Adolescents and Dual Diagnosis in a Psychiatric Emergency Service. / Adolescentes y Diagnóstico Dual en el Servicio de Urgencias Psiquiátricas.

In recent years, both the prevalence of drug use and related child and adolescent psychiatric emergencies have risen sharply. There are few studies about the impact on child and adolescent emergency services. This study has a twofold aim. The first is to describe the prevalence of substance use disorders, mental disorders and dual diagnosis (substance use problems plus mental disorder) in adolescents in psychiatric emergency service. The second is to analyze clinical and healthcare differences between patients with dual diagnosis and patients with a mental disorder without substance use disorder.We retrospectively reviewed 4012 discharge forms for emergencies treated at the psychiatric emergency department during the period 2007-2009. We obtained a sample of 1795 visits. This sample was divided into two groups: the dual diagnosis group (n = 477) and the psychiatric disorder group (n = 1318).The dual diagnosis group accounted for 26.5% of psychiatric emergencies analyzed. Compared to the psychiatric disorder group,the dual diagnosis group had significantly more conduct disorders, social problems, involuntariness in the visit, less hospital admissions and less connection with the healthcare network.Adolescents with a dual diagnosis account for a high percentage of visits at child and adolescent psychiatric emergency services. This patient group requires specialized care both at emergency services and in specific units. Accordingly, these units should play a triple role when handling dual diagnosis: detection, brief treatment and referral to a specialised unit.

En los últimos años, la prevalencia del consumo de drogas y las urgencias psiquiátricas relacionadas han incrementado notablemente en los adolescentes. Pocos estudios han examinado el impacto en los servicios de urgencias psiquiátricos infantojuveniles.Este estudio tiene un doble objetivo. Primero, describir la prevalencia del consumo de sustancias y de otros trastornos mentales comórbidos en una muestra de adolescentes que consultan a un servicio de urgencias psiquiátricas. Segundo, analizar las diferencias clínicas y asistenciales entre el grupo de pacientes con patología dual (comorbilidad de trastorno mental y trastorno por uso de sustancias) y el grupo de pacientes con trastorno mental sin consumo.Se revisaron 4012 historias de adolescentes que acudieron a un servicio de urgencias de psiquiatría durante los años 2007-2009, obteniéndose una muestra de 1795 visitas. La muestra se dividió en dos grupos: el grupo de patología dual (n = 477) y el grupo de patología psiquiátrica (n = 1318). El grupo con patología dual representó el 26,5% de las urgencias analizadas. En comparación con el grupo de pacientes psiquiátricos, presentaba significativamente más trastornos de conducta, patología social, involuntariedad en las visitas, más ingresos y menor vinculación a la red asistencial.Los adolescentes con una patología dual generan un elevado impacto en los Servicios de Urgencia psiquiátricos infantojuveniles. Este grupo requiere de una atención especializada tanto en los servicios de urgencias como en unidades específicas. En consecuencia, los servicios de urgencias deben cumplir una triple función en el abordaje de pacientes con patología dual: la detección, la intervención breve y la derivación a unidades especializadas.

Role of macroalgal forests within Mediterranean shallow bays in blue carbon storage.

