuroticism itself was a risk factor for Gaming Disorder (B = 0.50; p < 0.001). Conclusion: These results reflect that Parental style with low affection and communication was directly and indirectly related to the Gaming Disorder, as well as male sex and personality trait of Neuroticism.

[Opiate dependence type II or antisocial: Cloninger's Psychobiological Model and its usefullness in addictions]. / Dependencia de Opiáceos tipo II o antisocial: utilidad del Modelo Psicobiológico de Cloninger en adicciones.

The aim was to analyze the relationship between Cloninger's dimensions and Personality Disorders (PD) (with DSM-IV criteria) in opiate dependents. The study was Cross-sectional. The sampling of 196 patients with opiate dependence was consecutive. All were receiving treatment in an inpatient detoxification unit. Cloninger's Temperament and Character Inventory (TCI), International Personality Disorders Examination (IPDE) and a Substance Use Questionnaire were used. Character's dimensions as Self-directness and Cooperation were related with PD when scored low. Opposite to Cloninger descriptions, high scores of Self-transcendence were related with presence of PD. Related to temperamental dimensions, cluster A was related with low scores of Reward Dependence (RD) and cluster C with high scores of Harm Avoidance (HA). Otherwise, in cluster B, while Borderline PD had high scores of Novelty Seeking (as high HA), the Antisocial PD only were related to low scores of RD. RD dimension seems useful to differ from presence or absence of Antisocial PD, also when alcohol consumption is considered. Cloninger's Model of Personality is useful in drug dependents for the definition of the different PD, as well as for probable PD's aggregation. This model also helps to create subtypes in opiate dependents as the antisocial or type II.

Sexual Differences in Addictions and Dual Disorders: Importance of Gender Perspective.

Sex (the biological attributes of females and males) and gender (socially constructed roles, behaviours, and identities) both affect molecular and cellular processes, protective and vulnerability factors, social and relational life [...].

Sex Differences in Substance Use, Prevalence, Pharmacological Therapy, and Mental Health in Adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD).

Sex differences are poorly studied within the field of mental health, even though there is evidence of disparities (with respect to brain anatomy, activation patterns, and neurochemistry, etc.) that can significantly influence the etiology and course of mental disorders. The objective of this work was to review sex differences in adolescents (aged 13-18 years) diagnosed with ADHD (according to the DSM-IV, DSM-IV-TR and DSM-5 criteria) in terms of substance use disorder (SUD), prevalence, pharmacological therapy and mental health. We searched three academic databases (PubMed, Web of Science, and Scopus) and performed a narrative review of a total of 21 articles. The main conclusions of this research were (1) girls with ADHD are more at risk of substance use than boys, although there was no consensus on the prevalence of dual disorders; (2) girls are less frequently treated because of underdiagnosis and because they are more often inattentive and thereby show less disruptive behavior; (3) together with increased impairment in cognitive and executive functioning in girls, the aforementioned could be related to greater substance use and poorer functioning, especially in terms of more self-injurious behavior; and (4) early diagnosis and treatment of ADHD, especially in adolescent girls, is essential to prevent early substance use, the development of SUD, and suicidal behavior.

The Efficacy of Animal-Assisted Therapy in Patients with Dual Diagnosis: Schizophrenia and Addiction.

The objective of the study was to evaluate the efficacy of an animal-assisted-therapy (AAT) program in patients diagnosed with schizophrenia-spectrum disorders and substance-use disorders in residential treatment in order to intervene in the remission of negative and positive symptoms and improve quality of life and adherence to treatment, favouring the clinical stabilization of patients who participate in the AAT program, within the context of a mental-illness-treatment device. This was a quasi-experimental prospective study with intersubject and intrasubject factors. The sample comprised 36 patients (21 in the experimental group and 15 in the control group) who were evaluated at three time points (in the 3rd, 6th, and 10th sessions). The program lasted 3 months and consisted of 10 sessions that were implemented once a week, with a maximum participation of 10 patients per group. The participants were evaluated with the Positive and Negative Syndrome Scale (PANSS) for schizophrenia and the Life Skills Profile-20 (LSP-20) questionnaire. We observed a decrease in the positive symptoms of psychosis (F: 27.80, p = 0.001) and an improvement in functionality (F: 26.70, p < 0.001) as the sessions progressed. On the basis of these results, we concluded that AAT seems to be valid as a coadjuvant therapy as part of the rehabilitation processes of patients diagnosed with schizophrenia and addiction-spectrum disorders (dual diagnosis).

