Professional quality of life and fear of COVID-19 among Spanish nurses: A longitudinal repeated cross-sectional study.

AIM AND OBJECTIVES: To evaluate changes in compassion fatigue (CF), burnout (BO), compassion satisfaction (CS) and fear of COVID-19 among Spanish nurses by comparing two assessment points: before and after the COVID-19 vaccination campaign. BACKGROUND: The COVID-19 pandemic has produced a great impact in healthcare worker's professional quality of life, especially among nurses. CF, BO and fear of COVID-19 decisively affect the care provided by nurses and put them at risk for mental health problems, so longitudinal studies are essential. DESIGN: A repeated cross-sectional design was carried out with a time-lapse of 12 months. METHODS: A total of 439 registered nurses in December 2020 and 410 in December 2021 participated in this study through an online survey. Data were collected using the Professional Quality of Life Questionnaire and the Fear of COVID-19 Scale. Occupational and sociodemographic variables were also analysed. This article adheres to the STROBE guidelines for the reporting of observational studies. RESULTS: The fear of COVID-19 has not been reduced among nurses. The levels of BO remain stable and continue to be high in half of the professionals. CF has been reduced with a small effect size (d = 0.30), while CS has also decreased (d = 0.30). Positive correlations were found in both assessment points between fear of COVID-19 and BO (r = .44, p ≤ .001; r = .41, p ≤ .001) and also between fear of COVID and CF (r = .57, p ≤ .001; r = .50, p ≤ .001). Negative correlations between fear and CS were also found (r = - .16, p = .001; r = - .22, p ≤ .001). RELEVANCE TO CLINICAL PRACTICE: Programmes to reduce fear of COVID-19, BO and CF are needed to improve mental health and to prevent psychological distress among nurses, as well as to increase CS and preserve the productivity and quality of nursing care. PATIENT OR PUBLIC CONTRIBUTION: The nurses collaborated by participating in the present study anonymously and disinterestedly.

Experiences of Self-Stigma in People with Chronic Psychosis: A Qualitative Study.

We present the results of a phenomenological study understanding the personal meaning of self-stigma in people with chronic psychosis. Self-stigma is a frequent phenomenon in the lives of people with psychosis and their families and it functions as a barrier to recovery. Semi-structured in-depth interviews were conducted with fourteen outpatients that suffer from chronic psychosis during January 2020. Data analysis was carried out using an inductive approach as described by Graneheim and Lundman through the MAXQDA 2022 program. The themes observed were: "Contextual Stigma", "Components of Self-Stigma", "Skills Loss" and "Coping with Self-Stigma". The main categories and subcategories were avoidance and escape behaviours from their social environment, labelling, loss of social relationships, negative impact and self-concealment of the diagnosis. Our results revealed influence on each other, forming a looping effect that explains and amplifies the lived experience of self-stigma. These findings highlight the need to implement strategies in nursing practice aimed at training the acceptance and distancing necessary to minimize the impact of self-stigma on people with chronic psychosis. This study adheres to the EQUATOR guidelines for the Consolidated Criteria for Reporting Qualitative Research (COREQ).

A new Algorithm for Detecting Clinical High Risk of Psychosis in Adolescents.

BACKGROUND: The delimitation of the clinical high risk of psychosis (CHRp) is characterized by the wide variety of symptoms assessed from different approaches from the onset of psychosis. This study aimed to create a systematic procedure for an effective and accurate earlydetection of CHRp in educational settings. METHOD: A representative sample of 1,824 adolescents (average age, 15.79; 53.8%, women) was used to develop an online assessment system and a new 3-track, 3-level algorithm that combines symptoms of the main risk approaches: ultra-high risk (UHR), basic symptoms (BS), and anomalies in the subjective self-experience (ASE) with functional deficit. RESULTS: The acceptability and feasibility of the online screening system were confirmed by the data. Of the total participants, 68 (3.7%) were identified as high-risk and 417 (22.9%) were identified as moderate, which also supports the functionality of the proposed algorithm. CONCLUSIONS: The system indicates a dynamic model of progression of the different symptoms in the early stages of psychosis, and it may constitute a first line of identification for severe mental disorders in young people in the earliest stages, allowing application of initial preventive measures.