Although seaweeds rank among the most productive vegetated habitats globally, their inclusion within Blue Carbon frameworks is at its onset, partially because they usually grow in rocky substrates and their organic carbon (Corg) is mostly exported and stored beyond their habitat and thus, demonstrating its long-term storage is challenging. Here, we studied the sedimentary Corg storage in macroalgal forests dominated by Gongolaria barbata and in adjacent seagrass Cymodocea nodosa mixed with Caulerpa prolifera algae meadows, and bare sand habitats in Mediterranean shallow coastal embayments. We characterized the biogeochemistry of top 30 cm sedimentary deposits, including sediment grain-size, organic matter and Corg contents, Corg burial rates and the provenance of sedimentary Corg throughout stable carbon isotopes (δ13Corg) and pyrolysis analyses. Sediment Corg stocks and burial rates (since 1950) in G. barbata forests (mean ± SE, 3.5 ± 0.2 kg Corg m-2 accumulated at 15.5 ± 1.6 g Corg m-2 y-1) fall within the range of those reported for traditional Blue Carbon Ecosystems. Although the main species contributing to sedimentary Corg stocks in all vegetated habitats examined was C. nodosa (36 ± 2 %), macroalgae contributed 49 % (19 ± 2 % by G. barbata and 30 ± 3 % by C. prolifera) based on isotope mixing model results. Analytical pyrolysis confirmed the presence of macroalgae-derived compounds in the sediments, including N-compounds and α-tocopherol linked to G. barbata and C. prolifera, respectively. The sedimentary Corg burial rate linked to macroalgae within the macroalgal forests examined ranged from 5.4 to 9.5 g Corg m-2 y-1 (7.4 ± 2 g Corg m-2 y-1). This study provides empirical evidence for the long-term (∼70 years) sequestration of macroalgae-derived Corg within and beyond seaweed forests in Mediterranean shallow coastal embayments and thereby, supports the inclusion of macroalgae in Blue Carbon frameworks.

Global warming-enhanced stratification and mass mortality events in the Mediterranean.

Summer conditions in the Mediterranean Sea are characterized by high temperatures and low food availability. This leads to "summer dormancy" in many benthic suspension feeders due to energetic constraints. Analysis of the most recent 33-year temperature time series demonstrated enhanced stratification due to global warming, which produced a approximately 40% lengthening of summer conditions. Many biological processes are expected to be affected by this trend, culminating in such events as mass mortality of invertebrates. Climatic anomalies concomitant with the occurrence of these events represent prolonged exposure to warmer summer conditions coupled with reduced food resources. Simulation of the effects of these conditions on a model organism demonstrated a biomass loss of >35%. Losses of this magnitude result in mortality similar to that noted in field observations during mass mortality events. These results indicate that temperature anomalies are the underlying cause of the events, with energetic constraints serving as the main triggering mechanism.

Demographics of the zooxanthellate coral Oculina patagonica along the Mediterranean Iberian coast in relation to environmental parameters.

Marine ecosystems are threatened by cumulative human-related impacts that cause structural and functional alterations. In the Mediterranean Sea, the zooxanthellate coral Oculina patagonica (Scleractinia, Oculinidae) can turn algal forests into coral-dominated ecosystems and provides a case study for examining how zooxanthellate corals can affect the structure of algal-dominated shallow-water rocky ecosystems in temperate areas. Our goal was to provide a quantitative baseline assessment of O. patagonica demographics along ~1300km of the Mediterranean Iberian coast and relate them to environmental parameters. The highest coral success was in the South Balearic Sea zone, where the populations exhibited >6-fold higher mean living coral cover, lower partial colony mortality and colony size distributions indicating that the populations in this zone were growing faster than those in the peripheral south-west (North Alborán Sea) and north-east (Mid and North Balearic Sea, and West Gulf of Lyons) zones. The coral demographics (i.e., density, cover, and skewness and kurtosis coefficients of colony size distributions) were positively correlated with each other and the annual mean seawater temperature (ST), 10th-ST percentile (P10th-ST), 90th-ST percentile (P90th-ST) and photosynthetically active radiation at 3-m depth (PAR-3m), but they were negatively correlated with chlorophyll-a. Based on these results, we identified the following thresholds that may constrain the growth of O. patagonica colonies and populations: annual mean ST <19-20°C, P10th-ST <14°C, P90th-ST <25°C and >27°C, and PAR-3m <30molphotonsm-2day-1. The species abundance along the Iberian coast conforms to the abundant-center pattern of distribution. However, the coral demographics indicated that this pattern was not only related to the time of establishment but also to differences in coral population growth, which were correlated with key environmental parameters. Our results contribute understanding of the forces driving population growth of O. patagonica and support the hypothesis of an ongoing coral-mediated tropicalization of macroalgae-dominated temperate ecosystems.

Stable symbionts across the HMA-LMA dichotomy: low seasonal and interannual variation in sponge-associated bacteria from taxonomically diverse hosts.

