Motivos para el consumo de tabaco, alcohol y cannabis en el contexto del confinamiento por COVID-19 / Motives for tobacco, alcohol, and cannabis use in the confinement context due to COVID-19 pandemic

Introducción. Las drogas producen importantes consecuencias negativas en las sociedades. La prevalencia de su consumo sigue aumentando debido a que existen diversos motivos que acercan a las personas a consumirlas. Objetivo. Identificar las diferencias en la frecuencia y cantidad del consumo de tabaco, alcohol y cannabis durante y después del confinamiento por la pandemia de COVID-19; así como la influencia del confinamiento en los motivos y los riesgos de desarrollar un consumo problemático. Metodología. Estudio transversal analítico con muestreo no probabilístico en dos momentos. Participaron 520 jóvenes: 246 estudiantes de bachillerato y universidad en el año 2020, durante el confinamiento y 274, en 2022. Se evaluaron datos sociodemográficos, motivos de consumo y consumo problemático. Resultados. El consumo de cannabis durante el confinamiento (41,1 %) fue mayor que en el posconfinamiento (29,6 %; p 0,006). Hubo diferencias entre los grupos de consumo problemático de tabaco durante el confinamiento y los motivos sociales (W 8,178, p 0,017) y de afrontamiento (W 26,456, p < 0,001); también, entre los grupos de consumo problemático de alcohol y los motivos sociales (W 6865,5, p < 0,001); de animación (W 6768,0, p < 0,001); de afrontamiento (W 6176,0, p = 0,002) y de expansión (W 6774,0, p < 0,001). Entre los motivos del consumo problemático de cannabis se destacan los sociales (W 6,404, p 0,041); de animación (W 9,409, p 0,009); de afrontamiento (W 9,265, p 0,010) y de expansión (W 27,692, p < 0,001). Conclusión. El confinamiento incrementó el riesgo de consumir tabaco y cannabis. Los motivos de consumo también aumentaron, excepto las asociadas al consumo de alcohol en universitarios. El consumo problemático de tabaco estuvo motivado por necesidades sociales y de afrontamiento; el de alcohol y cannabis, por necesidades sociales, de animación, de afrontamiento y de expansión

Introduction. Drugs produce significant negative consequences in societies. The prevalence of drug use continues to increase because various reasons lead people to use them. Objective. Identify differences in the frequency and amount of tobacco, alcohol, and cannabis use during and after COVID-19 pandemic confinement, the influence of confinement on motives, and risks for developing problematic use. Methodology. Analytical cross-sectional study with non-probabilistic sampling at two points in time. Five hundred and twenty young people participated: 246 high school and university students during the confinement in 2020, and 274 in 2022. Sociodemographic data, reasons for consumption, and problematic consumption were evaluated. Results. Cannabis use during confinement (41.1 %) was higher than post-confinement (29.6 %; p 0.006). There were differences between the groups of problematic tobacco use during confinement and the social (W 8.178, p 0.017), and coping (W 26.456, p < 0.001) motives; also, between the groups of problematic alcohol consumption and social motives (W 6865.5, p < 0.001); encouragement (W 6768.0, p < 0.001); coping (W 6176.0, p = 0.002) and expansion (W 6774.0, p < 0.001). Among the motives for problematic cannabis use, social (W 6.404, p 0.041); animation (W 9.409, p 0.009); coping (W 9.265, p 0.010), and expansion (W 27.692, p < 0.001) were highlighted. Conclusion.Confinement increased the risk of tobacco and cannabis use. Motives for use also increased, except those associated with alcohol use in university students. Problem tobacco use was motivated by social and coping needs; alcohol and cannabis use was motivated by social, entertainment, coping and expansion needs

"Healthy immigrant effect" among individuals experiencing homelessness in Spain?: Foreign-born individuals had higher average age at death in 15-year retrospective cohort study.