The role of nurses' professional values during the COVID-19 crisis.

BACKGROUND: The COVID-19 pandemic has produced high stress in nurses, affecting their professional quality of life. Different variables affect psychological stress response and professional quality of life. In this context, the role of professional values represents an interesting object of research. OBJECTIVES: To analyze the relationship between professional values, perceived stress, and professional quality of life among nurses during the COVID-19 crisis. RESEARCH DESIGN, PARTICIPANTS, AND RESEARCH CONTEXT: Descriptive cross-sectional study. Participants were 439 registered nurses from the public health system. Perceived stress, professional quality of life, and professional values were evaluated by using measuring instruments adapted and validated in the geographic context of research. Data were collected online in December 2020 during the second wave of the COVID-19 pandemic in Spain. ETHICAL CONSIDERATIONS: This study was approved by the Ethics Committee on Clinical Research of the Principality of Asturias. FINDINGS: Within professional values, ethics obtained higher scores showing the primacy of ethical values among nurses. Moderate correlations between ethics, mastery, expertise, and compassion satisfaction were found. Frontline nurses informed high perceived stress. The correlations between professional values and compassion satisfaction were higher in non-frontline nurses. A moderate negative correlation between perceived stress and compassion satisfaction was found in both groups, which implies that the higher the stress, the lower the satisfaction in the helping relationship. CONCLUSION: Professional values positively influence compassion satisfaction during the COVID-19 pandemic. Compassion satisfaction presents a negative correlation with fatigue compassion and burnout in frontline and non-frontline nurses. Given the functionality of values both to guide clinical practice professionally and ethically, and prevent dissatisfaction with one's professional quality of life by reinforcing compassion satisfaction, it is necessary to reinforce them with an intensive and cross-sectional learning during the university training.

A new Algorithm for Detecting Clinical High Risk of Psychosis in Adolescents / Un Nuevo Algoritmo para la Detección del Alto Riesgo Clínico de Psicosis en Adolescentes

Background: The delimitation of the clinical high risk of psychosis (CHRp) is characterized by the wide variety of symptoms assessed from different approaches from the onset of psychosis. This study aimed to create a systematic procedure for an effective and accurate earlydetection of CHRp in educational settings. Method: A representative sample of 1,824 adolescents (average age, 15.79; 53.8%, women) was used to develop an online assessment system and a new 3-track, 3-level algorithm that combines symptoms of the main risk approaches: ultra-high risk (UHR), basic symptoms (BS), and anomalies in the subjective self-experience (ASE) with functional deficit. Results: The acceptability and feasibility of the online screening system were confirmed by the data. Of the total participants, 68 (3.7%) were identified as high-risk and 417 (22.9%) were identified as moderate, which also supports the functionality of the proposed algorithm. Conclusions: The system indicates a dynamic model of progression of the different symptoms in the early stages of psychosis, and it may constitute a first line of identification for severe mental disorders in young people in the earliest stages, allowing application of initial preventive measures.(AU)

Antecedentes: La delimitación del alto riesgo clínico de psicosis (CHRp, por sus siglas en inglés) se caracteriza por la gran variedad de síntomas evaluados desde diferentes enfoques y la dificultad que existe para detectar los estadios clínicos más alejados del inicio de la psicosis. Este estudio tiene como objetivo la creación de un procedimiento sistemático para una detección temprana eficaz y precisa del CHRp en entornos educativos. Método: A partir de una muestra representativa de 1.824 adolescentes (edad, media= 15,79 años; 53,8%, mujeres) se ha desarrollado un sistema de evaluación online y un algoritmo de tres vías y tres niveles de riesgo que combina los síntomas de los principales enfoques de riesgo: ultra-alto riesgo (UHR), síntomas básicos (SB) y anomalías en la autoexperiencia subjetiva (ASE), además del déficit funcional. Resultados: A la luz de los datos obtenidos se han confirmado la aceptabilidad y viabilidad del sistema de cribado online. Del total de participantes, 68 (3,7%) fueron identificados como de alto riesgo y 417 (22,9%) como de riesgo moderado, lo que también avala la funcionalidad del algoritmo propuesto. Conclusiones: El sistema apoya la existencia de un modelo dinámico de progresión de los diferentes síntomas en las primeras etapas de la psicosis, y puede constituir una primera línea de identificación de los trastornos mentales graves en los jóvenes en las etapas más tempranas, de cara a la aplicación de las medidas preventivas iniciales.(AU)

