Factors associated with the evolution of attitudes towards mental illness in a cohort of nursing students.

WHAT IS KNOWN ON THE SUBJECT?: People with mental health difficulties have poorer physical health than the general population. The stigmatizing attitude of health professionals impacts the quality of care for these people. There is a broad background on the effectiveness of activities based on theoretical training, clinical practices or social contact to improve nursing students' attitudes towards people with mental health difficulties. There is an important need to assess whether the benefits identified in the short term are maintained in the longer term. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The positive evolution of attitudes towards mental illness does not last over time. Some students' attitude towards people with a mental health difficulty worsened in the final stage of their training after completing clinical practices. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: It is necessary for tutors incorporate an understanding of stigma throughout the degree training and to discuss with the students the emotional aspects experienced during the performance of clinical practices. The design of any anti-stigma intervention must include the factor of "time". ABSTRACT: Introduction The stigma of health professionals is a contributing factor to morbi-mortality among people with mental health difficulties. There is a lack of research on long-term outcomes in nursing students. Objective To identify factors associated with the evolution of stigmatizing attitudes towards mental illness in a cohort of students trained in mental health. Method A prospective observational study of the impact of training in mental health care. Age, gender, stigma, level of previous familiarity with mental illness, self-education by Internet, academic performance and the place where practicums are conducted were evaluated on three occasions over 15 months. Results Academic performance, online consultation and the size or origin of the theoretical group were indicators of better attitudes. The positive evolution of attitudes does not last over time. Discussion Instability over time could be explained by students' experience in the practicum, although the time itself has been identified as a determining factor. Practical implications Further studies should be promoted in academia to assess the content of mental health training and its influence on the evolution of the stigmatizing attitude. It is also necessary to address stigma in small groups, where students with better academic results lead anti-stigma activities.

Patrones de consumo de alcohol en estudiantes universitarios de Ciencias de la Salud / Alcohol consumption patterns of university students of health sciences

Objetivo: Describir los patrones de consumo de alcohol y de episodios de consumo intensivo (ECI) en una muestra de estudiantes de Ciencias de la Salud, así como identificar factores asociados. Método: Estudio descriptivo que mediante cuestionario autoadministrado recoge variables sociodemográficas y el diario consumo de alcohol, registrando el número de unidades de bebida estándar consumidas en varios momentos del día. Resultados: Participaron 286 estudiantes (66,1% mujeres) pertenecientes a la Universidad de Cádiz (193 Medicina y 93 Enfermería), con una edad media de 21,1 años (DE 2,8). El 44,8% vive en domicilio familiar. El 65,7% consumió alcohol en la última semana, siendo más frecuente en varones. El patrón de consumo semanal fue del 74,5% para consumo de riesgo bajo, 21% riesgo moderado y 4,5% riesgo elevado. Un 33,9% tuvo entre 1-2 ECI en la última semana, apareciendo estos independientemente del patrón de consumo semanal. De los alumnos que residen fuera del domicilio familiar, un 26,6% tuvieron un consumo de riesgo moderado, un 8,2% riesgo elevado y un 41,8% ECI. Se evidencian asociaciones estadísticamente significativas entre el consumo semanal de alcohol y las variables sexo, domicilio habitual y ECI. Conclusiones: Más de la mitad de los estudiantes consumió alcohol en la última semana, con un consumo mayoritariamente de fin de semana, destacando la alta prevalencia de ECI. Se propone incidir en la detección precoz y campañas en estos grupos

Aim: To describe the alcohol drinking patterns and binge drinking episodes (BDE) in a sample of Health Science students, as well as identify associated factors. Method: It is a descriptive study, in which sociodemographic variables and a weekly alcohol consumption diary recording the number of standard drinking units consumed at different times of the day are collected by means of a self-administered questionnaire. Results: 286 students (66.1% women) from Cadiz University (193 Medical students and 93 Nursing students), with a mean age of 21.1 (SD 2.8) years, took part in this study. Forty-four point 8 percent of the students live with their families. Sixty-five point 7 percent of the students drank alcohol in the previous week, this was more usual in the males. The weekly alcohol consumption pattern was 74.5% for low-risk alcohol consumption, 21% for moderate-risk and 4.5% for a high-risk consumption. Thirty-three point 9 percent had 1-2 BDE over the previous week apart from their weekly consumption pattern. Twenty-six point 6 percent of the students who were emancipated had moderate-risk consumption, 8.2% had a high-risk consumption and 41.8% had a binge drinking episode. There were statistically significant associations between the weekly consumption pattern regarding sex, habitual residence and BDE variables. Conclusions: More than half the students had taken alcohol the previous week, mainly at weekends. The high prevalence of BDE is highlighted. We propose enhancing early detection and prevention campaigns in this population

Relationship between craving and impulsivity in patients with alcohol dependence with or without dual disorders in an outpatient treatment center: a descriptive study.