BACKGROUND: Individuals experiencing homelessness (IEHs) suffer from severe health inequities. Place of origin is linked to health and mortality of IEHs. In the general population the "healthy immigrant effect" provides a health advantage to foreign-born people. This phenomenon has not been sufficiently studied among the IEH population. The objectives are to study morbidity, mortality, and age at death among IEHs in Spain, paying special attention to their origin (Spanish-born or foreign-born) and to examine correlates and predictors of age at death. METHODS: Retrospective cohort study (observational study) of a 15-year period (2006-2020). We included 391 IEHs who had been attended at one of the city's public mental health, substance use disorder, primary health, or specialized social services. Subsequently, we noted which subjects died during the study period and analyzed the variables related to their age at death. We compared the results based on origin (Spanish-born vs. foreign-born) and fitted a multiple linear regression model to the data to establish predictors of an earlier age at death. RESULTS: The mean age at death was 52.38 years. Spanish-born IEHs died on average almost nine years younger. The leading causes of death overall were suicide and drug-related disorders (cirrhosis, overdose, and chronic obstructive pulmonary disease [COPD]). The results of the linear regression showed that earlier death was linked to COPD (b = - 0.348), being Spanish-born (b = 0.324), substance use disorder [cocaine (b =-0.169), opiates (b =.-243), and alcohol (b =-0.199)], cardiovascular diseases (b = - 0.223), tuberculosis (b = - 0.163), high blood pressure (b =-0.203), criminal record (b =-0.167), and hepatitis C (b =-0.129). When we separated the causes of death for Spanish-born and foreign-born subjects, we found that the main predictors of death among Spanish-born IEHs were opiate use disorder (b =-0.675), COPD (b =-0.479), cocaine use disorder (b =-0.208), high blood pressure (b =-0.358), multiple drug use disorder (b =-0.365), cardiovascular disease (b =-0.306), dual pathology (b =-0.286), female gender (b =-0.181), personality disorder (b =-0.201), obesity (b =-0.123), tuberculosis (b =-0.120) and having a criminal record (b =-0.153). In contrast, the predictors of death among foreign-born IEHs were psychotic disorder (b =-0.134), tuberculosis (b =-0.132), and opiate (b =-0.119) or alcohol use disorder (b =-0.098). CONCLUSIONS: IEHs die younger than the general population, often due to suicide and drug use. The healthy immigrant effect seems to hold in IEHs as well as in the general population.

The Prevalence and Nature of Violence Against Women Experiencing Homelessness: A Quantitative Study.

Individuals experiencing homelessness-an extreme form of social exclusion-have considerably higher risk of being victims of violence than the general population. We analyze the episodes of violence suffered by 504 individuals experiencing homelessness in Spain, as well as the differences between men and women. The results indicate high levels of violence and suggest that gender (specifically, being a woman) is the primary factor driving exposure to violence among this group. Highlighting the reality of women experiencing homelessness can help social, mental health, and addiction services adjust responses to better address the needs of this group and offer comprehensive care.

[Homelessness and mental health diagnose during the Great Recession (2008-2017): the effect of immigration.] / Sinhogarismo y salud mental durante la Gran Recesión (2008-2017): el efecto de la inmigración.

OBJECTIVE: Homelessness, which is a severe social problem across Europe and on the rise over the past decade, is closely linked to organic and mental health problems. In front of the lack of diagnostic analysis studies in the Spanish territory, this research aimed to determine the sociodemographic characteristics of a sample of individuals experiencing homelessness (IEH), to determine the prevalence of diagnoses of substance use disorders, dual pathology and other mental disorders and to analyze the existence of diagnostic differences between IEH born in the country and immigrant IEH. METHODS: A transversal and observational study was carried out, based on the analysis of mental health diagnostics of the medical histories of a sample of 1,072 IEH (453 locals and 619 immigrants) assisted between 2008 and 2017 in mental health services in Girona, northeastern Spain. For the statistical analysis, Student's t test was used to compare means and the chi-squared test was used for the analysis of qualitative variables. A binary logistic regression analysis was carried out to establish the predictor variables for the diagnosis of drug addiction and dual pathology. RESULTS: IEH showed high rates of mental disorders, especially psychoactive substances (82.6% of diagnosed people). 43.9% of IEH showed alcohol dependence as the reason for their diagnosis, followed by cocaine addiction and opiates. Foreign born IEH had more diagnoses for alcohol dependence and less for opiates or dual pathology than spanish born IEH. IEH born in Spain showed a higher vulnerability and received more mental health diagnoses than immigrant IEH. CONCLUSIONS: Even though immigrant PESS show more diagnoses for alcohol dependence, PESS born in Spain show a higher vulnerability and receive more mental health diagnoses than immigrant PESS. The process of migrating seems to establish a difference in the kind of mental disorders and addictions the PESS collective is prone to.