Psychological Inflexibility in People with Chronic Psychosis: The Mediating Role of Self-Stigma and Social Functioning.

Psychosis is associated with self-stigmatization and loss of social functioning that increase the severity of the disorder. Psychological inflexibility (PI)-an individual's tendency to suppress undesirable private events-plays a fundamental role in the emergence and worst prognosis of psychosis. The main objective of this study was to analyze whether self-stigma and social functioning mediate the association of PI with the severity of psychosis in adults with chronic schizophrenia. The study was carried out with a sample of 103 outpatients. The Acceptance and Action Questionnaire, the Internalized Stigma of Mental Illness Scale, and the Social Functioning Scale were used for clinical assessments. Data analyses were performed by using the PROCESS macro for SPSS. Results showed that the link between PI and the severity of psychosis is not direct, but is better explained by mediation of the self-stigma and social functioning of those assessed. PI also predicts worse social functioning without the need to take self-stigma into account. Moreover, self-stigma alone does not predict the severity of psychotic symptoms; this relationship has to be mediated by social functioning. These findings suggest that interventions designed to increase psychological flexibility, such as Acceptance and Commitment Therapy (ACT), may offer an alternative to attenuate the negative impact of self-stigma and to improve the social functioning.

[Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art].

Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art. BACKGROUND: The empirical evidence accumulated on the efficacy, effectiveness, and efficiency of psychotherapeutic treatments in children and adolescents calls for an update. The main goal of this paper objective was to carry out a selective review of empirically supported psychological treatments for a variety of common psychological disorders and problems in childhood and adolescence. METHOD: A review was carried out of the psychological treatments for different psychological disorders and problems in social-emotional or behavioral adjustment in the child-adolescent population according to the Spanish National Health System (Clinical Practice Guidelines) levels of evidence and degrees of recommendation. RESULTS: The findings suggest that psychological treatments have empirical support for addressing a wide range of psychological problems in these developmental stages. The degree of empirical support ranges from low to high depending on the phenomenon analyzed. The review suggests unequal progress in the different fields of intervention. CONCLUSIONS: From this update, psychologists will be able to make informed decisions when implementing those empirically supported treatments to address the problems that occur in childhood and adolescence.

Dual Diagnosis in Prisoners: Childhood Sexual and Physical Abuse as Predictors in Men and Women.

The study aims to determine the rate of dual diagnosis (DD), examine the most common mental disorders, and determine whether a history of childhood sexual/physical abuse (CSA/CPA) is associated with this phenomenon. One-hundred and eighty inmates from a Spanish prison were assessed using the Mini International Neuropsychiatric Interview and the Addiction Severity Index-6. The data showed that 46.8% of the males and 65.1% of the females had a substance use disorder. With regard to CPA, similar percentages were found in both genders. Nevertheless, rates of CSA were highest in females. Logistic regression analysis was performed by gender. CPA was predictor of DD for males, and CSA was predictor of DD for females, showing the greatest weight. In addition, in both cases, the number of drugs of abuse was an adequate predictor. We can state that these forms of maltreatment are risk factors for the development of a broad range of psychopathological problems.

Acceptance and commitment therapy versus cognitive behavioral therapy in the treatment of substance use disorder with incarcerated women.

