Executive functions profile in extreme eating/weight conditions: from anorexia nervosa to obesity.

BACKGROUND Extreme weight conditions (EWC) groups along a continuum may share some biological risk factors and intermediate neurocognitive phenotypes. A core cognitive trait in EWC appears to be executive dysfunction, with a focus on decision making, response inhibition and cognitive flexibility. Differences between individuals in these areas are likely to contribute to the differences in vulnerability to EWC. The aim of the study was to investigate whether there is a common pattern of executive dysfunction in EWC while comparing anorexia nervosa patients (AN), obese subjects (OB) and healthy eating/weight controls (HC). METHODS Thirty five AN patients, fifty two OB and one hundred thirty seven HC were compared using the Wisconsin Card Sorting Test (WCST); Stroop Color and Word Test (SCWT); and Iowa Gambling Task (IGT). All participants were female, aged between 18 and 60 years. RESULTS There was a significant difference in IGT score (F(1.79); p<.001), with AN and OB groups showing the poorest performance compared to HC. On the WCST, AN and OB made significantly more errors than controls (F(25.73); p<.001), and had significantly fewer correct responses (F(2.71); p<.001). Post hoc analysis revealed that the two clinical groups were not significantly different from each other. Finally, OB showed a significant reduced performance in the inhibition response measured with the Stroop test (F(5.11); p<.001) compared with both AN and HC. CONCLUSIONS These findings suggest that EWC subjects (namely AN and OB) have similar dysfunctional executive profile that may play a role in the development and maintenance of such disorders.

Celebrado el día mundial de la salud mental 2012

Boletín semanal para profesionales sanitarios de la Secretaría General de Salud Pública, Inclusión y Calidad de Vida de la Consejería de Salud y Bienestar Social

10 de octubre, día mundial de la salud mental 2012

Boletín semanal para profesionales sanitarios de la Secretaría General de Salud Pública, Inclusión y Calidad de Vida de la Consejería de Salud y Bienestar Social

Efectos de los factores dietéticos sobre la conducta agresiva y otras patologías del comportamiento del perro

Studies show that feeding patterns, environmental conditions, and pet management mainly affect animal health, behavior and welfare. However, little epidemiologic data exist about pet dog feeding habits and management and canine behavior, especially aggression. Moreover, it is well known that serotonin is involved in aggression: a diet low in tryptophan (serotonin precursor) with high levels of neutral amino-acids could decrease the central levels of serotonin and increase the expression of aggression and impulsiveness in several domestic animals. oreover, brain levels of serotonin in humans and other species can be increased by physical activity. In this study we alysed the effects of diet management, supplementation and regular physical activity on oncentration of serotonin in a population of non aggressive dogs. The general aim of the study is to determine the effect of environmental factors on the dogs’ feeding habits as well as the relationship between the type of food provided and management and behavioral problems in dogs. The specific objectives were: characterization and comparison of different physiological and blood parameters between dogs with and without behavior pathologies. Observation of the impact of the diet and managment factors (exercise, education) on those parameters and on dog’s behavior, with particular attention to aggression. This study is divided into three phases, according with the objectives. Firstly, characterization of the dogs’ characteristics and serics profiles on the basis of the blood tests. Comparison between the values noticed on animals without any behavior pathology and animals with behavior disorder to point out the difference between the biochemical parameters of the two groups. Secondly, the purpose of the second phase is to verify whether a type of food is able to affect the biochemical paramenters of a population of non-aggressive dogs. Thirdly, the goal is to evaluate the effects of different diet factors, management and physical exercise on the canine aggression.