OBJETIVO: El sinhogarismo, grave problema social en toda Europa y en aumento durante la última década, está estrechamente vinculado a problemas orgánicos y de salud mental. Frente a la ausencia de estudios de análisis diagnóstico en territorio español, esta investigación pretendió conocer las características sociodemográficas de una muestra de personas en situación de sinhogarismo (PESS), determinar la prevalencia de diagnósticos de trastorno por uso de sustancias psicoactivas, patología dual y otros trastornos mentales y analizar la existencia de diferencias diagnósticas entre PESS nacidas en el país y PESS inmigrantes. METODOS: Se realizó un estudio transversal, observacional y analítico a partir del análisis de los diagnósticos de salud mental de las historias clínicas de una muestra de 1.072 PESS (453 autóctonas y 619 inmigrantes), atendidas durante 2008 y 2017 en los Servicios de Salud Mental de Girona (noreste de España). Para el análisis estadístico se utilizó t de Student para la comparación de medias y el ji-cuadrado para el análisis de variables categóricas. Se efectuó un análisis de regresión logística binaria para establecer las variables predictoras del diagnóstico de drogodependencias y patología dual. RESULTADOS: El 44% de la muestra estaba historiado en la Red de Salud Mental y Adicciones. Las PESS mostraron elevados índices de trastornos mentales, especialmente trastornos por uso de sustancias psicoactivas (82,6% de las personas diagnosticadas). El 43,9% de las PESS diagnosticadas lo fueron por dependencia al alcohol, seguidos de la dependencia a cocaína y a opiáceos. Las PESS inmigrantes tuvieron más diagnósticos por dependencia al alcohol y menos por dependencia a los opiáceos o patología dual que las PESS autóctonas. CONCLUSIONES: Aunque las PESS inmigrantes presentan más diagnósticos en dependencia al alcohol, las PESS nacidas en España muestran una mayor vulnerabilidad y reciben más diagnósticos de salud mental que las PESS inmigrantes. El proceso migratorio establece pues diferencias en el tipo de trastornos mentales y por uso de sustancias en la población de PESS.

Absence of Objective Differences between Self-Identified Addicted and Healthy Smartphone Users?

Smartphones are used by billions of people worldwide. However, some psychologists have argued that use of this technology is addictive, even though little research utilises objective smartphone usage records to verify this claim. We conducted an exploratory study to identify whether behavioural differences exist between those who self-identify as addicted smartphone users and those who do not. We gathered retrospective smartphone usage data from 131 Android users and asked them about their past use to compare their perception of their usage against their actual usage. We could not identify any reliable differences between the smartphone activity of those self-identified as addicted smartphone users and other users. Furthermore, smartphone scales are generally good at identifying who believes themselves to be addicted, although they do not reflect objective smartphone use. This study questions the use of self-report measures to diagnosis behavioural addictions without relevant psychopathological constructs and emphasises the need for more rigorous study to conceptualise smartphone addiction.

Mortality Risk Factors for Individuals Experiencing Homelessness in Catalonia (Spain): A 10-Year Retrospective Cohort Study.

(1) Background: Current evidence suggests that mortality is considerably higher in individuals experiencing homelessness. The aim of this study was to analyze the mortality rate and the mortality risk factors in a sample of individuals experiencing homelessness in the city of Girona over a ten-year period. (2) Methods: We retrospectively examined the outcomes of 475 people experiencing homelessness with the available clinical and social data. Our sample was comprised of 84.4% men and 51.8% foreign-born people. Cox's proportional hazard models were used to identify mortality risk factors between origin groups. (3) Results: 60 people died during the ten-year period. The average age of death was 49.1 years. After adjusting for demographic characteristics and the duration of homelessness, the risk factors for mortality were origin (people born in Spain) (HR = 4.34; 95% CI = 1.89-10.0), type 2 diabetes (HR = 2.9; 95% CI = 1.62-5.30), alcohol use disorder (HR = 1.9; 95% CI = 1.12-3.29), and infectious diseases (HR = 1.6; 95% CI = 1.09-2.39). Our results show a high prevalence of infectious and chronic diseases. Type 2 diabetes emerges as an important risk factor in homelessness. The average age of death of individuals experiencing homelessness was significantly lower than the average age of death in the general population (which is greater than 80 years). (4) Conclusions: Foreign-born homeless people were generally younger and healthier than Spanish-born homeless people. Chronic diseases were controlled better in Spanish-born people, but this group showed an increased risk of mortality.

Expert appraisal of criteria for assessing gaming disorder: an international Delphi study.

