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BACKGROUND: Psychotic-like experiences (PLEs) are subtle, subclinical perturbations of perceptions and thoughts and are common in the general population. Their characterisation and unidimensionality are still debated. METHODS: This study was conducted by the Electronic-halluCinations-Like Experiences Cross-culTural International Consortium (E-CLECTIC) and aimed at measuring the Community Assessment of Psychic Experiences (CAPE) factorial structure across five European countries (Belgium; Czech Republic, Germany; Greece, and Spain) and testing the adequacy of the unidimensional polytomous Rasch model of the tool via Partial Credit Model (PCM) of the CAPE to detect people with a high risk for developing psychosis. RESULTS: The sample included 1461 participants from the general population. The factorial analysis confirmed the best fit for the bifactor implementation of the three-factor model, including the positive, negative and depressive dimensions and a general factor. Moreover, the unidimensional polytomous Rasch analysis confirmed that CAPE responses reflected one underlying psychosis proneness. CONCLUSIONS: The study proved that the CAPE measures a single latent dimension of psychosis-proneness. The CAPE might help locate and estimate psychosis risk and can be used as a screening tool in primary care settings/education settings.
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Psicometría , Trastornos Psicóticos , Humanos , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/psicología , Masculino , Femenino , Psicometría/normas , Adulto , Adulto Joven , Persona de Mediana Edad , Comparación Transcultural , Alemania , Europa (Continente) , Grecia , Bélgica , República Checa , España , Escalas de Valoración Psiquiátrica/normas , Alucinaciones/diagnóstico , Adolescente , Análisis FactorialRESUMEN
This study examined the associations between psychopathy dimensions (triarchic phenotypes and classical factors), empathy domains (cognitive and affective), and interoception (interoceptive attention and accuracy) while accounting for the putative role of alexithymia. A community sample (n = 515) completed an online survey encompassing: Triarchic Psychopathy Measure (boldness, meanness, disinhibition); Levenson Self-Report Psychopathy Scale (primary and secondary psychopathy); Body Perception Questionnaire (interoceptive attention); Interoceptive Accuracy Scale; Toronto Alexithymia Scale. Hierarchical linear regression models were implemented for hypothesis-driven analyses examining the associations between psychopathy, empathy, and interoception while controlling for sex, age, and alexithymia. Exploratory path models were employed to investigate alexithymia and/or cognitive empathy as mediators between interoception and psychopathy. Our results largely confirmed the postulated empathy profiles across psychopathy dimensions, as meanness and primary psychopathy displayed a broad empathy impairment, while disinhibition and secondary psychopathy were only associated with diminished cognitive empathy. Importantly, boldness displayed a unique pattern (enhanced cognitive empathy and reduced affective empathy), further reinforcing its importance within the constellation of psychopathy traits. Contrary to our hypotheses, self-perceived interoceptive attention and accuracy were not associated with either psychopathy dimension after controlling for alexithymia. However, interoceptive accuracy and alexithymia were associated with cognitive empathy, while alexithymia was also positively related to all psychopathy dimensions (as expected), despite the unexpected strong and negative association with boldness. Exploratory analyses suggested significant indirect effects (mediation) between interoceptive accuracy and psychopathy via alexithymia and/or cognitive empathy. These mediating effects must be interpreted with caution and future studies should be designed to formally test this model.
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The main purpose of this preliminary study was to investigate a potential relationship between early maladaptive schemas (EMSs) and impulsive and compulsive buying tendencies in a sample of young adults (college students). This research adds to the cognitive perspective of consumer behavior that the cognitive schemas putatively associated with early experiences may have a strong impact on impulsive and compulsive buying. Data was obtained from 365 participants in a cross-sectional study design. Participants completed an online survey with the following instruments: Young Schema Questionnaire; Impulsive Buying Tendency Measurement Scale; Richmond Compulsive Buying Scale; and Hospital Anxiety and Depression Scale. Using multiple linear hierarchical regressions, we confirmed that the domain of over vigilance and inhibition schemas was positively associated with impulsive and compulsive buying tendencies, while an opposite association was found for the domain of impaired limits. Being a female was also a predictor of impulsive buying and compulsive buying. The results were discussed in terms of the coping mechanisms to deal with negative emotions, as a way to obtain rewards, or as a way to escape painful self-awareness. Other mechanisms related to the internalization of perfectionist expectations and the propensity to shame were also explored.