OBJECTIVES: To compare alcohol and other drugs abuse, state impulsivity, craving and the relationship between craving and impulsivity in alcohol-dependent patients with or without dual disorder attending to an alcohol treatment center in Cadiz town. METHOD: An observational, descriptive and transversal study performed on 112 alcohol dependent patient sample who were seeking treatment in ARCA outpatient treatment center in Cadiz. The sample was divided in two groups, according to present dual diagnosis or not. The sample was assessed with an AdHoc sociodemographic and clinical questionnaire and specific scales and interviews that included: 5.0 Mini International Neuropsychiatric Interview results (MINI), State Impulsivity Scale (SIS), and Multidimensional Alcohol Craving Scale (MACS). RESULTS: The prevalence of dual diagnosis was 50%, being the most prevalent disorders: Current and recurrent Major Depressive Episode Mood Disorder, Current Dysthymic Mood Disorder, Panic Disorder and Anxiety Disorder. 52,7% of the total sample had a positive result on the State Impulsivity Scale. No statistically significant results were found on the Craving Scale (neither in the score or in the sub-sections). A relationship between craving and impulsivity were found for all groups and researched items. CONCLUSIONS: As a relationship between craving and impulsivity was observed, these aspects should be considered as main factors for the treatment and evolution of alcohol- dependent patients.

Relación entre craving e impulsividad en pacientes con dependencia alcohólica con o sin patología dual en tratamiento ambulatorio: un estudio descriptivo / elationship between craving and impulsivity in patients with alcohol dependence with or without dual disorders in an outpatient treatment center: a descriptive study

Introducción: Comparar el consumo de alcohol y otras drogas, la impulsividad estado, el craving y la relación entre estos últimos en pacientes con dependencia alcohólica con o sin patología dual que acuden a un centro de tratamiento específico de alcoholismo en la ciudad de Cádiz. Metodología. Estudio observacional, descriptivo y transversal de una muestra de 112 pacientes con dependencia alcohólica que acuden para solicitar tratamiento al Centro de Tratamiento Ambulatorio ARCA, de Cádiz. Se divide a los pacientes en dos grupos, según padezcan o no patología dual, mediante la entrevista MINI 5.0. Se evalúa la impulsividad mediante la Escala de Impulsividad de Estado (EIE) y el craving mediante la Escala Multidimensional de Craving de Alcohol (EMCA) y se rellena un cuestionario de información adicional que recoge datos sociobiográficos, educativos, económicos y relativos al consumo de alcohol y otras drogas. Resultados. La prevalencia de patología dual es del 50%, las patologías más prevalentes son: Episodio Depre-sivo Mayor actual y recurrente, Trastorno Distímico actual, Trastorno de Angustia y Trastorno de Ansiedad. El 52,7% de la muestra global presenta un resultado positivo en la escala EIE. No existen diferencias de puntuación significativas, tanto en la valoración global como en los subapartados de la escala de craving. Existe una asociación entre el craving y la impulsividad en todos los subgrupos de población y en todas las categorías. Conclusiones. Existe una relación entre craving e impulsividad, lo que debe ser tenido en cuenta en el momento e planificar el tratamiento y diseñar estrategias de prevención de recaídas

Objectives: To compare alcohol and other drugs abuse, state impulsivity, craving and the relationship between craving and impulsivity in alcohol-dependent patients with or without dual disorder attending to an alcohol treatment center in Cadiz town. Method. An observational, descriptive and transversal study performed on 112 alcohol dependent patient sample who were seeking treatment in ARCA outpatient treatment center in Cadiz. The sample was divided in two groups, ac-cording to present dual diagnosis or not. The sample was assessed with an AdHoc sociodemographic and clinical questionnaire and specific scales and interviews that included: 5.0 Mini International Neuropsychiatric Interview results (MINI), State Impulsivity Scale (SIS), and Multidimensional Alcohol Craving Scale (MACS). Results. The prevalence of dual diagnosis was 50%, be-ing the most prevalent disorders: Current and recurrent Ma-jor Depressive Episode Mood Disorder, Current Dysthymic Mood Disorder, Panic Disorder and Anxiety Disorder. 52,7% of the total sample had a positive result on the State Impulsivity Scale. No statistically significant results were found on the Craving Scale (neither in the score or in the subsecions). A relationship between craving and impulsivity were found for all groups and researched items. Conclusions. As a relationship between craving and impulsivity was observed, these aspects should be considered as main factors for the treatment and evolution of alcohol-dependent patients

