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1.
Adicciones ; 35(1): 21-32, 2023 Jan 01.
Article in English, Spanish | MEDLINE | ID: mdl-33768265

ABSTRACT

The aim of this work is to determine if relapses can hinder the sequence of psychological recovery and to rebuild this sequence in patients with severe alcohol dependence that seek treatment. The sample was comprised of 159 patients seeking an intensive outpatient treatment of two years duration and who were subject to follow-up during four years after discharge. Patients were grouped according to the presence of relapse during follow-up, resulting in abstainers (n = 80) and relapsers (n = 79). Assessments were carried out in the following periods: baseline, at discharge, and at the second- and fourth-year follow-ups. The measurement variables were avoidance behavior, anxiety, depression, impulsivity and meaning in life (MiL). A control group (n = 74) was evaluated at the same periods as the patients. Results indicate a slower recovery in relapsers in comparison to abstainers in all psychological dimensions and periods assessed. At the second-year follow-up, the abstainers achieved similar scores in depression as the control participants, in addition to higher scores in Meaning in Life at the end of treatment. In patients with severe alcohol dependence, our data supports a sequence of recovery that could continue beyond the four years of follow-up after treatment. This sequence would begin with the avoidance of risk situations and continue with the rest of dimensions (anxiety, depression, impulsivity).


El objetivo de este trabajo es comprobar si las recaídas dificultan la secuencia de la recuperación psicológica y reconstruir la secuencia de la recuperación de pacientes graves que solicitan tratamiento. Los participantes fueron 159 pacientes tratados durante dos años en un programa ambulatorio intensivo y tras ser dados de alta fueron seguidos durante cuatro años. En función de la presencia o no de recaída durante el seguimiento se configuraron dos grupos, el de abstinentes (n = 80) y el de pacientes que recaen (n = 79). Las evaluaciones se realizaron: basal, al alta del tratamiento, al 2.º y 4.º año de seguimiento. Las variables fueron: conductas de evitación, ansiedad, depresión, impulsividad y sentido de la vida. Se incluyó un grupo de control (n = 74) que fue evaluado con la misma cadencia que los pacientes. Los resultados indican una recuperación más lenta en el grupo con recaídas frente a los abstinentes, en todas las dimensiones psicológicas y los períodos estudiados. A los dos años de seguimiento, los pacientes abstinentes obtuvieron puntuaciones en depresión similares a los controles, además de puntuaciones superiores en sentido de la vida (MiL) a partir del final del tratamiento. Al menos en pacientes con dependencia grave del alcohol, nuestros resultados apoyan una secuencia de recuperación que podría continuar más allá de los cuatro años de seguimiento. Se inicia con la evitación de situaciones de riesgo y continúa con el resto de las dimensiones (ansiedad, depresión, impulsividad).


Subject(s)
Alcoholism , Humans , Follow-Up Studies , Alcoholism/therapy , Alcoholism/psychology , Outpatients , Anxiety/therapy , Anxiety Disorders , Recurrence
2.
Psychol Med ; 51(11): 1846-1860, 2021 08.
Article in English | MEDLINE | ID: mdl-32249725

ABSTRACT

BACKGROUND: The benefits of cognitive-behavioral treatment (CBT) and positive psychology therapy (PPT) in patients with cardiovascular disease are still not well defined. We assessed the efficacy of CBT and PPT on psychological outcomes in coronary artery disease (CAD) patients. METHODS: Randomized controlled trials evaluating CBT or PPT in CAD patients published until May 2018 were systematically analyzed. Primary outcomes were depression, stress, anxiety, anger, happiness, and vital satisfaction. Random effects meta-analyses using the inverse variance method were performed. Effects were expressed as standardized mean difference (SMD) or mean differences (MD) with their 95% confidence intervals (CIs); risk of bias was assessed with the Cochrane tool. RESULTS: Nineteen trials were included (n = 1956); sixteen evaluated CBT (n = 1732), and three PPT (n = 224). Compared with control groups, depressive symptoms (13 trials; SMD -0.80; 95% CI -1.33 to -0.26), and anxiety (11 trials; SMD -1.26; 95% CI -2.11 to -0.41) improved after the PI, and depression (6 trials; SMD -2.08; 95% CI -3.22 to -0.94), anxiety (5 trials; SMD -1.33; 95% CI -2.38 to -0.29), and stress (3 trials; SMD -3.72; 95% CI -5.91 to -1.52) improved at the end of follow-up. Vital satisfaction was significantly increased at follow-up (MD 1.30, 0.27, 2.33). Non-significant effects on secondary outcomes were found. Subgroup analyses were consistent with overall analyses. CONCLUSION: CBT and PPT improve several psychological outcomes in CAD patients. Depression and anxiety improved immediately after the intervention while stress and vital satisfaction improve in the mid-term. Future research should assess the individual role of CBT and PPT in CAD populations.