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With the increase in the number of people using digital devices, complaints about eye and vision problems have been increasing, making the problem of computer vision syndrome (CVS) more serious. Accompanying the increase in CVS in occupational settings, new and unobstructive solutions to assess the risk of this syndrome are of paramount importance. This study aims, through an exploratory approach, to determine if blinking data, collected using a computer webcam, can be used as a reliable indicator for predicting CVS on a real-time basis, considering real-life settings. A total of 13 students participated in the data collection. A software that collected and recorded users' physiological data through the computer's camera was installed on the participants' computers. The CVS-Q was applied to determine the subjects with CVS and its severity. The results showed a decrease in the blinking rate to about 9 to 17 per minute, and for each additional blink the CVS score lowered by 1.26. These data suggest that the decrease in blinking rate was directly associated with CVS. These results are important for allowing the development of a CVS real-time detection algorithm and a related recommendation system that provides interventions to promote health, well-being, and improved performance.
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Parpadeo , Promoción de la Salud , Humanos , Computadores , Síndrome , Encuestas y CuestionariosRESUMEN
PURPOSE/AIM OF THE STUDY: The purpose of this study was to analyse the relationship between digital media use and expressive language skills in the semantic and morphosyntactic domains, of pre-school-aged children (3 years-and-0 months to 5 years-and-11 months). MATERIALS AND METHODS: Verbal oral expression (VOE) tasks of the Pre-school Assessment of Language Test (Teste de Linguagem-Avaliação da Linguagem Pré-Escolar) were administered to 237 pre-school children with no previous identified neurological or developmental conditions associated with language disorders to assess expressive language skills in the semantic and morphosyntactic domains. Parents completed a questionnaire about their children's medical conditions, development (using the milestones of the Survey of Well-being of Young Children and the Pre-school Paediatric Symptom Checklist), and exposure to screens (using ScreenQ). Correlations between VOE and continuous variables such as ScreenQ were computed and a regression model incorporating all variables significantly associated with total language verbal expression was created. RESULTS: ScreenQ revealed a negative and significant correlation with children's verbal oral expression as well as significance in the regression model. Parents' education was the most significant predictor in this regression model. CONCLUSIONS: This study emphasizes the importance of parents establishing limits for digital media use and promote good practices such as co-viewing.
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The manufacturing process in thermoset-based carbon fiber-reinforced polymers (CFRPs) usually requires a curing stage where the material is transformed from a gel state to a monolithic solid state. During the curing process, micro-residual stresses are developed in the material due to the different chemical-thermal-mechanical properties of the fiber and of the polymer, reducing the mechanical performance of the composite material compared to the nominal performance. In this study, computational micromechanics is used to analyze the micro-residual stresses development and to predict its influence on the mechanical performance of a pre-impregnated unidirectional CFRP made of T700-fibers and an aeronautical grade epoxy. The numerical model of a representative volume element (RVE) was developed in the commercial software Abaqus® and user-subroutines are used to simulate the thermo-curing process coupled with the mechanical constitutive model. Experimental characterization of the bulk resin properties and curing behavior was made to setup the models. The higher micro-residual stresses occur at the thinner fiber gaps, acting as triggers to failure propagation during mechanical loading. These micro-residual stresses achieve peak values above the yield stress of the resin 55 MPa, but without achieving damage. These micro-residual stresses reduce the transverse strength by at least 10%, while the elastic properties remain almost unaffected. The numerical results of the effective properties show a good agreement with the macro-scale experimentally measured properties at coupon level, including transverse tensile, longitudinal shear and transverse shear moduli and strengths, and minor in-plane and transverse Poisson's ratios. A sensitivity analysis was performed on the thermal expansion coefficient, chemical shrinkage, resin elastic modulus and cure temperature. All these parameters change the micro-residual stress levels and reduce the strength properties.
