The effectiveness of acceptance and commitment therapy upon weight management and psychological well-being of adults with overweight or obesity: A systematic review.

Several studies have examined acceptance and commitment therapy's (ACT) effectiveness for addressing physical and psychological distress people with obesity can face. Nevertheless, no review focusing specifically on ACT analysing randomized controlled trials (RCT) has been done up to date in this field. The present systematic review was developed following the PRISMA statement and aimed to examine ACT's effects on weight management and psychological well-being of adults with overweight or obesity. A conjunction of keywords related to ACT and excess weight was searched in four databases (Medline, PubMed, Psycinfo and Scopus) for articles meeting inclusion criteria. The literature search yielded 2,074 papers, and 16 were included in the review, finally. In 71.43% of the studies, ACT was effective to enhance psychological well-being; in 50% effectively targeted process variables and health behaviours related to weight management; in 31.82% of studies, physical variables were improved; and 21.38% of studies showed evidence in favour of ACT for eating behaviour modification. The present review supports ACT for promoting emotional aspects of individuals immersed in such weight-related battles and highlights the benefits of psychological well-being-oriented ACT in the context of obesity treatment. More studies targeting psychological well-being primarily and with longer follow-ups are required.

Cognitive Distortions in Gamblers and Non-gamblers of a Representative Spanish Sample.

Cognitive biases or distortions related to gambling, present in all people, are considered a relevant factor in the development of gambling-related problems. OBJECTIVE: to establish whether the presence of these biases or cognitive distortions, in gamblers and non-gamblers, is related to the presence of gambling problems. METHOD: 3000 people aged 18-81 years, representative of the Spanish adult population, underwent a structured survey. RESULTS: the presence of distortions was relevant to distinguish gamblers according to their level of gambling engagement and problems. There is a constant and significant tendency to have more cognitive distortions as gambling problems increase. But not all distortions have the same ability to distinguish between the different groups of gamblers. The results seem to group gamblers into three groups according to the presence of cognitive distortions, from less to more: (1) non-gamblers, (2) low-risk and at-risk gamblers, and (3) problem and pathological gamblers. The relevance of this research and its practical implications for both treatment and prevention work is discussed.

Improving clinical symptoms, functioning, and quality of life in chronic schizophrenia with an integrated psychological therapy (IPT) plus emotional management training (EMT): A controlled clinical trial.

Objective: This paper describes the results of testing a multi-component psychological therapy that includes integrated psychological therapy (IPT), together with an adaptation of emotional management therapy (EMT), versus treatment as usual (TAU), delivered in a community mental health setting for individual with chronic schizophrenia. We investigated the effectiveness of a psychological intervention on clinical symptoms, cognitive and social functioning, as well as the feasibility of treatment and its acceptance. Method: 77 outpatients were recruited, 42 in the experimental group, who were treated with IPT + EMT, and 35 participants in control condition (TAU), both during 8 months. The subjects of both groups were assessed pre and postreatment. Results: Treatment attendance was 98% in experimental group and none of patients required hospital admission during therapy, meanwhile 11 patients from the TAU group withdrew and 3 were hospitalized during therapy. After therapy, patients in the experimental group compared to TAU, reduced clinical symptoms and improved cognitive functioning and quality of life. Conclusion: Psychological therapy seems to be a feasible intervention even in the chronic stages of the disease.

Partner’s Emotional Dependency Scale: Psychometrics.

INTRODUCTION: Emotional dependency in a partner implies an excessive permanent affectional bonding to the other individual that is dysfunctional, associated with low self-esteem and conceals a lack of affection. Emotional dependency generates a series of negative emotional consequences: symptoms of anxiety and depression, obsessive thoughts, sleep disorders and abandonment of social relations and leisure. In recent decades several tools have been developed to measure emotional dependency, but they are more focused on measuring dependent personality disorder, centered on an exclusively young population or are not validated in the Spanish population. The aim of this research is to design and validate a new scale to overcome these limitations. METHOD: The sample population included 166 adults (53 men and 113 women) from the general population, to whom a new scale was applied (partner’s emotional dependency scale, SED), as well as the CDE (Emotional Dependency Questionnaire). RESULTS: The scale has a unidimensional structure, showing good internal consistency (Cronbach’s alpha = .90) and a high convergent validity with the CDE (r = .86). There is no difference between men and women with regarding emotional dependency. Some cut-off points have been established based on the degree of emotional dependency (low, moderate, high and extreme). CONCLUSIONS: The SED is a brief assessment tool, simple to conduct and allows the degree of emotional dependency to be assessed unidimensionally with regard to a stable intimate relationship (current or past) in a normative population.