Subject(s)
Cognitive Behavioral Therapy , Coronary Artery Disease/psychology , Psychosocial Intervention , Anxiety/therapy , Depression/therapy , Humans , Stress, Psychological/psychology
3.
Actas Esp Psiquiatr ; 49(6): 282-285, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34734643

ABSTRACT

Major depressive disorder (MDD) is a common complication of pregnancy and the postpartum period. Approximately 5% of women who have MDD during pregnancy or the postpartum period meet criteria for resistant depression, associated with increased morbidity in both the newborn and the pregnant woman. Currently we have different therapeutic options for the treatment of MDD during pregnancy, although in cases of resistance during that period the treatment criteria are not that well established.


Subject(s)
Depression, Postpartum , Depressive Disorder, Major , Pregnancy Complications , Antidepressive Agents/therapeutic use , Depression , Depressive Disorder, Major/drug therapy , Female , Humans , Infant, Newborn , Pregnancy , Pregnancy Complications/drug therapy
4.
J Neurosci Res ; 98(10): 1857-1876, 2020 10.
Article in English | MEDLINE | ID: mdl-32585750

ABSTRACT

There is supporting evidence of alcohol negative effects on the brain: neuroimaging and psychophysiological studies finding anatomical and functional connectivity (FC) changes associated with the dependence process. Thus, the aim of this work was to evaluate brain FC and network characteristics of alcohol-dependent individuals in resting state. For this study, we included males diagnosed with alcohol dependence (N = 25) and a group of healthy individuals (N = 23). Simultaneous EEG-MEG (electroencephalographic and magnetoencephalographic) activity was recorded in 5 min of eyes-closed resting state. EEG-MEG activity was preprocessed and FC was computed through the leakage-corrected version of phase locking value (ciPLV). Additionally, local (degree, efficiency, clustering) and global (efficiency, characteristic path length) network parameters were computed. Connectivity analysis showed an increase in phase-lagged synchronization, mainly between frontal and frontotemporal regions, in high beta band, and a decrease in interhemispheric gamma, for alcohol-dependent individuals. Network analysis revealed intergroup differences at the local level for high beta, indicating higher degree, clustering, and efficiency, mostly at frontal nodes, together with a decrease in these measures at more posterior sites for patients' group. The hyper-synchronization in beta, next to the hypo-synchronization in gamma, could indicate an alteration in communication between hemispheres, but also a possible functional compensation mechanism in neural circuits. This could be also supported by network characteristic data, where local alterations in communication are observed.


Subject(s)
Alcoholism/diagnosis , Alcoholism/physiopathology , Electroencephalography/methods , Frontal Lobe/physiopathology , Magnetoencephalography/methods , Nerve Net/physiopathology , Adult , Alcoholism/therapy , Female , Humans , Male , Middle Aged , Rest/physiology
5.
Alcohol Clin Exp Res ; 41(6): 1212-1219, 2017 Jun.
Article in English | MEDLINE | ID: mdl-28494516

ABSTRACT

BACKGROUND: Previous studies demonstrated that patients with alcohol use disorders (AUDs) show altered startle reflex responses to alcohol-related stimuli. However, there is little information about the role of these altered responses in the development of AUDs. This study examined the startle reflex response to different visual stimuli and the role of these patterns in the development of AUDs in a 4-year follow-up. METHODS: Two hundred and thirty-nine (nondependent) heavy-drinking participants were selected. In the baseline period, the startle reflex responses to alcohol-related, aversive, appetitive, and neutral pictures were assessed. Startle reflex responses to these pictures were used as predictive variables. Status drinking (alcohol dependence and nondependence) assessed at 4-year follow-up was used as outcome measure. RESULTS: At the 4-year follow-up assessment, 46% of participants fulfilled DSM-IV alcohol abuse or dependence criteria. Alcohol dependence status was predicted by an attenuated startle reflex response to alcohol-related and aversive pictures. CONCLUSIONS: This study revealed that an attenuated modulation of startle reflex response to alcohol-related and aversive stimuli could be used as a clinical marker to predict the development of AUDs in participants with previous alcohol consumption.


