Network and Exploratory Factorial Analysis of the Depression Clinical Evaluation Test.

Depression is a highly prevalent disorder with a wide range of symptomatology. Existing instruments for its assessment have only a few items for each factor. The Depression Clinical Evaluation Test (DCET) has been created to cover all depression symptoms at different times (month, year, and always) with several items for each facet. The content validity of this instrument has been judged by experts and, in this paper, we analyse its factorial structure and make a network analysis of it. The test (196 items) was administered to 602 adults without psychological disorders (Mage = 24.7, SD = 8.38, 72% women) both online and on paper. A network was estimated for each time point, using the absolute minimum selection and shrinkage operator. From the factor analysis, 12 factors were established for month, 11 for year, and 10 for always, leaving 94 items. The network analysis showed that the facets of depressive mood, anhedonia, and thoughts of Death, are central to all the estimated networks. The DCET is proposed as a valid and reliable multifactorial instrument to detect the variability of depressive symptoms in adults, guaranteeing its diagnostic usefulness.

Content Validity through Expert Judgment for the Depression Clinical Evaluation Test.

Background/Objective: The evaluation of depression requires valid and reliable measuring instruments, which collect a wide spectrum of symptoms that this disorder displays, in order to carry out an accurate and differential diagnosis. The objective of this work is the construction of the Depression Clinical Evaluation Test (DCET), where affective, somatic, cognitive, behavioral and interpersonal symptoms are considered and also analyze its content validity through an expert judgment. Method: Based on different diagnostic and manual classifications, a specification table for a depression test was established. In its evaluation, 16 experts in Psychological Assessment, Psychometry and/or Psychopathology participated. A total of 300 items were created. The experts had to assess the items according to the criteria of Content, Relevance, Clarity, Comprehension, Sensitivity, and Offensiveness. In addition, 50 adults, evaluated the compression of the items. Results: The degree of understanding for all the items was high and the expert judgment favoured the suppression of 104 items, thus obtaining a shorter measuring instrument with a total of 196 items for ease of application. Conclusions: The content validity of the test is adequate and fits the agreed definition of depression.

Antecedentes: La evaluación de la depresión requiere de instrumentos de medida válidos, fiables y que recojan el amplio espectro de síntomas que este trastorno conlleva, para poder llevar a cabo un diagnóstico certero y diferencial. El objetivo de este trabajo es la construcción del Test de Evaluación Clínica de la Depresión (TECD), que contempla síntomas afectivos, somáticos, cognitivos, conductuales e interpersonales, y analizar su validez de contenido a través de un juicio de expertos. Método: A partir de diferentes clasificaciones diagnósticas y manuales se estableció la tabla de especificación del test para este cuestionario de depresión. En la evaluación de este participaron 16 expertos en Evaluación Psicológica, Psicometría y/o Psicopatología. Se crearon 300 ítems en total, que los expertos tuvieron que valorar atendiendo a los criterios de Contenido, Relevancia, Claridad, Comprensión, Sensitividad y Ofensividad. Además, 50 adultos, valoraron la compresión de los items. Resultados: El grado de comprensión de todos los ítems fue elevado y el juicio de expertos supuso la supresión de 104 ítems, obteniendo así un instrumento de medida más breve, con 196 ítems en total, lo que facilitará su aplicación. Conclusiones: La validez de contenido del test es adecuada y se adapta a la definición de depresión establecida.

Content Validity through Expert Judgment for the Depression Clinical Evaluation Test / Validez de contenido mediante juicio de expertos para el Test de Evaluación Clínica de la Depresión

AbstractBackground/Objective: The evaluation of depression requires valid and reliable measuring instruments, which collect a wide spectrum of symptoms that this disorder displays, in order to carry out an accurate and differential diagnosis. The objective of this work is the construction of the Depression Clinical Evaluation Test (DCET), where affective, somatic, cognitive, behavioral and interpersonal symptoms are considered and also analyze its content validity through an expert judgment. Method: Based on different diagnostic and manual classifications, a specification table for a depression test was established. In its evaluation, 16 experts in psychological evaluation, psychometry and/or psychopathology participated. A total of 300 items were created. The experts had to assess the items according to the criteria of Content, Relevance, Clarity, Comprehension, Sensitivity and Offensiveness. In addition, 50 adults, evaluated the compression of the items. Results: The degree of understanding for all the items was high and the expert judgment favoured the suppression of 104 items, thus obtaining a shorter measuring instrument with a total of 196 items for ease of application. Conclusions: The content validity of the test is adequate and fits the agreed definition of depression.

