Efficacy of the Therapeutic Game "Trisquel" in the Treatment of Patients With Substance-Related Disorders Randomized Clinical Study.

Substance-related disorders (SRD) have been consistently associated with alterations both in cognitive and executive functions, which affect to patients' quality of life. The main objective of this work was to test the beneficial cognitive effects on patients with SRD after the implementation of "Trisquel," an intervention program in board game format. To check the effectiveness of Trisquel program, a group of people diagnosed with SRD was randomly assigned either to the experimental group or to the control group. The experimental group performed Trisquel structured sessions twice a week during 3 months, while the control group performed routinely conventional therapeutic activities with the same frequency and duration. Neuropsychological tests were done to both groups before and after the intervention. After the 3 months of intervention the experimental group showed the following statistically significant improvements for WAIS-III subtests: number key, symbol search, arithmetic, direct digits, inverse digits, total digits, letters-numbers in the processing speed index and in the working memory index. Regarding STROOP tests, statistically significant progress was observed in the phonetic fluency letter P, phonetic fluency letter M, phonetic fluency letter R subtests, word-reading and word-color subtests. The control group only obtained improvements for WAIS-III subtests of arithmetic, letters-numbers and in the working memory index. The results of this study confirm that "Trisquel" is an effective intervention program for people diagnosed with SRD, getting improvements in processing speed (psychomotor and reading), attentional subprocesses (focused and sustained) and executive functions (updating and inhibition).

A pilot study on the adequacy of the TOMM in detecting invalid performance in patients with substance use disorders.

Objective: The validity of neuropsychological test performance has scarcely been studied in patients with substance use disorders (SUD), despite the possibility that some SUD individuals may distort their performance for compensation seeking (e.g., work leave, permanent or total disability, or the designation of services such as sheltered housing). Thus, the aim of the present study is to determine: (i) the possible utility of the Test of Memory Malingering (TOMM) in detecting invalid test results among SUD patients, and (ii) the percentage of individuals that underperform the TOMM among SUD patients seeking compensation.Method: Seventy-seven patients (59 men and 18 women) with SUD in outpatient treatment with an age range between 20 and 59 years were divided into two groups: SUD patients without compensation seeking (n = 41), and SUD patients with compensation seeking (n = 36). Participants performed a neuropsychological assessment with measures of processing speed, working memory, inhibition, verbal memory, cognitive flexibility, and decision-making, that also included the TOMM.Results: Our results demonstrate that there were no significant differences on TOMM performance between the two groups. Only one participant underperformed the TOMM (1.3% of the sample). Results showed cognitive impairment in the sample, but no differences between the groups on the different neuropsychological measures.Conclusions: This constitutes the first study to explore the capacity of a forced-choice test to detect invalid test results in an SUD population. There was a high performance on the TOMM among the SUD participants of our study despite their cognitive impairment, indicating adequate effort in their neuropsychological test performance. Further, these findings suggest that the probability of showing invalid neuropsychological performance among SUD compensation seeking patients is much lower than what has been found in other populations, such as in mild brain injury patients.

Effectiveness of the “Trisquel” board game intervention program for patients with schizophrenia spectrum disorders.

Schizophrenia spectrum disorders present emotional, cognitive and/or behavioural alterations relat- ed to daily functioning. Therefore, it is necessary to develop intervention programs focused on the improvement of these constructs. The aim of this work is to analyse the effect of the intervention program “Trisquel” on cognitive functioning, symptomatologic perception and psychosocial functioning.

Efectividad del programa de intervención «El Trisquel» en personas con trastornos del espectro de la esquizofrenia / Effectiveness of the «Trisquel» board game intervention program for patients with schizophrenia spectrum disorders

