Relación entre el trastorno por déficit de atención con hiperactividad y el trastorno por consumo de sustancias (revisión) / Relation between attention-deficit/ hiperactivity disorder and substance use disorder (a review)

Introducción: Existe una elevada comorbilidad entre el trastorno por déficit de atención e hiperactividad (TDAH) y el trastorno por consumo de sustancias, asociando una mayor gravedad de las adicciones, menor edad de inicio del consumo, así como una mayor cronicidad de la drogodependencia. En los pacientes con patología dual el tratamiento resulta ser una tarea compleja, por lo que la eficacia farmacológica ha sido objeto de múltiples estudios académicos en las últimas décadas. Objetivos: El objetivo principal es realizar una revisión bibliográfica acerca de esta comorbilidad, para conocer si el TDAH se considera un factor de riesgo en el desarrollo de un Trastorno por Consumo de Sustancias (TCS) en la adolescencia y en la edad adulta. También se pretende examinar si el tratamiento farmacológico del TDAH previene el desarrollo de TCS y si es segura su prescripción en pacientes con dicha comorbilidad. Metodología: Se realizó una búsqueda bibliográfica principalmente en la base de datos PubMed, en la que se introdujeron las palabras clave y se aplicaron los criterios de inclusión y de exclusión. Resultados: Los pacientes con TDAH tienen más riesgo de desarrollar dependencia al alcohol (OR 2,31), a la nicotina (OR 2,28) y al cannabis (OR 1,73); así como de desarrollar un TCS (OR 2,49) en la edad adulta. Conclusiones: El TDAH es un factor de riesgo para padecer un TCS, siendo seguro el tratamiento en pacientes con patología dual además de mejorar la drogodependencia. (AU)

Introduction: There is a high comorbidity between attention deficit hyperactivity disorder (ADHD) and substance use disorder, with a higher severity of addictions, an earlier age on the onset of the consumption, as well as an increased chronic drug dependence. In patients with dual pathology treatment appears to be a complex task, causing the pharmacological efficacy to be object of study of multiple academic studies in the recent decades. Objectives: The main objective is to carry out a literature review on this comorbidity, in order to know if ADHD is considered a risk factor in the development of a Substance use disorders (SUD) in adolescence and adulthood. It is also intended to analyze whether the pharmacological treatment of ADHD prevents from the development of SUD and whether its prescription is safe in patients with such comorbidity. Methodology: A bibliographic research was carried out mainly in the PubMed database, in which the keywords were introduced, and the inclusion and exclusion criteria applied. Results: Patients with ADHD are at greater risk of developing dependence on alcohol (OR 2.31), nicotine (OR 2.28) and cannabis (OR 1.73); and developing a substance abuse disorder (SUD) (OR 2.49) in adulthood. Conclusions: Attention deficit hyperactivity disorder is a risk factor for developing a substance abuse disorder, being the treatment safe in patients with dual pathology as well as improving the drug dependence. (AU)

Consumo de drogas y confinamiento/Estado de Alarma Covid-19 / Drug use and confinement / Covid-19 Alarm Status

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Cannabis, opiniones y ciencias / Cannabis, opinions and sciences

Reflexionamos sobre el debate que existe en la comunidad científica acerca de los artículos de opinión que plantean valorar el posible uso terapéutico que puede tener el consumo regulado del Cannabis y, por otra parte, los estudios que muestran la relación entre el consumo de esta sustancia y el riesgo de enfermedad mental. Se diferencia entre "riesgo de enfermedad" y causalidad y se explica el concepto de estocasticidad en psiquiatría. Debemos valorar, así mismo, "el coste de oportunidad que está suponiendo que el debate sobre el cannabis se siga planteando como un conflicto bélico entre partidarios y detractores del uso de esta sustancia milenaria y compleja"

We reflect on the debate that exists in the scientific community about the opinion articles that propose assessing the possible therapeutic use that the regulated cannabis consumption can have and on the other hand the studies that show the relationship between the consumption of this substance and the risk of mental illness. Differs between "risk of disease" and causality, and explain the concept of stochasticity in psychiatry. We must value "the loss of opportunity that is assuming that the debate on cannabis continues to arise as a war conflict between supporters and detractors of the uso of this ancient and complex substance"

