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1.
J Forensic Sci ; 65(1): 160-165, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31343744

RESUMO

The characteristics of mental disorders, as well as deficiencies in their treatment, must be properly defined. This was a prospective, longitudinal, observational study, in which all men referred to a penitentiary psychiatric consultation of three penitentiary centers in Spain were invited to participate. Those who consented to participation (1328) were interviewed at the baseline timepoint and at intervals for up to 3 years. The presence of mental disorders was high: 68.2% had a cluster B personality disorder, 14% had an affective and/or anxiety disorders, 13% had schizophrenia, and over 80% had a dual disorder. Polypharmacy was the norm. Moreover, the health care received in prison did not match that provided in the community in terms of quantity and quality. These results should help to facilitate the design of mental healthcare provision for prisoners, focusing on both the most frequent patient profiles and equality of care.


Assuntos
Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Prisioneiros/psicologia , Prisões , Adulto , Coinfecção , Feminino , Infecções por HIV/epidemiologia , Hepatite C Crônica/epidemiologia , Humanos , Estudos Longitudinais , Masculino , Polimedicação , Estudos Prospectivos , Psicotrópicos/uso terapêutico , Espanha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
2.
J Addict Med ; 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31743124

RESUMO

OBJECTIVES: Prescription opioid use disorder (POUD) is an established public health crisis in many countries, and current evidence indicates it is a growing problem in Europe. Many specialists play a role, including pain and addiction medicine specialists, in the diagnosis and management of POUD, but neither group can fully address these patients' needs alone. The purpose of this consensus process was to bring together experts from pain and addiction medicine to examine the positions of both specialties. METHODS: In all, 13 international pain medicine, addiction medicine, and addiction psychiatry experts convened a meeting to formulate a set of consensus statements on the diagnosis and management of POUD. The statements were further refined by a wider group of 22 European expert clinicians. At a second meeting of all 35 participants, a set of controversy statements was also developed to recognize some of the key areas of divergent opinion. RESULTS/CONCLUSIONS: There was a high level of agreement between pain and addiction specialists. Key themes that emerged were the need to strengthen interdisciplinary communication, a desire for greater education and training for clinicians in both specialties, and mutual acknowledgment of the importance of multidisciplinary management of POUD. The blurred line between poorly managed pain and POUD was also a subject of much discussion, reflecting the difficulties in defining and diagnosing this complex condition.

3.
Medicine (Baltimore) ; 98(43): e17489, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651851

RESUMO

Very few studies have been published on cardiovascular morbidity in Spanish patients diagnosed with systemic lupus erythematosus (SLE). Moreover, knowledge of the predictive factors for the occurrence of nonfatal events in this group of patients is scarce.This was a multicenter, observational, cross-sectional study designed to ascertain the prevalence of nonfatal cardiovascular risk factors and cardiovascular events (CVEs) in 335 Spanish women diagnosed with SLE between 2003 and 2013.The average patient age was 36.0 years (range: 26.4-45.6); 35 patients (10.7%) experienced at least 1 CVE, which most frequently affected the brain, followed by the heart, and finally, the peripheral vasculature. Both the number of admissions because of SLE (95% confidence interval [CI] odds ratio [OR] = 1.024-1.27, P = .017) and the systemic lupus international collaborating clinics (SLICC) chronicity index score (95% CI OR = 1.479-2.400, P = .000) resulted in an increase in the OR of these patients presenting a CVE. Regarding the classic risk factors, only the interaction between hypertension (HT) and treatment with antihypertensive drugs influenced the presence of CVEs (95% CI OR = 2.165-10.377, P = .000). The presence of a family history of early cardiovascular disease was also related to CVEs (95% CI OR = 2.355-40.544, P = .002). Binary logistic regression including the above factors resulted in a model in which the 3 main variables in each group persisted, implying that they must be independent of each other. However, the weight of the interaction between the family history of early cardiovascular disease and the interaction between HT and the use of antihypertensives was higher than for the number of admissions for SLE.The SLE disease activity over time (measured using the SLICC) and the number of hospital admissions due to the disease itself, both increase the risk of women with SLE presenting a CVE. Classic cardiovascular risk factors, especially HT and its treatment, as well as a family history of early CVEs, should be considered when assessing the risk of nonfatal CVEs in women with SLE.


Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Lúpus Eritematoso Sistêmico/complicações , Adulto , Anti-Hipertensivos/uso terapêutico , Estudos Transversais , Feminino , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Hipertensão/etiologia , Modelos Logísticos , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Medição de Risco , Fatores de Risco , Espanha/epidemiologia
4.
J Dual Diagn ; 15(4): 243-253, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31287382

RESUMO

Objective: Schizophrenia, cocaine-related disorder, antisocial personality disorder, and psychopathy share biological bases, but few studies discriminate between these disorders by means of prepulse inhibition. This work studies the phenotype of patients with cocaine-related disorders who are vulnerable to presenting a dual diagnosis of schizophrenia or antisocial personality disorder, by evaluating their prepulse inhibition, impulsivity and psychopathy personality traits. Methods: The sample (n = 38) was divided into three groups: (1) cocaine-related disorder (8 individuals diagnosed with cocaine-related disorder who did not present any other mental disorder), (2) cocaine-related disorder and schizophrenia (n = 14), and (3) cocaine-related disorder and antisocial personality disorder (n = 16). Results: The prepulse inhibition in the two groups with dual diagnosis was lower than that in the cocaine-related disorder group, F(2, 35) = 6.52, p = .004, while there was no significant differences between the two dual-diagnosis groups. Psychopathy was evaluated with the revised Hare Psychopathy Checklist and showed no correlation with the prepulse inhibition. Secondary psychopathy (impulsivity and poor behavior control), as evaluated with Levenson Self-Report Psychopathy Scale, was related to the prepulse inhibition. Two discriminating functions were obtained that allowed prediction of patient inclusion in the groups using the prepulse inhibition and the revised Hare Psychopathy Checklist with a success rate of 81.6% (cocaine-related disorder = 62.5%; cocaine-related disorder and schizophrenia = 78.6%; cocaine-related disorder and antisocial personality disorder = 93.8%). These results are discussed in regard to the neurobiological implications of prepulse inhibition in dual diagnosis. Conclusions: The results suggest that the prepulse inhibition is a promising dual-diagnosis vulnerability marker in individuals with cocaine addiction, because prepulse inhibition deficits are related both to schizophrenia and antisocial personality disorder. In addition, prepulse inhibition, which is considered a good endophenotype for studies on the genetic and neurobiological basis of cocaine-related disorder and schizophrenia, could be used in the same way in studies on antisocial personality disorder.

5.
Int J Ment Health Nurs ; 28(5): 1090-1098, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31184429

RESUMO

Checking whether changes in the perception of the quality of life related to health, after the nursing intervention, influence these patients' motivation to change. This was a two-staged study undertaken in entertainment-sector workers in Spain: the first part was transversal and observational, and the second was semi-experimental. First part undertook in 284 entertainment-sector workers, selected by non-probabilistic sampling, while second part undertook in 50 entertainment-business workers, selected by consecutive sampling from those who consumed substances. A short group-based motivational intervention session was implemented by nursing staff, and a before and after evaluation was completed. The EuroQol-5D and Test for the Evaluation of the Quality of Life in Addicts to Psychoactive Substances (TECVASP) were used. The patients' motivation to change was evaluated through the Stages of Change Readiness and Treatment Eagerness Scale. The results analysis showed that the nursing intervention reduced the participants' perceptions of their health-related quality of life (t = 4.23; P = 0.00009) and of their quality of life in addicts to psychoactive substances (t = 3.38; P = 0.00140). There was an increase in the motivation of 6 workers (12%) to seek treatment of their addiction (χ2  = 13.02; P = 0.0091). The post-test contemplation stage score was predicted (F = 6.56; P = 0.003; R = 0.46) with post-test TECVASP score and pre-post difference in TECVASP score. By reducing the patients' perception of their quality of life, this brief nursing intervention facilitated a favourable increase in the motivation for change among these workers and was effective in 12% of cases.

6.
Adicciones ; 31(2): 117-135, 2019 Apr 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29353299

RESUMO

Parenting is linked to conduct disorders (CD) and substance related disorders (SRD) in adolescents, but with differences according to cultural context. A questionnaire with two versions (parenting questionnaire TXP-A for adolescents and TXP-C  for primary caregivers) was designed using the Delphi method to evaluate parenting practices related to CD and SRD in a Spanish population. It was validated in a community sample of 631 adolescents aged between 14 and 16 and their caregivers. Results suggest a 29-item TXP-A questionnaire with bifactorial structure: affection-communication and control-structure, with high internal (Cronbach’s alpha=0.89) and test-retest (intraclass correlation coefficient=0.94) reliabilities. Both factors are related to SRD (r=0.273, p<0.001) and with most of the psychopathological dimensions studied. The total score and affection-communication are related to dissocial disorder (t=3.259, p=0.001) and its severity (r=-0,119; p=0.003). Inter-observer reliability between adolescents and caregivers is low, in part because the 16-item TXP-C has a different bifactorial structure: affection-communication and prosocial values. TXP-C’s internal (Cronbach’s alpha=0.87) and test-retest (intraclass correlation coefficient=0.94) reliabilities are high. The total score and affection-communication were related to dissocial disorder (t=2.586; p=0.010) but TXP-C did not discriminate according to SRD. In conclusion, the TXP-A questionnaire for adolescents seems to be a reliable, valid and unbiased instrument that evaluates the perception of parenting practices, relating higher affection-communication and control-structure to less psychopathology and alcohol and drug use. TXP-C also seems to be reliable and unbiased, but shows less evidence of validity regarding substance use and psychopathology. .