OBJECTIVES: This randomized controlled study compared acceptance and commitment therapy (ACT), cognitive-behavioral therapy (CBT), and a control group. METHOD: The participants were 50 incarcerated women diagnosed with current substance use disorder. Two psychologists carried out pre- and posttreatment assessment and a 6-month follow-up assessment using the following instruments: Anxiety Sensitivity Index, Addiction Severity Index-6, Mini International Neuropsychiatric Interview, and Acceptance and Action Questionnaire. RESULTS: The study shows that the women who received treatment benefited differentially from the interventions. At posttreatment, CBT was more effective than ACT in reducing anxiety sensitivity; however, at follow-up, ACT was more effective than CBT in reducing drug use (43.8 vs. 26.7%, respectively) and improving mental health (26.4% vs. 19.4%, respectively). CONCLUSION: ACT may be an alternative to CBT for treatment of drug abuse and associated mental disorders. In fact, at long-term, ACT may be more appropriate than CBT for incarcerated women who present serious problems.

Acceptance and commitment therapy for drug abuse in incarcerated women / Terapia de Aceptación y Compromiso para el abuso de sustancias en mujeres encarceladas

Background: Acceptance and Commitment Therapy is the third wave therapy with the greatest empirical evidence in the treatment of drug abuse. Method: Thirty-one women with substance use disorder (SUD) were randomly assigned to two conditions, an intervention based on Acceptance and Commitment Therapy (ACT) and a control group on a waiting list. All participants were assessed three times (before treatment, at the end, and at a six-month follow-up) using urinalysis, the Mini International Neuropsychiatric Interview (MINI), the Addiction Severity Index (ASI-6), the Anxiety Sensitivity Index, and the Acceptance and Action Questionnaire (AAQ-II). Results: After 16 ACT intervention sessions, abstinence rates of 27.8% were observed, increasing to 43.8% after six months. The treatment also promoted improvements in other areas, such as reductions in the percentage of comorbid psychopathology and anxiety sensitivity, and the increase of psychological flexibility, which, in general, were not documented in the comparison group. Conclusions: Clinical gains were achieved, and we consider ACT to be an effective and appropriate treatment to be applied in the prison context (AU)

Antecedentes: la Terapia de Aceptación y Compromiso (ACT) es una de las terapias de tercera generación que cuenta con mayor evidencia empírica en el tratamiento del abuso de sustancias (TUS). Método: treinta y un mujeres con TUS fueron asignadas al azar a dos condiciones: un tratamiento de 16 sesiones con base en ACT y un grupo de control en lista de espera. Todas fueron evaluadas en 3 momentos (pre, post y al cabo de seis meses de recibir el tratamiento) mediante analíticas de orina, la Mini International Neuropsychiatric Interview (MINI), el Addiction Severity Index (ASI-6), el Índice de sensibilidad a la Ansiedad y el Cuestionario de Aceptación y Acción (AAQ-II). Resultados: tras la intervención, se observó un porcentaje de abstinencia del 27,8% y del 43,8% al cabo de seis meses. La intervención también provocó mejorías en otras áreas, como reducciones en los porcentajes de psicopatología asociada y de sensibilidad a la ansiedad, así como aumento de la flexibilidad psicológica, que, en general, no se documentaron en el grupo de comparación. Conclusiones: se discuten estas ganancias clínicas y se ofrece ACT como un tratamiento apropiado para ser dispensado en mujeres reclusas con trastorno por abuso de sustancias (AU)

Acceptance and Commitment Therapy for drug abuse in incarcerated women.

BACKGROUND: Acceptance and Commitment Therapy is the third wave therapy with the greatest empirical evidence in the treatment of drug abuse. METHOD: Thirty-one women with substance use disorder (SUD) were randomly assigned to two conditions, an intervention based on Acceptance and Commitment Therapy (ACT) and a control group on a waiting list. All participants were assessed three times (before treatment, at the end, and at a six-month follow-up) using urinalysis, the Mini International Neuropsychiatric Interview (MINI), the Addiction Severity Index (ASI-6), the Anxiety Sensitivity Index, and the Acceptance and Action Questionnaire (AAQ-II). RESULTS: After 16 ACT intervention sessions, abstinence rates of 27.8% were observed, increasing to 43.8% after six months. The treatment also promoted improvements in other areas, such as reductions in the percentage of comorbid psychopathology and anxiety sensitivity, and the increase of psychological flexibility, which, in general, were not documented in the comparison group. CONCLUSIONS: Clinical gains were achieved, and we consider ACT to be an effective and appropriate treatment to be applied in the prison context.