Esquizofilia real. Delirio genealógico o delirio de Mignon como realización patoplástica / Royal Eschizophilia. Genealogical delusion or Mignon delusion as a pathoplastic realization

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Interdisciplinaria y adicción neurocultural / Interdisciplinary and neuro-cultural addiction

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Change of attitude in Spanish professional dentists as regards risk of HIV/Aids infection / Cambio actitudinal en dentistas españoles ante el riesgo de VIH

Objective: The aim is to estimate the changes in attitude arising after eighteen years in the perception of the risk of contracting HIV/Aids among Spanish dental health workers and the general public. Design: We performed a cross-sectional comparative investigation with the data collected from a survey in 1996 and 2014. Method: two experimental random samples have been selected which make up both groups of dental health workers and general population. Participants were provided with the Global AIDS Attitudes questionnaire and form a B Eysenck Personality Inventory. The data was subsequently subjected to statistical analysis in order to find any significant differences in both years’ samples. Results: The general public of 1996 perceived greater risk in situations like ‘surgery with risk for the patient’ and ‘donating blood’ than dentists. That trend was inverted in 2014. In 1996, male dentists perceived more risk in general terms than women, but in 2014 women assigned more risk (mainly in dental surgery or sharing a syringe). According to age, only in 1996 data showed that dentists over forty perceived more risk than those under twenty-five. Conclusion: After 18 years, positive changes in the general public’s attitudes have taken place but dental health workers have increased their perception of risk of contagion. In the 1996 survey male dentists perceived greater risk while in 2014 it was women who perceived this

Objetivo: estimar los cambios actitudinales producidos en los dentistas españoles y la población general ante la percepción de riesgo de contagio del VIH/Sida dieciocho años después. Diseño: se ha realizado un estudio comparativo transversal de los datos obtenidos por una encuesta realizada en 1996 y otra en el año 2014. Método: se han seleccionado dos muestras aleatorias experimentales que conforman los grupos de profesionales dentistas y población general. A los participantes se les ha administrado el Cuestionario Global de Actitudes del SIDA y la forma B del Inventario de Personalidad de Eysenck. Posteriormente los resultados se han sometido a análisis estadístico para comprobar si existen diferencias significativas entre los resultados de ambos años. Resultados: En 1996 la Población General (PG) percibió más riesgo de contagio que los Dentistas (DT) en la ‘intervención quirúrgica con riesgo para el paciente’ y en la donación de sangre y en el año 2014 son los dentistas los que perciben mayor riesgo. Según sexo, en 1996 son los dentistas varones los que perciben más riesgo, pero en 2014 son las mujeres las que lo perciben (en intervención dental o quirúrgica o al compartir jeringuilla). En relación con la edad solo en 1996 se encontró más percepción de riesgo en dentista mayores de 40 años y menores de 25 años. Conclusiones: Tras 18 años se ha producido un cambio favorable en la percepción de riesgo de contagio en la población general pero los dentistas han aumentado su percepción de riesgo de contagio. En la encuesta de 1996 los hombres dentistas percibían más riesgo y en el 2014 las mujeres

La Revista Española de Drogodependencias: un proceso y una continua dedicación profesional durante 40 años / Revista Española de Drogodependencias: a process and a continuous professional dedication for 40 years

Se presentan los principales cambios e innovaciones producidos en la Revista Española de Drogodependencias , en adelante RED, entre los años 2006-2016 (cuarta década de edición de la revista). Primera publicación científica de habla hispana especializada en alcoholismo y otras adicciones proveniente del modelo de revistas biomédicas. Los cambios hechos en el transcurso de sus cuarenta años ininterrumpidos de edición la han convertido en una revista independiente con temática diversa dirigida a todos los profesionales del campo de las adicciones. Se describen los cambios realizados en el proceso editorial, la innovación y la investigación, la cuestión del género en los órganos de decisión así como otros aspectos sobre la visibilidad y la financiación