Gender commonalities and differences in risk and protective factors of suicidal thoughts and behaviors: A cross-sectional study of Spanish university students.

AIM: To assess gender differences in the association between risk/protective factors and suicidal thoughts and behaviors (STB); and whether there is any gender-interaction with those factors and STB; among Spanish university students. METHODS: Data from baseline online survey of UNIVERSAL project, a multicenter, observational study of first-year Spanish university students (18-24 years). We assessed STB; lifetime and 12-month negative life-events and family adversities; mental disorders; personal and community factors. Gender-specific regression models and gender-interactions were also analyzed. RESULTS: We included 2,105 students, 55.4% women. Twelve-month prevalence of suicidal ideation (SI) was 10%, plans 5.7%, attempts 0.6%. Statistically significant gender-interactions were found for lifetime anxiety disorder, hopelessness, violence between parents, chronic health conditions and family support. Lifetime mood disorder was a common risk factor of SI for both genders (Females: OR= 5.5; 95%CI 3.3-9.3; Males: OR= 4.4; 95%CI 2.0-9.7). For females, exposure to violence between parents (OR= 3.5; 95%CI 1.7-7.2), anxiety disorder (OR= 2.7; 95%CI 1.6-4.6), and alcohol/substance disorder (OR= 2.1; 95%CI 1.1-4.3); and for males, physical childhood maltreatment (OR= 3.6; 95%CI 1.4-9.2), deceased parents (OR= 4.6; 95%CI 1.2-17.7), and hopelessness (OR= 7.7; 95%CI 2.8-21.2), increased SI risk. Family support (OR= 0.5; 95%CI 0.2-0.9) and peers/others support (OR= 0.4; 95%CI 0.2-0.8) were associated to a lower SI risk only among females. CONCLUSIONS: Only mood disorder was a common risk factor of SI for both genders, whereas important gender-differences were observed regarding the other factors assessed. The protective effect from family and peers/others support was observed only among females. Further research assessing underlying mechanisms and pathways of gender-differences is needed.

Predictive models for suicidal thoughts and behaviors among Spanish University students: rationale and methods of the UNIVERSAL (University & mental health) project.

BACKGROUND: Suicide is a leading cause of death among young people. While suicide prevention is considered a research and intervention priority, longitudinal data is needed to identify risk and protective factors associate with suicidal thoughts and behaviors. Here we describe the UNIVERSAL (University and Mental Health) project which aims are to: (1) test prevalence and 36-month incidence of suicidal thoughts and behaviors; and (2) identify relevant risk and protective factors associated with the incidence of suicidal thoughts and behaviors among university students in Spain. METHODS: An ongoing multicenter, observational, prospective cohort study of first year university students in 5 Spanish universities. Students will be assessed annually during a 36 month follow-up. The surveys will be administered through an online, secure web-based platform. A clinical reappraisal will be completed among a subsample of respondents. Suicidal thoughts and behaviors will be assess with the Self-Injurious Thoughts and Behaviors Interview (SITBI) and the Columbia-Suicide Severity Rating Scale (C-SSRS). Risk and protective factors will include: mental disorders, measured with the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and Screening Scales (CIDI-SC), and the Epi-Q Screening Survey (EPI-Q-SS), socio-demographic variables, self-perceived health status, health behaviors, well-being, substance use disorders, service use and treatment. The UNIVERSAL project is part of the International College Surveys initiative, which is a core project within the World Mental Health consortium. Lifetime and the 12-month prevalence will be calculated for suicide ideation, plans and attempts. Cumulative incidence of suicidal thoughts and behaviors, and mental disorders will be measured using the actuarial method. Risk and protective factors of suicidal thoughts and behaviors will be analyzed by Cox proportional hazard models. DISCUSSION: The study will provide valid, innovative and useful data for developing prevention programs for youth suicide and for improving early identification for high-risk students. The longitudinal design of this study will improve causal interpretation of analyzed associations, needed for generating and validating predictive models. It will represent the first results about suicidal thoughts and behaviors in the Spanish university population. The World Mental Health Survey collaboration will permit accurate cross-national comparisons.