INTRODUCCIÓN: Los trastornos del espectro de la esquizofrenia presentan alteraciones emocionales, cognitivas o conductuales relacionadas con el funcionamiento diario. Por ello, es necesario desarrollar programas de intervención enfocados a la mejora de estos constructos. El objetivo de este trabajo es analizar el efecto en el funcionamiento cognitivo, la percepción sintomatológica y el funcionamiento psicosocial del programa de intervención «El Trisquel». METODOLOGÍA: Se llevó a cabo un diseño experimental con un total de 24 personas con diagnóstico de trastorno del espectro de la esquizofrenia que fueron asignadas aleatoriamente al grupo experimental «El Trisquel» y al grupo control. El grupo «El Trisquel» realizó dos sesiones estructuradas semanales durante tres meses, mientras que el grupo control realizó sesiones de estimulación cognitiva con la misma frecuencia e intensidad. Se administraron pruebas neuropsicológicas, clínicas y funcionales antes y después de la intervención. RESULTADOS: Tras el programa de intervención, en el grupo «El Trisquel» se encontraron mejorías estadísticamente significativas en los subtests de letras y números (p = 0,029), en el índice de memoria de trabajo (p = 0,020) WAIS-III, en sensibilidad interpersonal (p = 0,015) e ideación paranoide (p = 0,049) SCL-90-R y en funcionamiento psicosocial EEAG (p = 0,020). Y en el grupo control, en velocidad de procesa-miento (p = 0,034) WAIS-III y percepción de la salud SF-36 (p = 0,017). CONCLUSIONES: Los resultados de este estudio sugieren que «El Trisquel» puede ser un programa de intervención eficaz para inducir mejoras en el funcionamiento de la memoria operativa, en las dimensiones sintomatológicas de sensibilidad interpersonal e ideación paranoide y en el funcionamiento psicosocial en personas con diagnóstico de trastorno del espectro de la esquizofrenia

INTRODUCTION: The disorders of the schizophrenia spectrum present emotional, cognitive and/or behavioural alterations, related to daily functioning, therefore it is necessary to develop intervention programmes focused on the improvement of these constructs. The objective of this work is to analyze the effect on cognitive functioning, symptomatological perception and psychosocial functioning of the Trisquel intervention program. METHODOLOGY: An experimental design was carried out with a total of 24 people with a diagnosis of schizophrenia spectrum disorder who were randomly assigned to the experimental group Trisquel and the control group. The Trisquel group con-ducted two structured weekly sessions for three months, while the control group conducted cognitive stimulation sessions with the same frequency and intensity. Neuropsychological, clinical and functional tests were administered before and after the intervention. RESULTS: After the intervention program in the Trisquel group, statistically significant improvements were found in the subtest of letters and numbers (p = 0,029), in the working memory index (p = 0,020) WAIS-III, in interpersonal sensitivity (p = 0,015) and paranoid ideation (p = 0,049) SCL-90-R and in psychosocial functioning EEAG (p = 0,020). And in the control group, in processing speed (p = 0,034) WAIS-III and health perception SF-36 (p = 0,017). CONCLUSIONS: The results of this study suggest that «Trisquel» may be an effective intervention program to induce improvements in the functioning of working memory, in the symptomatic dimensions of interpersonal sensitivity and paranoid ideation, and in psychosocial functioning in people with a diagnosis of schizophrenia spectrum disorder

Diferencias entre hombres y mujeres en los procesos de toma de decisiones en pacientes con trastornos relacionados con sustancias / Differences between men and women in decision-making processes in patients with substance-related disorders

Resumen Los trastornos relacionados con sustancias (TRS) pueden cursar con alteraciones neuropsicológicas que afectan las actividades de la vida diaria de una persona. El objetivo principal de este trabajo es estudiar el proceso de la toma de decisiones en pacientes con TRS y analizar si hay diferencias entre hombres y mujeres. Se administró una versión computarizada de la Iowa Gambling Task (IGT) a una muestra total de 101 pacientes con TRS que solicitaron tratamiento ambulatorio, 81 hombres (80,2%) y 20 mujeres (19,8%). Los resultados muestran una alteración en la toma de decisiones. Asimismo, se observó un peor rendimiento en el grupo de los hombres en la toma de decisiones en comparación con el grupo de las mujeres. Estos datos comprueban la importancia de tener en cuenta el sexo a la hora del diagnóstico e intervención en personas con TRS. Se precisan estudios futuros que profundicen en estas diferencias.

Abstract Substance-related disorders (TRS) can cause neuropsychological alterations that affect the activities of a person's daily life. The main objective of this work is to study the process of decision making in patients with TRS and to analyze if there are differences between men and women. A computerized version of the Iowa Gambling Task (IGT) was administered to a total sample of 101 patients with TRS who requested outpatient treatment, 81 men (80.2%) and 20 women (19.8%). The results obtained show an alteration in the decision making. Likewise, a worse performance was observed in the group of men in decision making compared to the group of women. These data point to the importance of taking into account sex at the time of diagnosis and intervention in people with SDB. Future studies are needed to delve into these differences.