The main changes and innovations produced in the Revista Española de Drogodependencias, herein-after RED, are presented between 2006-2016 (fourth decade of publication). First Spanish-language scientific publication specializing in alcoholism and other addictions from the model of biomedical journals. The changes made in the course of its forty years of uninterrupted editing have made it an independent magazine with a diverse theme addressed to all professionals in the field of addictions. It describes changes in the editorial process, innovation and research, gender issues in decision-making bodies as well as other aspects of visibility and funding

Adicciones y Big Data / Addictions and Big Data

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Adicción y conciencia avatar / Addiction and Avatar Consciousness

El objetivo de este trabajo es entender el cambio de estado o dimensión de conciencia del paciente adicto. No es suficiente con el conocimiento del estado de conciencia consensuado pues aparece en muchos pacientes un nuevo estado de conciencia que le impele al consumo y quizá, si no tenemos capacidad de catalizar en ellos una conciencia unitiva, no consigamos mejorar los fracasos frecuentes que tenemos con muchos de estos pacientes

This work sets out to understand the change in the state or dimension of the addicted patient’s consciousness. Knowledge of the consensual state of consciousness is not enough, since a new state of consciousness appears in many patients, driving them to consumption, and we will quite possibly not manage to improve on the frequent failure rates that we find with many of these patients if we are unable to catalyse a unitive consciousness in them

Analgesic and physiological effects in conscious sedation with different nitrous oxide concentrations.

OBJECTIVES: to study the physiological changes, as well as the psychosedative and analgesic effects of nitrous oxide, in experimental conditions. STUDY DESIGN: 101 dental students volunteers participated in a single nitrous oxide sedation session without dental treatment. Signs and symptoms were registered during and after the procedure. Pulse rate and hemoglobin oxygen saturation were monitored at: 100 per cent O2, 30 per cent N2O, 50 per cent N2O and 5 minutes after 100 per cent O2. A Likert scale was used to evaluate pain perception. The analgesic effects of nitrous oxide were evaluated at: 30 per cent N2O, 50 per cent N2O, and five minutes postoperatively. RESULTS: Pulse rate and hemoglobin oxygen saturation decreased significantly through all the procedure and after recovery. However, oxygen saturation recovered after the final oxygenation. Only 8.2% of subjects reported the pain stimulus as being quite annoying when they inhaled 30 per cent N2O, while this percentage was of 15.8 % when inhaling 50 per cent N2O, and of 32.7 % during the recovery period. The most common effects of nitrous oxide sedation were bright eyes (99%), voice change (98%) and smiling (91%). Most of the subjects reported tingling (98%) and relax (91.1%) CONCLUSIONS: nitrous oxide causes a significant decrease in heart rate and oxygen saturation, but always within safety limits. Maintaining an appropriate level of consciousness was confirmed as a feature in 50 per cent dose in this study. The analgesic effect of nitrous oxide was confirmed but a dose dependency could not be established. Key words:Nitrous oxide, conscious sedation, anxiolysis, safety, physiogical parameters, signs, symptoms, analgesia.

Anxiety before extraction of impacted lower third molars

OBJECTIVES: Assess levels of trait anxiety, state anxiety and dental anxiety before extraction of lower third molars and check the correlation and reliability of the scales used for the measurement of preoperative anxiety. Study DESIGN: A prospective study of patients treated with extraction of a lower third molar between September2010 to December 2010 was carried out. A total of 125 patients were included in the study. All of them were patients of the Oral Surgery and Implantology Department (Valencia University Medical and Dental School, Valencia, Spain). Before surgery, patients had to complete a preoperative protocol with 4 scales: the STAI-T (State-Trait Anxiety Inventory-Trait) for measuring trait anxiety, the STAI-S (State-Trait Anxiety Inventory-State) for measuring state anxiety, and DAS (Dental anxiety Scale of N. Corah) and APAIS (Amsterdam Preoperative anxiety and Information Scale) for measuring dental anxiety. RESULTS: Patients undergoing extractions of an impacted lower third molar showed low levels of trait anxiety and moderate levels of state anxiety and dental anxiety. Higher levels of trait anxiety were obtained for older patients. Women had higher mean levels of dental anxiety and state anxiety that men with a statistically significant difference in STAI-S scales, DAS, and APAIS. Patients with higher trait anxiety and state anxiety showed higher levels of dental anxiety. A significant correlation (p ≤ 0.01) (p = 0.00) was found between the four scales used to measure anxiety. The scale showed higher correlation was STAI-S scale. The 4 scales showed high reliability (alpha of C.> 0.80).CONCLUSIONS: Patients with highest levels of trait anxiety and state anxiety, had more dental anxiety. The STAI-T,STAI-S, DAS and APAIS scales provided useful information about anxiety before the extraction of lower impacted third molars. The STAI-S is the scale with highest correlation and reliability