BACKGROUND AND AIMS: Following the recognition of 'internet gaming disorder' (IGD) as a condition requiring further study by the DSM-5, 'gaming disorder' (GD) was officially included as a diagnostic entity by the World Health Organization (WHO) in the 11th revision of the International Classification of Diseases (ICD-11). However, the proposed diagnostic criteria for gaming disorder remain the subject of debate, and there has been no systematic attempt to integrate the views of different groups of experts. To achieve a more systematic agreement on this new disorder, this study employed the Delphi expert consensus method to obtain expert agreement on the diagnostic validity, clinical utility and prognostic value of the DSM-5 criteria and ICD-11 clinical guidelines for GD. METHODS: A total of 29 international experts with clinical and/or research experience in GD completed three iterative rounds of a Delphi survey. Experts rated proposed criteria in progressive rounds until a pre-determined level of agreement was achieved. RESULTS: For DSM-5 IGD criteria, there was an agreement both that a subset had high diagnostic validity, clinical utility and prognostic value and that some (e.g. tolerance, deception) had low diagnostic validity, clinical utility and prognostic value. Crucially, some DSM-5 criteria (e.g. escapism/mood regulation, tolerance) were regarded as incapable of distinguishing between problematic and non-problematic gaming. In contrast, ICD-11 diagnostic guidelines for GD (except for the criterion relating to diminished non-gaming interests) were judged as presenting high diagnostic validity, clinical utility and prognostic value. CONCLUSIONS: This Delphi survey provides a foundation for identifying the most diagnostically valid and clinically useful criteria for GD. There was expert agreement that some DSM-5 criteria were not clinically relevant and may pathologize non-problematic patterns of gaming, whereas ICD-11 diagnostic guidelines are likely to diagnose GD adequately and avoid pathologizing.

Internet Addiction Test research through a cross-cultural perspective: Spain, USA and Colombia. / La investigación del Internet Addiction Test desde una perspectiva intercultural: España, Estados Unidos y Colombia.

Internet users worldwide often experience problems related to their Internet use, and although culture has an important influence over how people communicate, what they value, and therefore how they use the Internet, little cross-cultural research on the subject of problematic Internet use has been carried out. The Internet Addiction Test (IAT), the most common measurement tool for this purpose, has been used in various countries. In this study we compared and analyzed the cross-cultural results found in the most recent research on the IAT factor analysis. We found that in countries with two or more studies, results are often replicated, suggesting that cultural context influences Internet behaviors. We conducted our own IAT factor analysis studies in three countries - Spain, USA, and Colombia - with a total of 1,273 participants. We compared our results with those from previous studies in the same countries and found similar results. The most notable finding was that all the IAT factor analyses, both ours and the previous ones in the same regions, contained a factor related to loss of control/time management problems and another factor related to emotional/psychological problems, thereby suggesting that impulse control problems and unfulfilled emotional needs are the most important components in the development of problematic Internet use in various countries around the world. Future research on problematic Internet use should focus on these aspects.

Los usuarios de Internet frecuentemente experimentan problemas relacionados con su uso de Internet y, aunque la cultura tiene una influencia importante en la forma en que las personas se comunican, en lo que valoran y, por lo tanto, en cómo utilizan Internet, hay escasas publicaciones sobre investigación intercultural del uso problemático de Internet. La herramienta más común para medir dicho uso, el Internet Addiction Test (IAT) se ha utilizado en varios países. En este estudio comparamos los resultados interculturales de las investigaciones más recientes sobre el análisis factorial del IAT. Encontramos que los resultados a menudo se replican en países con dos o más estudios, lo que sugiere que el contexto cultural influye en los comportamientos en Internet. Llevamos a cabo nuestros propios estudios de análisis factorial del IAT en tres países (España, EE. UU. y Colombia) con 1.273 participantes. Al comparar nuestros resultados con los de estudios anteriores, encontramos que nuestros resultados fueron similares a los de estudios anteriores. El hallazgo más notable fue que todos los análisis factoriales de IAT, tanto los nuestros como los anteriores en las mismas regiones, contenían un factor relacionado con la pérdida de control/problemas de gestión del tiempo y otro factor relacionado con problemas emocionales/psicológicos, lo que sugiere que el control de impulsos y las necesidades emocionales no satisfechas son componentes importantes en el desarrollo del uso problemático de Internet en todo el mundo. La investigación futura sobre el uso problemático de Internet debería centrarse en estos aspectos.

Evaluation of the efficacy of WhatsApp through a harm reduction intervention group for injecting drug users. / Evaluación de la eficacia de WhatsApp en un programa grupal de reducción de daños asociados al consumo inyectado de drogas.

This study aims to analyse the use of an instant messaging app (WhatsApp®) as a means of communication for reaching people who inject drugs. An eight-week prospective longitudinal and observational study with three observations was designed for five addiction centres in Catalonia. The participants were 105 people who inject drugs, distributed in five intervention groups. The results of the Risk Assessment Battery (RAB) were compared in the three levels of analysis pre-test, post intervention and one month after the intervention. The main results indicate a significative reduction in RAB scores after the intervention. The main conclusion was that the WhatsApp® intervention has great potential for developing harm reduction interventions and to reduce the HIV contagion risk.

