Association between maltreatment and polydrug use among adolescents.

Different studies have related sexual and physical abuse during childhood and adolescence to the development of substance abuse disorders. Nevertheless, we are not aware of the role that other more common maltreatment types, such as neglect, will play among the most risky pattern of consumption: the polydrug use. A clinical sample of 655 adolescents, divided into two groups: polydrug users and non-polydrug users, were assessed on their pattern of drug consumption, history of childhood maltreatment, current psychopathology and their family history of alcoholism. Polydrug users had a greater prevalence of all types of maltreatment, although the most associated to this group were sexual abuse and emotional neglect. Other relevant variables to adolescent consumption were: the diagnosis of depressive disorder, the presence of anxiety traits and the family history of alcohol dependence. Polydrug users have higher risks of having had problems during infancy and adolescence, such as maltreatment and other psychopathological conditions, with the addition of family history of alcoholism. Accordingly, practitioners should take into account that those variables may influence polydrug abuse because it is the most risky pattern for subsequent dependence of substances, and they should always be considered during treatment.

The MCCB impairment profile in a Spanish sample of patients with schizophrenia: Effects of diagnosis, age, and gender on cognitive functioning.

The MATRICS Consensus Cognitive Battery (MCCB) was administered to 293 schizophrenia outpatients and 210 community residents in Spain. Our first objective was to identify the age- and gender-corrected MCCB cognitive profile of patients with schizophrenia. The profile of schizophrenia patients showed deficits when compared to controls across the seven MCCB domains. Reasoning and Problem Solving and Social Cognition were the least impaired, while Visual Learning and Verbal Learning showed the greatest deficits. Our second objective was to study the effects on cognitive functioning of age and gender, in addition to diagnosis. Diagnosis was found to have the greatest effect on cognition (Cohen's d>0.8 for all MCCB domains); age and gender also had effects on cognitive functioning, although to a lesser degree (with age usually having slightly larger effects than gender). The effects of age were apparent in all domains (with better performance in younger subjects), except for Social Cognition. Gender had effects on Attention/Vigilance, Working Memory, Reasoning and Problem Solving (better performance in males), and Social Cognition (better performance in females). No interaction effects were found between diagnosis and age, or between diagnosis and gender. This lack of interactions suggests that age and gender effects are not different in patients and controls.

Differential relationships between set-shifting abilities and dimensions of insight in schizophrenia.

BACKGROUND: To assess insight in a large sample of patients with schizophrenia and to study its relationship with set shifting as an executive function. METHODS: The insight of a sample of 161 clinically stable, community-dwelling patients with schizophrenia was evaluated by means of the Scale to Assess Unawareness of Mental Disorder (SUMD). Set shifting was measured using the Trail-Making Test time required to complete part B minus the time required to complete part A (TMT B-A). Linear regression analyses were performed to investigate the relationships of TMT B-A with different dimensions of general insight. RESULTS: Regression analyses revealed a significant association between TMT B-A and two of the SUMD general components: 'awareness of mental disorder' and 'awareness of the efficacy of treatment'. The 'awareness of social consequences' component was not significantly associated with set shifting. CONCLUSIONS: Our results show a significant relation between set shifting and insight, but not in the same manner for the different components of the SUMD general score.

The MATRICS consensus cognitive battery (MCCB): co-norming and standardization in Spain.

The MATRICS Consensus Cognitive Battery (MCCB), developed by the National Institute of Mental Health (NIMH) Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative, has been recommended as the standard battery for clinical trials of cognition-enhancing interventions for schizophrenia. Normative data for the MCCB has been previously obtained in the U.S. Extrapolation of these normative data to different countries may be problematic due to the translation of the different tests, as well as potential cultural influences. We present the process of obtaining normative data for the MCCB in Spain with administration of the battery to a general community standardization sample. In addition, we examine the influence of age, gender, and educational level on test performance. The MCCB was administered to a total sample of 210 healthy volunteers, at three Spanish sites. For each site, recruitment of the sample was stratified according to age, gender, and educational level. Our findings indicate significant age, gender, and education effects on the normative data for the MCCB in Spain, which are comparable to those effects described for the original standardized English version in the U.S. The fact that the normative data are comparable, and that the variables age, gender, and education have a similar influence on performance, supports the robustness of the MCCB for use in different countries.