Antecedentes La evaluación de la depresión requiere de instrumentos de medida válidos, fiables y que recojan el amplio espectro de síntomas que este trastorno conlleva, para poder llevar a cabo un diagnóstico certero y diferencial. El objetivo de este trabajo es la construcción del Test de Evaluación Clínica de la Depresión (TECD), que contempla síntomas afectivos, somáticos, cognitivos, conductuales e interpersonales, y analizar su validez de contenido a través de un juicio de expertos. Método A partir de diferentes clasificaciones diagnósticas y manuales se estableció la tabla de especificación del test para este cuestionario de depresión. En la evaluación de este participaron 16 expertos en Evaluación Psicológica, Psicometría y/o Psicopatología. Se crearon 300 ítems en total, que los expertos tuvieron que valorar atendiendo a los criterios de Contenido, Relevancia, Claridad, Comprensión, Sensitividad y Ofensividad. Además, 50 adultos, valoraron la compresión de los items. Resultados El grado de comprensión de todos los ítems fue elevado y el juicio de expertos supuso la supresión de 104 ítems, obteniendo así un instrumento de medida más breve, con 196 ítems en total, lo que facilitará su aplicación. Conclusiones La validez de contenido del test es adecuada y se adapta a la definición de depresión establecida.

Effect of an Interdisciplinary Weight Loss and Lifestyle Intervention on Obstructive Sleep Apnea Severity: The INTERAPNEA Randomized Clinical Trial.

Importance: Obesity is the leading cause of obstructive sleep apnea (OSA); however, the effects of weight loss and lifestyle interventions on OSA and comorbidities remain uncertain. Objective: To evaluate the effect of an interdisciplinary weight loss and lifestyle intervention on OSA and comorbidities among adults with moderate to severe OSA and overweight or obesity. Design, Setting, and Participants: The Interdisciplinary Weight Loss and Lifestyle Intervention for OSA (INTERAPNEA) study was a parallel-group open-label randomized clinical trial conducted at a hospital-based referral center in Granada, Spain, from April 1, 2019, to October 23, 2020. The study enrolled 89 Spanish men aged 18 to 65 years with moderate to severe OSA and a body mass index (calculated as weight in kilograms divided by height in meters squared) of 25 or greater who were receiving continuous positive airway pressure (CPAP) therapy. The sole inclusion of men was based on the higher incidence and prevalence of OSA in this population, the differences in OSA phenotypes between men and women, and the known effectiveness of weight loss interventions among men vs women. Interventions: Participants were randomized to receive usual care (CPAP therapy) or an 8-week weight loss and lifestyle intervention involving nutritional behavior change, aerobic exercise, sleep hygiene, and alcohol and tobacco cessation combined with usual care. Main Outcomes and Measures: The primary end point was the change in the apnea-hypopnea index (AHI) from baseline to the intervention end point (8 weeks) and 6 months after intervention. Secondary end points comprised changes in other OSA sleep-related outcomes, body weight and composition, cardiometabolic risk, and health-related quality of life. Results: Among 89 men (mean [SD] age, 54.1 [8.0] years; all of Spanish ethnicity; mean [SD] AHI, 41.3 [22.2] events/h), 49 were randomized to the control group and 40 were randomized to the intervention group. The intervention group had a greater decrease in AHI (51% reduction; change, -21.2 events/h; 95% CI, -25.4 to -16.9 events/h) than the control group (change, 2.5 events/h; 95% CI, -2.0 to 6.9 events/h) at the intervention end point, with a mean between-group difference of -23.6 events/h (95% CI, -28.7 to -18.5 events/h). At 6 months after intervention, the reduction in AHI was 57% in the intervention group, with a mean between-group difference of -23.8 events/h (95% CI, -28.3 to -19.3 events/h). In the intervention group, 18 of 40 participants (45.0%) no longer required CPAP therapy at the intervention end point, and 6 of 40 participants (15.0%) attained complete OSA remission. At 6 months after intervention, 21 of 34 participants (61.8%) no longer required CPAP therapy, and complete remission of OSA was attained by 10 of 34 participants (29.4%). In the intervention vs control group, greater improvements in body weight (change, -7.1 kg [95% CI, -8.6 to -5.5 kg] vs -0.3 kg [95% CI, -1.9 to 1.4 kg]) and composition (eg, change in fat mass, -2.9 kg [95% CI, -4.5 to -1.3 kg] vs 1.4 kg [95% CI, -0.3 to 3.1 kg]), cardiometabolic risk (eg, change in blood pressure, -6.5 mm Hg [95% CI, -10.3 to -2.6 mm Hg] vs 2.2 mm Hg [95% CI, -2.1 to 6.6 mm Hg]), and health-related quality of life (eg, change in Sleep Apnea Quality of Life Index, 0.8 points [95% CI, 0.5-1.1 points] vs 0.1 points [95% CI, -0.3 to 0.4 points]) were also found at the intervention end point. Conclusions and Relevance: In this study, an interdisciplinary weight loss and lifestyle intervention involving Spanish men with moderate to severe OSA and had overweight or obesity and were receiving CPAP therapy resulted in clinically meaningful and sustainable improvements in OSA severity and comorbidities as well as health-related quality of life. This approach may therefore be considered as a central strategy to address the substantial impact of this increasingly common sleep-disordered breathing condition. Trial Registration: ClinicalTrials.gov Identifier: NCT03851653.