El presente estudio analiza el uso de una aplicación de mensajería instantánea (WhatsApp®) como canal de acceso a personas que se inyectan drogas. Se diseñó un estudio observacional longitudinal prospectivo de ocho semanas y tres observaciones en cinco centros de adicciones en Cataluña. Participaron 105 personas que consumían drogas por vía parenteral, distribuidas en cinco grupos de intervención grupal. Se compararon los resultados de la escala Risk Assessment Battery (RAB) (después de ser traducida al español y analizada su consistencia interna) en las tres fases de análisis pre test, post intervención y un mes después de la intervención. Los resultados indican una disminución significativa de las puntuaciones RAB tras la intervención a través de WhatsApp®. Se concluye que la intervención grupal a través de WhatsApp presenta grandes potencialidades para realizar intervenciones en reducción de daños y reducir el riesgo de contagio del VIH.

When people who inject drugs speak: Qualitative thematic analysis of the perception of a mobile app for needle exchange programs. / Cuando las personas que consumen drogas inyectadas tienen la palabra: Análisis cualitativo de contenido temático sobre la percepción de uso de una aplicación móvil para los programas de intercambio de jeringas.

Spain is the Western European country with the highest prevalence of Human Immunodeficiency Virus among people who inject drugs. The Hepatitis-C Virus affects over fifty per cent of this population. At the same time, the World Health Organization considers that the average coverage of injection material for drug user per year is low. Harm reduction programs and services have been deployed for over thirty years, and these could now incorporate the advantages of eHealth and mHealth to improve harm reduction. The aim of this qualitative and descriptive study is to analyze how people who inject drugs perceive an application for mobile devices. Fifty-one such drug users participated actively in five focus groups. The main results of the thematic content analysis indicated that the application was welcomed as easy and useful. Participants reported that the application contributed to improving access to injection material, reducing the stigma of drug-dependence and optimizing the organization of the ritual of injection. Excessive preventive information and problems downloading the web app were identified as aspects for improvement. In conclusion, the application was seen as a useful eHealth tool that complements the normal intervention of needle exchange programs.

España es el país de Europa Occidental con más prevalencia del Virus de la Inmunodeficiencia Humana entre personas que se inyectan drogas. La presencia de Virus de la Hepatitis-C supera el cincuenta por ciento en esta población. Al mismo tiempo, la Organización Mundial de la Salud considera que la cobertura media de material de inyección por usuario y año es baja. Con más de treinta años de experiencia en el despliegue de los servicios y programas de reducción de daños, las ventajas que posibilita la eSalud y la mSalud como la accesibilidad y asequibilidad, pueden incorporarse también a la reducción de daños. El objetivo de este estudio fue analizar la percepción que las personas que consumen drogas inyectadas tienen sobre una aplicación móvil para mejorar el acceso a material de inyección. Partiendo de un enfoque cualitativo se recogió información a través de cinco grupos focales en los que participaron 51 personas consumidoras de drogas inyectadas en activo. Se llevó a cabo un análisis de contenido temático cuyos principales resultados indicaron que la aplicación tuvo una buena aceptación y se consideró sencilla y útil. Los participantes refirieron que la aplicación contribuía a mejorar el acceso a material de inyección, a reducir el estigma de los drogodependientes, y a optimizar la planificación del usuario para adquirir la jeringa en el proceso ritual del consumo. Como puntos a mejorar, destacaron reducir el exceso de información preventiva y simplificar la ruta de descarga de la webapp. En conclusión, la aplicación se posiciona como una herramienta útil para complementar la intervención ordinaria de los programas de intercambio de jeringas.

La investigación del Internet Addiction Test desde una perspectiva intercultural: España, Estados Unidos y Colombia / Internet Addiction Test research through a cross-cultural perspective: Spain, USA and Colombia

Los usuarios de Internet frecuentemente experimentan problemasrelacionados con su uso de Internet y, aunque la cultura tiene unainfluencia importante en la forma en que las personas se comunican,en lo que valoran y, por lo tanto, en cómo utilizan Internet, hay escasaspublicaciones sobre investigación intercultural del uso problemáticode Internet. La herramienta más común para medir dicho uso, el Internet Addiction Test (IAT) se ha utilizado en varios países. En este estudio comparamos los resultados interculturales de las investigacionesmás recientes sobre el análisis factorial del IAT. Encontramos que losresultados a menudo se replican en países con dos o más estudios, loque sugiere que el contexto cultural influye en los comportamientosen Internet. Llevamos a cabo nuestros propios estudios de análisis factorial del IAT en tres países (España, EE. UU. y Colombia) con 1.273participantes. Al comparar nuestros resultados con los de estudios anteriores, encontramos que nuestros resultados fueron similares a los deestudios anteriores. El hallazgo más notable fue que todos los análisisfactoriales de IAT, tanto los nuestros como los anteriores en las mismasregiones, contenían un factor relacionado con la pérdida de control/problemas de gestión del tiempo y otro factor relacionado con problemas emocionales/psicológicos, lo que sugiere que el control de impulsos y las necesidades emocionales no satisfechas son componentesimportantes en el desarrollo del uso problemático de Internet en todoel mundo. La investigación futura sobre el uso problemático de Internet debería centrarse en estos aspectos. (AU)