Subject(s)
Alcoholism/diagnosis , Alcoholism/psychology , Photic Stimulation/methods , Reflex, Startle , Adult , Alcohol Drinking/epidemiology , Alcohol Drinking/psychology , Alcoholic Intoxication/diagnosis , Alcoholic Intoxication/epidemiology , Alcoholic Intoxication/psychology , Alcoholism/epidemiology , Follow-Up Studies , Humans , Male , Middle Aged , Predictive Value of Tests , Reflex, Startle/physiology
6.
Actas Esp Psiquiatr ; 45(1): 21-31, 2017 01.
Article in English | MEDLINE | ID: mdl-28186316

ABSTRACT

INTRODUCTION: Inhibitory control is clearly impaired in alcohol dependent individuals, being associated to the addiction process establishment and abstinence maintenance difficulties. Inhibitory control assessment tasks involving responses to neutral stimuli are available, although a Spanish version task including contextual cues influence on inhibition capacity has not been performed yet. Alcohol related stimuli can modify behavioural inhibition performance. Thus, the purpose of this study was the Spanish translation of a modified stop signal task that assessed inhibitory control, as well as the degree of interference produced by the presence of alcohol related words. METHODOLOGY: A modified stop signal reaction task, based on a fast lexical decision paradigm was employed. Stimuli used were translated from Zack et al.1, according to frequency of use in Spanish, including neutral words, pseudowords and alcohol-related words. Task was applied to 85 alcohol dependent patients, with a minimum of 28 days of abstinence and to 27 healthy participants constituting the control group. RESULTS: Patients showed a poorer performance, with a lower stop signal mean delay comparing to control group, in presence of neutral and alcohol-related words. CONCLUSIONS: Alcohol dependent individuals exhibit a lower behavioural inhibition performance, added to a significant influence of contextual cues on the stop signal task, resulting in impulsive behaviour, only in the patients group.


Subject(s)
Alcoholism/psychology , Inhibition, Psychological , Adult , Aged , Female , Humans , Male , Middle Aged , Task Performance and Analysis
7.
Actas Esp Psiquiatr ; 45(5): 201-17, 2017 Sep.
Article in English | MEDLINE | ID: mdl-29044445

ABSTRACT

INTRODUCTION: Several studies have found cognitive impairment in patients with a history of alcohol use disorder, affecting their psychosocial functioning and the achievement of therapeutic goals. In order to identify these effects, several cognitive screening tests have been used, though they were not specific for alcoholic population, possibly leading to an increase in the risk of error. OBJECTIVE: The aim of this study is to assess the main cognitive deficits in patients with history of alcohol use disorders, through the development of a specific screening test for alcohol-related cognitive impairment. METHODOLOGY: The TEDCA (Test of detection of cognitive impairment in alcoholism) was designed based on three dimensions: Visuospatial Cognition, Memory / Learning and Executive Function. The study was divided in two phases: During phase 1, test items with greater capacity for discrimination between patients with different levels of cognitive impairment were selected, and during phase 2, the analysis for validity and reliability indexes took place. The sample consisted of 248 participants, 88 controls (phase 2) and 160 patients (phase 1: n=70 and phase 2: n=90). RESULTS: TEDCA test obtained a high reliability (Cronbach’s alpha 0.754) value and the factor analysis confirmed the presence of the three dimensions previously defined. The present screening tool also discriminated between patients and control group, together with a good diagnostic validity of cognitive impairment. CONCLUSIONS: TEDCA is a new screening test, which identifies the possible presence of cognitive impairment in patients with a history of alcohol use disorders, which can be used in the fields of psychiatry, primary care and research.