Assuntos
Comportamento do Adolescente/psicologia , Poder Familiar/psicologia , Psicometria/instrumentação , Inquéritos e Questionários , Adolescente , Adulto , Transtorno da Conduta/diagnóstico , Transtorno da Conduta/psicologia , Técnica Delfos , Análise Fatorial , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Espanha , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/psicologia
7.
Adicciones (Palma de Mallorca) ; 31(2): 117-135, 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185206

RESUMO

El estilo parental de socialización se relaciona con trastornos de conducta (TC) y trastornos relacionados con sustancias (TRS) en adolescentes, con diferencias según el contexto cultural. Se diseñó mediante método Delphi un cuestionario con dos versiones (Cuestionario de socialización parental TXP-A para adolescentes y TXP-C para cuidador principal) para evaluar en población española las prácticas de socialización parental relacionadas con TC y TRS. Se validó en una muestra comunitaria de 631 adolescentes entre 14 y 16 años y sus cuidadores. Los resultados recomiendan un cuestionario TXP-A de 29 ítems y estructura bifactorial: afecto-comunicación y controlestructura, mostrando alta fiabilidad interna (alfa de Cronbach = 0,89) y test-retest (coeficiente de correlación intraclase = 0,94). Ambos factores correlacionan con TRS (r = 0,273; p < 0,001) y con la mayoría de las dimensiones psicopatológicas estudiadas. La puntuación total y afectocomunicación se relacionan con el trastorno disocial (t = 3,259; p = 0,001) y su gravedad (r = -0,119; p = 0,003). La fiabilidad interjueces entre adolescentes y cuidadores es baja, en parte porque el TXP-C, de 16 ítems, presenta una estructura bifactorial diferente: afecto-comunicación y valores prosociales. La fiabilidad interna (alfa de Cronbach = 0,87) y test-retest (coeficiente de correlación intraclase = 0,94) del TXP-C son altas. La puntuación total y afecto-comunicación se relacionan con el trastorno disocial (t = 2,586; p = 0,010) pero no discrimina según el TRS. En conclusión, el cuestionario TXP-A para adolescentes parece un instrumento fiable, válido y sin sesgos que evalúa la percepción de las prácticas de socialización parental, relacionando mayores puntuaciones en afecto-comunicación y control-estructura con menor psicopatología y consumo de alcohol y drogas. El TXP-C también parece fiable y sin sesgos, pero muestra menos evidencias de validez respecto al consumo de sustancias y la psicopatología


Parenting is linked to conduct disorders (CD) and substance related disorders (SRD) in adolescents, but with differences according to cultural context. A questionnaire with two versions (parenting questionnaire TXP-A for adolescents and TXP-C for primary caregivers) was designed using the Delphi method to evaluate parenting practices related to CD and SRD in a Spanish population. It was validated in a community sample of 631 adolescents aged between 14 and 16 and their caregivers. Results suggest a 29-item TXP-A questionnaire with bifactorial structure: affection-communication and control-structure, with high internal (Cronbach's alpha = 0.89) and test-retest (intraclass correlation coefficient = 0.94) reliabilities. Both factors are related to SRD (r = 0.273, p < 0.001) and with most of the psychopathological dimensions studied. The total score and affection-communication are related to dissocial disorder (t = 3.259, p = 0.001) and its severity (r = -0,119; p = 0.003). Inter-observer reliability between adolescents and caregivers is low, in part because the 16-item TXP-C has a different bifactorial structure: affection-communication and prosocial values. TXP-C's internal (Cronbach’s alpha=0.87) and test-retest (intraclass correlation coefficient=0.94) reliabilities are high. The total score and affection-communication were related to dissocial disorder (t = 2.586; p = 0.010) but TXP-C did not discriminate according to SRD. In conclusion, the TXP-A questionnaire for adolescents seems to be a reliable, valid and unbiased instrument that evaluates the perception of parenting practices, relating higher affection-communication and control-structure to less psychopathology and alcohol and drug use. TXP-C also seems to be reliable and unbiased, but shows less evidence of validity regarding substance use and psychopathology


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Comportamento do Adolescente/psicologia , Poder Familiar/psicologia , Psicometria/instrumentação , Inquéritos e Questionários , Transtorno da Conduta/diagnóstico , Transtorno da Conduta/psicologia , Técnica Delfos , Análise Fatorial , Reprodutibilidade dos Testes , Espanha , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/psicologia
8.
Anal Bioanal Chem ; 408(1): 151-64, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26476921