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AIM: Digital media use is prevalent among children and linked to potential developmental and health risks, but validated measures of children's digital media use are lacking. The aim of this study was to validate the Portuguese version of the ScreenQ with three distinct children's age groups. METHODS: Parents of children living in Portugal completed an online survey including the 16-item version of the ScreenQ and items related to home activities and digital media use. A combination of classical and modern theory (Rasch) methods was used for analysis. RESULTS: A total of 549 mothers and 51 fathers of 325 girls and 322 boys from 6 months to 9 years and 11 months old responded to the survey. Point-measure correlations were all positive and endorsement of item values were within acceptable ranges. Cronbach's coefficient α was acceptable for a new measure, and test-retest reliability was high. Statistically significant correlations were found between ScreenQ total scores and relevant demographic, play-related, parenting and digital media use items. CONCLUSION: The Portuguese version of the ScreenQ exhibited sound psychometric properties, including internal consistency and concurrent validity referenced to external items. Higher ScreenQ scores were correlated with higher digital media multitasking, lower parent-child interaction, and higher concerns regarding child's learning and behaviour.
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Internet , Preescolar , Femenino , Humanos , Lactante , Masculino , Portugal , Psicometría , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
CONTEXT: Biological and translational insights from large-scale, array-based genetic studies of fat distribution, a key determinant of metabolic health, have been limited by the difficulty in linking predominantly noncoding variants to specific gene targets. Rare coding variant analyses provide greater confidence that a specific gene is involved, but do not necessarily indicate whether gain or loss of function (LoF) would be of most therapeutic benefit. OBJECTIVE: This work aimed to identify genes/proteins involved in determining fat distribution. METHODS: We combined the power of genome-wide analysis of array-based rare, nonsynonymous variants in 450â 562 individuals in the UK Biobank with exome-sequence-based rare LoF gene burden testing in 184â 246 individuals. RESULTS: The data indicate that the LoF of 4 genes (PLIN1 [LoF variants, Pâ =â 5.86â ×â 10-7], INSR [LoF variants, Pâ =â 6.21â ×â 10-7], ACVR1C [LoFâ +â moderate impact variants, Pâ =â 1.68â ×â 10-7; moderate impact variants, Pâ =â 4.57â ×â 10-7], and PDE3B [LoF variants, Pâ =â 1.41â ×â 10-6]) is associated with a beneficial effect on body mass index-adjusted waist-to-hip ratio and increased gluteofemoral fat mass, whereas LoF of PLIN4 (LoF variants, Pâ =â 5.86â ×â 10-7 adversely affects these parameters. Phenotypic follow-up suggests that LoF of PLIN1, PDE3B, and ACVR1C favorably affects metabolic phenotypes (eg, triglycerides [TGs] and high-density lipoprotein [HDL] cholesterol concentrations) and reduces the risk of cardiovascular disease, whereas PLIN4 LoF has adverse health consequences. INSR LoF is associated with lower TG and HDL levels but may increase the risk of type 2 diabetes. CONCLUSION: This study robustly implicates these genes in the regulation of fat distribution, providing new and in some cases somewhat counterintuitive insight into the potential consequences of targeting these molecules therapeutically.
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Diabetes Mellitus Tipo 2 , Receptores de Activinas Tipo I/genética , Distribución de la Grasa Corporal , Diabetes Mellitus Tipo 2/genética , Exoma , Variación Genética , Estudio de Asociación del Genoma Completo , HumanosRESUMEN
RATIONALE: The COVID-19 pandemic is a worldwide threat to public health and the global economy. The climate of fear and uncertainty associated with the pandemic has fostered the emergence of a wide range of COVID-19 conspiracy theories that have the potential to shape public opinion and hinder the effective dissemination of valid information. Beliefs in conspiracy theories have been associated with maladaptive personality traits such as schizotypy and paranoia, as well as other non-psychotic psychological characteristics (e.g., social isolation, stress). METHODS: An online survey was conducted to examine the associations between beliefs in COVID-19 conspiracy theories and psychotic-like experiences in a Portuguese community sample (N = 438), while also addressing the role of sociodemographic variables, psychological outcomes (e.g., stress, affective states), confinement-related factors (e.g., confinement conditions/behaviors), and pandemic-related factors (e.g., health concerns, financial issues). RESULTS: Findings suggest that psychotic-like experiences are associated with beliefs in COVID-19 conspiracy theories, particularly perceptual abnormalities and persecutory ideation. Moreover, increased health-related concerns and reduced education levels also seem to be liability factors for these conspiracy beliefs. CONCLUSION: These results add important insights into how the adherence to illogical and erroneous disease-related arguments can be related to psychotic-like experiences. COVID-19 conspiracy theories are yet another major challenge that governments and policymakers must contemplate when defining strategic directions to manage the current and future pandemics.