High frequency of childhood ADHD history in women with fibromyalgia.

Fibromyalgia and ADHD share some clinical features, and a reduced dopamine function has been proposed for both disorders. Here we found, in a large sample of fibromyalgia female patients, a higher frequency of childhood ADHD antecedent when compared with healthy women. Our data suggest that Fibromyalgia and ADHD have some common etiopathological mechanism.

The ANKK1 protein associated with addictions has nuclear and cytoplasmic localization and shows a differential response of Ala239Thr to apomorphine.

The TaqIA single-nucleotide polymorphism (SNP), which is the most widely studied genetic polymorphism in addictions, is located at the gene that encodes the RIP kinase ANKK1 near the gene for dopamine receptor D2. The TaqIA SNP is in strong linkage disequilibrium with the SNP rs7118900, which changes the alanine at position 239 to threonine in the ANKK1 protein (Ala239/A2; Thr239/A1). In silico analysis has predicted that this polymorphic substitution creates an additional phosphorylation site in the kinase domain of ANKK1. To investigate the contribution of ANKK1 to the pathophysiology of TaqIA-associated phenotypes, we analyzed transfected HEK293T cells with the human ANKK1-kinase(Ala239) and ANKK1-kinase(Thr239) variants tagged with GFP. We observed that the ANKK1-kinase is located in both the nucleus and the cytoplasm, suggesting that there is nucleocytoplasmic shuttling of this putative signal transducer. In addition, we found that the Ala239Thr ANKK1-kinase polymorphism exhibited strong expression differences in both the nucleus and the cytoplasm at basal level and when stimulated with the dopamine agonist apomorphine. Specifically, the ANKK1-kinase(Thr239) variant showed the highest level of basal protein expression, while ANKK1-kinase(Ala239) was 0.64-fold lower. After treatment with apomorphine, ANKK1-kinase(Ala239) showed a 2.4-fold increment in protein levels, whereas a 0.67-fold reduction was observed in ANKK1-kinase(Thr239). Thus, here we provide the first evidence of functional ANKK1 differences that are marked by TaqIA and could be associated with vulnerability to addiction.

Zonisamide versus diazepam in the treatment of alcohol withdrawal syndrome.

INTRODUCTION: Anticonvulsant drugs have been used in the treatment of alcohol detoxification. The purpose of the present study was to evaluate the efficacy and safety of zonisamide in a sample of patients presenting alcohol withdrawal syndrome. METHOD: In this 3-week, randomized, flexible-dose trial, 40 inpatients with alcohol dependence disorder received zonisamide or diazepam for detoxification. Zonisamide was started at a dose of 400-600 mg/day (week 1), tapering to a minimum dose of 100-300 mg/day (week 3). Diazepam was administered using a similar regimen (from 130-50 mg/day tapering to 5-15 mg/day). Subjects were treated initially (weeks 1 and 2) in an inpatient unit and for the final week in an outpatient facility. During the inpatient period, the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) was used to assess the efficacy of each substance. During the outpatient period the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar), Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and a craving scale were used. RESULTS: All subjects completed the study. During the inpatient period both drugs reduced alcohol withdrawal symptoms, but the decrease was more marked in the zonisamide group. At the end of the study (week 3) participants treated with zonisamide showed lower CIWA-Ar scores than subjects receiving diazepam. Also, individuals in the zonisamide group had less craving for alcohol, less anxiety, and less daytime sedation compared with participants treated with diazepam. CONCLUSION: Zonisamide can be a valuable alternative to benzodiazepines in the prevention of alcohol withdrawal syndrome.

The D2 dopamine receptor gene variant C957T affects human fear conditioning and aversive priming.