Subject(s)
Alcoholism/complications , Cognitive Dysfunction/diagnosis , Cognitive Dysfunction/etiology , Cognition Disorders , Female , Humans , Male , Middle Aged , Neuropsychological Tests , Reproducibility of Results
8.
Eur Arch Psychiatry Clin Neurosci ; 266(8): 743-753, 2016 Dec.
Article in English | MEDLINE | ID: mdl-26831320

ABSTRACT

Gamma oscillations are key in coordinating brain activity and seem to be altered in schizophrenia. In previous work, we studied the spatial distribution of a noise power measure (scalp-recorded electroencephalographic activity unlocked to stimuli) and found higher magnitudes in the gamma band related to symptoms and cognition in schizophrenia. In the current study, we sought to replicate those findings and to study its specificity for schizophrenia in a completely independent sample. A principal component analysis (PCA) was used to determine the factorial structure of gamma noise power acquired with an electroencephalographic recording during an odd-ball P300 paradigm in the 250- to 550-ms window in 70 patients with schizophrenia (16 patients with first episode), 45 bipolar patients and 65 healthy controls. Clinical and cognitive correlates of the resulting factors were also assessed. Three factors arose from the PCA. The first displayed a midline-parietal distribution (roughly corresponding to the default mode network), the second was centro-temporal and the third anterior-frontal. Schizophrenia but not bipolar patients showed higher gamma noise power loadings in the first factor in comparison with controls. Scores for this factor were significantly and directly associated with positive and total symptoms in patients and inversely associated with global cognition in all participants. The results of this study replicate those of our previous publication and suggest an elevated midline-parietal gamma noise power specific to schizophrenia. The gamma noise power measure seems to be a useful tool for studying background oscillatory activity during performance of cognitive tasks.


Subject(s)
Bipolar Disorder/pathology , Brain Mapping , Gamma Rhythm/physiology , Parietal Lobe/physiopathology , Schizophrenia/pathology , Adult , Bipolar Disorder/physiopathology , Cognition Disorders/diagnosis , Cognition Disorders/etiology , Electroencephalography , Female , Humans , Linear Models , Male , Middle Aged , Multivariate Analysis , Neuropsychological Tests , Noise , Principal Component Analysis , Psychiatric Status Rating Scales , Schizophrenia/physiopathology
9.
J Nerv Ment Dis ; 204(12): 877-884, 2016 Dec.
Article in English | MEDLINE | ID: mdl-27483114

ABSTRACT

Sensory gating deficits are commonly found in patients with schizophrenia. However, there is still scarce research on this issue. Thirty-eight patients with first-episode psychosis (FEP) were compared to thirty-eight controls. A condition-test paradigm of event-related potentials (ERP), prepulse inhibition (PPI), and some specific tasks of the MATRICS Consensus Cognitive Battery (MCCB) were used (i.e., TMT, BACS-SC, and Fluency for processing speed and CPT-IP for attention and vigilance). The ERP components measured were P50, N1, and P2. The PPI intervals examined were 30, 60, and 120 msec. Regarding the MCCB, processing speed and attention/vigilance cognitive domains were selected. FEP patients showed significant deficits in N1 and P2 components, at 30 and 60 PPI levels and in all the MCCB subtests selected. We obtained significant relationships in N1 with PPI-60, and with one MCCB subtest for processing speed. In addition, this same subtest showed significant association with P2. Therefore, sensory gating functioning is widely impaired since the very early stages of schizophrenia.


Subject(s)
Neuropsychological Tests , Psychotic Disorders/physiopathology , Reflex, Startle/physiology , Schizophrenia/physiopathology , Schizophrenic Psychology , Sensory Gating/physiology , Acoustic Stimulation/methods , Adult , Electroencephalography/methods , Female , Humans , Male , Psychophysiologic Disorders/diagnosis , Psychophysiologic Disorders/physiopathology , Psychophysiologic Disorders/psychology , Psychophysiology , Psychotic Disorders/diagnosis , Psychotic Disorders/psychology , Schizophrenia/diagnosis
10.
J Neuropsychiatry Clin Neurosci ; 27(1): 48-53, 2015.
Article in English | MEDLINE | ID: mdl-25716487

ABSTRACT

Deficits in prepulse inhibition (PPI) and cannabis abuse are consistently found in schizophrenia. The authors studied PPI deficits in first episode psychosis (FEP) with schizophrenia and cannabis abuse influence. Thirty-five patients with FEP and 22 control subjects were examined. Patients were divided into cannabis use disorder (CUD) (N=21) and non-CUD (N=14). Startle measures were as follows: PPI at 30, 60, and 120 msec. Patients with CUD and patients without CUD showed lower PPI at 30 msec than control subjects. At 60 msec, patients with CUD obtained higher %PPI than patients without CUD, and patients without CUD obtained lower levels than control subjects. These findings show that cannabis abuse may improve PPI in patients with FEP at some levels.