Characteristics of sleep spindles in school-aged children with attention-deficit/hyperactivity disorder.

OBJECTIVE: Attention deficit/hyperactivity disorder (ADHD) is a complex disorder, characterized by different presentations with distinct cognitive and neurobiological characterizations. Here we aimed to investigate whether sleep spindle activity, which has been associated with brain maturation, may be a potential biomarker able to differentiate ADHD presentations in school-aged children (7-11 years). METHOD: Spindle characteristics were extracted from overnight polysomnography in 74 children (27 ADHD-Inattentive [IQ = 96.04], 25 ADHD-hyperactive/impulsive [IQ = 98.9], and 22 ADHD-combined [IQ = 96.1]). We obtained data of the frontal (Fz) and parietal (Pz) derivations using a validated spindle detection algorithm. RESULTS: Children with ADHD showed a higher number and density of slow compared to fast spindles which were more frequent in frontal area. No differences were observed among ADHD presentations for any spindle characteristics. Spindle frequency and density increased with age, indicating an age-dependent maturation of different sleep spindles. However, no associations between IQ and spindle characteristics were observed. CONCLUSIONS: In children with ADHD the spindle characteristics evolve with age but sleep spindle activity does not seem to be a valid biomarker of ADHD phenotypes or general cognitive ability.

Sleep, academic achievement, and cognitive performance in children with attention-deficit hyperactivity disorder: A polysomnographic study.

The objective of this study was to examine the influence of parent-reported and polysomnography (PSG)-measured sleep patterns on the academic and cognitive performance of children with attention-deficit hyperactivity disorder (ADHD). We assessed 91 children (18 girls) diagnosed with ADHD aged 7-11 years (29 ADHD-Inattentive, 32 ADHD-Hyperactive/Impulsive, and 31 ADHD-Combined). The Paediatric Sleep Questionnaire (PSQ) and Paediatric Daytime Sleepiness Scale (PDSS) were used to assess subjective sleep quality, as perceived by parents, and objective sleep variables were assessed by PSG. Cognitive performance was evaluated using the Wechsler Intelligence Scale for Children (WISC), and the final average grade of the last school year was used as a measure of academic performance. Academic performance was predicted by the following sleep variables: Sleep time, time in bed, night awakenings, and daytime sleepiness. The best predictors of cognitive performance in children with ADHD were rapid eye movement latency, light sleep, periodic limb movements index (PLMs), awakenings, and daytime sleepiness. In conclusion, sleep parameters are closely associated with the academic and cognitive functioning of children with ADHD.

A Meta-Analysis of the Generalization of the Reliability of State/Trait Depression Inventory Scores / Meta-Análisis de Generalización de la Fiabilidad de las Puntuaciones del Inventario de Depresión Estado/Rasgo

BACKGROUND: Depression is a disorder that is highly prevalent nowadays. Within the dimensional explanatory model of depression, the State/Trait Depression Inventory was developed. Its objective is to identify the degree of affectation (state) and the frequency of occurrence (trait) of the affective component of depression. The instrument has proven reliable and comprises two factors in its structure: state and trait, with two euthymia and dysthymia subscales in each one. The objective of this meta-analysis is to find an average alpha for the questionnaire. METHOD: A bibliographical search was conducted on Web of Science and Scopus. Forty-five articles were selected. RESULTS: The alpha ranges from .84 to .89 for all factorizations, and in most studies a bifactorial structure of state and trait depression was found. CONCLUSIONS: The State/Trait Depression Inventory is a reliable and suitable instrument for measuring depression