Internet users worldwide often experience problems related totheir Internet use, and although culture has an important influenceover how people communicate, what they value, and therefore howthey use the Internet, little cross-cultural research on the subject ofproblematic Internet use has been carried out. The Internet Addiction Test (IAT), the most common measurement tool for this purpose,has been used in various countries. In this study we compared andanalyzed the cross-cultural results found in the most recent researchon the IAT factor analysis. We found that in countries with two ormore studies, results are often replicated, suggesting that cultural context influences Internet behaviors. We conducted our own IAT factoranalysis studies in three countries – Spain, USA, and Colombia – witha total of 1,273 participants. We compared our results with those fromprevious studies in the same countries and found similar results. Themost notable finding was that all the IAT factor analyses, both oursand the previous ones in the same regions, contained a factor relatedto loss of control/time management problems and another factor related to emotional/psychological problems, thereby suggesting thatimpulse control problems and unfulfilled emotional needs are themost important components in the development of problematic Internet use in various countries around the world. Future research onproblematic Internet use should focus on these aspects. (AU)

Evaluación de la eficacia de WhatsApp en un programa grupal de reducción de daños asociados al consumo inyectado de drogas / Evaluation of the efficacy of WhatsApp through a harm reduction intervention group for injecting drug users

El presente estudio analiza el uso de una aplicación de mensajeríainstantánea (WhatsApp®) como canal de acceso a personas que seinyectan drogas. Se diseñó un estudio observacional longitudinalprospectivo de ocho semanas y tres observaciones en cinco centrosde adicciones en Cataluña. Participaron 105 personas que consumían drogas por vía parenteral, distribuidas en cinco grupos de intervención grupal. Se compararon los resultados de la escala RiskAssessment Battery (RAB) (después de ser traducida al español y analizada su consistencia interna) en las tres fases de análisis pre test,post intervención y un mes después de la intervención. Los resultadosindican una disminución significativa de las puntuaciones RAB tras laintervención a través de WhatsApp®. Se concluye que la intervencióngrupal a través de WhatsApp presenta grandes potencialidades pararealizar intervenciones en reducción de daños y reducir el riesgo decontagio del VIH. (AU)

This study aims to analyse the use of an instant messaging app(WhatsApp®) as a means of communication for reaching peoplewho inject drugs. An eight-week prospective longitudinal and observational study with three observations was designed for five addictioncentres in Catalonia. The participants were 105 people who injectdrugs, distributed in five intervention groups. The results of the RiskAssessment Battery (RAB) were compared in the three levels of analysis pre-test, post intervention and one month after the intervention.The main results indicate a significative reduction in RAB scores afterthe intervention. The main conclusion was that the WhatsApp® intervention has great potential for developing harm reduction interventions and to reduce the HIV contagion risk. (AU)

Cuando las personas que consumen drogas inyectadas tienen la palabra: Análisis cualitativo de contenidotemático sobre la percepción de uso de una aplicación móvil para los programas de intercambio de jeringas / When people who inject drugs speak: Qualitative thematic analysis of the perception of a mobile app for needle exchange programs

España es el país de Europa Occidental con más prevalencia del Virusde la Inmunodeficiencia Humana entre personas que se inyectan drogas. La presencia de Virus de la Hepatitis-C supera el cincuenta porciento en esta población. Al mismo tiempo, la Organización Mundialde la Salud considera que la cobertura media de material de inyecciónpor usuario y año es baja. Con más de treinta años de experiencia enel despliegue de los servicios y programas de reducción de daños, lasventajas que posibilita la eSalud y la mSalud como la accesibilidad yasequibilidad, pueden incorporarse también a la reducción de daños.El objetivo de este estudio fue analizar la percepción que las personasque consumen drogas inyectadas tienen sobre una aplicación móvilpara mejorar el acceso a material de inyección. Partiendo de un enfoque cualitativo se recogió información a través de cinco grupos focalesen los que participaron 51 personas consumidoras de drogas inyectadas en activo. Se llevó a cabo un análisis de contenido temático cuyos principales resultados indicaron que la aplicación tuvo una buenaaceptación y se consideró sencilla y útil. Los participantes refirieronque la aplicación contribuía a mejorar el acceso a material de inyección, a reducir el estigma de los drogodependientes, y a optimizar laplanificación del usuario para adquirir la jeringa en el proceso ritualdel consumo. Como puntos a mejorar, destacaron reducir el excesode información preventiva y simplificar la ruta de descarga de la webapp. En conclusión, la aplicación se posiciona como una herramienta útil para complementar la intervención ordinaria de los programasde intercambio de jeringas. (AU)