Subject(s)
Marijuana Abuse/physiopathology , Prepulse Inhibition/physiology , Psychotic Disorders/etiology , Schizophrenia/complications , Acoustic Stimulation , Adult , Female , Humans , Male , Reflex, Startle , Spain , Young Adult
11.
Eur Addict Res ; 21(4): 195-203, 2015.
Article in English | MEDLINE | ID: mdl-25896747

ABSTRACT

AIMS: Little is known about changes in the modulation of the startle reflex when patients go through an alcohol-dependence treatment in an outpatient facility. In the current study, the affective modulation of the cue-related startle reflex has been used to evaluate changes in the emotional processing of alcohol-related stimuli that occurred after a standard cognitive-behavioral intervention, and to assess the outcome of this intervention. We hypothesized a 'normalization' of the startle inhibition for the alcohol-related cues during the period of treatment. We also assumed that higher startle inhibition at baseline elicited by alcohol cues would predict the relapse on alcohol consumption during treatment. PARTICIPANTS: A total of 98 alcohol-dependent subjects were included who fulfilled DSM-IV criteria for alcohol dependence. A control group of 72 subjects was selected to match demographic characteristics. MEASUREMENTS: All patients received a standard cognitive-behavioral therapy once a week throughout the study period. FINDINGS: Results show that the startle response differed significantly after 12 weeks of treatment for alcohol-related, neutral and aversive stimuli between alcohol-dependent patients and controls. Low startle responses at baseline to alcohol cues predicted relapse. CONCLUSIONS: These results may indicate that the startle reflex is referred to enduring and permanent processes of cue reactivity, and that the emotional processing of alcohol-associated cues assessed with the affect-modulated startle reflex is less altered by interventions attempting to influence explicit cognitions. Furthermore, lower values of the baseline startle reflex elicited by alcohol-associated stimuli were associated with higher probability of relapse on alcohol use.


Subject(s)
Alcoholism/therapy , Cognitive Behavioral Therapy , Reflex, Startle , Adult , Alcoholism/physiopathology , Case-Control Studies , Cues , Female , Humans , Male , Psychiatric Status Rating Scales , Psychological Tests , Surveys and Questionnaires , Treatment Outcome
12.
Biomedicines ; 11(7)2023 Jun 23.
Article in English | MEDLINE | ID: mdl-37509436

ABSTRACT

The cognitive decline in people with substance use disorders is well known and can be found during both the dependence and drug abstinence phases. At the clinical level, cognitive decline impairs the response to addiction treatment and increases dropout rates. It can be irreversible, even after the end of drug abuse consumption. Improving our understanding of the molecular and cellular alterations associated with cognitive decline could be essential to developing specific therapeutic strategies for its treatment. Developing animal models to simulate drug abuse-induced learning and memory alterations is critical to continue exploring this clinical situation. The main aim of this review is to summarize the most recent evidence on cognitive impairment and the associated biological markers in patients addicted to some of the most consumed drugs of abuse and in animal models simulating this clinical situation. The available information suggests the need to develop more studies to further explore the molecular alterations associated with cognitive impairment, with the ultimate goal of developing new potential therapeutic strategies.

13.
Front Psychiatry ; 14: 1130078, 2023.
Article in English | MEDLINE | ID: mdl-37398602

ABSTRACT

Introduction: The consensus on recovery from alcohol use disorder (AUD) has shifted toward encompassing psychological wellbeing and quality of life dimensions. However, few studies have explored the long-term recovery process and its dimensions, timing, styles, and modes. The aim of this study was to investigate the extent, timing, and process of psychological wellbeing and quality of life recovery in alcohol use disorder (AUD) patients, as well as the relationship with classic dimensions of AUD recovery. Method: A cross-sectional study has been carried out with 348 participants with AUD, in different abstinence periods (1 month-28 years), and 171 control subjects. Participants underwent a psychological evaluation, which included self-informed measures of psychological wellbeing, quality of life, negative emotionality, and coping strategies related to alcohol consumption avoidance. Statistical analysis included linear and non-linear regression models between psychological dimensions and maintenance of abstinence, as well as matching the scores of the sample with AUD to those of controls. Scatter plots were used to explore inflection points. In addition, mean comparison tests were performed between participants with AUD and controls and by gender. Results: In general, according to the regression models, there were pronounced increases in indices of wellbeing and coping strategies (and pronounced decreases in negative emotionality) during the first 5 years of abstinence, followed by less pronounced improvements. The matching of AUD subjects in wellbeing and negative emotionality indices with controls occurs at different times: (a) 1 year or less: physical health; (b) 1-4 years: psychological health; (c) 4-10 years: social relationships, wellbeing, and negative emotionality; and (d) more than 10 years: autonomy and self-acceptance. There are statistically significant differences by gender for the negative emotionality and physical health variables. Conclusion: Recovery from AUD is a long process that involves improvements in wellbeing and quality of life. Four stages can be described in this process, with the most pronounced changes occurring during the first 5 years of abstinence. However, AUD patients take more time to obtain similar scores to controls in several psychological dimensions.