ANTECEDENTES: la depresión es un trastorno de alta prevalencia en la actualidad. Dentro del modelo explicativo dimensional de la depresión, se desarrolló el Inventario de Depresión Estado/Rasgo, cuyo objetivo es identificar el grado de afectación (estado) y la frecuencia de ocurrencia (rasgo) del componente afectivo de la depresión. Este instrumento ha demostrado ser fiable y poseer dos factores en su estructura: estado y rasgo con dos subescalas eutimia y distimia en cada uno. El objetivo de este meta-análisis es hallar un alfa medio de las puntuaciones cuestionario. MÉTODO: se realizó una búsqueda bibliográfica en Web of Science y Scopus. Se seleccionaron 45 artículos. RESULTADOS: el alfa oscila entre 0,84 y 0,89 para todas las factorizaciones, y en la mayoría de los estudios se halló una estructura bifactorial de depresión estado y rasgo. CONCLUSIONES: el Inventario de Depresión Estado/Rasgo es un instrumento fiable y adecuado para medir la depresión

A Meta-Analysis of the Generalization of the Reliability of State/Trait Depression Inventory Scores.

BACKGROUND: Depression is a disorder that is highly prevalent nowadays. Within the dimensional explanatory model of depression, the State/Trait Depression Inventory was developed. Its objective is to identify the degree of affectation (state) and the frequency of occurrence (trait) of the affective component of depression. The instrument has proven reliable and comprises two factors in its structure: state and trait, with two euthymia and dysthymia subscales in each one. The objective of this meta-analysis is to find an average alpha for the questionnaire. METHOD: A bibliographical search was conducted on Web of Science and Scopus. Forty-five articles were selected. RESULTS: The alpha ranges from .84 to .89 for all factorizations, and in most studies a bifactorial structure of state and trait depression was found. CONCLUSIONS: The State/Trait Depression Inventory is a reliable and suitable instrument for measuring depression.

Sleep among presentations of Attention-Deficit/Hyperactivity Disorder: Analysis of objective and subjective measures / El sueño en las diferentes presentaciones del Trastorno por déficit de atención/hiperactividad: análisis de medidas objetivas y subjetivas

BACKGROUND/OBJECTIVE: To examine subjective and objective sleep patterns in children with different Attention-Deficit/Hyperactivity Disorder (ADHD) presentations. METHOD: We assessed 92 children diagnosed with ADHD (29 ADHD-Inattentive [ADHD-I], 31 ADHD-Hyperactive/Impulsive [ADHD-H/I], and 32 ADHD-Combined [ADHD-C)]) aged 7-11 years. The Pediatric Sleep Questionnaire (PSQ), Pediatric Daytime Sleepiness Scale (PDSS), and a sleep diary were used as subjective sleep measures, and polysomnography was used to objectively assess sleep quantity, quality, and fragmentation. RESULTS: Subjective data showed impaired sleep in 12.7% of the sample. No significant differences were found between ADHD presentations in any objective and subjective sleep variable. Nevertheless, data on sleep fragmentation suggested a worse sleep continuity for the ADHD-H/I group, and correlation analyses confirmed that sleep is affected by age. CONCLUSIONS: Children with ADHD may suffer from sleep breathing problems and daytime sleepiness, as reported by their parents, even when their total sleep time and sleep efficiency are not affected. It seems that sleep in this population does not largely vary as a function of the ADHD presentation. Sleep in children with ADHD evolves with age

ANTECEDENTES/OBJETIVO: Examinar los patrones de sueño subjetivos y objetivos de niños con diferentes presentaciones del Trastorno por déficit de atención e hiperactividad (TDAH). MÉTODO: Se evaluaron 92 niños (29 TDAH-inatento [TDAH-I)], 31 TDAH-hiperactivo/impulsivo [TDAH-H/I] y 32 TDAH-combinado [TDAH-C]) de entre 7-11 años. El Pediatric Sleep Questionnaire (PSQ), la Pediatric Daytime Sleepiness Scale (PDSS) y un diario de sueño se utilizaron como medidas subjetivas de sueño. Para evaluar objetivamente la cantidad, calidad y fragmentación del sueño se utilizó la polisomnografía. RESULTADOS: Los datos subjetivos mostraron alteraciones del sueño en el 12,7% de la muestra. No se observaron diferencias significativas en ninguna variable objetiva y subjetiva de sueño entre las diferentes presentaciones de TDAH. No obstante, los datos de fragmentación de sueño sugirieron una peor continuidad en el grupo con TDAH-H/I, y los análisis correlacionales confirmaron que el sueño se ve afectado por la edad. CONCLUSIONES: Los niños con TDAH pueden experimentar problemas respiratorios durante el sueño y somnolencia diurna, según lo informado por sus padres, incluso cuando su tiempo total y eficiencia de sueño no se vean afectados. Parece que el sueño en el TDAH no varía en función de la presentación. El sueño en los niños con TDAH evoluciona con la edad

Sleep among presentations of Attention-Deficit/Hyperactivity Disorder: Analysis of objective and subjective measures.