Substance abuse and crime: considerations for a comprehensive forensic assessment.

There is a strong link between drug use and crime, but this relationship is complex. Drug use does not necessarily lead to an increase in crimes, such as theft, rape or assault, even among regular users or addicts. However, in cases of individuals who consume drugs excessively and commit crimes, both factors are linked. Poverty, personality disorders, social and cultural variables, relationships with other users and previous incarceration or drug use are all factors. These issues play an important role in understanding the risk of crime and drug use. Most addicts should be held liable for most criminal behaviour motivated by addiction, but that addiction can, in some cases, affect one's capacity for self-control over one's actions. This paper examines the current response of the Spanish Criminal Justice System to various aspects of drug abuse, focusing on court decisions related with the nature and enforcement of drug laws. It also addresses aspects of criminal responsibility for drug abuse and drug-related crimes and suggests legislation on drugs, sentencing alternatives for drug offenses, and drug treatment options. Expert evidence plays a crucial role in this area in the court.

Hay una estrecha relación entre el uso de alcohol/drogas y la delincuencia, pero esta relación es compleja. El consumo de drogas no conduce inexorablemente a conductas delictivas, como robos, asaltos o violaciones, ni siquiera entre las personas que las consumen regularmente o que han desarrollado una adicción. Sin embargo, hay algunas personas en que el exceso de alcohol/drogas está relacionado directamente con la delincuencia. Son muchos los factores que pueden dar cuenta de este fenómeno: pobreza, trastornos de personalidad, factores culturales y sociales, amigos consumidores o contacto con la prisión. Estos aspectos sirven para comprender el riesgo de delincuencia y de drogodependencia. La mayoría de los adictos son responsables penalmente de las conductas delictivas cometidas relacionadas con la adicción, pero la adicción puede en algunos casos socavar la libertad de la persona para controlar su conducta. Se analiza en este artículo el Código Penal español, reformado por la Ley Orgánica 1/2015, y la jurisprudencia existente sobre este tema, especialmente en relación con las circunstancias eximentes y atenuantes de la responsabilidad penal en los supuestos de adicción. Los informes forenses desempeñan un papel muy importante en los tribunales para ayudar al juez a tomar la decisión adecuada entre las distintas alternativas existentes.

The hybrid model for the classification of personality disorders in DSM-5: a critical analysis.

A personality disorder can be considered to be a generalized pattern of behaviors, cognitions, and emotions that is enduring, begins in adolescence or early adulthood, remains stable over time, and generates stress or psychological damage. The current focus on personality disorders (PDs) is found in Section II of DSM-5 and is unchanged compared to DSMIV, except that the PDs were removed from the former Axis II of the DSM-IV and included in the central classification of disorders. However, an alternative model for further study is presented in Section III that aims to address the deficiencies in the current categorical model of PDs. The underlying idea is that PDs are an extreme version of the personality traits that everyone has. According to this approach, PDs are characterized by impaired personality functioning (areas of identity, self-direction, empathy, and intimacy) and pathological personality factors (negative affectivity, detachment, antagonism, disinhibition, and psychoticism). The diagnostic categories derived from this model include only antisocial, avoidant, borderline, narcissistic, obsessive-compulsive, and schizotypal PDs. This hybrid approach to the diagnosis of PDs is complex and requires more empirical evidence before it can be incorporated into clinical practice. The proposals of the draft ICD-11 for PDs, which are based primarily on severity and dominant personality traits, are also included.

Suicidal ideation risk among LGB Spanish university students: The role of childhood and adolescence adversities and mental disorders.