Predictors of retention in a drug-free unit/substance abuse treatment in prison.

The high rate of dropout from treatment programs is a recurring problem in the field of drug dependence. The purpose of this study was to identify the predictors of retention in a prison-based drug-free unit (DFU). The relationships among subscales of the Addiction Severity Index (ASI) as well as motivation and personality profiles and length of stay in a DFU, of 57 prisoners admitted for the first time to the program were analyzed. The mean dropout rates were 52.9% at six months and 67.8% at one year. The mean length of stay was 195.05 days. Predictors of retention at six months included the ASI Family Composite Score, the motivation subscale Taking Steps, and Narcissistic personality trait score. Predictors of retention at one year included lower ASI Psychological Composite Score, higher scores on the motivation subscale Ambivalence, and higher number of charges pending at the time of admission to the program. Identification of these predictor variables may be useful for developing strategies to increase retention in the context of in-prison substance abuse treatment.

What predicts retention on an in-prison drug treatment program?

UNLABELLED: The effectiveness of treatments for substance use disorders is strongly related to retention, since early dropout from treatment is associated with greater likelihood of relapse. The purpose of this prospective, ex post facto study is to analyze the effect of individual variables on retention in a treatment program carried out in a prison drug-free unit. The Addiction Severity Index, motivation and personality profile of fifty inmates were assessed on entry to the prison. Inmates were monitored for a year to identify length of stay. RESULTS: Motivation variables at intake play a vital role in the prediction of retention in a prison drug-free unit; scores on the Aggressive-Sadistic and Narcissistic scales are also strong predictors of treatment retention.

What predicts retention on an in-prison drug treatment program?

The effectiveness of treatments for substance use disorders is strongly related to retention, since early dropout from treatment is associated with greater likelihood of relapse. The purpose of this prospective, ex post facto study is to analyze the effect of individual variables on retention in a treatment program carried out in a prison drug-free unit. The Addiction Severity Index, motivation and personality profile of fifty inmates were assessed on entry to the prison. Inmates were monitored for a year to identify length of stay. Results: Motivation variables at intake play a vital role in the prediction of retention in a prison drug-free unit; scores on the Aggressive-Sadistic and narcissistic scales are also strong predictors of treatment retention (AU)

La eficacia de los tratamientos para los trastornos por uso de sustancias está altamente relacionada con la retention, pues entre otras cosas el abandono del tratamiento se vincula con una mayor probabilidad de recaída. El propósito de este estudio prospectivo ex post facto es analizar el efecto de distintas variables individuales sobre la retención en el tratamiento dispensado en una unidad libre de drogas intrapenitenciaria. Cincuenta internos de este programa fueron evaluados al ingreso en variables relacionadas con el perfil de gravedad de la adicción, la motivación y la personalidad. Resultados: La motivación inicial es una variable fuertemente predictora de la retención en el tratamiento, tanto a los seis meses como al año de estancia. Asimismo, las escalas Narcisista y Agresivo-Sádica evaluadas por el instrumento MCMI-II también tuvieron capacidad pronóstica en la retención (AU)

Evaluación de la eficacia de un tratamiento libre de drogas intrapenitenciario / Evaluation of the effectiveness of a prison-based drug treatment