To examine subjective and objective sleep patterns in children with different Attention-Deficit/Hyperactivity Disorder (ADHD) presentations. METHOD: We assessed 92 children diagnosed with ADHD (29 ADHD-Inattentive [ADHD-I], 31 ADHD-Hyperactive/Impulsive [ADHD-H/I], and 32 ADHD-Combined [ADHD-C)]) aged 7-11 years. The Pediatric Sleep Questionnaire (PSQ), Pediatric Daytime Sleepiness Scale (PDSS), and a sleep diary were used as subjective sleep measures, and polysomnography was used to objectively assess sleep quantity, quality, and fragmentation. RESULTS: Subjective data showed impaired sleep in 12.7% of the sample. No significant differences were found between ADHD presentations in any objective and subjective sleep variable. Nevertheless, data on sleep fragmentation suggested a worse sleep continuity for the ADHD-H/I group, and correlation analyses confirmed that sleep is affected by age. CONCLUSIONS: Children with ADHD may suffer from sleep breathing problems and daytime sleepiness, as reported by their parents, even when their total sleep time and sleep efficiency are not affected. It seems that sleep in this population does not largely vary as a function of the ADHD presentation. Sleep in children with ADHD evolves with age.

ANTECEDENTES/OBJETIVO: Examinar los patrones de sueño subjetivos y objetivos de niños con diferentes presentaciones del Trastorno por déficit de atención e hiperactividad (TDAH). Método: Se evaluaron 92 niños (29 TDAH-inatento [TDAH-I)], 31 TDAH-hiperactivo/impulsivo [TDAH-H/I] y 32 TDAH-combinado [TDAH-C]) de entre 7­11 años. El Pediatric Sleep Questionnaire (PSQ), la Pediatric Daytime Sleepiness Scale (PDSS) y un diario de sueño se utilizaron como medidas subjetivas de sueño. Para evaluar objetivamente la cantidad, calidad y fragmentación del sueño se utilizó la polisomnografía. Resultados: Los datos subjetivos mostraron alteraciones del sueño en el 12,7% de la muestra. No se observaron diferencias significativas en ninguna variable objetiva y subjetiva de sueño entre las diferentes presentaciones de TDAH. No obstante, los datos de fragmentación de sueño sugirieron una peor continuidad en el grupo con TDAH-H/I, y los análisis correlacionales confirmaron que el sueño se ve afectado por la edad. Conclusiones: Los niños con TDAH pueden experimentar problemas respiratorios durante el sueño y somnolencia diurna, según lo informado por sus padres, incluso cuando su tiempo total y eficiencia de sueño no se vean afectados. Parece que el sueño en el TDAH no varía en función de la presentación. El sueño en los niños con TDAH evoluciona con la edad.

Anxiety and Depression in Patients with Obstructive Sleep Apnoea before and after Continuous Positive Airway Pressure: The ADIPOSA Study.

The prevalence and treatment response of depression and anxiety symptoms in obstructive sleep apnoea (OSA), although widely addressed in research and clinical settings, still remain unclear due to overlapping symptoms. The ADIPOSA study sought to elucidate the presence of non-overlapping symptoms of depression and anxiety in patients with moderate to severe OSA before and after continuous positive airway pressure (CPAP) treatment. Forty-eight adults aged 18-80 (68.75% men) with moderate to severe OSA were enrolled in this twelve-week longitudinal single-arm trial and completed a full-night ambulatory sleep diagnostic test and an assessment of cognitive-affective depression and anxiety symptoms using the Beck-Depression Inventory-Fast Screen (BDI-FS), the State-Trait Depression Inventory (IDER) and the State-Trait Anxiety Inventory (STAI). We found no cognitive-affective depression or anxiety symptoms of clinical relevance at baseline. The amelioration of depression and anxiety symptoms after CPAP use was only statistically significant when considering anxiety-trait (p < 0.01; d = 0.296) and euthymia (p < 0.05; d = 0.402), the distinctive component of depression. Although dysthymia or high negative affect remained unchanged, CPAP may be effective at reducing the lack of positive affect, a well-established health-protective factor. However, not until depression and anxiety disorders related to OSA are accurately measured in clinical and research settings will it be possible to obtain robust conclusions on the occurrence and amelioration of these symptoms after treatment.