BACKGROUND: Childhood/adolescence adversities and mental disorders are higher among LGB youths. AIMS: To evaluate the role of childhood maltreatment, bullying, and mental disorders on the association between sexual orientation and suicidal ideation (SI); and the role of mental disorders on the association between sexual orientation discrimination and SI. METHODS: Baseline and 12-month follow-up online surveys of Spanish first-year university students (18-24-year-olds). Multivariable logistic regression models assessed the effects of childhood/adolescence adversities and mental disorders in the relationship between sexual orientation, discrimination and SI. RESULTS: A total of 1224 students were included (16.4 % LGBs). Risk factors of lifetime SI were sexual orientation (OR 2.4), any bullying (OR 2.4), any childhood maltreatment (OR 4.0), and any mental disorders (OR 3.8). Final model Area Under the Curve (AUC) 0.78. Among homosexual and bisexual students, discrimination showed increased risk of 12-month SI (OR 2.2), but this effect was no longer statistically significant when any 12-month mental disorder was added (OR 7.8). Final model AUC 0.72. LIMITATIONS: Sample of interest was relatively small. But it was similar to comparable studies and statistical adjustments have been performed. Assessment of mental disorders and SI was not based on clinical assessment. However, validated scales showing good diagnostic agreement with clinical judgement were used. CONCLUSIONS: Childhood/adolescence adversities and mental disorders interact in the association between sexual orientation and SI. Mental disorders may mediate the association between sexual orientation discrimination and SI. Further research using larger samples and causal modelling approach assessing the mediators of SI risk among LGBs is needed.

Schizophrenia: analysis and psychological treatment according to the clinical staging.

The present paper provides an overview of the recent contributions to the study of the course of schizophrenia. This is not a disorder as chronic and as acute at its start as traditionally thought. Beyond the positive and negative symptoms and different subtypes of illness, it is important to call attention to the development and course of schizophrenia. According to this approach, the aim of this paper is to review the most recent studies on schizophrenia according to clinical stages. With this aim, we review the research carried out by leading research teams and recently published clinical practice guidelines (Birmingham Group, Melbourne Group, GPCSNS, NICE) in relation to the course, the main features, and more adjusted treatment alternatives, aimed to improve the characteristic symptoms of each stage of the disease. Finally, we point out the necessity to integrate this approach with the proposed changes for the upcoming DSM-V. This review identifies effective treatment options for each of the phases of the disease defined by the clinical stage approach.

Psychometric properties of the Spanish Acceptance and Action Questionnaire for Weight-Related Difficulties-Revised (AAQW-R).

Based on the original 22-item single-factor questionnaire, the 10-item second-order Acceptance and Action Questionnaire for Weight-Related Difficulties-Revised (AAQW-R) was developed for measuring weight-related experiential avoidance. This instrument showed good psychometric properties, and it has been validated to different contexts. However, no Spanish validation has been conducted, to date. Therefore, the aim of this study was to analyze the psychometric properties of the Spanish version of the instrument in a sample of adults from the Spanish context across the whole body mass index spectrum (N = 393). Confirmatory factor analysis was performed to examine the fit of the first- and second-order AAQW-R structures. Internal reliability, construct validity, external reliability, and sensitivity to change were also analyzed. The Spanish AAQW-R presented a good fit to the data, the overall scale and subscale scores showed acceptable-to-good internal consistencies, and adequate construct validity. Likewise, test-retest reliability parameters were high, and the instrument showed sensitivity to change. The findings demonstrate that the Spanish AAQW-R is an instrument with good psychometric properties, supporting its use for measuring adults' weight-related experiential avoidance in both research and clinical settings within the Spanish context. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Predictors of good outcome in patients with refractory bipolar disorder after a drug or a drug and cognitive-behavioral treatment.