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COVID-19 , Humanos , Pandemias , Salud Pública , Opinión Pública , SARS-CoV-2RESUMEN
Purpose: The recommended way to assess consciousness in prolonged disorders of consciousness is to observe the patient's responses to sensory stimulation. Multiple assessment sessions have to be completed in order to reach a correct diagnosis. There is, however, a lack of data on how many sessions are sufficient for validity and reliability. The aim of this study was to identify the number of Sensory Modality Assessment and Rehabilitation Technique (SMART) assessment sessions needed to reach a reliable diagnosis. A secondary objective was to identify which sensory stimulation modalities are more useful to reach a diagnosis. Materials and Methods: A retrospective analysis of all the adult patients (who received a SMART assessment) admitted to a specialist brain injury unit over the course of 4 years was conducted (n = 35). An independent rater analyzed the SMART levels for each modality and session and provided a suggestive diagnosis based on the highest SMART level per session. Results: For the vast majority of patients between 5 and 6 sessions was sufficient to reach the final clinical diagnosis. The visual, auditory, tactile, and motor function modalities were found to be more associated with the final diagnosis than the olfactory and gustatory modalities. Conclusion: These findings provide for the first time a rationale for optimizing the time spent on assessing patients using SMART.
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The number of patients surviving severe brain injury is increasing; however, many are left in a prolonged disorder of consciousness. With appropriate treatment, patients with prolonged disorders of consciousness can survive for years. Unless an advance directive exists, the treating clinicians can authorize withdrawal of clinically assisted nutrition and hydration for these patients, based on best interests. The classic terminology used in prolonged disorders of consciousness ranges from coma, vegetative state to minimally conscious state. However, a new group of patients with covert cognition has been identified in the last decade, making it necessary to revise the current taxonomy to better reflect our understanding of these conditions. With the introduction of a less ambiguous terminology, the challenges when it comes to withdrawal of clinically assisted nutrition and hydration of these patients may ease. A decision-making pathway for withdrawal of clinically assisted nutrition and hydration for patients with prolonged disorders of consciousness, based on a new taxonomy is proposed. These decisions should be based primarily on best interests. The adoption of a new classification for impairments of consciousness would clarify and improve how we think about these patients. Moreover, the development of accurate prognostic predictors would be a major step in the decision-making process, as it would influence the beneficent pathway towards the best clinical outcome.
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Clasificación/métodos , Trastornos de la Conciencia/terapia , Toma de Decisiones/fisiología , Evaluación Nutricional , Femenino , Humanos , MasculinoRESUMEN
The coronavirus disease 2019 outbreak forced most of the world's population to be confined at home to prevent contagion. Research reveals that one of the consequences of this confinement for children is an increased amount of time spent using screens (television, computers, and mobile devices, etc.) at home. This exploratory study aims to analyze the association between screen time exposure and emotional/behavioral problems of infants and children aged under 7 years, as manifested during the lockdown period in Portugal due to the coronavirus disease 2019 outbreak. The study was controlled for sociodemographic and confinement variables. A sample of 193 parents of children aged from 6 months to 6 years and 12 months, residing in Portugal, completed a survey about the time and manner of use of screen time exposure of their children. Data were derived on circumstances both before and after the confinement; the survey also explored the child's behavioral and emotional adjustment. The findings revealed a modest relationship between children's exposure time to screens and behavioral and emotional problems on children studied. It was also found that parents may play an important role in children's behavioral and emotional adjustment during the confinement period.