Marine sponges host bacterial communities with important ecological and economic roles in nature and society, yet these benefits depend largely on the stability of host-symbiont interactions and their susceptibility to changing environmental conditions. Here, we investigated the temporal stability of complex host-microbe symbioses in a temperate, seasonal environment over three years, targeting sponges across a range of symbiont density (high and low microbial abundance, HMA and LMA) and host taxonomy (six orders). Symbiont profiling by terminal restriction fragment length polymorphism analysis of 16S rRNA gene sequences revealed that bacterial communities in all sponges exhibited a high degree of host specificity, low seasonal dynamics and low interannual variability: results that represent an emerging trend in the field of sponge microbiology and contrast sharply with the seasonal dynamics of free-living bacterioplankton. Further, HMA sponges hosted more diverse, even and similar symbiont communities than LMA sponges and these differences in community structure extended to core members of the microbiome. Together, these findings show clear distinctions in symbiont structure between HMA and LMA sponges while resolving notable similarities in their stability over seasonal and inter-annual scales, thus providing insight into the ecological consequences of the HMA-LMA dichotomy and the temporal stability of complex host-microbe symbioses.

Rapid northward spread of a zooxanthellate coral enhanced by artificial structures and sea warming in the western Mediterranean.

The hermatypic coral Oculina patagonica can drive a compositional shift in shallow water benthic marine communities in the northwestern Mediterranean. Here, we analyze a long-term, large-scale observational dataset to characterize the dynamics of the species' recent northward range shift along the coast of Catalonia and examine the main factors that could have influenced this spread. The variation in the distributional range of Oculina patagonica was examined by monitoring 223 locations including natural and artificial habitats along >400 km of coastline over the last 19 years (1992-2010). Abundance of the species increased from being present in one location in 1992 to occur on 19% of the locations in 2010, and exhibited an acceleration of its spreading over time driven by the join action of neighborhood and long-distance dispersal. However, the pattern of spread diverged between artificial and natural habitats. A short lag phase and a high slope on the exponential phase characterized the temporal pattern of spread on artificial habitats in contrast to that observed on natural ones. Northward expansion has occurred at the fastest rate (22 km year(-1)) reported for a coral species thus far, which is sufficiently fast to cope with certain climate warming predictions. The pattern of spread suggests that this process is mediated by the interplay of (i) the availability of open space provided by artificial habitats, (ii) the seawater temperature increase with the subsequent extension of the growth period, and (iii) the particular biological features of O. patagonica (current high growth rates, early reproduction, and survival to low temperature and in polluted areas). These results are indicative of an ongoing fundamental modification of temperate shallow water assemblages, which is consistent with the predictions indicating that the Mediterranean Sea is one of the most sensitive regions to global change.

Sea urchins predation facilitates coral invasion in a marine reserve.

Macroalgae is the dominant trophic group on Mediterranean infralittoral rocky bottoms, whereas zooxanthellate corals are extremely rare. However, in recent years, the invasive coral Oculina patagonica appears to be increasing its abundance through unknown means. Here we examine the pattern of variation of this species at a marine reserve between 2002 and 2010 and contribute to the understanding of the mechanisms that allow its current increase. Because indirect interactions between species can play a relevant role in the establishment of species, a parallel assessment of the sea urchin Paracentrotus lividus, the main herbivorous invertebrate in this habitat and thus a key species, was conducted. O. patagonica has shown a 3-fold increase in abundance over the last 8 years and has become the most abundant invertebrate in the shallow waters of the marine reserve, matching some dominant erect macroalgae in abundance. High recruitment played an important role in this increasing coral abundance. The results from this study provide compelling evidence that the increase in sea urchin abundance may be one of the main drivers of the observed increase in coral abundance. Sea urchins overgraze macroalgae and create barren patches in the space-limited macroalgal community that subsequently facilitate coral recruitment. This study indicates that trophic interactions contributed to the success of an invasive coral in the Mediterranean because sea urchins grazing activity indirectly facilitated expansion of the coral. Current coral abundance at the marine reserve has ended the monopolization of algae in rocky infralittoral assemblages, an event that could greatly modify both the underwater seascape and the sources of primary production in the ecosystem.