14.
Int J Psychophysiol ; 177: 240-248, 2022 07.
Article in English | MEDLINE | ID: mdl-35662565

ABSTRACT

The heterogeneity of the population with alcohol use disorder (AUD) sometimes makes the knowledge generated in areas such as neuroscience appear to be contradictory. One aspect that may help elucidate this apparent contradiction is controlling for certain variables that are not usually controlled, such as the abstinence time in people with AUD. This research aims to study the neuroelectrical oscillations in people with AUD with longer and shorter abstinence time in comparison with healthy individuals. We recruited twenty-nine individuals with AUD with abstinence time longer than fifteen days and shorter than six months (STA), twenty-six individuals with AUD with abstinence time longer than six months and shorter than thirteen months (LTA), and sixteen healthy individuals (HC). All participants underwent electroencephalographic recording in resting-state with eyes closed. The oscillatory activity obtained was analyzed to obtain the spectral power and phase synchronization level. Regarding the obtained spectral power results, these revealed that the STA group showed higher theta band power and lower alpha band power than the LTA and HC groups. The obtained results at the phase synchronization level also show two main results. On the one hand, the STA group showed lower alpha band phase synchronization than the LTA and HC groups. On the other hand, the HC group showed higher beta band phase synchronization than the STA and LTA groups. In conclusion, the obtained results reflect that abstinence maintenance for six or more months appears to produce an important oscillatory brain functioning normalization in people with AUD.


Subject(s)
Alcohol Abstinence , Alcoholism , Alcohol Drinking , Brain , Electroencephalography , Humans
15.
Span J Psychol ; 25: e16, 2022 May 03.
Article in English | MEDLINE | ID: mdl-35503039

ABSTRACT

Recovery from alcohol use disorder involves achieving certain resources for positive lifestyle changes, well-being, and long-term abstinence. The present study aims to translate and validate the Assessment Capital Recovery (ARC) in a Spanish clinical sample of individuals with alcohol use disorder, in abstinence. The participants were 184 patients who attended outpatient treatments. They were evaluated with the adapted version of the ARC (Spanish abbreviation: "Valoración del Capital de Recuperación, VCR") and by WHOQOL-BREF (quality of life scale), in one session. Statistical analysis included the calculation of reliability, convergent validity (relationship with WHOQOL-BREF), specificity and sensitivity, as well as validity based on internal structure (confirmatory factor analysis). VCR scores show appropriate values for reliability (α = .90), and a low convergent validity with WHOQOL-BREF (Rho = .33-.53). The VCR appears to distinguish between patients with early and stable sobriety (χ2 = 20.55, p < .01). The ROC curve indicates significant discrimination values (p < .05) for stable recovery (5 years of abstinence) and sensitivity of 85.2% and specificity of 71.2%. Further, confirmatory factor analysis suggests the presence of a single factor, with relatively acceptable values of goodness of fit and factor loadings. We used ULS parameter estimation to study VCR properties, an appropriate tool for assessing recovery in clinical populations of individuals with alcohol use disorder in abstinence.


Subject(s)
Alcoholism , Humans , Psychometrics , Quality of Life , Reproducibility of Results , Surveys and Questionnaires
16.
J Psychosom Res ; 153: 110710, 2022 Feb.
Article in English | MEDLINE | ID: mdl-34999380