Polymorphisms of DRD2 and ANKK1 have been associated with psychiatric syndromes where there is believed to be an underlying learning process deficit such as addiction, post-traumatic stress disorder and psychopathy. We investigated the effects of the DRD2 C957T and ANKK1 TaqIA single nucleotide polymorphism (SNP), which have been associated with psychopathic traits in alcoholic patients, on fear conditioning and aversive priming in healthy volunteers. We found that the DRD2 C957T SNP, but not the ANKK1 TaqIA SNP, was associated with both differential conditioning of the skin conductance response and the aversive priming effect. There were no differences between the genotype groups with respect to the extinction of the skin-conductance conditioned response. These results suggest that the C957T SNP could be related to learning differences associated with the risk of developing psychiatric disorders in individuals that are carriers of the C homozygous genotype. Our genetic data raise the possibility that the dopaminergic system functional variations determined by this SNP could affect fear learning.

P300 in alcohol dependence: Effectsof TaqI-A genotype

Background and Objectives: TaqI-A polymorphism, related to D2dopamine receptor (DRD2), and event-related P300 potentials have been consideredmarkers of alcohol dependence. The effect of alcohol use variables and TaqI-A on P300 ina single sample have been hardly analysed previously. This study examined changes inP300 parameters after six months of abstinence in alcohol-dependent subjects classifiedby their TaqI-A genotype.Methods: 102 men with alcohol dependence were studied at baseline and at 6 monthsof continued abstinence. P300 was recorded using an auditory paradigm. TaqI-A polymorphismwas genotyped: 34.3% of sample was classified as A1[TaqI-A1/TaqI-A1andTaqI-A1/TaqI-A2] and 65.7% as A2 [TaqI-A2/TaqI-A2]. The association between P300and TaqI-A and the correlation with age and alcohol consumption were considered.Results: The abstinence period was not associated to differences in neither P300 latency(F[1, 99] = 1.154 p = 0.285) nor amplitude (F[1, 99] = 1.453, p = 0.231). A1 subgroup was relatedto a longer latency (F[1, 99] = 5.055 p = 0.027), an early abuse age onset (F[1, 100] =14.552 p < 0.001) and close to be significant to an early dependence age onset (F[1, 100] =3.868 p = 0.052). Other drinking pattern variables were not associated to p300 measures. Familyhistory for alcoholism and TaqI-A were not related (X[1] = 0.327 p = 0.568) and no associationwas found with p300 measures. Current age correlated positively with P300 latency (F[1,99] = 26.082, p < 0,001) and negatively with amplitude (F[1, 99] = 5.297 p = 0.023). P300 amplitudewas not influenced by alcohol use variables nor TaqI-A polymorphism.Conclusions: P300 latency could be a biological marker of vulnerability to alcohol dependencerelated to TaqI-A1 polymorphism, irrespective of alcohol use variables (AU)

Trastorno bipolar asociado al uso de sustancias adictivas (patología dual). Revisión sistemática de la evidencia científica y consenso entre profesionales expertos / Bipolar disorder associated to substance use disorders (dual diagnosis). Systematic review of the scientific evidence and expert consensus

El presente trabajo está focalizado en la llamada patología dual (PD): trastorno bipolar (TB) asociado a un trastorno por uso de sustancias (TUS). A pesar de que tanto los psiquiatras que tratan a pacientes con TB como los médicos que tratan a los pacientes con TUS encuentran frecuentemente esta asociación, lamentablemente las publicaciones que exploran la PD son escasas. El Grupo Español de Trabajo en Patología Dual en Trastorno Bipolar realizó una revisión del material publicado mediante una búsqueda bibliográfica en Medline y seleccionó los artículos relevantes publicados hasta el momento; a continuación se llevó a cabo un consenso de expertos y finalmente se realizó una encuesta a expertos en PD para responder a las áreas que no estaban suficientemente cubiertas por la evidencia científica o en las cuales no se llegó a un consenso dentro del grupo de trabajo. Se concluye que en las actuales circunstancias el establecimiento de un consenso constituye una herramienta muy útil para complementarla evidencia científica existente (AU)