RESUMO

The potential of high-resolution mass spectrometry (HRMS) for the investigation of human in vivo metabolism of 3,4-methylenedioxypyrovalerone (MDPV) using urine collected from a consumer (this is, in non-controlled experiments) has been investigated. As a control sample was not available, the common approach based on the comparison of a control/blank sample and samples collected after drug intake could not be used. Alternatively, an investigation based on common fragmentation pathways was applied, assuming that most metabolites share some fragments with the parent drug. An extension of this approach was also applied based on the fragmentation pathway of those metabolites identified in urine samples in the first step. The use of MS(E) experiments (sequential acquisition of mass spectra at low and high collision energy) has been crucial to this aim as it allowed promoting fragmentation in the collision cell without any previous precursor ion selection. MDPV belongs to the group of new psychoactive substances (NPS), being known as the "cannibal drug". This substance is being abused more and more and is associated with dangerous side effects. The human metabolites (both phase I and phase II) were detected and tentatively identified by accurate mass full-spectrum measurements using ultra-high performance liquid chromatography coupled to hybrid quadrupole time-of-flight mass spectrometry (UHPLC-QTOF MS). Following this strategy, up to 10 phase I metabolites, together with some glucuronides and sulphates, were detected and tentative structures were proposed. Several compounds identified in this work have not been previously reported in the literature.


Assuntos
Benzodioxóis/urina , Espectrometria de Massas/métodos , Pirrolidinas/urina , Adulto , Benzodioxóis/química , Benzodioxóis/metabolismo , Cromatografia Líquida de Alta Pressão/métodos , Humanos , /metabolismo , Masculino , Estrutura Molecular , Pirrolidinas/química , Pirrolidinas/metabolismo
9.
Trials ; 16: 488, 2015 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-26519046

RESUMO

BACKGROUND: Emotional disorders (depression and anxiety disorders) are highly prevalent mental health problems. Although evidence showing the effectiveness of disorder-specific treatments exists, high comorbidity rates among emotional disorders limit the utility of these protocols. This has led some researchers to focus their interest on transdiagnostic interventions, a treatment perspective that might be more widely effective across these disorders. Also, the current way of delivering treatments makes it difficult provide assistance to all of the population in need. The use of the Internet in the delivery of evidence-based treatments may help to disseminate treatments among the population. In this study, we aim to test the effectiveness of EmotionRegulation, a new transdiagnostic Internet-based protocol for unipolar mood disorders, five anxiety disorders (panic disorder, agoraphobia, social anxiety disorder, generalized anxiety disorder and anxiety disorder not otherwise specified), and obsessive-compulsive disorder in comparison to treatment as usual as provided in Spanish public specialized mental health care. We will also study its potential impact on basic temperament dimensions (neuroticism/behavioral inhibition and extraversion/behavioral activation). Expectations and opinions of patients about this protocol will also be studied. METHODS/DESIGN: The study is a randomized controlled trial. 200 participants recruited in specialized care will be allocated to one of two treatment conditions: a) EmotionRegulation or b) treatment as usual. Primary outcome measures will be the BAI and the BDI-II. Secondary outcomes will include a specific measure of the principal disorder, and measures of neuroticism/behavioral inhibition and extraversion/behavioral activation. Patients will be assessed at baseline, post-treatment, and 3- and 12-month follow-ups. Intention to treat and per protocol analyses will be performed. DISCUSSION: Although the effectiveness of face-to-face transdiagnostic protocols has been investigated in previous studies, the number of published transdiagnostic Internet-based programs is still quite low. To our knowledge, this is the first randomized controlled trial studying the effectiveness of a transdiagnostic Internet-based treatment for several emotional disorders in public specialized care. Combining both a transdiagnostic approach with an Internet-based therapy format may help to decrease the burden of mental disorders, reducing the difficulties associated with disorder-specific treatments and facilitating access to people in need of treatment. Strengths and limitations are discussed. TRIAL REGISTRATION: ClinicalTrials.gov NCT02345668 . Registered 27 July 2015.


Assuntos
Transtornos de Ansiedade/terapia , Assistência à Saúde , Transtorno Depressivo/terapia , Emoções , Internet , Psicoterapia/métodos , Terapia Assistida por Computador/métodos , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Protocolos Clínicos , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/psicologia , Feminino , Humanos , Análise de Intenção de Tratamento , Masculino , Satisfação do Paciente , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Projetos de Pesquisa , Espanha , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento
10.
Rev. esp. drogodepend ; 40(3): 61-79, jul.-sept. 2015. tab
Artigo em Espanhol | IBECS | ID: ibc-144208

RESUMO

Introducción: El término patología dual (PD) se refiere a la comorbilidad de los trastornos por uso de sustancias (TUS) con trastornos mentales graves. Se asocia con peores resultados de tratamiento que cada uno de estos trastornos por separado, por lo que es importante desarrollar terapias específicas para estos pacientes. En este sentido, el Hospital Provincial de Castellón adaptó la Terapia Psicoeducativa Motivacional Breve (efectiva en pacientes con TUS en Unidad de Desintoxicación Hospitalaria) para ser usada también con pacientes con PD (TPMB-D), incluyendo a pacientes con TUS y con PD en los mismos grupos terapéuticos. Método: Estudio experimental doble ciego con dos grupos aleatorios que evaluó la eficacia de la TPMB-D comparada con terapia ocupacional (TO) en pacientes hospitalizados con TUS y con PD. Ciento sesenta y tres pacientes completaron el estudio, de los que el 68.7% presentaban PD y el 31,3% TUS. El 55,8% fueron asignados al grupo TPMB-D y el 44,2% al grupo TO. Se evaluaron en el pretest el nivel de conocimientos sobre adicciones y PD (cuestionario ad hoc) y la motivación para el cambio (cuestionario SOCRATES 8D de Miller y Tonigan). Después de recibir tres sesiones de TPMB-D o TO se volvieron a evaluar postest estas variables y la satisfacción con la terapia recibida (Cuestionario de Percepciones del Tratamiento de Marsden et ál.). Resultados: La TPMB-D aumenta la motivación para el cambio y los conocimientos sobre adicciones y PD más que la TO, generando también niveles más altos de satisfacción