El presente estudio evalúa la eficacia de una unidad libre de drogas intrapenitenciaria en la reducción del consumo de sustancias, y analiza los cambios en el perfil de gravedad de la adicción, la motivación y el perfil de personalidad provocados por la intervención. Se trata de una evaluación externa, con un diseño ex post facto de medidas repetidas. Se evalúan 87 reclusos a lo largo de un año de estancia en el programa. La mayoría son varones jóvenes y policonsumidores que cumplen condena por delitos contra la salud pública y contra la propiedad. Muchos presentan necesidad de tratamiento psiquiátrico al ingreso, con una comorbilidad del 85% con trastornos de personalidad. La motivación para el tratamiento es baja, y se mantiene estable a lo largo de los 12 meses que dura el estudio. La unidad libre de drogas consigue disminuir el consumo de drogas, y mejorar las áreas de consumo, de relaciones familiares y el perfil de personalidad. Sin embargo, no se logran cambios en las áreas médica y psiquiátrica, por lo que se resalta la necesidad de intervención en estos ámbitos (AU)

The present study evaluated the effectiveness of a drug-free unit (DFU) in reducing the use of substances by incarcerated adult offenders, and to analyze changes in the addiction severity index, motivation, and personality caused by the program. This is an external evaluation, with an ex post facto design with repeated measures. Eighty-seven prisoners from the DFU were evaluated during the first year of residence in the program. Most are young men, polydrug addicts and mainly serving sentences for public health crimes and property offenses. There is need of psychiatric treatment at the baseline, with 85% comorbid personality disorders. Motivation for treatment is low, and remains stable over 12 month’s duration of the study. The DFU was found to have a significant effect in reducing the use of drugs by offenders and to improve the drug and family composite scores, also reducing scores on personality scales. However, it fails to change medical and psychiatric scores, so that the need for intervention in these areas is underscored (AU)

[Evaluation of the effectiveness of a prison-based drug treatment]. / Evaluación de la efi cacia de un tratamiento libre de drogas intrapenitenciario.

The present study evaluated the effectiveness of a drug-free unit (DFU) in reducing the use of substances by incarcerated adult offenders, and to analyze changes in the addiction severity index, motivation, and personality caused by the program. This is an external evaluation, with an ex post facto design with repeated measures. Eighty-seven prisoners from the DFU were evaluated during the first year of residence in the program. Most are young men, polydrug addicts and mainly serving sentences for public health crimes and property offenses. There is need of psychiatric treatment at the baseline, with 85% comorbid personality disorders. Motivation for treatment is low, and remains stable over 12 month's duration of the study. The DFU was found to have a significant effect in reducing the use of drugs by offenders and to improve the drug and family composite scores, also reducing scores on personality scales. However, it fails to change medical and psychiatric scores, so that the need for intervention in these areas is underscored.

Perfil adictivo, delictivo y psicopatológico de una muestra de mujeres en prisión / Addictive, criminal and psychopathological profile of a sample of women in prison

En este estudio se analiza el perfil adictivo, delictivo y psicopatológico de una muestra de 59 mujeres encarceladas en el Centro Penitenciario (C.P.) de Villabona (Asturias). Para ello se administraron los instrumentos EuropASI, SCL-90-R y una entrevista semiestructurada. Los resultados mostraron que se trata de una mujer joven, soltera y con carga familiar que cumple una condena media de 5 años de encarcelamiento. Del total de la muestra, el 64.4% presentaron criterios para un trastorno por abuso de sustancias. Se halló una relación estadísticamente significativa entre las variables consumo-no consumo y tipo de delito, siendo las mujeres consumidoras las que más delitos contra la propiedad y contra el orden socioeconómico habían cometido. Respecto a la psicopatología, el 44.06% de la muestra cumplía los requisitos de caso clínico de acuerdo a los criterios de Derogatis (1994). Los resultados del SCL-90-R mostraron que los trastornos psicológicos predominantes eran, en este orden, la depresión, la somatización, el trastorno obsesivo-compulsivo y la ideación paranoide. Además, en el grupo de mujeres consumidoras, el 47.4% presentaba patología dual. Se puso en evidencia la relación estadísticamente significativa entre caso clínico y consumo de sustancias. Por último, se observaron diferencias estadísticamente significativas entre los grupos consumo-no consumo de drogas en el perfil de gravedad del EuropASI. Fueron el área médica, familiar y psiquiátrica del grupo consumo las que mayores puntuaciones presentaron (AU)