The present work focuses on the so-called dual diagnosis (DD): bipolar disorder (BD) associated with substance use disorders (SUD). Although the psychiatrists who treat patients with BD and physicians in charge of patients with SUD frequently find this association with DD, unfortunately there are few scientific works that have studied this association. The Spanish Working Groupon Bipolar Disorders in Dual Diagnosis reviewed the published material using a Medline search and selected the most relevant articles. Following this, the Work Group developed an expert consensus in DD and finally, a survey was performed among a group of experts in this disorder to cover the areas that were not fully addressed by the scientific evidence or in those areas in which the Work Group was unable to reach a consensus. We conclude that, in view of the above, establishment of a consensus is a valid tool to complement the current scientific evidence (AU)

Bipolar disorder associated to substance use disorders (dual diagnosis). Systematic review of the scientific evidence and expert consensus.

The present work focuses on the so-called dual diagnosis (DD): bipolar disorder (BD) associated with substance use disorders (SUD). Although the psychiatrists who treat patients with BD and physicians in charge of patients with SUD frequently find this association with DD, unfortunately there are few scientific works that have studied this association. The Spanish Working Group on Bipolar Disorders in Dual Diagnosis reviewed the published material using a Medline search and selected the most relevant articles. Following this, the Work Group developed an expert consensus in DD and finally, a survey was performed among a group of experts in this disorder to cover the areas that were not fully addressed by the scientific evidence or in those areas in which the Work Group was unable to reach a consensus. We conclude that, in view of the above, establishment of a consensus is a valid tool to complement the current scientific evidence.

DRD2 and ANKK1 genotype in alcohol-dependent patients with psychopathic traits: association and interaction study.

BACKGROUND: The TaqI-A polymorphism of the ANKK1 gene, adjacent to the DRD2 gene, has been associated with alcoholism and other psychiatric conditions, although other DRD2 gene variants, such as the C957T polymorphism, could be related to these phenotypic traits. AIMS: To investigate the contribution of the TaqI-A and the C957T polymorphisms to the presence of psychopathic traits in patients with alcoholism. METHOD: We performed association and interaction analyses of the polymorphisms in 150 controls and 176 male alcohol-dependent patients assessed for the presence of dissocial personal disorder, using the Psychopathy Checklist-Revised (PCL-R). RESULTS: There was a significant association of the TaqI-A and C957T polymorphisms when both genotypes were present, with PCL-R scores of F(1-171=0.13) (P=0.01) and a frequency of dissocial personal disorder OR=10.52, P<0.001. CONCLUSIONS: The TaqI-A of the ANKK1 gene and the C957T of the DRD2 gene are epistatically associated with psychopathic traits in alcohol-dependent patients.

Estudio preliminar dirigido a la construcción de un cuestionario de derivación de la atención primaria a los servicios de salud mental / Preliminary study aimed at the construction of a questionnaire for referral from primary care to mental health services

La alta prevalencia de morbilidad psiquiátrica en atención primaria, la mayor percepción de necesidad de ayuda de los casos más leves y que las derivaciones sean poco discriminadas, incrementa la presión asistencial en los servicios de salud mental. Todo ello hace necesario disponer de instrumentos que mejoren el reconocimiento de los casos más graves y que ayuden en la toma de decisión de la derivación. Con esta finalidad hemos elaborado una escala con criterios de derivación a salud mental (CDSM) que es multidimensional y hetero aplicada. En este trabajo se muestran los resultados preliminares de su aplicación por un grupo de médicos de atención primaria en un estudio piloto realizado sobre una muestra de 198 pacientes. Los datos obtenidos confirman la existencia de un alto porcentaje de posibles casos psiquiátricos (46,9%) y detecta un 4% de casos susceptibles de derivación. Los resultados también ponen de manifiesto una baja capacidad de detección de dicha patología por parte de los médicos de atención primaria. La CDSM presenta una moderada asociación con el General Health Questionnaire (GHQ) y con el reconocimiento de psicopatología por el médico de atención primaria. Otros factores diferentes de la gravedad clínica evaluada por el CDSM, posiblemente pertenecientes a la relación médico-paciente y que convendría estudiar, parecen estar influyendo en la decisión de derivación a salud mental. En un trabajo ulterior se publicará la validación de la escala para nuestro entorno asistencial (AU)