La utilització dels "serious games" en el tractament dels trastorns mentals : una revisió

Aquest article de revisió analitza l'ús que s'està fent dels anomenats "serious games" en el tractament dels trastorns mentals. La recerca efectuada a les bases de dades Medline i PsycINFO han donat com a resultat la localització de 537 articles que fan referència als "serious games" i als "computer games", dels quals 71 ho fan a la seva aplicació en l'àmbit de la salut i 14 a l'àmbit mes concret dels trastorns mentals. S'han trobat estudis que contemplen tractaments per l'esquizofrènia, el Trastorn per Dèficit d'Atenció i Hiperactivitat (TDAH), el Trastorn per Estrès Posttraumàtic (TEPT), l'autisme, el retard mental i les fòbies. Hi ha resultats encoratjadors en quan a l'eficàcia dels tractaments utilitzant jocs d'ordinador, realitat virtual i realitat augmentada, si bé degut a ser un camp de recerca molt jove es necessita replicar molts estudis per tal de donar validesa científica als resultats provisionals obtinguts.

TDA-H en la escuela : un trabajo multidisciplinar

A lo largo de este trabajo nos sumergiremos en la importancia que tiene la detección temprana de este trastorno, así como en los involucrados en esta (psicólogos, pedagogos, profesores, escuela y familia), dando un enfoque del lugar que cada uno de ellos ocupa y como se han de coordinan para poder realizar desde la detección hasta el diagnostico y seguimiento. Por último abordaremos uno de los temas más conflictivos que envuelven a este trastorno "la medicación" (Metilfenidato) y qué efectos produce en los niños que han iniciado el tratamiento, las mejoras que se presentan, así como los efectos secundarios que pueden dejar en el niño afectado.

Response to methylphenidate by adult and pediatric patients with attention-deficit/hyperactivity disorder: the Spanish multicenter DIHANA study.

BACKGROUND The purpose of this multicenter Spanish study was to evaluate the response to immediate-release methylphenidate by children and adults diagnosed with attention-deficit/hyperactivity disorder (ADHD), as well as to obtain information on current therapy patterns and safety characteristics. METHODS This multicenter, observational, retrospective, noninterventional study included 730 patients aged 4-65 years with a diagnosis of ADHD. Information was obtained based on a review of medical records for the years 2002-2006 in sequential order. RESULTS The ADHD predominantly inattentive subtype affected 29.7% of patients, ADHD predominantly hyperactive-impulsive was found in 5.2%, and the combined subtype in 65.1%. Overall, a significant lower Clinical Global Impression (CGI) score and mean number of DSM-IV TR (Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision) symptoms by subtype were found after one year of treatment with immediate-release methylphenidate; CGI decreased from 4.51 to 1.69, symptoms of inattention from 7.90 to 4.34, symptoms of hyperactivity from 6.73 to 3.39, and combined subtype symptoms from 14.62 to 7.7. Satisfaction with immediate-release methylphenidate after one year was evaluated as "very satisfied" or "satisfied" by 86.90% of the sample; 25.75% of all patients reported at least one adverse effect. At the end of the study, 41.47% of all the patients treated with immediate-release methylphenidate were still receiving it, with a mean time of 3.80 years on therapy. CONCLUSION Good efficacy and safety results were found for immediate-release methylphenidate in patients with ADHD.

Low intensity vs. self-guided internet-delivered psychotherapy for major depression: a multicenter, controlled, randomized study.

BACKGROUND Major depression will become the second most important cause of disability in 2020. Computerized cognitive-behaviour therapy could be an efficacious and cost-effective option for its treatment. No studies on cost-effectiveness of low intensity vs self-guided psychotherapy has been carried out. The aim of this study is to assess the efficacy of low intensity vs self-guided psychotherapy for major depression in the Spanish health system. METHODS The study is made up of 3 phases: 1.- Development of a computerized cognitive-behaviour therapy for depression tailored to Spanish health system. 2.- Multicenter controlled, randomized study: A sample (N=450 patients) with mild/moderate depression recruited in primary care. They should have internet availability at home, not receive any previous psychological treatment, and not suffer from any other severe somatic or psychological disorder. They will be allocated to one of 3 treatments: a) Low intensity Internet-delivered psychotherapy + improved treatment as usual (ITAU) by GP, b) Self-guided Internet-delivered psychotherapy + ITAU or c) ITAU. Patients will be diagnosed with MINI psychiatric interview. Main outcome variable will be Beck Depression Inventory. It will be also administered EuroQol 5D (quality of life) and Client Service Receipt Inventory (consume of health and social services). Patients will be assessed at baseline, 3 and 12 months. An intention to treat and a per protocol analysis will be performed. DISCUSSION The comparisons between low intensity and self-guided are infrequent, and also a comparative economic evaluation between them and compared with usual treatment in primary. The strength of the study is that it is a multicenter, randomized, controlled trial of low intensity and self-guided Internet-delivered psychotherapy for depression in primary care, being the treatment completely integrated in primary care setting. TRIAL REGISTRATION Clinical Trials NCT01611818.