Neuropsychological functioning in methadone maintenance patients with HIV / Función neuropsicológica en el tratamiento de mantenimiento con metadona en pacientes con VIH

Although highly active antiretroviral therapy (HAART) has improved survival rates of HIV patients, HIV-associated neurocognitive disorders (HAND) still exist in a highly prevalent group of persons with this disease. In this study we seek to evaluate the influence of drug use in the neuropsychological performance of seropositive drug users. We carried out an extensive neuropsychological evaluation and compared the performance of seropositive drug users (n = 90) with that of a control group of seronegative drug users (n = 48). The results reveal that methadone maintenance programmes can make the seropositive subject neuropsychologically vulnerable. Likewise, we found that giving up drugs have a protective effect in the presence of neuropsychological alterations associated with HIV. These findings lead us to suggest that seropositivity is not sufficient to explain the neuropsychological alterations of seropositive drug users, noting that these alterations are multifactorial.

Aunque la terapia antirretroviral de gran actividad (TARGA) ha mejorado los índices de supervivencia de los pacientes infectados por el VIH, los trastornos neurocognitivos asociados con el VIH (TNAV) todavía existen en un grupo de personas altamente prevalente a esta enfermedad. En este estudio buscamos evaluar la influencia del consumo de drogas en el rendimiento neuropsicológico de los usuarios de drogas seropositivos. Llevamos a cabo una amplia evaluación neuropsicológica, y el rendimiento de los usuarios de drogas seropositivos (n = 90) se comparó con la de un grupo control de usuarios de drogas seronegativos (n = 48). Los resultados demuestran que los programas de tratamiento de mantenimiento con metadona pueden convertir en vulnerable a nivel neuropsicológico al individuo seropositivo. Asimismo, descubrimos que abandonar las drogas provoca un efecto protector frente a la existencia de alteraciones neuropsicológicas asociadas con el VIH. Estos resultados nos llevan a sugerir que la seropositividad no basta para explicar las alteraciones neuropsicológicas de los usuarios de drogas seropositivos, ya que estas alteraciones al parecer son multifactoriales.

Alteraciones neuropsicológicas en pacientes con VIH e historia previa de consumo de sustancias. Un estudio preliminar / HIV-related neuropsychological impairment in patients with previous substance use: A preliminary study

El virus de la inmunodeficiencia humana (VIH) puede llegar a producir alteraciones cognitivas que interfieren de forma significativa en la vida diaria de las personas que lo padecen. Estos déficits pueden incrementarse cuando existe historia previa de consumo de sustancias psicoactivas. El objetivo de este trabajo es estudiar el perfil neuropsicológico de un grupo de pacientes con VIH e historia previa de consumo de drogas y compararlo con un grupo de pacientes ex drogodependientes seronegativos. Se administró una batería neuropsicológica a una muestra de 28 sujetos españoles, 14 con VIH y 14 seronegativos, donde se evaluaron los 8 dominios cognitivos que suelen estar más afectados en el VIH: atención/memoria de trabajo, velocidad de procesamiento de la información, memoria/aprendizaje, abstracción/función ejecutiva, lenguaje/verbal y habilidades motoras. Los resultados mostraron peor ejecución del grupo con VIH en todos los dominios cognitivos. El menor rendimiento neuropsicológico del grupo con VIH podría deberse presumiblemente a la acción del virus. Independientemente de cuál sea la etiología del deterioro cognitivo, lo importante es detectar los déficits neuropsicológicos de la forma más precoz posible para mejorar la calidad de vida de los pacientes mediante la intervención neuropsicológica.

Human immunodeficiency virus (HIV) can result in cognitive disorders that significantly interfere with the daily activities of HIV patients. These disorders may be worse when there is a history of psychoactive substance use. Our objective is to assess the neuropsychological profile in a group of HIV patients with previous drug use compared to a group of HIV-negative patients with a history of drug use. The study included a total of 28 Spanish adult subjects, of which 14 were HIV-infected and 14 were HIV-negative. The subjects were assessed using a neuropsychological test battery to evaluate the following 8 most commonly affected cognitive domains in people with HIV: attention and working memory, speed of information processing, memory and learning capacity, abstract thinking and executive functions, speech and language skills, and psychomotor skills. The results showed a worse performance in all the cognitive areas among HIV patients as compared to HIV-negative patients. The worse performance of this group could be a result of the viral infection. Regardless of the cognitive impairment a etiology, the key task here is to diagnose neuropsychological deficits as soon as possible in order to improve the quality of life of HIV patients through neuropsychological intervention.