Introduction: Dual diagnosis (DD) is the term used for comorbidity of substance use disorders (SUD) with severe mental disorders and is associated with worse outcomes than each of these disorders separately, it thus being important to develop specific therapies for these patients. The Provincial Hospital of Castellon has adapted Brief Motivational Psychoeducational Therapy (effective in SUD patients in the Hospital’s Detoxification Unit) for DD patients (D-BMPT), and includes patients with SUD and those with DD in the same therapeutic groups. Method: This double-blind experimental study used two randomized groups with the aim of assessing the efficacy of D-BMPT compared to occupational therapy (OT) in patients hospitalized with SUD and with DD. One hundred and sixty-three patients completed the study, 68.7% of whom had DD and 31.3% SUD. Their level of knowledge about drug addictions and DD (ad hoc questionnaire) and their motivation for change (Miller and Tonigan’s SOCRATES 8D questionnaire) were evaluated pre- and post-treatment, and their satisfaction with the therapy received (Marsden et al.’s Treatment Perceptions Questionnaire) was evaluated post-treatment. Results: D-BMPT increases motivation for change and knowledge about drug addictions and DD more than OT, also generating higher levels of satisfaction


Assuntos
Feminino , Humanos , Masculino , Diagnóstico Duplo (Psiquiatria)/instrumentação , Diagnóstico Duplo (Psiquiatria)/métodos , Diagnóstico Duplo (Psiquiatria) , Transtornos Relacionados ao Uso de Substâncias/psicologia , Motivação/fisiologia , Comorbidade , Transtornos Mentais/complicações , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Método Duplo-Cego , Resultado do Tratamento , Inquéritos e Questionários
12.
J Mass Spectrom ; 48(6): 685-94, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23722959

RESUMO

'Legal highs' are novel substances which are intended to elicit a psychoactive response. They are sold from 'head shops', the internet and from street suppliers and may be possessed without legal restriction. Several months ago, a 19-year-old woman came searching for medical treatment as she had health problems caused by smoking legal highs. The substances were sold as herbal blends in plastic bags under four different labels. In this work, samples of these herbal blends have been analysed to investigate the presence of psychoactive substances without any reference standard being available at the laboratory. A screening strategy for a large number of synthetic and natural cannabinoids has been applied based on the use of ultra-high pressure liquid chromatography coupled to quadrupole-time of flight mass spectrometry (UHPLC-QTOF MS) under MS(E) mode. A customized home-made database containing literature-based exact masses for parent and product ions of around 200 synthetic and natural cannabinoids was compiled. The presence of the (de)protonated molecule measured at its accurate mass was evaluated in the samples. When a peak was detected, collision-induced dissociation fragments and characteristic isotopic ions were also evaluated and used for tentative identification. After this tentative identification, four synthetic cannabinoids (JWH-081, JWH-250, JWH-203 and JWH-019) were unequivocally confirmed by subsequent acquisition of reference standards. The presence in the herbal blends of these synthetic cannabinoids might explain the psychotic and catatonic symptoms observed in the patient, as JWH compounds could act as potent agonists of CB1 and CB2 receptors located in the Limbic System and Basal ganglia of the human brain.


Assuntos
Canabinoides/química , Drogas Desenhadas/química , Indóis/química , Espectrometria de Massas/métodos , Naftalenos/química , Extratos Vegetais/química , Canabinoides/análise , Cromatografia Líquida/métodos , Bases de Dados de Compostos Químicos , Drogas Desenhadas/análise , Indóis/análise , Naftalenos/análise
13.
Adicciones ; 24(2): 131-8, 2012.
Artigo em Espanhol | MEDLINE | ID: mdl-22648316

RESUMO

The aim was to analyze the relationship between Cloninger's dimensions and Personality Disorders (PD) (with DSM-IV criteria) in opiate dependents. The study was Cross-sectional. The sampling of 196 patients with opiate dependence was consecutive. All were receiving treatment in an inpatient detoxification unit. Cloninger's Temperament and Character Inventory (TCI), International Personality Disorders Examination (IPDE) and a Substance Use Questionnaire were used. Character's dimensions as Self-directness and Cooperation were related with PD when scored low. Opposite to Cloninger descriptions, high scores of Self-transcendence were related with presence of PD. Related to temperamental dimensions, cluster A was related with low scores of Reward Dependence (RD) and cluster C with high scores of Harm Avoidance (HA). Otherwise, in cluster B, while Borderline PD had high scores of Novelty Seeking (as high HA), the Antisocial PD only were related to low scores of RD. RD dimension seems useful to differ from presence or absence of Antisocial PD, also when alcohol consumption is considered. Cloninger's Model of Personality is useful in drug dependents for the definition of the different PD, as well as for probable PD's aggregation. This model also helps to create subtypes in opiate dependents as the antisocial or type II.