Intervenció psicopedagògica del Trastorn de Dèficit d'Atenció amb Hiperactivitat

El meu projecte final del Pràcticum I es centra en el trastorn de dèficit d'atenció amb hiperactivitat (TDA-H). En aquest projecte exposo les activitats que he portat a terme en el centre psicopedagògic on he realitzat les pràctiques i les reflexions que aquesta experiència m'ha generat.

El treball amb alumnat TDAH : El treball de les habilitats socials i les emocions

El treball presenta una intervenció que busca afavorir el desenvolupament de les capacitats relacionals de l'alumnat amb Trastorn per Dèficit d'Atenció amb Hiperactivitat (TDAH). La intervenció té en compte l'enfocament cognitiu-conductual, a més del model constructivista de l'ensenyament i el model d'assessorament col·laboratiu. A més, s'ha elaborat un programa d'activitats per a l'ensenyament de les habilitats socials i emocions basat en els programes desenvolupats per Monjas (1993) i Orjales (2010).

Efficacy of lisdexamfetamine dimesylate throughout the day in children and adolescents with attention-deficit/hyperactivity disorder: results from a randomized, controlled trial.

Lisdexamfetamine dimesylate (LDX) is a long-acting, prodrug stimulant therapy for patients with attention-deficit/hyperactivity disorder (ADHD). This randomized placebo-controlled trial of an optimized daily dose of LDX (30, 50 or 70 mg) was conducted in children and adolescents (aged 6-17 years) with ADHD. To evaluate the efficacy of LDX throughout the day, symptoms and behaviors of ADHD were evaluated using an abbreviated version of the Conners' Parent Rating Scale-Revised (CPRS-R) at 1000, 1400 and 1800 hours following early morning dosing (0700 hours). Osmotic-release oral system methylphenidate (OROS-MPH) was included as a reference treatment, but the study was not designed to support a statistical comparison between LDX and OROS-MPH. The full analysis set comprised 317 patients (LDX, n = 104; placebo, n = 106; OROS-MPH, n = 107). At baseline, CPRS-R total scores were similar across treatment groups. At endpoint, differences (active treatment - placebo) in least squares (LS) mean change from baseline CPRS-R total scores were statistically significant (P < 0.001) throughout the day for LDX (effect sizes: 1000 hours, 1.42; 1400 hours, 1.41; 1800 hours, 1.30) and OROS-MPH (effect sizes: 1000 hours, 1.04; 1400 hours, 0.98; 1800 hours, 0.92). Differences in LS mean change from baseline to endpoint were statistically significant (P < 0.001) for both active treatments in all four subscales of the CPRS-R (ADHD index, oppositional, hyperactivity and cognitive). In conclusion, improvements relative to placebo in ADHD-related symptoms and behaviors in children and adolescents receiving a single morning dose of LDX or OROS-MPH were maintained throughout the day and were ongoing at the last measurement in the evening (1800 hours).