Ranking 2019 de investigación de las universidades públicas españolas / Research Ranking of Spanish Public Universities (2019)

ANTECEDENTES: los cambios producidos en el sistema universitario español con el proceso Bolonia hacen necesaria la realización periódica de informes de evaluación de la actividad investigadora. El objetivo de este estudio es actualizar el último ranking disponible de investigación de las universidades públicas españolas con los datos de 2013-2018. MÉTODO: se evaluó la producción y productividad de cada universidad, atendiendo a siete indicadores específicos y a una puntuación global: artículos en revistas indexadas en el JCR (Journal Citation Reports), tramos de investigación, proyectos I+D, tesis doctorales, ayudas FPU (formación de profesorado universitario), ayudas FPI (formación de personal investigador) y patentes. RESULTADOS: a nivel global, las universidades Complutense de Madrid, Barcelona y Granada se sitúan en las primeras posiciones en producción, mientras que las primeras posiciones en productividad son ocupadas por las universidades Pompeu Fabra, Autónoma de Madrid y Autónoma de Barcelona. CONCLUSIONES: las universidades que ocupan las primeras posiciones en este ranking se mantienen relativamente estables a lo largo del tiempo y son también las que destacan en clasificaciones internacionales

BACKGROUND: The changes produced in the Spanish university system due to the Bologna process require periodically updated evaluation reports of research activity. The objective of this study is to update the last available ranking of Spanish public universities, based on data from 2013-2018. METHOD: The production and productivity of each university were assessed based on seven specific indicators and a global score: articles in journals indexed in the JCR (Journal Citation Reports), research periods, R+D projects, doctoral theses, FPU (training of university professors) grants, FPI (training of personal researchers) grants, and patents. RESULTS: Globally, the universities Complutense of Madrid, Barcelona, and Granada hold the first positions in terms of production, while the first positions in terms of productivity are held by the universities Pompeu Fabra, Autonomous of Madrid, and Autonomous of Barcelona. CONCLUSIONS: The universities that hold the top positions in this ranking remain relatively steady over time and are also the Spanish universities that stand out in international classifications

[Research Ranking of Spanish Public Universities (2019)].

Research Ranking of Spanish Public Universities (2019). BACKGROUND: The changes produced in the Spanish university system due to the Bologna process require periodically updated evaluation reports of research activity. The objective of this study is to update the last available ranking of Spanish public universities, based on data from 2013-2018. METHOD: The production and productivity of each university were assessed based on seven specific indicators and a global score: articles in journals indexed in the JCR (Journal Citation Reports), research periods, R+D projects, doctoral theses, FPU (training of university professors) grants, FPI (training of personal researchers) grants, and patents. RESULTS: Globally, the universities Complutense of Madrid, Barcelona, and Granada hold the first positions in terms of production, while the first positions in terms of productivity are held by the universities Pompeu Fabra, Autonomous of Madrid, and Autonomous of Barcelona. CONCLUSIONS: The universities that hold the top positions in this ranking remain relatively steady over time and are also the Spanish universities that stand out in international classifications.

Interdisciplinary Weight Loss and Lifestyle Intervention for Obstructive Sleep Apnoea in Adults: Rationale, Design and Methodology of the INTERAPNEA Study.

Obesity is a major risk factor for obstructive sleep apnoea (OSA), the most common sleep-disordered breathing related to neurocognitive and metabolic syndromes, type II diabetes, and cardiovascular diseases. Although strongly recommended for this condition, there are no studies on the effectiveness of an interdisciplinary weight loss and lifestyle intervention including nutrition, exercise, sleep hygiene, and smoking and alcohol cessation. INTERAPNEA is a randomised controlled trial with a two-arm parallel design aimed at determining the effects of an interdisciplinary tailored weight loss and lifestyle intervention on OSA outcomes. The study will include 84 males aged 18-65 with a body mass index of ≥25 kg/m2 and severe to moderate OSA randomly assigned to usual care (i.e., continuous positive airway pressure), or interdisciplinary weight loss and lifestyle intervention combined with usual care. Outcomes will be measured at baseline, intervention end-point, and six-month post-intervention, including apnoea-hypopnoea index (primary outcome), other neurophysical and cardiorespiratory polysomnographic outcomes, sleep quality, daily functioning and mood, body weight and composition, physical fitness, blood biomarkers, health-related quality of life, and cost-effectiveness. INTERAPNEA may serve to establish a cost-effective treatment not only for the improvement of OSA and its vast and severe comorbidities, but also for a potential remission of this condition.