Assuntos
Modelos Psicológicos , Transtornos Relacionados ao Uso de Opioides/complicações , Transtornos Relacionados ao Uso de Opioides/psicologia , Transtornos da Personalidade/complicações , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Opioides/classificação , Análise de Regressão , Adulto Jovem
14.
Adicciones (Palma de Mallorca) ; 24(2): 131-138, abr.-jun. 2012. tab
Artigo em Espanhol | IBECS | ID: ibc-101462

RESUMO

El objetivo es relacionar las dimensiones del modelo de Cloninger y los trastornos de personalidad (TP) según criterios DSM-IV en dependientes de opiáceos. Para ello se realizó un estudio transversal, por muestreo consecutivo, en 196 dependientes de opiáceos ingresados en una Unidad de Desintoxicación Hospitalaria. Se usaron un cuestionario de consumo de sustancias, el inventario de temperamento y carácter de Cloninger (Temperament and Character Inventory, TCI) y la entrevista diagnóstica internacional de los trastornos de la personalidad (International Personality Disorders Examination, IPDE). Los resultados mostraron que puntuaciones bajas en las dimensiones caracteriales auto-dirección y cooperación se asocian con la presencia de TP. Al contrario de lo descrito por Cloninger, puntuaciones altas en la dimensión caracterial autotrascendencia se relacionan significativamente con la presencia de TP. Respecto a las dimensiones temperamentales, el clúster A se relaciona con baja dependencia del refuerzo (DR) y el clúster C con alta evitación del daño (ED). No obstante, en el clúster B, si bien el trastorno límite de la personalidad presenta alta Búsqueda de Novedad (además de alta ED), el trastorno antisocial de la personalidad (TAP) sólo se relaciona con bajas puntuaciones en DR. DR diferencia entre la ausencia o presencia de TAP, incluso considerando la influencia de la dependencia de alcohol. Por todo ello, el modelo de personalidad de Cloninger es útil para definirlos diferentes TP en población drogodependiente, permitiendo agrupar el diagnóstico probable de TP, así como para crear subtipos como el antisocial o tipo II en dependientes de opiáceos(AU)


The aim was to analyze the relationship between Cloninger’s dimensions and Personality Disorders (PD) (with DSM-IV criteria) in opiate dependents. The study was Cross-sectional. The sampling of 196 patients with opiate dependence was consecutive. All were receiving treatment in an inpatient detoxification unit. Cloninger’s Temperament and Character Inventory (TCI), International Personality Disorders Examination (IPDE)and a Substance Use Questionnaire were used. Character’s dimensions as Self-directness and Cooperation were related with PD when scored low. Opposite to Cloninger descriptions, high scores of Self-transcendence were related with presence of PD. Related to temperamental dimensions, cluster A was related with low scores of Reward Dependence (RD) and cluster C with high scores of Harm Avoidance (HA). Otherwise, in cluster B, while Borderline PD had high scores of Novelty Seeking (as high HA), the Antisocial PD only were related to low scores of RD. RD dimension seems useful to differ from presence or absence of Antisocial PD, also when alcohol consumption is considered. Cloninger’s Model of Personality is useful in drug dependents for the definition of the different PD, as well as for probable PD’s aggregation. This model also helps to create subtypes in opiate dependents as the antisocial or type II(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Transtornos Relacionados ao Uso de Opioides/diagnóstico , Legislação de Medicamentos/ética , Transtorno da Personalidade Antissocial/diagnóstico , Transtorno da Personalidade Antissocial/psicologia , Transtorno da Personalidade Antissocial/patologia , Transtornos Relacionados ao Uso de Opioides/psicologia , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia , Transtornos Relacionados ao Uso de Opioides/etiologia , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Transtornos Relacionados ao Uso de Opioides/terapia , Legislação de Medicamentos/estatística & dados numéricos , Legislação de Medicamentos/normas , Manual Diagnóstico e Estatístico de Transtornos Mentais
15.
16.
Adicciones ; 22(1): 15-24, 2010.
Artigo em Espanhol | MEDLINE | ID: mdl-20300710