Spain is the Western European country with the highest prevalenceof Human Immunodeficiency Virus among people who inject drugs.The Hepatitis-C Virus affects over fifty per cent of this population. Atthe same time, the World Health Organization considers that the average coverage of injection material for drug user per year is low. Harmreduction programs and services have been deployed for over thirtyyears, and these could now incorporate the advantages of eHealth andmHealth to improve harm reduction. The aim of this qualitative anddescriptive study is to analyze how people who inject drugs perceive anapplication for mobile devices. Fifty-one such drug users participatedactively in five focus groups. The main results of the thematic content analysis indicated that the application was welcomed as easy anduseful. Participants reported that the application contributed to improving access to injection material, reducing the stigma of drug-dependence and optimizing the organization of the ritual of injection.Excessive preventive information and problems downloading the webapp were identified as aspects for improvement. In conclusion, theapplication was seen as a useful eHealth tool that complements thenormal intervention of needle exchange programs. (AU)

Developing and Testing the Populi Needle Exchange Point Finder: An App to Reduce Harm Associated With Intravenous Drug Consumption Among Homeless and Non-homeless Drug Users.

The spread of viral infections remains a serious public health problem. People who inject drugs represent one of the highest-risk groups. eHealth and mHealth have been shown to be effective in improving individuals' management of their own health and their access to health care and to contribute to reducing the costs associated with certain medical interventions. People who inject drugs, including homeless people, tend to have access to technology. Young homeless people in particular are likely to use smartphones and social networking sites in ways that are similar to the general population. Despite this widespread use of technology, there are no apps designed specifically to reduce harm in people who inject drugs. The objective of this study is to analyze the development and usability testing process for an application for mobile devices, designed to complement the Needle Exchange Program. This app-the first of its kind-was developed by a public health agency, specialized professionals and people who inject drugs. We analyzed the differences in how health providers and drug users experienced the usability of the app. The participants were 61 members of multidisciplinary professional group and 16 people who inject drugs. We used a cross-sectional quantitative, observational design. First, we created and administered a questionnaire to collect the sociodemographic characteristics that could mediate the use of technology. Next participants tried the app and filled out a second questionnaire in which they rated their experience on a Likert scale from 1 to 7 in the following dimensions: overall attractiveness of the app, ease/difficulty of use, the extent to which they believed the app could improve access to injection materials, the extent to which they thought it would improve PWID's participation in the needle exchange program, overall utility, the degree to which they thought PWID would use the app, and the need for the app. To analyze the answers, we used contingency tables and compared means using a Student's t test. Finally, we conducted six audio-recorded focus groups about how the participants experienced the usability of the app. The objective of this part of the study was to classify and quantify the contributions of individuals and the group according to three predefined categories: potential benefits and positive aspects, potential obstacles or difficulties in carrying out the project, and concrete suggestions for improving the interface. There were not significant differences between the sociodemographic variables and the variables related to use of the app between professionals and PWID. Both professionals and PWID rated the app as intuitive and useful, especially the geolocation function for NEPs. Both groups also thought that the interface contained too much information and that this excess could be confusing for users. Both groups also had similar opinions about the app and its uses. An important difference between the two groups is that PWID reported that they would use the app, while professionals reported that they didn't think PWID would use it. All participants proposed improvements on the prototype, suggestions that will be applied in the creation of the definitive interface. Including professionals and patients in this sort of usability test enables researchers and developers to detect the needs of potential app users.

El diagnóstico de adicción a videojuegos en el DSM-5 y la CIE-11: Retos y oportunidades para clínicos / The diagnosis of video game addiction in the DSM-5 and the ICD-11: Challenges and opportunities for clinicians

El trastorno de juego por internet (conocida como adicción a videojuegos) se caracteriza por un patrón de comportamiento de juego persistente y recurrente que conlleva un deterioro o malestar clínicamente significativo por un periodo de 12 meses. El objetivo del presente análisis del estado de la cuestión es comentar los retos y oportunidades del DSM-5 y la CIE-11 para su diagnóstico dada su actualidad y su rápida evolución. Para ello se revisan las posibles adicciones tecnológicas que no están incluidas en el DSM-5, sus ventajas y retos y oportunidades y se comentan algunos de ellos: gravedad de los síntomas y del trastorno, el riesgo de patologizar la vida cotidiana, edad de la población afectada, los juegos freemium y los pay-to-play, los e-Sports y la cartera de servicios de salud

Internet gaming disorder (IGD) (formerly known as video game addiction) is characterized by a pattern of persistent and recurring video game behavior leading to clinically significant impairment or distress for a period of 12 months. The objective of the following state-of-the-art analysis is to comment on the challenges and opportunities of the DSM-5 and ICD-11 regarding the diagnosis of IGD that is still being developed. With this purpose in mind, possible technological addictions that are not included in the DSM-5 are reviewed and some of their advantages, challenges, and opportunities are commented on, including severity of effects, age of the most affected population, freemium vs. pay-to-play games, the risk of pathologizing daily life, e-Sports, and the health services portfolio

Individuals experiencing chronic homelessness: A 10-year follow-up of a cohort in Spain.