Factores predictores del riesgo en los agresores violentos encarcelados

La finalidad de este estudio cuasi-experimental fue fue identificar los factores de riesgo para la reincidencia en los delitos violentos, sexuales y delitos de violencia doméstica y evaluar la eficacia del tratamiento. Se seleccionó una muestra de 120 internos del Centre Penitenciari Ponent condenados por delitos violentos, sexuales y de violencia doméstica que obtuvieron la libertad entre los años 2001 y 2006; el período de seguimiento osciló entre 3 y 8 años. Se analizaron veintisiete variables agrupadas en factores de riesgo y la reincidencia. Los datos se obtuvieron de la administración del HCR-20, de la SVR-20, de la S.A.R.A., de la PCL-R, del IPDE y del MMPI-2 y de las bases de datos del Departamento de justicia de Cataluña. Los internos con trastorno mental reincidieron más en delitos sexuales y de violencia doméstica y aquellos con trastornos de personalidad reincidieron más en delitos violentos. Una puntuación elevada en HCR-20, SVR-20, S.A.R.A. y PCL-R incrementó el riesgo de reincidencia. Al contrario, superar el tratamiento reduce la reincidencia pero presentar trastornos mentales, trastornos de personalidad, toxicomanías y puntuar alto en el HCR-20 y en la PCL-R dificultaron superar el tratamiento. A mayor período de seguimiento menor capacidad predictiva de los instrumentos de evaluación del riesgo y del tratamiento.

Factors associated with chronic pain in patients with bipolar depression: a cross-sectional study.

BACKGROUND While pain is frequently associated with unipolar depression, few studies have investigated the link between pain and bipolar depression. In the present study we estimated the prevalence and characteristics of pain among patients with bipolar depression treated by psychiatrists in their regular clinical practice. The study was designed to identify factors associated with the manifestation of pain in these patients. METHODS Patients diagnosed with bipolar disorder (n=121) were selected to participate in a cross-sectional study in which DSM-IV-TR criteria were employed to identify depressive episodes. The patients were asked to describe any pain experienced during the study, and in the 6 weeks beforehand, by means of a Visual Analogical Scale (VAS). RESULTS Over half of the bipolar depressed patients (51.2%, 95% CI: 41.9%-60.6%), and 2/3 of the female experienced concomitant pain. The pain was of moderate to severe intensity and prolonged duration, and it occurred at multiple sites, significantly limiting the patient's everyday activities. The most important factors associated with the presence of pain were older age, sleep disorders and delayed diagnosis of bipolar disorder. CONCLUSIONS Chronic pain is common in bipolar depressed patients, and it is related to sleep disorders and delayed diagnosis of their disorder. More attention should be paid to study the presence of pain in bipolar depressed patients, in order to achieve more accurate diagnoses and to provide better treatment options.

Suicidal ideation and the risk of suicide in patients with fibromyalgia: a comparison with non-pain controls and patients suffering from low-back pain.

Fibromyalgia is associated with an increased rate of mortality from suicide. In fact, this disease is associated with several characteristics that are linked to an increased risk of suicidal behaviors, such as being female and experiencing chronic pain, psychological distress, and sleep disturbances. However, the literature concerning suicidal behaviors and their risk factors in fibromyalgia is sparse. The objectives of the present study were to evaluate the prevalence of suicidal ideation and the risk of suicide in a sample of patients with fibromyalgia compared with a sample of healthy subjects and a sample of patients with chronic low-back pain. We also aimed to evaluate the relevance of pain intensity, depression, and sleep quality as variables related to suicidal ideation and risks. Logistic regression was applied to estimate the likelihood of suicidal ideation and the risk of suicide adjusted by age and sex. We also used two logistic regression models using age, sex, pain severity score, depression severity, sleep quality, and disease state as independent variables and using the control group as a reference. Forty-four patients with fibromyalgia, 32 patients with low-back pain, and 50 controls were included. Suicidal ideation, measured with item 9 of the Beck Depression Inventory, was almost absent among the controls and was low among patients with low-back pain; however, suicidal ideation was prominent among patients with fibromyalgia (P<0.0001). The risk of suicide, measured with the Plutchik Suicide Risk Scale, was also higher among patients with fibromyalgia than in patients with low-back pain or in controls (P<0.0001). The likelihood for suicidal ideation and the risk of suicide were higher among patients with fibromyalgia (odds ratios of 26.9 and 48.0, respectively) than in patients with low-back pain (odds ratios 4.6 and 4.7, respectively). Depression was the only factor associated with suicidal ideation or the risk of suicide.

TDAH

The project is based on the case of or diagnosed with attention deficit combined type.