1. Investigación

Objetivo: identificar los condicionantes del establecimiento y duración de la lactancia materna (LM) durante la COVID-19 desde la perspectiva de las matronas de la provincia de Castellón (España). Métodos: estudio cualitativo realizado en 2021 mediante la realización de cuatro grupos focales (GF) con matronas de la provincia de Castellón. La recolección de la información se hizo mediante videoconferencias con grabación de voz, que fueron transcritas para posterior análisis del discurso con el programa ATLAS.ti. Resultados: las matronas identificaron como facilitadores de la LM, la puesta en valor de la LM ante las madres y el fomento de la accesibilidad a recursos para solucionar situaciones problemáticas, entre otros. Como barreras refirieron ideas maternas sobre alimentación con fórmulas artificiales construidas desde su biografía, consideración social sesgada sobre el amamantamiento, falta de protocolos para extracción de calostro y déficit en la calidad de información en las redes sociales, principalmente. Reconocen que la pandemia COVID-19 produjo impactos positivos y negativos en la LM. Surgieron medidas para optimizar la promoción de la LM como aumentar la ratio matronas/madres gestantes, asistencia domiciliaria a las 24 h del alta, unificación de protocolos intercentros, ampliación a seis meses el tiempo de incorporación al trabajo y adaptación de la promoción de la LM en redes sociales. Conclusiones: se reportaron condicionantes de la lactancia emergentes del escenario sociosanitario español que sirven de base para diseñar acciones específicas de promoción. Los impactos de la pandemia COVID-19 sobre la LM deben considerarse en situaciones de confinamiento prolongado de la madre.

Background: Health sciences students experience high levels of psychopathology conditioned by psychosocial, financial, and academic factors. However, COVID-19 pandemic might even have worsened their mental health. Thus, this article aims to evaluate how the exposure to COVID-19 pandemic has affected these students’ mental health and to determine the effect of purpose in life and character strengths on this psychopathology. Methods: A cross-sectional study of unpaired samples was carried out in Spain during the first and third waves of the pandemic in 70 medical and 52 nursing students. Results: The risk factor that most determined the appearance of anxiety was the exposure of family and friends to COVID-19 (OR = 4.01; p < 0.001), while the most protective factors were honesty (OR = –1.14; p = 0.025) and purpose in life (OR = – 0.18; p < 0.001). Purpose in life also protected against the onset of depression and total psychopathology. In addition, we observed studying medicine was a protective factor against total psychopathology while being a nursing student was associated with high levels of acute stress. Conclusion: Exposure of the students’ family and friends to SARS-CoV-2 favored the appearance of symptoms of anxiety. Honesty had a preventing role in the onset of anxiety and a high purpose in life was protective against the appearance of anxiety, depression, and total psychopathology.

Cocaine addiction is frequently associated with different psychiatric disorders, especially schizophrenia and antisocial personality disorder. A small number of studies have used prepulse inhibition (PPI) as a discriminating factor between these disorders. This work evaluated PPI and the phenotype of patients with cocaine-related disorder (CRD) who presented a dual diagnosis of schizophrenia or antisocial personality disorder. A total of 74 men aged 18–60 years were recruited for this research. The sample was divided into four groups: CRD (n = 14), CRD and schizophrenia (n = 21), CRD and antisocial personality disorder (n = 16), and a control group (n = 23). We evaluated the PPI and other possible vulnerability factors in these patients by using different assessment scales. PPI was higher in the CRD group at 30 ms (F(3, 64) = 2.972, p = 0.038). Three discriminant functions were obtained which allowed us to use the overall Hare Psychopathy Checklist Revised score, reward sensitivity, and PPI at 30 ms to predict inclusion of these patients in the different groups with a success rate of 79.7% (42.9% for CRD, 76.2% for CRD and schizophrenia, 100% for CRD and antisocial personality disorder, and 91.3% in the control group). Despite the differences we observed in PPI, this factor is of little use for discriminating between the different diagnostic groups and it acts more as a non-specific endophenotype in certain mental disorders, such as in patients with a dual diagnosis.