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Comprehensive social cognition training programs have been effective to improve social cognition in people with chronic schizophrenia, although there is insufficient quality evidence for recent-onset psychosis. The aim of this study was to assess the effects of Social Cognition and Interaction Training (SCIT) in a sample of recent-onset schizophrenia outpatients. Sixteen participants who had their first psychotic episode for less than 2 years were randomly allocated to the SCIT group during 20 weeks (weekly sessions) or to a psychoeducation group and completed baseline and post-training assessment for cognitive biases, social cognition, clinical symptoms and functioning. Permutation-based analysis revealed improvements in overall functioning (P = 0.036) and blame score (P = 0.070) in the SCIT group compared to the psychoeducation intervention, with large effect sizes (d = 1.438 and d = 1.204, respectively). There were also large effect sizes for hostility, emotion recognition, social perception, positive and total symptoms (d = 0.833-1.158). These results suggest that SCIT may be an effective tool to improve attributional biases and functional outcomes in recent-onset schizophrenia outpatients. Future controlled trials with larger sample size and follow-up assessments should be developed to further understand effective intervention outcomes for this population.
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Terapia Cognitivo-Conductual , Trastornos Psicóticos , Esquizofrenia , Cognición , Humanos , Esquizofrenia/terapia , Cognición Social , Percepción SocialRESUMEN
AIM: To evaluate the efficacy of metacognitive group training in reducing psychotic symptoms and improving cognitive insight and functions in people with schizophrenia. DESIGN: Randomized controlled trial. It was carried out between July 2019 -February 2020. METHODS: Fifty-six patients with schizophrenia were enrolled and randomly assigned to either a control group (N = 29) or a metacognitive training group (N = 27). Blinded assessments were made at baseline, 1-week post-treatment and at follow-up 3 months after treatment. The primary outcome measure was psychotic symptoms based on the Psychotic Symptom Rating Scales (PSYRATS). Secondary outcomes were assessed by the Beck Cognitive Insight Scale (BCIS), the Personal and Social Performance (PSP) scale and the World Health Organization Disability Assessment Schedule (WHODAS). RESULTS: Completion at follow-up was high (92.86%). The intention-to-treat analyses demonstrated that patients in the metacognitive training group had significantly greater improvements of the Psychotic Symptom Rating Scales delusion score and total score and the Personal and Social Performance Scale, after 3 months, compared with the control group. The effect size was medium to large. The intention-to-treat analyses also demonstrated that patients in the metacognitive training group had significantly greater reductions of the Psychotic Symptom Rating Scales hallucination score and Beck Cognitive Insight Scale self-certainty score post-treatment, compared with the control group. The effect size was medium to large. CONCLUSION: The metacognitive training administered by psychiatric and mental health nurses was effective in ameliorating delusions and social functioning over time and it immediately reduced hallucinations post-treatment. IMPACT: Metacognitive training for treating psychosis in patients with schizophrenia is efficacious and administration is clinically feasible in the Portuguese context. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov ID NCT03891186.
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Terapia Cognitivo-Conductual , Enfermeras y Enfermeros , Trastornos Psicóticos , Esquizofrenia , Estudios de Factibilidad , Humanos , Salud Mental , Escalas de Valoración Psiquiátrica , Trastornos Psicóticos/terapia , Esquizofrenia/terapia , Resultado del TratamientoRESUMEN
Life cycle assessment is a methodology to assess environmental impacts associated with a product or system/process by accounting resource requirements and emissions over its life cycle. The life cycle consists of four stages: material production, manufacturing, use, and end-of-life. This study highlights the need to conduct life cycle assessment (LCA) early in the new product development process, as a means to assess and evaluate the environmental impacts of (nano)enhanced carbon fibre-reinforced polymer (CFRP) prototypes over their entire life cycle. These prototypes, namely SleekFast sailing boat and handbrake lever, were manufactured by functionalized carbon fibre fabric and modified epoxy resin with multi-walled carbon nanotubes (MWCNTs). The environmental impacts of both have been assessed via LCA with a functional unit of '1 product piece'. Climate change has been selected as the key impact indicator for hotspot identification (kg CO2 eq). Significant focus has been given to the end-of-life phase by assessing different recycling scenarios. In addition, the respective life cycle inventories (LCIs) are provided, enabling the identification of resource hot spots and quantifying the environmental benefits of end-of-life options.