This study examines the addictive, criminal and psychopathological profile of a sample of 59 women incarcerated in the Villabona prisonin Asturias (a region in northern Spain). The instruments administered were the EuropASI, the SCL-90-R and a semi-structured interview. Results showed that the profile is a young, single women with family dependents serving an average of 5 years’ imprisonment. Of the total sample, 64.4% met criteria for a substance abuse disorder. We found a statistically significant relationship between the variables use-nonuse and type of crime: women who used substances had committed the most crimes against property and against the socioeconomic order. As regards psychopathology, 44.06% of the sample fulfilled the requirements for clinical case according to Derogatis’ (1994) criteria. The results of theSCL-90-R showed that the predominant psychological disorders were, in the following order, depression, somatization, obsessive-compulsive disorder and paranoid ideation. Moreover, in the group of female users, 47.4% had dual pathology. Our results revealed a statistically significant relationship between clinical case and substance use. Finally, statistically significant differences were found between the user and nonuser groups in the EuropASI severity profile. Highest scores were found for the medical, psychiatric and family areas in the user group (AU)

[Addictive, criminal and psychopathological profile of a sample of women in prison]. / Perfil adictivo, delictivo y psicopatológico de una muestra de mujeres en prisión.

This study examines the addictive, criminal and psychopathological profile of a sample of 59 women incarcerated in the Villabona prison in Asturias (a region in northern Spain). The instruments administered were the EuropASI, the SCL-90-R and a semi-structured interview. Results showed that the profile is a young, single women with family dependents serving an average of 5 years' imprisonment. Of the total sample, 64.4% met criteria for a substance abuse disorder. We found a statistically significant relationship between the variables use-nonuse and type of crime: women who used substances had committed the most crimes against property and against the socioeconomic order. As regards psychopathology, 44.06% of the sample fulfilled the requirements for clinical case according to Derogatis' (1994) criteria. The results of the SCL-90-R showed that the predominant psychological disorders were, in the following order, depression, somatization, obsessive-compulsive disorder and paranoid ideation. Moreover, in the group of female users, 47.4% had dual pathology. Our results revealed a statistically significant relationship between clinical case and substance use. Finally, statistically significant differences were found between the user and nonuser groups in the EuropASI severity profile. Highest scores were found for the medical, psychiatric and family areas in the user group.

[Need for the assessment of dual diagnosis in prisons]. / Necesidad de evaluación de la patología dual en contexto penitenciario.

INTRODUCTION: Data show that 92.5% of prison inmates report drug or alcohol use. In spite of this, only 2% of dual diagnosis research has been carried out in the prison context. Therefore, the aim of this descriptive cross-sectional study was to analyze the profiles of dual diagnosis in a Spanish prison and test the feasibility of two assessment instruments. METHOD: The sample was made up of 152 drug-addicts imprisoned in the Villabona Penitentiary Center (Asturias, Spain) who volunteered to be interviewed. The sixth version of the Addiction Severity Index and the International Neuropsychiatric Interview - MINI- were used for the assessment of inmates' psychopathological status and drug problems. RESULTS: The results show that, in general, the offender's profile is: male, 34 years old, unmarried, with children and with an average time spent in prison of approximately five years. Only 4.5% of respondents did not use drugs at the time of the study. In the remainder, the most widely used substances are cocaine (37.6%), heroin (29.9%) and alcohol (10.8%), with 52.7% reporting having used drugs in the last month. With regard to psychopathological state, only 12.9% have no associated disorders, and the most prevalent symptoms correspond to antisocial personality disorder (65.6%), risk of suicide (45.2%), depression (35.9%) and anxiety (25.5%). CONCLUSION: The instruments proposed (ASI-6 and MINI) are feasible tools for detecting addiction severity and associated psychopathology in this context.