Reliability and validity of the Basic Depression Questionnaire / Fiabilidad y validez del Cuestionario Básico de Depresión

Background/Objective: Depressive disorders have a high prevalence around the world. They present a great comorbidity with other disorders like anxiety, thereby making a differential diagnosis very difficult. The Basic Depression Questionnaire was designed to palliate this issue by isolating specific depression symptoms. Our aim is to study the reliability, factorial structure, and differential item functioning of this questionnaire. Method: The sample consisted of 1,397 adults without psychological problems (Mage=29.76, SD=11.25, 64.78% women) who completed the CBD. Results: We observed that none of the items presented differential functioning. A monofactorial structure was established. In this model a good fit was obtained by confirmatory factor analysis and a strict invariance by sex. The ordinal alpha was used to check the reliability and it fetched an index of .95. Conclusions: The Basic Depression Questionnaire has adequate psychometric properties. The absence of differential item functioning and the invariance by sex are guarantees of an adequate use to diagnose depression for men and women. So, its clinical use can help to differentiate between the specific diagnoses for depressive disorders and anxiety disorders

Antecedentes/Objetivo: Los trastornos depresivos tienen una elevada prevalencia a nivel mundial. Presentan una gran comorbilidad con otros trastornos como la ansiedad, lo que hace muy difícil su diagnóstico diferencial. El Cuestionario Básico de Depresión (CBD) fue diseñado para aislar los síntomas específicos de la depresión y así paliar este problema. El objetivo de este estudio es analizar la fiabilidad, la estructura factorial y el funcionamiento diferencial de los ítems del CBD. Método: La muestra estuvo compuesta de 1.397 adultos sin problemas psicológicos (64,78% mujeres, Medad=29,76, DT=11,25) a los que se le administró el CBD. Resultados:Se observó que ninguno de los ítems presentaba funcionamiento diferencial. Se obtuvo una estructura monofactorial. En dicho modelo se obtuvo un buen ajuste mediante análisis factorial confirmatorio y una invarianza estricta por sexo. Se usó el alfa ordinal para comprobar la fiabilidad, obteniendo un índice de 0,95. Conclusiones: El Cuestionario Básico de Depresión tiene adecuadas propiedades psicométricas. La ausencia de funcionamiento diferencial del ítem y la invarianza por sexo son garantías de un adecuado uso para diagnosticar depresión en hombres y mujeres. Por ello, su uso clínico puede ayudar al diagnóstico específico de trastornos depresivos frente a trastornos de ansiedad

Shorter REM latency in children with attention-deficit/hyperactivity disorder.

The discrepancies in prior research about the actual sleep problems underlying attention-deficit/hyperactivity disorder (ADHD) demand more studies of children with this disorder. This study aimed to compare the subjective and objective sleep characteristics of 20 children with ADHD (DSM-IV criteria) and 20 typically developing children (aged 7-11 years). We assessed the children using sleep questionnaires and polysomnography recordings and analysed differences between the two groups using two-tailed Mann-Whitney U exact tests and Rosenthal's r as effect size measure. We also assessed associations between sleep measures and psychopathology using Spearman's correlation coefficients. No significant difference was found between the groups in almost any objective sleep variable, except for shorter REM latency in the ADHD group. Children with ADHD also showed significantly higher levels of daytime sleepiness and greater general sleep problems than control children, as reported by their parents, after discarding the primary sleep problems commonly associated with ADHD. Significant correlations were found between psychopathology and sleep measures. Our findings might support the link between narcolepsy-like sleep phenotype and ADHD. However, longitudinal research combining objective and subjective assessments should further explore the involvement of other variables, such as ADHD subtypes, medication, and comorbid symptoms in this relationship.

Weight loss and lifestyle interventions for obstructive sleep apnoea in adults: Systematic review and meta-analysis.

Lifestyle interventions addressing diet, exercise-training, sleep hygiene, and/or tobacco/alcohol cessation are recommended in the management of obstructive sleep apnoea (OSA). Yet their effectiveness on this condition still requires further research. This systematic review and meta-analysis was aimed at establishing (a) the effectiveness of lifestyle interventions on apnoea-hypopnoea index (AHI), oxygen desaturation index (ODI), excessive daytime sleepiness (EDS), and secondary OSA measures among adults, and (b) which intervention characteristics may drive the greatest improvements. A systematic search of studies was conducted using CINAHL, ProQuest, Psicodoc, Scopus, and Web of Science, from inception to April 2018. Standardized mean differences were calculated using the inverse variance method and random-effects models. The meta-analyses of 13 randomized controlled trials and 22 uncontrolled before-and-after studies (1420 participants) revealed significant reductions on AHI (d = -0.61 and -0.46, respectively), ODI (d = -0.61 and -0.46) and EDS (d = -0.41 and -0.49). Secondary OSA outcomes were also improved after interventions. However, effectiveness of interventions differed depending on their components, OSA severity, and gender. Thus, until future research further supports the differential effectiveness among lifestyle interventions on OSA, those addressing weight loss through diet and exercise-training may be the most effective treatments for male patients with moderate-severe OSA.