Alcohol consumption patterns of university students of health sciences. / Patrones de consumo de alcohol en estudiantes universitarios de Ciencias de la Salud.

AIM: To describe the alcohol drinking patterns and binge drinking episodes (BDE) in a sample of Health Science students, as well as identify associated factors. METHOD: It is a descriptive study, in which sociodemographic variables and a weekly alcohol consumption diary recording the number of standard drinking units consumed at different times of the day are collected by means of a self-administered questionnaire. RESULTS: 286 students (66.1% women) from Cadiz University (193 Medical students and 93 Nursing students), with a mean age of 21.1 (SD 2.8) years, took part in this study. Forty-four point 8percent of the students live with their families. Sixty-five point 7percent of the students drank alcohol in the previous week, this was more usual in the males. The weekly alcohol consumption pattern was 74.5% for low-risk alcohol consumption, 21% for moderate-risk and 4.5% for a high-risk consumption. Thirty-three point 9percent had 1-2 BDE over the previous week apart from their weekly consumption pattern. Twenty-six point 6percent of the students who were emancipated had moderate-risk consumption, 8.2% had a high-risk consumption and 41.8% had a binge drinking episode. There were statistically significant associations between the weekly consumption pattern regarding sex, habitual residence and BDE variables. CONCLUSIONS: More than half the students had taken alcohol the previous week, mainly at weekends. The high prevalence of BDE is highlighted. We propose enhancing early detection and prevention campaigns in this population.

Diferencias entre craving y calidad de vida relacionada con la salud en pacientes con dependencia alcohólica con o sin enfermedad dual en tratamiento ambulatorio: estudio descriptivo / Differences between craving and health-related quality of life in patients with alcohol dependence with or without dual pathology in outpatient treatment: A descriptive study

Fundamentos y objetivo: Enfermedad dual es la coexistencia al mismo tiempo de un trastorno adictivo y otro trastorno mental. El objetivo es estimar el craving y la calidad de vida autopercibida en una muestra de pacientes con dependencia alcohólica, con o sin enfermedad dual, que acuden a un centro de tratamiento ambulatorio. Pacientes y método: Estudio transversal de 112 pacientes (56 duales y 56 no duales) diagnosticados de dependencia de alcohol según el DSM-IV-TR. Se determina la presencia de craving mediante la Escala Multidimensional de Craving de Alcohol y la calidad de vida mediante el Cuestionario de Salud SF-36. Resultados: No existen diferencias estadísticamente significativas en el craving entre ambos subgrupos; los duales tienden a referir menor craving de alcohol que los pacientes no duales. Los dualestienen una peor calidad de vida en todas las categorías evaluadas, destacando una peor calidad de vida en las categorías: función social, rol emocional, vitalidad y salud general. El sexo femenino presenta una menor calidad de vida, destacando las categorías de función social y rol emocional. No se detectan diferencias en relación al craving entre los 2 grupos. Conclusiones: Para realizar un correcto abordaje clínico y terapéutico de los pacientes con dependencia alcohólica se debe plantear evaluar el craving y la calidad de vida, puesto que son parámetros importantes para la evaluación del paciente con dependencia alcohólica. Además, el cravinges un parámetro propio de la dependencia alcohólica, no de la dualidad (AU)