Little data are available for women diagnosed with a dual diagnosis. However, dual diagnosis in women presents increased stigma, social penalties, and barriers to access to treatment than it does for men. Indeed, it increases the probability of suffering physical or sexual abuse, violent victimization, gender-based violence, unemployment, social exclusion, social-role problems, and physical and psychiatric comorbidities. Thus, a transversal sex and gender-based perspective is required to adequately study and treat dual diagnosis. For this, sex and gender factors should be included in every scientific analysis; professionals should review their own prejudices and stereotypes and train themselves specifically from a gender perspective; administrations should design and provide specific treatment resources for women; and we could all contribute to a structural social transformation that goes beyond gender mandates and norms and reduces the risk of abuse and violence inflicted on women.

Although the required personal protective equipment was not available during the first wave of the COVID-19 pandemic, Spanish healthcare workers continued to work, being dubbed as ‘healthcare kamikazes’. Two possible reasons are moral courage and purpose in life that, in turn, would modulate the appearance of psychopathology. Cross-sectional study was carried out in 90 Spanish and 59 Mexican healthcare professionals, and 56 medical and nursing students. Spanish professionals had suffered more work and overall exposure (M = 8.30; SD = 2.57 and M = 9.03; SD = 2.66) than Mexican (M = 5.10; SD = 1.87 and M = 5.55; SD = 2.35). Mexican professionals had fewer anxiety disorders (30.5%; n = 18) and a lower depression score (M = 4.45; SD = 5.63) than the Spanish (43.7%; n = 38; and M = 8.69; SD = 8.07). Spanish professionals more often experienced acute stress disorder (32.6%; n = 29). Purpose in life, in addition to having a direct protective effect on psychopathology, also modulated the relationship between personal and family exposure and psychopathology. In conclusion, purpose in life protects against the appearance of psychopathology in healthcare workers with personal and family exposure to SARS-CoV-2.

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 entertainmentsector 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 (χ = 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.

Objective:Schizophrenia, cocaine-related disorder, antisocial personality disorder, andpsychopathy share biological bases, but few studies discriminate between these disordersby 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 orantisocial personality disorder, by evaluating their prepulse inhibition, impulsivity and psych-opathy personality traits.Methods:The sample (n¼38) was divided into three groups: (1)cocaine-related disorder (8 individuals diagnosed with cocaine-related disorder who did notpresent any other mental disorder), (2) cocaine-related disorder and schizophrenia (n¼14),and (3) cocaine-related disorder and antisocial personality disorder (n¼16).Results:Theprepulse inhibition in the two groups with dual diagnosis was lower than that in thecocaine-related disorder group,F(2, 35)¼6.52,p¼.004, while there was no significant differ-ences between the two dual-diagnosis groups. Psychopathy was evaluated with the revisedHare Psychopathy Checklist and showed no correlation with the prepulse inhibition.Secondary psychopathy (impulsivity and poor behavior control), as evaluated with LevensonSelf-Report Psychopathy Scale, was related to the prepulse inhibition. Two discriminating functions were obtained that allowed prediction of patient inclusion in the groups usingthe prepulse inhibition and the revised Hare Psychopathy Checklist with a success rate of81.6% (cocaine-related disorder¼62.5%; cocaine-related disorder and schizophrenia¼78.6%;cocaine-related disorder and antisocial personality disorder¼93.8%). These results are dis-cussed in regard to the neurobiological implications of prepulse inhibition in dual diagnosis.Conclusions:The results suggest that the prepulse inhibition is a promising dual-diagnosisvulnerability marker in individuals with cocaine addiction, because prepulse inhibition defi-cits are related both to schizophrenia and antisocial personality disorder. In addition, pre-pulse inhibition, which is considered a good endophenotype for studies on the genetic andneurobiological basis of cocaine-related disorder and schizophrenia, could be used in thesame way in studies on antisocial personality disorder.