Fuertes Saiz, Alejandro

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.

The objective of the study was to evaluate the efficacy of an animal-assisted-therapy (AAT) program in patients diagnosed with schizophrenia-spectrum disorders and substance-use disorders in residential treatment in order to intervene in the remission of negative and positive symptoms and improve quality of life and adherence to treatment, favouring the clinical stabilization of patients who participate in the AAT program, within the context of a mental-illness-treatment device. This was a quasi-experimental prospective study with intersubject and intrasubject factors. The sample comprised 36 patients (21 in the experimental group and 15 in the control group) who were evaluated at three time points (in the 3rd, 6th, and 10th sessions). The program lasted 3 months and consisted of 10 sessions that were implemented once a week, with a maximum participation of 10 patients per group. The participants were evaluated with the Positive and Negative Syndrome Scale (PANSS) for schizophrenia and the Life Skills Profile-20 (LSP-20) questionnaire. We observed a decrease in the positive symptoms of psychosis (F: 27.80, p = 0.001) and an improvement in functionality (F: 26.70, p < 0.001) as the sessions progressed. On the basis of these results, we concluded that AAT seems to be valid as a coadjuvant therapy as part of the rehabilitation processes of patients diagnosed with schizophrenia and addiction-spectrum disorders (dual diagnosis).

Sex differences are poorly studied within the field of mental health, even though there is evidence of disparities (with respect to brain anatomy, activation patterns, and neurochemistry, etc.) that can significantly influence the etiology and course of mental disorders. The objective of this work was to review sex differences in adolescents (aged 13–18 years) diagnosed with ADHD (according to the DSM-IV, DSM-IV-TR and DSM-5 criteria) in terms of substance use disorder (SUD), prevalence, pharmacological therapy and mental health. We searched three academic databases (PubMed, Web of Science, and Scopus) and performed a narrative review of a total of 21 articles. The main conclusions of this research were (1) girls with ADHD are more at risk of substance use than boys, although there was no consensus on the prevalence of dual disorders; (2) girls are less frequently treated because of underdiagnosis and because they are more often inattentive and thereby show less disruptive behavior; (3) together with increased impairment in cognitive and executive functioning in girls, the aforementioned could be related to greater substance use and poorer functioning, especially in terms of more self-injurious behavior; and (4) early diagnosis and treatment of ADHD, especially in adolescent girls, is essential to prevent early substance use, the development of SUD, and suicidal behavior.

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.