ABSTRACT

OBJECTIVES: Psychological factors influence clinical outcomes in patients with coronary artery disease (CAD). Therefore, psychological interventions (PIs) may have beneficial effects in these patients. We evaluated the efficacy of PIs based on cognitive-behavioral therapy (CBT) and positive psychology therapy (PPT) on clinical and laboratory outcomes in CAD. METHODS: Randomized controlled trials evaluating CBT or PPT in CAD patients published until May 2020 were systematically reviewed and analyzed. Primary outcomes were all-cause mortality, cardiovascular mortality, any cardiovascular event, myocardial infarction (MI), stroke, coronary revascularization, angina, and readmission. Random effects meta-analyses using the inverse variance method were performed. Effects were expressed as risk ratios (RR) or standardized mean difference (SMD) with 95% confidence intervals (CIs). RESULTS: Twenty-five trials were included (n = 8119); 22 evaluating the effects of multi-component CBT (n = 7909), and three PPT (n = 210). Thirteen RCTs were at high risk of bias due to limitations in randomization or blinding. Compared with control groups any cardiovascular event (RR 0.82; 0.70 to 0.97; 5 studies), MI (RR 0.72; 0.52 to 0.98; 9 studies), and angina duration and intensity (SMD -0.64; -0.98 to -0.30; 4 studies; and -0.64; -1.17 to -0.11; 2 trials) were significantly reduced with PIs at the end of follow-up. PIs had no effect on other primary outcomes, laboratory or anthropometrical results and presented a moderate to high heterogeneity. CONCLUSIONS: CBT- and PPT-based PIs reduce the risk of cardiovascular events, MI and angina in patients with CAD. Future research should assess the individual role of CBT and PPT in CAD populations.


Subject(s)
Cognitive Behavioral Therapy , Coronary Artery Disease , Myocardial Infarction , Coronary Artery Disease/therapy , Humans , Myocardial Infarction/therapy , Psychosocial Intervention
17.
J Psychiatr Res ; 149: 210-216, 2022 05.
Article in English | MEDLINE | ID: mdl-35287051

ABSTRACT

Structural brain damages caused by chronic alcohol consumption have been extensively reported. However, the neuroimaging findings in people with alcohol use disorder (AUD) are relatively inconsistent. This inconsistency may be due to the influence of different variables that are not always considered, such as the presence of a family history of alcoholism (FHA). The main aim of this research is to study the gray (GM) and white matter (WM) volumes in male participants with AUD without FHA compared to healthy control males (HC) without FHA. For this study, we included 19 participants with AUD without FHA and 18 HC males without FHA. T1-weighted images were acquired with a General Electric Signa Exite 1.5 T scanner. GM and WM tissues were calculated using Diffeomorphic Anatomical Registration Through Exponentiated Lie algebra (DARTEL). All analyses were controlled for age and total brain volume. The statistical threshold was calculated with AlphaSim and further adjusted to account for the non-isotropic smoothness of structural images, according to Hayasaka et al. (2004). The obtained main results showed that, relative to the HC group, the participants with AUD without FHA had significantly lower GM in several brain structures, reflecting relatively purely the effects of chronic alcohol intake on brain volume. GM structure integrity is relevant for the efficient functioning of low and high-order cognitive processes used in everyday life, and its damage seems to be related to the severity/intensity/chronicity of the AUD. As such, it becomes relevant to assess and follow brain structural changes through the dependence course.


Subject(s)
Alcoholism , Alcohol Drinking , Alcoholism/diagnostic imaging , Alcoholism/psychology , Brain/diagnostic imaging , Gray Matter/diagnostic imaging , Humans , Magnetic Resonance Imaging/methods , Male , Neuroimaging
18.
Psychiatry Res ; 190(2-3): 187-92, 2011 Dec 30.
Article in English | MEDLINE | ID: mdl-21704386

ABSTRACT

Disruption of prepulse inhibition of the startle response (PPI) has been widely identified in patients with schizophrenia, as well as impairment in many domains of cognitive functioning. However, there is some controversy regarding the relationship between PPI and the different neuropsychological tasks assessing inhibition. This controversy may be due to the influence of other variables, such as substance abuse. We aimed to determine whether differences in inhibition in schizophrenia subjects were related to their pattern of substance use and whether there was a correlation between the changes in each process. PPI and neuropsychological functioning were studied in three groups of subjects with schizophrenia (N=73): tobacco dependents (ToD; n=22), multiple substance abusers (MSUD; n=31) and non-substance abusers (non-SUD; n=20). All subjects were assessed using PPI and neuropsychological tests (Stroop and Wisconsin Card Sorting Test [WCST]). ToD showed better pre-attentive inhibitory function compared to the other two groups, and MSUD showed lower resistance to interference. Furthermore, significant correlations were found between PPI, Stroop, and WCST. Our data suggest that there is a relationship between the different tasks assessing inhibition in schizophrenia, being affected by substance abuse history. We also found differences in inhibition capacity depending on substance abuse in patients with schizophrenia.


