Cannabis use and involuntary admission may mediate long-term adherence in first-episode psychosis patients: a prospective longitudinal study

Background: This study aimed to examine factors associated with treatment adherence in first-episode psychosis (FEP) patients followed up over 8 years, especially involuntary first admission and stopping cannabis use. Methods: This prospective, longitudinal study of FEP patients collected data on symptoms, adherence, functioning,and substance use. Adherence to treatment was the main outcome variable and was categorized as ‘good’ or ‘bad’. Cannabis use during follow-up was stratified as continued use, stopped use, and never used. Bivariate and logistic regression models identified factors significantly associated with adherence and changes in adherence over the 8-year follow-up period. Results: Of the 98 FEP patients analyzed at baseline, 57.1% had involuntary first admission, 74.4% bad adherence,and 52% cannabis use. Good adherence at baseline was associated with Global Assessment of Functioning score (p = 0.019), Hamilton Depression Rating Scale score (p = 0.017) and voluntary admission (p < 0.001). Adherence patterns over 8 years included: 43.4% patients always bad, 26.1% always good, 25% improved from bad to good. Among the improved adherence group, 95.7% had involuntary first admission and 38.9% stopped cannabis use. In the subgroup of patients with bad adherence at baseline, involuntary first admission and quitting cannabis use during follow up were associated with improved adherence. Conclusions: The long-term association between treatment adherence and type of first admission and cannabis use in FEP patients suggest targets for intervention to improve clinical outcomes.

Subclinical Depressive Symptoms and Continued Cannabis Use: Predictors of Negative Outcomes in First Episode Psychosis

Background Although depressive symptoms in first episode psychosis have been associated with cannabis abuse, their influence on the long-term functional course of FEP patients who abuse cannabis is unknown. The aims of the study were to examine the influence of subclinical depressive symptoms on the long-term outcome in first episode-psychosis patients who were cannabis users and to assess the influence of these subclinical depressive symptoms on the ability to quit cannabis use. Methods 64 FEP patients who were cannabis users at baseline were followed-up for 5 years. Two groups were defined: (a) patients with subclinical depressive symptoms at least once during follow-up (DPG), and (b) patients without subclinical depressive symptoms during follow-up (NDPG). Psychotic symptoms were measured using the Positive and Negative Syndrome Scale (PANSS), depressive symptoms using the Hamilton Depression Rating Scale (HDRS)-17, and psychosocial functioning was assessed using the Global Assessment of Functioning (GAF). A linear mixed-effects model was used to analyze the combined influence of cannabis use and subclinical depressive symptomatology on the clinical outcome. Results Subclinical depressive symptoms were associated with continued abuse of cannabis during follow-up (beta=4.45; 95% confidence interval [CI]: 1.78 to 11.17; P=.001) and with worse functioning (beta=-5.50; 95% CI: -9.02 to -0.33; P=.009). Conclusions Subclinical depressive symptoms and continued cannabis abuse during follow-up could be predictors of negative outcomes in FEP patients.

Plasma brain-derived neurotrophic factor levels, learning capacity and cognition in patients with first episode psychosis

Background: Cognitive impairments are seen in first psychotic episode (FEP) patients. The neurobiological underpinnings that might underlie these changes remain unknown. The aim of this study is to investigate whether Brain Derived Neurotrophic Factor (BDNF) levels are associated with cognitive impairment in FEP patients compared with healthy controls. Methods: 45 FEP patients and 45 healthy controls matched by age, gender and educational level were selected from the Basque Country area of Spain. Plasma BDNF levels were assessed in healthy controls and in patients. A battery of cognitive tests was applied to both groups, with the patients being assessed at 6 months after the acute episode and only in those with a clinical response to treatment. Results: Plasma BDNF levels were altered in patients compared with the control group. In FEP patients, we observed a positive association between BDNF levels at six months and five cognitive domains (learning ability,immediate and delayed memory, abstract thinking and processing speed) which persisted after controlling for medications prescribed, drug use, intelligence quotient (IQ) and negative symptoms. In the healthy control group, BDNF levels were not associated with cognitive test scores. Conclusion: Our results suggest that BDNF is associated with the cognitive impairment seen after a FEP. Further investigations of the role of this neurotrophin in the symptoms associated with psychosis onset are warranted.

Factors behind the wage in the Basque Country

[EN]This project aims to determine the factors which influence workers’ wages in the Basque Country, taking data from the INE (Spanish Statistical Office). In first place, I will decide which variables to choose and describe them. Then they will be used to build a wage model. At this point I will observe their behaviour according to their values and the possible differences between them. Once these variables are described, they will be used to develop an econometric model that will allow to see the different effects of the variables on the endogenous variable, in this case the gross annual wage. Finally, all the analysed data will be taken and examined to draw the final conclusions and see how workers’ age, training or gender affect their salary. [EN]

Wage factors in the Basque Economy

[EN] This project aims to determine the factors which influence workers’ wages in the Basque Country, taking data from the INE (Spanish Statistical Office). In first place, I will decide which variables to choose and describe them. Then they will be used to build a wage model. At this point I will observe their behaviour according to their values and the possible differences between them. Once these variables are described, they will be used to develop an econometric model that will allow to see the different effects of the variables on the endogenous variable, in this case the gross annual wage. Finally, all the analysed data will be taken and examined to draw the final conclusions and see how workers’ age, training or gender affect their salary. [EN]

Bertsogintzaren erabilera didaktikoa zornotzako larrea eskolaren lehen hezkuntzako 1. Zikloaren 6-7 urteko umeen gela batean

[eus] Proiektu honen bidez, Lehen Hezkuntzako lehenengo zikloan bertsogintza eta koplagintza lantzea posible dela erakutsi nahian, eguneroko errutinetan eta ipuin baten sekuentzializazioan bertsoak eta koplak txertatu ditut. Horretarako, hizkuntza lantzea izan da nire helbururik nagusiena, taldea motibatuz eta bertsoekiko zaletasuna bultzatuz. Ebaluaketa egiterakoan, metodo kualitatiboan oinarritu naiz ikasleen garapenaz ohartzeko. Azkenik, emaitzak eta ondorioak plazaratu ditut.

Lehen Hezkuntzako ingeleseko testuliburuak. Euskal Autonomia Erkidegoan erabiltzen diren materialen analisia

[eus] Ikerketa honen bidez, Euskal Autonomia Erkidegoan erabiltzen diren Lehen Hezkuntzako lehenengo zikloko ingeleseko testuliburuak hizkuntzen ikaskuntzaren teoriei, Europako Erreferentzia Marko Bateratuari eta Curriculum dokumentuei egokitzen zaizkien baieztatu nahi izan da. Horretarako, aipatutako teorietan eta dokumentuetan oinarrituta, sei aldagai diseinatu eta, horiek erabiliz, Euskal Autonomia Erkidegoan erabiltzen diren sei testuliburu aztertu dira. Ikerketatik ondorioztatzen da aztertutako testuliburuak ez datozela bat legediaren ikuspegi komunikatiboarekin ezta atazetan oinarritutako ikaskuntzarekin ere. Hala ere, hizkuntzaren inputa testuinguruan ematen dute eta, Curriculumean eskatzen den bezala, aspektu kulturalak lantzen dituzte.