Background and objective: Dual diagnosis is the coexistence of an addictive disorder and another mental disorder. The objective is to estimate cravings and self-reported quality of life in a sample of patients with alcoholic dependence, with or without dual pathology, who attend an outpatient treatment centre. Patients and method: A cross-sectional study of 112 patients (56 dual and 56 non-dual), diagnosed with alcohol dependence according to DSM-IV-TR. The presence of cravings is determined by the Multidimensional Alcohol Craving Scale and quality of life through the SF-36 Health Questionnaire. Results: There are no statistically significant differences in cravings in either subgroup; the latter tend to refer to lower alcohol cravings than non-dual patients. The dual patients have a worse quality of life in all categories evaluated, highlighting a worse quality of life in the categories: social function, emotional role, vitality and general health. Females present a lower quality of life emphasising those of social function and emotional role. No differences were detected in relation to cravings between the 2 groups. Conclusions: In order to perform a correct clinical and therapeutic approach for patients with alcohol dependence, we should consider focusing on the evaluation of cravings and quality of life. In order to perform a correct clinical and therapeutic approach for patients with alcohol dependence, it is necessary to consider cravings and quality of life, since these parameters are important for the evaluation of patients with alcohol dependence (AU)

Differences between craving and health-related quality of life in patients with alcohol dependence with or without dual pathology in outpatient treatment: A descriptive study. / Diferencias entre craving y calidad de vida relacionada con la salud en pacientes con dependencia alcohólica con o sin enfermedad dual en tratamiento ambulatorio: estudio descriptivo.

BACKGROUND AND OBJECTIVE: Dual diagnosis is the coexistence of an addictive disorder and another mental disorder. The objective is to estimate cravings and self-reported quality of life in a sample of patients with alcoholic dependence, with or without dual pathology, who attend an outpatient treatment centre. PATIENTS AND METHOD: A cross-sectional study of 112 patients (56 dual and 56 non-dual), diagnosed with alcohol dependence according to DSM-IV-TR. The presence of cravings is determined by the Multidimensional Alcohol Craving Scale and quality of life through the SF-36 Health Questionnaire. RESULTS: There are no statistically significant differences in cravings in either subgroup; the latter tend to refer to lower alcohol cravings than non-dual patients. The dual patients have a worse quality of life in all categories evaluated, highlighting a worse quality of life in the categories: social function, emotional role, vitality and general health. Females present a lower quality of life emphasising those of social function and emotional role. No differences were detected in relation to cravings between the 2 groups. CONCLUSIONS: In order to perform a correct clinical and therapeutic approach for patients with alcohol dependence, we should consider focusing on the evaluation of cravings and quality of life. In order to perform a correct clinical and therapeutic approach for patients with alcohol dependence, it is necessary to consider cravings and quality of life, since these parameters are important for the evaluation of patients with alcohol dependence.

Validation of the Alcohol Use Disorders Identification Test in university students: AUDIT and AUDIT-C. / Validación del test para la identificación de trastornos por uso de alcohol en población universitaria: AUDIT y AUDIT-C.

The aim of this study was to determine the psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT and AUDIT-C) in order to detect problems related to the consumption of alcohol in the university population. The sample consisted of 1309 students.A Weekly Alcohol Consumption Diary was used as a gold standard; Cronbach's Alpha, the Kappa index, Spearman's correlation coefficient and exploratory factor analysis were applied for diagnostic reliability and validity, with ROC curves used to establish the different cut-off points. Binge Drinking (BD) episodes were found in 3.9% of men and 4.0% of women with otherwise low-risk drinking patterns. AUDIT identified 20.1% as high-risk drinkers and 6.4% as drinkers with physical-psychological problems and probable alcohol dependence.Cronbach's alpha of 0.75 demonstrates good internal consistency. The best cut-off points for high-risk drinking students were 8 for males and 6 for females. As for problem drinkers and probable ADS, 13 was the best cut-off point for both sexes. In relation to AUDIT-C, 5 and 4 were the best cut-off points for males and females with high-risk patterns, respectively. The criterion validity of AUDIT and AUDIT-C to detect binge drinking episodes was found to have a moderate K value. The results obtained show that AUDIT has good psychometric properties to detect early alcohol abuse disorders in university students; however, it is recommended that the cut-off point be reduced to 8 in men. AUDIT-C improves its predictive value by raising the cut-off point by one unit. Items 2 and 3 should be reviewed to increase its predictive value for BD.