RESUMO

INTRODUCTION: It is important to assess the interaction between family psychopathologic history (FH), family dynamics (FD), behavior disorders, substance-use disorders and personality disorders (PD). METHODOLOGY: Cross-sectional design. The sample was made up of 350 subjects with substance-use disorders who were assessed for FH including alcoholism and substance-use disorders through an interview; for substance use via a questionnaire; for FD; for PD using the International Personality Disorder Examination (IPDE); for behavior problems in adolescence; and for disocial disorder. Correlated variables were included in logistic regression models. RESULTS: Early age of onset for substance use is related to FH of substance use disorders and poorer FD. FH of alcoholism, substance-use disorders and psychiatric disorders are related to poorer FD. Early age of onset for substance use, FH and a disruptive FD are related to behavior problems and disocial disorder. Early age of onset for substance use, FH, disruptive FD, behavior problems and disocial disorder are related to presence of PD. Logistic regression predicted the presence of PD by age of onset for use of methadone (CI(95):1.005/3.222; p=0.048) and of other opiates (CI(95):0.864/0.992;p=0.028). FH score in alcoholism predicted Borderline Personality Disorder (CI(95):1.137- 2.942; p=0.013), and age of onset of cocaine use predicted Antisocial Personality Disorder (CI(95):0.864/0.992; p=0.028). CONCLUSIONS: FH of substance use and own use predict the presence of some PDs.


Assuntos
Saúde da Família , Relações Familiares , Transtornos da Personalidade/etiologia , Transtornos Relacionados ao Uso de Substâncias/etiologia , Adulto , Pesquisa Biomédica , Estudos Transversais , Diagnóstico Duplo (Psiquiatria) , Feminino , Humanos , Masculino , Transtornos da Personalidade/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
17.
Adicciones (Palma de Mallorca) ; 22(1): 15-24, ene.-mar. 2010. tab
Artigo em Espanhol | IBECS | ID: ibc-78873

RESUMO

Introducción: Es importante evaluar la interacción entre los antecedentes psicopatológicos familiares (AF), la dinámica familiar (DF), los trastornos de conducta, los trastornos por uso de sustancias y los trastornos de personalidad (TP). Metodología: Estudio transversal con 350 drogodependientes evaluados los AF psiquiátricos, de alcoholismo y de drogodependencias; la DF; consumo de sustancias; y la presencia de TP, los problemas de conducta (PC) en la adolescencia y el trastorno disocial (TD). Las variables correlacionadas fueron incluidas en varios modelos de regresión logística. Resultados: Una edad de inicio en el consumo más temprana se relaciona con AF de drogodependencia y peor DF. Los AF de alcoholismo, drogodependencias y psiquiátricos se relacionan con peor DF. Edad de inicio en el consumo más temprana, los AF y una peor DF se relacionan con los PC y el TD. Edad de inicio en el consumo más temprana, tener AF, una peor DF, los PC y el TD se relacionan con la presencia de algún TP. Permiten predecir la presencia de algún TP la edad de inicio en el consumo de metadona (IC (95):1,005/3,222; p=0,048) y de otros opiáceos (IC(95):0,233/0,894; p=0,022). La puntuación en AF de alcoholismo permite predecir la presencia de TP límite (IC (95):1,137-2,942; p=0,013), y la edad de inicio en el consumo de cocaína permite predecir la presencia de TP antisocial (IC (95):0,864/0,992; p=0,028). Conclusiones: Los AF de consumo de sustancias y el consumo propio, predicen la presencia de algunos TP (AU)


Introduction: It is important to assess the interaction between family psychopathologic history (FH), family dynamics (FD), behavior disorders, substance-use disorders and personality disorders (PD). Methodology: Cross-sectional design. The sample was made up of 350 subjects with substance-use disorders who were assessed for FH including alcoholism and substance-use disorders through an interview; for substance use via a questionnaire; for FD; for PD using the International Personality Disorder Examination (IPDE); for behavior problems in adolescence; and for dissocial disorder. Correlated variables were included in logistic regression models. Results: Early age of onset for substance use is related to FH of substance use disorders and poorer FD. FH of alcoholism, substance-use disorders and psychiatric disorders are related to poorer FD. Early age of onset for substance use, FH and a disruptive FD are related to behavior problems and disocial disorder. Early age of onset for substance use, FH, disruptive FD, behavior problems and disocial disorder are related to presence of PD. Logistic regression predicted the presence of PD by age of onset for use of methadone(CI(95):1.005/3.222; p=0.048) and of other opiates (CI(95):0.864/0.992;p=0.028).FH score in alcoholism predicted Borderline Personality Disorder (CI(95):1.137-2.942; p=0.013), and age of onset of cocaine use predicted Antisocial Personality Disorder (CI(95):0.864/0.992; p=0.028). Conclusions: FH of substance use and own use predict the presence of some PD (AU)