Purpose in Life and Character Strengths as Predictors of Health Sciences Students' Psychopathology During the COVID-19 Pandemic.

Background: Health sciences students experience high levels of psychopathology conditioned by psychosocial, financial, and academic factors. However, COVID-19 pandemic might even have worsened their mental health. Thus, this article aims to evaluate how the exposure to COVID-19 pandemic has affected these students' mental health and to determine the effect of purpose in life and character strengths on this psychopathology. Methods: A cross-sectional study of unpaired samples was carried out in Spain during the first and third waves of the pandemic in 70 medical and 52 nursing students. Results: The risk factor that most determined the appearance of anxiety was the exposure of family and friends to COVID-19 (OR = 4.01; p < 0.001), while the most protective factors were honesty (OR = -1.14; p = 0.025) and purpose in life (OR = -0.18; p < 0.001). Purpose in life also protected against the onset of depression and total psychopathology. In addition, we observed studying medicine was a protective factor against total psychopathology while being a nursing student was associated with high levels of acute stress. Conclusion: Exposure of the students' family and friends to SARS-CoV-2 favored the appearance of symptoms of anxiety. Honesty had a preventing role in the onset of anxiety and a high purpose in life was protective against the appearance of anxiety, depression, and total psychopathology.

Substance Use in the Transgender Population: A Meta-Analysis.

(1) Background: This meta-analysis aimed to assess the relationship between identifying as transgender and substance use. (2) Methods: We searched for relevant studies in PubMed, Scopus, the Web of Science, and PsycINFO on 21 July 2021. (3) Results: Twenty studies comparing transgender and cisgender people were included in this work, accounting for a total of 2,376,951 participants (18,329 of whom were transgender). These articles included data on current tobacco use, current tobacco use disorder, current alcohol use, current alcohol use disorder, lifetime substance (all) use, current substance use (excluding tobacco and alcohol), current use of specific substances (excluding tobacco and alcohol and including cocaine, amphetamines, methamphetamines, ecstasy, stimulants, heroin, opiates, cannabis, marijuana, LSD, hallucinogens, steroids, inhalants, sedatives, Ritalin or Adderall, diet pills, cold medicine, prescription medications, polysubstance, other club drugs, and other illegal drugs), and current substance use disorder (excluding tobacco and alcohol). We used the ORs and their 95% CIs to state the association between identifying as transgender and those variables. The control reference category used in all cases was cisgender. We employed a random-effects model. Transgender people were more likely to use tobacco (odds ratio (OR) = 1.65; 95% CI [1.37, 1.98]), have used substances throughout their lives (OR = 1.48; 95% CI [1.30, 1.68]), and present current use of specific substances (OR = 1.79; 95% CI [1.54, 2.07]). When current alcohol and substance use in general and tobacco, alcohol, and substance use disorders specifically were considered, the likelihood did not differ from that of cisgender people. (4) Conclusions: The presence of substance use disorders did not differ between transgender and cisgender people. Considering this population as consumers or as addicted may be a prejudice that perpetuates stigma. Nonetheless, transgender people were more likely to use tobacco and other substances, but not alcohol. Hypothetically, this might be an emotional regulation strategy, a maladaptive mechanism for coping with traumatic experiences, or could respond to minority stress, produced by stigma, prejudice, discrimination, and harassment. It is of particular importance to implement policies against discrimination and stigmatisation and to adapt prevention and treatment services so that they are inclusive of the 2SLGBTQIA+ community.

Burnout, psychopathology and purpose in life in healthcare workers during COVID-19 pandemic.

Background: The COVID-19 pandemic has led to a significant increase in the workload of healthcare workers that, together with the risks associated with exposure to this new virus, has affected their mental health. Objectives: The objective of the current study was to determine the prevalence of psychopathology and burnout syndrome in healthcare workers and the predictive role of purpose in life and moral courage in this relationship. Methods: A cross-sectional study was carried out in 115 Spanish healthcare workers. Results: Participants with burnout had higher anxiety (p = 0.001), depression (p < 0.001), post-traumatic stress (p = 0.01) and alcohol consumption (p = 0.03) levels. The different components of burnout (emotional fatigue and despersonalization) were associated with the occurrence of anxiety (OR = 0.31) and depression (OR = 0.26), respectively. A strong purpose in life decreased emotional fatigue (OR = -0.39) depersonalization (OR = -0.23) scores, increased personal accomplishment (OR = 0.52), subsequently reducing burnout levels (OR = -0.45). Conclusions: Purpose in life was most strongly related to decreased levels of burnout. Furthermore, an association between anxiety, depression and the components of burnout was found.