The high prevalence of psychiatric morbidity in primary care, the growing perception of the need for specialized help by the least severe patients and the lack of accuracy in referrals, contribute to the increasing overload in mental health services. So it seems necessary to design diagnostic tools in order to improve the detection of more severe patients and to help in the referral decision. With this purpose in mind, we have designed the multidimensional hetero-administrated Scale Referral Criteria for Mental Health (CRMH). This paper presents the preliminary results of a pilot study on its application in a sample of 198 patients by a group of Primary Care Physicians (PCP). The data show the detection of a high percentage of potential psychiatric patients (46.9%) and 4% of patients who having the possibility of being referred. The results also illustrate the low ability of PCP to detect these disorders. CRMH has a moderate correlation with the General Health Questionnaire (GHQ) and with detection of psychopathology by PCP. Other factors, apart from clinical severity evaluated through CRMH, possibly belonging to doctor-patient relationship, which should be analyzed, seem to influence the mental health referral. Ina future article, we will present the validation of this scale in our care setting (AU)

Psychopathology and Wisconsin Card Sorting Test performance in male schizophrenic patients: influence of dual diagnosis.

BACKGROUND: Different neuropsychological studies have shown schizophrenic patients to have executive function deficits, as illustrated by their performance in neuropsychological tasks such as the Wisconsin Card Sorting Test (WCST); certain studies have described a relationship between these deficits and negative symptoms. Schizophrenic patients also exhibit a high lifetime prevalence (40-50%) of comorbid substance use disorders (SUDs). However, little attention has been paid to this comorbidity (dual diagnosis) in studies associating executive functions and negative symptoms. SAMPLING AND METHODS: Our objective is to investigate the relationship between performance in the WCST and psychopathology as measured by the Positive and Negative Syndrome Scale (PANSS) in a sample of 65 male schizophrenic patients with a history of SUDs (Sch SUD+) and in a sample of 48 male schizophrenic patients without such history (Sch SUD-). RESULTS: In the Sch SUD- group, patients who completed 4 or more categories in the WCST ('good performers') obtained a mean score of 21.2 +/- 8.8 on the negative subscale of the PANSS, compared with a mean score of 27.8 +/- 8.6 in those who completed 3 or less ('poor performers'); these differences were statistically significant (p = 0.015). In the Sch SUD+ group, however, no association was found between WCST performance and the PANSS negative subscale score. CONCLUSIONS: The presence of a history of comorbid SUDs should be taken into consideration in studies investigating executive functions and negative symptoms in schizophrenia.

Utilización de antidepresivos inhibidores selectivos de la recaptación de serotonina en niños y adolescentes con depresión mayor / Selective serotonin reuptake inhibitors: use in children and adolescents with major depressive disorder

El tratamiento de la depresión en niños y adolescentes es una cuestión sanitaria de primer orden y actualmente asociada a elevada alarma social. En los últimos años han aparecido estudios que ponen en cuestión el uso de los antidepresivos en estas poblaciones del modo en que se ha estado realizando. En este trabajo analizamos la información proporcionada por los organismos oficiales y por las principales revisiones publicadas sobre el tema. Los resultados muestran un aumento del riesgo de desinhibición conductual, irritabilidad, conductas agresivas, autolesiones e incremento de ideación suicida con el uso de los antidepresivos en niños y jóvenes. Se puede añadir que no se han registrado suicidios consumados. Hasta el momento actual sólo disponemos de pruebas de eficacia antidepresiva en el caso de fluoxetina para depresiones moderadas-graves en niños y adolescentes y para los antidepresivos tricíclicos en los adolescentes. Las importantes dificultades metodológicas y la escasez de estudios sólo permiten considerar los resultados como exploratorios y es difícil extraer conclusiones clínicas definitivas, pero son útiles para guiar la investigación futura