Assuntos
Humanos , Masculino , Feminino , Diagnóstico Duplo (Psiquiatria)/métodos , Diagnóstico Duplo (Psiquiatria)/tendências , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos da Personalidade/complicações , Transtornos da Personalidade/diagnóstico , Estatísticas não Paramétricas , Transtornos Mentais/complicações , Transtornos Mentais/epidemiologia , Psicopatologia , Comportamento/fisiologia , Estudos Transversais , Coleta de Dados , Modelos Logísticos , Transtorno da Personalidade Antissocial/complicações , Transtorno da Personalidade Antissocial/diagnóstico
18.
Rev. ecuat. ortop. traumatol ; 10(1): 122-126, ago. 2008.
Artigo em Espanhol | LILACS | ID: lil-572896

RESUMO

En las infecciones de prótesis articulares hay que distinguir la del implante, la de la interfase implante hueso, y la del propio hueso que rodea al cuerpo extraño. La prevalencia de las infecciones en el momento actual en las mejores series, en torno al 1% en las de cadera y al 2,5% en las de rodilla. La etiología varía según el mecanismo patogénico de la infección. El diagnóstico clínico de estas infecciones no es fácil. La prevención es el aspecto más importante en el control de las infecciones de las prótesis articulares. Los objetivos ante un paciente con una prótesis infectada son erradicar la infección, eliminar el dolor y restaurar la funcionalidad de la articulación con la menor morbilidad posible.


Assuntos
Prótese Articular
19.
Eur Psychiatry ; 22(5): 305-8, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17521889

RESUMO

PURPOSE: The aim of this study is to determine if personality traits contribute to the likelihood of substance abuse in Bipolar Disorder (BD). SUBJECTS/MATERIALS AND METHODS: Fifty-nine patients meeting DSM-IV criteria for BD: 20 without any history of Substance Related Disorder (SRD), 21 with a lifetime history of SRD but without current SRD, and 18 with current SRD. Patients filled out the TCI, the differences were analyzed by ANOVA and the likelihood was obtained by Multinomial Logistic Regression. RESULTS: Only Novelty Seeking (NS) is statistically different between the groups. Patients with BD with current SRD have higher rates in NS than those with past SRD, and those without a history of SRD. NS was confirmed as a predicting variable, both to current SRD (OR [CI 95%]=1.039/1.351; p=0.011) and past SRD (OR [CI 95%]=1.004/1.277; p=0.042) on patients with BD. DISCUSSION: The results shown would appear to confirm the relationship of NS with the SRD, so long as there is no clear evidence that indicates the association of NS with BD. CONCLUSIONS: There appears a greater predisposition to develop SRD in those patients with a higher degree of NS. The use of the Cloninger's TCI could be used in BD to determine the risk of developing an SRD. Early detection might help improve prognosis.


Assuntos
Transtorno Bipolar/psicologia , Caráter , Transtornos Relacionados ao Uso de Substâncias/psicologia , Temperamento , Adulto , Transtorno Bipolar/epidemiologia , Comorbidade , Comportamento Exploratório , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inventário de Personalidade/estatística & dados numéricos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Psicometria , Reprodutibilidade dos Testes , Fatores de Risco , Estatística como Assunto , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
20.
Drug Alcohol Depend ; 73(3): 307-13, 2004 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-15036553

RESUMO

A survey was carried out to evaluate the satisfaction with methadone treatment centres of methadone-maintained opioid-dependent patients from Spain. Independent interviewers asked 505 consecutively arriving clients from 20 randomly selected centres (14 conventional centres, two bus units, and four prisons) to participate; 370 (73.3%) clients agreed to fill out the questionnaire, and 351 (69.5%) completed it. Satisfaction was assessed using the Verona Service Satisfaction Scale for methadone treatment (VSSS-MT). The prison sub-sample (n=43) was excluded from overall analysis because survey acceptance and satisfaction was very different in prisons than in the other centres. Mean overall satisfaction in the non-prison sub-sample (n=308) was 3.5 (S.D.=0.6) on a 1-5 point scale (1=terrible; 5=excellent). The percentage of these clients who felt dissatisfied (VSSS-MT scores: < or =3) and satisfied (VSSS-MT scores: >3) was, by category: overall satisfaction, 15.9% dissatisfied, 84.1% satisfied; basic interventions, 16.0% versus 84.0%; specific interventions, 45.4% versus 54.6%; social worker skills, 33.8% versus 66.2%; psychologist skills, 38.5% versus 61.5%. The number of hours per week that the centre dispensed methadone was the only variable able to predict satisfaction. This regression model accounted for only 2.5% of the variance in VSSS-MT overall scores. These results show that Spanish clients are slightly satisfied with conventional centres and bus units, although they fail to detect specific variables that are strongly related to that satisfaction.


Assuntos
Metadona/administração & dosagem , Entorpecentes/administração & dosagem , Transtornos Relacionados ao Uso de Opioides/reabilitação , Centros de Tratamento de Abuso de Substâncias , Adolescente , Adulto , Análise de Variância , Feminino , Humanos , Masculino , Serviços de Saúde Mental , Pessoa de Meia-Idade , Satisfação do Paciente/estatística & dados numéricos , Espanha , Inquéritos e Questionários
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