El objetivo de este trabajo fue determinar las propiedades psicométricas de los cuestionarios Alcohol Use Disorders Identification Test (AUDIT y AUDIT-C) para la detección de problemas por consumo de alcohol en universitarios. Participaron 1309 estudiantes, utilizando el Diario de consumo semanal como patrón de referencia y para el análisis de fiabilidad y validez el alfa de Cronbach, análisis exploratorio, índice kappa, coeficiente de correlación de Spearman y curvas ROC para los diferentes puntos de corte. Un 3,9% de hombres y un 4% de mujeres con consumo de riesgo bajo presentaba consumo intensivo de alcohol (BD).AUDIT identificó un 20,1% de Bebedor de riesgo y un 6,4% de Bebedor con problemas físico-psíquicos y probable dependencia alcohólica. El instrumento presentó un alfa-Cronbach de 0,75 demostrando buena consistencia interna. Los puntos de corte óptimos fueron ocho para Bebedor de riesgo en hombres y seis para mujeres; trece puntos para Bebedor con problemas físico-psíquicos y probable dependencia alcohólica en ambos sexos; con AUDIT-C, fueron para Consumo de riesgo cinco para hombres y cuatro para mujeres. La validez de criterio para detectar consumo intensivo de alcohol (BD) con ambas versiones presentó un valor K moderado. Los resultados indican que AUDIT cuenta con adecuadas propiedades psicométricas para detectar precozmente problemas de consumo de alcohol en universitarios, recomendándose reducir su punto de corte a ocho en varones. El AUDIT-C mejora su poder predictivo aumentando en una unidad el punto de corte. Se recomienda revisar los ítems 2 y 3 para aumentar el valor predictivo del BD.

Validación del test para la identificación de trastornos por uso de alcohol en población universitaria: AUDIT y AUDIT-C / Validation of the alcohol use disorders identification test in university students: AUDIT and AUDIT-C

El objetivo de este trabajo fue determinar las propiedades psicométricas de los cuestionarios Alcohol Use Disorders Identification Test (AUDIT y AUDIT-C) para la detección de problemas por consumo de alcohol en universitarios. Participaron 1309 estudiantes, utilizando el Diario de consumo semanal como patrón de referencia y para el análisis de fiabilidad y validez el alfa de Cronbach, análisis exploratorio, índice kappa, coeficiente de correlación de Spearman y curvas ROC para los diferentes puntos de corte. Un 3,9% de hombres y un 4% de mujeres con consumo de riesgo bajo presentaba consumo intensivo de alcohol (BD). AUDIT identificó un 20,1% de Bebedor de riesgo y un 6,4% de Bebedor con problemas físico-psíquicos y probable dependencia alcohólica. El instrumento presentó un alfa-Cronbach de 0,75 demostrando buena consistencia interna. Los puntos de corte óptimos fueron ocho para Bebedor de riesgo en hombres y seis para mujeres; trece puntos para Bebedor con problemas físico-psíquicos y probable dependencia alcohólica en ambos sexos; con AUDIT-C, fueron para Consumo de riesgo cinco para hombres y cuatro para mujeres. La validez de criterio para detectar consumo intensivo de alcohol (BD) con ambas versiones presentó un valor K moderado. Los resultados indican que AUDIT cuenta con adecuadas propiedades psicométricas para detectar precozmente problemas de consumo de alcohol en universitarios, recomendándose reducir su punto de corte a ocho en varones. El AUDIT-C mejora su poder predictivo aumentando en una unidad el punto de corte. Se recomienda revisar los ítems 2 y 3 para aumentar el valor predictivo del BD

The aim of this study was to determine the psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT and AUDIT-C) in order to detect problems related to the consumption of alcohol in the university population. The sample consisted of 1309 students. A Weekly Alcohol Consumption Diary was used as a gold standard; Cronbach’s Alpha, the Kappa index, Spearman’s correlation coefficient and exploratory factor analysis were applied for diagnostic reliability and validity, with ROC curves used to establish the different cut-off points. Binge Drinking (BD) episodes were found in 3.9% of men and 4.0% of women with otherwise low-risk drinking patterns. AUDIT identified 20.1% as high-risk drinkers and 6.4% as drinkers with physical-psychological problems and probable alcohol dependence. Cronbach’s alpha of 0.75 demonstrates good internal consistency. The best cut-off points for high-risk drinking students were 8 for males and 6 for females. As for problem drinkers and probable ADS, 13 was the best cut-off point for both sexes. In relation to AUDIT-C, 5 and 4 were the best cut-off points for males and females with high-risk patterns, respectively. The criterion validity of AUDIT and AUDIT-C to detect binge drinking episodes was found to have a moderate K value. The results obtained show that AUDIT has good psychometric properties to detect early alcohol abuse disorders in university students; however, it is recommended that the cut-off point be reduced to 8 in men. AUDIT-C improves its predictive value by raising the cut-off point by one unit. Items 2 and 3 should be reviewed to increase its predictive value for BD