OBJECTIVE: The objective of the present research study was to analyze the variables involved in the favorable prognosis of patients with refractory bipolar disorder after a drug or a drug and cognitive-behavioral treatment. METHODS: A sample of 40 patients was divided into 2 groups: (1) combined drug plus psychoeducational and cognitive-behavioral treatment or (2) drug treatment only (control group). We used a multigroup design with repeated measures at different times (baseline, posttreatment, 6-month follow-up, and 12-month follow-up) to evaluate the following variables: age, sex, number of hospitalizations, type of treatment, mania (Young Mania Rating Scale, or YMRS) and depression (Beck Depression Index, or BDI) symptoms, subsyndromal symptoms (BDI >7; YMRS >6), global suffering index, general index of social ability, self-esteem (Rosenberg scale), inadaptation (inadaptation Scale), anxiety (State-Trait Anxiety Inventory), quality of life (Global Activity Functioning), and health (European Quality of Life Scale). We considered favorable prognosis for subjects without persistent affective symptoms (BDI <7; YMRS <6) and/or without relevant difficulties in adaptation (Inadaptation Scale <14) in a 12-month follow-up. RESULTS: A binary logistic regression showed that the type of treatment (combined therapy corresponded to better progression), the number of prior hospitalizations (fewer hospitalizations corresponded to better progression), and self-esteem (higher self-esteem corresponded to better prognosis) were statistically significant. CONCLUSIONS: The type of treatment, the number of prior hospitalizations, and the level of self-esteem were the most influencing factors for a favorable progression of refractory bipolar disorder. Differently from other studies, no significant influences of age, sex, subsyndromal symptoms, anxiety, and depression symptoms on the prognosis of refractory bipolar disorder were observed in our study.

[Does really sex addiction exist?]. / ¿Existe realmente la adicción al sexo?

Hypersexual Disorder has been proposed as a new psychiatric disorder for DSM-V, characterized by an increased frequency and intensity of sexually motivated fantasies, arousal, urges, and enacted behavior in association with an impulsivity component. Excessive appetitive and consummatory behaviors, including hypersexuality, can become a non-chemical addiction. Sexual addiction afflicts people having paraphilic or nonparaphilic behaviors associated with progressive risk-taking sexual behaviors, escalation or progression of sexual behaviors (tolerance), loss of control and significant adverse psychosocial consequences, such as unplanned pregnancy, pair-bond dysfunction, marital separation, financial problems and sexually transmitted diseases including HIV. The most common behaviors involved in sexual addiction are fantasy sex, compulsive masturbation, pornography, cybersex, voyeuristic sex, anonymous sex and multiple sexual partners. These behaviors are intended to reduce anxiety and other dysphoric affects (e.g., shame and depression). Axis I psychiatric diagnosis, especially mood disorders, psychoactive substance abuse disorders and attention deficit hyperactivity disorders, are common comorbid disorders with sexual addiction. There are significant gaps in the current scientific knowledge base regarding the clinical course, development risk factors and family history and data on women with sexual addiction are lacking.

Adolescents Adjudicated for Sexual Offending: Differences Between Sexual Reoffenders and Sexual Non-Reoffenders.

Although a very small group of adolescents adjudicated for sexual offending (ASO) will persist into adulthood, the use of official records of sexual recidivism after long-term follow-up periods underrates the repetition of sexually coercive behaviors during adolescence. Additionally, limited research has considered sexual reoffending as a criterion to classify this heterogeneous population. The aims of this study were to determine the prevalence of ASO who engaged in repetitive sexual offending before their adjudication, and to use it as a classification criterion to examine the differential characteristics associated with each group. A sample of 73 adjudicated ASO in Spain was examined. They were divided into sexual reoffenders (SR) (n = 34) and sexual nonreoffenders (SNR) (n = 39). An ex post facto research design was carried out. Assessments included reviews of official files, interviews with professionals in charge, and interviews with the ASO in which the Interpersonal Reactivity Index (IRI) was administered. Descriptive analyses were conducted for all variables and Odds Ratio (OR) was used to compare intergroup differences. Results showed that SR had 12.95 times the odds of sexual victimization, 6.91 times the odds of having lived in a sexualized family environment, and 3 times the odds of bullying victimization. Deviant sexual fantasies were exclusively present among SR (44%). Significant differences between groups were also found in some sexual crime variables but not on the empathy scale. These results have implications for the distinction between ASO who have repeatedly engaged in sexually coercive behavior and those who engaged in a single event of sexual offending. The identification of specific risk factors and criminogenic needs for each group would benefit court decisions and more tailored interventions.