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The auditory N1 component has been gaining interest as a possible biomarker in schizophrenia (SCZ). N1 to right (RE) and left ear (LE) amplitudes and latencies were assessed using a monoaural auditory oddball paradigm in 12 SCZ subjects and 15 matched healthy controls (M=40.1±8.53 and 39.4±7.73, respectively). T-student test revealed no differences between RE and LE stimulation for N1 amplitude and latency to both groups. However, there were differences in peak-to-peak N1 amplitudes between the two groups for both LE (t=-3.067; ρ=0.003) and RE (t=-2.794; ρ=0.007). These findings strengthen auditory N1 has an electrophysiological biomarker for schizophrenia.
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Potenciales Evocados Auditivos , Esquizofrenia , Biomarcadores , Electroencefalografía , Humanos , Tiempo de Reacción , Esquizofrenia/diagnósticoRESUMEN
Werner Syndrome (WS) and Bloom Syndrome (BS) are disorders of DNA damage repair caused by biallelic disruption of the WRN or BLM DNA helicases respectively. Both are commonly associated with insulin resistant diabetes, usually accompanied by dyslipidemia and fatty liver, as seen in lipodystrophies. In keeping with this, progressive reduction of subcutaneous adipose tissue is commonly observed. To interrogate the underlying cause of adipose tissue dysfunction in these syndromes, CRISPR/Cas9 genome editing was used to generate human pluripotent stem cell (hPSC) lacking either functional WRN or BLM helicase. No deleterious effects were observed in WRN-/- or BLM-/- embryonic stem cells, however upon their differentiation into adipocyte precursors (AP), premature senescence emerged, impairing later stages of adipogenesis. The resulting adipocytes were also found to be senescent, with increased levels of senescent markers and senescence-associated secretory phenotype (SASP) components. SASP components initiate and reinforce senescence in adjacent cells, which is likely to create a positive feedback loop of cellular senescence within the adipocyte precursor compartment, as demonstrated in normal ageing. Such a scenario could progressively attenuate adipose mass and function, giving rise to "lipodystrophy-like" insulin resistance. Further assessment of pharmacological senolytic strategies are warranted to mitigate this component of Werner and Bloom syndromes.
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Adipocitos/metabolismo , Síndrome de Bloom , Senescencia Celular , Células Madre Embrionarias Humanas/metabolismo , Modelos Biológicos , Síndrome de Werner , Adipocitos/patología , Síndrome de Bloom/genética , Síndrome de Bloom/metabolismo , Síndrome de Bloom/patología , Sistemas CRISPR-Cas , Línea Celular , Eliminación de Gen , Células Madre Embrionarias Humanas/patología , Humanos , Síndrome de Werner/genética , Síndrome de Werner/metabolismo , Síndrome de Werner/patologíaRESUMEN
RATIONALE: The nuclear receptor retinoid X receptor (RXR) belongs to a nuclear receptor superfamily that modulates diverse functions via homodimerization with itself or several other nuclear receptors, including PPARα. While the activation of PPARα by natural or synthetic agonists regulates the sleep-wake cycle, the role of RXR in the sleep modulation is unknown. OBJECTIVES: We investigated the effects of bexarotene (Bexa, a RXR agonist) or UVI 3003 (UVI, a RXR antagonist) on sleep, sleep homeostasis, levels of neurochemical related to sleep modulation, and c-Fos and NeuN expression. METHODS: The sleep-wake cycle and sleep homeostasis were analyzed after application of Bexa or UVI. Moreover, we also evaluated whether Bexa or UVI could induce effects on dopamine, serotonin, norepinephrine epinephrine, adenosine, and acetylcholine contents, collected from either the nucleus accumbens or basal forebrain. In addition, c-Fos and NeuN expression in the hypothalamus was determined after Bexa or UVI treatments. RESULTS: Systemic application of Bexa (1 mM, i.p.) attenuated slow-wave sleep and rapid eye movement sleep. In addition, Bexa increased the levels of dopamine, serotonin, norepinephrine epinephrine, adenosine, and acetylcholine sampled from either the nucleus accumbens or basal forebrain. Moreover, Bexa blocked the sleep rebound period after total sleep deprivation, increased in the hypothalamus the expression of c-Fos, and decreased NeuN activity. Remarkably, UVI 3003 (1 mM, i.p.) induced opposite effects in sleep, sleep homeostasis, neurochemicals levels, and c-Fos and NeuN activity. CONCLUSIONS: The administration of RXR agonist or antagonist significantly impaired the sleep-wake cycle and exerted effects on the levels of neurochemicals related to sleep modulation. Moreover, Bexa or UVI administration significantly affected c-Fos and NeuN expression in the hypothalamus. Our findings highlight the neurobiological role of RXR on sleep modulation.