Treatment of depression in children and adolescents is a health care question of primary importance and it is presently associated to significant social concern. In recent years some studies have appeared that throw light on the question of the use of antidepressants in these sectors of the population in which they have been used. Information provided by national agencies, associations of health professional’s guidelines and other publications have been reviewed. The results show an increase in aggressive and desinhibitional behavior, irritability, self-injuries and an increase in suicidal motivation with the use of antidepressants in children and adolescents. It can be added that no completed suicides have been recorded. Proof of antidepressant effectiveness only appears in the case of fluoxetine for moderate to severe depressions in children and adolescents and for tricyclic antidepressants in adolescents. The important methodological difficulties and the lack of studies only allow to consider the results as exploratory and it is hard to obtain definitive clinical results, however, they are useful to guide future investigation

Selective serotonin reuptake inhibitors: use in children and adolescents with major depressive disorder.

Treatment od depression in children and adolescents is a health care question of primary importance and it is presently associated to significant social concern. In recent years some studies have appeared that throw light on the question of the use of antidepressants in these sectors of the population in which they have been used. Information provided by national agencies, associations of health professional's guidelines and other publications have been reviewed. The results show an increase in aggressive and disinhibitional behavior, irritability, self-injuries and an increase in suicidal motivation with the use of antidepressants in children and adolescents. It can be added that no completed suicides have been recorded. Proof of antidepressant effectiveness only appears in the case of fluoxetine for moderate to severe depressions in children and adolescents and for tricyclic antidepressants in adolescents. The important methodological difficulties and the lack of studies only allow to consider the results as exploratory and it is hard to obtain definitive clinical results, however, they are useful to guide future investigation.

Diagnostic stability and evolution of bipolar disorder in clinical practice: a prospective cohort study.

OBJECTIVE: To evaluate the long-term stability of International Classification of Diseases-10th revision bipolar affective disorder (BD) in multiple settings. METHOD: A total of 34 368 patients received psychiatric care in the catchment area of a Spanish hospital (1992-2004). The analyzed sample included patients aged > or =18 years who were assessed on > or =10 occasions and received a diagnosis of BD at least once (n = 1153; 71,543 assessments). Prospective and retrospective consistencies and the proportion of subjects who received a BD diagnosis in > or =75% of assessments were calculated. Factors related to diagnostic shift were analyzed with traditional statistical methods and Markov's models. RESULTS: Thirty per cent of patients received a BD diagnosis in the first assessment and 38% in the last assessment. Prospective and retrospective consistencies were 49% and 38%. Twenty-three per cent of patients received a BD diagnosis during > or =75% of the assessments. CONCLUSION: There was a high prevalence of misdiagnosis and diagnostic shift from other psychiatric disorders to BD. Temporal consistency was lower than in other studies.

Sistema endocannabinoide y polimorfismos del gen CNR1 en la esquizofrenia y los trastornos adictivos / Endocannabinoid system and CNR1 gene polymorphisms in schizophrenia and addictive disorders

La esquizofrenia presenta una alta comorbilidad con los trastornos adictivos, siendo el cannabis una de las sustancias más frecuentemente consumidas por estos pacientes. En los últimos años hemos asistido al descubrimiento del sistema endocannabinoide, conociéndose que las acciones centrales de los endocannabinoides se vehiculan a través de los receptores cerebrales de tipo 1 (CB1) codificados por el gen CNR1. El sistema endocannabinoide interviene en una gran cantidad de procesos cerebrales a través de su interacción con otros sistemas de neurotransmisión, encontrándose implicado a su vez en la neurobiología de la esquizofrenia y de los trastornos adictivos. La investigación genética en los últimos años se ha dirigido en pacientes con estos trastornos psiquiátricos al estudio de marcadores polimórficos de genes candidatos, entre ellos el gen CNR1. En esta revisión se describen los estudios realizados con el gen CNR1 en ambos trastornos