Cognitive Behavioral Therapy Program for Cannabis Use Cessation in First-Episode Psychosis Patients: A 1-Year Randomized Controlled Trial.

Despite the negative influence of cannabis use on the development and prognosis of first-episode psychosis (FEP), there is little evidence on effective specific interventions for cannabis use cessation in FEP. The aim of this study was to compare the efficacy of a specific cognitive behavioral therapy (CBT) for cannabis cessation (CBT-CC) with treatment as usual (TAU) in FEP cannabis users. In this single-blind, 1-year randomized controlled trial, 65 participants were randomly assigned to CBT-CC or TAU. The primary outcome was the reduction in cannabis use severity. The CBT-CC group had a greater decrease in cannabis use severity and positive psychotic symptoms over time, and a greater improvement in functioning at post-treatment than TAU. The treatment response was also faster in the CBT-CC group, reducing cannabis use, anxiety, positive and general psychotic symptoms, and improving functioning earlier than TAU in the follow-up. Moreover, patients who stopped and/or reduced cannabis use during the follow-up, decreased psychotic symptoms and increased awareness of disease compared to those who continued using cannabis. Early intervention based on a specific CBT for cannabis cessation, may be effective in reducing cannabis use severity, in addition to improving clinical and functional outcomes of FEP cannabis users.

Predictive models for first-onset and persistence of depression and anxiety among university students.

BACKGROUND: Depression and anxiety are both prevalent among university students. They frequently co-occur and share risk factors. Yet few studies have focused on identifying students at highest risk of first-onset and persistence of either of these conditions. METHODS: Multicenter cohort study among Spanish first-year university students. At baseline, students were assessed for lifetime and 12-month Major Depressive Episode and/or Generalized Anxiety Disorder (MDE-GAD), other mental disorders, childhood-adolescent adversities, stressful life events, social support, socio-demographics, and psychological factors using web-based surveys; 12-month MDE-GAD was again assessed at 12-month follow-up. RESULTS: A total of 1253 students participated in both surveys (59.2% of baseline respondents; mean age = 18.7 (SD = 1.3); 56.0% female). First-onset of MDE-GAD at follow-up was 13.3%. Also 46.7% of those with baseline MDE-GAD showed persistence at follow-up. Childhood/Adolescence emotional abuse or neglect (OR= 4.33), prior bipolar spectrum disorder (OR= 4.34), prior suicidal ideation (OR=4.85) and prior lifetime symptoms of MDE (ORs=2.33-3.63) and GAD (ORs=2.15-3.75) were strongest predictors of first-onset MDE-GAD. Prior suicidal ideation (OR=3.17) and prior lifetime GAD symptoms (ORs=2.38-4.02) were strongest predictors of MDE-GAD persistence. Multivariable predictions from baseline showed AUCs of 0.76 for first-onset and 0.81 for persistence. 74.9% of first-onset MDE-GAD cases occurred among 30% students with highest predicted risk at baseline. LIMITATIONS: Self-report data were used; external validation of the multivariable prediction models is needed. CONCLUSION: MDE-GAD among university students is frequent, suggesting the need to implement web-based screening at university entrance that identify those students with highest risk.

Clinical gender differences among adult pathological gamblers seeking treatment.

This study aimed to examine the gender-related differences in demographics, gambling measures, psychological functioning, and motivation for therapy in an outpatient sample of pathological gamblers seeking treatment. Participants in this multisite study included 103 adult outpatients (51 women and 52 men) meeting current DSM-IV-TR criteria for PG. Logistic regression was used to examine if gender was related together to categorical and continuous independent variables. Female gamblers were older than men and more likely to be divorced or widowed and to have a lower annual income. Women became more dependent on bingo and men on slot machines. Gambling motivation and the course of illness for both sexes were also different. Female gamblers were more anxious and with a poorer self-esteem than male gamblers and more affected by depressive symptoms; in turn, men were more impulsive and higher sensation seekers than women and more affected by drug/alcohol abuse. The 68.6% of female gamblers reported being victims of intimate partner violence. There were no gender differences about the motivation for treatment. Future research should examine gambling behaviors and psychological functioning and suggest treatment approaches to address specific goals according to these gender-related differences.