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Bexaroteno/farmacología , Ácidos Cumáricos/farmacología , Receptores X Retinoide/metabolismo , Fases del Sueño/efectos de los fármacos , Fases del Sueño/fisiología , Tetrahidronaftalenos/farmacología , Animales , Masculino , Núcleo Accumbens/efectos de los fármacos , Núcleo Accumbens/metabolismo , Ratas , Ratas Wistar , Receptores Citoplasmáticos y Nucleares/agonistas , Receptores Citoplasmáticos y Nucleares/antagonistas & inhibidores , Receptores Citoplasmáticos y Nucleares/metabolismo , Receptores X Retinoide/agonistas , Receptores X Retinoide/antagonistas & inhibidoresRESUMEN
Aging is an inevitable process that involves changes across life in multiple neurochemical, neuroanatomical, hormonal systems, and many others. In addition, these biological modifications lead to an increase in age-related sickness such as cardiovascular diseases, osteoporosis, neurodegenerative disorders, and sleep disturbances, among others that affect activities of daily life. Demographic projections have demonstrated that aging will increase its worldwide rate in the coming years. The research on chronic diseases of the elderly is important to gain insights into this growing global burden. Novel therapeutic approaches aimed for treatment of age-related pathologies have included the endocannabinoid system as an effective tool since this biological system shows beneficial effects in preclinical models. However, and despite these advances, little has been addressed in the arena of the endocannabinoid system as an option for treating sleep disorders in aging since experimental evidence suggests that some elements of the endocannabinoid system modulate the sleep-wake cycle. This article addresses this less-studied field, focusing on the likely perspective of the implication of the endocannabinoid system in the regulation of sleep problems reported in the aged. We conclude that beneficial effects regarding the putative efficacy of the endocannabinoid system as therapeutic tools in aging is either inconclusive or still missing.
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Endocannabinoides/farmacología , Endocannabinoides/fisiología , Trastornos del Sueño-Vigilia/tratamiento farmacológico , Trastornos del Sueño-Vigilia/fisiopatología , Anciano , Envejecimiento , Ritmo Circadiano , Humanos , Receptores de Cannabinoides , SueñoRESUMEN
AIM: To evaluate the efficacy of the Portuguese version of the metacognitive training (MCT) programme for schizophrenia and its effects on psychotic symptoms, insight into the disorder and functionality. DESIGN: This is a randomized controlled trial that will be undertaken in six psychiatric institutions in Portugal. METHODS: This study was approved in March 2019. The sample will consist of people with schizophrenia. The evaluation instruments will include sociodemographic and clinical questionnaires, the Psychotic Symptom Rating Scales, the Beck Cognitive Insight Scale, the World Health Disability Assessment Schedule, and the Personal and Social Performance Scale, applied to both groups at three different times. In the experimental group, the eight MCT modules will be applied over 4 weeks. DISCUSSION: It is expected that at the end of the programme, the experimental group will have reduced severity of psychotic symptoms and improved insight into the disease and functionality. IMPACT: Schizophrenia is a severe mental disorder that, in most cases, leads to the deterioration of cognitive and social functioning as a result of psychotic symptoms. Metacognitive training for schizophrenia has been used in several countries, but its efficacy remains unclear. It is a type of programme that consists of changing the cognitive infrastructure of delusions.