Reliability and validity of the Basic Depression Questionnaire.

Depressive disorders have a high prevalence around the world. They present a great comorbidity with other disorders like anxiety, thereby making a differential diagnosis very difficult. The Basic Depression Questionnaire was designed to palliate this issue by isolating specific depression symptoms. Our aim is to study the reliability, factorial structure, and differential item functioning of this questionnaire. METHOD: The sample consisted of 1,397 adults without psychological problems (M age  = 29.76, SD = 11.25, 64.78% women) who completed the CBD. RESULTS: We observed that none of the items presented differential functioning. A monofactorial structure was established. In this model a good fit was obtained by confirmatory factor analysis and a strict invariance by sex. The ordinal alpha was used to check the reliability and it fetched an index of .95. CONCLUSIONS: The Basic Depression Questionnaire has adequate psychometric properties. The absence of differential item functioning and the invariance by sex are guarantees of an adequate use to diagnose depression for men and women. So, its clinical use can help to differentiate between the specific diagnoses for depressive disorders and anxiety disorders.

Los trastornos depresivos tienen una elevada prevalencia a nivel mundial. Presentan una gran comorbilidad con otros trastornos como la ansiedad, lo que hace muy difícil su diagnóstico diferencial. El Cuestionario Básico de Depresión (CBD) fue diseñado para aislar los síntomas específicos de la depresión y así paliar este problema. El objetivo de este estudio es analizar la fiabilidad, la estructura factorial y el funcionamiento diferencial de los ítems del CBD. Método: La muestra estuvo compuesta de 1.397 adultos sin problemas psicológicos (64,78% mujeres, M edad  = 29,76, DT = 11,25) a los que se le administró el CBD. Resultados:Se observó que ninguno de los ítems presentaba funcionamiento diferencial. Se obtuvo una estructura monofactorial. En dicho modelo se obtuvo un buen ajuste mediante análisis factorial confirmatorio y una invarianza estricta por sexo. Se usó el alfa ordinal para comprobar la fiabilidad, obteniendo un índice de 0,95. Conclusiones: El Cuestionario Básico de Depresión tiene adecuadas propiedades psicométricas. La ausencia de funcionamiento diferencial del ítem y la invarianza por sexo son garantías de un adecuado uso para diagnosticar depresión en hombres y mujeres. Por ello, su uso clínico puede ayudar al diagnóstico específico de trastornos depresivos frente a trastornos de ansiedad.

Sexism and sexual risk behavior in adolescents: Gender differences / Sexismo y conducta sexual de riesgo en adolescentes: diferencias en función del género

Background/Objective: This study examines whether there are differences in the maintenance of ambivalent sexist beliefs on the basis of gender and sexual experience in adolescents. The study also investigates whether the sexist beliefs themselves are linked to sexual risk behaviors. Method: A representative sample of 2,703 Spanish adolescents was carried out in public and private secondary schools, with an age range of 14 to 20 years old (M = 15.89; SD = 1.29). Results: Males maintain more hostile, benevolent and ambivalent sexist beliefs compared to females. Sexual experience (both coital and non-coital) is linked to a greater degree of hostile and benevolent sexist beliefs, but only within the male group. In males, greater benevolent sexism is linked to vaginal sex initiation at an earlier age, while greater hostile sexism is linked to a lower proportion of condom use. In females, greater hostile sexism is linked to a greater number of sex partners. Conclusions: It is necessary to include specific actions on sexist beliefs in programs for the prevention of sexually transmitted infections and HIV

Antecedentes/Objetivo: Se examina si existen diferencias en el mantenimiento de creencias sexistas ambivalentes en función del género y de la experiencia sexual en adolescentes. Además, se investiga si las propias creencias sexistas se asocian con la emisión de comportamientos sexuales de riesgo. Método: Se llevó a cabo en una muestra representativa de 2.703 adolescentes españoles procedentes de centros de Secundaria públicos y privados con edades entre 14 y 20 años (M = 15,89; DT = 1,29). Resultados: Los varones mantienen más creencias sexistas hostiles, benevolentes y ambivalentes que las mujeres. La experiencia sexual (coital y no coital) se asocia con una mayor adhesión a las creencias sexistas hostiles y benevolentes, pero sólo en el grupo de varones. En varones, un mayor sexismo benevolente se asocia con una edad de inicio sexual vaginal más temprana, mientras que un mayor sexismo hostil con una menor proporción en el uso del preservativo. En mujeres, un mayor sexismo hostil se asocia con un mayor número de parejas sexuales. Conclusiones: Existe la necesidad de incluir la intervención específica sobre creencias sexistas en programas de prevención de infecciones de transmisión sexual y VIH