The Effectiveness of an Acceptance and Commitment Therapy and Mindfulness Group Intervention for Enhancing the Psychological and Physical Well-Being of Adults with Overweight or Obesity Seeking Treatment: The Mind&Life Randomized Control Trial Study Protocol.

Although several interventions that target obesity have been examined, the success of these interventions in generating and maintaining positive results has yet to be confirmed. This study protocol therefore presents a trial aimed at analyzing the effectiveness of a well-being-centered acceptance and commitment therapy (ACT)- and mindfulness-based group intervention following the valued-based healthy living (VHL) approach (Mind&Life intervention) for individuals experiencing overweight-related distress. A randomized controlled trial with two parallel groups will be conducted in 110 adults attending primary care units with overweight or obesity. Participants will be randomly allocated to one of the two study conditions. Interventions will either be the treatment as usual (TAU) or the Mind&Life intervention-an ACT- and mindfulness-based intervention-plus the TAU intervention. Quality of life, weight self-stigma, general health status, eating habits, physical activity, eating behavior, anthropometric, body composition, cardiovascular, and physiological variables, as well as process variables, will be examined at baseline, posttreatment, 6-month follow-up, and 1-year follow-up. This trial aims to offer a novel psychological approach for addressing the psychological and physical impairments suffered by people with overweight or obesity in the current environment. ClinicalTrials.gov identifier: NCT03718728.

A Multicentre, Randomised, Controlled Trial of a Combined Clinical Treatment for First-Episode Psychosis.

INTRODUCTION: There is evidence that early intervention contributes to improving the prognosis and course of first-episode psychosis (FEP). However, further randomised treatment clinical trials are needed. OBJECTIVES: The aim of this study was to compare the efficacy of a combined clinical treatment involving Cognitive Behavioural Therapy (CBT) as an adjunctive to treatment-as-usual (TAU) (CBT+TAU) versus TAU alone for FEP. PATIENTS AND METHODS: In this multicentre, single-blind, randomised controlled trial, 177 participants were randomly allocated to either CBT+TAU or TAU. The primary outcome was post-treatment patient functioning. RESULTS: The CBT+TAU group showed a greater improvement in functioning, which was measured using the Global Assessment Functioning (GAF) and Functioning Assessment Short Test (FAST), compared to the TAU group post-treatment. The CBT+TAU participants exhibited a greater decline in depressive, negative, and general psychotic symptoms; a better awareness of the disease and treatment adherence; and a greater increase in brain-derived neurotrophic factor levels than TAU participants. CONCLUSIONS: Early intervention based on a combined clinical treatment involving CBT as an adjunctive to standard treatment may improve clinical and functional outcomes in FEP.

Validation of an Online Version of the Alcohol Use Disorders Identification Test (AUDIT) for Alcohol Screening in Spanish University Students.

Online alcohol screening may be helpful in preventing alcohol use disorders. We assessed psychometric properties of an online version of the Alcohol Use Disorders Identification Test (AUDIT) among Spanish university students. We used a longitudinal online survey (the UNIVERSAL project) of first-year students (18-24 years old) in five universities, including the AUDIT, as part of the WHO World Mental Health International College Student (WMH-ICS) initiative. A reappraisal interview was carried out with the Timeline Followback (TLFB) for alcohol consumption categories and the Mini International Neuropsychiatric Interview (MINI) for alcohol use disorder. Reliability, construct validity and diagnostic accuracy were assessed. Results: 287 students (75% women) completed the MINI, of whom 242 also completed the TLFB. AUDIT's Cronbach's alpha was 0.82. The confirmatory factor analysis for the one-factor solution of the AUDIT showed a good fit to the data. Significant AUDIT score differences were observed by TLFB categories and by MINI disorders. Areas under the curve (AUC) were very large for dependence (AUC = 0.96) and adequate for consumption categories (AUC > 0.7). AUDIT cut-off points of 6/8 (women/men) for moderate-risk drinking and 13 for alcohol dependence showed sensitivity/specificity of 76.2%/78.9% and 56%/97.5%, respectively. The online version of the AUDIT is useful for detecting alcohol consumption categories and alcohol dependence in Spanish university students.