With the start of the great economic recession in 2007, homelessness increased fivefold in some regions of southern Europe. Larger numbers of people experiencing homelessness, compounded by a lowered capacity for social and health services to respond to their needs, precipitated an increase in so-called 'chronic homelessness'. The aim of this study was to establish the presence of chronic homelessness in a defined geographical area of Spain, and to determine the prevalence of diagnosed mental disorders within both the chronic and non-chronic homeless population. A prospective and descriptive study was designed to monitor a cohort of 826 individuals experiencing homelessness who constituted the entire identified homeless population in the relevant territory in 2006. This sample was followed until 2016 and sociodemographic as well as clinical information was collected, including the time spent homeless. The results obtained indicated that one in 10 participants met the criteria for chronic homelessness, a rate that is lower than in the US, where the definition of chronicity that was applied originates from. Alcohol use disorder was the most common mental health disorder that contributed to the chronicity associated with homelessness. Being born in the country (Spain) where the study was conducted and being older were the main other variables associated with chronicity. People defined as chronically homeless in Spain were on average younger than in the US, but women were present in the chronic subgroup at a similar rate. We also reflect on the limitations of the study and in particular the appropriateness of the concept of chronicity as applied to homelessness.

Spanish Validation of the Internet Gaming Disorder Scale-Short Form (IGDS9-SF): Prevalence and Relationship with Online Gambling and Quality of Life.

Online gaming is a very common form of leisure among adolescents and young people, although its excessive and/or compulsive use is associated with psychological impairments in a minority of gamers. The latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, Section III) tentatively introduced Internet Gaming Disorder (IGD). Since then, a number of evaluation tools using the DSM-5 criteria have been developed, including the Internet Gaming Disorder Scale-Short Form (IGDS9-SF). The main objective of this study was to translate and adapt the IGDS9-SF into Spanish, as well as to obtain indicators relating to its validity and reliability. The Spanish version of four scales were administered: IGDS9-SF, Mobile Phone-Related Experiences Questionnaire (CERM), Online Gambling Disorder Questionnaire (OGD-Q), and KIDSCREEN-27. The sample comprised 535 Vocational Training students (mean age 18.35 years; SD±2.13; 78.5% males) who reported playing video games in the past 12 months. Confirmatory factor analysis yielded a one-dimensional model with a good fit while the reliability indicators were satisfactory. Findings indicated that 1.9% of gamers were classified with IGD (meeting five or more criteria for more than 12 months). Additionally, another 1.9% were considered gamers 'at-risk' because they endorsed four criteria. Positive and significant relationships were found between the IGDS9-SF, the CERM, and the OGD-Q. Participants classified with IGD had poorer health-related quality of life. In conclusion, the Spanish IGDS9-SF is a valid and reliable instrument to assess IGD according to the DSM-5.

¿Qué motiva a las personas con alcoholismo a seguir en Alcohólicos Anónimos? / What motivates alcoholics to remain inAlcoholics Anonymous?

El grupo de autoayuda para alcohólicos más extendido en todo el mundo es Alcohólicos Anónimos (AA). Por esta razón, se decidió estudiar los motivos de los alcohólicos para seguir acudiendo a las reuniones de esta comunidad. Así pues, se realizó un estudio cualitativo exploratorio con cuatro personas con más de diez años de abstinencia que forman parte de un grupo de AA de Cataluña, a partir de grabar, transcribir y analizar una entrevista semiestructurada. Los resultados indican que todos los motivos de los participantes para seguir acudiendo a las reuniones de la comunidad son: miedo a recaer, para ayudar, para seguir creciendo y por la relación con el grupo

The most widespread group of self-help for alcoholics in the world is Alcoholics Anonymous (AA). For this reason, it was decided to study the motives of alcoholics to continue attending the meetings of this community. Thus, a qualitative exploratory study was conducted with four people with more than ten years of abstinence who are part of an AA group in Catalonia, by recording, transcribing and analyzing a semi-structured interview. The results indicate that all participants agreed that the reasons to continue attending community meetings are: fear of relapse, to help, to continue growing and because of the relationship with the group