Sexual dysfunction in drug- naïve first episode nonaffective psychosis patients. Relationship with prolactin and psychotic symptoms. Gender differences.

BACKGROUND: Our aim is to examine differences in sexual functioning (SF) between patients with drug-naïve first episode psychosis (FEP) and healthy controls (HC). We will also examine correlations between prolactin levels, testosterone levels and psychotic symptomatology with SF from a gender perspective. METHODS: Cross-sectional study. We included 68 FEP patients and 50 HC. A blood sample was extracted. We used the Positive and Negative Syndrome Scale to assess symptom severity, using the five factor structure according to Emsley. The Changes in Sexual Function Questionnaire (CSFQ) was administered. RESULTS: We found significantly better SF in HC than in patients (in CSFQ total score (p = 0.032) and in CSFQ Desire (p = 0.032)). A significant correlation between prolactin or testosterone and SF was not observed. We found a negative significant correlation between the disorganised subscale of the EMSLEY and total CSFQ (p = 0.027; r = -0.329), CSFQ Desire (p = 0.028; r = -0.329) and CSFQ Arousal (p = 0.026; r = -0.332) in the patient sample. In a regression model, we found sex (p = 0.003) and disorganized symptoms (p = 0.034) as significant predictors. CONCLUSIONS: We found evidence for better SF in HC than in FEP patients. We could not confirm an association between prolactin or testosterone and SF. Disorganized symptomatology could be a relevant factor in SF.

[Implementation and evaluation of case management in Catalonia: the ISP-SMD program]. / La implementación y evaluación del modelo de gestión de casos (case management) en Cataluña: el programa PSI-TMS.

INTRODUCTION: The pilot study of the Individualized Service Program for people with Severe Mental Disorders (ISP-SMD) consists of the implementation of case management services in Catalonia. METHODOLOGY: The ISP-SMD has been implemented in two health care sectors and will be expanded to the rest of Catalonia in the next years. The program serves people with persistent mental disorders who have serious social or family problems and/or who have inadequate mental health service use (high use of inpatient services, no use of community services). The ISP-SMD is a community intervention program that focuses its activities on direct care and coordination between services. Thirty patients have been included in the evaluation. RESULTS: The results of the pilot study have shown that, compared to the year before entering the program, the patients show better clinical status, they decrease their unmet need level, they have more appropriate use of health services and have lower treatment costs. Satisfaction of the patients, family members and professionals with the program is very high. CONCLUSION: It is possible to adapt and implement case management services in Catalonia. When implemented, they improve patient quality of life.

Seguimiento de un programa de naltrexona tras antagonización rápida de opiáceos / Follow-up of a naltrexone program after rapid antagonization of opiates

Objetivo: se realiza un estudio de seguimiento de 91 pacientes en programa de deshabituación con naltrexona tras antagonización rápida de opiáceos. Material y métodos: fue evaluada la retención de 91 pacientes a las 24 horas del alta del tratamiento de desintoxicación así como la retención a los 3 y 6 meses. Se analizan las variables sociodemográficas, de historia de consumo, clínicas y de tratamiento asociadas a la retención en los diferentes momentos de medida. Resultados: las cifras de retención son del 85,6 por ciento (77/91) a las 24 horas, 60,4 por ciento (55/91) a los 3 meses y 59,3 por ciento (54/91) a los 6 meses. Estas cifras difieren significativamente de las aportadas por otros estudios realizados en el mismo ámbito. Conclusiones: las variables que sugieren retención son preferentemente las relacionadas con un mayor período del consumo de heroína y una experiencia previa en programas de naltrexona. (AU)