Subject(s)
Cognition Disorders/etiology , Inhibition, Psychological , Schizophrenia/complications , Schizophrenic Psychology , Substance-Related Disorders/complications , Substance-Related Disorders/psychology , Acoustic Stimulation/adverse effects , Adolescent , Adult , Analysis of Variance , Female , Humans , Male , Middle Aged , Neuropsychological Tests , Psychiatric Status Rating Scales , Reflex, Startle/physiology , Statistics as Topic , Young Adult
19.
Int J Psychophysiol ; 158: 123-135, 2020 12.
Article in English | MEDLINE | ID: mdl-33075432

ABSTRACT

Studying the functioning of the frontal lobe during the performance of an inhibitory activity according to automatic tendency of action would allow a better understanding of the relationship between the reflexive and impulsive system described in the dual-process models. This study aims to prove which is the inhibitory capacity and the underlying brain activity of people with alcohol-use disorder in abstinence with a greater avoidance tendency compared to those with a higher approach tendency and healthy controls. In order to group participants with AUD, the total approach/avoidance index (TAAI) - obtained from the modified alcohol approach/avoidance task - was used, therefore resulting in three groups: TAAI- (TAAI < Percentile 35: n = 20), TAAI± (TAAI = Percentile 35-65: n = 20) and TAAI+ (TAAI > Percentile 65: n = 20). In addition to this, 15 healthy controls were recruited. They all had an electroencephalographic recording while completing the modified stop-signal task. The results showed that the TAAI+ group had a worse inhibition compared to healthy controls. Moreover, the TAAI+ group showed a hyperactivation of the inferior frontal gyrus, precentral gyrus and orbital gyrus compared to the healthy controls group and the TAAI- group. The results obtained reflect that those people with AUD with a tendency to approach alcohol have a worse inhibitory capacity and a frontal hyperactivation. Moreover, people with AUD with an avoidance tendency to alcohol have also been found to have a similar inhibitory capacity and frontal activation to healthy controls.


Subject(s)
Alcoholism , Inhibition, Psychological , Frontal Lobe , Humans , Impulsive Behavior , Prefrontal Cortex
20.
Front Psychiatry ; 11: 315, 2020.
Article in English | MEDLINE | ID: mdl-32395111

ABSTRACT

The high heterogeneity of psychiatric disorders leads to a lack of diagnostic precision. Therefore, the search of biomarkers is a fundamental aspect in psychiatry to reach a more personalized medicine. The endocannabinoid system (ECS) has gained increasing interest due to its involvement in many different functional processes in the brain, including the regulation of emotions, motivation, and cognition. This article reviews the role of the main components of the ECS as biomarkers in certain psychiatric disorders. Studies carried out in rodents evaluating the effects of pharmacological and genetic manipulation of cannabinoid receptors or endocannabinoids (eCBs) degrading enzymes were included. Likewise, the ECS-related alterations occurring at the molecular level in animal models reproducing some behavioral and/or neuropathological aspects of psychiatric disorders were reviewed. Furthermore, clinical studies evaluating gene or protein alterations in post-mortem brain tissue or in vivo blood, plasma, and cerebrospinal fluid (CSF) samples were analyzed. Also, the results from neuroimaging studies using positron emission tomography (PET) or functional magnetic resonance (fMRI) were included. This review shows the close involvement of cannabinoid receptor 1 (CB1r) in stress regulation and the development of mood disorders [anxiety, depression, bipolar disorder (BD)], in post-traumatic stress disorder (PTSD), as well as in the etiopathogenesis of schizophrenia, attention deficit hyperactivity disorder (ADHD), or eating disorders (i.e. anorexia and bulimia nervosa). On the other hand, recent results reveal the potential therapeutic action of the endocannabinoid tone manipulation by inhibition of eCBs degrading enzymes, as well as by the modulation of cannabinoid receptor 2 (CB2r) activity on anxiolytic, antidepressive, or antipsychotic associated effects. Further clinical research studies are needed; however, current evidence suggests that the components of the ECS may become promising biomarkers in psychiatry to improve, at least in part, the diagnosis and pharmacological treatment of psychiatric disorders.

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