Substance abuse is the most prevalent comorbid psychiatric condition associated with schizophrenia. Cannabis is a drug frequently used for schizoprenic patients. In the last decades the endocannabinoid system and their endogenous ligands have been discovered. Endogenous cannabinoids act in the brain on cannabinoid CB1 receptor. On the other hand this system may be involved in several brain functions through neuromodulation dopaminergic and other neurotransmitter system involved in schizophrenic and substance abuse disorders. Advances of genetic research have addressed the focus on the search of candidate genes for both disorders. In this review we have summarized the studies published about the CNR1 gene on szhizophrenia and substance abuse disorders

Disfunciones ejecutivas en adultos con trastorno por déficit de atención e hiperactividad / Executive dysfunctions in adults with attention deficit hyperactivity disorder

Introducción. Diversos estudios de seguimiento han mostrado la persistencia del trastorno por déficit de atención e hiperactividad (TDAH) en la edad adulta. Objetivo. Revisar los hallazgos en adultos con TDAH relacionados con alteraciones en las funciones ejecutivas. Desarrollo. Las investigaciones realizadas en población infantil con TDAH muestran la existencia de alteraciones en diferentes tareas que evalúan funciones ejecutivas: test de planificación, tareas atencionales de vigilancia, tareas de flexibilidad cognitiva, de fluidez verbal y de memoria de trabajo, así como en diversas tareas de inhibición de respuesta. En los adultos con TDAH, a pesar del menor número de publicaciones, así como de las limitaciones metodológicas existentes en algunos estudios, también se han descrito resultados análogos con relación al funcionamiento ejecutivo: alteración en la respuesta de inhibición, en la capacidad de planificación, dificultades en la flexibilidad cognitiva y la fluidez verbal, y dificultades en la memoria de trabajo, que incluyen aspectos de memoria de trabajo espacial, de memoria lógica o visual. Conclusiones. Los hallazgos disponibles permiten afirmar la persistencia de disfunciones ejecutivas en pacientes adultos con TDAH similares a las observadas en niños con TDAH

Introduction. Several different follow-up studies have shown that attention deficit hyperactivity disorder (ADHD) can persist into adulthood. Aim. To review the findings in adults with ADHD related to alterations in the executive functions. Development. Research conducted among children with ADHD has revealed the existence of alterations in different tasks that evaluate the executive functions, such as the planning test, sustained attention tasks, cognitive flexibility, verbal fluency and working memory tasks, as well as several inhibition response tasks. In adults with ADHD, despite the lower number of reports in the literature and the methodological shortcomings that exist in some studies, analogous results have also been described with respect to executive functioning, namely, disorders affecting inhibition response, the capacity for planning, difficulties in cognitive flexibility and verbal fluency, and problems with working memory, which include aspects of spatial working memory, logical or visual memory. Conclusions. The findings we have available at present enable us to confirm the persistence of executive dysfunctions in adult patients with ADHD that are similar to those observed in children with ADHD

C957T DRD2 polymorphism is associated with schizophrenia in Spanish patients.

OBJECTIVE: The objective was to confirm whether a homozygous genotype for the C957 allele of the C957T DRD2 gene single nucleotide polymorphism (SNP) is associated with schizophrenia in an independent study population. METHOD: We examined the genotypic distribution of this SNP in a set of clinically ascertained schizophrenic patients (n = 131) and age-matched control subjects (n = 364). Individuals were genotyped using automated analysis of fluorescently labeled PCR products. RESULTS: The distribution of grouped genotypes for the C957T DRD2 SNP (CC vs. CT, TT) showed that C homozygote genotype was over-represented in our patient sample when compared with control subjects. This difference reaches the statistical significance (chi(2) = 7.0; df = 1; P = 0.008; OR = 2.05; % CI 1.2-3.4). CONCLUSION: The findings of this study provide additional evidence that genetic variation at the DRD2 gene plays an important role in the vulnerability to schizophrenia.