Anxiety before extraction of impacted lower third molars.

OBJETIVES: Assess levels of trait anxiety, state anxiety and dental anxiety before extraction of lower third molars and check the correlation and reliability of the scales used for the measurement of preoperative anxiety. STUDY DESIGN: A prospective study of patients treated with extraction of a lower third molar between September 2010 to December 2010 was carried out. A total of 125 patients were included in the study. All of them were patients of the Oral Surgery and Implantology Department (Valencia University Medical and Dental School, Valencia, Spain). Before surgery, patients had to complete a preoperative protocol with 4 scales: the STAI-T (State-Trait Anxiety Inventory-Trait) for measuring trait anxiety, the STAI-S (State-Trait Anxiety Inventory-State) for measuring state anxiety, and DAS (Dental anxiety Scale of N. Corah) and APAIS (Amsterdam Preoperative anxiety and Information Scale) for measuring dental anxiety. RESULTS: Patients undergoing extractions of an impacted lower third molar showed low levels of trait anxiety and moderate levels of state anxiety and dental anxiety. Higher levels of trait anxiety were obtained for older patients. Women had higher mean levels of dental anxiety and state anxiety that men with a statistically significant difference in STAI-S scales, DAS, and APAIS. Patients with higher trait anxiety and state anxiety showed higher levels of dental anxiety. A significant correlation (p ≤ 0.01) (p = 0.00) was found between the four scales used to measure anxiety. The scale showed higher correlation was STAI-S scale. The 4 scales showed high reliability (α of C.> 0.80). CONCLUSIONS: Patients with highest levels of trait anxiety and state anxiety, had more dental anxiety. The STAI-T, STAI-S, DAS and APAIS scales provided useful information about anxiety before the extraction of lower impacted third molars. The STAI-S is the scale with highest correlation and reliability.

Tratamiento de la drogadicción de larga duración y ontoterapia. A propósito de tres casos / No disponible

Los autores analizan, a partir de tres casos, factores clínicos, sociales, temperamentales y situacionales en pacientes drogodependientes de larga duración. Se valora especialmente la importancia que tiene el hecho que el consumo de drogas empiece en la adolescencia pues esto dificulta significativamente la creación de relaciones sociales y laborales estables. Además, las dificultades de adaptación son especialmente graves cuando los pacientes han llegado a una edad cercana o superior a los 30 años sin haber dejado de consumir drogas. El análisis fenomenológico-histórico nos lleva a la conclusión de que en muchos casos si no hay una conciencia reflexiva centrada en un proyecto vital, el tratamiento suele fracasar. La posibilidad de realizar un tratamiento ontoterápico ha de valorarse como un paso importante para evaluar las posibilidades fiables de curación en pacientes consumidores de larga duración (AU)

The authors analyze clinical, social, temperamental and situational factors from three cases of patients with drug dependence. The importance of using drugs from adolescence was given particular value since this signifi cantly complicates the creation of their employment and social relations. Adaptation diffi culties are moreover particularly serious when the patient reaches the age of thirty years old or more without having ceased to consume drugs. We reach the conclusion through phenomenologicalhistorical analysis that the treatment tends to fail if there is no refl exive conscience focused on a life project. The chance of performing ontotherapy treatment has to be valued as a signifi cant step forward for appraising the reliable possibilities of recovery of long-term drug consumers (AU)